Minnesota Legislature
SF 3346
3rd Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; appropriating money; 1.3 changing provisions for long-term care, health care 1.4 programs, and provisions including MA and GAMC, 1.5 MinnesotaCare, welfare reform, work first, compulsive 1.6 gambling, child welfare modifications and child 1.7 support, and regional treatment centers; providing 1.8 administrative penalties; providing for the recording 1.9 and reporting of abortion data; amending Minnesota 1.10 Statutes 1996, sections 62A.65, subdivision 5; 1.11 62D.042, subdivision 2; 62E.16; 62J.321, by adding a 1.12 subdivision; 62Q.095, subdivision 3; 144.226, 1.13 subdivision 3; 144.701, subdivisions 1, 2, and 4; 1.14 144.702, subdivisions 1, 2, and 8; 144.9501, 1.15 subdivisions 1, 17, 18, 20, 23, 30, 32, and by adding 1.16 subdivisions; 144.9502, subdivisions 3, 4, and 9; 1.17 144.9503, 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; 145.11, by adding a 1.25 subdivision; 145A.15, subdivision 2; 157.15, 1.26 subdivisions 9, 12, 12a, 13, and 14; 214.03; 245.462, 1.27 subdivisions 4 and 8; 245.4871, subdivision 4; 1.28 245A.03, by adding subdivisions; 245A.035, subdivision 1.29 4; 245A.14, subdivision 4; 254A.17, subdivision 1, and 1.30 by adding a subdivision; 256.01, subdivision 12, and 1.31 by adding subdivisions; 256.014, subdivision 1; 1.32 256.969, subdivisions 16 and 17; 256B.03, subdivision 1.33 3; 256B.055, subdivision 7, and by adding a 1.34 subdivision; 256B.057, subdivision 3a, and by adding 1.35 subdivisions; 256B.0625, subdivisions 7, 17, 19a, 20, 1.36 34, 38, and by adding subdivisions; 256B.0627, 1.37 subdivision 4; 256B.0911, subdivision 4; 256B.0916; 1.38 256B.41, subdivision 1; 256B.431, subdivisions 2b, 2i, 1.39 4, 11, 22, and by adding subdivisions; 256B.501, 1.40 subdivisions 2 and 12; 256B.69, subdivision 22, and by 1.41 adding subdivisions; 256D.03, subdivision 4, and by 1.42 adding a subdivision; 256D.051, by adding a 1.43 subdivision; 256D.46, subdivision 2; 256I.04, 1.44 subdivisions 1, 3, and by adding a subdivision; 1.45 256I.05, subdivision 2; 257.42; 257.43; 259.24, 1.46 subdivision 1; 259.37, subdivision 2; 259.67, 2.1 subdivision 1; 260.011, subdivision 2; 260.141, by 2.2 adding a subdivision; 260.172, subdivision 1; 260.221, 2.3 as amended; 268.88; 268.92, subdivision 4; 609.115, 2.4 subdivision 9; and 626.556, by adding a subdivision; 2.5 Minnesota Statutes 1997 Supplement, sections 13.99, by 2.6 adding a subdivision; 60A.15, subdivision 1; 62D.11, 2.7 subdivision 1; 62J.69, subdivisions 1, 2, and by 2.8 adding subdivisions; 62J.71, subdivisions 1, 3, and 4; 2.9 62J.72, subdivision 1; 62J.75; 62Q.105, subdivision 1; 2.10 62Q.30; 103I.208, subdivision 2; 119B.01, subdivision 2.11 16; 119B.02; 123.70, subdivision 10, as amended; 2.12 144.1494, subdivision 1; 144.218, subdivision 2; 2.13 144.226, subdivision 4; 144.9504, subdivision 2; 2.14 144.9506, subdivision 1; 144A.071, subdivision 4a; 2.15 144A.4605, subdivision 4; 157.16, subdivision 3; 2.16 171.29, subdivision 2; 214.32, subdivision 1; 245A.03, 2.17 subdivision 2; 245A.04, subdivisions 3b and 3d; 2.18 245B.06, subdivision 2; 256.01, subdivision 2; 2.19 256.031, subdivision 6; 256.741, by adding a 2.20 subdivision; 256.82, subdivision 2; 256.9657, 2.21 subdivision 3; 256.9685, subdivision 1; 256.9864; 2.22 256B.04, subdivision 18; 256B.056, subdivisions 1a and 2.23 4; 256B.06, subdivision 4; 256B.062; 256B.0625, 2.24 subdivision 31a; 256B.0627, subdivisions 5 and 8; 2.25 256B.0635, by adding a subdivision; 256B.0645; 2.26 256B.0911, subdivisions 2 and 7; 256B.0913, 2.27 subdivision 14; 256B.0915, subdivisions 1d and 3; 2.28 256B.0951, by adding a subdivision; 256B.431, 2.29 subdivisions 3f and 26; 256B.433, subdivision 3a; 2.30 256B.434, subdivision 10; 256B.69, subdivisions 2 and 2.31 3a; 256B.692, subdivisions 2 and 5; 256B.77, 2.32 subdivisions 3, 7a, 10, and 12; 256D.03, subdivision 2.33 3; 256D.05, subdivision 8; 256F.05, subdivision 8; 2.34 256J.02, subdivision 4; 256J.03; 256J.08, subdivisions 2.35 11, 26, 28, 40, 60, 68, 73, 83, and by adding 2.36 subdivisions; 256J.09, subdivisions 6 and 9; 256J.11, 2.37 subdivision 2, as amended; 256J.12; 256J.14; 256J.15, 2.38 subdivision 2; 256J.20, subdivisions 2 and 3; 256J.21; 2.39 256J.24, subdivisions 1, 2, 3, 4, 7, and by adding 2.40 subdivisions; 256J.26, subdivisions 1, 2, 3, and 4; 2.41 256J.28, subdivisions 1, 2, and by adding a 2.42 subdivision; 256J.30, subdivisions 10 and 11; 256J.31, 2.43 subdivisions 5, 10, and by adding a subdivision; 2.44 256J.32, subdivisions 4, 6, and by adding a 2.45 subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.46 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.47 subdivisions; 256J.38, subdivision 1; 256J.39, 2.48 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45, 2.49 subdivisions 1, 2, and by adding a subdivision; 2.50 256J.46, subdivisions 1, 2, and 2a; 256J.47, 2.51 subdivision 4; 256J.48, subdivisions 2 and 3; 256J.49, 2.52 subdivision 4; 256J.50, subdivision 5, and by adding 2.53 subdivisions; 256J.515; 256J.52, subdivision 4, and by 2.54 adding subdivisions; 256J.54, subdivisions 2, 3, 4, 2.55 and 5; 256J.55, subdivision 5; 256J.56; 256J.57, 2.56 subdivision 1; 256J.645, subdivision 3; 256J.74, 2.57 subdivision 2, and by adding a subdivision; 256K.03, 2.58 subdivision 5; 256L.01; 256L.02, subdivision 3, and by 2.59 adding a subdivision; 256L.03, subdivisions 1, 3, 4, 2.60 5, and by adding subdivisions; 256L.04, subdivisions 2.61 1, 2, 7, 8, 9, 10, and by adding subdivisions; 2.62 256L.05, subdivisions 2, 3, 4, and by adding 2.63 subdivisions; 256L.06, subdivision 3; 256L.07; 2.64 256L.09, subdivisions 2, 4, and 6; 256L.11, 2.65 subdivision 6; 256L.12, subdivision 5; 256L.15; 2.66 256L.17, by adding a subdivision; 257.071, subdivision 2.67 1d; 257.85, subdivision 5; 259.22, subdivision 4; 2.68 259.47, subdivision 3; 259.58; 259.60, subdivision 2; 2.69 260.012; 260.015, subdivisions 2a and 29; 260.161, 2.70 subdivision 2; 260.191, subdivisions 1, 1a, 3a, and 2.71 3b; 260.241, subdivision 3; and 270A.03, subdivision 3.1 5; Laws 1994, chapter 633, article 7, section 3; Laws 3.2 1997, chapter 195, section 5; chapter 203, article 4, 3.3 section 64; article 9, section 21; chapter 207, 3.4 section 7; chapter 225, article 2, section 64; and 3.5 chapter 248, section 46, as amended; proposing coding 3.6 for new law in Minnesota Statutes, chapters 62J; 62Q; 3.7 144; 145; 245; 256; 256B; 256D; and 256J; repealing 3.8 Minnesota Statutes 1996, sections 62J.685; 144.0721, 3.9 subdivision 3a; 144.491; 144.9501, subdivisions 12, 3.10 14, and 16; 144.9503, subdivisions 5, 8, and 9; 3.11 157.15, subdivision 15; 256.031, subdivisions 1, 2, 3, 3.12 and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 3.13 6; 256.034; 256.035; 256.036; 256.0361; 256.047; 3.14 256.0475; 256.048; and 256.049; Minnesota Statutes 3.15 1997 Supplement, sections 62D.042, subdivision 3; 3.16 144.0721, subdivision 3; 256.031, subdivisions 5 and 3.17 6; 256.033, subdivisions 1 and 1a; 256B.057, 3.18 subdivision 1a; 256B.062; 256B.0913, subdivision 15; 3.19 256J.25; 256J.28, subdivision 4; 256J.32, subdivision 3.20 5; 256J.34, subdivision 5; 256L.04, subdivisions 3, 4, 3.21 5, and 6; 256L.06, subdivisions 1 and 2; 256L.08; 3.22 256L.09, subdivision 3; 256L.13; and 256L.14; Laws 3.23 1997, chapter 85, article 1, sections 61 and 71; and 3.24 article 3, section 55. 3.25 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.26 ARTICLE 1 3.27 APPROPRIATIONS 3.28 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.29 The sums shown in the columns marked "APPROPRIATIONS" are 3.30 appropriated from the general fund, or any other fund named, to 3.31 the agencies and for the purposes specified in the following 3.32 sections of this article, to be available for the fiscal years 3.33 indicated for each purpose. The figures "1998" and "1999" where 3.34 used in this article, mean that the appropriation or 3.35 appropriations listed under them are available for the fiscal 3.36 year ending June 30, 1998, or June 30, 1999, respectively. 3.37 Where a dollar amount appears in parentheses, it means a 3.38 reduction of an appropriation. 3.39 SUMMARY BY FUND 3.40 APPROPRIATIONS BIENNIAL 3.41 1998 1999 TOTAL 3.42 General $ (139,959,000)$ (161,811,000)$ (301,770,000) 3.43 State Government 3.44 Special Revenue 113,000 231,000 344,000 3.45 Health Care Access 3.46 Fund (3,130,000) (14,203,000) (17,333,000) 3.47 TOTAL $ (142,976,000)$ (175,783,000)$ (318,759,000) 3.48 APPROPRIATIONS 3.49 Available for the Year 3.50 Ending June 30 4.1 1998 1999 4.2 Sec. 2. COMMISSIONER OF 4.3 HUMAN SERVICES 4.4 Subdivision 1. Total 4.5 Appropriation $ (143,089,000)$ (196,131,000) 4.6 Summary by Fund 4.7 General (139,959,000) (181,669,000) 4.8 Health Care Access (3,130,000) (14,462,000) 4.9 This appropriation is taken from the 4.10 appropriation in Laws 1997, chapter 4.11 203, article 1, section 2. 4.12 The amounts that are added to or 4.13 reduced from the appropriation for each 4.14 program are specified in the following 4.15 subdivisions. 4.16 Subd. 2. Children's Grants 4.17 -0- 1,618,000 4.18 [CRISIS NURSERY PROGRAMS.] Of this 4.19 appropriation, $200,000 in fiscal year 4.20 1999 is from the general fund to the 4.21 commissioner to contract for technical 4.22 assistance with counties and private 4.23 nonprofit agencies that are interested 4.24 in developing a crisis nursery 4.25 program. The technical assistance must 4.26 be designed to assist interested 4.27 counties in building capacity to 4.28 develop and maintain a crisis nursery 4.29 program in the county. The grant 4.30 amounts must not exceed $20,000. To be 4.31 eligible to receive a grant under this 4.32 program, the county must not have an 4.33 existing crisis nursery program and 4.34 must not be a metropolitan county, as 4.35 that term is defined in Minnesota 4.36 Statutes, section 473.121. Grants must 4.37 be distributed by award letters to 4.38 agencies demonstrating a need for 4.39 crisis nursery services and documenting 4.40 community support for these efforts. 4.41 This appropriation shall not become 4.42 part of base level funding for the 4.43 2000-2001 biennium. 4.44 [CHILDREN'S MENTAL HEALTH SERVICES.] 4.45 (a) Of this appropriation, $300,000 in 4.46 fiscal year 1999 is from the general 4.47 fund for the commissioner to award 4.48 grants to counties that have a 4.49 relatively low net tax capacity to 4.50 provide children's mental health 4.51 services to children and families 4.52 residing outside of a metropolitan 4.53 statistical area, as that term is 4.54 defined by the United States Census 4.55 Bureau. Funds shall be used to provide 4.56 services according to an individual 4.57 family community support plan as 4.58 described in Minnesota Statutes, 4.59 section 245.4881, subdivision 4. The 4.60 plan must be developed using a process 5.1 that enhances consumer empowerment. 5.2 Counties with an approved children's 5.3 mental health collaborative may 5.4 integrate funds appropriated for fiscal 5.5 years 1998 and 1999 with existing funds 5.6 to meet the needs identified in the 5.7 child's individual family community 5.8 support plan. 5.9 (b) In awarding grants to counties 5.10 under this provision, the commissioner 5.11 shall follow the process established in 5.12 Minnesota Statutes, section 245.4886, 5.13 subdivision 2. The commissioner shall 5.14 give priority for funding to counties 5.15 that continued to spend for mental 5.16 health services specified in Minnesota 5.17 Statutes, sections 245.461 to 245.486 5.18 and 245.487 to 245.4888, according to 5.19 generally accepted accounting 5.20 principles, in an amount equal to the 5.21 total expenditures shown in the 5.22 county's approved 1987 CSSA plan for 5.23 services to persons with mental illness 5.24 plus the comparable figure for 5.25 facilities licensed under Minnesota 5.26 Rules, chapter 9545, for target 5.27 populations other than mental illness 5.28 in the county's approved 1989 CSSA 5.29 plan. The commissioner shall ensure 5.30 that grant funds are not used to 5.31 replace existing funds. 5.32 [PRIMARY SUPPORT TO IMPLEMENT THE 5.33 INDIAN FAMILY PRESERVATION ACT.] For 5.34 fiscal year 1998, $100,000 of federal 5.35 funds are transferred from the state's 5.36 federal TANF block grant and added to 5.37 the state's allocation of federal Title 5.38 XX block grant funds. Notwithstanding 5.39 the provisions of Minnesota Statutes 5.40 1997 Supplement, section 256E.07, the 5.41 commissioner shall use $100,000 of the 5.42 state's Title XX block grant funds for 5.43 a grant under Minnesota Statutes, 5.44 section 257.3571, subdivision 1, to an 5.45 Indian organization licensed as an 5.46 adoption agency. The grant must be 5.47 used to provide primary support for 5.48 implementation of the Minnesota Indian 5.49 Family Preservation Act and compliance 5.50 with the Indian Child Welfare Act. 5.51 This appropriation must be used 5.52 according to the requirements of United 5.53 States Code, title 42, section 5.54 604(d)(3)(B). This appropriation is 5.55 available until June 30, 1999. 5.56 [ADOPTION ASSISTANCE CARRYFORWARD.] Of 5.57 the appropriation in Laws 1997, chapter 5.58 203, section 2, subdivision 3, for 5.59 children's grants for fiscal year 1998, 5.60 $600,000 of the amount appropriated for 5.61 the adoption assistance program is 5.62 available for the same purpose in 5.63 fiscal year 1999. The amount carried 5.64 forward shall become part of the base 5.65 for the adoption assistance program in 5.66 the 2000-2001 biennial budget. 5.67 [FAMILY PRESERVATION PROGRAM FUNDING.] 6.1 $10,200,000 is transferred in fiscal 6.2 year 1999 from the state's federal TANF 6.3 block grant to the state's federal 6.4 Title XX block grant. Notwithstanding 6.5 the provisions of Minnesota Statutes 6.6 1997 Supplement, section 256E.07, in 6.7 fiscal year 1999 the commissioner shall 6.8 transfer $10,000,000 of the state's 6.9 Title XX block grant funds to the 6.10 family preservation program under 6.11 Minnesota Statutes, chapter 256F. The 6.12 commissioner shall transfer $200,000 to 6.13 the commissioner of health for the 6.14 program under Minnesota Statutes, 6.15 section 145A.15, that funds home 6.16 visiting projects; these transferred 6.17 funds are available until expended. 6.18 The commissioners shall ensure that 6.19 money allocated to counties under this 6.20 provision must be used in accordance 6.21 with the requirements of United States 6.22 Code, title 42, section 604(d)(3)(B). 6.23 These are one-time appropriations that 6.24 shall not be added to the base for 6.25 these programs for the 2000-2001 6.26 biennial budget. 6.27 Subd. 3. Basic Health Care Grants 6.28 (97,529,000) (146,802,000) 6.29 Summary by Fund 6.30 General (94,591,000) (128,833,000) 6.31 Health Care Access (2,938,000) (17,969,000) 6.32 The amounts that may be spent from this 6.33 appropriation for each purpose are as 6.34 follows: 6.35 (a) Minnesota Care Grants 6.36 Health Care Access Fund 6.37 (2,938,000) (17,969,000) 6.38 [SUBSIDIZED FAMILY HEALTH COVERAGE.] Of 6.39 this appropriation, $500,000 from the 6.40 health care access fund in fiscal year 6.41 1999 is to implement the 6.42 employer-subsidized health coverage 6.43 program described in article 5, section 6.44 45. 6.45 (b) MA Basic Health Care Grants- 6.46 Families and Children 6.47 General (32,047,000) (65,249,000) 6.48 [FETAL ALCOHOL SYNDROME MEDICAL 6.49 ASSISTANCE FEDERAL MATCH.] The 6.50 commissioner shall claim all available 6.51 federal match under Title XIX for the 6.52 fetal alcohol syndrome/fetal alcohol 6.53 effect initiatives. Grants and 6.54 projects shall be developed which focus 6.55 treatment on community-based options 6.56 which consider the availability of 6.57 federal match. 6.58 (c) MA Basic Health Care Grants- 7.1 Elderly and Disabled 7.2 General (25,643,000) (40,952,000) 7.3 (d) General Assistance Medical Care 7.4 General (36,901,000) (22,632,000) 7.5 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 7.6 September 15, 1998, federal approval is 7.7 obtained to provide a prescription drug 7.8 benefit for qualified Medicare 7.9 beneficiaries at no less than 100 7.10 percent of the federal poverty 7.11 guidelines and service-limited Medicare 7.12 beneficiaries under Minnesota Statutes, 7.13 section 256B.057, subdivision 3a, at no 7.14 less than 120 percent of federal 7.15 poverty guidelines, the commissioner of 7.16 human services shall not implement the 7.17 senior citizen drug program under 7.18 Minnesota Statutes, section 256.955, 7.19 but shall implement a drug benefit in 7.20 accordance with the approved waiver. 7.21 Upon approval of this waiver, the total 7.22 appropriation for the senior citizen 7.23 drug program under Laws 1997, chapter 7.24 225, article 7, section 2, shall be 7.25 transferred to the medical assistance 7.26 account to fund the federally approved 7.27 coverage for eligible persons for 7.28 fiscal year 1999. 7.29 (b) The commissioner may seek approval 7.30 for a higher copayment for eligible 7.31 persons above 100 percent of the 7.32 federal poverty guidelines. 7.33 (c) The commissioner shall report by 7.34 October 15, 1998, to the chairs of the 7.35 health and human services policy and 7.36 fiscal committees of the house and 7.37 senate whether the waiver referred to 7.38 in paragraph (a) has been approved and 7.39 will be implemented or whether the 7.40 state senior citizen drug program will 7.41 be implemented. 7.42 (d) If the commissioner does not 7.43 receive federal waiver approval at or 7.44 above the level of eligibility defined 7.45 in paragraph (a), the commissioner 7.46 shall implement the program under 7.47 Minnesota Statutes, section 256.955. 7.48 [HEALTH CARE ACCESS FUND TRANSFERS TO 7.49 THE GENERAL FUND.] Notwithstanding Laws 7.50 1997, chapter 203, article 1, section 7.51 2, subdivision 5, the commissioner 7.52 shall transfer funds from the health 7.53 care access fund to the general fund to 7.54 offset the projected savings to general 7.55 assistance medical care (GAMC) that 7.56 would result from the transition of 7.57 GAMC parents and adults without 7.58 children to MinnesotaCare. For fiscal 7.59 year 1998, the amount transferred from 7.60 the health care access fund to the 7.61 general fund shall be $13,700,000. The 7.62 amount of transfer for fiscal year 1999 7.63 shall be $2,659,000. 8.1 Subd. 4. Basic Health Care Management 8.2 (192,000) 2,448,000 8.3 Summary by Fund 8.4 General -0- 25,000 8.5 Health Care Access (192,000) 2,423,000 8.6 The amounts that may be spent from this 8.7 appropriation for each purpose are as 8.8 follows: 8.9 (a) Health Care Policy Administration 8.10 General -0- 25,000 8.11 Health Care Access (192,000) 354,000 8.12 [DELAY IN TRANSFERRING GAMC CLIENTS.] 8.13 Due to delaying the transfer of GAMC 8.14 clients to MinnesotaCare until January 8.15 1, 2000, $192,000 in fiscal year 1998 8.16 health care access fund administrative 8.17 funds, appropriated in Laws 1997, 8.18 chapter 225, article 7, section 2, 8.19 subdivision 1, are canceled. 8.20 [HEALTH CARE MANUAL PRODUCTION COSTS.] 8.21 For the biennium ending June 30, 1999, 8.22 the commissioner may charge a fee for 8.23 the health care manual. The difference 8.24 between the cost of producing and 8.25 distributing the department of human 8.26 services health care manual, and the 8.27 fees paid by individuals and private 8.28 entities on January 1, 1998, is 8.29 appropriated to the commissioner to 8.30 defray manual production and 8.31 distribution costs. The commissioner 8.32 must provide the health care manual to 8.33 government agencies and nonprofit 8.34 agencies serving the legal and social 8.35 service needs of clients at no cost to 8.36 those agencies. 8.37 [TRANSFER.] For fiscal years 2000 and 8.38 2001, the commissioner of finance shall 8.39 transfer from the health care access 8.40 fund to the general fund an amount to 8.41 cover the expenditures associated with 8.42 the services provided to pregnant women 8.43 and children under the age of two 8.44 enrolled in the MinnesotaCare program. 8.45 Notwithstanding section 7, this 8.46 provision expires on July 1, 2001. 8.47 [FEDERAL CONTINGENCY RESERVE LIMIT.] 8.48 Notwithstanding Minnesota Statutes, 8.49 section 16A.76, subdivision 2, the 8.50 federal contingency reserve limit shall 8.51 be reduced for fiscal years 1999, 2000, 8.52 and 2001 by the cumulative amount of 8.53 the expenditures associated with 8.54 services provided to pregnant women and 8.55 children enrolled in the MinnesotaCare 8.56 program in these fiscal years. 8.57 Notwithstanding section 7, this 8.58 provision expires on July 1, 2001. 9.1 [MINNESOTACARE OUTREACH FEDERAL 9.2 MATCHING FUNDS.] Any federal matching 9.3 funds received as a result of the 9.4 MinnesotaCare outreach activities 9.5 authorized by Laws 1997, chapter 225, 9.6 article 7, section 2, subdivision 1, 9.7 shall be deposited in the health care 9.8 access fund and dedicated to the 9.9 commissioner of human services to be 9.10 used for those outreach purposes. 9.11 (b) Health Care Operations 9.12 Health Care Access -0- 2,069,000 9.13 [MINNESOTACARE OUTREACH.] Unexpended 9.14 money in fiscal year 1998 for 9.15 MinnesotaCare outreach activities 9.16 appropriated in Laws 1997, chapter 225, 9.17 article 7, section 2, subdivision 1, 9.18 does not cancel, but is available for 9.19 those purposes in fiscal year 1999. 9.20 Subd. 5. State-Operated Services 9.21 -0- (254,000) 9.22 The amounts that may be spent from this 9.23 appropriation for each purpose are as 9.24 follows: 9.25 (a) RTC Facilities 9.26 -0- 700,000 9.27 [LEAVE LIABILITIES.] The accrued leave 9.28 liabilities of state employees 9.29 transferred to state-operated community 9.30 services programs may be paid from the 9.31 appropriation for state-operated 9.32 services in Laws 1997, chapter 203, 9.33 article 1, section 2, subdivision 7, 9.34 paragraph (a). Funds set aside for 9.35 this purpose shall not exceed the 9.36 amount of the actual leave liability 9.37 calculated as of June 30, 1999, and 9.38 shall be available until expended. 9.39 This provision is effective the day 9.40 following final enactment. 9.41 [GRAVE MARKERS.] Of the $195,000 9.42 retained by the commissioner from the 9.43 $200,000 appropriation in Laws 1997, 9.44 chapter 203, article 1, section 2, 9.45 subdivision 7, paragraph (a), for grave 9.46 markers at regional treatment centers, 9.47 $29,250 is for community organizing, 9.48 coordination, fundraising, and 9.49 administration. 9.50 [RTC BUILDING AND SPACE ANALYSIS.] Of 9.51 this appropriation, $50,000 from the 9.52 general fund in fiscal year 1999 is for 9.53 the commissioner to conduct an analysis 9.54 of surplus land and buildings on the 9.55 regional treatment center campuses and 9.56 to develop recommendations for future 9.57 utilization of this property. The 9.58 commissioner shall report to the 9.59 legislature by January 15, 1999, with 9.60 recommendations for an orderly process 10.1 to sell, lease, demolish, transfer, or 10.2 otherwise dispose of unneeded buildings 10.3 and land. 10.4 (b) State-Operated Community 10.5 Services - DD 10.6 -0- (954,000) 10.7 Subd. 6. Continuing Care and 10.8 Community Support Grants 10.9 (36,806,000) (9,289,000) 10.10 The amounts that may be spent from this 10.11 appropriation for each purpose are as 10.12 follows: 10.13 (a) Community Services Block Grants 10.14 130,000 846,000 10.15 [WILKIN COUNTY FLOOD COSTS.] Of this 10.16 appropriation, $130,000 for fiscal year 10.17 1998 is to reimburse Wilkin county for 10.18 flood-related human service and public 10.19 health costs which cannot be reimbursed 10.20 through any other source. 10.21 (b) Aging Adult Service Grants 10.22 -0- 250,000 10.23 [METROPOLITAN AREA AGENCY ON AGING.] Of 10.24 this appropriation, $100,000 in fiscal 10.25 year 1999 from the general fund is for 10.26 the commissioner for the metropolitan 10.27 area agency on aging to provide 10.28 technical support and planning services 10.29 to enable older adults to remain living 10.30 in the community. This appropriation 10.31 shall not cancel but is available until 10.32 expended. 10.33 [HOME SHARING.] Of this appropriation, 10.34 $150,000 in fiscal year 1999 is from 10.35 the general fund to the commissioner 10.36 for the home-sharing program under 10.37 Minnesota Statutes, section 256.973, 10.38 which links elderly, disabled, and 10.39 families together to share a home. 10.40 (c) Deaf and Hard-of-Hearing 10.41 Services Grants 10.42 -0- 234,000 10.43 [SERVICES FOR DEAF-BLIND PERSONS.] Of 10.44 this appropriation, $150,000 in fiscal 10.45 year 1999 is for the following: 10.46 (1) $100,000 for a grant to Deaf Blind 10.47 Services Minnesota, Inc., in order to 10.48 provide services to deaf-blind children 10.49 and their families. The services 10.50 include providing intervenors to assist 10.51 deaf-blind children in participating in 10.52 their community and providing family 10.53 education specialists to teach siblings 10.54 and parents skills to support the 10.55 deaf-blind child in the family. 11.1 (2) $50,000 is for a grant to Deaf 11.2 Blind Services Minnesota, Inc., and 11.3 Duluth Lighthouse for the Blind, Inc., 11.4 in order to provide assistance to 11.5 deaf-blind persons who are working 11.6 toward establishing and maintaining 11.7 independence. 11.8 (d) Mental Health Grants 11.9 100,000 1,803,000 11.10 [DD CRISIS INTERVENTION PROJECT.] Of 11.11 this appropriation, $125,000 in fiscal 11.12 year 1999 is from the general fund to 11.13 the commissioner for start-up operating 11.14 and training costs for the action, 11.15 support, and prevention project of 11.16 southeastern Minnesota. This 11.17 appropriation is to provide crisis 11.18 intervention through community-based 11.19 services in the private sector to 11.20 persons with developmental disabilities 11.21 under Laws 1995, chapter 207, article 11.22 3, section 22. This appropriation 11.23 shall not become part of base level 11.24 funding for the 2000-2001 biennium. 11.25 [FLOOD COSTS.] Of this appropriation, 11.26 $100,000 for fiscal year 1998 and 11.27 $700,000 for fiscal year 1999 is to pay 11.28 for flood-related mental health 11.29 services and to reimburse mental health 11.30 centers for the cost of disruptions in 11.31 the mental health centers' other 11.32 services that were caused by diversion 11.33 of staff to flood efforts. Funding is 11.34 limited to costs for services which 11.35 cannot be reimbursed through any other 11.36 source in counties officially declared 11.37 as disaster areas. 11.38 [COMPULSIVE GAMBLING CARRYFORWARD.] 11.39 Unexpended funds appropriated to the 11.40 commissioner for compulsive gambling 11.41 programs for fiscal year 1998 do not 11.42 cancel but are available for these 11.43 purposes for fiscal year 1999. 11.44 (e) Developmental Disabilities 11.45 Support Grants 11.46 -0- 162,000 11.47 (f) Medical Assistance Long-Term 11.48 Care Waivers and Home Care 11.49 (3,936,000) (2,435,000) 11.50 [JULY 1, 1998, PROVIDER RATE INCREASE.] 11.51 (1) Effective for services rendered on 11.52 or after July 1, 1998, the commissioner 11.53 shall increase reimbursement or 11.54 allocation rates by three percent, and 11.55 county boards shall adjust provider 11.56 contracts as needed, for home and 11.57 community-based waiver services for 11.58 persons with mental retardation or 11.59 related conditions under Minnesota 11.60 Statutes, section 256B.501; home and 11.61 community-based waiver services for the 12.1 elderly under Minnesota Statutes, 12.2 section 256B.0915; waivered services 12.3 under community alternatives for 12.4 disabled individuals under Minnesota 12.5 Statutes, section 256B.49; community 12.6 alternative care waivered services 12.7 under Minnesota Statutes, section 12.8 256B.49; traumatic brain injury 12.9 waivered services under Minnesota 12.10 Statutes, section 256B.49; nursing 12.11 services and home health services under 12.12 Minnesota Statutes, section 256B.0625, 12.13 subdivision 6a; personal care services 12.14 and nursing supervision of personal 12.15 care services under Minnesota Statutes, 12.16 section 256B.0625, subdivision 19a; 12.17 private duty nursing services under 12.18 Minnesota Statutes, section 256B.0625, 12.19 subdivision 7; day training and 12.20 habilitation services for adults with 12.21 mental retardation or related 12.22 conditions under Minnesota Statutes, 12.23 sections 252.40 to 252.46; physical 12.24 therapy services under Minnesota 12.25 Statutes, sections 256B.0625, 12.26 subdivision 8, and 256D.03, subdivision 12.27 4; occupational therapy services under 12.28 Minnesota Statutes, sections 256B.0625, 12.29 subdivision 8a, and 256D.03, 12.30 subdivision 4; speech-language therapy 12.31 services under Minnesota Statutes, 12.32 section 256D.03, subdivision 4, and 12.33 Minnesota Rules, part 9505.0390; 12.34 respiratory therapy services under 12.35 Minnesota Statutes, section 256D.03, 12.36 subdivision 4, and Minnesota Rules, 12.37 part 9505.0295; dental services under 12.38 Minnesota Statutes, sections 256B.0625, 12.39 subdivision 9, and 256D.03, subdivision 12.40 4; alternative care services under 12.41 Minnesota Statutes, section 256B.0913; 12.42 adult residential program grants under 12.43 Minnesota Rules, parts 9535.2000 to 12.44 9535.3000; adult and family community 12.45 support grants under Minnesota Rules, 12.46 parts 9535.1700 to 9535.1760; 12.47 semi-independent living services under 12.48 Minnesota Statutes, section 252.275, 12.49 including SILS funding under county 12.50 social services grants formerly funded 12.51 under Minnesota Statutes, chapter 256I; 12.52 day treatment under Minnesota Rules, 12.53 part 9505.0323; the skills training 12.54 component of (a) family community 12.55 support services under Minnesota 12.56 Statutes, section 256B.0625, 12.57 subdivisions 5 and 35, (b) therapeutic 12.58 support of foster care under Minnesota 12.59 Statutes, section 256B.0625, 12.60 subdivisions 5 and 36, and (c) 12.61 home-based treatment under Minnesota 12.62 Rules, part 9505.0324; and community 12.63 support services for deaf and 12.64 hard-of-hearing adults with mental 12.65 illness who use or wish to use sign 12.66 language as their primary means of 12.67 communication. 12.68 (2) Effective January 1, 1999, the 12.69 commissioner shall increase capitation 12.70 rates in the prepaid medical assistance 13.1 program, prepaid general assistance 13.2 medical care program, and prepaid 13.3 MinnesotaCare program as appropriate to 13.4 reflect the rate increases in paragraph 13.5 (l). 13.6 (3) It is the intention of the 13.7 legislature that the compensation 13.8 packages of staff within each service 13.9 be increased by three percent. 13.10 (4) Section 7, sunset of uncodified 13.11 language, does not apply to this 13.12 provision. 13.13 (g) Medical Assistance Long-Term 13.14 Care Facilities 13.15 (24,318,000) (16,911,000) 13.16 [ICFs/MR AND NURSING FACILITY 13.17 FLOOD-RELATED REPORTING.] For the 13.18 reporting year ending December 31, 13.19 1997, for ICFs/MR that temporarily 13.20 admitted victims of the flood of 1997, 13.21 the resident days related to the 13.22 temporary placement of persons not 13.23 formally admitted who continued to be 13.24 billed under the evacuated facility's 13.25 provider number shall not be counted in 13.26 the cost report submitted to calculate 13.27 October 1, 1998, rates, and the 13.28 additional expenditures shall be 13.29 considered nonallowable. 13.30 For the reporting year ending September 13.31 30, 1997, for nursing facilities that 13.32 temporarily admitted victims of the 13.33 flood of 1997, the resident days 13.34 related to the temporary placement of 13.35 persons not formally admitted who 13.36 continued to be billed under the 13.37 evacuated facility's provider number 13.38 shall not be counted in the cost report 13.39 submitted to calculate July 1, 1998, 13.40 rates, and the additional expenditures 13.41 shall be considered nonallowable. 13.42 [ICF/MR DISALLOWANCES.] Of this 13.43 appropriation, $65,000 in fiscal year 13.44 1999 is from the general fund to the 13.45 commissioner for the purpose of 13.46 reimbursing a 12-bed ICF/MR in Stearns 13.47 county and a 12-bed ICF/MR in Sherburne 13.48 county for disallowances resulting from 13.49 field audit findings. The commissioner 13.50 shall exempt these facilities from the 13.51 provisions of Minnesota Statutes, 13.52 section 256B.501, subdivision 5b, 13.53 paragraph (d), clause (6), for the rate 13.54 years beginning October 1, 1997, and 13.55 October 1, 1998. Section 10, sunset of 13.56 uncodified language, does not apply to 13.57 this provision. 13.58 [NURSING HOME MORATORIUM EXCEPTIONS.] 13.59 Base level funding for medical 13.60 assistance long-term care facilities is 13.61 increased by $255,000 in fiscal year 13.62 2000 and by $278,000 in fiscal year 13.63 2001 for the additional medical 14.1 assistance costs of the nursing home 14.2 moratorium exceptions under Minnesota 14.3 Statutes 1997 Supplement, section 14.4 144A.071, subdivision 4a, paragraphs 14.5 (w) and (x). Notwithstanding the 14.6 provisions of section 7, sunset of 14.7 uncodified language, this provision 14.8 shall not expire. 14.9 (h) Alternative Care Grants 14.10 -0- 22,663,000 14.11 (i) Group Residential Housing 14.12 (8,782,000) (8,408,000) 14.13 [SERVICES TO DEAF PERSONS WITH MENTAL 14.14 ILLNESS.] Of this appropriation, 14.15 $65,000 in fiscal year 1999 is from the 14.16 general fund to the commissioner for a 14.17 grant to a nonprofit agency that 14.18 currently serves deaf and 14.19 hard-of-hearing adults with mental 14.20 illness through residential programs 14.21 and supported housing outreach 14.22 activities. The grant must be used to 14.23 continue or maintain community support 14.24 services for deaf and hard-of-hearing 14.25 adults with mental illness who use or 14.26 wish to use sign language as their 14.27 primary means of communication. This 14.28 appropriation is in addition to the 14.29 appropriation in Laws 1997, chapter 14.30 203, article 1, section 2, subdivision 14.31 8, paragraph (d), for a grant to this 14.32 nonprofit agency. This appropriation 14.33 shall not become part of base level 14.34 funding for the 2000-2001 biennium. 14.35 (j) Chemical Dependency 14.36 Entitlement Grants 14.37 -0- (7,893,000) 14.38 [CHEMICAL DEPENDENCY RESERVE ACCOUNT.] 14.39 For fiscal year 1999, $3,000,000 is 14.40 canceled from the chemical dependency 14.41 reserve account within the consolidated 14.42 chemical dependency treatment fund to 14.43 the general fund. 14.44 (k) Chemical Dependency 14.45 Nonentitlement Grants 14.46 -0- 400,000 14.47 [MATCHING GRANT FOR YOUTH ALCOHOL 14.48 TREATMENT.] Of this appropriation, 14.49 $400,000 in fiscal year 1999 is from 14.50 the general fund for the commissioner 14.51 to provide a grant to the board of 14.52 directors of the Minnesota Indian 14.53 Primary Residential Treatment Center, 14.54 Inc., to build a youth alcohol 14.55 treatment wing at the Mash-Ka-Wisen 14.56 Treatment Center. This appropriation 14.57 is available only if matched by a 14.58 $1,500,000 federal grant and a $100,000 14.59 grant from state Indian bands. 15.1 [MATCHING GRANT FOR PROJECT TURNABOUT.] 15.2 If money is appropriated in fiscal year 15.3 1999 to the commissioner from the 15.4 lottery prize fund, the money shall be 15.5 used to provide a grant for capital 15.6 improvements to Project Turnabout in 15.7 Granite Falls. A local match is 15.8 required before the commissioner may 15.9 release this appropriation to the 15.10 facility. The facility shall receive 15.11 state funds equal to the amount of 15.12 local matching funds provided, up to 15.13 the limit of this appropriation. 15.14 Subd. 7. Continuing Care and 15.15 Community Support Management 15.16 -0- 25,000 15.17 [REGION 10 COMMISSION CARRYOVER 15.18 AUTHORITY.] Any unspent portion of the 15.19 appropriation to the commissioner in 15.20 Laws 1997, chapter 203, article 1, 15.21 section 2, subdivision 9, for the 15.22 region 10 quality assurance commission 15.23 for fiscal year 1998 shall not cancel 15.24 but shall be available for the 15.25 commission for fiscal year 1999. 15.26 [STUDY OF DAY TRAINING CAPITAL NEEDS.] 15.27 (a) Of this appropriation, $25,000 in 15.28 fiscal year 1999 is from the general 15.29 fund to the commissioner to conduct a 15.30 study to: 15.31 (1) determine the extent to which day 15.32 training and habilitation programs have 15.33 unmet capital improvement needs; 15.34 (2) ascertain the degree to which these 15.35 unmet capital needs impact consumers of 15.36 day training and habilitation programs; 15.37 (3) determine the state's role and 15.38 responsibility in meeting the capital 15.39 improvement needs of day training and 15.40 habilitation programs; and 15.41 (4) examine the relationship among the 15.42 state, counties, and community 15.43 resources in meeting the capital 15.44 improvement needs of day training and 15.45 habilitation programs. 15.46 (b) The commissioner shall report to 15.47 the legislature by January 15, 1999, 15.48 the results of the study along with 15.49 recommendations for involving the 15.50 state, counties, and community 15.51 resources in collaborative initiatives 15.52 to assist in meeting the capital 15.53 improvement needs of day training and 15.54 habilitation programs. 15.55 (c) This appropriation shall not become 15.56 part of base level funding for the 15.57 2000-2001 biennium. 15.58 Subd. 8. Economic Support Grants 15.59 (8,562,000) (44,961,000) 16.1 The amounts that may be spent from this 16.2 appropriation for each purpose are as 16.3 follows: 16.4 (a) Assistance to Families Grants 16.5 1,173,000 (32,282,000) 16.6 [FEDERAL TANF FUNDS.] Notwithstanding 16.7 any contrary provisions of Laws 1997, 16.8 chapter 203, article 1, section 2, 16.9 subdivision 12, federal TANF block 16.10 grant funds are appropriated to the 16.11 commissioner in amounts up to 16.12 $230,200,000 in fiscal year 1998 and 16.13 $285,990,000 in fiscal year 1999. 16.14 Additional federal TANF funds may be 16.15 expended but only to the extent that an 16.16 equal amount of state funds have been 16.17 transferred to the TANF reserve under 16.18 Minnesota Statutes, section 256J.03. 16.19 [TRANSFER OF STATE MONEY FROM TANF 16.20 RESERVE.] For fiscal year 1999, 16.21 $5,416,000 is appropriated from the 16.22 state money in the TANF reserve to the 16.23 commissioner for the purposes of 16.24 funding the Minnesota food assistance 16.25 program under Minnesota Statutes, 16.26 section 256D.053, and the eligibility 16.27 of legal noncitizens who were not 16.28 Minnesota residents on March 1, 1997, 16.29 for the general assistance program 16.30 under the amendments to Minnesota 16.31 Statutes, section 256D.05, subdivision 16.32 8, in article 6. 16.33 [TRANSFER OF FEDERAL TANF FUNDS TO 16.34 CHILD CARE DEVELOPMENT FUND.] $791,000 16.35 is transferred in fiscal year 1999 from 16.36 the state's federal TANF block grant to 16.37 the state's child care development 16.38 fund, and is appropriated to the 16.39 commissioner of children, families, and 16.40 learning for the purposes of Minnesota 16.41 Statutes, section 119B.05. 16.42 [TRANSFER FROM STATE TANF RESERVE.] 16.43 Notwithstanding the provisions of 16.44 Minnesota Statutes, section 256J.03, 16.45 $7,799,000 is transferred from the 16.46 state TANF reserve account to the 16.47 general fund in fiscal year 2000. 16.48 Notwithstanding section 7, this 16.49 provision expires on July 1, 2000. 16.50 (b) Work Grants 16.51 -0- (1,000,000) 16.52 [FOOD STAMP EMPLOYMENT AND TRAINING 16.53 APPROPRIATION REDUCTION.] The 16.54 appropriation in Laws 1997, chapter 16.55 203, article 1, section 2, subdivision 16.56 10, paragraph (b), for fiscal year 1999 16.57 for work grants is reduced by 16.58 $1,000,000. This reduction shall be 16.59 taken from the fiscal year 1999 16.60 appropriation for the food stamp 16.61 employment and training program. 17.1 (c) Child Support Enforcement 17.2 -0- (1,100,000) 17.3 [CHILD SUPPORT CARRYOVER AUTHORITY.] 17.4 Any unspent portion of the 17.5 appropriation to the commissioner in 17.6 Laws 1997, chapter 203, article 1, 17.7 section 2, subdivision 10, for child 17.8 support enforcement activities for 17.9 fiscal year 1998 shall not cancel but 17.10 shall be available to the commissioner 17.11 for fiscal year 1999. The 17.12 appropriation in Laws 1997, chapter 17.13 203, article 1, section 2, subdivision 17.14 10, for child support enforcement 17.15 activities for fiscal year 1999 is 17.16 reduced by $1,100,000. This reduction 17.17 shall not reduce base level funding for 17.18 these activities for the 2000-2001 17.19 biennium. 17.20 (d) General Assistance 17.21 (6,933,000) (6,321,000) 17.22 (e) Minnesota Supplemental Aid 17.23 (2,802,000) (4,258,000) 17.24 Subd. 9. Economic Support 17.25 Management 17.26 Health Care Access -0- 1,084,000 17.27 [ASSESSMENT OF AFFORDABLE HOUSING 17.28 SUPPLY.] The commissioner of human 17.29 services shall assess the statewide 17.30 supply of affordable housing for all 17.31 MFIP-S and GA recipients, and report to 17.32 the legislature by January 15, 1999, on 17.33 the results of this assessment. 17.34 Sec. 3. COMMISSIONER OF HEALTH 17.35 Subdivision 1. Total 17.36 Appropriation -0- 20,147,000 17.37 Summary by Fund 17.38 General -0- 19,780,000 17.39 State Government 17.40 Special Revenue -0- 108,000 17.41 Health Care Access -0- 259,000 17.42 This appropriation is added to the 17.43 appropriation in Laws 1997, chapter 17.44 203, article 1, section 3. 17.45 The amounts that may be spent from this 17.46 appropriation for each program are 17.47 specified in the following subdivisions. 17.48 Subd. 2. Health Systems 17.49 and Special Populations -0- 15,459,000 17.50 Summary by Fund 17.51 General -0- 15,200,000 18.1 Health Care Access -0- 259,000 18.2 [FETAL ALCOHOL SYNDROME.] (a) Of this 18.3 appropriation, $5,000,000 in fiscal 18.4 year 1999 is from the general fund to 18.5 the commissioner for the fetal alcohol 18.6 syndrome/fetal alcohol effect (FAS/FAE) 18.7 initiatives specified in paragraphs (b) 18.8 to (k). 18.9 (b) Of the amount in paragraph (a), 18.10 $200,000 is transferred to the 18.11 commissioner of children, families, and 18.12 learning for school-based pilot 18.13 programs to identify and implement 18.14 effective educational strategies for 18.15 individuals with FAS/FAE. 18.16 (c) Of the amount in paragraph (a), 18.17 $800,000 is for the public awareness 18.18 campaign under Minnesota Statutes, 18.19 section 145.9266, subdivision 1. 18.20 (d) Of the amount in paragraph (a), 18.21 $400,000 is to develop a statewide 18.22 network of regional FAS diagnostic 18.23 clinics under Minnesota Statutes, 18.24 section 145.9266, subdivision 2. 18.25 (e) Of the amount in paragraph (a), 18.26 $150,000 is for professional training 18.27 about FAS under Minnesota Statutes, 18.28 section 145.9266, subdivision 3. 18.29 (f) Of the amount in paragraph (a), 18.30 $350,000 is for the fetal alcohol 18.31 coordinating board under Minnesota 18.32 Statutes, section 145.9266, subdivision 18.33 6. 18.34 (g) Of the amount in paragraph (a), 18.35 $800,000 is transferred to the 18.36 commissioner of human services to 18.37 expand the maternal and child health 18.38 social service programs under Minnesota 18.39 Statutes, section 254A.17, subdivision 18.40 1. Of this amount, $184,000 shall be 18.41 used by the commissioner of human 18.42 services to eliminate the asset 18.43 standards for medical assistance 18.44 eligibility for pregnant women. 18.45 (h) Of the amount in paragraph (a), 18.46 $200,000 is for the commissioner to 18.47 study the extent of fetal alcohol 18.48 syndrome in the state. 18.49 (i) Of the amount in paragraph (a), 18.50 $400,000 is transferred to the 18.51 commissioner of human services for the 18.52 intervention and advocacy program under 18.53 Minnesota Statutes, section 254A.17, 18.54 subdivision 1b. 18.55 (j) Of the amount in paragraph (a), 18.56 $850,000 is for the FAS community grant 18.57 program under Minnesota Statutes, 18.58 section 145.9266, subdivision 4. 18.59 (k) Of the amount in paragraph (a), 18.60 $850,000 is transferred to the 19.1 commissioner of human services to 19.2 expand treatment services and halfway 19.3 houses for pregnant women and women 19.4 with children who abuse alcohol during 19.5 pregnancy. 19.6 [RURAL PHYSICIAN LOAN FORGIVENESS 19.7 BUDGET REQUEST.] The budget request for 19.8 the rural physician loan forgiveness 19.9 program in the 2000-2001 biennial 19.10 budget shall detail the amount of funds 19.11 carried forward and obligations 19.12 canceled. 19.13 [CONSUMER ADVISORY BOARD.] Of the 19.14 general fund appropriation for fiscal 19.15 year 1999, $50,000 is to the 19.16 commissioner to reimburse members of 19.17 the consumer advisory board for travel, 19.18 food, and lodging expenses incurred by 19.19 board members in the course of 19.20 conducting board duties. 19.21 [MEDICAL EDUCATION AND RESEARCH TRUST 19.22 FUND.] Of the general fund 19.23 appropriation, $10,000,000 in fiscal 19.24 year 1999 is to the commissioner for 19.25 the medical education and research 19.26 trust fund. Of this amount, $5,000,000 19.27 shall become part of base level funding 19.28 for the biennium beginning July 1, 1999. 19.29 [MERC FEDERAL FINANCIAL PARTICIPATION.] 19.30 (1) The commissioner of human services 19.31 shall seek to maximize federal 19.32 financial participation for payments 19.33 for medical education and research 19.34 costs. 19.35 (2) If the commissioner of human 19.36 services determines that federal 19.37 financial participation is available 19.38 for the fiscal year 1999 appropriation 19.39 for the medical education and research 19.40 trust fund under this subdivision, the 19.41 commissioner of health shall transfer 19.42 to the commissioner of human services 19.43 the amount of state funds necessary to 19.44 maximize the federal funds. 19.45 (3) The transferred amount, plus the 19.46 federal financial participation amount, 19.47 shall be distributed to medical 19.48 assistance providers according to the 19.49 distribution methodology of the medical 19.50 education research trust fund 19.51 established under Minnesota Statutes, 19.52 section 62J.69. 19.53 [DIABETES PREVENTION.] Of this 19.54 appropriation, $50,000 in fiscal year 19.55 1999 from the general fund is to the 19.56 commissioner for statewide activities 19.57 related to general diabetes prevention, 19.58 the development and dissemination of 19.59 prevention materials to health care 19.60 providers, and for other statewide 19.61 activities related to diabetes 19.62 prevention and control for targeted 19.63 populations who are at high risk for 19.64 developing diabetes or health 20.1 complications from diabetes. 20.2 Subd. 3. Health Protection -0- 4,688,000 20.3 Summary by Fund 20.4 General -0- 4,580,000 20.5 State Government 20.6 Special Revenue -0- 108,000 20.7 [FOOD, BEVERAGE, AND LODGING PROGRAM 20.8 STAFF RESTORATION.] Of the 20.9 appropriation from the state government 20.10 special revenue fund, $101,000 in 20.11 fiscal year 1999 is for the 20.12 commissioner to restore staffing for 20.13 the food, beverage, and lodging program. 20.14 [OCCUPATIONAL RESPIRATORY DISEASE 20.15 INFORMATION SYSTEM.] Of the general 20.16 fund appropriation, $250,000 in fiscal 20.17 year 1999 is to design an occupational 20.18 respiratory disease information 20.19 system. This appropriation is 20.20 available until expended. This 20.21 appropriation is added to the base for 20.22 the 2000-2001 biennial budget. 20.23 [LEAD-SAFE PROPERTY CERTIFICATION 20.24 PROGRAM.] Of this appropriation, 20.25 $75,000 in fiscal year 1999 is from the 20.26 general fund to the commissioner for 20.27 the purposes of the lead-safe property 20.28 certification program under Minnesota 20.29 Statutes, section 144.9511. 20.30 [INFECTION CONTROL.] Of the general 20.31 fund appropriation, $200,000 in fiscal 20.32 year 1999 is for infection control 20.33 activities, including training and 20.34 technical assistance of health care 20.35 personnel to prevent and control 20.36 disease outbreaks, and for hospital and 20.37 public health laboratory testing and 20.38 other activities to monitor trends in 20.39 drug-resistant infections. 20.40 [CANCER SCREENING.] Of the general fund 20.41 appropriation, $1,255,000 in fiscal 20.42 year 1999 is for increased cancer 20.43 screening and diagnostic services for 20.44 women, particularly underserved women, 20.45 and to improve cancer screening rates 20.46 for the general population. Of this 20.47 amount, at least $855,000 is for grants 20.48 to support local boards of health in 20.49 providing outreach and coordination and 20.50 to reimburse health care providers for 20.51 screening and diagnostic tests, and up 20.52 to $400,000 is for technical 20.53 assistance, consultation, and outreach. 20.54 [SEXUALLY TRANSMITTED DISEASE.] (a) of 20.55 this appropriation, $300,000 in fiscal 20.56 year 1999 is from the general fund to 20.57 the commissioner to do the following, 20.58 in consultation with the HIV/STD 20.59 prevention task force and the 20.60 commissioner of children, families, and 20.61 learning: 21.1 (1) $100,000 to conduct a statewide 21.2 assessment of need and capacity to 21.3 prevent and treat sexually transmitted 21.4 diseases and prepare a comprehensive 21.5 plan for how to prevent and treat 21.6 sexually transmitted diseases, 21.7 including strategies for reducing 21.8 infection and for increasing access to 21.9 treatment; 21.10 (2) $150,000 to conduct research on the 21.11 prevalence of sexually transmitted 21.12 diseases among populations at highest 21.13 risk for infection. The research may 21.14 be done in collaboration with the 21.15 University of Minnesota and nonprofit 21.16 community health clinics; and 21.17 (3) $50,000 to conduct laboratory 21.18 screenings for sexually transmitted 21.19 diseases at no charge to patients 21.20 participating in epidemiological 21.21 research activities specified in clause 21.22 (2). 21.23 (b) This appropriation shall not become 21.24 part of the base for the 2000-2001 21.25 biennium. 21.26 Sec. 4. HEALTH-RELATED BOARDS 21.27 Subdivision 1. Total 21.28 Appropriation 113,000 123,000 21.29 This appropriation is added to the 21.30 appropriation in Laws 1997, chapter 21.31 203, article 1, section 5. 21.32 The appropriations in this section are 21.33 from the state government special 21.34 revenue fund. 21.35 [NO SPENDING IN EXCESS OF REVENUES.] 21.36 The commissioner of finance shall not 21.37 permit the allotment, encumbrance, or 21.38 expenditure of money appropriated in 21.39 this section in excess of the 21.40 anticipated biennial revenues or 21.41 accumulated surplus revenues from fees 21.42 collected by the boards. Neither this 21.43 provision nor Minnesota Statutes, 21.44 section 214.06, applies to transfers 21.45 from the general contingent account. 21.46 Subd. 2. Board of Medical 21.47 Practice 80,000 90,000 21.48 This appropriation is added to the 21.49 appropriation in Laws 1997, chapter 21.50 203, article 1, section 5, subdivision 21.51 6, and is for the health professional 21.52 services activity. 21.53 Subd. 3. Board of Veterinary 21.54 Medicine 33,000 33,000 21.55 This appropriation is added to the 21.56 appropriation in Laws 1997, chapter 21.57 203, article 1, section 5, subdivision 21.58 14, and is for national examination 21.59 costs. 22.1 Sec. 5. EMERGENCY MEDICAL 22.2 SERVICES BOARD 22.3 General -0- 78,000 22.4 This appropriation is added to the 22.5 appropriation in Laws 1997, chapter 22.6 203, article 1, section 6. 22.7 [EMERGENCY MEDICAL SERVICES 22.8 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 22.9 Of this appropriation, $78,000 in 22.10 fiscal year 1999 is from the general 22.11 fund to the board to conduct an 22.12 emergency medical services needs 22.13 assessment for areas outside the 22.14 seven-county metropolitan area. The 22.15 assessment shall determine the current 22.16 status of and need for emergency 22.17 medical services communications 22.18 equipment. All regional emergency 22.19 medical services programs designated by 22.20 the board under Minnesota Statutes 1997 22.21 Supplement, section 144E.50, shall 22.22 cooperate in the preparation of the 22.23 assessment. 22.24 (b) The appropriation for this project 22.25 shall be distributed through the 22.26 emergency medical services system fund 22.27 under Minnesota Statutes, section 22.28 144E.50, through a request-for-proposal 22.29 process. The board must select a 22.30 regional EMS program that receives at 22.31 least 20 percent of its funding from 22.32 nonstate sources to conduct the 22.33 assessment. The request for proposals 22.34 must be issued by August 1, 1998. 22.35 (c) A final report with recommendations 22.36 shall be presented to the board and the 22.37 legislature by July 1, 1999. 22.38 (d) This appropriation shall not become 22.39 part of base level funding for the 22.40 2000-2001 biennium. 22.41 Sec. 6. [CARRYOVER LIMITATION.] None 22.42 of the appropriations in this act which 22.43 are allowed to be carried forward from 22.44 fiscal year 1998 to fiscal year 1999 22.45 shall become part of the base level 22.46 funding for the 2000-2001 biennial 22.47 budget, unless specifically directed by 22.48 the legislature. 22.49 Sec. 7. [SUNSET OF UNCODIFIED 22.50 LANGUAGE.] All uncodified language 22.51 contained in this article expires on 22.52 June 30, 1999, unless a different 22.53 expiration date is explicit. 22.54 Sec. 8. [EFFECTIVE DATE.] 22.55 The appropriations and reductions for fiscal year 1998 in 22.56 this article are effective the day following final enactment. 22.57 ARTICLE 2 22.58 HEALTH DEPARTMENT AND HEALTH PROFESSIONALS 23.1 Section 1. Minnesota Statutes 1997 Supplement, section 23.2 13.99, is amended by adding a subdivision to read: 23.3 Subd. 19m. [DATA HELD BY OFFICE OF HEALTH CARE CONSUMER 23.4 ASSISTANCE, ADVOCACY, AND INFORMATION.] Consumer complaint data 23.5 collected or maintained by the office of health care consumer 23.6 assistance, advocacy, and information under sections 62J.77 and 23.7 62J.80 are classified under section 62J.79, subdivision 4. 23.8 Sec. 2. Minnesota Statutes 1997 Supplement, section 23.9 62D.11, subdivision 1, is amended to read: 23.10 Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health 23.11 maintenance organization shall establish and maintain a 23.12 complaint system, as required under section 62Q.105 to provide 23.13 reasonable procedures for the resolution of written complaints 23.14 initiated by or on behalf of enrollees concerning the provision 23.15 of health care services. "Provision of health services" 23.16 includes, but is not limited to, questions of the scope of 23.17 coverage, quality of care, and administrative operations. The 23.18 health maintenance organization must inform enrollees that they 23.19 may choose to usealternative dispute resolutionarbitration to 23.20 appeal a health maintenance organization's internal appeal 23.21 decision. The health maintenance organization must also inform 23.22 enrollees that they have the right to use arbitration to appeal 23.23 a health maintenance organization's internal appeal decision not 23.24 to certify an admission, procedure, service, or extension of 23.25 stay under section 62M.06. If an enrollee chooses to usean23.26alternative dispute resolution processarbitration, the health 23.27 maintenance organization must participate. 23.28 Sec. 3. Minnesota Statutes 1996, section 62J.321, is 23.29 amended by adding a subdivision to read: 23.30 Subd. 5a. [PRESCRIPTION DRUG PRICE DISCLOSURE 23.31 DATA.] Notwithstanding subdivisions 1 and 5, data collected 23.32 under section 62J.381 shall be classified as public data. 23.33 Sec. 4. [62J.381] [PRESCRIPTION DRUG PRICE DISCLOSURE.] 23.34 By April 1, 1999, and annually thereafter, hospitals 23.35 licensed under chapter 144 and group purchasers required to file 23.36 a full report under section 62J.38 and the rules promulgated 24.1 thereunder, must submit to the commissioner of health the total 24.2 amount of: 24.3 (1) aggregate purchases of or payments for prescription 24.4 drugs; and 24.5 (2) aggregate cash rebates, discounts, other payments 24.6 received, and any fees associated with education, data 24.7 collection, research, training, or market share movement, which 24.8 are received during the previous calendar year from a 24.9 manufacturer as defined under section 151.44, paragraph (c), or 24.10 wholesale drug distributor as defined under section 151.44, 24.11 paragraph (d). 24.12 The data collected under this section shall be distributed 24.13 through the information clearinghouse under section 62J.2930. 24.14 The identification of individual manufacturers or wholesalers or 24.15 specific drugs shall not be required under this section. 24.16 Sec. 5. Minnesota Statutes 1997 Supplement, section 24.17 62J.69, subdivision 1, is amended to read: 24.18 Subdivision 1. [DEFINITIONS.] For purposes of this 24.19 section, the following definitions apply: 24.20 (a) "Medical education" means the accredited clinical 24.21 training of physicians (medical students and residents), doctor 24.22 of pharmacy practitioners, doctors of chiropractic, dentists, 24.23 advanced practice nurses (clinical nurse specialist, certified 24.24 registered nurse anesthetists, nurse practitioners, and 24.25 certified nurse midwives), and physician assistants. 24.26 (b) "Clinical training" means accredited training for the 24.27 health care practitioners listed in paragraph (a) that is funded 24.28and was historically fundedin part byinpatientpatient care 24.29 revenues and that occurs inbotheither an inpatientandor 24.30 ambulatory patient caresettingstraining site. 24.31 (c) "Trainee" means students involved in an accredited 24.32 clinical training program for medical education as defined in 24.33 paragraph (a). 24.34 (d) "Eligible trainee" means a student involved in an 24.35 accredited training program for medical education as defined in 24.36 paragraph (a), which meets the definition of clinical training 25.1 in paragraph (b), who is in a training site that is located in 25.2 Minnesota and which has a medical assistance provider number. 25.3 (e) "Health care research" means approved clinical, 25.4 outcomes, and health services investigations that are funded by 25.5 patient out-of-pocket expenses or a third-party payer. 25.6(e)(f) "Commissioner" means the commissioner of health. 25.7(f)(g) "Teaching institutions" means any hospital, medical 25.8 center, clinic, or other organization that currently sponsors or 25.9 conducts accredited medical education programs or clinical 25.10 research in Minnesota. 25.11 (h) "Accredited training" means training provided by a 25.12 program that is accredited through an organization recognized by 25.13 the department of education or the health care financing 25.14 administration as the official accrediting body for that program. 25.15 (i) "Sponsoring institution" means a hospital, school, or 25.16 consortium located in Minnesota that sponsors and maintains 25.17 primary organizational and financial responsibility for an 25.18 accredited medical education program in Minnesota and which is 25.19 accountable to the accrediting body. 25.20 Sec. 6. Minnesota Statutes 1997 Supplement, section 25.21 62J.69, subdivision 2, is amended to read: 25.22 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 25.23 RESEARCH.] (a) The commissioner may establish a trust fund for 25.24 the purposes of funding medical education and research 25.25 activities in the state of Minnesota. 25.26 (b) By January 1, 1997, the commissioner may appoint an 25.27 advisory committee to provide advice and oversight on the 25.28 distribution of funds from the medical education and research 25.29 trust fund. If a committee is appointed, the commissioner 25.30 shall: (1) consider the interest of all stakeholders when 25.31 selecting committee members; (2) select members that represent 25.32 both urban and rural interest; and (3) select members that 25.33 include ambulatory care as well as inpatient perspectives. The 25.34 commissioner shall appoint to the advisory committee 25.35 representatives of the following groups: medical researchers, 25.36 public and private academic medical centers, managed care 26.1 organizations, Blue Cross and Blue Shield of Minnesota, 26.2 commercial carriers, Minnesota Medical Association, Minnesota 26.3 Nurses Association, medical product manufacturers, employers, 26.4 and other relevant stakeholders, including consumers. The 26.5 advisory committee is governed by section 15.059, for membership 26.6 terms and removal of members and will sunset on June 30, 1999. 26.7 (c) Eligible applicants for funds are accredited medical 26.8 education teaching institutions, consortia, and programs 26.9 operating in Minnesota. Applications must be submitted by the 26.10 sponsoring institution on behalf of the teaching program, and 26.11 must be received by September 30 of each year for distribution 26.12 in January of the following year. An application for funds must 26.13 include the following: 26.14 (1) the official name and address of the sponsoring 26.15 institution and the official name and address of the facility or 26.16programprograms on whose behalf the institution is applying for 26.17 funding; 26.18 (2) the name, title, and business address of those persons 26.19 responsible for administering the funds; 26.20 (3)the total number, type, and specialty orientation of26.21eligible Minnesota-based trainees infor each accredited medical 26.22 education program for which funds are being sought the type and 26.23 specialty orientation of trainees in the program, the name, 26.24 address, and medical assistance provider number of each training 26.25 site used in the program, the total number of trainees at each 26.26 site, and the total number of eligible trainees at each training 26.27 site; 26.28 (4) audited clinical training costs per trainee for each 26.29 medical education program where available or estimates of 26.30 clinical training costs based on audited financial data; 26.31 (5) a description of current sources of funding for medical 26.32 education costs including a description and dollar amount of all 26.33 state and federal financial support, including Medicare direct 26.34 and indirect payments; 26.35 (6) other revenue received for the purposes of clinical 26.36 training; and 27.1 (7)a statement identifying unfunded costs; and27.2(8)other supporting information the commissioner, with 27.3 advice from the advisory committee, determines is necessary for 27.4 the equitable distribution of funds. 27.5 (d) The commissioner shall distribute medical education 27.6 funds to all qualifying applicants based on the following basic 27.7 criteria: (1) total medical education funds available; (2) 27.8 total eligible trainees in each eligible education program; and 27.9 (3) the statewide average cost per trainee, by type of trainee, 27.10 in each medical education program. Funds distributed shall not 27.11 be used to displace current funding appropriations from federal 27.12 or state sources. Funds shall be distributed to the sponsoring 27.13 institutions indicating the amount to be paid to each of the 27.14 sponsor's medical education programs based on the criteria in 27.15 this paragraph. Sponsoring institutions which receive funds 27.16 from the trust fund must distribute approved funds to the 27.17 medical education program according to the commissioner's 27.18 approval letter. Further, programs must distribute funds among 27.19 the sites of trainingbased on the percentage of total program27.20training performed at each site.as specified in the 27.21 commissioner's approval letter. Any funds not distributed as 27.22 directed by the commissioner's approval letter shall be returned 27.23 to the medical education and research trust fund within 30 days 27.24 of a notice from the commissioner. The commissioner shall 27.25 distribute returned funds to the appropriate entities in 27.26 accordance with the commissioner's approval letter. 27.27 (e) Medical education programs receiving funds from the 27.28 trust fund must submitannual cost and program reportsa medical 27.29 education and research grant verification report (GVR) through 27.30 the sponsoring institution based on criteria established by the 27.31 commissioner. If the sponsoring institution fails to submit the 27.32 GVR by the stated deadline, or to request and meet the deadline 27.33 for an extension, the sponsoring institution is required to 27.34 return the full amount of the medical education and research 27.35 trust fund grant to the medical education and research trust 27.36 fund within 30 days of a notice from the commissioner. The 28.1 commissioner shall distribute returned funds to the appropriate 28.2 entities in accordance with the commissioner's approval letter. 28.3 The reports must include: 28.4 (1) the total number of eligible trainees in the program; 28.5 (2) the programs and residencies funded, the amounts of 28.6 trust fund payments to each program, and within each program, 28.7 thepercentagedollar amount distributed to each training site; 28.8 and 28.9 (3)the average cost per trainee and a detailed breakdown28.10of the components of those costs;28.11(4) other state or federal appropriations received for the28.12purposes of clinical training;28.13(5) other revenue received for the purposes of clinical28.14training; and28.15(6)other information the commissioner, with advice from 28.16 the advisory committee, deems appropriate to evaluate the 28.17 effectiveness of the use of funds for clinical training. 28.18 The commissioner, with advice from the advisory committee, 28.19 will provide an annual summary report to the legislature on 28.20 program implementation due February 15 of each year. 28.21 (f) The commissioner is authorized to distribute funds made 28.22 available through: 28.23 (1) voluntary contributions by employers or other entities; 28.24 (2) allocations for the department of human services to 28.25 support medical education and research; and 28.26 (3) other sources as identified and deemed appropriate by 28.27 the legislature for inclusion in the trust fund. 28.28 (g) The advisory committee shall continue to study and make 28.29 recommendations on: 28.30 (1) the funding of medical research consistent with work 28.31 currently mandated by the legislature and under way at the 28.32 department of health; and 28.33 (2) the costs and benefits associated with medical 28.34 education and research. 28.35 Sec. 7. Minnesota Statutes 1997 Supplement, section 28.36 62J.69, is amended by adding a subdivision to read: 29.1 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 29.2 SERVICES.] (a) The amount transferred according to section 29.3 256B.69, subdivision 5c, shall be distributed to qualifying 29.4 applicants based on a distribution formula that reflects a 29.5 summation of two factors: 29.6 (1) an education factor, which is determined by the total 29.7 number of eligible trainees and the total statewide average 29.8 costs per trainee, by type of trainee, in each program; and 29.9 (2) a public program volume factor, which is determined by 29.10 the total volume of public program revenue received by each 29.11 training site as a percentage of all public program revenue 29.12 received by all training sites in the trust fund pool. 29.13 In this formula, the education factor shall be weighted at 29.14 50 percent and the public program volume factor shall be 29.15 weighted at 50 percent. 29.16 (b) Public program revenue for the formula in paragraph (a) 29.17 shall include revenue from medical assistance, prepaid medical 29.18 assistance, general assistance medical care, and prepaid general 29.19 assistance medical care. 29.20 (c) Training sites that receive no public program revenue 29.21 shall be ineligible for payments from the prepaid medical 29.22 assistance program transfer pool. 29.23 Sec. 8. Minnesota Statutes 1997 Supplement, section 29.24 62J.69, is amended by adding a subdivision to read: 29.25 Subd. 5. [REVIEW OF ELIGIBLE PROVIDERS.] (a) Provider 29.26 groups added after January 1, 1998, to the list of providers 29.27 eligible for the trust fund shall not receive funding from the 29.28 trust fund without prior evaluation by the commissioner and the 29.29 medical education and research costs advisory committee. The 29.30 evaluation shall consider the degree to which the training of 29.31 the provider group: 29.32 (1) takes place in patient care settings, which are 29.33 consistent with the purposes of this section; 29.34 (2) is funded with patient care revenues; 29.35 (3) takes place in patient care settings, which face 29.36 increased financial pressure as a result of competition with 30.1 nonteaching patient care entities; and 30.2 (4) emphasizes primary care or specialties, which are in 30.3 undersupply in Minnesota. 30.4 Results of this evaluation shall be reported to the 30.5 legislative commission on health care access. The legislative 30.6 commission on health care access must approve funding for the 30.7 provider group prior to their receiving any funding from the 30.8 trust fund. In the event that a reviewed provider group is not 30.9 approved by the legislative commission on health care access, 30.10 trainees in that provider group shall be considered ineligible 30.11 trainees for the trust fund distribution. 30.12 (b) The commissioner and the medical education and research 30.13 costs advisory committee may also review provider groups, which 30.14 were added to the eligible list of provider groups prior to 30.15 January 1, 1998, to assure that the trust fund money continues 30.16 to be distributed consistent with the purpose of this section. 30.17 The results of any such reviews must be reported to the 30.18 legislative commission on health care access. Trainees in 30.19 provider groups, which were added prior to January 1, 1998, and 30.20 which are reviewed by the commissioner and the medical education 30.21 and research costs advisory committee, shall be considered 30.22 eligible trainees for purposes of the trust fund distribution 30.23 unless and until the legislative commission on health care 30.24 access disapproves their eligibility, in which case they shall 30.25 be considered ineligible trainees. 30.26 Sec. 9. [62J.701] [GOVERNMENTAL PROGRAMS.] 30.27 Beginning January 1, 1999, the provisions in paragraphs (a) 30.28 to (d) apply. 30.29 (a) For purposes of sections 62J.695 to 62J.80, the 30.30 requirements and other provisions that apply to health plan 30.31 companies also apply to governmental programs. 30.32 (b) For purposes of this section, "governmental programs" 30.33 means the medical assistance program, the MinnesotaCare program, 30.34 the general assistance medical care program, the state employee 30.35 group insurance program, the public employees insurance program 30.36 under section 43A.316, and coverage provided by political 31.1 subdivisions under section 471.617. 31.2 (c) Notwithstanding paragraph (a), section 62J.72 does not 31.3 apply to the fee-for-service programs under medical assistance, 31.4 MinnesotaCare, and general assistance medical care. 31.5 (d) If a state commissioner or local unit of government 31.6 contracts with a health plan company or a third party 31.7 administrator, the contract may assign any obligations under 31.8 paragraph (a) to the health plan company or third party 31.9 administrator. Nothing in this paragraph shall be construed to 31.10 remove or diminish any enforcement responsibilities of the 31.11 commissioners of health or commerce provided in sections 62J.695 31.12 to 62J.80. 31.13 Sec. 10. Minnesota Statutes 1997 Supplement, section 31.14 62J.71, subdivision 1, is amended to read: 31.15 Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.] The 31.16 following types of agreements and directives are contrary to 31.17 state public policy, are prohibited under this section, and are 31.18 null and void: 31.19 (1) any agreement or directive that prohibits a health care 31.20 provider from communicating with an enrollee with respect to the 31.21 enrollee's health status, health care, or treatment options, if 31.22 the health care provider is acting in good faith and within the 31.23 provider's scope of practice as defined by law; 31.24 (2) any agreement or directive that prohibits a health care 31.25 provider from making a recommendation regarding the suitability 31.26 or desirability of a health plan company, health insurer, or 31.27 health coverage plan for an enrollee, unless the provider has a 31.28 financial conflict of interest in the enrollee's choice of 31.29 health plan company, health insurer, or health coverage plan; 31.30 (3) any agreement or directive that prohibits a provider 31.31 from providing testimony, supporting or opposing legislation, or 31.32 making any other contact with state or federal legislators or 31.33 legislative staff or with state and federal executive branch 31.34 officers or staff; 31.35 (4) any agreement or directive that prohibits a health care 31.36 provider from disclosing accurate information about whether 32.1 services or treatment will be paid for by a patient's health 32.2 plan company or health insurer or health coverage plan; and 32.3 (5) any agreement or directive that prohibits a health care 32.4 provider from informing an enrollee about the nature of the 32.5 reimbursement methodology used by an enrollee's health plan 32.6 company, health insurer, or health coverage plan to pay the 32.7 provider. 32.8 Sec. 11. Minnesota Statutes 1997 Supplement, section 32.9 62J.71, subdivision 3, is amended to read: 32.10 Subd. 3. [RETALIATION PROHIBITED.] No person, health plan 32.11 company, or other organization may take retaliatory action 32.12 against a health care provider solely on the grounds that the 32.13 provider: 32.14 (1) refused to enter into an agreement or provide services 32.15 or information in a manner that is prohibited under this section 32.16 or took any of the actions listed in subdivision 1; 32.17 (2) disclosed accurate information about whether a health 32.18 care service or treatment is covered by an enrollee's health 32.19 plan company, health insurer, or health coverage plan;or32.20 (3) discussed diagnostic, treatment, or referral options 32.21 that are not covered or are limited by the enrollee's health 32.22 plan company, health insurer, or health coverage plan; 32.23 (4) criticized coverage of the enrollee's health plan 32.24 company, health insurer, or health coverage plan; or 32.25 (5) expressed personal disagreement with a decision made by 32.26 a person, organization, or health care provider regarding 32.27 treatment or coverage provided to a patient of the provider, or 32.28 assisted or advocated for the patient in seeking reconsideration 32.29 of such a decision, provided the health care provider makes it 32.30 clear that the provider is acting in a personal capacity and not 32.31 as a representative of or on behalf of the entity that made the 32.32 decision. 32.33 Sec. 12. Minnesota Statutes 1997 Supplement, section 32.34 62J.71, subdivision 4, is amended to read: 32.35 Subd. 4. [EXCLUSION.] (a) Nothing in this section 32.36 prohibitsa health planan entity that is subject to this 33.1 section from taking action against a provider if thehealth plan33.2 entity has evidence that the provider's actions are illegal, 33.3 constitute medical malpractice, or are contrary to accepted 33.4 medical practices. 33.5 (b) Nothing in this section prohibits a contract provision 33.6 or directive that requires any contracting party to keep 33.7 confidential or to not use or disclose the specific amounts paid 33.8 to a provider, provider fee schedules, provider salaries, and 33.9 other proprietary information of a specifichealth plan or33.10health plan companyentity that is subject to this section. 33.11 Sec. 13. Minnesota Statutes 1997 Supplement, section 33.12 62J.72, subdivision 1, is amended to read: 33.13 Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan 33.14 company, as defined under section 62J.70, subdivision 3, a 33.15 health care network cooperative as defined under section 62R.04, 33.16 subdivision 3, and a health care provider as defined under 33.17 section 62J.70, subdivision 2, shall, during open enrollment, 33.18 upon enrollment, and annually thereafter, provide enrollees with 33.19 a description of the general nature of the reimbursement 33.20 methodologies used by the health plan company, health insurer, 33.21 or health coverage plan to pay providers. The description must 33.22 explain clearly any aspect of the reimbursement methodology that 33.23 creates a financial incentive for the health care provider to 33.24 limit or restrict the health care provided to enrollees. An 33.25 entity required to disclose shall also disclose if no 33.26 reimbursement methodology is used that creates a financial 33.27 incentive for the health care provider to limit or restrict the 33.28 health care provided to enrollees. This description may be 33.29 incorporated into the member handbook, subscriber contract, 33.30 certificate of coverage, or other written enrollee 33.31 communication. The general reimbursement methodology shall be 33.32 made available to employers at the time of open enrollment. 33.33 (b) Health plan companies, health care network 33.34 cooperatives, and providers must, upon request, provide an 33.35 enrollee with specific information regarding the reimbursement 33.36 methodology, including, but not limited to, the following 34.1 information: 34.2 (1) a concise written description of the provider payment 34.3 plan, including any incentive plan applicable to the enrollee; 34.4 (2) a written description of any incentive to the provider 34.5 relating to the provision of health care services to enrollees, 34.6 including any compensation arrangement that is dependent on the 34.7 amount of health coverage or health care services provided to 34.8 the enrollee, or the number of referrals to or utilization of 34.9 specialists; and 34.10 (3) a written description of any incentive plan that 34.11 involves the transfer of financial risk to the health care 34.12 provider. 34.13 (c) The disclosure statement describing the general nature 34.14 of the reimbursement methodologies must comply with the 34.15 Readability of Insurance Policies Act in chapter 72C.34.16Notwithstanding any other law to the contrary, the disclosure34.17statement may voluntarily be filed with the commissioner for34.18approvaland must be filed with and approved by the commissioner 34.19 prior to its use. 34.20 (d) A disclosure statement that hasvoluntarilybeen filed 34.21 with the commissioner for approval underchapter 72C or34.22voluntarily filed with the commissioner for approval for34.23purposes other than pursuant to chapter 72Cparagraph (c) is 34.24 deemed approved 30 days after the date of filing, unless 34.25 approved or disapproved by the commissioner on or before the end 34.26 of that 30-day period. 34.27 (e) The disclosure statement describing the general nature 34.28 of the reimbursement methodologies must be provided upon request 34.29 in English, Spanish, Vietnamese, and Hmong. In addition, 34.30 reasonable efforts must be made to provide information contained 34.31 in the disclosure statement to other non-English-speaking 34.32 enrollees. 34.33 (f) Health plan companies and providers may enter into 34.34 agreements to determine how to respond to enrollee requests 34.35 received by either the provider or the health plan company. 34.36 This subdivision does not require disclosure of specific amounts 35.1 paid to a provider, provider fee schedules, provider salaries, 35.2 or other proprietary information of a specific health plan 35.3 company or health insurer or health coverage plan or provider. 35.4 Sec. 14. Minnesota Statutes 1997 Supplement, section 35.5 62J.75, is amended to read: 35.6 62J.75 [CONSUMER ADVISORY BOARD.] 35.7 (a) The consumer advisory board consists of 18 members 35.8 appointed in accordance with paragraph (b). All members must be 35.9 public, consumer members who: 35.10 (1) do not have and never had a material interest in either 35.11 the provision of health care services or in an activity directly 35.12 related to the provision of health care services, such as health 35.13 insurance sales or health plan administration; 35.14 (2) are not registered lobbyists; and 35.15 (3) are not currently responsible for or directly involved 35.16 in the purchasing of health insurance for a business or 35.17 organization. 35.18 (b) The governor, the speaker of the house of 35.19 representatives, and the subcommittee on committees of the 35.20 committee on rules and administration of the senate shall each 35.21 appointtwosix members.The Indian affairs council, the35.22council on affairs of Chicano/Latino people, the council on35.23Black Minnesotans, the council on Asian-Pacific Minnesotans,35.24mid-Minnesota legal assistance, and the Minnesota chamber of35.25commerce shall each appoint one member. The member appointed by35.26the Minnesota chamber of commerce must represent small business35.27interests. The health care campaign of Minnesota, Minnesotans35.28for affordable health care, and consortium for citizens with35.29disabilities shall each appoint two members. Members serve35.30without compensation or reimbursement for expenses.Members may 35.31 be compensated in accordance with section 15.059, subdivision 3, 35.32 except that members shall not receive per diem compensation or 35.33 reimbursements for child care expenses. 35.34 (c) The board shall advise the commissioners of health and 35.35 commerce on the following: 35.36 (1) the needs of health care consumers and how to better 36.1 serve and educate the consumers on health care concerns and 36.2 recommend solutions to identified problems; and 36.3 (2) consumer protection issues in the self-insured market, 36.4 including, but not limited to, public education needs. 36.5 The board also may make recommendations to the legislature 36.6 on these issues. 36.7 (d) The board and this section expire June 30, 2001. 36.8 Sec. 15. [62J.77] [DEFINITIONS.] 36.9 Subdivision 1. [APPLICABILITY.] For purposes of sections 36.10 62J.77 to 62J.80, the terms defined in this section have the 36.11 meanings given them. 36.12 Subd. 2. [ENROLLEE.] "Enrollee" means a natural person 36.13 covered by a health plan company, health insurance, or health 36.14 coverage plan and includes an insured, policyholder, subscriber, 36.15 contract holder, member, covered person, or certificate holder. 36.16 Subd. 3. [PATIENT.] "Patient" means a former, current, or 36.17 prospective patient of a health care provider. 36.18 Subd. 4. [COMMISSIONER.] "Commissioner" means the 36.19 commissioner of health. 36.20 Sec. 16. [62J.78] [ESTABLISHMENT; ORGANIZATION.] 36.21 Subdivision 1. [GENERAL.] The commissioner shall establish 36.22 within the department of health the office of health care 36.23 consumer assistance, advocacy, and information to provide 36.24 assistance, advocacy, and information to all health care 36.25 consumers within the state. The office shall have no regulatory 36.26 power or authority, shall be separated from all regulatory 36.27 functions within the department of health, and shall not provide 36.28 legal representation in a court of law. 36.29 Subd. 2. [EXECUTIVE DIRECTOR.] An executive director shall 36.30 be appointed by the commissioner, in consultation with the 36.31 consumer advisory board, and shall report directly to the 36.32 commissioner. The executive director must be selected without 36.33 regard to political affiliation and must be a person who has 36.34 knowledge and experience concerning the needs and rights of 36.35 health care consumers and must be qualified to analyze questions 36.36 of law, administrative functions, and public policy. No person 37.1 may serve as executive director while holding another public 37.2 office. The director shall serve in the unclassified service. 37.3 Subd. 3. [STAFF.] The executive director shall appoint at 37.4 least nine consumer advocates to discharge the responsibilities 37.5 and duties of the office. 37.6 Subd. 4. [TRAINING.] The executive director shall ensure 37.7 that the consumer advocates are adequately trained. 37.8 Subd. 5. [STATEWIDE ADVOCACY.] The executive director 37.9 shall assign a consumer advocate to represent each regional 37.10 coordinating board's geographic area. 37.11 Subd. 6. [FINANCIAL INTEREST.] The executive director and 37.12 staff must not have any direct personal financial interest in 37.13 the health care system, except as an individual consumer of 37.14 health care services. 37.15 Subd. 7. [ADMINISTRATION.] To the extent practical, the 37.16 office of health care consumer assistance, advocacy, and 37.17 information and all ombudsman offices with health care 37.18 responsibilities shall have their telephone systems linked in 37.19 order to facilitate immediate referrals. 37.20 Sec. 17. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF 37.21 HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.] 37.22 Subdivision 1. [DUTIES.] (a) The office of health care 37.23 consumer assistance, advocacy, and information shall provide 37.24 information and assistance to all health care consumers by: 37.25 (1) assisting patients and enrollees in understanding and 37.26 asserting their contractual and legal rights, including the 37.27 rights under an alternative dispute resolution process. This 37.28 assistance may include advocacy for enrollees in administrative 37.29 proceedings or other formal or informal dispute resolution 37.30 processes; 37.31 (2) assisting enrollees in obtaining health care referrals 37.32 under their health plan company, health insurance, or health 37.33 coverage plan; 37.34 (3) assisting patients and enrollees in accessing the 37.35 services of governmental agencies, regulatory boards, and other 37.36 state consumer assistance programs, ombudsman, or advocacy 38.1 services whenever appropriate so that the patient or enrollee 38.2 can take full advantage of existing mechanisms for resolving 38.3 complaints; 38.4 (4) referring patients and enrollees to governmental 38.5 agencies and regulatory boards for the investigation of health 38.6 care complaints and for enforcement action; 38.7 (5) educating and training enrollees about their health 38.8 plan company, health insurance, or health coverage plan in order 38.9 to enable them to assert their rights and to understand their 38.10 responsibilities; 38.11 (6) assisting enrollees in receiving a timely resolution of 38.12 their complaints; 38.13 (7) monitoring health care complaints addressed by the 38.14 office to identify specific complaint patterns or areas of 38.15 potential improvement; 38.16 (8) recommending to health plan companies ways to identify 38.17 and remove any barriers that might delay or impede the health 38.18 plan company's effort to resolve consumer complaints; and 38.19 (9) in performing the duties specified in clauses (1) to 38.20 (8), taking into consideration the special situations of 38.21 patients and enrollees who have unique culturally defined needs. 38.22 (b) The executive director shall prioritize the duties 38.23 listed in this subdivision within the appropriations allocated. 38.24 Subd. 2. [COMMUNICATION.] (a) The executive director shall 38.25 meet at least six times per year with the consumer advisory 38.26 board. The executive director shall share all public 38.27 information obtained by the office of health care consumer 38.28 assistance, advocacy, and information with the consumer advisory 38.29 board in order to assist the consumer advisory board in its role 38.30 of advising the commissioners of health and commerce and the 38.31 legislature in accordance with section 62J.75. 38.32 (b) The executive director shall have the authority to make 38.33 recommendations to the legislature on any issue related to the 38.34 needs and interests of health care consumers. 38.35 Subd. 3. [REPORTS.] Beginning July 1, 1999, the executive 38.36 director, on at least a quarterly basis, shall provide data from 39.1 the health care complaints addressed by the office to the 39.2 commissioners of health and commerce, the consumer advisory 39.3 board, the Minnesota council of health plans, and the Insurance 39.4 Federation of Minnesota. Beginning January 15, 2000, the 39.5 executive director must make an annual written report to the 39.6 legislature regarding activities of the office, including 39.7 recommendations on improving health care consumer assistance and 39.8 complaint resolution processes. 39.9 Subd. 4. [DATA PRIVACY.] (a) Consumer complaint data, 39.10 including medical records and other documentation, provided by a 39.11 patient or enrollee to the office of health care consumer 39.12 assistance, advocacy, and information shall be classified as 39.13 private data on individuals under section 13.02, subdivision 12. 39.14 (b) Except as provided in paragraph (a), all data collected 39.15 or maintained by the office in the course of assisting a patient 39.16 or enrollee in resolving a complaint, including data collected 39.17 or maintained for the purpose of assistance during a formal or 39.18 informal dispute resolution process, shall be classified as 39.19 investigative data under section 13.39 except that inactive 39.20 investigative data shall be classified as private data on 39.21 individuals under section 13.02, subdivision 12. 39.22 Sec. 18. [62J.80] [RETALIATION.] 39.23 A health plan company or health care provider shall not 39.24 retaliate or take adverse action against an enrollee or patient 39.25 who, in good faith, makes a complaint against a health plan 39.26 company or health care provider. If retaliation is suspected, 39.27 the executive director may report it to the appropriate 39.28 regulatory authority. 39.29 Sec. 19. Minnesota Statutes 1996, section 62Q.095, 39.30 subdivision 3, is amended to read: 39.31 Subd. 3. [MANDATORY OFFERING TO ENROLLEES.] (a) Each 39.32 health plan company shall offer to enrollees the option of 39.33 receiving covered services through the expanded network of 39.34 allied independent health providers established under 39.35 subdivisions 1 and 2. This expanded network option may be 39.36 offered as a separate health plan. The network may establish 40.1 separate premium rates and cost-sharing requirements for this 40.2 expanded network plan, as long as these premium rates and 40.3 cost-sharing requirements are actuarially justified and approved 40.4 by the commissioner. This subdivision does not apply to 40.5 Medicare, medical assistance, general assistance medical care, 40.6 and MinnesotaCare.This subdivision is effective January 1,40.71995, and applies to health plans issued or renewed, or offers40.8of health plans to be issued or renewed, on or after January 1,40.91995, except that this subdivision is effective January 1, 1996,40.10for collective bargaining agreements of the department of40.11employee relations and the University of Minnesota.40.12 (b) Information on this expanded provider network option 40.13 must be provided by each health plan company during open 40.14 enrollment and upon enrollment. 40.15 Sec. 20. Minnesota Statutes 1997 Supplement, section 40.16 62Q.105, subdivision 1, is amended to read: 40.17 Subdivision 1. [ESTABLISHMENT.] Each health plan company 40.18 shall establish and make available to enrollees, by July 1,199840.19 1999, an informal complaint resolution process that meets the 40.20 requirements of this section. A health plan company must make 40.21 reasonable efforts to resolve enrollee complaints, and must 40.22 inform complainants in writing of the company's decision within 40.23 30 days of receiving the complaint. The complaint resolution 40.24 process must treat the complaint and information related to it 40.25 as required under sections 72A.49 to 72A.505. 40.26 Sec. 21. [62Q.107] [PROHIBITED PROVISION; EFFECT OF DENIAL 40.27 OF CLAIM.] 40.28 Beginning January 1, 1999, no health plan, including the 40.29 coverages described in section 62A.011, subdivision 3, clauses 40.30 (7) and (10), may specify a standard of review upon which a 40.31 court may review denial of a claim or of any other decision made 40.32 by a health plan company with respect to an enrollee. This 40.33 section prohibits limiting court review to a determination of 40.34 whether the health plan company's decision is arbitrary and 40.35 capricious, an abuse of discretion, or any other standard less 40.36 favorable to the enrollee than a preponderance of the evidence. 41.1 Sec. 22. Minnesota Statutes 1997 Supplement, section 41.2 62Q.30, is amended to read: 41.3 62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 41.4 PROCESS.] 41.5 The commissioner shall establish an expedited fact finding 41.6 and dispute resolution process to assist enrollees of health 41.7 plan companies with contested treatment, coverage, and service 41.8 issues to be in effect July 1,19981999. If the disputed issue 41.9 relates to whether a service is appropriate and necessary, the 41.10 commissioner shall issue an order only after consulting with 41.11 appropriate experts knowledgeable, trained, and practicing in 41.12 the area in dispute, reviewing pertinent literature, and 41.13 considering the availability of satisfactory alternatives. The 41.14 commissioner shall take steps including but not limited to 41.15 fining, suspending, or revoking the license of a health plan 41.16 company that is the subject of repeated orders by the 41.17 commissioner that suggests a pattern of inappropriate 41.18 underutilization. 41.19 Sec. 23. Minnesota Statutes 1997 Supplement, section 41.20 103I.208, subdivision 2, is amended to read: 41.21 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 41.22 property owner is: 41.23 (1) for a well that is not in use under a maintenance 41.24 permit, $100 annually; 41.25 (2) for construction of a monitoring well, $120, which 41.26 includes the state core function fee; 41.27 (3) for a monitoring well that is unsealed under a 41.28 maintenance permit, $100 annually; 41.29 (4) for monitoring wells used as a leak detection device at 41.30 a single motor fuel retail outletor, a single petroleum bulk 41.31 storage site excluding tank farms, or a single agricultural 41.32 chemical facility site, the construction permit fee is $120, 41.33 which includes the state core function fee, per site regardless 41.34 of the number of wells constructed on the site, and the annual 41.35 fee for a maintenance permit for unsealed monitoring wells is 41.36 $100 per site regardless of the number of monitoring wells 42.1 located on site; 42.2 (5) for a groundwater thermal exchange device, in addition 42.3 to the notification fee for wells, $120, which includes the 42.4 state core function fee; 42.5 (6) for a vertical heat exchanger, $120; 42.6 (7) for a dewatering well that is unsealed under a 42.7 maintenance permit, $100 annually for each well, except a 42.8 dewatering project comprising more than five wells shall be 42.9 issued a single permit for $500 annually for wells recorded on 42.10 the permit; and 42.11 (8) for excavating holes for the purpose of installing 42.12 elevator shafts, $120 for each hole. 42.13 Sec. 24. Minnesota Statutes 1997 Supplement, section 42.14 123.70, subdivision 10, as amended by Laws 1998, chapter 305, 42.15 section 4, is amended to read: 42.16 Subd. 10. A statement required to be submitted under 42.17 subdivisions 1, 2, and 4 to document evidence of immunization 42.18 shall include month, day, and year for immunizations 42.19 administered after January 1, 1990. 42.20 (a) For persons enrolled in grades 7 and 12 during the 42.21 1996-1997 school term, the statement must indicate that the 42.22 person has received a dose of tetanus and diphtheria toxoid no 42.23 earlier than 11 years of age. 42.24 (b) Except as specified in paragraph (e), for persons 42.25 enrolled in grades 7, 8, and 12 during the 1997-1998 school 42.26 term, the statement must indicate that the person has received a 42.27 dose of tetanus and diphtheria toxoid no earlier than 11 years 42.28 of age. 42.29 (c) Except as specified in paragraph (e), for persons 42.30 enrolled in grades 7 through 12 during the 1998-1999 school term 42.31 and for each year thereafter, the statement must indicate that 42.32 the person has received a dose of tetanus and diphtheria toxoid 42.33 no earlier than 11 years of age. 42.34 (d) For persons enrolled in grades 7 through 12 during the 42.35 1996-1997 school year and for each year thereafter, the 42.36 statement must indicate that the person has received at least 43.1 two doses of vaccine against measles, mumps, and rubella, given 43.2 alone or separately and given not less than one month apart. 43.3 (e) A person who has received at least three doses of 43.4 tetanus and diphtheria toxoids, with the most recent dose given 43.5 after age six and before age 11, is not required to have 43.6 additional immunization against diphtheria and tetanus until ten 43.7 years have elapsed from the person's most recent dose of tetanus 43.8 and diphtheria toxoid. 43.9 (f) The requirement for hepatitis B vaccination shall apply 43.10 to persons enrolling in kindergarten beginning with the 43.11 2000-2001 school term. 43.12 (g) The requirement for hepatitis B vaccination shall apply 43.13 to persons enrolling inkindergarten throughgrade 7 beginning 43.14 with the2007-20082001-2002 school term. 43.15 Sec. 25. Minnesota Statutes 1997 Supplement, section 43.16 144.1494, subdivision 1, is amended to read: 43.17 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 43.18 education account is established in the health care access 43.19 fund. The commissioner shall use money from the account to 43.20 establish a loan forgiveness program for medical residents 43.21 agreeing to practice in designated rural areas, as defined by 43.22 the commissioner. Appropriations made to this account do not 43.23 cancel and are available until expended, except that at the end 43.24 of each biennium the commissioner shall cancel to the health 43.25 care access fund any remaining unobligated balance in this 43.26 account. 43.27 Sec. 26. [144.6905] [OCCUPATIONAL RESPIRATORY DISEASE 43.28 INFORMATION SYSTEM ADVISORY GROUP.] 43.29 Subdivision 1. [ADVISORY GROUP.] The commissioner of 43.30 health shall convene an occupational respiratory disease 43.31 advisory group and shall consult with the group on the 43.32 development, implementation, and ongoing operation of an 43.33 occupational respiratory disease information system. Membership 43.34 in the group shall include representatives of academia, 43.35 government, industry, labor, medicine, and consumers from areas 43.36 of the state targeted by the information system. From members 44.1 of the advisory group, the commissioner shall form a technical 44.2 and medical committee to create information system protocols and 44.3 a legal and policy committee to address data privacy issues. 44.4 The advisory group is governed by section 15.059, except that 44.5 members shall not receive per diem compensation. 44.6 Subd. 2. [DATA PROVISIONS.] No individually identifying 44.7 data shall be collected or entered into the occupational 44.8 respiratory disease information system without further action of 44.9 the legislature. 44.10 Sec. 27. Minnesota Statutes 1996, section 144.701, 44.11 subdivision 1, is amended to read: 44.12 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 44.13 health shall ensure that the total costs, total 44.14 revenues, overall utilization, and total services of each 44.15 hospital and each outpatient surgical center are reported to the 44.16 public in a form understandable to consumers. 44.17 Sec. 28. Minnesota Statutes 1996, section 144.701, 44.18 subdivision 2, is amended to read: 44.19 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 44.20 health shall compile relevant financial and accounting, 44.21 utilization, and services data concerning hospitals and 44.22 outpatient surgical centers in order to have statistical 44.23 information available for legislative policy making. 44.24 Sec. 29. Minnesota Statutes 1996, section 144.701, 44.25 subdivision 4, is amended to read: 44.26 Subd. 4. [FILING FEES.] Each report which is required to 44.27 be submitted to the commissioner of health under sections 44.28 144.695 to 144.703 and which is not submitted to a voluntary, 44.29 nonprofit reporting organization in accordance with section 44.30 144.702 shall be accompanied by a filing fee in an amount 44.31 prescribed by rule of the commissioner of health.Fees received44.32pursuant to this subdivision shall be deposited in the general44.33fund of the state treasury.Upon the withdrawal of approval of 44.34 a reporting organization, or the decision of the commissioner to 44.35 not renew a reporting organization, fees collected under section 44.36 144.702 shall be submitted to the commissionerand deposited in45.1the general fund. Fees received under this subdivision shall be 45.2 deposited in a revolving fund and are appropriated to the 45.3 commissioner of health for the purposes of sections 144.695 to 45.4 144.703. The commissioner shall report the termination or 45.5 nonrenewal of the voluntary reporting organization to the chair 45.6 of the health and human services subdivision of the 45.7 appropriations committee of the house of representatives, to the 45.8 chair of the health and human services division of the finance 45.9 committee of the senate, and the commissioner of finance. 45.10 Sec. 30. Minnesota Statutes 1996, section 144.702, 45.11 subdivision 1, is amended to read: 45.12 Subdivision 1. [REPORTING THROUGH A REPORTING 45.13 ORGANIZATION.] A hospital or outpatient surgical center may 45.14 agree to submit its financial, utilization, and services reports 45.15 to a voluntary, nonprofit reporting organization whose reporting 45.16 procedures have been approved by the commissioner of health in 45.17 accordance with this section. Each report submitted to the 45.18 voluntary, nonprofit reporting organization under this section 45.19 shall be accompanied by a filing fee. 45.20 Sec. 31. Minnesota Statutes 1996, section 144.702, 45.21 subdivision 2, is amended to read: 45.22 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 45.23 PROCEDURES.] The commissioner of health may approve voluntary 45.24 reporting procedures consistent with written operating 45.25 requirements for the voluntary, nonprofit reporting organization 45.26 which shall be established annually by the commissioner. These 45.27 written operating requirements shall specify reports, analyses, 45.28 and other deliverables to be produced by the voluntary, 45.29 nonprofit reporting organization, and the dates on which those 45.30 deliverables must be submitted to the commissioner. These 45.31 written operating requirements shall specify deliverable dates 45.32 sufficient to enable the commissioner of health to process and 45.33 report health care cost information system data to the 45.34 commissioner of human services by August 15 of each year. The 45.35 commissioner of health shall, by rule, prescribe standards for 45.36 submission of data by hospitals and outpatient surgical centers 46.1 to the voluntary, nonprofit reporting organization or to the 46.2 commissioner. These standards shall provide for: 46.3 (a) the filing of appropriate financial, utilization, and 46.4 services information with the reporting organization; 46.5 (b) adequate analysis and verification of that financial, 46.6 utilization, and services information; and 46.7 (c) timely publication of the costs, revenues, and rates of 46.8 individual hospitals and outpatient surgical centers prior to 46.9 the effective date of any proposed rate increase. The 46.10 commissioner of health shall annually review the procedures 46.11 approved pursuant to this subdivision. 46.12 Sec. 32. Minnesota Statutes 1996, section 144.702, 46.13 subdivision 8, is amended to read: 46.14 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 46.15 ORGANIZATION.] The commissioner may withdraw approval of any 46.16 voluntary, nonprofit reporting organization for failure on the 46.17 part of the voluntary, nonprofit reporting organization to 46.18 comply with the written operating requirements under subdivision 46.19 2. Upon the effective date of the withdrawal, all funds 46.20 collected by the voluntary, nonprofit reporting organization 46.21 undersection 144.701,subdivision41, but not expended shall 46.22 be deposited inthe general funda revolving fund and are 46.23 appropriated to the commissioner of health for the purposes of 46.24 sections 144.695 to 144.703. 46.25 The commissioner may choose not to renew approval of a 46.26 voluntary, nonprofit reporting organization if the organization 46.27 has failed to perform its obligations satisfactorily under the 46.28 written operating requirements under subdivision 2. 46.29 Sec. 33. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 46.30 REPORTING ORGANIZATIONS.] 46.31 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 46.32 an order to the voluntary, nonprofit reporting organization 46.33 requiring violations to be corrected and administratively assess 46.34 monetary penalties for violations of sections 144.695 to 144.703 46.35 or rules, written operating requirements, orders, stipulation 46.36 agreements, settlements, or compliance agreements adopted, 47.1 enforced, or issued by the commissioner. 47.2 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 47.3 administrative penalty under this section must include: 47.4 (1) a concise statement of the facts alleged to constitute 47.5 a violation; 47.6 (2) a reference to the section of law, rule, written 47.7 operating requirement, order, stipulation agreement, settlement, 47.8 or compliance agreement that has been violated; 47.9 (3) a statement of the amount of the administrative penalty 47.10 to be imposed and the factors upon which the penalty is based; 47.11 (4) a statement of the corrective actions necessary to 47.12 correct the violation; and 47.13 (5) a statement of the right to request a hearing according 47.14 to sections 14.57 to 14.62. 47.15 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 47.16 may issue an order assessing an administrative penalty and 47.17 requiring the violations cited in the order be corrected within 47.18 30 calendar days from the date the order is received. Before 47.19 the 31st day after the order was received, the voluntary, 47.20 nonprofit reporting organization that is subject to the order 47.21 shall provide the commissioner with information demonstrating 47.22 that the violation has been corrected or that a corrective plan 47.23 acceptable to the commissioner has been developed. The 47.24 commissioner shall determine whether the violation has been 47.25 corrected and notify the voluntary, nonprofit reporting 47.26 organization of the commissioner's determination. 47.27 Subd. 4. [PENALTY.] If the commissioner determines that 47.28 the violation has been corrected or an acceptable corrective 47.29 plan has been developed, the penalty may be forgiven, except 47.30 where there are repeated or serious violations, the commissioner 47.31 may issue an order with a penalty that will not be forgiven 47.32 after corrective action is taken. Unless there is a request for 47.33 review of the order under subdivision 6 before the penalty is 47.34 due, the penalty is due and payable: 47.35 (1) on the 31st calendar day after the order was received, 47.36 if the voluntary, nonprofit reporting organization fails to 48.1 provide information to the commissioner showing that the 48.2 violation has been corrected or that appropriate steps have been 48.3 taken toward correcting the violation; 48.4 (2) on the 20th day after the voluntary, nonprofit 48.5 reporting organization receives the commissioner's determination 48.6 that the information provided is not sufficient to show that 48.7 either the violation has been corrected or that appropriate 48.8 steps have been taken toward correcting the violation; or 48.9 (3) on the 31st day after the order was received where the 48.10 penalty is for repeated or serious violations and according to 48.11 the order issued, the penalty will not be forgiven after 48.12 corrective action is taken. 48.13 All penalties due under this section are payable to the 48.14 treasurer, state of Minnesota, and shall be deposited in the 48.15 general fund. 48.16 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 48.17 maximum amount of an administrative penalty order is $5,000 for 48.18 each specific violation identified in an inspection, 48.19 investigation, or compliance review, up to an annual maximum 48.20 total for all violations of ten percent of the fees collected by 48.21 the voluntary, nonprofit reporting organization under section 48.22 144.702, subdivision 1. The annual maximum is based on a 48.23 reporting year. 48.24 (b) In determining the amount of the administrative 48.25 penalty, the commissioner shall consider the following: 48.26 (1) the willfulness of the violation; 48.27 (2) the gravity of the violation; 48.28 (3) the history of past violations; 48.29 (4) the number of violations; 48.30 (5) the economic benefit gained by the person allowing or 48.31 committing the violation; and 48.32 (6) other factors as justice may require, if the 48.33 commissioner specifically identifies the additional factors in 48.34 the commissioner's order. 48.35 (c) In determining the amount of a penalty for a violation 48.36 subsequent to an initial violation under paragraph (a), the 49.1 commissioner shall also consider: 49.2 (1) the similarity of the most recent previous violation 49.3 and the violation to be penalized; 49.4 (2) the time elapsed since the last violation; and 49.5 (3) the response of the voluntary, nonprofit reporting 49.6 organization to the most recent previous violation. 49.7 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 49.8 ORDER.] A request for hearing must be in writing, delivered to 49.9 the commissioner by certified mail within 20 calendar days after 49.10 the receipt of the order, and specifically state the reasons for 49.11 seeking review of the order. The commissioner must initiate a 49.12 hearing within 30 calendar days from the date of receipt of the 49.13 written request for hearing. The hearing shall be conducted 49.14 pursuant to the contested case procedures in sections 14.57 to 49.15 14.62. No earlier than ten calendar days after and within 30 49.16 calendar days of receipt of the presiding administrative law 49.17 judge's report, the commissioner shall, based on all relevant 49.18 facts, issue a final order modifying, vacating, or making the 49.19 original order permanent. If, within 20 calendar days of 49.20 receipt of the original order, the voluntary, nonprofit 49.21 reporting organization fails to request a hearing in writing, 49.22 the order becomes the final order of the commissioner. 49.23 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 49.24 PENALTY.] Once the commissioner issues a final order, any 49.25 penalty due under that order shall be paid within 30 calendar 49.26 days after the date of the final order, unless review of the 49.27 final order is requested. The final order of the commissioner 49.28 may be appealed in the manner prescribed in sections 14.63 to 49.29 14.69. If the final order is reviewed and upheld, the penalty 49.30 shall be paid 30 calendar days after the date of the decision of 49.31 the reviewing court. Failure to request an administrative 49.32 hearing pursuant to subdivision 6 shall constitute a waiver of 49.33 the right to further agency or judicial review of the final 49.34 order. 49.35 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If, 49.36 upon reinspection, or in the determination of the commissioner, 50.1 it is found that any deficiency specified in the order has not 50.2 been corrected or an acceptable corrective plan has not been 50.3 developed, the voluntary, nonprofit reporting organization is in 50.4 noncompliance. The commissioner shall issue a notice of 50.5 noncompliance and may impose any additional remedy available 50.6 under this chapter. 50.7 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 50.8 on behalf of the commissioner to enforce penalties that are due 50.9 and payable under this section in any manner provided by law for 50.10 the collection of debts. 50.11 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 50.12 ORGANIZATION.] The commissioner may withdraw or not renew 50.13 approval of any voluntary, nonprofit reporting organization for 50.14 failure on the part of the voluntary, nonprofit reporting 50.15 organization to pay penalties owed under this section. 50.16 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 50.17 commissioner to issue an administrative penalty order is in 50.18 addition to other lawfully available remedies. 50.19 Subd. 12. [MEDIATION.] In addition to review under 50.20 subdivision 6, the commissioner is authorized to enter into 50.21 mediation concerning an order issued under this section if the 50.22 commissioner and the voluntary, nonprofit reporting organization 50.23 agree to mediation. 50.24 Sec. 34. Minnesota Statutes 1996, section 144.9501, 50.25 subdivision 1, is amended to read: 50.26 Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509 50.27 may be cited as the "childhoodLead Poisoning Prevention Act." 50.28 Sec. 35. Minnesota Statutes 1996, section 144.9501, is 50.29 amended by adding a subdivision to read: 50.30 Subd. 4a. [ASSESSING AGENCY.] "Assessing agency" means the 50.31 commissioner or a board of health with authority and 50.32 responsibility to conduct lead risk assessments in response to 50.33 reports of children or pregnant women with elevated blood lead 50.34 levels. 50.35 Sec. 36. Minnesota Statutes 1996, section 144.9501, is 50.36 amended by adding a subdivision to read: 51.1 Subd. 6b. [CLEARANCE INSPECTION.] "Clearance inspection" 51.2 means a visual identification of deteriorated paint and bare 51.3 soil and a resampling and analysis of interior dust lead 51.4 concentrations in a residence to ensure that the lead standards 51.5 established in rules adopted under section 144.9508 are not 51.6 exceeded. 51.7 Sec. 37. Minnesota Statutes 1996, section 144.9501, 51.8 subdivision 17, is amended to read: 51.9 Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard reduction" 51.10 means action undertakenin response to a lead orderto make a 51.11 residence, child care facility, school, or playground lead-safe 51.12 by complying with the lead standards and methods adopted under 51.13 section 144.9508, by: 51.14 (1) a property owner orlead contractor complyingpersons 51.15 hired by the property owner to comply with a lead order issued 51.16 under section 144.9504;or51.17 (2) a swab team service provided in response to a lead 51.18 order issued under section 144.9504; or 51.19 (3) a renter residing at a rental property or one or more 51.20 volunteers to comply with a lead order issued under section 51.21 144.9504. 51.22 Sec. 38. Minnesota Statutes 1996, section 144.9501, is 51.23 amended by adding a subdivision to read: 51.24 Subd. 17a. [LEAD HAZARD SCREEN.] "Lead hazard screen" 51.25 means visual identification of the existence and location of any 51.26 deteriorated paint, collection and analysis of dust samples, and 51.27 visual identification of the existence and location of bare soil. 51.28 Sec. 39. Minnesota Statutes 1996, section 144.9501, 51.29 subdivision 18, is amended to read: 51.30 Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a 51.31qualitative orquantitativeanalytical inspection of a residence51.32for deteriorated paint or bare soil and the collection of51.33samples of deteriorated paint, bare soil, dust, or drinking51.34water for analysis to determine if the lead concentrations in51.35the samples exceed standards adopted under section 144.9508.51.36Lead inspection includes the clearance inspection after the52.1completion of a lead ordermeasurement of the lead content of 52.2 paint and a visual identification of the existence and location 52.3 of bare soil. 52.4 Sec. 40. Minnesota Statutes 1996, section 144.9501, 52.5 subdivision 20, is amended to read: 52.6 Subd. 20. [LEAD ORDER.] "Lead order" means a legal 52.7 instrument to compel a property owner to engage in lead hazard 52.8 reduction according to the specifications given by the 52.9inspectingassessing agency. 52.10 Sec. 41. Minnesota Statutes 1996, section 144.9501, is 52.11 amended by adding a subdivision to read: 52.12 Subd. 20a. [LEAD PROJECT DESIGNER.] "Lead project designer" 52.13 means an individual who is responsible for planning the 52.14 site-specific performance of lead abatement or lead hazard 52.15 reduction and who has been licensed by the commissioner under 52.16 section 144.9505. 52.17 Sec. 42. Minnesota Statutes 1996, section 144.9501, is 52.18 amended by adding a subdivision to read: 52.19 Subd. 20b. [LEAD RISK ASSESSMENT.] "Lead risk assessment" 52.20 means a quantitative measurement of the lead content of paint, 52.21 interior dust, and bare soil to determine compliance with the 52.22 standards established under section 144.9508. 52.23 Sec. 43. Minnesota Statutes 1996, section 144.9501, is 52.24 amended by adding a subdivision to read: 52.25 Subd. 20c. [LEAD RISK ASSESSOR.] "Lead risk assessor" 52.26 means an individual who performs lead risk assessments or lead 52.27 inspections and who has been licensed by the commissioner under 52.28 section 144.9506. 52.29 Sec. 44. Minnesota Statutes 1996, section 144.9501, is 52.30 amended by adding a subdivision to read: 52.31 Subd. 22a. [LEAD SUPERVISOR.] "Lead supervisor" means an 52.32 individual who is responsible for the on-site performance of 52.33 lead abatement or lead hazard reduction and who has been 52.34 licensed by the commissioner under section 144.9505. 52.35 Sec. 45. Minnesota Statutes 1996, section 144.9501, 52.36 subdivision 23, is amended to read: 53.1 Subd. 23. [LEAD WORKER.] "Lead worker" meansany person53.2who is certifiedan individual who performs lead abatement or 53.3 lead hazard reduction and who has been licensed by the 53.4 commissioner under section 144.9505. 53.5 Sec. 46. Minnesota Statutes 1996, section 144.9501, is 53.6 amended by adding a subdivision to read: 53.7 Subd. 25a. [PLAY AREA.] "Play area" means any established 53.8 area where children play, or on residential property, any 53.9 established area where children play or bare soil is accessible 53.10 to children. 53.11 Sec. 47. Minnesota Statutes 1996, section 144.9501, is 53.12 amended by adding a subdivision to read: 53.13 Subd. 28a. [STANDARD.] "Standard" means a quantitative 53.14 assessment of lead in any environmental media or consumer 53.15 product, or a work practice or method that reduces the 53.16 likelihood of lead exposure. 53.17 Sec. 48. Minnesota Statutes 1996, section 144.9501, 53.18 subdivision 30, is amended to read: 53.19 Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" meansa53.20person who is certifiedan individual who performs swab team 53.21 services and who has been licensed by the commissioner as a lead 53.22 worker under section 144.9505. 53.23 Sec. 49. Minnesota Statutes 1996, section 144.9501, 53.24 subdivision 32, is amended to read: 53.25 Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary 53.26 lead hazard reduction" meansaction undertaken by a property53.27owner with the intention to engage in lead hazard reduction or53.28abatementlead hazard reduction activities defined in 53.29 subdivision 17, but not undertaken in response to the issuance 53.30 of a lead order. 53.31 Sec. 50. Minnesota Statutes 1996, section 144.9502, 53.32 subdivision 3, is amended to read: 53.33 Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a) 53.34 Every hospital, medical clinic, medical laboratory,orother 53.35 facility, or individual performing blood lead analysis shall 53.36 report the results after the analysis of each specimen analyzed, 54.1 for both capillary and venous specimens, and epidemiologic 54.2 information required in this section to the commissioner of 54.3 health, within the time frames set forth in clauses (1) and (2): 54.4 (1) within two working days by telephone, fax, or 54.5 electronic transmission, with written or electronic confirmation 54.6 within one month, for a venous blood lead level equal to or 54.7 greater than 15 micrograms of lead per deciliter of whole blood; 54.8 or 54.9 (2) within one month in writing or by electronic 54.10 transmission, foraany capillary result or for a venous blood 54.11 lead level less than 15 micrograms of lead per deciliter of 54.12 whole blood. 54.13 (b) If a blood lead analysis is performed outside of 54.14 Minnesota and the facility performing the analysis does not 54.15 report the blood lead analysis results and epidemiological 54.16 information required in this section to the commissioner, the 54.17 provider who collected the blood specimen must satisfy the 54.18 reporting requirements of this section. For purposes of this 54.19 section, "provider" has the meaning given in section 62D.02, 54.20 subdivision 9. 54.21 (c) The commissioner shall coordinate with hospitals, 54.22 medical clinics, medical laboratories, and other facilities 54.23 performing blood lead analysis to develop a universal reporting 54.24 form and mechanism. 54.25The reporting requirements of this subdivision shall expire54.26on December 31, 1997. Beginning January 1, 1998, every54.27hospital, medical clinic, medical laboratory, or other facility54.28performing blood lead analysis shall report the results within54.29two working days by telephone, fax, or electronic transmission,54.30with written or electronic confirmation within one month, for54.31capillary or venous blood lead level equal to the level for54.32which reporting is recommended by the Center for Disease Control.54.33 Sec. 51. Minnesota Statutes 1996, section 144.9502, 54.34 subdivision 4, is amended to read: 54.35 Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC 54.36 INFORMATION.] The blood lead analysis reports required in this 55.1 section must specify: 55.2 (1) whether the specimen was collected as a capillary or 55.3 venous sample; 55.4 (2) the date the sample was collected; 55.5 (3) the results of the blood lead analysis; 55.6 (4) the date the sample was analyzed; 55.7 (5) the method of analysis used; 55.8 (6) the full name, address, and phone number of the 55.9 laboratory performing the analysis; 55.10 (7) the full name, address, and phone number of the 55.11 physician or facility requesting the analysis; 55.12 (8) the full name, address, and phone number of the person 55.13 with theelevatedblood lead level, and the person's birthdate, 55.14 gender, and race. 55.15 Sec. 52. Minnesota Statutes 1996, section 144.9502, 55.16 subdivision 9, is amended to read: 55.17 Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any law 55.18 to the contrary, including section 13.05, subdivision 9, data 55.19 collected by the commissioner of health about persons with 55.20elevatedblood lead levels, including analytic results from 55.21 samples of paint, soil, dust, and drinking water taken from the 55.22 individual's home and immediate property, shall be private and 55.23 may only be used by the commissioner of health, the commissioner 55.24 of labor and industry, authorized agents of Indian tribes, and 55.25 authorized employees of local boards of health for the purposes 55.26 set forth in this section. 55.27 Sec. 53. Minnesota Statutes 1996, section 144.9503, 55.28 subdivision 4, is amended to read: 55.29 Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must 55.30 include the use of swab team services in census tracts 55.31 identified at high risk for toxic lead exposure as identified by 55.32 the commissioner under this section. The swab team services may 55.33 be provided based onvisual inspectionslead hazard screens 55.34 whenever possible and must at least include lead 55.35 hazardmanagementreduction for deteriorated interior lead-based 55.36 paint, bare soil, and dust. 56.1 Sec. 54. Minnesota Statutes 1996, section 144.9503, 56.2 subdivision 6, is amended to read: 56.3 Subd. 6. [VOLUNTARY LEAD ABATEMENT OR LEAD HAZARD 56.4 REDUCTION.] The commissioner shall monitor the lead abatement or 56.5 lead hazard reduction methods adopted under section 144.9508 in 56.6 cases of voluntary lead abatement or lead hazard reduction. All 56.7contractorspersons hired to do voluntary lead abatement or lead 56.8 hazard reduction must be licensedlead contractorsby the 56.9 commissioner under section 144.9505 or 144.9506. Renters and 56.10 volunteers performing lead abatement or lead hazard reduction 56.11 must be trained and licensed as lead supervisors or lead 56.12 workers. If a property owner does notuse a lead contractor56.13 hire a person for voluntary lead abatement or lead hazard 56.14 reduction, the property owner shall provide the commissioner 56.15 with a work plan for lead abatement or lead hazard reduction at 56.16 least ten working days before beginning the lead abatement or 56.17 lead hazard reduction. The work plan must include the details 56.18 required in section 144.9505, and notice as to when 56.19 lead abatement or lead hazard reduction activities will begin. 56.20 Within the limits of appropriations, the commissioner shall 56.21 review work plans and shall approve or disapprove them as to 56.22 compliance with the requirements in section 144.9505. No 56.23 penalty shall be assessed against a property owner for 56.24 discontinuing voluntary lead hazard reduction before completion 56.25 of the work plan, provided that the property owner discontinues 56.26 theplanlead hazard reduction in a manner that leaves the 56.27 property in a condition no more hazardous than its condition 56.28 before the work plan implementation. 56.29 Sec. 55. Minnesota Statutes 1996, section 144.9503, 56.30 subdivision 7, is amended to read: 56.31 Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July 56.32 1, 1995, and amended and updated as necessary, the commissioner 56.33 shall develop in cooperation with the commissioner of 56.34 administration provisions and procedures to define 56.35 lead-safe informational directives for residential remodeling, 56.36 renovation, installation, and rehabilitation activities that are 57.1 not lead hazard reduction, but may disrupt lead-based paint 57.2 surfaces. 57.3 (b) The provisions and procedures shall define lead-safe 57.4 directives for nonlead hazard reduction activities including 57.5 preparation, cleanup, and disposal procedures. The directives 57.6 shall be based on the different levels and types of work 57.7 involved and the potential for lead hazards. The directives 57.8 shall address activities including painting; remodeling; 57.9 weatherization; installation of cable, wire, plumbing, and gas; 57.10 and replacement of doors and windows. The commissioners of 57.11 health and administration shall consult with representatives of 57.12 builders, weatherization providers, nonprofit rehabilitation 57.13 organizations, each of the affected trades, and housing and 57.14 redevelopment authorities in developing the directives and 57.15 procedures. This group shall also make recommendations for 57.16 consumer and contractor education and training. The 57.17 commissioner of health shall report to the legislature by 57.18 February 15, 1996, regarding development of the provisions 57.19 required under thissubdivisionparagraph. 57.20 (c) By January 1, 1999, the commissioner, in cooperation 57.21 with interested and informed persons and using the meeting 57.22 structure and format developed in paragraph (b), shall develop 57.23 lead-safe informational directives on the following topics: 57.24 (1) maintaining floors, walls, and ceilings; 57.25 (2) maintaining and repairing porches; 57.26 (3) conducting a risk evaluation for lead; and 57.27 (4) prohibited practices when working with lead. 57.28 The commissioner shall report to the legislature by January 1, 57.29 1999, regarding development of the provisions required under 57.30 this paragraph. 57.31 Sec. 56. Minnesota Statutes 1996, section 144.9504, 57.32 subdivision 1, is amended to read: 57.33 Subdivision 1. [JURISDICTION.] (a) A board of health 57.34 serving cities of the first class must conduct leadinspections57.35 risk assessments for purposes of secondary prevention, according 57.36 to the provisions of this section. A board of health not 58.1 serving cities of the first class must conduct leadinspections58.2 risk assessments for the purposes of secondary prevention, 58.3 unless theycertifycertified in writing to the commissioner by 58.4 January 1, 1996, that theydesiredesired to relinquish these 58.5 duties back to the commissioner. At the discretion of the 58.6 commissioner, a board of health may relinquish the authority and 58.7 duty to perform lead risk assessments for secondary prevention 58.8 by so certifying in writing to the commissioner by December 31, 58.9 1999. At the discretion of the commissioner, a board of health 58.10 may, upon written request to the commissioner, resume these 58.11 duties. 58.12 (b)InspectionsLead risk assessments must be conducted by 58.13 a board of health serving a city of the first class. The 58.14 commissioner must conduct leadinspectionsrisk assessments in 58.15 any area not including cities of the first class where a board 58.16 of health has relinquished to the commissioner the 58.17 responsibility for leadinspectionsrisk assessments. The 58.18 commissioner shall coordinate with the board of health to ensure 58.19 that the requirements of this section are met. 58.20 (c) The commissioner may assist boards of health by 58.21 providing technical expertise, equipment, and personnel to 58.22 boards of health. The commissioner may provide laboratory or 58.23 field lead-testing equipment to a board of health or may 58.24 reimburse a board of health for direct costs associated with 58.25 leadinspectionsrisk assessments. 58.26 (d) The commissioner shall enforce the rules under section 58.27 144.9508 in cases of voluntary lead hazard reduction. 58.28 Sec. 57. Minnesota Statutes 1997 Supplement, section 58.29 144.9504, subdivision 2, is amended to read: 58.30 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT.] (a) 58.31 Aninspectingassessing agency shall conduct a leadinspection58.32 risk assessment of a residence according to the venous blood 58.33 lead level and time frame set forth in clauses (1) to (5) for 58.34 purposes of secondary prevention: 58.35 (1) within 48 hours of a child or pregnant female in the 58.36 residence being identified to the agency as having a venous 59.1 blood lead level equal to or greater than 70 micrograms of lead 59.2 per deciliter of whole blood; 59.3 (2) within five working days of a child or pregnant female 59.4 in the residence being identified to the agency as having a 59.5 venous blood lead level equal to or greater than 45 micrograms 59.6 of lead per deciliter of whole blood; 59.7 (3) within ten working days of a child in the residence 59.8 being identified to the agency as having a venous blood lead 59.9 level equal to or greater than 20 micrograms of lead per 59.10 deciliter of whole blood; 59.11 (4) within ten working days of a child in the residence 59.12 being identified to the agency as having a venous blood lead 59.13 level that persists in the range of 15 to 19 micrograms of lead 59.14 per deciliter of whole blood for 90 days after initial 59.15 identification; or 59.16 (5) within ten working days of a pregnant female in the 59.17 residence being identified to the agency as having a venous 59.18 blood lead level equal to or greater than ten micrograms of lead 59.19 per deciliter of whole blood. 59.20 (b) Within the limits of available state and federal 59.21 appropriations, aninspectingassessing agency may also conduct 59.22 a leadinspectionrisk assessment for children with any elevated 59.23 blood lead level. 59.24 (c) In a building with two or more dwelling units, an 59.25inspectingassessing agency shall inspect the individual unit in 59.26 which the conditions of this section are met and shall also 59.27 inspect all common areas. If a child visits one or more other 59.28 sites such as another residence, or a residential or commercial 59.29 child care facility, playground, or school, theinspecting59.30 assessing agency shall also inspect the other sites. 59.31 Theinspectingassessing agency shall have one additional day 59.32 added to the time frame set forth in this subdivision to 59.33 complete the leadinspectionrisk assessment for each additional 59.34 site. 59.35 (d) Within the limits of appropriations, theinspecting59.36 assessing agency shall identify the known addresses for the 60.1 previous 12 months of the child or pregnant female with venous 60.2 blood lead levels of at least 20 micrograms per deciliter for 60.3 the child or at least ten micrograms per deciliter for the 60.4 pregnant female; notify the property owners, landlords, and 60.5 tenants at those addresses that an elevated blood lead level was 60.6 found in a person who resided at the property; and give them a 60.7 copy of the leadinspectionrisk assessment guide. The 60.8inspectingassessing agency shall provide the notice required by 60.9 this subdivision without identifying the child or pregnant 60.10 female with the elevated blood lead level. Theinspecting60.11 assessing agency is not required to obtain the consent of the 60.12 child's parent or guardian or the consent of the pregnant female 60.13 for purposes of this subdivision. This information shall be 60.14 classified as private data on individuals as defined under 60.15 section 13.02, subdivision 12. 60.16 (e) Theinspectingassessing agency shall conduct the lead 60.17inspectionrisk assessment according to rules adopted by the 60.18 commissioner under section 144.9508. Aninspectingassessing 60.19 agency shall have leadinspectionsrisk assessments performed by 60.20 leadinspectorsrisk assessors licensed by the commissioner 60.21 according to rules adopted under section 144.9508. If a 60.22 property owner refuses to allowan inspectiona lead risk 60.23 assessment, theinspectingassessing agency shall begin legal 60.24 proceedings to gain entry to the property and the time frame for 60.25 conducting a leadinspectionrisk assessment set forth in this 60.26 subdivision no longer applies.An inspectorA lead risk 60.27 assessor orinspectingassessing agency may observe the 60.28 performance of lead hazard reduction in progress and shall 60.29 enforce the provisions of this section under section 144.9509. 60.30 Deteriorated painted surfaces, bare soil, and dust, and drinking60.31watermust be tested with appropriate analytical equipment to 60.32 determine the lead content, except that deteriorated painted 60.33 surfaces or bare soil need not be tested if the property owner 60.34 agrees to engage in lead hazard reduction on those 60.35 surfaces. The lead content of drinking water must be measured 60.36 if a probable source of lead exposure is not identified by 61.1 measurement of lead in paint, bare soil, or dust. Within a 61.2 standard metropolitan statistical area, an assessing agency may 61.3 order lead hazard reduction of bare soil without measuring the 61.4 lead content of the bare soil if the property is in a census 61.5 tract in which soil sampling has been performed according to 61.6 rules established by the commissioner and at least 25 percent of 61.7 the soil samples contain lead concentrations above the standard 61.8 in section 144.9508. 61.9 (f) A leadinspectorrisk assessor shall notify the 61.10 commissioner and the board of health of all violations of lead 61.11 standards under section 144.9508, that are identified in a 61.12 leadinspectionrisk assessment conducted under this section. 61.13 (g) Eachinspectingassessing agency shall establish an 61.14 administrative appeal procedure which allows a property owner to 61.15 contest the nature and conditions of any lead order issued by 61.16 theinspectingassessing agency.InspectingAssessing agencies 61.17 must consider appeals that propose lower cost methods that make 61.18 the residence lead safe. 61.19 (h) Sections 144.9501 to 144.9509 neither authorize nor 61.20 prohibit aninspectingassessing agency from charging a property 61.21 owner for the cost of a leadinspectionrisk assessment. 61.22 Sec. 58. Minnesota Statutes 1996, section 144.9504, 61.23 subdivision 3, is amended to read: 61.24 Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a 61.25 leadinspectionrisk assessment or following a lead order, the 61.26inspectingassessing agency shall ensure that a family will 61.27 receive a visit at their residence by a swab team worker or 61.28 public health professional, such as a nurse, sanitarian, public 61.29 health educator, or other public health professional. The swab 61.30 team worker or public health professional shall inform the 61.31 property owner, landlord, and the tenant of the health-related 61.32 aspects of lead exposure; nutrition; safety measures to minimize 61.33 exposure; methods to be followed before, during, and after the 61.34 lead hazard reduction process; and community, legal, and housing 61.35 resources. If a family moves to a temporary residence during 61.36 the lead hazard reduction process, lead education services 62.1 should be provided at the temporary residence whenever feasible. 62.2 Sec. 59. Minnesota Statutes 1996, section 144.9504, 62.3 subdivision 4, is amended to read: 62.4 Subd. 4. [LEADINSPECTIONRISK ASSESSMENT GUIDES.] (a) The 62.5 commissioner of health shall develop or purchase leadinspection62.6 risk assessment guides that enable parents and other caregivers 62.7 to assess the possible lead sources present and that suggest 62.8 lead hazard reduction actions. The guide must provide 62.9 information on lead hazard reduction and disposal methods, 62.10 sources of equipment, and telephone numbers for additional 62.11 information to enable the persons to either selecta lead62.12contractorpersons licensed by the commissioner under section 62.13 144.9505 or 144.9506 to perform lead hazard reduction or perform 62.14 the lead hazard reduction themselves. The guides must explain: 62.15 (1) the requirements of this section and rules adopted 62.16 under section 144.9508; 62.17 (2) information on the administrative appeal procedures 62.18 required under this section; 62.19 (3) summary information on lead-safe directives; 62.20 (4) be understandable at an eighth grade reading level; and 62.21 (5) be translated for use by non-English-speaking persons. 62.22 (b) Aninspectingassessing agency shall provide the lead 62.23inspectionrisk assessment guides at no cost to: 62.24 (1) parents and other caregivers of children who are 62.25 identified as having blood lead levels of at least ten 62.26 micrograms of lead per deciliter of whole blood; 62.27 (2) all property owners who are issued housing code or lead 62.28 orders requiring lead hazard reduction of lead sources and all 62.29 occupants of those properties; and 62.30 (3) occupants of residences adjacent to the inspected 62.31 property. 62.32 (c) Aninspectingassessing agency shall provide the lead 62.33inspectionrisk assessment guides on request to owners or 62.34 occupants of residential property, builders, contractors, 62.35 inspectors, and the public within the jurisdiction of 62.36 theinspectingassessing agency. 63.1 Sec. 60. Minnesota Statutes 1996, section 144.9504, 63.2 subdivision 5, is amended to read: 63.3 Subd. 5. [LEAD ORDERS.] Aninspectingassessing agency, 63.4 after conducting a leadinspectionrisk assessment, shall order 63.5 a property owner to perform lead hazard reduction on all lead 63.6 sources that exceed a standard adopted according to section 63.7 144.9508. If leadinspectionsrisk assessments and lead orders 63.8 are conducted at times when weather or soil conditions do not 63.9 permit the leadinspectionrisk assessment or lead hazard 63.10 reduction, external surfaces and soil lead shall be inspected, 63.11 and lead orders complied with, if necessary, at the first 63.12 opportunity that weather and soil conditions allow. If the 63.13 paint standard under section 144.9508 is violated, but the paint 63.14 is intact, theinspectingassessing agency shall not order the 63.15 paint to be removed unless the intact paint is a known source of 63.16 actual lead exposure to a specific person. Before the 63.17inspectingassessing agency may order the intact paint to be 63.18 removed, a reasonable effort must be made to protect the child 63.19 and preserve the intact paint by the use of guards or other 63.20 protective devices and methods. Whenever windows and doors or 63.21 other components covered with deteriorated lead-based paint have 63.22 sound substrate or are not rotting, those components should be 63.23 repaired, sent out for stripping or be planed down to remove 63.24 deteriorated lead-based paint or covered with protective guards 63.25 instead of being replaced, provided that such an activity is the 63.26 least cost method. However, a property owner who has been 63.27 ordered to perform lead hazard reduction may choose any method 63.28 to address deteriorated lead-based paint on windows, doors, or 63.29 other components, provided that the method is approved in rules 63.30 adopted under section 144.9508 and that it is appropriate to the 63.31 specific property. Lead orders must require that any source of 63.32 damage, such as leaking roofs, plumbing, and windows, be 63.33 repaired or replaced, as needed, to prevent damage to 63.34 lead-containing interior surfaces. Theinspectingassessing 63.35 agency is not required to pay for lead hazard reduction. Lead 63.36 orders must be issued within 30 days of receiving the blood lead 64.1 level analysis. Theinspectingassessing agency shall enforce 64.2 the lead orders issued to a property owner under this section. 64.3 A copy of the lead order must be forwarded to the commissioner. 64.4 Sec. 61. Minnesota Statutes 1996, section 144.9504, 64.5 subdivision 6, is amended to read: 64.6 Subd. 6. [SWAB TEAM SERVICES.] After a leadinspection64.7 risk assessment or after issuing lead orders, theinspecting64.8 assessing agency, within the limits of appropriations and 64.9 availability, shall offer the property owner the services of a 64.10 swab team free of charge and, if accepted, shall send a swab 64.11 team within ten working days to the residence to perform swab 64.12 team services as defined in section 144.9501. If theinspecting64.13 assessing agency provides swab team services after a 64.14 leadinspectionrisk assessment, but before the issuance of a 64.15 lead order, swab team services do not need to be repeated after 64.16 the issuance of the lead order if the swab team services 64.17 fulfilled the lead order. Swab team services are not considered 64.18 completed until the clearance inspection required under this 64.19 section shows that the property is lead safe. 64.20 Sec. 62. Minnesota Statutes 1996, section 144.9504, 64.21 subdivision 7, is amended to read: 64.22 Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits 64.23 of appropriations, theinspectingassessing agency shall ensure 64.24 that residents are relocated from rooms or dwellings during a 64.25 lead hazard reduction process that generates leaded dust, such 64.26 as removal or disruption of lead-based paint or plaster that 64.27 contains lead. Residents shall not remain in rooms or dwellings 64.28 where the lead hazard reduction process is occurring. An 64.29inspectingassessing agency is not required to pay for 64.30 relocation unless state or federal funding is available for this 64.31 purpose. Theinspectingassessing agency shall make an effort 64.32 to assist the resident in locating resources that will provide 64.33 assistance with relocation costs. Residents shall be allowed to 64.34 return to the residence or dwelling after completion of the lead 64.35 hazard reduction process. Aninspectingassessing agency shall 64.36 use grant funds under section 144.9507 if available, in 65.1 cooperation with local housing agencies, to pay for moving costs 65.2 and rent for a temporary residence for any low-income resident 65.3 temporarily relocated during lead hazard reduction. For 65.4 purposes of this section, "low-income resident" means any 65.5 resident whose gross household income is at or below 185 percent 65.6 of federal poverty level. 65.7 (b) A resident of rental property who is notified by an 65.8inspectingassessing agency to vacate the premises during lead 65.9 hazard reduction, notwithstanding any rental agreement or lease 65.10 provisions: 65.11 (1) shall not be required to pay rent due the landlord for 65.12 the period of time the tenant vacates the premises due to lead 65.13 hazard reduction; 65.14 (2) may elect to immediately terminate the tenancy 65.15 effective on the date the tenant vacates the premises due to 65.16 lead hazard reduction; and 65.17 (3) shall not, if the tenancy is terminated, be liable for 65.18 any further rent or other charges due under the terms of the 65.19 tenancy. 65.20 (c) A landlord of rental property whose tenants vacate the 65.21 premises during lead hazard reduction shall: 65.22 (1) allow a tenant to return to the dwelling unit after 65.23 lead hazard reduction and clearance inspection, required under 65.24 this section, is completed, unless the tenant has elected to 65.25 terminate the tenancy as provided for in paragraph (b); and 65.26 (2) return any security deposit due under section 504.20 65.27 within five days of the date the tenant vacates the unit, to any 65.28 tenant who terminates tenancy as provided for in paragraph (b). 65.29 Sec. 63. Minnesota Statutes 1996, section 144.9504, 65.30 subdivision 8, is amended to read: 65.31 Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners 65.32 shall comply with lead orders issued under this section within 65.33 60 days or be subject to enforcement actions as provided under 65.34 section 144.9509. For orders or portions of orders concerning 65.35 external lead hazards, property owners shall comply within 60 65.36 days, or as soon thereafter as weather permits. If the property 66.1 owner does notuse a lead contractorhire a person licensed by 66.2 the commissioner under section 144.9505 for compliance with the 66.3 lead orders, the property owner shall submit a work plan to 66.4 theinspectingassessing agency within 30 days after receiving 66.5 the orders. The work plan must include the details required in 66.6 section 144.9505 as to how the property owner intends to comply 66.7 with the lead orders and notice as to when lead hazard reduction 66.8 activities will begin. Within the limits of appropriations, the 66.9 commissioner shall review plans and shall approve or disapprove 66.10 them as to compliance with the requirements in section 144.9505, 66.11 subdivision 5. Renters and volunteers performing lead abatement 66.12 or lead hazard reduction must be trained and licensed as lead 66.13 supervisors or lead workers under section 144.9505. 66.14 Sec. 64. Minnesota Statutes 1996, section 144.9504, 66.15 subdivision 9, is amended to read: 66.16 Subd. 9. [CLEARANCE INSPECTION.] After completion of swab 66.17 team services and compliance with the lead orders by the 66.18 property owner, including any repairs ordered by a local housing 66.19 or building inspector, theinspectingassessing agency shall 66.20 conduct a clearance inspection byvisually inspecting the66.21residence forvisual identification of deteriorated paint and 66.22 bare soil and retest the dust lead concentration in the 66.23 residence to assure that violations of the lead standards under 66.24 section 144.9508 no longer exist. Theinspectingassessing 66.25 agency is not required to test a dwelling unit after lead hazard 66.26 reduction that was not ordered by theinspectingassessing 66.27 agency. 66.28 Sec. 65. Minnesota Statutes 1996, section 144.9504, 66.29 subdivision 10, is amended to read: 66.30 Subd. 10. [CASE CLOSURE.] A leadinspectionrisk 66.31 assessment is completed and the responsibility of theinspecting66.32 assessing agency ends when all of the following conditions are 66.33 met: 66.34 (1) lead orders are written on all known sources of 66.35 violations of lead standards under section 144.9508; 66.36 (2) compliance with all lead orders has been completed; and 67.1 (3) clearance inspections demonstrate that no deteriorated 67.2 lead paint, bare soil, or lead dust levels exist that exceed the 67.3 standards adopted under section 144.9508. 67.4 Sec. 66. Minnesota Statutes 1996, section 144.9505, 67.5 subdivision 1, is amended to read: 67.6 Subdivision 1. [LICENSING AND CERTIFICATION.] (a)Lead67.7contractorsA person shall, before performing abatement or lead 67.8 hazard reduction or providing planning services for lead 67.9 abatement or lead hazard reduction, obtain a license from the 67.10 commissioner as a lead supervisor, lead worker, or lead project 67.11 designer.Workers for lead contractors shall obtain67.12certification from the commissioner.The commissioner shall 67.13 specify training and testing requirements for licensure and 67.14 certification as required in section 144.9508 and shall charge a 67.15 fee for the cost of issuing a license or certificate and for 67.16 training provided by the commissioner.Fees collected under67.17this section shall be set in amounts to be determined by the67.18commissioner to cover but not exceed the costs of adopting rules67.19under section 144.9508, the costs of licensure, certification,67.20and training, and the costs of enforcing licenses and67.21certificates under this section.License fees shall be 67.22 nonrefundable and must be submitted with each application in the 67.23 amount of $50 for each lead supervisor, lead worker, or lead 67.24 inspector and $100 for each lead project designer, lead risk 67.25 assessor, or certified firm. All fees received shall be paid 67.26 into the state treasury and credited to the lead abatement 67.27 licensing and certification account and are appropriated to the 67.28 commissioner to cover costs incurred under this section and 67.29 section 144.9508. 67.30 (b)ContractorsPersons shall not advertise or otherwise 67.31 present themselves as leadcontractorssupervisors, lead 67.32 workers, or lead project designers unless they havelead67.33contractorlicenses issued by thedepartment of health67.34 commissioner under section 144.9505. 67.35 Sec. 67. Minnesota Statutes 1996, section 144.9505, 67.36 subdivision 4, is amended to read: 68.1 Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD 68.2 REDUCTION WORK.] (a) At least five working days before starting 68.3 work at each lead abatement or lead hazard reduction worksite, 68.4 the person performing the lead abatement or lead hazard 68.5 reduction work shall give written notice and an approved work 68.6 plan as required in this section to the commissioner and the 68.7 appropriate board of health. Within the limits of 68.8 appropriations, the commissioner shall review plans and shall 68.9 approve or disapprove them as to compliance with the 68.10 requirements in subdivision 5. 68.11 (b) This provision does not apply to swab team workers 68.12 performing work under an order of aninspectingassessing agency. 68.13 Sec. 68. Minnesota Statutes 1996, section 144.9505, 68.14 subdivision 5, is amended to read: 68.15 Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.] 68.16 (a) Alead contractorperson who performs lead abatement or lead 68.17 hazard reduction shall present a lead abatement or lead hazard 68.18 reduction work plan to the property owner with each bid or 68.19 estimate for lead abatement or lead hazard reduction work. 68.20 The work plan does not replace or supersede more stringent 68.21 contractual agreements. A written lead abatement or lead hazard 68.22 reduction work plan must be prepared which describes the 68.23 equipment and procedures to be used throughout the lead 68.24 abatement or lead hazard reduction work project. At a minimum, 68.25 the work plan must describe: 68.26 (1) the building area and building components to be worked 68.27 on; 68.28 (2) the amount of lead-containing material to be removed, 68.29 encapsulated, or enclosed; 68.30 (3) the schedule to be followed for each work stage; 68.31 (4) the workers' personal protection equipment and 68.32 clothing; 68.33 (5) the dust suppression and debris containment methods; 68.34 (6) the lead abatement or lead hazard reduction methods to 68.35 be used on each building component; 68.36 (7) cleaning methods; 69.1 (8) temporary, on-site waste storage, if any; and 69.2 (9) the methods for transporting waste material and its 69.3 destination. 69.4 (b)A lead contractorThe work plan shall itemize the costs 69.5 for each item listed in paragraph (a) and for any other expenses 69.6 associated with the lead abatement or lead hazard reduction work 69.7 and shallpresent these costsbe presented to the property owner 69.8 with any bid or estimate for lead abatement or lead hazard 69.9 reduction work. 69.10 (c)A lead contractorThe person performing the lead 69.11 abatement or lead hazard reduction shall keep a copy of the work 69.12 plan readily available at the worksite for the duration of the 69.13 project and present it to theinspectingassessing agency on 69.14 demand. 69.15 (d)A lead contractorThe person performing the lead 69.16 abatement or lead hazard reduction shall keep a copy of the work 69.17 plan on record for one year after completion of the project and 69.18 shall present it to theinspectingassessing agency on demand. 69.19 (e) This provision does not apply to swab team workers 69.20 performing work under an order of aninspectingassessing agency 69.21 or providing services at no cost to a property owner with 69.22 funding under a state or federal grant. 69.23 Sec. 69. Minnesota Statutes 1997 Supplement, section 69.24 144.9506, subdivision 1, is amended to read: 69.25 Subdivision 1. [LICENSE REQUIRED.] (a) Alead69.26inspectorperson shall obtain a license as a lead inspector or a 69.27 lead risk assessor before performing lead inspections, lead 69.28 hazard screens, or lead risk assessments and shall renew 69.29 itannuallyas required in rules adopted under section 144.9508. 69.30 The commissioner shall charge a fee and requireannualrefresher 69.31 training, as specified in this section. A lead inspector or 69.32 lead risk assessor shall have the lead inspector's license or 69.33 lead risk assessor's license readily available at all times 69.34 atana lead inspection site or lead risk assessment site and 69.35 make it available, on request, forinspectionexamination by the 69.36inspectingassessing agency with jurisdiction over the site. A 70.1 license shall not be transferred. License fees shall be 70.2 nonrefundable and must be submitted with each application in the 70.3 amount of $50 for each lead inspector and $100 for each lead 70.4 risk assessor. 70.5 (b) Individuals shall not advertise or otherwise present 70.6 themselves as lead inspectors or lead risk assessors unless 70.7 licensed by the commissioner. 70.8 (c) An individual may use sodium rhodizonate to test paint 70.9 for the presence of lead without obtaining a lead inspector or 70.10 lead risk assessor license, but must not represent the test as a 70.11 lead inspection or lead risk assessment. 70.12 Sec. 70. Minnesota Statutes 1996, section 144.9506, 70.13 subdivision 2, is amended to read: 70.14 Subd. 2. [LICENSE APPLICATION.] An application for a 70.15 license or license renewal shall be on a form provided by the 70.16 commissioner and shall include: 70.17 (1) a$50nonrefundable fee, in a form approved by the 70.18 commissioner; and 70.19 (2) evidence that the applicant has successfully completed 70.20 a lead inspector training course approved under this section or 70.21 from another state with which the commissioner has established 70.22 reciprocity. The fee required in this section is waived for 70.23 federal, state, or local government employees within Minnesota. 70.24 Sec. 71. Minnesota Statutes 1996, section 144.9507, 70.25 subdivision 2, is amended to read: 70.26 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT CONTRACTS.] The 70.27 commissioner shall, within available federal or state 70.28 appropriations, contract with boards of health to conduct 70.29 leadinspectionsrisk assessments to determine sources of lead 70.30 contamination and to issue and enforce lead orders according to 70.31 section 144.9504. 70.32 Sec. 72. Minnesota Statutes 1996, section 144.9507, 70.33 subdivision 3, is amended to read: 70.34 Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The 70.35 commissioner shall, within the limits of available 70.36 appropriations, contract with boards of health for temporary 71.1 housing, to be used in meeting relocation requirements in 71.2 section 144.9504, and award grants to boards of health for the 71.3 purposes of paying housing and relocation costs under section 71.4 144.9504. The commissioner may use up to 15 percent of the 71.5 available appropriations to provide temporary lead-safe housing 71.6 in areas of the state in which the commissioner has the duty 71.7 under section 144.9504 to perform secondary prevention. 71.8 Sec. 73. Minnesota Statutes 1996, section 144.9507, 71.9 subdivision 4, is amended to read: 71.10 Subd. 4. [LEAD CLEANUP EQUIPMENT AND MATERIALGRANTS TO 71.11 NONPROFIT ORGANIZATIONS.] (a) The commissioner shall, within the 71.12 limits of available state or federal appropriations, provide 71.13 funds for lead cleanup equipment and materials under a grant 71.14 program to nonprofit community-based organizations in areas at 71.15 high risk for toxic lead exposure, as provided for in section 71.16 144.9503. 71.17 (b) Nonprofit community-based organizations in areas at 71.18 high risk for toxic lead exposure may apply for grants from the 71.19 commissioner to purchase lead cleanup equipment and materials 71.20 and to pay for training for staff and volunteers for lead 71.21 licensure under sections 144.9505 and 144.9506. 71.22 (c) For purposes of this section, lead cleanup equipment 71.23 and materials means high efficiency particle accumulator (HEPA) 71.24 and wet vacuum cleaners, wash water filters, mops, buckets, 71.25 hoses, sponges, protective clothing, drop cloths, wet scraping 71.26 equipment, secure containers, dust and particle containment 71.27 material, and other cleanup and containment materials to remove 71.28 loose paint and plaster, patch plaster, control household dust, 71.29 wax floors, clean carpets and sidewalks, and cover bare soil. 71.30 (d) The grantee's staff and volunteers may make lead 71.31 cleanup equipment and materials available to residents and 71.32 property owners and instruct them on the proper use of the 71.33 equipment. Lead cleanup equipment and materials must be made 71.34 available to low-income households, as defined by federal 71.35 guidelines, on a priority basis at no fee. Other households may 71.36 be charged on a sliding fee scale. 72.1 (e) The grantee shall not charge a fee for services 72.2 performed using the equipment or materials. 72.3 (f) Any funds appropriated for purposes of this subdivision 72.4 that are not awarded, due to a lack of acceptable proposals for 72.5 the full amount appropriated, may be used for any purpose 72.6 authorized in this section. 72.7 Sec. 74. Minnesota Statutes 1996, section 144.9508, 72.8 subdivision 1, is amended to read: 72.9 Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner 72.10 shall adopt, by rule,visual inspection and sampling and72.11analysismethods for: 72.12 (1) lead inspectionsunder section 144.9504, lead hazard 72.13 screens, lead risk assessments, and clearance inspections; 72.14 (2) environmental surveys of lead in paint, soil, dust, and 72.15 drinking water to determine census tracts that are areas at high 72.16 risk for toxic lead exposure; 72.17 (3) soil sampling for soil used as replacement soil;and72.18 (4) drinking water sampling, which shall be done in 72.19 accordance with lab certification requirements and analytical 72.20 techniques specified by Code of Federal Regulations, title 40, 72.21 section 141.89; and 72.22 (5) sampling to determine whether at least 25 percent of 72.23 the soil samples collected from a census tract within a standard 72.24 metropolitan statistical area contain lead in concentrations 72.25 that exceed 100 parts per million. 72.26 Sec. 75. Minnesota Statutes 1996, section 144.9508, is 72.27 amended by adding a subdivision to read: 72.28 Subd. 2a. [LEAD STANDARDS FOR EXTERIOR SURFACES AND STREET 72.29 DUST.] The commissioner may, by rule, establish lead standards 72.30 for exterior horizontal surfaces, concrete or other impervious 72.31 surfaces, and street dust on residential property to protect the 72.32 public health and the environment. 72.33 Sec. 76. Minnesota Statutes 1996, section 144.9508, 72.34 subdivision 3, is amended to read: 72.35 Subd. 3. [LEAD CONTRACTORS AND WORKERSLICENSURE AND 72.36 CERTIFICATION.] The commissioner shall adopt rules to license 73.1 leadcontractors and to certifysupervisors, lead workersof73.2lead contractors who perform lead abatement or lead hazard73.3reduction, lead project designers, lead inspectors, and lead 73.4 risk assessors. The commissioner shall also adopt rules 73.5 requiring certification of firms that perform lead abatement, 73.6 lead hazard reduction, lead hazard screens, or lead risk 73.7 assessments. The commissioner shall require periodic renewal of 73.8 licenses and certificates and shall establish the renewal 73.9 periods. 73.10 Sec. 77. Minnesota Statutes 1996, section 144.9508, 73.11 subdivision 4, is amended to read: 73.12 Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall 73.13 establish by rule a permit fee to be paid by a training course 73.14 provider on application for a training course permit or renewal 73.15 period for each lead-related training course required for 73.16 certification or licensure. The commissioner shall establish 73.17 criteria in rules for the content and presentation of training 73.18 courses intended to qualify trainees for licensure under 73.19 subdivision 3. Training course permit fees shall be 73.20 nonrefundable and must be submitted with each application in the 73.21 amount of $500 for an initial training course, $250 for renewal 73.22 of a permit for an initial training course, $250 for a refresher 73.23 training course, and $125 for renewal of a permit of a refresher 73.24 training course. 73.25 Sec. 78. Minnesota Statutes 1996, section 144.9509, 73.26 subdivision 2, is amended to read: 73.27 Subd. 2. [DISCRIMINATION.] A person who discriminates 73.28 against or otherwise sanctions an employee who complains to or 73.29 cooperates with theinspectingassessing agency in administering 73.30 sections 144.9501 to 144.9509 is guilty of a petty misdemeanor. 73.31 Sec. 79. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.] 73.32 Subdivision 1. [LEAD-SAFE PROPERTY CERTIFICATION PROGRAM 73.33 ESTABLISHED.] (a) The commissioner shall establish, within the 73.34 limits of available appropriations, recommended protocols for a 73.35 voluntary lead-safe property certification program for 73.36 residential properties. This program shall involve an initial 74.1 property certification process, a property condition report, and 74.2 a lead-safe property certification booklet. 74.3 (b) The commissioner shall establish recommended protocols 74.4 for an initial property certification process composed of the 74.5 following: 74.6 (1) a lead hazard screen, which shall include a visual 74.7 evaluation of a residential property for both deteriorated paint 74.8 and bare soil; and 74.9 (2) a quantitative measure of lead in dust within the 74.10 structure and in common areas as determined by rule adopted 74.11 under authority of section 144.9508. 74.12 (c) The commissioner shall establish forms, checklists, and 74.13 protocols for conducting a property condition report. A 74.14 property condition report is an evaluation of property 74.15 components, without regard to aesthetic considerations, to 74.16 determine whether any of the following conditions are likely to 74.17 occur within one year of the report: 74.18 (1) that paint will become chipped, flaked, or cracked; 74.19 (2) that structural defects in the roof, windows, or 74.20 plumbing will fail and cause paint to deteriorate; 74.21 (3) that window wells or window troughs will not be 74.22 cleanable and washable; 74.23 (4) that windows will generate dust due to friction; 74.24 (5) that cabinet, room, and threshold doors will rub 74.25 against casings or have repeated contact with painted surfaces; 74.26 (6) that floors will not be smooth and cleanable and 74.27 carpeted floors will not be cleanable; 74.28 (7) that soil will not remain covered; 74.29 (8) that bare soil in vegetable and flower gardens will not 74.30 (i) be inaccessible to children or (ii) be tested to determine 74.31 if it is below the soil standard under section 144.9508; 74.32 (9) that parking areas will not remain covered by an 74.33 impervious surface or gravel; 74.34 (10) that covered soil will erode, particularly in play 74.35 areas; and 74.36 (11) that gutters and down spouts will not function 75.1 correctly. 75.2 (d) The commissioner shall develop a lead-safe property 75.3 certification booklet that contains the following: 75.4 (1) information on how property owners and their 75.5 maintenance personnel can perform essential maintenance 75.6 practices to correct any of the property component conditions 75.7 listed in paragraph (c) that may occur; 75.8 (2) the lead-safe work practices fact sheets created under 75.9 section 144.9503, subdivision 7; 75.10 (3) forms, checklists, and copies of recommended lead-safe 75.11 property certification certificates; and 75.12 (4) an educational sheet for landlords to give to tenants 75.13 on the importance of having tenants inform property owners or 75.14 designated maintenance staff of one or more of the conditions 75.15 listed in paragraph (c). 75.16 Subd. 2. [CONDITIONS FOR CERTIFICATION.] A property shall 75.17 be certified as lead safe only if the following conditions are 75.18 met: 75.19 (1) the property passes the initial certification process 75.20 in subdivision 1; 75.21 (2) the property owner agrees in writing to perform 75.22 essential maintenance practices; 75.23 (3) the property owner agrees in writing to use lead-safe 75.24 work practices, as provided for under section 144.9503, 75.25 subdivision 7; 75.26 (4) the property owner performs essential maintenance as 75.27 the need arises or uses maintenance personnel who have completed 75.28 a U.S. Environmental Protection Agency- or Minnesota department 75.29 of health-approved maintenance training program or course to 75.30 perform essential maintenance; 75.31 (5) the lead-safe property certification booklet is 75.32 distributed to the property owner, maintenance personnel, and 75.33 tenants at the completion of the initial certification process; 75.34 and 75.35 (6) a copy of the lead-safe property certificate is filed 75.36 with the commissioner along with a $5 filing fee. 76.1 Subd. 3. [LEAD STANDARDS.] Lead standards used in this 76.2 section shall be those approved by the commissioner under 76.3 section 144.9508. 76.4 Subd. 4. [LEAD RISK ASSESSORS.] Lead-safe property 76.5 certifications shall only be performed by lead risk assessors 76.6 licensed by the commissioner under section 144.9506. 76.7 Subd. 5. [EXPIRATION.] Lead-safe property certificates are 76.8 valid for one year. 76.9 Subd. 6. [LIST OF CERTIFIED PROPERTIES.] Within the limits 76.10 of available appropriations, the commissioner shall maintain a 76.11 list of all properties certified as lead-safe under this section 76.12 and make it freely available to the public. 76.13 Subd. 7. [RE-APPLICATION.] Properties failing the initial 76.14 property certification may re-apply for a lead-safe property 76.15 certification by having a new initial certification process 76.16 performed and by correcting any condition listed by the licensed 76.17 lead risk assessor in the property condition report. Properties 76.18 that fail the initial property certification process must have 76.19 the condition corrected by the property owner, by trained 76.20 maintenance staff, or by a contractor with personnel licensed 76.21 for lead hazard reduction or lead abatement work by the 76.22 commissioner under section 144.9505, in order to have the 76.23 property certified. 76.24 Sec. 80. Minnesota Statutes 1996, section 144.99, 76.25 subdivision 1, is amended to read: 76.26 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 76.27 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 76.28 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 76.29 (14), and (15); 144.121; 144.1222; 144.35; 144.381 to 144.385; 76.30 144.411 to 144.417;144.491;144.495; 144.71 to 144.74; 144.9501 76.31 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 76.32 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, 76.33 stipulation agreements, settlements, compliance agreements, 76.34 licenses, registrations, certificates, and permits adopted or 76.35 issued by the department or under any other law now in force or 76.36 later enacted for the preservation of public health may, in 77.1 addition to provisions in other statutes, be enforced under this 77.2 section. 77.3 Sec. 81. Minnesota Statutes 1996, section 144A.44, 77.4 subdivision 2, is amended to read: 77.5 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 77.6 rights are established for the benefit of persons who receive 77.7 home care services. "Home care services" means home care 77.8 services as defined in section 144A.43, subdivision 3. A home 77.9 care provider may not require a person to surrender these rights 77.10 as a condition of receiving services. A guardian or conservator 77.11 or, when there is no guardian or conservator, a designated 77.12 person, may seek to enforce these rights. This statement of 77.13 rights does not replace or diminish other rights and liberties 77.14 that may exist relative to persons receiving home care services, 77.15 persons providing home care services, or providers licensed 77.16 under Laws 1987, chapter 378. A copy of these rights must be 77.17 provided to an individual at the time home care services are 77.18 initiated. The copy shall also contain the address and phone 77.19 number of the office of health facility complaints and the 77.20 office of the ombudsman for older Minnesotans and a brief 77.21 statement describing how to file a complaint withthat office77.22 these offices. Information about how to contact the office of 77.23 the ombudsman for older Minnesotans shall be included in notices 77.24 of change in client fees and in notices where home care 77.25 providers initiate transfer or discontinuation of services. 77.26 Sec. 82. Minnesota Statutes 1997 Supplement, section 77.27 144A.4605, subdivision 4, is amended to read: 77.28 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 77.29 establishment registered under chapter 144D that is required to 77.30 obtain a home care license must obtain an assisted living home 77.31 care license according to this section or a class A or class E 77.32 license according to rule. A housing with services 77.33 establishment that obtains a class E license under this 77.34 subdivision remains subject to the payment limitations in 77.35 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 77.36 subdivision 3, paragraph (g). 78.1 (b) A board and lodging establishment registered for 78.2 special services as of December 31, 1996, and also registered as 78.3 a housing with services establishment under chapter 144D, must 78.4 deliver home care services according to sections 144A.43 to 78.5 144A.49, and may apply for a waiver from requirements under 78.6 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 78.7 licensed agency under the standards of section 157.17. Such 78.8 waivers as may be granted by the department will expire upon 78.9 promulgation of home care rules implementing section 144A.4605. 78.10 (c) An adult foster care provider licensed by the 78.11 department of human services and registered under chapter 144D 78.12 may continue to provide health-related services under its foster 78.13 care license until the promulgation of home care rules 78.14 implementing this section. 78.15 Sec. 83. [145.905] [LOCATION FOR BREAST-FEEDING.] 78.16 A mother may breast-feed in any location, public or 78.17 private, where the mother and child are otherwise authorized to 78.18 be, irrespective of whether the nipple of the mother's breast is 78.19 uncovered during or incidental to the breast-feeding. 78.20 Sec. 84. [145.926] [ABSTINENCE EDUCATION GRANT PROGRAM.] 78.21 The commissioner of health shall expend federal funds for 78.22 abstinence education programs provided under United States Code, 78.23 title 42, section 710, and state matching funds for abstinence 78.24 education programs only to an abstinence education program that 78.25 complies with the state plan that has been submitted to and 78.26 approved by the federal Department of Health and Human Services. 78.27 Sec. 85. [145.9266] [FETAL ALCOHOL SYNDROME.] 78.28 Subdivision 1. [PUBLIC AWARENESS.] The commissioner of 78.29 health shall design and implement an ongoing statewide campaign 78.30 to raise public awareness about fetal alcohol syndrome and other 78.31 effects of prenatal alcohol exposure. The campaign shall 78.32 include messages directed to the general population as well as 78.33 culturally specific and community-based messages. A toll-free 78.34 resource and referral telephone line shall be included in the 78.35 messages. The commissioner of health shall conduct an 78.36 evaluation to determine the effectiveness of the campaign. 79.1 Subd. 2. [STATEWIDE NETWORK OF FAS DIAGNOSTIC CLINICS.] A 79.2 statewide network of regional fetal alcohol syndrome diagnostic 79.3 clinics shall be developed between the department of health and 79.4 the University of Minnesota. This collaboration shall be based 79.5 on a statewide needs assessment and shall include involvement 79.6 from consumers, providers, and payors. By the end of calendar 79.7 year 1998, a plan shall be developed for the clinic network, and 79.8 shall include a comprehensive evaluation component. Sites shall 79.9 be established in calendar year 1999. The commissioner shall 79.10 not access or collect individually identifiable data for the 79.11 statewide network of regional fetal alcohol syndrome diagnostic 79.12 clinics. Data collected at the clinics shall be maintained 79.13 according to applicable data privacy laws, including section 79.14 144.335. 79.15 Subd. 3. [PROFESSIONAL TRAINING ABOUT FAS.] (a) The 79.16 commissioner of health, in collaboration with the board of 79.17 medical practice, the board of nursing, and other professional 79.18 boards and state agencies, shall develop curricula and materials 79.19 about fetal alcohol syndrome for professional training of health 79.20 care providers, social service providers, educators, and 79.21 judicial and corrections systems professionals. The training 79.22 and curricula shall increase knowledge and develop practical 79.23 skills of professionals to help them address the needs of 79.24 at-risk pregnant women and the needs of individuals affected by 79.25 fetal alcohol syndrome or fetal alcohol effects and their 79.26 families. 79.27 (b) Training for health care providers shall focus on skill 79.28 building for screening, counseling, referral, and follow-up for 79.29 women using or at risk of using alcohol while pregnant. 79.30 Training for health care professionals shall include methods for 79.31 diagnosis and evaluation of fetal alcohol syndrome and fetal 79.32 alcohol effects. Training for education, judicial, and 79.33 corrections professionals shall involve effective education 79.34 strategies, methods to identify the behaviors and learning 79.35 styles of children with alcohol-related birth defects, and 79.36 methods to identify available referral and community resources. 80.1 (c) Training for social service providers shall focus on 80.2 resources for assessing, referring, and treating at-risk 80.3 pregnant women, changes in the mandatory reporting and 80.4 commitment laws, and resources for affected children and their 80.5 families. 80.6 Subd. 4. [FAS COMMUNITY GRANT PROGRAM.] The commissioner 80.7 of health shall administer a grant program to provide money to 80.8 community organizations and coalitions to collaborate on fetal 80.9 alcohol syndrome prevention and intervention strategies and 80.10 activities. The commissioner shall disburse grant money through 80.11 a request for proposal process or sole-source distribution where 80.12 appropriate, and shall include at least one grant award for 80.13 transitional skills and services for individuals with fetal 80.14 alcohol syndrome or fetal alcohol effects. 80.15 Subd. 5. [SCHOOL PILOT PROGRAMS.] (a) The commissioner of 80.16 children, families, and learning shall award up to four grants 80.17 to schools for pilot programs to identify and implement 80.18 effective educational strategies for individuals with fetal 80.19 alcohol syndrome and other alcohol-related birth defects. 80.20 (b) One grant shall be awarded in each of the following age 80.21 categories: 80.22 (1) birth to three years; 80.23 (2) three to five years; 80.24 (3) six to 12 years; and 80.25 (4) 13 to 18 years. 80.26 (c) Grant proposals must include an evaluation plan, 80.27 demonstrate evidence of a collaborative or multisystem approach, 80.28 provide parent education and support, and show evidence of a 80.29 child- and family-focused approach consistent with 80.30 research-based educational practices and other guidelines 80.31 developed by the department of children, families, and learning. 80.32 (d) Children participating in the pilot program sites may 80.33 be identified through child find activities or a diagnostic 80.34 clinic. No identification activity may be undertaken without 80.35 the consent of a child's parent or guardian. 80.36 Subd. 6. [FETAL ALCOHOL COORDINATING BOARD; DUTIES.] (a) 81.1 The fetal alcohol coordinating board consists of: 81.2 (1) the commissioners of health, human services, 81.3 corrections, public safety, economic security, and children, 81.4 families, and learning; 81.5 (2) the director of the office of strategic and long-range 81.6 planning; 81.7 (3) the chair of the maternal and child health advisory 81.8 task force established by section 145.881, or the chair's 81.9 designee; 81.10 (4) a representative of the University of Minnesota 81.11 academic health center, appointed by the provost; 81.12 (5) five members from the general public appointed by the 81.13 governor, one of whom must be a family member of an individual 81.14 with fetal alcohol syndrome or fetal alcohol effect; and 81.15 (6) one member from the judiciary appointed by the chief 81.16 justice of the supreme court. 81.17 Terms, compensation, removal, and filling of vacancies of 81.18 appointed members are governed by section 15.0575. The board 81.19 shall elect a chair from its membership to serve a one-year 81.20 term. The commissioner of health shall provide staff and 81.21 consultant support for the board. Support must be provided 81.22 based on an annual budget and work plan developed by the board. 81.23 The board shall contract with the department of health for 81.24 necessary administrative services. Administrative services 81.25 include personnel, budget, payroll, and contract 81.26 administration. The board shall adopt an annual budget and work 81.27 program. 81.28 (b) Board duties include: 81.29 (1) reviewing programs of state agencies that involve fetal 81.30 alcohol syndrome and coordinating those that are 81.31 interdepartmental in nature; 81.32 (2) providing an integrated and comprehensive approach to 81.33 fetal alcohol syndrome prevention and intervention strategies 81.34 both at a local and statewide level; 81.35 (3) approving on an annual basis the statewide public 81.36 awareness campaign as designed and implemented by the 82.1 commissioner of health under subdivision 1; 82.2 (4) reviewing fetal alcohol syndrome community grants 82.3 administered by the commissioner of health under subdivision 4; 82.4 and 82.5 (5) submitting a report to the governor on January 15 of 82.6 each odd-numbered year summarizing board operations, activities, 82.7 findings, and recommendations, and fetal alcohol syndrome 82.8 activities throughout the state. 82.9 (c) The board expires on January 1, 2001. 82.10 Subd. 7. [FEDERAL FUNDS; CONTRACTS; DONATIONS.] The fetal 82.11 alcohol coordinating board may apply for, receive, and disburse 82.12 federal funds made available to the state by federal law or 82.13 rules adopted for any purpose related to the powers and duties 82.14 of the board. The board shall comply with any requirements of 82.15 federal law, rules, and regulations in order to apply for, 82.16 receive, and disburse funds. The board may contract with or 82.17 provide grants to public and private nonprofit entities. The 82.18 board may accept donations or grants from any public or private 82.19 entity. Money received by the board must be deposited in a 82.20 separate account in the state treasury and invested by the state 82.21 board of investment. The amount deposited, including investment 82.22 earnings, is appropriated to the board to carry out its duties. 82.23 Money deposited in the state treasury shall not cancel. 82.24 Sec. 86. Minnesota Statutes 1996, section 145A.15, 82.25 subdivision 2, is amended to read: 82.26 Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is 82.27 authorized to award grants to programs that meet the 82.28 requirements of subdivision 3 and include a strong child abuse 82.29 and neglect prevention focus for families in need of services. 82.30 Priority will be given to families considered to be in need of 82.31 additional services. These families include, but are not 82.32 limited to, families with: 82.33 (1) adolescent parents; 82.34 (2) a history of alcohol and other drug abuse; 82.35 (3) a history of child abuse, domestic abuse, or other 82.36 types of violence in the family of origin; 83.1 (4) a history of domestic abuse, rape, or other forms of 83.2 victimization; 83.3 (5) reduced cognitive functioning; 83.4 (6) a lack of knowledge of child growth and development 83.5 stages; 83.6 (7) low resiliency to adversities and environmental 83.7 stresses; or 83.8 (8) lack of sufficient financial resources to meet their 83.9 needs. 83.10 (b) Grants made under this section shall be used to fund 83.11 existing and new home visiting programs. In awarding grants 83.12 under this section, the commissioner shall give priority to new 83.13 home visiting programs with local matching funds. 83.14 Sec. 87. Minnesota Statutes 1996, section 157.15, 83.15 subdivision 9, is amended to read: 83.16 Subd. 9. [MOBILE FOOD UNIT.] "Mobile food unit" means a 83.17 food and beverage service establishment that is a vehicle 83.18 mounted unit, either motorized or trailered, operating no more 83.19 than1421 days annually at any one place or is operated in 83.20 conjunction with a permanent business licensed under this 83.21 chapter or chapter 28A at the site of the permanent business by 83.22 the same individual or company, and readily movable, without 83.23 disassembling, for transport to another location. 83.24 Sec. 88. Minnesota Statutes 1996, section 157.15, 83.25 subdivision 12, is amended to read: 83.26 Subd. 12. [RESTAURANT.] "Restaurant" means a food and 83.27 beverage service establishment, whether the establishment serves 83.28 alcoholic or nonalcoholic beverages, which operates from a 83.29 location for more than1421 days annually. Restaurant does not 83.30 include a food cart or a mobile food unit. 83.31 Sec. 89. Minnesota Statutes 1996, section 157.15, 83.32 subdivision 12a, is amended to read: 83.33 Subd. 12a. [SEASONAL PERMANENT FOOD STAND.] "Seasonal 83.34 permanent food stand" means a food and beverage service 83.35 establishment which is a permanent food service stand or 83.36 building, but which operates no more than1421 days annually. 84.1 Sec. 90. Minnesota Statutes 1996, section 157.15, 84.2 subdivision 13, is amended to read: 84.3 Subd. 13. [SEASONAL TEMPORARY FOOD STAND.] "Seasonal 84.4 temporary food stand" means a food and beverage service 84.5 establishment that is a food stand which is disassembled and 84.6 moved from location to location, but which operates no more than 84.71421 days annually at any one location. 84.8 Sec. 91. Minnesota Statutes 1996, section 157.15, 84.9 subdivision 14, is amended to read: 84.10 Subd. 14. [SPECIAL EVENT FOOD STAND.] "Special event food 84.11 stand" means a food and beverage service establishment which is 84.12 used in conjunction with celebrations and special events, and 84.13 which operatesonce or twiceno more than three times annually 84.14 for no more thanseventen total days. 84.15 Sec. 92. Minnesota Statutes 1997 Supplement, section 84.16 157.16, subdivision 3, is amended to read: 84.17 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 84.18 following fees are required for food and beverage service 84.19 establishments, hotels, motels, lodging establishments, and 84.20 resorts licensed under this chapter. Food and beverage service 84.21 establishments must pay the highest applicable fee under 84.22 paragraph (e), clause (1), (2), (3), or (4), and establishments 84.23 serving alcohol must pay the highest applicable fee under 84.24 paragraph (e), clause (6) or (7). 84.25 (b) All food and beverage service establishments, except 84.26 special event food stands, and all hotels, motels, lodging 84.27 establishments, and resorts shall pay an annual base fee of $100. 84.28 (c) A special event food stand shall pay a flat fee 84.29 of$60$30 annually. "Special event food stand" means a fee 84.30 category where food is prepared or served in conjunction with 84.31 celebrations, county fairs, or special events from a special 84.32 event food stand as defined in section 157.15. 84.33 (d)A special event food stand-limited shall pay a flat fee84.34of $30.84.35(e)In addition to the base fee in paragraph (b), each food 84.36 and beverage service establishment, other than a special event 85.1 food stand, and each hotel, motel, lodging establishment, and 85.2 resort shall pay an additional annual fee for each fee category 85.3 as specified in this paragraph: 85.4 (1) Limited food menu selection, $30. "Limited food menu 85.5 selection" means a fee category that provides one or more of the 85.6 following: 85.7 (i) prepackaged food that receives heat treatment and is 85.8 served in the package; 85.9 (ii) frozen pizza that is heated and served; 85.10 (iii) a continental breakfast such as rolls, coffee, juice, 85.11 milk, and cold cereal; 85.12 (iv) soft drinks, coffee, or nonalcoholic beverages; or 85.13 (v) cleaning for eating, drinking, or cooking utensils, 85.14 when the only food served is prepared off site. 85.15 (2) Small establishment, including boarding establishments, 85.16 $55. "Small establishment" means a fee category that has no 85.17 salad bar and meets one or more of the following: 85.18 (i) possesses food service equipment that consists of no 85.19 more than a deep fat fryer, a grill, two hot holding containers, 85.20 and one or more microwave ovens; 85.21 (ii) serves dipped ice cream or soft serve frozen desserts; 85.22 (iii) serves breakfast in an owner-occupied bed and 85.23 breakfast establishment; 85.24 (iv) is a boarding establishment; or 85.25 (v) meets the equipment criteria in clause (3), item (i) or 85.26 (ii), and has a maximum patron seating capacity of not more than 85.27 50. 85.28 (3) Medium establishment, $150. "Medium establishment" 85.29 means a fee category that meets one or more of the following: 85.30 (i) possesses food service equipment that includes a range, 85.31 oven, steam table, salad bar, or salad preparation area; 85.32 (ii) possesses food service equipment that includes more 85.33 than one deep fat fryer, one grill, or two hot holding 85.34 containers; or 85.35 (iii) is an establishment where food is prepared at one 85.36 location and served at one or more separate locations. 86.1 Establishments meeting criteria in clause (2), item (v), 86.2 are not included in this fee category. 86.3 (4) Large establishment, $250. "Large establishment" means 86.4 either: 86.5 (i) a fee category that (A) meets the criteria in clause 86.6 (3), items (i) or (ii), for a medium establishment, (B) seats 86.7 more than 175 people, and (C) offers the full menu selection an 86.8 average of five or more days a week during the weeks of 86.9 operation; or 86.10 (ii) a fee category that (A) meets the criteria in clause 86.11 (3), item (iii), for a medium establishment, and (B) prepares 86.12 and serves 500 or more meals per day. 86.13 (5) Other food and beverage service, including food carts, 86.14 mobile food units, seasonal temporary food stands, and seasonal 86.15 permanent food stands, $30. 86.16 (6) Beer or wine table service, $30. "Beer or wine table 86.17 service" means a fee category where the only alcoholic beverage 86.18 service is beer or wine, served to customers seated at tables. 86.19 (7) Alcoholic beverage service, other than beer or wine 86.20 table service, $75. 86.21 "Alcohol beverage service, other than beer or wine table 86.22 service" means a fee category where alcoholic mixed drinks are 86.23 served or where beer or wine are served from a bar. 86.24 (8) Lodging per sleeping accommodation unit, $4, including 86.25 hotels, motels, lodging establishments, and resorts, up to a 86.26 maximum of $400. "Lodging per sleeping accommodation unit" 86.27 means a fee category including the number of guest rooms, 86.28 cottages, or other rental units of a hotel, motel, lodging 86.29 establishment, or resort; or the number of beds in a dormitory. 86.30 (9) First public swimming pool, $100; each additional 86.31 public swimming pool, $50. "Public swimming pool" means a fee 86.32 category that has the meaning given in Minnesota Rules, part 86.33 4717.0250, subpart 8. 86.34 (10) First spa, $50; each additional spa, $25. "Spa pool" 86.35 means a fee category that has the meaning given in Minnesota 86.36 Rules, part 4717.0250, subpart 9. 87.1 (11) Private sewer or water, $30. "Individual private 87.2 water" means a fee category with a water supply other than a 87.3 community public water supply as defined in Minnesota Rules, 87.4 chapter 4720. "Individual private sewer" means a fee category 87.5 with an individual sewage treatment system which uses subsurface 87.6 treatment and disposal. 87.7(f)(e) A fee is not required for a food and beverage 87.8 service establishment operated by a school as defined in 87.9 sections 120.05 and 120.101. 87.10(g)(f) A fee of $150 for review of the construction plans 87.11 must accompany the initial license application for food and 87.12 beverage service establishments, hotels, motels, lodging 87.13 establishments, or resorts. 87.14(h)(g) When existing food and beverage service 87.15 establishments, hotels, motels, lodging establishments, or 87.16 resorts are extensively remodeled, a fee of $150 must be 87.17 submitted with the remodeling plans. 87.18(i)(h) Seasonal temporary food stands,and special event 87.19 food stands, and special event food stands-limitedare not 87.20 required to submit construction or remodeling plans for review. 87.21 Sec. 93. Minnesota Statutes 1996, section 214.03, is 87.22 amended to read: 87.23 214.03 [STANDARDIZED TESTS.] 87.24 Subdivision 1. [STANDARDIZED TESTS USED.] All state 87.25 examining and licensing boards, other than the state board of 87.26 law examiners, the state board of professional responsibility or 87.27 any other board established by the supreme court to regulate the 87.28 practice of law and judicial functions, shall use national 87.29 standardized tests for the objective, nonpractical portion of 87.30 any examination given to prospective licensees to the extent 87.31 that such national standardized tests are appropriate, except 87.32 when the subject matter of the examination relates to the 87.33 application of Minnesota law to the profession or calling being 87.34 licensed. 87.35 Subd. 2. [HEALTH-RELATED BOARDS; SPECIAL ACCOUNT.] An 87.36 account is established in the special revenue fund where a 88.1 health-related licensing board may deposit applicants' payments 88.2 for national or regional standardized tests. Money in the 88.3 account is appropriated to each board that has deposited monies 88.4 into the account, in an amount equal to the amount deposited by 88.5 the board, to pay for the use of national or regional 88.6 standardized tests. 88.7 Sec. 94. Minnesota Statutes 1997 Supplement, section 88.8 214.32, subdivision 1, is amended to read: 88.9 Subdivision 1. [MANAGEMENT.] (a) A health professionals 88.10 services program committee is established, consisting of one 88.11 person appointed by each participating board, with each 88.12 participating board having one vote. The committee shall 88.13 designate one board to provide administrative management of the 88.14 program, set the program budget and the pro rata share of 88.15 program expenses to be borne by each participating board, 88.16 provide guidance on the general operation of the program, 88.17 including hiring of program personnel, and ensure that the 88.18 program's direction is in accord with its authority. No more 88.19 than half plus one of the members of the committee may be of one 88.20 gender. If the participating boards change which board is 88.21 designated to provide administrative management of the program, 88.22 any appropriation remaining for the program shall transfer to 88.23 the newly designated board on the effective date of the change. 88.24 The participating boards must inform the appropriate legislative 88.25 committees and the commissioner of finance of any change in the 88.26 administrative management of the program, and the amount of any 88.27 appropriation transferred under this provision. 88.28 (b) The designated board, upon recommendation of the health 88.29 professional services program committee, shall hire the program 88.30 manager and employees and pay expenses of the program from funds 88.31 appropriated for that purpose. The designated board may apply 88.32 for grants to pay program expenses and may enter into contracts 88.33 on behalf of the program to carry out the purposes of the 88.34 program. The participating boards shall enter into written 88.35 agreements with the designated board. 88.36 (c) An advisory committee is established to advise the 89.1 program committee consisting of: 89.2 (1) one member appointed by each of the following: the 89.3 Minnesota Academy of Physician Assistants, the Minnesota Dental 89.4 Association, the Minnesota Chiropractic Association, the 89.5 Minnesota Licensed Practical Nurse Association, the Minnesota 89.6 Medical Association, the Minnesota Nurses Association, and the 89.7 Minnesota Podiatric Medicine Association; 89.8 (2) one member appointed by each of the professional 89.9 associations of the other professions regulated by a 89.10 participating board not specified in clause (1); and 89.11 (3) two public members, as defined by section 214.02. 89.12 Members of the advisory committee shall be appointed for two 89.13 years and members may be reappointed. 89.14 No more than half plus one of the members of the committee 89.15 may be of one gender. 89.16 The advisory committee expires June 30, 2001. 89.17 Sec. 95. Minnesota Statutes 1996, section 254A.17, 89.18 subdivision 1, is amended to read: 89.19 Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a) 89.20 The commissioner shall fund maternal and child health and social 89.21 service programs designed to improve the health and functioning 89.22 of children born to mothers using alcohol and controlled 89.23 substances. Comprehensive programs shall include immediate and 89.24 ongoing intervention, treatment, and coordination of medical, 89.25 educational, and social services through a child's preschool 89.26 years. Programs shall also include research and evaluation to 89.27 identify methods most effective in improving outcomes among this 89.28 high-risk population. The commissioner shall ensure that the 89.29 programs are available on a statewide basis to the extent 89.30 possible with available funds. 89.31 (b) The commissioner of human services shall develop models 89.32 for the treatment of children ages 6 to 12 who are in need of 89.33 chemical dependency treatment. The commissioner shall fund at 89.34 least two pilot projects with qualified providers to provide 89.35 nonresidential treatment for children in this age group. Model 89.36 programs must include a component to monitor and evaluate 90.1 treatment outcomes. 90.2 Sec. 96. Minnesota Statutes 1996, section 254A.17, is 90.3 amended by adding a subdivision to read: 90.4 Subd. 1b. [INTERVENTION AND ADVOCACY PROGRAM.] Within the 90.5 limits of money available, the commissioner of human services 90.6 shall fund voluntary hospital-based outreach programs targeted 90.7 at women who deliver children affected by prenatal alcohol or 90.8 drug use. The program shall help women obtain treatment, stay 90.9 in recovery, and plan any future pregnancies. An advocate shall 90.10 be assigned to each woman in the program to provide guidance and 90.11 advice with respect to treatment programs, child safety and 90.12 parenting, housing, family planning, and any other personal 90.13 issues that are barriers to remaining free of chemical 90.14 dependence. The commissioner shall develop an evaluation 90.15 component and provide centralized coordination of the evaluation 90.16 process. 90.17 Sec. 97. Minnesota Statutes 1996, section 268.92, 90.18 subdivision 4, is amended to read: 90.19 Subd. 4. [LEADCONTRACTORSSUPERVISOR OR CERTIFIED FIRM.] 90.20 (a) Eligible organizations and leadcontractorssupervisors or 90.21 certified firms may participate in the swab team program. An 90.22 eligible organization receiving a grant under this section must 90.23 assure that all participating leadcontractorssupervisors or 90.24 certified firms are licensed and that all swab team workers are 90.25 certified by the department of health under section 144.9505. 90.26 Eligible organizations and leadcontractorssupervisors or 90.27 certified firms may distinguish between interior and exterior 90.28 services in assigning duties and may participate in the program 90.29 by: 90.30 (1) providing on-the-job training for swab team workers; 90.31 (2) providing swab team services to meet the requirements 90.32 of sections 144.9503, subdivision 4, and 144.9504, subdivision 90.33 6; 90.34 (3) providing a removal and replacement component using 90.35 skilled craft workers under subdivision 7; 90.36 (4) providing lead testing according to subdivision 7a; 91.1 (5) providing lead dust cleaning supplies, as described in 91.2 section144.9503144.9507, subdivision54, 91.3 paragraph(b)(c), to residents; or 91.4 (6) having a swab team worker instruct residents and 91.5 property owners on appropriate lead control techniques, 91.6 including the lead-safe directives developed by the commissioner 91.7 of health. 91.8 (b) Participating leadcontractorssupervisors or certified 91.9 firms must: 91.10 (1) demonstrate proof of workers' compensation and general 91.11 liability insurance coverage; 91.12 (2) be knowledgeable about lead abatement requirements 91.13 established by the Department of Housing and Urban Development 91.14 and the Occupational Safety and Health Administration and lead 91.15 hazard reduction requirements and lead-safe directives of the 91.16 commissioner of health; 91.17 (3) demonstrate experience with on-the-job training 91.18 programs; 91.19 (4) demonstrate an ability to recruit employees from areas 91.20 at high risk for toxic lead exposure; and 91.21 (5) demonstrate experience in working with low-income 91.22 clients. 91.23 Sec. 98. [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC 91.24 HEALTH CENTER.] 91.25 The University of Minnesota academic health center, after 91.26 consultation with the health care community and the medical 91.27 education and research costs advisory committee, is requested to 91.28 report to the commissioner of health and the legislative 91.29 commission on health care access by January 15, 1999, on plans 91.30 for the strategic direction and vision of the academic health 91.31 center. The report shall address plans for the ongoing 91.32 assessment of health provider workforce needs; plans for the 91.33 ongoing assessment of the educational needs of health 91.34 professionals and the implications for their education and 91.35 training programs; and plans for ongoing, meaningful input from 91.36 the health care community on health-related research and 92.1 education programs administered by the academic health center. 92.2 Sec. 99. [ADVICE AND RECOMMENDATIONS.] 92.3 The commissioners of health and commerce shall convene an 92.4 ad hoc advisory panel of selected representatives of health plan 92.5 companies, purchasers, and provider groups engaged in the 92.6 practice of health care in Minnesota, and interested 92.7 legislators. This advisory panel shall meet and assist the 92.8 commissioners in developing measures to prevent discrimination 92.9 against providers and provider groups in managed care in 92.10 Minnesota and clarify the requirements of Minnesota Statutes, 92.11 section 62Q.23, paragraph (c). Any such measures shall be 92.12 reported to the legislature prior to November 15, 1998. 92.13 Sec. 100. [OMBUDSMAN STUDY.] 92.14 The ombudsman for mental health and mental retardation and 92.15 the ombudsman for older Minnesotans shall convene a work group 92.16 to develop recommendations for interagency cooperation and/or 92.17 the consolidation of all health-related ombudsman and advocacy 92.18 programs provided by state agencies and to address issues to 92.19 improve ombudsmen and advocacy services to health care 92.20 consumers, including ease of access, timeliness of response, and 92.21 quality of outcome. In developing its recommendations, the work 92.22 group shall consider the unique needs of different populations 92.23 of health care consumers. It shall also consider: 92.24 (1) seamless access for health care consumers; 92.25 (2) consumer outreach methods; 92.26 (3) opportunities to share resources and training; 92.27 (4) nonduplication of effort; and 92.28 (5) the feasibility of colocation. 92.29 In developing its recommendations, the work group shall 92.30 confer with and have representatives of consumers, advocacy 92.31 organizations, the consumer advisory board, the office of health 92.32 care consumer assistance, advocacy, and information, affected 92.33 state agencies, the board on aging, and the advisory committee 92.34 to the ombudsman for mental health and mental retardation. The 92.35 work group shall make recommendations on how to better 92.36 coordinate consumer services and submit a report to the 93.1 legislature by December 15, 1999. 93.2 Sec. 101. [COMPLAINT PROCESS STUDY.] 93.3 The complaint process work group established by the 93.4 commissioners of health and commerce as required under Laws 93.5 1997, chapter 237, section 20, shall continue to meet to develop 93.6 a complaint resolution process for health plan companies to make 93.7 available to enrollees as required under Minnesota Statutes, 93.8 sections 62Q.105, 62Q.11, and 62Q.30. The commissioners of 93.9 health and commerce shall submit a progress report to the 93.10 legislative commission on health care access by September 15, 93.11 1998, and shall submit final recommendations to the legislature, 93.12 including draft legislation on developing such a process by 93.13 November 15, 1998. The recommendations must also include, in 93.14 consultation with the work group, a permanent method of 93.15 financing the office of health care consumer assistance, 93.16 advocacy, and information. 93.17 Sec. 102. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.] 93.18 The commissioner of health shall convene an advisory task 93.19 force to study issues related to the building codes and safety 93.20 standards that residential hospice facilities must meet for 93.21 licensure and to make recommendations on changes to these 93.22 standards. Task force membership shall include representatives 93.23 of residential hospices, pediatric residential hospices, the 93.24 Minnesota hospice organization, the Minnesota department of 93.25 health, and other interested parties. The task force is 93.26 governed by Minnesota Statutes, section 15.059, subdivision 6. 93.27 The task force shall submit recommendations and any draft 93.28 legislation to the legislature by January 15, 1999. 93.29 Sec. 103. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.] 93.30 Until October 31, 1998, the board of dietetics and 93.31 nutrition practice may waive the requirements for licensure as a 93.32 dietitian established in Minnesota Statutes, section 148.624, 93.33 subdivision 1, clause (1), and may issue a license to an 93.34 applicant who meets the qualifications for licensure specified 93.35 in Minnesota Statutes, section 148.627, subdivision 1. A waiver 93.36 may be granted in cases in which unusual or extraordinary 94.1 job-related circumstances prevented an applicant from applying 94.2 for licensure during the transition period specified in 94.3 Minnesota Statutes, section 148.627, subdivision 1. An 94.4 applicant must request a waiver in writing and must explain the 94.5 circumstances that prevented the applicant from applying for 94.6 licensure during the transition period. 94.7 Sec. 104. [UNITED STATES NUCLEAR REGULATORY COMMISSION 94.8 AGREEMENT.] 94.9 Subdivision 1. [AGREEMENT AUTHORIZED.] In order to have a 94.10 comprehensive program to protect the public from radiation 94.11 hazards, the governor may enter into an agreement with the 94.12 United States Nuclear Regulatory Commission, under the Atomic 94.13 Energy Act of 1954, United States Code, title 42, section 2021, 94.14 paragraph (b). The agreement may allow the state to assume 94.15 regulation over nonpower plant radiation hazards including 94.16 certain by-product, source, and special nuclear materials not 94.17 sufficient to form a critical mass. The agreement must be 94.18 approved in law prior to being implemented. 94.19 Subd. 2. [HEALTH DEPARTMENT DESIGNATED LEAD.] The 94.20 department of health is designated as the lead agency to pursue 94.21 an agreement on behalf of the governor, and for any assumption 94.22 of specified licensing and regulatory authority from the Nuclear 94.23 Regulatory Commission under an agreement. The commissioner may 94.24 enter into negotiations with the Nuclear Regulatory Commission 94.25 for that purpose. The commissioner of health shall establish an 94.26 advisory group to assist in preparing the state to meet the 94.27 requirements for achieving an agreement. 94.28 Subd. 3. [RULES.] The commissioner of health may adopt 94.29 rules for the state assumption of regulation under an agreement 94.30 under this section, including the licensing and regulation of 94.31 by-product, source, and special nuclear material not sufficient 94.32 to form a critical mass. 94.33 Subd. 4. [TRANSITION.] A person who, on the effective date 94.34 of an agreement under this section, possesses a Nuclear 94.35 Regulatory Commission license that is subject to the agreement 94.36 shall be deemed to possess a similar license issued by the 95.1 department of health. Licenses shall expire on the expiration 95.2 date specified in the federal license. 95.3 Subd. 5. [SUNSET.] An agreement entered into before August 95.4 2, 2002, shall remain in effect until terminated or suspended 95.5 under the Atomic Energy Act of 1954, United States Code, title 95.6 42, section 2021, paragraph (j). The governor may not enter 95.7 into an initial agreement with the Nuclear Regulatory Commission 95.8 after August 1, 2002. If an agreement is not entered into, any 95.9 rules adopted under this section are repealed on that date. 95.10 Sec. 105. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.] 95.11 The commissioner of health shall conduct a study of the 95.12 incidence and prevalence of fetal alcohol syndrome in Minnesota. 95.13 The commissioner shall not collect individually identifiable 95.14 data for this study. 95.15 Sec. 106. [MEDICAL EDUCATION AND RESEARCH TRUST FUND 95.16 STUDY.] 95.17 The commissioner of health shall review the current medical 95.18 education and research costs advisory committee structure and 95.19 composition and recommend methods to ensure balanced and 95.20 appropriate representation of major training programs. The 95.21 commissioner shall also review the statutory formula for the 95.22 prepaid medical assistance carve out to determine if any 95.23 adjustments should be made to correct existing or potential 95.24 inequities on current training programs. The commissioner shall 95.25 determine if there should be other criteria for weighting future 95.26 distributions of medical education and research funds beyond the 95.27 current statutory criteria, including the criteria that trainees 95.28 continue to practice in Minnesota. The commissioner shall 95.29 report the findings and recommendations to the legislative 95.30 commission on health care access by December 15, 1998. 95.31 Sec. 107. [FUNDING FOR IMMUNIZATIONS.] 95.32 The commissioner of health, in consultation with the 95.33 commissioner of children, families, and learning, 95.34 representatives of school nurses, and other interested parties, 95.35 shall develop recommendations on how to provide ongoing funding 95.36 for school districts to implement the provisions of Minnesota 96.1 Statutes, section 123.70. These recommendations shall specify 96.2 any statutory changes needed for their implementation. The 96.3 commissioners of health and of children, families, and learning 96.4 shall consider the recommendations in developing their budget 96.5 requests for the 2000-2001 biennial budget. The recommendations 96.6 and any draft legislation needed to implement the 96.7 recommendations shall be submitted to the chairs of the senate 96.8 health and family security budget division, the house health and 96.9 human services finance division, the senate K-12 education 96.10 budget division, and the house K-12 education finance division 96.11 by December 15, 1998. 96.12 Sec. 108. [BOARD OF REHABILITATION THERAPY.] 96.13 The commissioner of health shall convene a work group to 96.14 study the feasibility and need of creating a separate board of 96.15 rehabilitation therapy to regulate rehabilitation therapy 96.16 occupations, including physical therapists, occupational 96.17 therapists, speech-language pathologists, audiologists, and 96.18 hearing instrument dispensers. The work group shall consist of 96.19 members representing physical therapists, occupational 96.20 therapists, speech-language pathologists, audiologists, hearing 96.21 instrument dispensers, and any other related occupation group 96.22 that the commissioner determines should be included. The 96.23 commissioner, in consultation with the work group, shall submit 96.24 to the legislature by January 15, 1999, recommendations on 96.25 establishing a board of rehabilitation therapy and on the 96.26 appropriate occupational groups to be regulated by this board. 96.27 Sec. 109. [REPEALER.] 96.28 Minnesota Statutes 1996, sections 62J.685; 144.491; 96.29 144.9501, subdivisions 12, 14, and 16; and 144.9503, 96.30 subdivisions 5, 8, and 9; and 157.15, subdivision 15, are 96.31 repealed. 96.32 Sec. 110. [EFFECTIVE DATES.] 96.33 (a) Sections 2, 8, 20, 22, 34 to 80, 93, 94, and 97 to 108 96.34 are effective the day following final enactment. 96.35 (b) Sections 9 to 13, 21, and 81 are effective January 1, 96.36 1999. 97.1 ARTICLE 3 97.2 LONG-TERM CARE 97.3 Section 1. Minnesota Statutes 1996, section 144A.04, 97.4 subdivision 5, is amended to read: 97.5 Subd. 5. [ADMINISTRATORS.] Except as otherwise provided by 97.6 this subdivision, a nursing home must have a full time licensed 97.7 nursing home administrator serving the facility. In any nursing 97.8 home of less than2531 beds, the director of nursing services 97.9 may also serve as the licensed nursing home administrator. Two 97.10 nursing homes under common ownership having a total of 150 beds 97.11 or less and located within 75 miles of each other may share the 97.12 services of a licensed administrator if the administrator 97.13 divides full-time work week between the two facilities in 97.14 proportion to the number of beds in each facility. Every 97.15 nursing home shall have a person-in-charge on the premises at 97.16 all times in the absence of the licensed administrator. The 97.17 name of the person in charge must be posted in a conspicuous 97.18 place in the facility. The commissioner of health shall by rule 97.19 promulgate minimum education and experience requirements for 97.20 persons-in-charge, and may promulgate rules specifying the times 97.21 of day during which a licensed administrator must be on the 97.22 nursing home's premises. In the absence of rules adopted by the 97.23 commissioner governing the division of an administrator's time 97.24 between two nursing homes, the administrator shall designate and 97.25 post the times the administrator will be on site in each home on 97.26 a regular basis. A nursing home may employ as its administrator 97.27 the administrator of a hospital licensed pursuant to sections 97.28 144.50 to 144.56 if the individual is licensed as a nursing home 97.29 administrator pursuant to section 144A.20 and the nursing home 97.30 and hospital have a combined total of 150 beds or less and are 97.31 located within one mile of each other. A nonproprietary 97.32 retirement home having fewer than 15 licensed nursing home beds 97.33 may share the services of a licensed administrator with a 97.34 nonproprietary nursing home, having fewer than 150 licensed 97.35 nursing home beds, that is located within 25 miles of the 97.36 retirement home. A nursing home which is located in a facility 98.1 licensed as a hospital pursuant to sections 144.50 to 144.56, 98.2 may employ as its administrator the administrator of the 98.3 hospital if the individual meets minimum education and long term 98.4 care experience criteria set by rule of the commissioner of 98.5 health. 98.6 Sec. 2. Minnesota Statutes 1997 Supplement, section 98.7 144A.071, subdivision 4a, is amended to read: 98.8 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 98.9 best interest of the state to ensure that nursing homes and 98.10 boarding care homes continue to meet the physical plant 98.11 licensing and certification requirements by permitting certain 98.12 construction projects. Facilities should be maintained in 98.13 condition to satisfy the physical and emotional needs of 98.14 residents while allowing the state to maintain control over 98.15 nursing home expenditure growth. 98.16 The commissioner of health in coordination with the 98.17 commissioner of human services, may approve the renovation, 98.18 replacement, upgrading, or relocation of a nursing home or 98.19 boarding care home, under the following conditions: 98.20 (a) to license or certify beds in a new facility 98.21 constructed to replace a facility or to make repairs in an 98.22 existing facility that was destroyed or damaged after June 30, 98.23 1987, by fire, lightning, or other hazard provided: 98.24 (i) destruction was not caused by the intentional act of or 98.25 at the direction of a controlling person of the facility; 98.26 (ii) at the time the facility was destroyed or damaged the 98.27 controlling persons of the facility maintained insurance 98.28 coverage for the type of hazard that occurred in an amount that 98.29 a reasonable person would conclude was adequate; 98.30 (iii) the net proceeds from an insurance settlement for the 98.31 damages caused by the hazard are applied to the cost of the new 98.32 facility or repairs; 98.33 (iv) the new facility is constructed on the same site as 98.34 the destroyed facility or on another site subject to the 98.35 restrictions in section 144A.073, subdivision 5; 98.36 (v) the number of licensed and certified beds in the new 99.1 facility does not exceed the number of licensed and certified 99.2 beds in the destroyed facility; and 99.3 (vi) the commissioner determines that the replacement beds 99.4 are needed to prevent an inadequate supply of beds. 99.5 Project construction costs incurred for repairs authorized under 99.6 this clause shall not be considered in the dollar threshold 99.7 amount defined in subdivision 2; 99.8 (b) to license or certify beds that are moved from one 99.9 location to another within a nursing home facility, provided the 99.10 total costs of remodeling performed in conjunction with the 99.11 relocation of beds does not exceed $750,000; 99.12 (c) to license or certify beds in a project recommended for 99.13 approval under section 144A.073; 99.14 (d) to license or certify beds that are moved from an 99.15 existing state nursing home to a different state facility, 99.16 provided there is no net increase in the number of state nursing 99.17 home beds; 99.18 (e) to certify and license as nursing home beds boarding 99.19 care beds in a certified boarding care facility if the beds meet 99.20 the standards for nursing home licensure, or in a facility that 99.21 was granted an exception to the moratorium under section 99.22 144A.073, and if the cost of any remodeling of the facility does 99.23 not exceed $750,000. If boarding care beds are licensed as 99.24 nursing home beds, the number of boarding care beds in the 99.25 facility must not increase beyond the number remaining at the 99.26 time of the upgrade in licensure. The provisions contained in 99.27 section 144A.073 regarding the upgrading of the facilities do 99.28 not apply to facilities that satisfy these requirements; 99.29 (f) to license and certify up to 40 beds transferred from 99.30 an existing facility owned and operated by the Amherst H. Wilder 99.31 Foundation in the city of St. Paul to a new unit at the same 99.32 location as the existing facility that will serve persons with 99.33 Alzheimer's disease and other related disorders. The transfer 99.34 of beds may occur gradually or in stages, provided the total 99.35 number of beds transferred does not exceed 40. At the time of 99.36 licensure and certification of a bed or beds in the new unit, 100.1 the commissioner of health shall delicense and decertify the 100.2 same number of beds in the existing facility. As a condition of 100.3 receiving a license or certification under this clause, the 100.4 facility must make a written commitment to the commissioner of 100.5 human services that it will not seek to receive an increase in 100.6 its property-related payment rate as a result of the transfers 100.7 allowed under this paragraph; 100.8 (g) to license and certify nursing home beds to replace 100.9 currently licensed and certified boarding care beds which may be 100.10 located either in a remodeled or renovated boarding care or 100.11 nursing home facility or in a remodeled, renovated, newly 100.12 constructed, or replacement nursing home facility within the 100.13 identifiable complex of health care facilities in which the 100.14 currently licensed boarding care beds are presently located, 100.15 provided that the number of boarding care beds in the facility 100.16 or complex are decreased by the number to be licensed as nursing 100.17 home beds and further provided that, if the total costs of new 100.18 construction, replacement, remodeling, or renovation exceed ten 100.19 percent of the appraised value of the facility or $200,000, 100.20 whichever is less, the facility makes a written commitment to 100.21 the commissioner of human services that it will not seek to 100.22 receive an increase in its property-related payment rate by 100.23 reason of the new construction, replacement, remodeling, or 100.24 renovation. The provisions contained in section 144A.073 100.25 regarding the upgrading of facilities do not apply to facilities 100.26 that satisfy these requirements; 100.27 (h) to license as a nursing home and certify as a nursing 100.28 facility a facility that is licensed as a boarding care facility 100.29 but not certified under the medical assistance program, but only 100.30 if the commissioner of human services certifies to the 100.31 commissioner of health that licensing the facility as a nursing 100.32 home and certifying the facility as a nursing facility will 100.33 result in a net annual savings to the state general fund of 100.34 $200,000 or more; 100.35 (i) to certify, after September 30, 1992, and prior to July 100.36 1, 1993, existing nursing home beds in a facility that was 101.1 licensed and in operation prior to January 1, 1992; 101.2 (j) to license and certify new nursing home beds to replace 101.3 beds in a facilitycondemnedacquired by the Minneapolis 101.4 community development agency as part ofan economic101.5 redevelopmentplanactivities in a city of the first class, 101.6 provided the new facility is located withinone milethree miles 101.7 of the site of the old facility. Operating and property costs 101.8 for the new facility must be determined and allowed 101.9 underexisting reimbursement rulessection 256B.431 or 256B.434; 101.10 (k) to license and certify up to 20 new nursing home beds 101.11 in a community-operated hospital and attached convalescent and 101.12 nursing care facility with 40 beds on April 21, 1991, that 101.13 suspended operation of the hospital in April 1986. The 101.14 commissioner of human services shall provide the facility with 101.15 the same per diem property-related payment rate for each 101.16 additional licensed and certified bed as it will receive for its 101.17 existing 40 beds; 101.18 (l) to license or certify beds in renovation, replacement, 101.19 or upgrading projects as defined in section 144A.073, 101.20 subdivision 1, so long as the cumulative total costs of the 101.21 facility's remodeling projects do not exceed $750,000; 101.22 (m) to license and certify beds that are moved from one 101.23 location to another for the purposes of converting up to five 101.24 four-bed wards to single or double occupancy rooms in a nursing 101.25 home that, as of January 1, 1993, was county-owned and had a 101.26 licensed capacity of 115 beds; 101.27 (n) to allow a facility that on April 16, 1993, was a 101.28 106-bed licensed and certified nursing facility located in 101.29 Minneapolis to layaway all of its licensed and certified nursing 101.30 home beds. These beds may be relicensed and recertified in a 101.31 newly-constructed teaching nursing home facility affiliated with 101.32 a teaching hospital upon approval by the legislature. The 101.33 proposal must be developed in consultation with the interagency 101.34 committee on long-term care planning. The beds on layaway 101.35 status shall have the same status as voluntarily delicensed and 101.36 decertified beds, except that beds on layaway status remain 102.1 subject to the surcharge in section 256.9657. This layaway 102.2 provision expires July 1, 1998; 102.3 (o) to allow a project which will be completed in 102.4 conjunction with an approved moratorium exception project for a 102.5 nursing home in southern Cass county and which is directly 102.6 related to that portion of the facility that must be repaired, 102.7 renovated, or replaced, to correct an emergency plumbing problem 102.8 for which a state correction order has been issued and which 102.9 must be corrected by August 31, 1993; 102.10 (p) to allow a facility that on April 16, 1993, was a 102.11 368-bed licensed and certified nursing facility located in 102.12 Minneapolis to layaway, upon 30 days prior written notice to the 102.13 commissioner, up to 30 of the facility's licensed and certified 102.14 beds by converting three-bed wards to single or double 102.15 occupancy. Beds on layaway status shall have the same status as 102.16 voluntarily delicensed and decertified beds except that beds on 102.17 layaway status remain subject to the surcharge in section 102.18 256.9657, remain subject to the license application and renewal 102.19 fees under section 144A.07 and shall be subject to a $100 per 102.20 bed reactivation fee. In addition, at any time within three 102.21 years of the effective date of the layaway, the beds on layaway 102.22 status may be: 102.23 (1) relicensed and recertified upon relocation and 102.24 reactivation of some or all of the beds to an existing licensed 102.25 and certified facility or facilities located in Pine River, 102.26 Brainerd, or International Falls; provided that the total 102.27 project construction costs related to the relocation of beds 102.28 from layaway status for any facility receiving relocated beds 102.29 may not exceed the dollar threshold provided in subdivision 2 102.30 unless the construction project has been approved through the 102.31 moratorium exception process under section 144A.073; 102.32 (2) relicensed and recertified, upon reactivation of some 102.33 or all of the beds within the facility which placed the beds in 102.34 layaway status, if the commissioner has determined a need for 102.35 the reactivation of the beds on layaway status. 102.36 The property-related payment rate of a facility placing 103.1 beds on layaway status must be adjusted by the incremental 103.2 change in its rental per diem after recalculating the rental per 103.3 diem as provided in section 256B.431, subdivision 3a, paragraph 103.4 (d). The property-related payment rate for a facility 103.5 relicensing and recertifying beds from layaway status must be 103.6 adjusted by the incremental change in its rental per diem after 103.7 recalculating its rental per diem using the number of beds after 103.8 the relicensing to establish the facility's capacity day 103.9 divisor, which shall be effective the first day of the month 103.10 following the month in which the relicensing and recertification 103.11 became effective. Any beds remaining on layaway status more 103.12 than three years after the date the layaway status became 103.13 effective must be removed from layaway status and immediately 103.14 delicensed and decertified; 103.15 (q) to license and certify beds in a renovation and 103.16 remodeling project to convert 12 four-bed wards into 24 two-bed 103.17 rooms, expand space, and add improvements in a nursing home 103.18 that, as of January 1, 1994, met the following conditions: the 103.19 nursing home was located in Ramsey county; had a licensed 103.20 capacity of 154 beds; and had been ranked among the top 15 103.21 applicants by the 1993 moratorium exceptions advisory review 103.22 panel. The total project construction cost estimate for this 103.23 project must not exceed the cost estimate submitted in 103.24 connection with the 1993 moratorium exception process; 103.25 (r) to license and certify up to 117 beds that are 103.26 relocated from a licensed and certified 138-bed nursing facility 103.27 located in St. Paul to a hospital with 130 licensed hospital 103.28 beds located in South St. Paul, provided that the nursing 103.29 facility and hospital are owned by the same or a related 103.30 organization and that prior to the date the relocation is 103.31 completed the hospital ceases operation of its inpatient 103.32 hospital services at that hospital. After relocation, the 103.33 nursing facility's status under section 256B.431, subdivision 103.34 2j, shall be the same as it was prior to relocation. The 103.35 nursing facility's property-related payment rate resulting from 103.36 the project authorized in this paragraph shall become effective 104.1 no earlier than April 1, 1996. For purposes of calculating the 104.2 incremental change in the facility's rental per diem resulting 104.3 from this project, the allowable appraised value of the nursing 104.4 facility portion of the existing health care facility physical 104.5 plant prior to the renovation and relocation may not exceed 104.6 $2,490,000; 104.7 (s) to license and certify two beds in a facility to 104.8 replace beds that were voluntarily delicensed and decertified on 104.9 June 28, 1991; 104.10 (t) to allow 16 licensed and certified beds located on July 104.11 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 104.12 facility in Minneapolis, notwithstanding the licensure and 104.13 certification after July 1, 1995, of the Minneapolis facility as 104.14 a 147-bed nursing home facility after completion of a 104.15 construction project approved in 1993 under section 144A.073, to 104.16 be laid away upon 30 days' prior written notice to the 104.17 commissioner. Beds on layaway status shall have the same status 104.18 as voluntarily delicensed or decertified beds except that they 104.19 shall remain subject to the surcharge in section 256.9657. The 104.20 16 beds on layaway status may be relicensed as nursing home beds 104.21 and recertified at any time within five years of the effective 104.22 date of the layaway upon relocation of some or all of the beds 104.23 to a licensed and certified facility located in Watertown, 104.24 provided that the total project construction costs related to 104.25 the relocation of beds from layaway status for the Watertown 104.26 facility may not exceed the dollar threshold provided in 104.27 subdivision 2 unless the construction project has been approved 104.28 through the moratorium exception process under section 144A.073. 104.29 The property-related payment rate of the facility placing 104.30 beds on layaway status must be adjusted by the incremental 104.31 change in its rental per diem after recalculating the rental per 104.32 diem as provided in section 256B.431, subdivision 3a, paragraph 104.33 (d). The property-related payment rate for the facility 104.34 relicensing and recertifying beds from layaway status must be 104.35 adjusted by the incremental change in its rental per diem after 104.36 recalculating its rental per diem using the number of beds after 105.1 the relicensing to establish the facility's capacity day 105.2 divisor, which shall be effective the first day of the month 105.3 following the month in which the relicensing and recertification 105.4 became effective. Any beds remaining on layaway status more 105.5 than five years after the date the layaway status became 105.6 effective must be removed from layaway status and immediately 105.7 delicensed and decertified; 105.8 (u) to license and certify beds that are moved within an 105.9 existing area of a facility or to a newly constructed addition 105.10 which is built for the purpose of eliminating three- and 105.11 four-bed rooms and adding space for dining, lounge areas, 105.12 bathing rooms, and ancillary service areas in a nursing home 105.13 that, as of January 1, 1995, was located in Fridley and had a 105.14 licensed capacity of 129 beds; 105.15 (v) to relocate 36 beds in Crow Wing county and four beds 105.16 from Hennepin county to a 160-bed facility in Crow Wing county, 105.17 provided all the affected beds are under common ownership; 105.18 (w) to license and certify a total replacement project of 105.19 up to 49 beds located in Norman county that are relocated from a 105.20 nursing home destroyed by flood and whose residents were 105.21 relocated to other nursing homes. The operating cost payment 105.22 rates for the new nursing facility shall be determined based on 105.23 the interim and settle-up payment provisions of Minnesota Rules, 105.24 part 9549.0057, and the reimbursement provisions of section 105.25 256B.431, except that subdivision 26, paragraphs (a) and (b), 105.26 shall not apply until the second rate year after the settle-up 105.27 cost report is filed. Property-related reimbursement rates 105.28 shall be determined under section 256B.431, taking into account 105.29 any federal or state flood-related loans or grants provided to 105.30 the facility; 105.31 (x) to license and certify a total replacement project of 105.32 up to 129 beds located in Polk county that are relocated from a 105.33 nursing home destroyed by flood and whose residents were 105.34 relocated to other nursing homes. The operating cost payment 105.35 rates for the new nursing facility shall be determined based on 105.36 the interim and settle-up payment provisions of Minnesota Rules, 106.1 part 9549.0057, and the reimbursement provisions of section 106.2 256B.431, except that subdivision 26, paragraphs (a) and (b), 106.3 shall not apply until the second rate year after the settle-up 106.4 cost report is filed. Property-related reimbursement rates 106.5 shall be determined under section 256B.431, taking into account 106.6 any federal or state flood-related loans or grants provided to 106.7 the facility;or106.8 (y) to license and certify beds in a renovation and 106.9 remodeling project to convert 13 three-bed wards into 13 two-bed 106.10 rooms and 13 single-bed rooms, expand space, and add 106.11 improvements in a nursing home that, as of January 1, 1994, met 106.12 the following conditions: the nursing home was located in 106.13 Ramsey county, was not owned by a hospital corporation, had a 106.14 licensed capacity of 64 beds, and had been ranked among the top 106.15 15 applicants by the 1993 moratorium exceptions advisory review 106.16 panel. The total project construction cost estimate for this 106.17 project must not exceed the cost estimate submitted in 106.18 connection with the 1993 moratorium exception process.; 106.19 (z) to license and certify up to 150 nursing home beds to 106.20 replace an existing 285 bed nursing facility located in St. 106.21 Paul. The replacement project shall include both the renovation 106.22 of existing buildings and the construction of new facilities at 106.23 the existing site. The reduction in the licensed capacity of 106.24 the existing facility shall occur during the construction 106.25 project as beds are taken out of service due to the construction 106.26 process. Prior to the start of the construction process, the 106.27 facility shall provide written information to the commissioner 106.28 of health describing the process for bed reduction, plans for 106.29 the relocation of residents, and the estimated construction 106.30 schedule. The relocation of residents shall be in accordance 106.31 with the provisions of law and rule; or 106.32 (aa) to allow the commissioner of human services to license 106.33 an additional 36 beds to provide residential services for the 106.34 physically handicapped under Minnesota Rules, parts 9570.2000 to 106.35 9570.3400, in a 198-bed nursing home located in Red Wing, 106.36 provided that the total number of licensed and certified beds at 107.1 the facility does not increase. 107.2 Sec. 3. Minnesota Statutes 1996, section 144A.09, 107.3 subdivision 1, is amended to read: 107.4 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule107.5establishedSections 144A.04, subdivision 5, and 144A.18 to 107.6 144A.27, and rules adopted under sections 144A.01 to 144A.16 107.7 other than a rule relating to sanitation and safety of premises, 107.8 to cleanliness of operation, or to physical equipmentshalldo 107.9 not apply to a nursing home conducted by and for the adherents 107.10 of any recognized church or religious denomination for the 107.11 purpose of providing care and treatment for those who select and 107.12 depend upon spiritual means through prayer alone, in lieu of 107.13 medical care, for healing. 107.14 Sec. 4. Minnesota Statutes 1996, section 256B.431, 107.15 subdivision 2i, is amended to read: 107.16 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 107.17 [OTHER OPERATING COST LIMITS.] For the rate year beginning July 107.18 1, 1988, the commissioner shall increase the other operating 107.19 cost limits established in Minnesota Rules, part 9549.0055, 107.20 subpart 2, item E, to 110 percent of the median of the array of 107.21 allowable historical other operating cost per diems and index 107.22 these limits as in Minnesota Rules, part 9549.0056, subparts 3 107.23 and 4. The limits must be established in accordance with 107.24 subdivision 2b, paragraph (d). For rate years beginning on or 107.25 after July 1, 1989, the adjusted other operating cost limits 107.26 must be indexed as in Minnesota Rules, part 9549.0056, subparts 107.27 3 and 4. For the rate period beginning October 1, 1992, and for 107.28 rate years beginning after June 30, 1993, the amount of the 107.29 surcharge under section 256.9657, subdivision 1, shall be 107.30 included in the plant operations and maintenance operating cost 107.31 category. The surcharge shall be an allowable cost for the 107.32 purpose of establishing the payment rate. 107.33 (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate 107.34 year beginning July 1, 1988, the commissioner shall increase the 107.35 care-related operating cost limits established in Minnesota 107.36 Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 108.1 of the median of the array of the allowable historical case mix 108.2 operating cost standardized per diems and the allowable 108.3 historical other care-related operating cost per diems and index 108.4 those limits as in Minnesota Rules, part 9549.0056, subparts 1 108.5 and 2. The limits must be established in accordance with 108.6 subdivision 2b, paragraph (d). For rate years beginning on or 108.7 after July 1, 1989, the adjusted care-related limits must be 108.8 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 108.9 (c) [SALARY ADJUSTMENT PER DIEM.]For the rate period108.10 EffectiveOctoberJuly 1,19881998, to June 30,1990108.11 2000, the commissioner shalladd the appropriatemake available 108.12 the salary adjustment per diem calculated in clause (1) or (2) 108.13 to the total operating cost payment rate of each nursing 108.14 facility reimbursed under this section or section 256B.434. The 108.15 salary adjustment per diem for each nursing facility must be 108.16 determined as follows: 108.17 (1) For each nursing facility that reports salaries for 108.18 registered nurses, licensed practical nurses, and aides, 108.19 orderlies and attendants separately, the commissioner shall 108.20 determine the salary adjustment per diem by multiplying the 108.21 total salaries, payroll taxes, and fringe benefits allowed in 108.22 each operating cost category, except management fees and 108.23 administrator and central office salaries and the related 108.24 payroll taxes and fringe benefits, by3.53.0 percent and then 108.25 dividing the resulting amount by the nursing facility's actual 108.26 resident days; and. 108.27 (2) For each nursing facility that does not report salaries 108.28 for registered nurses, licensed practical nurses, aides, 108.29 orderlies, and attendants separately, the salary adjustment per 108.30 diem is the weighted average salary adjustment per diem increase 108.31 determined under clause (1). 108.32Each nursing facility that receives a salary adjustment per108.33diem pursuant to this subdivision shall adjust nursing facility108.34employee salaries by a minimum of the amount determined in108.35clause (1) or (2). The commissioner shall review allowable108.36salary costs, including payroll taxes and fringe benefits, for109.1the reporting year ending September 30, 1989, to determine109.2whether or not each nursing facility complied with this109.3requirement. The commissioner shall report the extent to which109.4each nursing facility complied with the legislative commission109.5on long-term care by August 1, 1990.109.6 (3) A nursing facility may apply for the salary adjustment 109.7 per diem calculated under clauses (1) and (2). The application 109.8 must be made to the commissioner and contain a plan by which the 109.9 nursing facility will distribute the salary adjustment to 109.10 employees of the nursing facility. In order to apply for a 109.11 salary adjustment, a nursing facility reimbursed under section 109.12 256B.434, must report the information required by clause (1) or 109.13 (2) in the application, in the manner specified by the 109.14 commissioner. For nursing facilities in which the employees are 109.15 represented by an exclusive bargaining representative, an 109.16 agreement negotiated and agreed to by the employer and the 109.17 exclusive bargaining representative, after July 1, 1998, may 109.18 constitute the plan for the salary distribution. The 109.19 commissioner shall review the plan to ensure that the salary 109.20 adjustment per diem is used solely to increase the compensation 109.21 of nursing home facility employees. To be eligible, a facility 109.22 must submit its plan for the salary distribution by December 31, 109.23 1998. If a facility's plan for salary distribution is effective 109.24 for its employees after July 1, 1998, the salary adjustment cost 109.25 per diem shall be effective the same date as its plan. 109.26 (4) Additional costs incurred by nursing facilities as a 109.27 result of this salary adjustment are not allowable costs for 109.28 purposes of the September 30, 1998, cost report. 109.29 (d) [NEW BASE YEAR.] The commissioner shall establish new 109.30 base years for both the reporting year ending September 30, 109.31 1989, and the reporting year ending September 30, 1990. In 109.32 establishing new base years, the commissioner must take into 109.33 account: 109.34 (1) statutory changes made in geographic groups; 109.35 (2) redefinitions of cost categories; and 109.36 (3) reclassification, pass-through, or exemption of certain 110.1 costs such as public employee retirement act contributions. 110.2 (e) [NEW BASE YEAR.] The commissioner shall establish a 110.3 new base year for the reporting years ending September 30, 1991, 110.4 and September 30, 1992. In establishing a new base year, the 110.5 commissioner must take into account: 110.6 (1) statutory changes made in geographic groups; 110.7 (2) redefinitions of cost categories; and 110.8 (3) reclassification, pass-through, or exemption of certain 110.9 costs. 110.10 Sec. 5. Minnesota Statutes 1996, section 256B.431, is 110.11 amended by adding a subdivision to read: 110.12 Subd. 2s. [NONALLOWABLE COST.] Costs incurred for any 110.13 activities which are directed at or are intended to influence or 110.14 dissuade employees in the exercise of their legal rights to 110.15 freely engage in the process of selecting an exclusive 110.16 representative for the purpose of collective bargaining with 110.17 their employer shall not be allowable for purposes of setting 110.18 payment rates. 110.19 Sec. 6. Minnesota Statutes 1997 Supplement, section 110.20 256B.431, subdivision 3f, is amended to read: 110.21 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 110.22 [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 110.23 1988, the replacement-cost-new per bed limit must be $32,571 per 110.24 licensed bed in multiple bedrooms and $48,857 per licensed bed 110.25 in a single bedroom. For the rate year beginning July 1, 1989, 110.26 the replacement-cost-new per bed limit for a single bedroom must 110.27 be $49,907 adjusted according to Minnesota Rules, part 110.28 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 110.29 1990, the replacement-cost-new per bed limits must be adjusted 110.30 annually as specified in Minnesota Rules, part 9549.0060, 110.31 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 110.32 replacement-cost-new per bed limits will be adjusted annually as 110.33 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 110.34 subitem (1), except that the index utilized will be the Bureau 110.35 of the Census: Composite fixed-weighted price index as 110.36 published in the C30 Report, Value of New Construction Put in 111.1 Place. 111.2 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 111.3 1988, the commissioner shall increase the rental factor as 111.4 established in Minnesota Rules, part 9549.0060, subpart 8, item 111.5 A, by 6.2 percent rounded to the nearest 100th percent for the 111.6 purpose of reimbursing nursing facilities for soft costs and 111.7 entrepreneurial profits not included in the cost valuation 111.8 services used by the state's contracted appraisers. For rate 111.9 years beginning on or after July 1, 1989, the rental factor is 111.10 the amount determined under this paragraph for the rate year 111.11 beginning July 1, 1988. 111.12 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 111.13 after July 1, 1988, in order to determine property-related 111.14 payment rates under Minnesota Rules, part 9549.0060, for all 111.15 nursing facilities except those whose average length of stay in 111.16 a skilled level of care within a nursing facility is 180 days or 111.17 less, the commissioner shall use 95 percent of capacity days. 111.18 For a nursing facility whose average length of stay in a skilled 111.19 level of care within a nursing facility is 180 days or less, the 111.20 commissioner shall use the greater of resident days or 80 111.21 percent of capacity days but in no event shall the divisor 111.22 exceed 95 percent of capacity days. 111.23 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 111.24 July 1, 1988, and July 1, 1989, the commissioner shall add ten 111.25 cents per resident per day to each nursing facility's 111.26 property-related payment rate. The ten-cent property-related 111.27 payment rate increase is not cumulative from rate year to rate 111.28 year. For the rate year beginning July 1, 1990, the 111.29 commissioner shall increase each nursing facility's equipment 111.30 allowance as established in Minnesota Rules, part 9549.0060, 111.31 subpart 10, by ten cents per resident per day. For rate years 111.32 beginning on or after July 1, 1991, the adjusted equipment 111.33 allowance must be adjusted annually for inflation as in 111.34 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 111.35 rate period beginning October 1, 1992, the equipment allowance 111.36 for each nursing facility shall be increased by 28 percent. For 112.1 rate years beginning after June 30, 1993, the allowance must be 112.2 adjusted annually for inflation. 112.3 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 112.4 INTEREST EXPENSE.] For rate years beginning on or after July 1, 112.5 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 112.6 not apply to outstanding related organization debt incurred 112.7 prior to May 23, 1983, provided that the debt was an allowable 112.8 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 112.9 debt is subject to repayment through annual principal payments, 112.10 and the nursing facility demonstrates to the commissioner's 112.11 satisfaction that the interest rate on the debt was less than 112.12 market interest rates for similar arms-length transactions at 112.13 the time the debt was incurred. If the debt was incurred due to 112.14 a sale between family members, the nursing facility must also 112.15 demonstrate that the seller no longer participates in the 112.16 management or operation of the nursing facility. Debts meeting 112.17 the conditions of this paragraph are subject to all other 112.18 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 112.19 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 112.20 WITH OPERATING LEASES.] For rate years beginning on or after 112.21 July 1, 1990, a nursing facility with operating lease costs 112.22 incurred for the nursing facility's buildings shall receive its 112.23 building capital allowance computed in accordance with Minnesota 112.24 Rules, part 9549.0060, subpart 8. If an operating lease 112.25 provides that the lessee's rent is adjusted to recognize 112.26 improvements made by the lessor and related debt, the costs for 112.27 capital improvements and related debt shall be allowed in the 112.28 computation of the lessee's building capital allowance, provided 112.29 that reimbursement for these costs under an operating lease 112.30 shall not exceed the rate otherwise paid. 112.31 Sec. 7. Minnesota Statutes 1996, section 256B.431, 112.32 subdivision 4, is amended to read: 112.33 Subd. 4. [SPECIAL RATES.] (a) For the rate years beginning 112.34 July 1, 1983, and July 1, 1984, a newly constructed nursing 112.35 facility or one with a capacity increase of 50 percent or more 112.36 may, upon written application to the commissioner, receive an 113.1 interim payment rate for reimbursement for property-related 113.2 costs calculated pursuant to the statutes and rules in effect on 113.3 May 1, 1983, and for operating costs negotiated by the 113.4 commissioner based upon the 60th percentile established for the 113.5 appropriate group under subdivision 2a, to be effective from the 113.6 first day a medical assistance recipient resides in the facility 113.7 or for the added beds. For newly constructed nursing facilities 113.8 which are not included in the calculation of the 60th percentile 113.9 for any group, subdivision 2f, the commissioner shall establish 113.10 by rule procedures for determining interim operating cost 113.11 payment rates and interim property-related cost payment rates. 113.12 The interim payment rate shall not be in effect for more than 17 113.13 months. The commissioner shall establish, by emergency and 113.14 permanent rules, procedures for determining the interim rate and 113.15 for making a retroactive cost settle-up after the first year of 113.16 operation; the cost settled operating cost per diem shall not 113.17 exceed 110 percent of the 60th percentile established for the 113.18 appropriate group. Until procedures determining operating cost 113.19 payment rates according to mix of resident needs are 113.20 established, the commissioner shall establish by rule procedures 113.21 for determining payment rates for nursing facilities which 113.22 provide care under a lesser care level than the level for which 113.23 the nursing facility is certified. 113.24 (b) For the rate years beginning on or after July 1, 1985, 113.25 a newly constructed nursing facility or one with a capacity 113.26 increase of 50 percent or more may, upon written application to 113.27 the commissioner, receive an interim payment rate for 113.28 reimbursement for property related costs, operating costs, and 113.29 real estate taxes and special assessments calculated under rules 113.30 promulgated by the commissioner. 113.31(c) For rate years beginning on or after July 1, 1983, the113.32commissioner may exclude from a provision of 12 MCAR S 2.050 any113.33facility that is licensed by the commissioner of health only as113.34a boarding care home, certified by the commissioner of health as113.35an intermediate care facility, is licensed by the commissioner113.36of human services under Minnesota Rules, parts 9520.0500 to114.19520.0690, and has less than five percent of its licensed114.2boarding care capacity reimbursed by the medical assistance114.3program. Until a permanent rule to establish the payment rates114.4for facilities meeting these criteria is promulgated, the114.5commissioner shall establish the medical assistance payment rate114.6as follows:114.7(1) The desk audited payment rate in effect on June 30,114.81983, remains in effect until the end of the facility's fiscal114.9year. The commissioner shall not allow any amendments to the114.10cost report on which this desk audited payment rate is based.114.11(2) For each fiscal year beginning between July 1, 1983,114.12and June 30, 1985, the facility's payment rate shall be114.13established by increasing the desk audited operating cost114.14payment rate determined in clause (1) at an annual rate of five114.15percent.114.16(3) For fiscal years beginning on or after July 1, 1985,114.17but before January 1, 1988, the facility's payment rate shall be114.18established by increasing the facility's payment rate in the114.19facility's prior fiscal year by the increase indicated by the114.20consumer price index for Minneapolis and St. Paul.114.21(4) For the fiscal year beginning on January 1, 1988, the114.22facility's payment rate must be established using the following114.23method: The commissioner shall divide the real estate taxes and114.24special assessments payable as stated in the facility's current114.25property tax statement by actual resident days to compute a real114.26estate tax and special assessment per diem. Next, the prior114.27year's payment rate must be adjusted by the higher of (1) the114.28percentage change in the consumer price index (CPI-U U.S. city114.29average) as published by the Bureau of Labor Statistics between114.30the previous two Septembers, new series index (1967-100), or (2)114.312.5 percent, to determine an adjusted payment rate. The114.32facility's payment rate is the adjusted prior year's payment114.33rate plus the real estate tax and special assessment per diem.114.34(5) For fiscal years beginning on or after January 1, 1989,114.35the facility's payment rate must be established using the114.36following method: The commissioner shall divide the real estate115.1taxes and special assessments payable as stated in the115.2facility's current property tax statement by actual resident115.3days to compute a real estate tax and special assessment per115.4diem. Next, the prior year's payment rate less the real estate115.5tax and special assessment per diem must be adjusted by the115.6higher of (1) the percentage change in the consumer price index115.7(CPI-U U.S. city average) as published by the Bureau of Labor115.8Statistics between the previous two Septembers, new series index115.9(1967-100), or (2) 2.5 percent, to determine an adjusted payment115.10rate. The facility's payment rate is the adjusted payment rate115.11plus the real estate tax and special assessment per diem.115.12(6) For the purpose of establishing payment rates under115.13this paragraph, the facility's rate and reporting years coincide115.14with the facility's fiscal year.115.15(d) A facility that meets the criteria of paragraph (c)115.16shall submit annual cost reports on forms prescribed by the115.17commissioner.115.18(e)(c) For the rate year beginning July 1, 1985, each 115.19 nursing facility total payment rate must be effective two 115.20 calendar months from the first day of the month after the 115.21 commissioner issues the rate notice to the nursing facility. 115.22 From July 1, 1985, until the total payment rate becomes 115.23 effective, the commissioner shall make payments to each nursing 115.24 facility at a temporary rate that is the prior rate year's 115.25 operating cost payment rate increased by 2.6 percent plus the 115.26 prior rate year's property-related payment rate and the prior 115.27 rate year's real estate taxes and special assessments payment 115.28 rate. The commissioner shall retroactively adjust the 115.29 property-related payment rate and the real estate taxes and 115.30 special assessments payment rate to July 1, 1985, but must not 115.31 retroactively adjust the operating cost payment rate. 115.32(f)(d) For the purposes of Minnesota Rules, part 115.33 9549.0060, subpart 13, item F, the following types of 115.34 transactions shall not be considered a sale or reorganization of 115.35 a provider entity: 115.36 (1) the sale or transfer of a nursing facility upon death 116.1 of an owner; 116.2 (2) the sale or transfer of a nursing facility due to 116.3 serious illness or disability of an owner as defined under the 116.4 social security act; 116.5 (3) the sale or transfer of the nursing facility upon 116.6 retirement of an owner at 62 years of age or older; 116.7 (4) any transaction in which a partner, owner, or 116.8 shareholder acquires an interest or share of another partner, 116.9 owner, or shareholder in a nursing facility business provided 116.10 the acquiring partner, owner, or shareholder has less than 50 116.11 percent ownership after the acquisition; 116.12 (5) a sale and leaseback to the same licensee which does 116.13 not constitute a change in facility license; 116.14 (6) a transfer of an interest to a trust; 116.15 (7) gifts or other transfers for no consideration; 116.16 (8) a merger of two or more related organizations; 116.17 (9) a transfer of interest in a facility held in 116.18 receivership; 116.19 (10) a change in the legal form of doing business other 116.20 than a publicly held organization which becomes privately held 116.21 or vice versa; 116.22 (11) the addition of a new partner, owner, or shareholder 116.23 who owns less than 20 percent of the nursing facility or the 116.24 issuance of stock; or 116.25 (12) an involuntary transfer including foreclosure, 116.26 bankruptcy, or assignment for the benefit of creditors. 116.27 Any increase in allowable debt or allowable interest 116.28 expense or other cost incurred as a result of the foregoing 116.29 transactions shall be a nonallowable cost for purposes of 116.30 reimbursement under Minnesota Rules, parts 9549.0010 to 116.31 9549.0080. 116.32 Sec. 8. Minnesota Statutes 1996, section 256B.431, 116.33 subdivision 11, is amended to read: 116.34 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 116.35 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 116.36 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 117.1 the rate year beginning July 1, 1990, a nursing facility leased 117.2 prior to January 1, 1986, and currently subject to adverse 117.3 licensure action under section 144A.04, subdivision 4, paragraph 117.4 (a), or section 144A.11, subdivision 2, and whose ownership 117.5 changes prior to July 1, 1990, shall be allowed a 117.6 property-related payment equal to the lesser of its current 117.7 lease obligation divided by its capacity days as determined in 117.8 Minnesota Rules, part 9549.0060, subpart 11, as modified by 117.9 subdivision 3f, paragraph (c), or the frozen property-related 117.10 payment rate in effect for the rate year beginning July 1, 117.11 1989. For rate years beginning on or after July 1, 1991, the 117.12 property-related payment rate shall be its rental rate computed 117.13 using the previous owner's allowable principal and interest 117.14 expense as allowed by the department prior to that prior owner's 117.15 sale and lease-back transaction of December 1985. 117.16 (b) Notwithstanding other provisions of applicable law, a 117.17 nursing facility licensed for 122 beds on January 1, 1998, and 117.18 located in Columbia Heights shall have its property-related 117.19 payment rate set under this subdivision. The commissioner shall 117.20 make a rate adjustment by adding $2.41 to the facility's July 1, 117.21 1997, property-related payment rate. The adjusted 117.22 property-related payment rate shall be effective for rate years 117.23 beginning on or after July 1, 1998. The adjustment in this 117.24 paragraph shall remain in effect so long as the facility's rates 117.25 are set under this section. If the facility participates in the 117.26 alternative payment system under section 256B.434, the 117.27 adjustment in this paragraph shall be included in the facility's 117.28 contract payment rate. If historical rates or property costs 117.29 recognized under this section become the basis for future 117.30 medical assistance payments to the facility under a managed 117.31 care, capitation, or other alternative payment system, the 117.32 adjustment in this paragraph shall be included in the 117.33 computation of the facility's payments. 117.34 Sec. 9. Minnesota Statutes 1996, section 256B.431, 117.35 subdivision 22, is amended to read: 117.36 Subd. 22. [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The 118.1 nursing facility reimbursement changes in paragraphs (a) to (e) 118.2 apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this 118.3 section, and are effective for rate years beginning on or after 118.4 July 1, 1993, unless otherwise indicated. 118.5 (a) In addition to the approved pension or profit sharing 118.6 plans allowed by the reimbursement rule, the commissioner shall 118.7 allow those plans specified in Internal Revenue Code, sections 118.8 403(b) and 408(k). 118.9 (b) The commissioner shall allow as workers' compensation 118.10 insurance costs under section 256B.421, subdivision 14, the 118.11 costs of workers' compensation coverage obtained under the 118.12 following conditions: 118.13 (1) a plan approved by the commissioner of commerce as a 118.14 Minnesota group or individual self-insurance plan as provided in 118.15 section 79A.03; 118.16 (2) a plan in which: 118.17 (i) the nursing facility, directly or indirectly, purchases 118.18 workers' compensation coverage in compliance with section 118.19 176.181, subdivision 2, from an authorized insurance carrier; 118.20 (ii) a related organization to the nursing facility 118.21 reinsures the workers' compensation coverage purchased, directly 118.22 or indirectly, by the nursing facility; and 118.23 (iii) all of the conditions in clause (4) are met; 118.24 (3) a plan in which: 118.25 (i) the nursing facility, directly or indirectly, purchases 118.26 workers' compensation coverage in compliance with section 118.27 176.181, subdivision 2, from an authorized insurance carrier; 118.28 (ii) the insurance premium is calculated retrospectively, 118.29 including a maximum premium limit, and paid using the paid loss 118.30 retro method; and 118.31 (iii) all of the conditions in clause (4) are met; 118.32 (4) additional conditions are: 118.33 (i) the costs of the plan are allowable under the federal 118.34 Medicare program; 118.35 (ii) the reserves for the plan are maintained in an account 118.36 controlled and administered by a person which is not a related 119.1 organization to the nursing facility; 119.2 (iii) the reserves for the plan cannot be used, directly or 119.3 indirectly, as collateral for debts incurred or other 119.4 obligations of the nursing facility or related organizations to 119.5 the nursing facility; 119.6 (iv) if the plan provides workers' compensation coverage 119.7 for non-Minnesota nursing facilities, the plan's cost 119.8 methodology must be consistent among all nursing facilities 119.9 covered by the plan, and if reasonable, is allowed 119.10 notwithstanding any reimbursement laws regarding cost allocation 119.11 to the contrary; 119.12 (v) central, affiliated, corporate, or nursing facility 119.13 costs related to their administration of the plan are costs 119.14 which must remain in the nursing facility's administrative cost 119.15 category and must not be allocated to other cost categories;and119.16 (vi) required security deposits, whether in the form of 119.17 cash, investments, securities, assets, letters of credit, or in 119.18 any other form are not allowable costs for purposes of 119.19 establishing the facilities payment rate.; and 119.20 (vii) for the rate year beginning on July 1, 1998, a group 119.21 of nursing facilities related by common ownership that 119.22 self-insures workers' compensation may allocate its directly 119.23 identified costs of self-insuring its Minnesota nursing facility 119.24 workers among those nursing facilities in the group that are 119.25 reimbursed under this section or section 256B.434. The method 119.26 of cost allocation shall be based on the ratio of each nursing 119.27 facility's total allowable salaries and wages to that of the 119.28 nursing facility group's total allowable salaries and wages, 119.29 then similarly allocated within each nursing facility's 119.30 operating cost categories. The costs associated with the 119.31 administration of the group's self-insurance plan must remain 119.32 classified in the nursing facility's administrative cost 119.33 category. A written request of the nursing facility group's 119.34 election to use this alternate method of allocation of 119.35 self-insurance costs must be received by the commissioner no 119.36 later than May 1, 1998, to take effect July 1, 1998, or such 120.1 costs shall continue to be allocated under the existing cost 120.2 allocation methods. Once a nursing facility group elects this 120.3 method of cost allocation for its workers' compensation 120.4 self-insurance costs, it shall remain in effect until such time 120.5 as the group no longer self-insures these costs; 120.6 (5) any costs allowed pursuant to clauses (1) to (3) are 120.7 subject to the following requirements: 120.8 (i) if the nursing facility is sold or otherwise ceases 120.9 operations, the plan's reserves must be subject to an 120.10 actuarially based settle-up after 36 months from the date of 120.11 sale or the date on which operations ceased. The facility's 120.12 medical assistance portion of the total excess plan reserves 120.13 must be paid to the state within 30 days following the date on 120.14 which excess plan reserves are determined; 120.15 (ii) any distribution of excess plan reserves made to or 120.16 withdrawals made by the nursing facility or a related 120.17 organization are applicable credits and must be used to reduce 120.18 the nursing facility's workers' compensation insurance costs in 120.19 the reporting period in which a distribution or withdrawal is 120.20 received; 120.21 (iii) if reimbursement for the plan is sought under the 120.22 federal Medicare program, and is audited pursuant to the 120.23 Medicare program, the nursing facility must provide a copy of 120.24 Medicare's final audit report, including attachments and 120.25 exhibits, to the commissioner within 30 days of receipt by the 120.26 nursing facility or any related organization. The commissioner 120.27 shall implement the audit findings associated with the plan upon 120.28 receipt of Medicare's final audit report. The department's 120.29 authority to implement the audit findings is independent of its 120.30 authority to conduct a field audit. 120.31 (c) In the determination of incremental increases in the 120.32 nursing facility's rental rate as required in subdivisions 14 to 120.33 21, except for a refinancing permitted under subdivision 19, the 120.34 commissioner must adjust the nursing facility's property-related 120.35 payment rate for both incremental increases and decreases in 120.36 recomputations of its rental rate; 121.1 (d) A nursing facility's administrative cost limitation 121.2 must be modified as follows: 121.3 (1) if the nursing facility's licensed beds exceed 195 121.4 licensed beds, the general and administrative cost category 121.5 limitation shall be 13 percent; 121.6 (2) if the nursing facility's licensed beds are more than 121.7 150 licensed beds, but less than 196 licensed beds, the general 121.8 and administrative cost category limitation shall be 14 percent; 121.9 or 121.10 (3) if the nursing facility's licensed beds is less than 121.11 151 licensed beds, the general and administrative cost category 121.12 limitation shall remain at 15 percent. 121.13 (e) The care related operating rate shall be increased by 121.14 eight cents to reimburse facilities for unfunded federal 121.15 mandates, including costs related to hepatitis B vaccinations. 121.16 (f) For the rate year beginning on July 1, 1998, a group of 121.17 nursing facilities related by common ownership that self-insures 121.18 group health, dental, or life insurance may allocate its 121.19 directly identified costs of self-insuring its Minnesota nursing 121.20 facility workers among those nursing facilities in the group 121.21 that are reimbursed under this section or section 256B.434. The 121.22 method of cost allocation shall be based on the ratio of each 121.23 nursing facility's total allowable salaries and wages to that of 121.24 the nursing facility group's total allowable salaries and wages, 121.25 then similarly allocated within each nursing facility's 121.26 operating cost categories. The costs associated with the 121.27 administration of the group's self-insurance plan must remain 121.28 classified in the nursing facility's administrative cost 121.29 category. A written request of the nursing facility group's 121.30 election to use this alternate method of allocation of 121.31 self-insurance costs must be received by the commissioner no 121.32 later than May 1, 1998, to take effect July 1, 1998, or those 121.33 self-insurance costs shall continue to be allocated under the 121.34 existing cost allocation methods. Once a nursing facility group 121.35 elects this method of cost allocation for its group health, 121.36 dental, or life insurance self-insurance costs, it shall remain 122.1 in effect until such time as the group no longer self-insures 122.2 these costs. 122.3 Sec. 10. Minnesota Statutes 1997 Supplement, section 122.4 256B.431, subdivision 26, is amended to read: 122.5 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 122.6 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 122.7 changes in paragraphs (a) to (f) shall apply in the sequence 122.8 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 122.9 this section, beginning July 1, 1997. 122.10 (a) For rate years beginning on or after July 1, 1997, the 122.11 commissioner shall limit a nursing facility's allowable 122.12 operating per diem for each case mix category for each rate year. 122.13 The commissioner shall group nursing facilities into two groups, 122.14 freestanding and nonfreestanding, within each geographic group, 122.15 using their operating cost per diem for the case mix A 122.16 classification. A nonfreestanding nursing facility is a nursing 122.17 facility whose other operating cost per diem is subject to the 122.18 hospital attached, short length of stay, or the rule 80 limits. 122.19 All other nursing facilities shall be considered freestanding 122.20 nursing facilities. The commissioner shall then array all 122.21 nursing facilities in each grouping by their allowable case mix 122.22 A operating cost per diem. In calculating a nursing facility's 122.23 operating cost per diem for this purpose, the commissioner shall 122.24 exclude the raw food cost per diem related to providing special 122.25 diets that are based on religious beliefs, as determined in 122.26 subdivision 2b, paragraph (h). For those nursing facilities in 122.27 each grouping whose case mix A operating cost per diem: 122.28 (1) is at or below the median of the array, the 122.29 commissioner shall limit the nursing facility's allowable 122.30 operating cost per diem for each case mix category to the lesser 122.31 of the prior reporting year's allowable operating cost per diem 122.32 as specified in Laws 1996, chapter 451, article 3, section 11, 122.33 paragraph (h), plus the inflation factor as established in 122.34 paragraph (d), clause (2), increased by two percentage points, 122.35 or the current reporting year's corresponding allowable 122.36 operating cost per diem; or 123.1 (2) is above the median of the array, the commissioner 123.2 shall limit the nursing facility's allowable operating cost per 123.3 diem for each case mix category to the lesser of the prior 123.4 reporting year's allowable operating cost per diem as specified 123.5 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 123.6 plus the inflation factor as established in paragraph (d), 123.7 clause (2), increased by one percentage point, or the current 123.8 reporting year's corresponding allowable operating cost per diem. 123.9 For purposes of paragraph (a), if a nursing facility 123.10 reports on its cost report a reduction in cost due to a refund 123.11 or credit for a rate year beginning on or after July 1, 1998, 123.12 the commissioner shall increase that facility's spend-up limit 123.13 for the rate year following the current rate year by the amount 123.14 of the cost reduction divided by its resident days for the 123.15 reporting year preceding the rate year in which the adjustment 123.16 is to be made. 123.17 (b) For rate years beginning on or after July 1, 1997, the 123.18 commissioner shall limit the allowable operating cost per diem 123.19 for high cost nursing facilities. After application of the 123.20 limits in paragraph (a) to each nursing facility's operating 123.21 cost per diem, the commissioner shall group nursing facilities 123.22 into two groups, freestanding or nonfreestanding, within each 123.23 geographic group. A nonfreestanding nursing facility is a 123.24 nursing facility whose other operating cost per diem are subject 123.25 to hospital attached, short length of stay, or rule 80 limits. 123.26 All other nursing facilities shall be considered freestanding 123.27 nursing facilities. The commissioner shall then array all 123.28 nursing facilities within each grouping by their allowable case 123.29 mix A operating cost per diem. In calculating a nursing 123.30 facility's operating cost per diem for this purpose, the 123.31 commissioner shall exclude the raw food cost per diem related to 123.32 providing special diets that are based on religious beliefs, as 123.33 determined in subdivision 2b, paragraph (h). For those nursing 123.34 facilities in each grouping whose case mix A operating cost per 123.35 diem exceeds 1.0 standard deviation above the median, the 123.36 commissioner shall reduce their allowable operating cost per 124.1 diem by three percent. For those nursing facilities in each 124.2 grouping whose case mix A operating cost per diem exceeds 0.5 124.3 standard deviation above the median but is less than or equal to 124.4 1.0 standard deviation above the median, the commissioner shall 124.5 reduce their allowable operating cost per diem by two percent. 124.6 However, in no case shall a nursing facility's operating cost 124.7 per diem be reduced below its grouping's limit established at 124.8 0.5 standard deviations above the median. 124.9 (c) For rate years beginning on or after July 1, 1997, the 124.10 commissioner shall determine a nursing facility's efficiency 124.11 incentive by first computing the allowable difference, which is 124.12 the lesser of $4.50 or the amount by which the facility's other 124.13 operating cost limit exceeds its nonadjusted other operating 124.14 cost per diem for that rate year. The commissioner shall 124.15 compute the efficiency incentive by: 124.16 (1) subtracting the allowable difference from $4.50 and 124.17 dividing the result by $4.50; 124.18 (2) multiplying 0.20 by the ratio resulting from clause 124.19 (1), and then; 124.20 (3) adding 0.50 to the result from clause (2); and 124.21 (4) multiplying the result from clause (3) times the 124.22 allowable difference. 124.23 The nursing facility's efficiency incentive payment shall 124.24 be the lesser of $2.25 or the product obtained in clause (4). 124.25 (d) For rate years beginning on or after July 1, 1997, the 124.26 forecasted price index for a nursing facility's allowable 124.27 operating cost per diem shall be determined under clauses (1) 124.28 and (2) using the change in the Consumer Price Index-All Items 124.29 (United States city average) (CPI-U) as forecasted by Data 124.30 Resources, Inc. The commissioner shall use the indices as 124.31 forecasted in the fourth quarter of the calendar year preceding 124.32 the rate year, subject to subdivision 2l, paragraph (c). 124.33 (1) The CPI-U forecasted index for allowable operating cost 124.34 per diem shall be based on the 21-month period from the midpoint 124.35 of the nursing facility's reporting year to the midpoint of the 124.36 rate year following the reporting year. 125.1 (2) For rate years beginning on or after July 1, 1997, the 125.2 forecasted index for operating cost limits referred to in 125.3 subdivision 21, paragraph (b), shall be based on the CPI-U for 125.4 the 12-month period between the midpoints of the two reporting 125.5 years preceding the rate year. 125.6 (e) After applying these provisions for the respective rate 125.7 years, the commissioner shall index these allowable operating 125.8 cost per diem by the inflation factor provided for in paragraph 125.9 (d), clause (1), and add the nursing facility's efficiency 125.10 incentive as computed in paragraph (c). 125.11 (f) For rate years beginning on or after July 1, 1997, the 125.12 total operating cost payment rates for a nursing facility shall 125.13 be the greater of the total operating cost payment rates 125.14 determined under this section or the total operating cost 125.15 payment rates in effect on June 30, 1997, subject to rate 125.16 adjustments due to field audit or rate appeal resolution. This 125.17 provision shall not apply to subsequent field audit adjustments 125.18 of the nursing facility's operating cost rates for rate years 125.19 beginning on or after July 1, 1997. 125.20 (g) For the rate years beginning on July 1, 1997,andJuly 125.21 1, 1998, and July 1, 1999, a nursing facility licensed for 40 125.22 beds effective May 1, 1992, with a subsequent increase of 20 125.23 Medicare/Medicaid certified beds, effective January 26, 1993, in 125.24 accordance with an increase in licensure is exempt from 125.25 paragraphs (a) and (b). 125.26 (h) For a nursing facility whose construction project was 125.27 authorized according to section 144A.073, subdivision 5, 125.28 paragraph (g), the operating cost payment rates for the third 125.29 location shall be determined based on Minnesota Rules, part 125.30 9549.0057. Paragraphs (a) and (b) shall not apply until the 125.31 second rate year after the settle-up cost report is filed. 125.32 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 125.33 and special assessments payable by the third location, a 125.34 501(c)(3) nonprofit corporation, shall be included in the 125.35 payment rates determined under this subdivision for all 125.36 subsequent rate years. 126.1 (i) For the rate year beginning July 1, 1997, the 126.2 commissioner shall compute the payment rate for a nursing 126.3 facility licensed for 94 beds on September 30, 1996, that 126.4 applied in October 1993 for approval of a total replacement 126.5 under the moratorium exception process in section 144A.073, and 126.6 completed the approved replacement in June 1995, with other 126.7 operating cost spend-up limit under paragraph (a), increased by 126.8 $3.98, and after computing the facility's payment rate according 126.9 to this section, the commissioner shall make a one-year positive 126.10 rate adjustment of $3.19 for operating costs related to the 126.11 newly constructed total replacement, without application of 126.12 paragraphs (a) and (b). The facility's per diem, before the 126.13 $3.19 adjustment, shall be used as the prior reporting year's 126.14 allowable operating cost per diem for payment rate calculation 126.15 for the rate year beginning July 1, 1998. A facility described 126.16 in this paragraph is exempt from paragraph (b) for the rate 126.17 years beginning July 1, 1997, and July 1, 1998. 126.18 (j) For the purpose of applying the limit stated in 126.19 paragraph (a), a nursing facility in Kandiyohi county licensed 126.20 for 86 beds that was granted hospital-attached status on 126.21 December 1, 1994, shall have the prior year's allowable 126.22 care-related per diem increased by $3.207 and the prior year's 126.23 other operating cost per diem increased by $4.777 before adding 126.24 the inflation in paragraph (d), clause (2), for the rate year 126.25 beginning on July 1, 1997. 126.26 (k) For the purpose of applying the limit stated in 126.27 paragraph (a), a 117 bed nursing facility located in Pine county 126.28 shall have the prior year's allowable other operating cost per 126.29 diem increased by $1.50 before adding the inflation in paragraph 126.30 (d), clause (2), for the rate year beginning on July 1, 1997. 126.31 (l) For the purpose of applying the limit under paragraph 126.32 (a), a nursing facility in Hibbing licensed for 192 beds shall 126.33 have the prior year's allowable other operating cost per diem 126.34 increased by $2.67 before adding the inflation in paragraph (d), 126.35 clause (2), for the rate year beginning July 1, 1997. 126.36 Sec. 11. Minnesota Statutes 1996, section 256B.431, is 127.1 amended by adding a subdivision to read: 127.2 Subd. 27. [CHANGES TO NURSING FACILITY REIMBURSEMENT 127.3 BEGINNING JULY 1, 1998.] (a) For the purpose of applying the 127.4 limit stated in subdivision 26, paragraph (a), a nursing 127.5 facility in Hennepin county licensed for 181 beds on September 127.6 30, 1996, shall have the prior year's allowable care-related per 127.7 diem increased by $1.455 and the prior year's other operating 127.8 cost per diem increased by $0.439 before adding the inflation in 127.9 subdivision 26, paragraph (d), clause (2), for the rate year 127.10 beginning on July 1, 1998. 127.11 (b) For the purpose of applying the limit stated in 127.12 subdivision 26, paragraph (a), a nursing facility in Hennepin 127.13 county licensed for 161 beds on September 30, 1996, shall have 127.14 the prior year's allowable care-related per diem increased by 127.15 $1.154 and the prior year's other operating cost per diem 127.16 increased by $0.256 before adding the inflation in subdivision 127.17 26, paragraph (d), clause (2), for the rate year beginning on 127.18 July 1, 1998. 127.19 (c) For the purpose of applying the limit stated in 127.20 subdivision 26, paragraph (a), a nursing facility in Ramsey 127.21 county licensed for 176 beds on September 30, 1996, shall have 127.22 the prior year's allowable care-related per diem increased by 127.23 $0.803 and the prior year's other operating cost per diem 127.24 increased by $0.272 before adding the inflation in subdivision 127.25 26, paragraph (d), clause (2), for the rate year beginning on 127.26 July 1, 1998. 127.27 (d) For the purpose of applying the limit stated in 127.28 subdivision 26, paragraph (a), a nursing facility in Brown 127.29 county licensed for 86 beds on September 30, 1996, shall have 127.30 the prior year's allowable care-related per diem increased by 127.31 $0.850 and the prior year's other operating cost per diem 127.32 increased by $0.275 before adding the inflation in subdivision 127.33 26, paragraph (d), clause (2), for the rate year beginning on 127.34 July 1, 1998. 127.35 (e) For the rate year beginning July 1, 1998, the 127.36 commissioner shall compute the payment rate for a nursing 128.1 facility, which was licensed for 110 beds on May 1, 1997, was 128.2 granted approval in January 1994 for a replacement and 128.3 remodeling project under the moratorium exception process in 128.4 section 144A.073, and completed the approved replacement and 128.5 remodeling project on March 14, 1997, by increasing the other 128.6 operating cost spend-up limit under paragraph (a) by $1.64. 128.7 After computing the facility's payment rate for the rate year 128.8 beginning July 1, 1998, according to this section, the 128.9 commissioner shall make a one-year positive rate adjustment of 128.10 48 cents for increased real estate taxes resulting from 128.11 completion of the moratorium exception project, without 128.12 application of paragraphs (a) and (b). 128.13 (f) For the rate year beginning July 1, 1998, the 128.14 commissioner shall compute the payment rate for a nursing 128.15 facility exempted from care-related limits under subdivision 2b, 128.16 paragraph (d), clause (2), with a minimum of three-quarters of 128.17 its beds licensed to provide residential services for the 128.18 physically handicapped under Minnesota Rules, parts 9570.2000 to 128.19 9570.3400, with the care-related spend-up limit under 128.20 subdivision 26, paragraph (a), increased by $13.21 for the rate 128.21 year beginning July 1, 1998, without application of subdivision 128.22 26, paragraph (b). For rate years beginning on or after July 1, 128.23 1999, the commissioner shall exclude that amount in calculating 128.24 the facility's operating cost per diem for purposes of applying 128.25 subdivision 26, paragraph (b). 128.26 (g) For the rate year beginning July 1, 1998, a nursing 128.27 facility in Canby, Minnesota, licensed for 75 beds shall be 128.28 reimbursed without the limitation imposed under subdivision 26, 128.29 paragraph (a), and for rate years beginning on or after July 1, 128.30 1999, its base costs shall be calculated on the basis of its 128.31 September 30, 1997, cost report. 128.32 (h) The nursing facility reimbursement changes in 128.33 paragraphs (i) and (j) shall apply in the sequence specified in 128.34 this section and Minnesota Rules, parts 9549.0010 to 9549.0080, 128.35 beginning July 1, 1998. 128.36 (i) For rate years beginning on or after July 1, 1998, the 129.1 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 129.2 and 22, paragraph (d), and any previously effective 129.3 corresponding limits in law or rule shall not apply, except that 129.4 these cost limits shall still be calculated for purposes of 129.5 determining efficiency incentive per diems. For rate years 129.6 beginning on or after July 1, 1998, the total operating cost 129.7 payment rates for a nursing facility shall be the greater of the 129.8 total operating cost payment rates determined under this section 129.9 or the total operating cost payment rates in effect on June 30, 129.10 1998, subject to rate adjustments due to field audit or rate 129.11 appeal resolution. 129.12 (j) For rate years beginning on or after July 1, 1998, the 129.13 operating cost per diem referred to in subdivision 26, paragraph 129.14 (a), clauses (1) and (2), is the sum of the care-related and 129.15 other operating per diems for a given case mix class. Any 129.16 reductions to the combined operating per diem shall be divided 129.17 proportionately between the care-related and other operating per 129.18 diems. 129.19 (k) For rate years beginning on or after July 1, 1998, the 129.20 commissioner shall modify the determination of the spend-up 129.21 limits referred to in subdivision 26, paragraph (a), by indexing 129.22 each group's previous year's median value by the factor in 129.23 subdivision 26, paragraph (d), clause (2), plus one percentage 129.24 point. 129.25 (l) For rate years beginning on or after July 1, 1998, the 129.26 commissioner shall modify the determination of the high cost 129.27 limits referred to in subdivision 26, paragraph (b), by indexing 129.28 each group's previous year's high cost per diem limits at .5 and 129.29 one standard deviations above the median by the factor in 129.30 subdivision 26, paragraph (d), clause (2), plus one percentage 129.31 point. 129.32 Sec. 12. Minnesota Statutes 1997 Supplement, section 129.33 256B.433, subdivision 3a, is amended to read: 129.34 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 129.35 BILLING.] The provisions of subdivision 3 do not apply to 129.36 nursing facilities that are reimbursed according to the 130.1 provisions of section 256B.431 and are located in a county 130.2 participating in the prepaid medical assistance 130.3 program. Nursing facilities that are reimbursed according to 130.4 the provisions of section 256B.434 and are located in a county 130.5 participating in the prepaid medical assistance program are 130.6 exempt from the maximum therapy rent revenue provisions of 130.7 subdivision 3, paragraph (c). 130.8 Sec. 13. Minnesota Statutes 1997 Supplement, section 130.9 256B.434, subdivision 10, is amended to read: 130.10 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 130.11 federal law, (1) a facility that has entered into a contract 130.12 under this section is not required to file a cost report, as 130.13 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 130.14 year after the base year that is the basis for the calculation 130.15 of the contract payment rate for the first rate year of the 130.16 alternative payment demonstration project contract; and (2) a 130.17 facility under contract is not subject to audits of historical 130.18 costs or revenues, or paybacks or retroactive adjustments based 130.19 on these costs or revenues, except audits, paybacks, or 130.20 adjustments relating to the cost report that is the basis for 130.21 calculation of the first rate year under the contract. 130.22 (b) A facility that is under contract with the commissioner 130.23 under this section is not subject to the moratorium on licensure 130.24 or certification of new nursing home beds in section 144A.071, 130.25 unless the project results in a net increase in bed capacity or 130.26 involves relocation of beds from one site to another. Contract 130.27 payment rates must not be adjusted to reflect any additional 130.28 costs that a nursing facility incurs as a result of a 130.29 construction project undertaken under this paragraph. In 130.30 addition, as a condition of entering into a contract under this 130.31 section, a nursing facility must agree that any future medical 130.32 assistance payments for nursing facility services will not 130.33 reflect any additional costs attributable to the sale of a 130.34 nursing facility under this section and to construction 130.35 undertaken under this paragraph that otherwise would not be 130.36 authorized under the moratorium in section 144A.073. Nothing in 131.1 this section prevents a nursing facility participating in the 131.2 alternative payment demonstration project under this section 131.3 from seeking approval of an exception to the moratorium through 131.4 the process established in section 144A.073, and if approved the 131.5 facility's rates shall be adjusted to reflect the cost of the 131.6 project. Nothing in this section prevents a nursing facility 131.7 participating in the alternative payment demonstration project 131.8 from seeking legislative approval of an exception to the 131.9 moratorium under section 144A.071, and, if enacted, the 131.10 facility's rates shall be adjusted to reflect the cost of the 131.11 project. 131.12 (c) Notwithstanding section 256B.48, subdivision 6, 131.13 paragraphs (c), (d), and (e), and pursuant to any terms and 131.14 conditions contained in the facility's contract, a nursing 131.15 facility that is under contract with the commissioner under this 131.16 section is in compliance with section 256B.48, subdivision 6, 131.17 paragraph (b), if the facility is Medicare certified. 131.18 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 131.19 health care financing administration has not approved a required 131.20 waiver, or the health care financing administration otherwise 131.21 requires cost reports to be filed prior to the waiver's 131.22 approval, the commissioner shall require a cost report for the 131.23 rate year. 131.24 (e) A facility that is under contract with the commissioner 131.25 under this section shall be allowed to change therapy 131.26 arrangements from an unrelated vendor to a related vendor during 131.27 the term of the contract. The commissioner may develop 131.28 reasonable requirements designed to prevent an increase in 131.29 therapy utilization for residents enrolled in the medical 131.30 assistance program. 131.31 Sec. 14. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 131.32 EFFECTIVE JULY 1, 2000.] 131.33 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 131.34 commissioner shall implement a performance-based contracting 131.35 system to replace the current method of setting operating cost 131.36 payment rates under sections 256B.431 and 256B.434 and Minnesota 132.1 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 132.2 operation on May 1, 1998, with payment rates not established 132.3 under section 256B.431 or 256B.434 on that date, is ineligible 132.4 for this performance-based contracting system. In determining 132.5 prospective payment rates of nursing facility services, the 132.6 commissioner shall distinguish between operating costs and 132.7 property-related costs. The commissioner of finance shall 132.8 include an annual inflationary adjustment in operating costs for 132.9 nursing facilities using the inflation factor specified in 132.10 subdivision 3 as a budget change request in each biennial 132.11 detailed expenditure budget submitted to the legislature under 132.12 section 16A.11. Property related payment rates, including real 132.13 estate taxes and special assessments, shall be determined under 132.14 section 256B.431 or 256B.434 or under a new property-related 132.15 reimbursement system, if one is implemented by the commissioner 132.16 under subdivision 3. 132.17 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 132.18 contract with each nursing facility must include provisions that: 132.19 (1) apply the resident case mix assessment provisions of 132.20 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 132.21 another assessment system, with the goal of moving to a single 132.22 assessment system; 132.23 (2) monitor resident outcomes through various methods, such 132.24 as quality indicators based on the minimum data set and other 132.25 utilization and performance measures; 132.26 (3) require the establishment and use of a continuous 132.27 quality improvement process that integrates information from 132.28 quality indicators and regular resident and family satisfaction 132.29 interviews; 132.30 (4) require annual reporting of facility statistical 132.31 information, including resident days by case mix category, 132.32 productive nursing hours, wages and benefits, and raw food costs 132.33 for use by the commissioner in the development of facility 132.34 profiles that include trends in payment and service utilization; 132.35 (5) require from each nursing facility an annual certified 132.36 audited financial statement consisting of a balance sheet, 133.1 income and expense statements, and an opinion from either a 133.2 licensed or certified public accountant, if a certified audit 133.3 was prepared, or unaudited financial statements if no certified 133.4 audit was prepared; and 133.5 (6) establish additional requirements and penalties for 133.6 nursing facilities not meeting the standards set forth in the 133.7 performance-based contract. 133.8 (b) The commissioner may develop additional incentive-based 133.9 payments for achieving outcomes specified in each contract. The 133.10 specified facility-specific outcomes must be measurable and 133.11 approved by the commissioner. 133.12 (c) The commissioner may also contract with nursing 133.13 facilities in other ways through requests for proposals, 133.14 including contracts on a risk or nonrisk basis, with nursing 133.15 facilities or consortia of nursing facilities, to provide 133.16 comprehensive long-term care coverage on a premium or capitated 133.17 basis. 133.18 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 133.19 beginning on or after July 1, 2000, within the limits of 133.20 appropriations specifically for this purpose, the commissioner 133.21 shall determine operating cost payment rates for each licensed 133.22 and certified nursing facility by indexing its operating cost 133.23 payment rates in effect on June 30, 2000, for inflation. The 133.24 inflation factor to be used must be based on the change in the 133.25 Consumer Price Index-All Items, United States city average 133.26 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 133.27 quarter preceding the rate year. The CPI-U forecasted index for 133.28 operating cost payment rates shall be based on the 12-month 133.29 period from the midpoint of the nursing facility's prior rate 133.30 year to the midpoint of the rate year for which the operating 133.31 payment rate is being determined. 133.32 (b) Beginning July 1, 2000, each nursing facility subject 133.33 to a performance-based contract under this section shall choose 133.34 one of two methods of payment for property related costs: 133.35 (1) the method established in section 256B.434; or 133.36 (2) the method established in section 256B.431. 134.1 Once the nursing facility has made the election in paragraph 134.2 (b), that election shall remain in effect for at least four 134.3 years or until an alternative property payment system is 134.4 developed. 134.5 (c) For rate years beginning on or after July 1, 2000, the 134.6 commissioner may implement a new method of payment for property 134.7 related costs that addresses the capital needs of nursing 134.8 facilities. Notwithstanding paragraph (b), the new property 134.9 payment system or systems, if implemented, shall replace the 134.10 current method of setting property payment rates under sections 134.11 256B.431 and 256B.434. 134.12 Sec. 15. Minnesota Statutes 1996, section 256B.501, 134.13 subdivision 12, is amended to read: 134.14 Subd. 12. [ICF/MR SALARY ADJUSTMENTS.]For the rate period134.15beginning JanuaryEffective July 1,19921998,and ending134.16September 30, 1993to September 30, 2000, the commissioner shall 134.17addmake available the appropriate salary adjustment cost per 134.18 diem calculated in paragraphs (a) to(d)(e) to the total 134.19 operating cost payment rate of each facility subject to 134.20 reimbursement under this section and Laws 1993 First Special 134.21 Session, chapter 1, article 4, section 11. The salary 134.22 adjustment cost per diem must be determined as follows: 134.23 (a) [COMPUTATION AND REVIEW GUIDELINES.]Except as134.24provided in paragraph (c),A state-operated community service, 134.25 and any facility whose payment rates are governed by closure 134.26 agreements, receivership agreements, or Minnesota Rules, part 134.27 9553.0075,areis not eligible for a salary adjustment otherwise 134.28 granted under this subdivision. For purposes of the salary 134.29 adjustment per diem computation and reviews in this subdivision, 134.30 the term "salary adjustment cost" means the facility's allowable 134.31 program operating cost category employee training expenses, and 134.32 the facility's allowable salaries, payroll taxes, and fringe 134.33 benefits. The term does not include these same salary-related 134.34 costs for both administrative or central office employees. 134.35 For the purpose of determining the amount of salary 134.36 adjustment to be granted under this subdivision, the 135.1 commissioner must use the reporting year ending December 31, 135.219901996, as the base year for the salary adjustment per diem 135.3 computation.For the purpose of both years' salary adjustment135.4cost review, the commissioner must use the facility's salary135.5adjustment cost for the reporting year ending December 31, 1991,135.6as the base year. If the base year and the reporting years135.7subject to review include salary cost reclassifications made by135.8the department, the commissioner must reconcile those135.9differences before completing the salary adjustment per diem135.10review.135.11 (b) [SALARY ADJUSTMENT PER DIEM COMPUTATION.] For the rate 135.12 period beginningJanuary 1, 1992July 1, 1998, each facility 135.13 shall receive a salary adjustment cost per diem equal to its 135.14 salary adjustment costs multiplied by1-1/23.0 percent, and 135.15 then divided by the facility's resident days. 135.16(c) [ADJUSTMENTS FOR NEW FACILITIES.] For newly135.17constructed or newly established facilities, except for135.18state-operated community services, whose payment rates are135.19governed by Minnesota Rules, part 9553.0075, if the settle-up135.20cost report includes a reporting year which is subject to review135.21under this subdivision, the commissioner shall adjust the rule135.22provision governing the maximum settle-up payment rate by135.23increasing the .4166 percent for each full month of the135.24settle-up cost report to .7083. For any subsequent rate period135.25which is authorized for salary adjustments under this135.26subdivision, the commissioner shall compute salary adjustment135.27cost per diems by annualizing the salary adjustment costs for135.28the settle-up cost report period and treat that period as the135.29base year for purposes of reviewing salary adjustment cost per135.30diems.135.31(d) [SALARY ADJUSTMENT PER DIEM REVIEW.] The commissioner135.32shall review the implementation of the salary adjustments on a135.33per diem basis. For reporting years ending December 31, 1992,135.34and December 31, 1993, the commissioner must review and135.35determine the amount of change in salary adjustment costs in135.36both of the above reporting years over the base year after the136.1reporting year ending December 31, 1993. The commissioner must136.2inflate the base year's salary adjustment costs by the136.3cumulative percentage increase granted in paragraph (b), plus136.4three percentage points for each of the two years reviewed. The136.5commissioner must then compare each facility's salary adjustment136.6costs for the reporting year divided by the facility's resident136.7days for both reporting years to the base year's inflated salary136.8adjustment cost divided by the facility's resident days for the136.9base year. If the facility has had a one-time program operating136.10cost adjustment settle-up during any of the reporting years136.11subject to review, the commissioner must remove the per diem136.12effect of the one-time program adjustment before completing the136.13review and per diem comparison.136.14The review and per diem comparison must be done by the136.15commissioner after the reporting year ending December 31, 1993.136.16If the salary adjustment cost per diem for the reporting years136.17being reviewed is less than the base year's inflated salary136.18adjustment cost per diem, the commissioner must recover the136.19difference within 120 days after the date of written notice.136.20The amount of the recovery shall be equal to the per diem136.21difference multiplied by the facility's resident days in the136.22reporting years being reviewed. Written notice of the amount136.23subject to recovery must be given by the commissioner following136.24both reporting years reviewed. Interest charges must be136.25assessed by the commissioner after the 120th day of that notice136.26at the same interest rate the commissioner assesses for other136.27balance outstanding.136.28 (c) [SUBMITTAL OF PLAN.] A facility may apply for the 136.29 salary adjustment per diem calculated under this subdivision. 136.30 The application must be made to the commissioner and contain a 136.31 plan by which the facility will distribute the salary adjustment 136.32 to employees of the facility. For facilities in which the 136.33 employees are represented by an exclusive bargaining 136.34 representative, an agreement negotiated and agreed to by the 136.35 employer and the exclusive bargaining representative, after July 136.36 1, 1998, may constitute the plan for the salary distribution. 137.1 The commissioner shall review the plan to ensure that the salary 137.2 adjustment per diem is used solely to increase the compensation 137.3 of facility employees. To be eligible, a facility must submit 137.4 its plan for the salary distribution by December 31, 1998. If a 137.5 facility's plan for salary distribution is effective for its 137.6 employees after July 1, 1998, the salary adjustment cost per 137.7 diem shall be effective the same date as its plan. 137.8 (d) [COST REPORT.] Additional costs incurred by facilities 137.9 as a result of this salary adjustment are not allowable costs 137.10 for purposes of the December 31, 1998, cost report. 137.11 (e) [SALARY ADJUSTMENT.] In order to apply for a salary 137.12 adjustment, a facility reimbursed under Laws 1993, First Special 137.13 Session chapter 1, article 4, section 11, must report the 137.14 information referred to in paragraph (a) in the application, in 137.15 the manner specified by the commissioner. 137.16 Sec. 16. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 137.17 EFFECTIVE OCTOBER 1, 2000.] 137.18 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 137.19 the commissioner shall implement a performance-based contracting 137.20 system to replace the current method of setting total cost 137.21 payment rates under section 256B.501 and Minnesota Rules, parts 137.22 9553.0010 to 9553.0080. In determining prospective payment 137.23 rates of intermediate care facilities for persons with mental 137.24 retardation or related conditions, the commissioner shall index 137.25 each facility's total payment rate by an inflation factor as 137.26 described in subdivision 3. The commissioner of finance shall 137.27 include annual inflation adjustments in operating costs for 137.28 intermediate care facilities for persons with mental retardation 137.29 and related conditions as a budget change request in each 137.30 biennial detailed expenditure budget submitted to the 137.31 legislature under section 16A.11. 137.32 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 137.33 contract with each intermediate care facility must include 137.34 provisions for: 137.35 (1) modifying payments when significant changes occur in 137.36 the needs of the consumers; 138.1 (2) monitoring service quality using performance indicators 138.2 that measure consumer outcomes; 138.3 (3) the establishment and use of continuous quality 138.4 improvement processes using the results attained through service 138.5 quality monitoring; 138.6 (4) the annual reporting of facility statistical 138.7 information on all supervisory personnel, direct care personnel, 138.8 specialized support personnel, hours, wages and benefits, 138.9 staff-to-consumer ratios, and staffing patterns; 138.10 (5) annual aggregate facility financial information or an 138.11 annual certified audited financial statement, including a 138.12 balance sheet and income and expense statements for each 138.13 facility, if a certified audit was prepared; and 138.14 (6) additional requirements and penalties for intermediate 138.15 care facilities not meeting the standards set forth in the 138.16 performance-based contract. 138.17 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 138.18 beginning on or after October 1, 2000, within the limits of 138.19 appropriations specifically for this purpose, the commissioner 138.20 shall determine the total payment rate for each licensed and 138.21 certified intermediate care facility by indexing the total 138.22 payment rate in effect on September 30, 2000, for inflation. 138.23 The inflation factor to be used must be based on the change in 138.24 the Consumer Price Index-All Items, United States city average 138.25 (CPI-U) as forecasted by Data Resources, Inc. in the first 138.26 quarter of the calendar year during which the rate year begins. 138.27 The CPI-U forecasted index for total payment rates shall be 138.28 based on the 12-month period from the midpoint of the facility's 138.29 prior rate year to the midpoint of the rate year for which the 138.30 operating payment rate is being determined. 138.31 Sec. 17. Minnesota Statutes 1996, section 256B.69, is 138.32 amended by adding a subdivision to read: 138.33 Subd. 26. [CONTINUATION OF PAYMENTS THROUGH DISCHARGE.] In 138.34 the event a medical assistance recipient or beneficiary enrolled 138.35 in a health plan under this section is denied nursing facility 138.36 services after residing in the facility for more than 180 days, 139.1 any denial of medical assistance payment to a provider under 139.2 this section shall be prospective only and payments to the 139.3 provider shall continue until the resident is discharged or 30 139.4 days after the effective date of the service denial, whichever 139.5 is sooner. 139.6 Sec. 18. Minnesota Statutes 1996, section 256I.04, 139.7 subdivision 1, is amended to read: 139.8 Subdivision 1. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An 139.9 individual is eligible for and entitled to a group residential 139.10 housing payment to be made on the individual's behalf if the 139.11 county agency has approved the individual's residence in a group 139.12 residential housing setting and the individual meets the 139.13 requirements in paragraph (a) or (b). 139.14 (a) The individual is aged, blind, or is over 18 years of 139.15 age and disabled as determined under the criteria used by the 139.16 title II program of the Social Security Act, and meets the 139.17 resource restrictions and standards of the supplemental security 139.18 income program, and the individual's countable income after 139.19 deducting the (1) exclusions and disregards of the SSI 139.20 programand, (2) the medical assistance personal needs allowance 139.21 under section 256B.35, and (3) an amount equal to the income 139.22 actually made available to a community spouse by an elderly 139.23 waiver recipient under the provisions of sections 256B.0575, 139.24 paragraph (a), clause (4), and 256B.058, subdivision 2, is less 139.25 than the monthly rate specified in the county agency's agreement 139.26 with the provider of group residential housing in which the 139.27 individual resides. 139.28 (b) The individual meets a category of eligibility under 139.29 section 256D.05, subdivision 1, paragraph (a), and the 139.30 individual's resources are less than the standards specified by 139.31 section 256D.08, and the individual's countable income as 139.32 determined under sections 256D.01 to 256D.21, less the medical 139.33 assistance personal needs allowance under section 256B.35 is 139.34 less than the monthly rate specified in the county agency's 139.35 agreement with the provider of group residential housing in 139.36 which the individual resides. 140.1 Sec. 19. Minnesota Statutes 1996, section 256I.04, 140.2 subdivision 3, is amended to read: 140.3 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 140.4 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 140.5 into agreements for new group residential housing beds with 140.6 total rates in excess of the MSA equivalent rate except: (1) 140.7 for group residential housing establishments meeting the 140.8 requirements of subdivision 2a, clause (2) with department 140.9 approval; (2) for group residential housing establishments 140.10 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 140.11 provided the facility is needed to meet the census reduction 140.12 targets for persons with mental retardation or related 140.13 conditions at regional treatment centers; (3) to ensure 140.14 compliance with the federal Omnibus Budget Reconciliation Act 140.15 alternative disposition plan requirements for inappropriately 140.16 placed persons with mental retardation or related conditions or 140.17 mental illness; (4) up to 80 beds in a single, specialized 140.18 facility located in Hennepin county that will provide housing 140.19 for chronic inebriates who are repetitive users of 140.20 detoxification centers and are refused placement in emergency 140.21 shelters because of their state of intoxication., and planning 140.22 for the specialized facility must have been initiated before 140.23 July 1, 1991, in anticipation of receiving a grant from the 140.24 housing finance agency under section 462A.05, subdivision 20a, 140.25 paragraph (b); or (5) notwithstanding the provisions of 140.26 subdivision 2a, for up to180190 supportive housing units in 140.27 Anoka, Dakota, Hennepin, or Ramsey county for homeless adults 140.28 with a mental illness, a history of substance abuse, or human 140.29 immunodeficiency virus or acquired immunodeficiency syndrome. 140.30 For purposes of this section, "homeless adult" means a person 140.31 who is living on the street or in a shelteror is evicted from a140.32dwelling unitor discharged from a regional treatment center, 140.33 community hospital, or residential treatment program and has no 140.34 appropriate housing available and lacks the resources and 140.35 support necessary to access appropriate housing. At least 70 140.36 percent of the supportive housing units must serve homeless 141.1 adults with mental illness, substance abuse problems, or human 141.2 immunodeficiency virus or acquired immunodeficiency syndrome who 141.3 are about to be or, within the previous six months, has been 141.4 discharged from a regional treatment center, or a 141.5 state-contracted psychiatric bed in a community hospital, or a 141.6 residential mental health or chemical dependency treatment 141.7 program. If a person meets the requirements of subdivision 1, 141.8 paragraph (a), and receives a federalSection 8or state housing 141.9 subsidy, the group residential housing rate for that person is 141.10 limited to the supplementary rate under section 256I.05, 141.11 subdivision 1a, and is determined by subtracting the amount of 141.12 the person's countable income that exceeds the MSA equivalent 141.13 rate from the group residential housing supplementary rate. A 141.14 resident in a demonstration project site who no longer 141.15 participates in the demonstration program shall retain 141.16 eligibility for a group residential housing payment in an amount 141.17 determined under section 256I.06, subdivision 8, using the MSA 141.18 equivalent rate. Service funding under section 256I.05, 141.19 subdivision 1a, will end June 30, 1997, if federal matching 141.20 funds are available and the services can be provided through a 141.21 managed care entity. If federal matching funds are not 141.22 available, then service funding will continue under section 141.23 256I.05, subdivision 1a. 141.24 (b) A county agency may enter into a group residential 141.25 housing agreement for beds with rates in excess of the MSA 141.26 equivalent rate in addition to those currently covered under a 141.27 group residential housing agreement if the additional beds are 141.28 only a replacement of beds with rates in excess of the MSA 141.29 equivalent rate which have been made available due to closure of 141.30 a setting, a change of licensure or certification which removes 141.31 the beds from group residential housing payment, or as a result 141.32 of the downsizing of a group residential housing setting. The 141.33 transfer of available beds from one county to another can only 141.34 occur by the agreement of both counties. 141.35 Sec. 20. Minnesota Statutes 1996, section 256I.04, is 141.36 amended by adding a subdivision to read: 142.1 Subd. 4. [RENTAL ASSISTANCE.] For participants in the 142.2 Minnesota supportive housing demonstration program under 142.3 subdivision 3, paragraph (a), clause (5), notwithstanding the 142.4 provisions of section 256I.06, subdivision 8, the amount of the 142.5 group residential housing payment for room and board must be 142.6 calculated by subtracting 30 percent of the recipient's adjusted 142.7 income as defined by the United States Department of Housing and 142.8 Urban Development for the Section 8 program from the fair market 142.9 rent established for the recipient's living unit by the federal 142.10 Department of Housing and Urban Development. This payment shall 142.11 be regarded as a state housing subsidy for the purposes of 142.12 subdivision 3. Notwithstanding the provisions of section 142.13 256I.06, subdivision 6, the recipient's countable income will 142.14 only be adjusted when a change of greater than $100 in a month 142.15 occurs or upon annual redetermination of eligibility, whichever 142.16 is sooner. The commissioner is directed to study the 142.17 feasibility of developing a rental assistance program to serve 142.18 persons traditionally served in group residential housing 142.19 settings and report to the legislature by February 15, 1999. 142.20 Sec. 21. Minnesota Statutes 1996, section 256I.05, 142.21 subdivision 2, is amended to read: 142.22 Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group 142.23 residential housing rate does not apply to a residence that on 142.24 August 1, 1984, was licensed by the commissioner of health only 142.25 as a boarding care home, certified by the commissioner of health 142.26 as an intermediate care facility, and licensed by the 142.27 commissioner of human services under Minnesota Rules, parts 142.28 9520.0500 to 9520.0690. Notwithstanding the provisions of 142.29 subdivision 1c, the rate paid to a facility reimbursed under 142.30 this subdivision shall be determined underMinnesota Rules,142.31parts 9510.0010 to 9510.0480section 256B.431, or under section 142.32 256B.434 if the facility is accepted by the commissioner for 142.33 participation in the alternative payment demonstration project. 142.34 Sec. 22. Laws 1997, chapter 207, section 7, is amended to 142.35 read: 142.36 Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 143.1 COUNTY.] 143.2 (a) Notwithstanding Minnesota Statutes, sections 92.45 and 143.3 282.018, subdivision 1, and the public sale provisions of 143.4 Minnesota Statutes, chapter 282, Carlton county may sell by 143.5 private sale the tax-forfeited land described in paragraph (d) 143.6 under the remaining provisions of Minnesota Statutes, chapter 143.7 282. 143.8 (b) The land described in paragraph (d) may be sold by 143.9 private sale. The considerationfor the conveyance must include143.10the taxes due on the property and any penalties, interest, and143.11costsshall be the appraised value of the land. If the lands 143.12 are sold, the conveyance must reserveto the statea 143.13conservationperpetual easement, in a form prescribed by the143.14commissioner of natural resources, for the land within 100 feet143.15of the ordinary high water level of Slaughterhouse creek for143.16public angler access and stream habitat protection and143.17enhancementfor the benefit of the state of Minnesota, 143.18 department of natural resources, over the following lands: 143.19 A strip of land lying in the North 6.66 acres of the West 143.20 Half of the Northeast Quarter of the Southwest Quarter of 143.21 Section 6, Township 48 North, Range 16 West, Carlton county. 143.22 Said strip lying 100 feet on each side of the centerline of 143.23 Slaughterhouse Creek. 143.24 (c) The conveyance must be in a form approved by the 143.25 attorney general. 143.26 (d) The land to be conveyed is located in Carlton county 143.27 and is described as: 143.28 North 6.66 acres of the West Half of the Northeast Quarter 143.29 of the Southwest Quarter, subject to pipeline easement, Section 143.30 6, Township 48 North, Range 16 West, City of Carlton. 143.31 (e) Carlton county has determined that this sale best 143.32 serves the land management interests of Carlton county. 143.33 Sec. 23. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 143.34 SYSTEM.] 143.35 (a) By January 15, 1999, the commissioner shall make 143.36 recommendations to the chairs of the health and human services 144.1 policy and fiscal committees on the repeal of specific statutes 144.2 and rules as well as any other additional recommendations 144.3 related to implementation of sections 11 and 12. 144.4 (b) In developing recommendations for nursing facility 144.5 reimbursement, the commissioner shall consider making each 144.6 nursing facility's total payment rates, both operating and 144.7 property rate components, prospective. The commissioner shall 144.8 involve nursing facility industry and consumer representatives 144.9 in the development of these recommendations. 144.10 (c) In making recommendations for ICF/MR reimbursement, the 144.11 commissioner may consider methods of establishing payment rates 144.12 that take into account individual client costs and needs, 144.13 include provisions to establish links between performance 144.14 indicators and reimbursement and other performance incentives, 144.15 and allow local control over resources necessary for local 144.16 agencies to set rates and contract with ICF/MR facilities. In 144.17 addition, the commissioner may establish methods that provide 144.18 information to consumers regarding service quality as measured 144.19 by performance indicators. The commissioner shall involve 144.20 ICF/MR industry and consumer representatives in the development 144.21 of these recommendations. 144.22 Sec. 24. [APPROVAL EXTENDED.] 144.23 Notwithstanding Minnesota Statutes, section 144A.073, 144.24 subdivision 3, the commissioner of health shall grant an 144.25 additional 18 months of approval for a proposed exception to the 144.26 nursing home licensure and certification moratorium, if the 144.27 proposal is to replace a 96-bed nursing home facility in Carlton 144.28 county and if initial approval for the proposal was granted in 144.29 November 1996. 144.30 Sec. 25. [EFFECTIVE DATE.] 144.31 Sections 1, 3, 22, and 24 are effective the day following 144.32 final enactment. 144.33 ARTICLE 4 144.34 HEALTH CARE PROGRAMS, INCLUDING MA AND GAMC 144.35 Section 1. Minnesota Statutes 1997 Supplement, section 144.36 171.29, subdivision 2, is amended to read: 145.1 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 145.2 license has been revoked as provided in subdivision 1, except 145.3 under section 169.121 or 169.123, shall pay a $30 fee before the 145.4 driver's license is reinstated. 145.5 (b) A person whose driver's license has been revoked as 145.6 provided in subdivision 1 under section 169.121 or 169.123 shall 145.7 pay a $250 fee plus a $10 surcharge before the driver's license 145.8 is reinstated. The $250 fee is to be credited as follows: 145.9 (1) Twenty percent shall be credited to the trunk highway 145.10 fund. 145.11 (2) Fifty-five percent shall be credited to the general 145.12 fund. 145.13 (3) Eight percent shall be credited to a separate account 145.14 to be known as the bureau of criminal apprehension account. 145.15 Money in this account may be appropriated to the commissioner of 145.16 public safety and the appropriated amount shall be apportioned 145.17 80 percent for laboratory costs and 20 percent for carrying out 145.18 the provisions of section 299C.065. 145.19 (4) Twelve percent shall be credited to a separate account 145.20 to be known as the alcohol-impaired driver education account. 145.21 Money in the account is appropriated as follows: 145.22 (i) The first $200,000 in a fiscal year is to the 145.23 commissioner of children, families, and learning for programs in 145.24 elementary and secondary schools. 145.25 (ii) The remainder credited in a fiscal year is 145.26 appropriated to the commissioner of transportation to be spent 145.27 as grants to the Minnesota highway safety center at St. Cloud 145.28 State University for programs relating to alcohol and highway 145.29 safety education in elementary and secondary schools. 145.30 (5) Five percent shall be credited to a separate account to 145.31 be known as the traumatic brain injury and spinal cord injury 145.32 account.$100,000 is annually appropriated from the account to145.33the commissioner of human services for traumatic brain injury145.34case management services.Theremainingmoney in the account is 145.35 annually appropriated to the commissioner of health to be used 145.36 as follows: 35 percent for a contract with a qualified 146.1 community-based organization to provide information, resources, 146.2 and support to assist persons with traumatic brain injury and 146.3 their families to access services, and 65 percent toestablish146.4andmaintain the traumatic brain injury and spinal cord injury 146.5 registry created in section 144.662and to reimburse the146.6commissioner of economic security for the reasonable cost of146.7services provided under section 268A.03, clause (o). For the 146.8 purposes of this clause, a "qualified community-based 146.9 organization" is a private, not-for-profit organization of 146.10 consumers of traumatic brain injury services and their family 146.11 members. The organization must be registered with the United 146.12 States Internal Revenue Service under the provisions of section 146.13 501(c)(3) as a tax exempt organization and must have as its 146.14 purposes: 146.15 (i) the promotion of public, family, survivor, and 146.16 professional awareness of the incidence and consequences of 146.17 traumatic brain injury; 146.18 (ii) the provision of a network of support for persons with 146.19 traumatic brain injury, their families, and friends; 146.20 (iii) the development and support of programs and services 146.21 to prevent traumatic brain injury; 146.22 (iv) the establishment of education programs for persons 146.23 with traumatic brain injury; and 146.24 (v) the empowerment of persons with traumatic brain injury 146.25 through participation in its governance. 146.26 No patient's name, identifying information or identifiable 146.27 medical data will be disclosed to the organization without the 146.28 informed voluntary written consent of the patient or patient's 146.29 guardian, or if the patient is a minor, of the parent or 146.30 guardian of the patient. 146.31 (c) The $10 surcharge shall be credited to a separate 146.32 account to be known as the remote electronic alcohol monitoring 146.33 pilot program account. The commissioner shall transfer the 146.34 balance of this account to the commissioner of finance on a 146.35 monthly basis for deposit in the general fund. 146.36 Sec. 2. Minnesota Statutes 1996, section 245.462, 147.1 subdivision 4, is amended to read: 147.2 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 147.3 individual employed by the county or other entity authorized by 147.4 the county board to provide case management services specified 147.5 in section 245.4711. A case manager must have a bachelor's 147.6 degree in one of the behavioral sciences or related fields from 147.7 an accredited college or university and have at least 2,000 147.8 hours of supervised experience in the delivery of services to 147.9 adults with mental illness, must be skilled in the process of 147.10 identifying and assessing a wide range of client needs, and must 147.11 be knowledgeable about local community resources and how to use 147.12 those resources for the benefit of the client. The case manager 147.13 shall meet in person with a mental health professional at least 147.14 once each month to obtain clinical supervision of the case 147.15 manager's activities. Case managers with a bachelor's degree 147.16 but without 2,000 hours of supervised experience in the delivery 147.17 of services to adults with mental illness must complete 40 hours 147.18 of training approved by the commissioner of human services in 147.19 case management skills and in the characteristics and needs of 147.20 adults with serious and persistent mental illness and must 147.21 receive clinical supervision regarding individual service 147.22 delivery from a mental health professional at least once each 147.23 week until the requirement of 2,000 hours of supervised 147.24 experience is met. Clinical supervision must be documented in 147.25 the client record. 147.26 Until June 30, 1999,a refugeean immigrant who does not 147.27 have the qualifications specified in this subdivision may 147.28 provide case management services to adultrefugeesimmigrants 147.29 with serious and persistent mental illness who are members of 147.30 the same ethnic group as the case manager if the person: (1) is 147.31 actively pursuing credits toward the completion of a bachelor's 147.32 degree in one of the behavioral sciences or a related field from 147.33 an accredited college or university; (2) completes 40 hours of 147.34 training as specified in this subdivision; and (3) receives 147.35 clinical supervision at least once a week until the requirements 147.36 ofobtaining a bachelor's degree and 2,000 hours of supervised148.1experiencethis subdivision are met. 148.2 (b) The commissioner may approve waivers submitted by 148.3 counties to allow case managers without a bachelor's degree but 148.4 with 6,000 hours of supervised experience in the delivery of 148.5 services to adults with mental illness if the person: 148.6 (1) meets the qualifications for a mental health 148.7 practitioner in subdivision 26; 148.8 (2) has completed 40 hours of training approved by the 148.9 commissioner in case management skills and in the 148.10 characteristics and needs of adults with serious and persistent 148.11 mental illness; and 148.12 (3) demonstrates that the 6,000 hours of supervised 148.13 experience are in identifying functional needs of persons with 148.14 mental illness, coordinating assessment information and making 148.15 referrals to appropriate service providers, coordinating a 148.16 variety of services to support and treat persons with mental 148.17 illness, and monitoring to ensure appropriate provision of 148.18 services. The county board is responsible to verify that all 148.19 qualifications, including content of supervised experience, have 148.20 been met. 148.21 Sec. 3. Minnesota Statutes 1996, section 245.462, 148.22 subdivision 8, is amended to read: 148.23 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 148.24 treatment services," or "day treatment program" means a 148.25 structured program of treatment and care provided to an adult in 148.26 or by: (1) a hospital accredited by the joint commission on 148.27 accreditation of health organizations and licensed under 148.28 sections 144.50 to 144.55; (2) a community mental health center 148.29 under section 245.62; or (3) an entity that is under contract 148.30 with the county board to operate a program that meets the 148.31 requirements of section 245.4712, subdivision 2, and Minnesota 148.32 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 148.33 group psychotherapy and other intensive therapeutic services 148.34 that are provided at least one day a weekfor a minimum148.35three-hour time blockby a multidisciplinary staff under the 148.36 clinical supervision of a mental health professional. The 149.1 services are aimed at stabilizing the adult's mental health 149.2 status, providing mental health services, and developing and 149.3 improving the adult's independent living and socialization 149.4 skills. The goal of day treatment is to reduce or relieve 149.5 mental illness and to enable the adult to live in the 149.6 community. Day treatment services are not a part of inpatient 149.7 or residential treatment services. Day treatment services are 149.8 distinguished from day care by their structured therapeutic 149.9 program of psychotherapy services. The commissioner may limit 149.10 medical assistance reimbursement for day treatment to 15 hours 149.11 per week per person instead of the three hours per day per 149.12 person specified in Minnesota Rules, part 9505.0323, subpart 15. 149.13 Sec. 4. Minnesota Statutes 1996, section 245.4871, 149.14 subdivision 4, is amended to read: 149.15 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 149.16 individual employed by the county or other entity authorized by 149.17 the county board to provide case management services specified 149.18 in subdivision 3 for the child with severe emotional disturbance 149.19 and the child's family. A case manager must have experience and 149.20 training in working with children. 149.21 (b) A case manager must: 149.22 (1) have at least a bachelor's degree in one of the 149.23 behavioral sciences or a related field from an accredited 149.24 college or university; 149.25 (2) have at least 2,000 hours of supervised experience in 149.26 the delivery of mental health services to children; 149.27 (3) have experience and training in identifying and 149.28 assessing a wide range of children's needs; and 149.29 (4) be knowledgeable about local community resources and 149.30 how to use those resources for the benefit of children and their 149.31 families. 149.32 (c) The case manager may be a member of any professional 149.33 discipline that is part of the local system of care for children 149.34 established by the county board. 149.35 (d) The case manager must meet in person with a mental 149.36 health professional at least once each month to obtain clinical 150.1 supervision. 150.2 (e) Case managers with a bachelor's degree but without 150.3 2,000 hours of supervised experience in the delivery of mental 150.4 health services to children with emotional disturbance must: 150.5 (1) begin 40 hours of training approved by the commissioner 150.6 of human services in case management skills and in the 150.7 characteristics and needs of children with severe emotional 150.8 disturbance before beginning to provide case management 150.9 services; and 150.10 (2) receive clinical supervision regarding individual 150.11 service delivery from a mental health professional at least once 150.12 each week until the requirement of 2,000 hours of experience is 150.13 met. 150.14 (f) Clinical supervision must be documented in the child's 150.15 record. When the case manager is not a mental health 150.16 professional, the county board must provide or contract for 150.17 needed clinical supervision. 150.18 (g) The county board must ensure that the case manager has 150.19 the freedom to access and coordinate the services within the 150.20 local system of care that are needed by the child. 150.21 (h) Until June 30, 1999,a refugeean immigrant who does 150.22 not have the qualifications specified in this subdivision may 150.23 provide case management services to childrefugeesimmigrants 150.24 with severe emotional disturbance of the same ethnic group as 150.25 therefugeeimmigrant if the person: 150.26 (1) is actively pursuing credits toward the completion of a 150.27 bachelor's degree in one of the behavioral sciences or related 150.28 fields at an accredited college or university; 150.29 (2) completes 40 hours of training as specified in this 150.30 subdivision; and 150.31 (3) receives clinical supervision at least once a week 150.32 until the requirements of obtaining a bachelor's degree and 150.33 2,000 hours of supervised experience are met. 150.34 (i) The commissioner may approve waivers submitted by 150.35 counties to allow case managers without a bachelor's degree but 150.36 with 6,000 hours of supervised experience in the delivery of 151.1 services to children with severe emotional disturbance if the 151.2 person: 151.3 (1) meets the qualifications for a mental health 151.4 practitioner in subdivision 26; 151.5 (2) has completed 40 hours of training approved by the 151.6 commissioner in case management skills and in the 151.7 characteristics and needs of children with severe emotional 151.8 disturbance; and 151.9 (3) demonstrates that the 6,000 hours of supervised 151.10 experience are in identifying functional needs of children with 151.11 severe emotional disturbance, coordinating assessment 151.12 information and making referrals to appropriate service 151.13 providers, coordinating a variety of services to support and 151.14 treat children with severe emotional disturbance, and monitoring 151.15 to ensure appropriate provision of services. The county board 151.16 is responsible to verify that all qualifications, including 151.17 content of supervised experience, have been met. 151.18 Sec. 5. Minnesota Statutes 1996, section 256.01, is 151.19 amended by adding a subdivision to read: 151.20 Subd. 15. [INFORMATION FOR PERSONS WITH LIMITED 151.21 ENGLISH-LANGUAGE PROFICIENCY.] By July 1, 1998, the commissioner 151.22 shall implement a procedure for public assistance applicants and 151.23 recipients to identify a language preference other than English 151.24 in order to receive information pertaining to the public 151.25 assistance programs in that preferred language. 151.26 Sec. 6. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 151.27 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 151.28 services shall establish and administer a program to pay for 151.29 costs of drugs prescribed exclusively for post-kidney transplant 151.30 maintenance when those costs are not otherwise reimbursed by a 151.31 third-party payer. The commissioner may contract with a 151.32 nonprofit entity to administer this program. 151.33 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 151.34 the program, an applicant must satisfy the following 151.35 requirements: 151.36 (1) the applicant's family gross income must not exceed 275 152.1 percent of the federal poverty level; and 152.2 (2) the applicant must be a Minnesota resident who has 152.3 resided in Minnesota for at least 12 months. 152.4 An applicant shall not be excluded because the applicant 152.5 received the transplant outside the state of Minnesota, so long 152.6 as the other requirements are met. 152.7 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 152.8 made for each eligible recipient shall be based on the following: 152.9 (1) available funds; and 152.10 (2) the cost of the post-kidney transplant maintenance 152.11 drugs. 152.12 (b) The payment rate under this program must be no greater 152.13 than the medical assistance reimbursement rate for the 152.14 prescribed drug. 152.15 (c) Payments shall be made to or on behalf of an eligible 152.16 recipient for the cost of the post-kidney transplant maintenance 152.17 drugs that is not covered, reimbursed, or eligible for 152.18 reimbursement by any other third party or government entity, 152.19 including, but not limited to, private or group health 152.20 insurance, medical assistance, Medicare, the Veterans 152.21 Administration, the senior citizen drug program established 152.22 under section 256.955, or under any waiver arrangement received 152.23 by the state to provide a prescription drug benefit for 152.24 qualified Medicare beneficiaries or service-limited Medicare 152.25 beneficiaries. 152.26 (d) The commissioner may restrict or categorize payments to 152.27 meet the appropriation allocated for this program. 152.28 (e) Any cost of the post-kidney transplant maintenance 152.29 drugs that is not reimbursed under this program is the 152.30 responsibility of the program recipient. 152.31 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 152.32 a drug formulary that includes all drugs eligible for 152.33 reimbursement by the program. The commissioner may use the drug 152.34 formulary established under section 256B.0625, subdivision 13. 152.35 The commissioner shall establish an internal review procedure 152.36 for updating the formulary that allows for the addition and 153.1 deletion of drugs to the formulary. The drug formulary must be 153.2 reviewed at least quarterly per fiscal year. 153.3 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 153.4 funding from other public or private sources. 153.5 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 153.6 Sec. 7. Minnesota Statutes 1997 Supplement, section 153.7 256.9657, subdivision 3, is amended to read: 153.8 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 153.9 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 153.10 1992, each health maintenance organization with a certificate of 153.11 authority issued by the commissioner of health under chapter 62D 153.12 and each community integrated service network licensed by the 153.13 commissioner under chapter 62N shall pay to the commissioner of 153.14 human services a surcharge equal to six-tenths of one percent of 153.15 the total premium revenues of the health maintenance 153.16 organization or community integrated service network as reported 153.17 to the commissioner of health according to the schedule in 153.18 subdivision 4. 153.19 (b) For purposes of this subdivision, total premium revenue 153.20 means: 153.21 (1) premium revenue recognized on a prepaid basis from 153.22 individuals and groups for provision of a specified range of 153.23 health services over a defined period of time which is normally 153.24 one month, excluding premiums paid to a health maintenance 153.25 organization or community integrated service network from the 153.26 Federal Employees Health Benefit Program; 153.27 (2) premiums from Medicare wrap-around subscribers for 153.28 health benefits which supplement Medicare coverage; 153.29 (3) Medicare revenue, as a result of an arrangement between 153.30 a health maintenance organization or a community integrated 153.31 service network and the health care financing administration of 153.32 the federal Department of Health and Human Services, for 153.33 services to a Medicare beneficiary, excluding Medicare revenue 153.34 that states are prohibited from taxing under sections 4001 and 153.35 4002 of Public Law Number 105-33 received by a health 153.36 maintenance organization or community integrated service network 154.1 through risk sharing or Medicare Choice Plus contracts; and 154.2 (4) medical assistance revenue, as a result of an 154.3 arrangement between a health maintenance organization or 154.4 community integrated service network and a Medicaid state 154.5 agency, for services to a medical assistance beneficiary. 154.6 If advance payments are made under clause (1) or (2) to the 154.7 health maintenance organization or community integrated service 154.8 network for more than one reporting period, the portion of the 154.9 payment that has not yet been earned must be treated as a 154.10 liability. 154.11 (c) When a health maintenance organization or community 154.12 integrated service network merges or consolidates with or is 154.13 acquired by another health maintenance organization or community 154.14 integrated service network, the surviving corporation or the new 154.15 corporation shall be responsible for the annual surcharge 154.16 originally imposed on each of the entities or corporations 154.17 subject to the merger, consolidation, or acquisition, regardless 154.18 of whether one of the entities or corporations does not retain a 154.19 certificate of authority under chapter 62D or a license under 154.20 chapter 62N. 154.21 (d) Effective July 1 of each year, the surviving 154.22 corporation's or the new corporation's surcharge shall be based 154.23 on the revenues earned in the second previous calendar year by 154.24 all of the entities or corporations subject to the merger, 154.25 consolidation, or acquisition regardless of whether one of the 154.26 entities or corporations does not retain a certificate of 154.27 authority under chapter 62D or a license under chapter 62N until 154.28 the total premium revenues of the surviving corporation include 154.29 the total premium revenues of all the merged entities as 154.30 reported to the commissioner of health. 154.31 (e) When a health maintenance organization or community 154.32 integrated service network, which is subject to liability for 154.33 the surcharge under this chapter, transfers, assigns, sells, 154.34 leases, or disposes of all or substantially all of its property 154.35 or assets, liability for the surcharge imposed by this chapter 154.36 is imposed on the transferee, assignee, or buyer of the health 155.1 maintenance organization or community integrated service network. 155.2 (f) In the event a health maintenance organization or 155.3 community integrated service network converts its licensure to a 155.4 different type of entity subject to liability for the surcharge 155.5 under this chapter, but survives in the same or substantially 155.6 similar form, the surviving entity remains liable for the 155.7 surcharge regardless of whether one of the entities or 155.8 corporations does not retain a certificate of authority under 155.9 chapter 62D or a license under chapter 62N. 155.10 (g) The surcharge assessed to a health maintenance 155.11 organization or community integrated service network ends when 155.12 the entity ceases providing services for premiums and the 155.13 cessation is not connected with a merger, consolidation, 155.14 acquisition, or conversion. 155.15 Sec. 8. Minnesota Statutes 1997 Supplement, section 155.16 256.9685, subdivision 1, is amended to read: 155.17 Subdivision 1. [AUTHORITY.] The commissioner shall 155.18 establish procedures for determining medical assistance and 155.19 general assistance medical care payment rates under a 155.20 prospective payment system for inpatient hospital services in 155.21 hospitals that qualify as vendors of medical assistance. The 155.22 commissioner shall establish, by rule, procedures for 155.23 implementing this section and sections 256.9686, 256.969, and 155.24 256.9695.The medical assistance payment rates must be based on155.25methods and standards that the commissioner finds are adequate155.26to provide for the costs that must be incurred for the care of155.27recipients in efficiently and economically operated hospitals.155.28 Services must meet the requirements of section 256B.04, 155.29 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 155.30 eligible for payment. 155.31 Sec. 9. Minnesota Statutes 1996, section 256.969, 155.32 subdivision 16, is amended to read: 155.33 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian155.34health serviceFacilities of the Indian health service and 155.35 facilities operated by a tribe or tribal organization under 155.36 funding authorized by title III of the Indian Self-Determination 156.1 and Education Assistance Act, Public Law Number 93-638, or by 156.2 United States Code, title 25, chapter 14, subchapter II, 156.3 sections 450f to 450n, are exempt from the rate establishment 156.4 methods required by this section and shall bereimbursed at156.5charges as limited to the amount allowed under federal lawpaid 156.6 according to the rate published by the United States assistant 156.7 secretary for health under authority of United States Code, 156.8 title 42, sections 248A and 248B. 156.9 Sec. 10. Minnesota Statutes 1996, section 256.969, 156.10 subdivision 17, is amended to read: 156.11 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 156.12 Out-of-state hospitals that are located within a Minnesota local 156.13 trade area and that have more than 20 admissions in the base 156.14 year shall have rates established using the same procedures and 156.15 methods that apply to Minnesota hospitals. For this subdivision 156.16 and subdivision 18, local trade area means a county contiguous 156.17 to Minnesota and located in a metropolitan statistical area as 156.18 determined by Medicare for October 1 prior to the most current 156.19 rebased rate year. Hospitals that are not required by law to 156.20 file information in a format necessary to establish rates shall 156.21 have rates established based on the commissioner's estimates of 156.22 the information. Relative values of the diagnostic categories 156.23 shall not be redetermined under this subdivision until required 156.24 by rule. Hospitals affected by this subdivision shall then be 156.25 included in determining relative values. However, hospitals 156.26 that have rates established based upon the commissioner's 156.27 estimates of information shall not be included in determining 156.28 relative values. This subdivision is effective for hospital 156.29 fiscal years beginning on or after July 1, 1988. A hospital 156.30 shall provide the information necessary to establish rates under 156.31 this subdivision at least 90 days before the start of the 156.32 hospital's fiscal year. 156.33 Sec. 11. Minnesota Statutes 1996, section 256B.03, 156.34 subdivision 3, is amended to read: 156.35 Subd. 3. [AMERICAN INDIAN HEALTH FUNDINGTRIBAL PURCHASING 156.36 MODEL.] (a) Notwithstanding subdivision 1 and sections 256B.0625 157.1 and 256D.03, subdivision 4, paragraph(f)(i), the commissioner 157.2 may make payments to federally recognized Indian tribes with a 157.3 reservation in the state to provide medical assistance and 157.4 general assistance medical care to Indians, as defined under 157.5 federal law, who reside on or near the reservation. The 157.6 payments may be made in the form of a block grant or other 157.7 payment mechanism determined in consultation with the tribe. 157.8 Any alternative payment mechanism agreed upon by the tribes and 157.9 the commissioner under this subdivision is not dependent upon 157.10 county or health plan agreement but is intended to create a 157.11 direct payment mechanism between the state and the tribe for the 157.12 administration of the medical assistanceprogramand general 157.13 assistance medical care programs, and for covered services. 157.14 (b) A tribe that implements a purchasing model under this 157.15 subdivision shall report to the commissioner at least annually 157.16 on the operation of the model. The commissioner and the tribe 157.17 shall cooperatively determine the data elements, format, and 157.18 timetable for the report. 157.19 (c) For purposes of this subdivision, "Indian tribe" means 157.20 a tribe, band, or nation, or other organized group or community 157.21 of Indians that is recognized as eligible for the special 157.22 programs and services provided by the United States to Indians 157.23 because of their status as Indians and for which a reservation 157.24 exists as is consistent with Public Law Number 100-485, as 157.25 amended. 157.26 (d) Payments under this subdivision may not result in an 157.27 increase in expenditures that would not otherwise occur in the 157.28 medical assistance program under this chapter or the general 157.29 assistance medical care program under chapter 256D. 157.30 Sec. 12. [256B.038] [PROVIDER RATE INCREASES AFTER JUNE 157.31 30, 1999.] 157.32 (a) For fiscal years beginning on or after July 1, 1999, 157.33 the commissioner of finance shall include an annual inflationary 157.34 adjustment in payment rates for the services listed in paragraph 157.35 (b) as a budget change request in each biennial detailed 157.36 expenditure budget submitted to the legislature under section 158.1 16A.11. The adjustment shall be accomplished by indexing the 158.2 rates in effect for inflation based on the change in the 158.3 Consumer Price Index-All Items (United States city 158.4 average)(CPI-U) as forecasted by Data Resources, Inc., in the 158.5 fourth quarter of the prior year for the calendar year during 158.6 which the rate increase occurs. 158.7 (b) Within the limits of appropriations specifically for 158.8 this purpose, the commissioner shall apply the rate increases in 158.9 paragraph (a) to home and community-based waiver services for 158.10 persons with mental retardation or related conditions under 158.11 section 256B.501; home and community-based waiver services for 158.12 the elderly under section 256B.0915; waivered services under 158.13 community alternatives for disabled individuals under section 158.14 256B.49; community alternative care waivered services under 158.15 section 256B.49; traumatic brain injury waivered services under 158.16 section 256B.49; nursing services and home health services under 158.17 section 256B.0625, subdivision 6a; personal care services and 158.18 nursing supervision of personal care services under section 158.19 256B.0625, subdivision 19a; private duty nursing services under 158.20 section 256B.0625, subdivision 7; day training and habilitation 158.21 services for adults with mental retardation or related 158.22 conditions under sections 252.40 to 252.46; physical therapy 158.23 services under sections 256B.0625, subdivision 8, and 256D.03, 158.24 subdivision 4; occupational therapy services under sections 158.25 256B.0625, subdivision 8a, and 256D.03, subdivision 4; 158.26 speech-language therapy services under section 256D.03, 158.27 subdivision 4, and Minnesota Rules, part 9505.0390; respiratory 158.28 therapy services under section 256D.03, subdivision 4, and 158.29 Minnesota Rules, part 9505.0295; physician services under 158.30 section 256B.0625, subdivision 3; dental services under sections 158.31 256B.0625, subdivision 9, and 256D.03, subdivision 4; 158.32 alternative care services under section 256B.0913; adult 158.33 residential program grants under Minnesota Rules, parts 158.34 9535.2000 to 9535.3000; adult and family community support 158.35 grants under Minnesota Rules, parts 9535.1700 to 9535.1760; and 158.36 semi-independent living services under section 252.275, 159.1 including SILS funding under county social services grants 159.2 formerly funded under chapter 256I. 159.3 (c) The commissioner shall increase prepaid medical 159.4 assistance program capitation rates as appropriate to reflect 159.5 the rate increases in this section. 159.6 (d) In implementing this section, the commissioner shall 159.7 consider proposing a schedule to equalize rates paid by 159.8 different programs for the same service. 159.9 Sec. 13. Minnesota Statutes 1996, section 256B.055, 159.10 subdivision 7, is amended to read: 159.11 Subd. 7. [AGED, BLIND, OR DISABLED PERSONS.] Medical 159.12 assistance may be paid for a person who meets the categorical 159.13 eligibility requirements of the supplemental security income 159.14 program or, who would meet those requirements except for excess 159.15 income or assets, and who meets the other eligibility 159.16 requirements of this section. 159.17Effective February 1, 1989, and to the extent allowed by159.18federal law the commissioner shall deduct state and federal159.19income taxes and federal insurance contributions act payments159.20withheld from the individual's earned income in determining159.21eligibility under this subdivision.159.22 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 159.23 amended by adding a subdivision to read: 159.24 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 159.25 CHILDREN.] Medical assistance may be paid for a person who is 159.26 under age 18 and who meets income and asset eligibility 159.27 requirements of the Supplemental Security Income program if the 159.28 person was receiving Supplemental Security Income payments on 159.29 the date of enactment of section 211(a) of Public Law Number 159.30 104-193, the Personal Responsibility and Work Opportunity Act of 159.31 1996, and the person would have continued to receive the 159.32 payments except for the change in the childhood disability 159.33 criteria in section 211(a) of Public Law Number 104-193. 159.34 Sec. 15. Minnesota Statutes 1997 Supplement, section 159.35 256B.056, subdivision 1a, is amended to read: 159.36 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 160.1 specifically required by state law or rule or federal law or 160.2 regulation, the methodologies used in counting income and assets 160.3 to determine eligibility for medical assistance for persons 160.4 whose eligibility category is based on blindness, disability, or 160.5 age of 65 or more years, the methodologies for the supplemental 160.6 security income program shall be used, except that payments made160.7according to a court order for the support of children shall be160.8excluded from income in an amount not to exceed the difference160.9between the applicable income standard used in the state's160.10medical assistance program for aged, blind, and disabled persons160.11and the applicable income standard used in the state's medical160.12assistance program for families with children. Exclusion of160.13court-ordered child support payments is subject to the condition160.14that if there has been a change in the financial circumstances160.15of the person with the legal obligation to pay support since the160.16support order was entered, the person with the legal obligation160.17to pay support has petitioned for modification of the support160.18order. For families and children, which includes all other 160.19 eligibility categories, the methodologies under the state's AFDC 160.20 plan in effect as of July 16, 1996, as required by the Personal 160.21 Responsibility and Work Opportunity Reconciliation Act of 1996 160.22 (PRWORA), Public Law Number 104-193, shall be used. Effective 160.23 upon federal approval, in-kind contributions to, and payments 160.24 made on behalf of, a recipient, by an obligor, in satisfaction 160.25 of or in addition to a temporary or permanent order for child 160.26 support or maintenance, shall be considered income to the 160.27 recipient. For these purposes, a "methodology" does not include 160.28 an asset or income standard, or accounting method, or method of 160.29 determining effective dates. 160.30 Sec. 16. Minnesota Statutes 1997 Supplement, section 160.31 256B.056, subdivision 4, is amended to read: 160.32 Subd. 4. [INCOME.] To be eligible for medical assistance, 160.33 a personmust not have, or anticipate receiving, semiannual160.34income in excess of 120 percent of the income standards by160.35family size used under the aid to families with dependent160.36children state plan as of July 16, 1996, as required by the161.1Personal Responsibility and Work Opportunity Reconciliation Act161.2of 1996 (PRWORA), Public Law Number 104-193, except161.3thateligible under section 256B.055, subdivision 7, and 161.4 families and children may have an income up to 133-1/3 percent 161.5 of the AFDC income standard in effect under the July 16, 1996, 161.6 AFDC state plan. For rate years beginning on or after July 1, 161.7 1999, the commissioner shall consider increasing the base AFDC 161.8 standard in effect July 16, 1996, by an amount equal to the 161.9 percent change in the Consumer Price Index for all urban 161.10 consumers for the previous October compared to one year 161.11 earlier. In computing income to determine eligibility of 161.12 persons who are not residents of long-term care facilities, the 161.13 commissioner shall disregard increases in income as required by 161.14 Public Law Numbers 94-566, section 503; 99-272; and 99-509. 161.15 Veterans aid and attendance benefits and Veterans Administration 161.16 unusual medical expense payments are considered income to the 161.17 recipient. 161.18 Sec. 17. Minnesota Statutes 1996, section 256B.057, 161.19 subdivision 3a, is amended to read: 161.20 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 161.21 PREMIUMS.] A person who would otherwise be eligible as a 161.22 qualified Medicare beneficiary under subdivision 3, except the 161.23 person's income is in excess of the limit, is eligible for 161.24 medical assistance reimbursement of Medicare Part B premiums if 161.25 the person's income is less than110120 percent of the official 161.26 federal poverty guidelines for the applicable family size.The161.27income limit shall increase to 120 percent of the official161.28federal poverty guidelines for the applicable family size on161.29January 1, 1995.161.30 Sec. 18. Minnesota Statutes 1996, section 256B.057, is 161.31 amended by adding a subdivision to read: 161.32 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 161.33 1998, to the extent of the federal allocation to Minnesota, a 161.34 person, who would otherwise be eligible as a qualified Medicare 161.35 beneficiary under subdivision 3, except that the person's income 161.36 is in excess of the limit, is eligible as a qualifying 162.1 individual according to the following criteria: 162.2 (1) if the person's income is greater than 120 percent, but 162.3 less than 135 percent of the official federal poverty guidelines 162.4 for the applicable family size, the person is eligible for 162.5 medical assistance reimbursement of Medicare Part B premiums; or 162.6 (2) if the person's income is equal to or greater than 135 162.7 percent but less than 175 percent of the official federal 162.8 poverty guidelines for the applicable family size, the person is 162.9 eligible for medical assistance reimbursement of that portion of 162.10 the Medicare Part B premium attributable to an increase in Part 162.11 B expenditures which resulted from the shift of home care 162.12 services from Medicare Part A to Medicare Part B under Public 162.13 Law Number 105-33, section 4732, the Balanced Budget Act of 1997. 162.14 The commissioner shall limit enrollment of qualifying 162.15 individuals under this subdivision according to the requirements 162.16 of Public Law Number 105-33, section 4732. 162.17 Sec. 19. Minnesota Statutes 1997 Supplement, section 162.18 256B.06, subdivision 4, is amended to read: 162.19 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 162.20 medical assistance is limited to citizens of the United States, 162.21 qualified noncitizens as defined in this subdivision, and other 162.22 persons residing lawfully in the United States. 162.23 (b) "Qualified noncitizen" means a person who meets one of 162.24 the following immigration criteria: 162.25 (1) admitted for lawful permanent residence according to 162.26 United States Code, title 8; 162.27 (2) admitted to the United States as a refugee according to 162.28 United States Code, title 8, section 1157; 162.29 (3) granted asylum according to United States Code, title 162.30 8, section 1158; 162.31 (4) granted withholding of deportation according to United 162.32 States Code, title 8, section 1253(h); 162.33 (5) paroled for a period of at least one year according to 162.34 United States Code, title 8, section 1182(d)(5); 162.35 (6) granted conditional entrant status according to United 162.36 States Code, title 8, section 1153(a)(7);or163.1 (7) determined to be a battered noncitizen by the United 163.2 States Attorney General according to the Illegal Immigration 163.3 Reform and Immigrant Responsibility Act of 1996, title V of the 163.4 Omnibus Consolidated Appropriations Bill, Public Law Number 163.5 104-200; 163.6 (8) is a child of a noncitizen determined to be a battered 163.7 noncitizen by the United States Attorney General according to 163.8 the Illegal Immigration Reform and Immigrant Responsibility Act 163.9 of 1996, title V, of the Omnibus Consolidated Appropriations 163.10 Bill, Public Law Number 104-200; or 163.11 (9) determined to be a Cuban or Haitian entrant as defined 163.12 in section 501(e) of Public Law Number 96-422, the Refugee 163.13 Education Assistance Act of 1980. 163.14 (c) All qualified noncitizens who were residing in the 163.15 United States before August 22, 1996, who otherwise meet the 163.16 eligibility requirements of chapter 256B, are eligible for 163.17 medical assistance with federal financial participation. 163.18 (d) All qualified noncitizens who entered the United States 163.19 on or after August 22, 1996, and who otherwise meet the 163.20 eligibility requirements of chapter 256B, are eligible for 163.21 medical assistance with federal financial participation through 163.22 November 30, 1996. 163.23 Beginning December 1, 1996, qualified noncitizens who 163.24 entered the United States on or after August 22, 1996, and who 163.25 otherwise meet the eligibility requirements of chapter 256B are 163.26 eligible for medical assistance with federal participation for 163.27 five years if they meet one of the following criteria: 163.28 (i) refugees admitted to the United States according to 163.29 United States Code, title 8, section 1157; 163.30 (ii) persons granted asylum according to United States 163.31 Code, title 8, section 1158; 163.32 (iii) persons granted withholding of deportation according 163.33 to United States Code, title 8, section 1253(h); 163.34 (iv) veterans of the United States Armed Forces with an 163.35 honorable discharge for a reason other than noncitizen status, 163.36 their spouses and unmarried minor dependent children; or 164.1 (v) persons on active duty in the United States Armed 164.2 Forces, other than for training, their spouses and unmarried 164.3 minor dependent children. 164.4 Beginning December 1, 1996, qualified noncitizens who do 164.5 not meet one of the criteria in items (i) to (v) are eligible 164.6 for medical assistance without federal financial participation 164.7 as described in paragraph (j). 164.8 (e) Noncitizens who are not qualified noncitizens as 164.9 defined in paragraph (b), who are lawfully residing in the 164.10 United States and who otherwise meet the eligibility 164.11 requirements of chapter 256B, are eligible for medical 164.12 assistance under clauses (1) to (3). These individuals must 164.13 cooperate with the Immigration and Naturalization Service to 164.14 pursue any applicable immigration status, including citizenship, 164.15 that would qualify them for medical assistance with federal 164.16 financial participation. 164.17 (1) Persons who were medical assistance recipients on 164.18 August 22, 1996, are eligible for medical assistance with 164.19 federal financial participation through December 31, 1996. 164.20 (2) Beginning January 1, 1997, persons described in clause 164.21 (1) are eligible for medical assistance without federal 164.22 financial participation as described in paragraph (j). 164.23 (3) Beginning December 1, 1996, persons residing in the 164.24 United States prior to August 22, 1996, who were not receiving 164.25 medical assistance and persons who arrived on or after August 164.26 22, 1996, are eligible for medical assistance without federal 164.27 financial participation as described in paragraph (j). 164.28 (f) Nonimmigrants who otherwise meet the eligibility 164.29 requirements of chapter 256B are eligible for the benefits as 164.30 provided in paragraphs (g) to (i). For purposes of this 164.31 subdivision, a "nonimmigrant" is a person in one of the classes 164.32 listed in United States Code, title 8, section 1101(a)(15). 164.33 (g) Payment shall also be made for care and services that 164.34 are furnished to noncitizens, regardless of immigration status, 164.35 who otherwise meet the eligibility requirements of chapter 256B, 164.36 if such care and services are necessary for the treatment of an 165.1 emergency medical condition, except for organ transplants and 165.2 related care and services and routine prenatal care. 165.3 (h) For purposes of this subdivision, the term "emergency 165.4 medical condition" means a medical condition that meets the 165.5 requirements of United States Code, title 42, section 1396b(v). 165.6 (i) Pregnant noncitizens who are undocumented or 165.7 nonimmigrants, who otherwise meet the eligibility requirements 165.8 of chapter 256B, are eligible for medical assistance payment 165.9 without federal financial participation for care and services 165.10 through the period of pregnancy, and 60 days postpartum, except 165.11 for labor and delivery. 165.12 (j) Qualified noncitizens as described in paragraph (d), 165.13 and all other noncitizens lawfully residing in the United States 165.14 as described in paragraph (e), who are ineligible for medical 165.15 assistance with federal financial participation and who 165.16 otherwise meet the eligibility requirements of chapter 256B and 165.17 of this paragraph, are eligible for medical assistance without 165.18 federal financial participation. Qualified noncitizens as 165.19 described in paragraph (d) are only eligible for medical 165.20 assistance without federal financial participation for five 165.21 years from their date of entry into the United States. 165.22 (k) The commissioner shall submit to the legislature by 165.23 December 31, 1998, a report on the number of recipients and cost 165.24 of coverage of care and services made according to paragraphs 165.25 (i) and (j). 165.26 Sec. 20. Minnesota Statutes 1996, section 256B.0625, is 165.27 amended by adding a subdivision to read: 165.28 Subd. 3a. [GENDER REASSIGNMENT SURGERY.] Gender 165.29 reassignment surgery and other gender reassignment medical 165.30 procedures including drug therapy for gender reassignment are 165.31 not covered unless the individual began receiving gender 165.32 reassignment services prior to July 1, 1998. 165.33 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 165.34 subdivision 7, is amended to read: 165.35 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 165.36 private duty nursing services in a recipient's home. Recipients 166.1 who are authorized to receive private duty nursing services in 166.2 their home may use approved hours outside of the home during 166.3 hours when normal life activities take them outside of their 166.4 home and when, without the provision of private duty nursing, 166.5 their health and safety would be jeopardized. To use private 166.6 duty nursing services at school, the recipient or responsible 166.7 party must provide written authorization in the care plan 166.8 identifying the chosen provider and the daily amount of services 166.9 to be used at school. Medical assistance does not cover private 166.10 duty nursing services for residents of a hospital, nursing 166.11 facility, intermediate care facility, or a health care facility 166.12 licensed by the commissioner of health, except as authorized in 166.13 section 256B.64 for ventilator-dependent recipients in hospitals 166.14 or unless a resident who is otherwise eligible is on leave from 166.15 the facility and the facility either pays for the private duty 166.16 nursing services or forgoes the facility per diem for the leave 166.17 days that private duty nursing services are used. Total hours 166.18 of service and payment allowed for services outside the home 166.19 cannot exceed that which is otherwise allowed in an in-home 166.20 setting according to section 256B.0627. All private duty 166.21 nursing services must be provided according to the limits 166.22 established under section 256B.0627. Private duty nursing 166.23 services may not be reimbursed if the nurse is the spouse of the 166.24 recipient or the parent or foster care provider of a recipient 166.25 who is under age 18, or the recipient's legal guardian. 166.26 Sec. 22. Minnesota Statutes 1996, section 256B.0625, 166.27 subdivision 17, is amended to read: 166.28 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 166.29 covers transportation costs incurred solely for obtaining 166.30 emergency medical care or transportation costs incurred by 166.31 nonambulatory persons in obtaining emergency or nonemergency 166.32 medical care when paid directly to an ambulance company, common 166.33 carrier, or other recognized providers of transportation 166.34 services. For the purpose of this subdivision, a person who is 166.35 incapable of transport by taxicab or bus shall be considered to 166.36 be nonambulatory. 167.1 (b) Medical assistance covers special transportation, as 167.2 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 167.3 if the provider receives and maintains a current physician's 167.4 order by the recipient's attending physician certifying that the 167.5 recipient has a physical or mental impairment that would 167.6 prohibit the recipient from safely accessing and using a bus, 167.7 taxi, other commercial transportation, or private automobile. 167.8 Special transportation includes driver-assisted service to 167.9 eligible individuals. Driver-assisted service includes 167.10 passenger pickup at and return to the individual's residence or 167.11 place of business, assistance with admittance of the individual 167.12 to the medical facility, and assistance in passenger securement 167.13 or in securing of wheelchairs or stretchers in the vehicle. The 167.14 commissioner shall establish maximum medical assistance 167.15 reimbursement rates for special transportation services for 167.16 persons who need a wheelchair lift van or stretcher-equipped 167.17 vehicle and for those who do not need a wheelchair lift van or 167.18 stretcher-equipped vehicle. The average of these two rates per 167.19 trip must not exceed$14$15 for the base rate and$1.10$1.20 167.20 per mile. Special transportation provided to nonambulatory 167.21 persons who do not need a wheelchair lift van or 167.22 stretcher-equipped vehicle, may be reimbursed at a lower rate 167.23 than special transportation provided to persons who need a 167.24 wheelchair lift van or stretcher-equipped vehicle. 167.25 Sec. 23. Minnesota Statutes 1996, section 256B.0625, is 167.26 amended by adding a subdivision to read: 167.27 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 167.28 services rendered on or after July 1, 1999, medical assistance 167.29 payments for ambulance services shall be increased by five 167.30 percent. 167.31 Sec. 24. Minnesota Statutes 1996, section 256B.0625, 167.32 subdivision 19a, is amended to read: 167.33 Subd. 19a. [PERSONAL CARE SERVICES.] Medical assistance 167.34 covers personal care services in a recipient's home. To qualify 167.35 for personal care services, recipients or responsible parties 167.36 must be able to identify the recipient's needs, direct and 168.1 evaluate task accomplishment, and provide for health and 168.2 safety. Approved hours may be used outside the home when normal 168.3 life activities take them outside the home and when, without the 168.4 provision of personal care, their health and safety would be 168.5 jeopardized. To use personal care services at school, the 168.6 recipient or responsible party must provide written 168.7 authorization in the care plan identifying the chosen provider 168.8 and the daily amount of services to be used at school. Total 168.9 hours for services, whether actually performed inside or outside 168.10 the recipient's home, cannot exceed that which is otherwise 168.11 allowed for personal care services in an in-home setting 168.12 according to section 256B.0627. Medical assistance does not 168.13 cover personal care services for residents of a hospital, 168.14 nursing facility, intermediate care facility, health care 168.15 facility licensed by the commissioner of health, or unless a 168.16 resident who is otherwise eligible is on leave from the facility 168.17 and the facility either pays for the personal care services or 168.18 forgoes the facility per diem for the leave days that personal 168.19 care services are used. All personal care services must be 168.20 provided according to section 256B.0627. Personal care services 168.21 may not be reimbursed if the personal care assistant is the 168.22 spouse or legal guardian of the recipient or the parent of a 168.23 recipient under age 18, or the responsible party or the foster 168.24 care provider of a recipient who cannot direct the recipient's 168.25 own care unless, in the case of a foster care provider, a county 168.26 or state case manager visits the recipient as needed, but not 168.27 less than every six months, to monitor the health and safety of 168.28 the recipient and to ensure the goals of the care plan are met. 168.29 Parents of adult recipients, adult children of the recipient or 168.30 adult siblings of the recipient may be reimbursed for personal 168.31 care services if they are not the recipient's legal guardian and 168.32 are granted a waiver under section 256B.0627. 168.33 Sec. 25. Minnesota Statutes 1996, section 256B.0625, 168.34 subdivision 20, is amended to read: 168.35 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 168.36 the extent authorized by rule of the state agency, medical 169.1 assistance covers case management services to persons with 169.2 serious and persistent mental illnessor subject to federal169.3approval,and children with severe emotional disturbance. 169.4 Services provided under this section must meet the relevant 169.5 standards in sections 245.461 to 245.4888, the Comprehensive 169.6 Adult and Children's Mental Health Acts, Minnesota Rules, parts 169.7 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 169.8 (b) Entities meeting program standards set out in rules 169.9 governing family community support services as defined in 169.10 section 245.4871, subdivision 17, are eligible for medical 169.11 assistance reimbursement for case management services for 169.12 children with severe emotional disturbance when these services 169.13 meet the program standards in Minnesota Rules, parts 9520.0900 169.14 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 169.15 10. 169.16(b) In counties where fewer than 50 percent of children169.17estimated to be eligible under medical assistance to receive169.18case management services for children with severe emotional169.19disturbance actually receive these services in state fiscal year169.201995, community mental health centers serving those counties,169.21entities meeting program standards in Minnesota Rules, parts169.229520.0570 to 9520.0870, and other entities authorized by the169.23commissioner are eligible for medical assistance reimbursement169.24for case management services for children with severe emotional169.25disturbance when these services meet the program standards in169.26Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,169.27excluding subpart 6.169.28 (c) Medical assistance and MinnesotaCare payment for mental 169.29 health case management shall be made on a monthly basis. In 169.30 order to receive payment for an eligible child, the provider 169.31 must document at least a face-to-face contact with the child, 169.32 the child's parents, or the child's legal representative. To 169.33 receive payment for an eligible adult, the provider must 169.34 document at least a face-to-face contact with the adult or the 169.35 adult's legal representative. 169.36 (d) Payment for mental health case management provided by 170.1 county or state staff shall be based on the monthly rate 170.2 methodology under section 256B.094, subdivision 6, paragraph 170.3 (b), with separate rates calculated for child welfare and mental 170.4 health, and within mental health, separate rates for children 170.5 and adults. 170.6 (e) Payment for mental health case management provided by 170.7 county-contracted vendors shall be based on a monthly rate 170.8 negotiated by the host county. The negotiated rate must not 170.9 exceed the rate charged by the vendor for the same service to 170.10 other payers. If the service is provided by a team of 170.11 contracted vendors, the county may negotiate a team rate with a 170.12 vendor who is a member of the team. The team shall determine 170.13 how to distribute the rate among its members. No reimbursement 170.14 received by contracted vendors shall be returned to the county, 170.15 except to reimburse the county for advance funding provided by 170.16 the county to the vendor. 170.17 (f) If the service is provided by a team which includes 170.18 contracted vendors and county or state staff, the costs for 170.19 county or state staff participation in the team shall be 170.20 included in the rate for county-provided services. In this 170.21 case, the contracted vendor and the county may each receive 170.22 separate payment for services provided by each entity in the 170.23 same month. In order to prevent duplication of services, the 170.24 county must document, in the recipient's file, the need for team 170.25 case management and a description of the roles of the team 170.26 members. 170.27 (g) The commissioner shall calculate the nonfederal share 170.28 of actual medical assistance and general assistance medical care 170.29 payments for each county, based on the higher of calendar year 170.30 1995 or 1996, by service date, project that amount forward to 170.31 1999, and transfer one-half of the result from medical 170.32 assistance and general assistance medical care to each county's 170.33 mental health grants under sections 245.4886 and 256E.12 for 170.34 calendar year 1999. The annualized minimum amount added to each 170.35 county's mental health grant shall be $3,000 per year for 170.36 children and $5,000 per year for adults. The commissioner may 171.1 reduce the statewide growth factor in order to fund these 171.2 minimums. The annualized total amount transferred shall become 171.3 part of the base for future mental health grants for each county. 171.4 (h) Any net increase in revenue to the county as a result 171.5 of the change in this section must be used to provide expanded 171.6 mental health services as defined in sections 245.461 to 171.7 245.4888, the Comprehensive Adult and Children's Mental Health 171.8 Acts, excluding inpatient and residential treatment. For 171.9 adults, increased revenue may also be used for services and 171.10 consumer supports which are part of adult mental health projects 171.11 approved under Laws 1997, chapter 203, article 7, section 25. 171.12 For children, increased revenue may also be used for respite 171.13 care and nonresidential individualized rehabilitation services 171.14 as defined in section 245.492, subdivisions 17 and 23. 171.15 "Increased revenue" has the meaning given in Minnesota Rules, 171.16 part 9520.0903, subpart 3. 171.17 (i) Notwithstanding section 256B.19, subdivision 1, the 171.18 nonfederal share of costs for mental health case management 171.19 shall be provided by the recipient's county of responsibility, 171.20 as defined in sections 256G.01 to 256G.12, from sources other 171.21 than federal funds or funds used to match other federal funds. 171.22 (j) The commissioner may suspend, reduce, or terminate the 171.23 reimbursement to a provider that does not meet the reporting or 171.24 other requirements of this section. The county of 171.25 responsibility, as defined in sections 256G.01 to 256G.12, is 171.26 responsible for any federal disallowances. The county may share 171.27 this responsibility with its contracted vendors. 171.28 (k) The commissioner shall set aside a portion of the 171.29 federal funds earned under this section to repay the special 171.30 revenue maximization account under section 256.01, subdivision 171.31 2, clause (15). The repayment is limited to: 171.32 (1) the costs of developing and implementing this section; 171.33 and 171.34 (2) programming the information systems. 171.35 (l) Notwithstanding section 256.025, subdivision 2, 171.36 payments to counties for case management expenditures under this 172.1 section shall only be made from federal earnings from services 172.2 provided under this section. Payments to contracted vendors 172.3 shall include both the federal earnings and the county share. 172.4 (m) Notwithstanding section 256B.041, county payments for 172.5 the cost of mental health case management services provided by 172.6 county or state staff shall not be made to the state treasurer. 172.7 For the purposes of mental health case management services 172.8 provided by county or state staff under this section, the 172.9 centralized disbursement of payments to counties under section 172.10 256B.041 consists only of federal earnings from services 172.11 provided under this section. 172.12 (n) Case management services under this subdivision do not 172.13 include therapy, treatment, legal, or outreach services. 172.14 (o) If the recipient is a resident of a nursing facility, 172.15 intermediate care facility, or hospital, and the recipient's 172.16 institutional care is paid by medical assistance, payment for 172.17 case management services under this subdivision is limited to 172.18 the last 30 days of the recipient's residency in that facility 172.19 and may not exceed more than two months in a calendar year. 172.20 (p) Payment for case management services under this 172.21 subdivision shall not duplicate payments made under other 172.22 program authorities for the same purpose. 172.23 (q) By July 1, 2000, the commissioner shall evaluate the 172.24 effectiveness of the changes required by this section, including 172.25 changes in number of persons receiving mental health case 172.26 management, changes in hours of service per person, and changes 172.27 in caseload size. 172.28 (r) For each calendar year beginning with the calendar year 172.29 2001, the annualized amount of state funds for each county 172.30 determined under paragraph (g) shall be adjusted by the county's 172.31 percentage change in the average number of clients per month who 172.32 received case management under this section during the fiscal 172.33 year that ended six months prior to the calendar year in 172.34 question, in comparison to the prior fiscal year. 172.35 Sec. 26. Minnesota Statutes 1997 Supplement, section 172.36 256B.0625, subdivision 31a, is amended to read: 173.1 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 173.2 SYSTEMS.] (a) Medical assistance covers augmentative and 173.3 alternative communication systems consisting of electronic or 173.4 nonelectronic devices and the related components necessary to 173.5 enable a person with severe expressive communication limitations 173.6 to produce or transmit messages or symbols in a manner that 173.7 compensates for that disability. 173.8 (b)By January 1, 1998, the commissioner, in cooperation173.9with the commissioner of administration, shall establish an173.10augmentative and alternative communication system purchasing173.11program within a state agency or by contract with a qualified173.12private entity. The purpose of this service is to facilitate173.13ready availability of the augmentative and alternative173.14communication systems needed to meet the needs of persons with173.15severe expressive communication limitations in an efficient and173.16cost-effective manner. This program shall:173.17(1) coordinate purchase and rental of augmentative and173.18alternative communication systems;173.19(2) negotiate agreements with manufacturers and vendors for173.20purchase of components of these systems, for warranty coverage,173.21and for repair service;173.22(3) when efficient and cost-effective, maintain and173.23refurbish if needed, an inventory of components of augmentative173.24and alternative communication systems for short- or long-term173.25loan to recipients;173.26(4) facilitate training sessions for service providers,173.27consumers, and families on augmentative and alternative173.28communication systems; and173.29(5) develop a recycling program for used augmentative and173.30alternative communications systems to be reissued and used for173.31trials and short-term use, when appropriate.173.32The availability of components of augmentative and173.33alternative communication systems through this program is173.34subject to prior authorization requirements established under173.35subdivision 25Until the volume of systems purchased increases 173.36 to allow a discount price, the commissioner shall reimburse 174.1 augmentative and alternative communication manufacturers and 174.2 vendors at the manufacturer's suggested retail price for 174.3 augmentative and alternative communication systems and related 174.4 components. The commissioner shall separately reimburse 174.5 providers for purchasing and integrating individual 174.6 communication systems which are unavailable as a package from an 174.7 augmentative and alternative communication vendor. 174.8 (c) Reimbursement rates established by this purchasing 174.9 program are not subject to Minnesota Rules, part 9505.0445, item 174.10 S or T. 174.11 Sec. 27. Minnesota Statutes 1996, section 256B.0625, 174.12 subdivision 34, is amended to read: 174.13 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 174.14 Medical assistance payments toAmerican Indian health services174.15facilities for outpatient medical services billed after June 30,174.161990, must befacilities of the Indian health service and 174.17 facilities operated by a tribe or tribal organization under 174.18 funding authorized by United States Code, title 25, sections 174.19 450f to 450n, or title III of the Indian Self-Determination and 174.20 Education Assistance Act, Public Law Number 93-638, shall be at 174.21 the option of the facility in accordance with the rate published 174.22 by the United States Assistant Secretary for Health under the 174.23 authority of United States Code, title 42, sections 248(a) and 174.24 249(b). General assistance medical care payments to facilities 174.25 of the American Indian health services and facilities operated 174.26 by a tribe or tribal organization for the provision of 174.27 outpatient medical care services billed after June 30, 1990, 174.28 must be in accordance with the general assistance medical care 174.29 rates paid for the same services when provided in a facility 174.30 other thanan Americana facility of the Indian health 174.31 service or a facility operated by a tribe or tribal organization. 174.32 Sec. 28. Minnesota Statutes 1996, section 256B.0625, 174.33 subdivision 38, is amended to read: 174.34 Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments 174.35 for mental health services covered under the medical assistance 174.36 program that are provided by masters-prepared mental health 175.1 professionals shall be 80 percent of the rate paid to 175.2 doctoral-prepared professionals. Payments for mental health 175.3 services covered under the medical assistance program that are 175.4 provided by masters-prepared mental health professionals 175.5 employed by community mental health centers shall be 100 percent 175.6 of the rate paid to doctoral-prepared professionals. For 175.7 purposes of reimbursement of mental health professionals under 175.8 the medical assistance program, all social workers who: 175.9 (1) have received a master's degree in social work from a 175.10 program accredited by the council on social work education; 175.11 (2) are licensed at the level of graduate social worker or 175.12 independent social worker; and 175.13 (3) are practicing clinical social work under appropriate 175.14 supervision, as defined by section 148B.18; meet all 175.15 requirements under Minnesota Rules, part 9505.0323, subpart 24, 175.16 and shall be paid accordingly. 175.17 Sec. 29. Minnesota Statutes 1996, section 256B.0627, 175.18 subdivision 4, is amended to read: 175.19 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 175.20 services that are eligible for payment are the following: 175.21 (1) bowel and bladder care; 175.22 (2) skin care to maintain the health of the skin; 175.23 (3) repetitive maintenance range of motion, muscle 175.24 strengthening exercises, and other tasks specific to maintaining 175.25 a recipient's optimal level of function; 175.26 (4) respiratory assistance; 175.27 (5) transfers and ambulation; 175.28 (6) bathing, grooming, and hairwashing necessary for 175.29 personal hygiene; 175.30 (7) turning and positioning; 175.31 (8) assistance with furnishing medication that is 175.32 self-administered; 175.33 (9) application and maintenance of prosthetics and 175.34 orthotics; 175.35 (10) cleaning medical equipment; 175.36 (11) dressing or undressing; 176.1 (12) assistance with eating and meal preparation and 176.2 necessary grocery shopping; 176.3 (13) accompanying a recipient to obtain medical diagnosis 176.4 or treatment; 176.5 (14) assisting, monitoring, or prompting the recipient to 176.6 complete the services in clauses (1) to (13); 176.7 (15) redirection, monitoring, and observation that are 176.8 medically necessary and an integral part of completing the 176.9 personal care services described in clauses (1) to (14); 176.10 (16) redirection and intervention for behavior, including 176.11 observation and monitoring; 176.12 (17) interventions for seizure disorders, including 176.13 monitoring and observation if the recipient has had a seizure 176.14 that requires intervention within the past three months;and176.15 (18) tracheostomy suctioning using a clean procedure if the 176.16 procedure is properly delegated by a registered nurse. Before 176.17 this procedure can be delegated to a personal care assistant, a 176.18 registered nurse must determine that the tracheostomy suctioning 176.19 can be accomplished utilizing a clean rather than a sterile 176.20 procedure and must ensure that the personal care assistant has 176.21 been taught the proper procedure; and 176.22 (19) incidental household services that are an integral 176.23 part of a personal care service described in clauses (1) to 176.24(17)(18). 176.25 For purposes of this subdivision, monitoring and observation 176.26 means watching for outward visible signs that are likely to 176.27 occur and for which there is a covered personal care service or 176.28 an appropriate personal care intervention. For purposes of this 176.29 subdivision, a clean procedure refers to a procedure that 176.30 reduces the numbers of microorganisms or prevents or reduces the 176.31 transmission of microorganisms from one person or place to 176.32 another. A clean procedure may be used beginning 14 days after 176.33 insertion. 176.34 (b) The personal care services that are not eligible for 176.35 payment are the following: 176.36 (1) services not ordered by the physician; 177.1 (2) assessments by personal care provider organizations or 177.2 by independently enrolled registered nurses; 177.3 (3) services that are not in the service plan; 177.4 (4) services provided by the recipient's spouse, legal 177.5 guardian for an adult or child recipient, or parent of a 177.6 recipient under age 18; 177.7 (5) services provided by a foster care provider of a 177.8 recipient who cannot direct the recipient's own care, unless 177.9 monitored by a county or state case manager under section 177.10 256B.0625, subdivision 19a; 177.11 (6) services provided by the residential or program license 177.12 holder in a residence for more than four persons; 177.13 (7) services that are the responsibility of a residential 177.14 or program license holder under the terms of a service agreement 177.15 and administrative rules; 177.16 (8) sterile procedures; 177.17 (9) injections of fluids into veins, muscles, or skin; 177.18 (10) services provided by parents of adult recipients, 177.19 adult children or adult siblings of the recipient, unless these 177.20 relatives meet one of the following hardship criteria and the 177.21 commissioner waives this requirement: 177.22 (i) the relative resigns from a part-time or full-time job 177.23 to provide personal care for the recipient; 177.24 (ii) the relative goes from a full-time to a part-time job 177.25 with less compensation to provide personal care for the 177.26 recipient; 177.27 (iii) the relative takes a leave of absence without pay to 177.28 provide personal care for the recipient; 177.29 (iv) the relative incurs substantial expenses by providing 177.30 personal care for the recipient; or 177.31 (v) because of labor conditions or intermittent hours of 177.32 care needed, the relative is needed in order to provide an 177.33 adequate number of qualified personal care assistants to meet 177.34 the medical needs of the recipient; 177.35 (11) homemaker services that are not an integral part of a 177.36 personal care services; 178.1 (12) home maintenance, or chore services; 178.2 (13) services not specified under paragraph (a); and 178.3 (14) services not authorized by the commissioner or the 178.4 commissioner's designee. 178.5 Sec. 30. Minnesota Statutes 1997 Supplement, section 178.6 256B.0627, subdivision 5, is amended to read: 178.7 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 178.8 payments for home care services shall be limited according to 178.9 this subdivision. 178.10 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 178.11 recipient may receive the following home care services during a 178.12 calendar year: 178.13 (1) any initial assessment; 178.14 (2) up to two reassessments per year done to determine a 178.15 recipient's need for personal care services; and 178.16 (3) up to five skilled nurse visits. 178.17 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 178.18 services above the limits in paragraph (a) must receive the 178.19 commissioner's prior authorization, except when: 178.20 (1) the home care services were required to treat an 178.21 emergency medical condition that if not immediately treated 178.22 could cause a recipient serious physical or mental disability, 178.23 continuation of severe pain, or death. The provider must 178.24 request retroactive authorization no later than five working 178.25 days after giving the initial service. The provider must be 178.26 able to substantiate the emergency by documentation such as 178.27 reports, notes, and admission or discharge histories; 178.28 (2) the home care services were provided on or after the 178.29 date on which the recipient's eligibility began, but before the 178.30 date on which the recipient was notified that the case was 178.31 opened. Authorization will be considered if the request is 178.32 submitted by the provider within 20 working days of the date the 178.33 recipient was notified that the case was opened; 178.34 (3) a third-party payor for home care services has denied 178.35 or adjusted a payment. Authorization requests must be submitted 178.36 by the provider within 20 working days of the notice of denial 179.1 or adjustment. A copy of the notice must be included with the 179.2 request; 179.3 (4) the commissioner has determined that a county or state 179.4 human services agency has made an error; or 179.5 (5) the professional nurse determines an immediate need for 179.6 up to 40 skilled nursing or home health aide visits per calendar 179.7 year and submits a request for authorization within 20 working 179.8 days of the initial service date, and medical assistance is 179.9 determined to be the appropriate payer. 179.10 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 179.11 authorization will be evaluated according to the same criteria 179.12 applied to prior authorization requests. 179.13 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 179.14 section 256B.0627, subdivision 1, paragraph (a), shall be 179.15 conducted initially, and at least annually thereafter, in person 179.16 with the recipient and result in a completed service plan using 179.17 forms specified by the commissioner. Within 30 days of 179.18 recipient or responsible party request for home care services, 179.19 the assessment, the service plan, and other information 179.20 necessary to determine medical necessity such as diagnostic or 179.21 testing information, social or medical histories, and hospital 179.22 or facility discharge summaries shall be submitted to the 179.23 commissioner. For personal care services: 179.24 (1) The amount and type of service authorized based upon 179.25 the assessment and service plan will follow the recipient if the 179.26 recipient chooses to change providers. 179.27 (2) If the recipient's medical need changes, the 179.28 recipient's provider may assess the need for a change in service 179.29 authorization and request the change from the county public 179.30 health nurse. Within 30 days of the request, the public health 179.31 nurse will determine whether to request the change in services 179.32 based upon the provider assessment, or conduct a home visit to 179.33 assess the need and determine whether the change is appropriate. 179.34 (3) To continue to receive personal care serviceswhen the179.35recipient displays no significant change, the county public179.36health nurse has the option to review with the commissioner, or180.1the commissioner's designee, the service plan on record and180.2receive authorization for up to an additional 12 months at a180.3time for up to three years.after the first year, the recipient 180.4 or the responsible party, in conjunction with the public health 180.5 nurse, may complete a service update on forms developed by the 180.6 commissioner. The service update may substitute for the annual 180.7 reassessment described in subdivision 1. 180.8 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 180.9 commissioner's designee, shall review the assessment, the 180.10 service plan, and any additional information that is submitted. 180.11 The commissioner shall, within 30 days after receiving a 180.12 complete request, assessment, and service plan, authorize home 180.13 care services as follows: 180.14 (1) [HOME HEALTH SERVICES.] All home health services 180.15 provided by a licensed nurse or a home health aide must be prior 180.16 authorized by the commissioner or the commissioner's designee. 180.17 Prior authorization must be based on medical necessity and 180.18 cost-effectiveness when compared with other care options. When 180.19 home health services are used in combination with personal care 180.20 and private duty nursing, the cost of all home care services 180.21 shall be considered for cost-effectiveness. The commissioner 180.22 shall limit nurse and home health aide visits to no more than 180.23 one visit each per day. 180.24 (2) [PERSONAL CARE SERVICES.] (i) All personal care 180.25 services and registered nurse supervision must be prior 180.26 authorized by the commissioner or the commissioner's designee 180.27 except for the assessments established in paragraph (a). The 180.28 amount of personal care services authorized must be based on the 180.29 recipient's home care rating. A child may not be found to be 180.30 dependent in an activity of daily living if because of the 180.31 child's age an adult would either perform the activity for the 180.32 child or assist the child with the activity and the amount of 180.33 assistance needed is similar to the assistance appropriate for a 180.34 typical child of the same age. Based on medical necessity, the 180.35 commissioner may authorize: 180.36 (A) up to two times the average number of direct care hours 181.1 provided in nursing facilities for the recipient's comparable 181.2 case mix level; or 181.3 (B) up to three times the average number of direct care 181.4 hours provided in nursing facilities for recipients who have 181.5 complex medical needs or are dependent in at least seven 181.6 activities of daily living and need physical assistance with 181.7 eating or have a neurological diagnosis; or 181.8 (C) up to 60 percent of the average reimbursement rate, as 181.9 of July 1, 1991, for care provided in a regional treatment 181.10 center for recipients who have Level I behavior, plus any 181.11 inflation adjustment as provided by the legislature for personal 181.12 care service; or 181.13 (D) up to the amount the commissioner would pay, as of July 181.14 1, 1991, plus any inflation adjustment provided for home care 181.15 services, for care provided in a regional treatment center for 181.16 recipients referred to the commissioner by a regional treatment 181.17 center preadmission evaluation team. For purposes of this 181.18 clause, home care services means all services provided in the 181.19 home or community that would be included in the payment to a 181.20 regional treatment center; or 181.21 (E) up to the amount medical assistance would reimburse for 181.22 facility care for recipients referred to the commissioner by a 181.23 preadmission screening team established under section 256B.0911 181.24 or 256B.092; and 181.25 (F) a reasonable amount of time for the provision of 181.26 nursing supervision of personal care services. 181.27 (ii) The number of direct care hours shall be determined 181.28 according to the annual cost report submitted to the department 181.29 by nursing facilities. The average number of direct care hours, 181.30 as established by May 1, 1992, shall be calculated and 181.31 incorporated into the home care limits on July 1, 1992. These 181.32 limits shall be calculated to the nearest quarter hour. 181.33 (iii) The home care rating shall be determined by the 181.34 commissioner or the commissioner's designee based on information 181.35 submitted to the commissioner by the county public health nurse 181.36 on forms specified by the commissioner. The home care rating 182.1 shall be a combination of current assessment tools developed 182.2 under sections 256B.0911 and 256B.501 with an addition for 182.3 seizure activity that will assess the frequency and severity of 182.4 seizure activity and with adjustments, additions, and 182.5 clarifications that are necessary to reflect the needs and 182.6 conditions of recipients who need home care including children 182.7 and adults under 65 years of age. The commissioner shall 182.8 establish these forms and protocols under this section and shall 182.9 use an advisory group, including representatives of recipients, 182.10 providers, and counties, for consultation in establishing and 182.11 revising the forms and protocols. 182.12 (iv) A recipient shall qualify as having complex medical 182.13 needs if the care required is difficult to perform and because 182.14 of recipient's medical condition requires more time than 182.15 community-based standards allow or requires more skill than 182.16 would ordinarily be required and the recipient needs or has one 182.17 or more of the following: 182.18 (A) daily tube feedings; 182.19 (B) daily parenteral therapy; 182.20 (C) wound or decubiti care; 182.21 (D) postural drainage, percussion, nebulizer treatments, 182.22 suctioning, tracheotomy care, oxygen, mechanical ventilation; 182.23 (E) catheterization; 182.24 (F) ostomy care; 182.25 (G) quadriplegia; or 182.26 (H) other comparable medical conditions or treatments the 182.27 commissioner determines would otherwise require institutional 182.28 care. 182.29 (v) A recipient shall qualify as having Level I behavior if 182.30 there is reasonable supporting evidence that the recipient 182.31 exhibits, or that without supervision, observation, or 182.32 redirection would exhibit, one or more of the following 182.33 behaviors that cause, or have the potential to cause: 182.34 (A) injury to the recipient's own body; 182.35 (B) physical injury to other people; or 182.36 (C) destruction of property. 183.1 (vi) Time authorized for personal care relating to Level I 183.2 behavior in subclause (v), items (A) to (C), shall be based on 183.3 the predictability, frequency, and amount of intervention 183.4 required. 183.5 (vii) A recipient shall qualify as having Level II behavior 183.6 if the recipient exhibits on a daily basis one or more of the 183.7 following behaviors that interfere with the completion of 183.8 personal care services under subdivision 4, paragraph (a): 183.9 (A) unusual or repetitive habits; 183.10 (B) withdrawn behavior; or 183.11 (C) offensive behavior. 183.12 (viii) A recipient with a home care rating of Level II 183.13 behavior in subclause (vii), items (A) to (C), shall be rated as 183.14 comparable to a recipient with complex medical needs under 183.15 subclause (iv). If a recipient has both complex medical needs 183.16 and Level II behavior, the home care rating shall be the next 183.17 complex category up to the maximum rating under subclause (i), 183.18 item (B). 183.19 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 183.20 nursing services shall be prior authorized by the commissioner 183.21 or the commissioner's designee. Prior authorization for private 183.22 duty nursing services shall be based on medical necessity and 183.23 cost-effectiveness when compared with alternative care options. 183.24 The commissioner may authorize medically necessary private duty 183.25 nursing services in quarter-hour units when: 183.26 (i) the recipient requires more individual and continuous 183.27 care than can be provided during a nurse visit; or 183.28 (ii) the cares are outside of the scope of services that 183.29 can be provided by a home health aide or personal care assistant. 183.30 The commissioner may authorize: 183.31 (A) up to two times the average amount of direct care hours 183.32 provided in nursing facilities statewide for case mix 183.33 classification "K" as established by the annual cost report 183.34 submitted to the department by nursing facilities in May 1992; 183.35 (B) private duty nursing in combination with other home 183.36 care services up to the total cost allowed under clause (2); 184.1 (C) up to 16 hours per day if the recipient requires more 184.2 nursing than the maximum number of direct care hours as 184.3 established in item (A) and the recipient meets the hospital 184.4 admission criteria established under Minnesota Rules, parts 184.5 9505.0500 to 9505.0540. 184.6 The commissioner may authorize up to 16 hours per day of 184.7 medically necessary private duty nursing services or up to 24 184.8 hours per day of medically necessary private duty nursing 184.9 services until such time as the commissioner is able to make a 184.10 determination of eligibility for recipients who are 184.11 cooperatively applying for home care services under the 184.12 community alternative care program developed under section 184.13 256B.49, or until it is determined by the appropriate regulatory 184.14 agency that a health benefit plan is or is not required to pay 184.15 for appropriate medically necessary health care services. 184.16 Recipients or their representatives must cooperatively assist 184.17 the commissioner in obtaining this determination. Recipients 184.18 who are eligible for the community alternative care program may 184.19 not receive more hours of nursing under this section than would 184.20 otherwise be authorized under section 256B.49. 184.21 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 184.22 ventilator-dependent, the monthly medical assistance 184.23 authorization for home care services shall not exceed what the 184.24 commissioner would pay for care at the highest cost hospital 184.25 designated as a long-term hospital under the Medicare program. 184.26 For purposes of this clause, home care services means all 184.27 services provided in the home that would be included in the 184.28 payment for care at the long-term hospital. 184.29 "Ventilator-dependent" means an individual who receives 184.30 mechanical ventilation for life support at least six hours per 184.31 day and is expected to be or has been dependent for at least 30 184.32 consecutive days. 184.33 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 184.34 or the commissioner's designee shall determine the time period 184.35 for which a prior authorization shall be effective. If the 184.36 recipient continues to require home care services beyond the 185.1 duration of the prior authorization, the home care provider must 185.2 request a new prior authorization. Under no circumstances, 185.3 other than the exceptions in paragraph (b), shall a prior 185.4 authorization be valid prior to the date the commissioner 185.5 receives the request or for more than 12 months. A recipient 185.6 who appeals a reduction in previously authorized home care 185.7 services may continue previously authorized services, other than 185.8 temporary services under paragraph (h), pending an appeal under 185.9 section 256.045. The commissioner must provide a detailed 185.10 explanation of why the authorized services are reduced in amount 185.11 from those requested by the home care provider. 185.12 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 185.13 the commissioner's designee shall determine the medical 185.14 necessity of home care services, the level of caregiver 185.15 according to subdivision 2, and the institutional comparison 185.16 according to this subdivision, the cost-effectiveness of 185.17 services, and the amount, scope, and duration of home care 185.18 services reimbursable by medical assistance, based on the 185.19 assessment, primary payer coverage determination information as 185.20 required, the service plan, the recipient's age, the cost of 185.21 services, the recipient's medical condition, and diagnosis or 185.22 disability. The commissioner may publish additional criteria 185.23 for determining medical necessity according to section 256B.04. 185.24 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 185.25 The agency nurse, the independently enrolled private duty nurse, 185.26 or county public health nurse may request a temporary 185.27 authorization for home care services by telephone. The 185.28 commissioner may approve a temporary level of home care services 185.29 based on the assessment, and service or care plan information, 185.30 and primary payer coverage determination information as required. 185.31 Authorization for a temporary level of home care services 185.32 including nurse supervision is limited to the time specified by 185.33 the commissioner, but shall not exceed 45 days, unless extended 185.34 because the county public health nurse has not completed the 185.35 required assessment and service plan, or the commissioner's 185.36 determination has not been made. The level of services 186.1 authorized under this provision shall have no bearing on a 186.2 future prior authorization. 186.3 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 186.4 Home care services provided in an adult or child foster care 186.5 setting must receive prior authorization by the department 186.6 according to the limits established in paragraph (a). 186.7 The commissioner may not authorize: 186.8 (1) home care services that are the responsibility of the 186.9 foster care provider under the terms of the foster care 186.10 placement agreement and administrative rules. Requests for home 186.11 care services for recipients residing in a foster care setting 186.12 must include the foster care placement agreement and 186.13 determination of difficulty of care; 186.14 (2) personal care services when the foster care license 186.15 holder is also the personal care provider or personal care 186.16 assistant unless the recipient can direct the recipient's own 186.17 care, or case management is provided as required in section 186.18 256B.0625, subdivision 19a; 186.19 (3) personal care services when the responsible party is an 186.20 employee of, or under contract with, or has any direct or 186.21 indirect financial relationship with the personal care provider 186.22 or personal care assistant, unless case management is provided 186.23 as required in section 256B.0625, subdivision 19a; 186.24 (4) home care services when the number of foster care 186.25 residents is greater than four unless the county responsible for 186.26 the recipient's foster placement made the placement prior to 186.27 April 1, 1992, requests that home care services be provided, and 186.28 case management is provided as required in section 256B.0625, 186.29 subdivision 19a; or 186.30 (5) home care services when combined with foster care 186.31 payments, other than room and board payments that exceed the 186.32 total amount that public funds would pay for the recipient's 186.33 care in a medical institution. 186.34 Sec. 31. Minnesota Statutes 1997 Supplement, section 186.35 256B.0627, subdivision 8, is amended to read: 186.36 Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.] 187.1 (a) Medical assistance payments for personal care assistance 187.2 shared care shall be limited according to this subdivision. 187.3 (b) Recipients of personal care assistant services may 187.4 share staff and the commissioner shall provide a rate system for 187.5 shared personal care assistant services. For two persons 187.6 sharing care, the ratesystempaid to a provider shall not 187.7 exceed 1-1/2 times theamountrate paid forproviding services187.8to one personserving a single individual, andshall increase187.9incrementally by one-half the cost of serving a single person,187.10for each person served. A personal care assistant may not serve187.11more than three children in a single setting.for three persons 187.12 sharing care, the rate paid to a provider shall not exceed twice 187.13 the rate paid for serving a single individual. These rates 187.14 apply only to situations in which all recipients were present 187.15 and received shared care on the date for which the service is 187.16 billed. No more than three persons may receive shared care from 187.17 a personal care assistant in a single setting. 187.18 (c) Shared care is the provision of personal care services 187.19 by a personal care assistant to two or three recipients at the 187.20 same time and in the same setting. For the purposes of this 187.21 subdivision, "setting" means: 187.22 (1) the home or foster care home of one of the individual 187.23 recipients; or 187.24 (2) a child care program in which all recipients served by 187.25 one personal care assistant are participating, which is licensed 187.26 under chapter 245A or operated by a local school district or 187.27 private school. 187.28 The provisions of this subdivision do not apply when a 187.29 personal care assistant is caring for multiple recipients in 187.30 more than one setting. 187.31 (d) The recipient or the recipient's responsible party, in 187.32 conjunction with the county public health nurse, shall determine: 187.33 (1) whether shared care is an appropriate option based on 187.34 the individual needs and preferences of the recipient; and 187.35 (2) the amount of shared care allocated as part of the 187.36 overall authorization of personal care services. 188.1 The recipient or the responsible party, in conjunction with 188.2 the supervising registered nurse, shall approve the setting, 188.3 grouping, and arrangement of shared care based on the individual 188.4 needs and preferences of the recipients. Decisions on the 188.5 selection of recipients to share care must be based on the ages 188.6 of the recipients, compatibility, and coordination of their care 188.7 needs. 188.8 (e) The following items must be considered by the recipient 188.9 or the responsible party and the supervising nurse, and 188.10 documented in the recipient's care plan: 188.11 (1) the additional qualifications needed by the personal 188.12 care assistant to provide care to several recipients in the same 188.13 setting; 188.14 (2) the additional training and supervision needed by the 188.15 personal care assistant to ensure that the needs of the 188.16 recipient are met appropriately and safely. The provider must 188.17 provide on-site supervision by a registered nurse within the 188.18 first 14 days of shared care, and monthly thereafter; 188.19 (3) the setting in which the shared care will be provided; 188.20 (4) the ongoing monitoring and evaluation of the 188.21 effectiveness and appropriateness of the service and process 188.22 used to make changes in service or setting; and 188.23 (5) a contingency plan which accounts for absence of the 188.24 recipient in a shared care setting due to illness or other 188.25 circumstances and staffing contingencies. 188.26 (f) The provider must offer the recipient or the 188.27 responsible party the option of shared or individual personal 188.28 care assistant care. The recipient or the responsible party can 188.29 withdraw from participating in a shared care arrangement at any 188.30 time. 188.31 (g) In addition to documentation requirements under 188.32 Minnesota Rules, part 9505.2175, a personal care provider must 188.33 meet documentation requirements for shared personal care 188.34 services and must document the following in the health service 188.35 record for each individual recipient sharing care: 188.36 (1) authorization by the recipient or the recipient's 189.1 responsible party, if any, for the maximum number of shared care 189.2 hours per week chosen by the recipient; 189.3 (2) authorization by the recipient or the recipient's 189.4 responsible party, if any, for personal care services provided 189.5 outside the recipient's residence; 189.6 (3) authorization by the recipient or the recipient's 189.7 responsible party, if any, for others to receive shared care in 189.8 the recipient's residence; 189.9 (4) revocation by the recipient or the recipient's 189.10 responsible party, if any, of the shared care authorization, or 189.11 the shared care to be provided to others in the recipient's 189.12 residence, or the shared care to be provided outside the 189.13 recipient's residence; 189.14 (5) supervision of the shared care by the supervisory 189.15 nurse, including the date, time of day, number of hours spent 189.16 supervising the provision of shared care services, whether the 189.17 supervision was face-to-face or another method of supervision, 189.18 changes in the recipient's condition, shared care scheduling 189.19 issues and recommendations; 189.20 (6) documentation by the personal care assistant of 189.21 telephone calls or other discussions with the supervisory nurse 189.22 regarding services being provided to the recipient; and 189.23 (7) daily documentation of the shared care services 189.24 provided by each identified personal care assistant including: 189.25 (i) the names of each recipient receiving shared care 189.26 together; 189.27 (ii) the setting for the day's care, including the starting 189.28 and ending times that the recipient received shared care; and 189.29 (iii) notes by the personal care assistant regarding 189.30 changes in the recipient's condition, problems that may arise 189.31 from the sharing of care, scheduling issues, care issues, and 189.32 other notes as required by the supervising nurse. 189.33 (h) Unless otherwise provided in this subdivision, all 189.34 other statutory and regulatory provisions relating to personal 189.35 care services apply to shared care services. 189.36 Nothing in this subdivision shall be construed to reduce 190.1 the total number of hours authorized for an individual recipient. 190.2 Sec. 32. Minnesota Statutes 1997 Supplement, section 190.3 256B.0645, is amended to read: 190.4 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 190.5 ELIGIBILITY.] 190.6 Payment to a provider for a health care service provided to 190.7 a general assistance medical care recipient who is later 190.8 determined eligible for medical assistance or MinnesotaCare 190.9 according to section256L.14256L.03, subdivision 1a, for the 190.10 period in which the health care service was provided,shall be190.11considered payment in full, and shall notmay be adjusted due to 190.12 the change in eligibility. This sectionappliesdoes not apply 190.13 toboth fee-for-service payments andpayments made to health 190.14 plans on a prepaid capitated basis. 190.15 Sec. 33. Minnesota Statutes 1997 Supplement, section 190.16 256B.0911, subdivision 2, is amended to read: 190.17 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 190.18 All applicants to Medicaid certified nursing facilities must be 190.19 screened prior to admission, regardless of income, assets, or 190.20 funding sources, except the following: 190.21 (1) patients who, having entered acute care facilities from 190.22 certified nursing facilities, are returning to a certified 190.23 nursing facility; 190.24 (2) residents transferred from other certified nursing 190.25 facilities located within the state of Minnesota; 190.26 (3) individuals who have a contractual right to have their 190.27 nursing facility care paid for indefinitely by the veteran's 190.28 administration; 190.29 (4) individuals who are enrolled in the Ebenezer/Group 190.30 Health social health maintenance organization project, or 190.31 enrolled in a demonstration project under section 256B.69, 190.32 subdivision188, at the time of application to a nursing home; 190.33 (5) individuals previously screened and currently being 190.34 served under the alternative care program or under a home and 190.35 community-based services waiver authorized under section 1915(c) 190.36 of the Social Security Act; or 191.1 (6) individuals who are admitted to a certified nursing 191.2 facility for a short-term stay, which, based upon a physician's 191.3 certification, is expected to be 14 days or less in duration, 191.4 and who have been screened and approved for nursing facility 191.5 admission within the previous six months. This exemption 191.6 applies only if the screener determines at the time of the 191.7 initial screening of the six-month period that it is appropriate 191.8 to use the nursing facility for short-term stays and that there 191.9 is an adequate plan of care for return to the home or 191.10 community-based setting. If a stay exceeds 14 days, the 191.11 individual must be referred no later than the first county 191.12 working day following the 14th resident day for a screening, 191.13 which must be completed within five working days of the 191.14 referral. Payment limitations in subdivision 7 will apply to an 191.15 individual found at screening to not meet the level of care 191.16 criteria for admission to a certified nursing facility. 191.17 Regardless of the exemptions in clauses (2) to (6), persons 191.18 who have a diagnosis or possible diagnosis of mental illness, 191.19 mental retardation, or a related condition must receive a 191.20 preadmission screening before admission unless the admission 191.21 prior to screening is authorized by the local mental health 191.22 authority or the local developmental disabilities case manager, 191.23 or unless authorized by the county agency according to Public 191.24 Law Number 101-508. 191.25 Before admission to a Medicaid certified nursing home or 191.26 boarding care home, all persons must be screened and approved 191.27 for admission through an assessment process. The nursing 191.28 facility is authorized to conduct case mix assessments which are 191.29 not conducted by the county public health nurse under Minnesota 191.30 Rules, part 9549.0059. The designated county agency is 191.31 responsible for distributing the quality assurance and review 191.32 form for all new applicants to nursing homes. 191.33 Other persons who are not applicants to nursing facilities 191.34 must be screened if a request is made for a screening. 191.35 Sec. 34. Minnesota Statutes 1996, section 256B.0911, 191.36 subdivision 4, is amended to read: 192.1 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 192.2 TEAM.] (a) The county shall: 192.3 (1) provide information and education to the general public 192.4 regarding availability of the preadmission screening program; 192.5 (2) accept referrals from individuals, families, human 192.6 service and health professionals, and hospital and nursing 192.7 facility personnel; 192.8 (3) assess the health, psychological, and social needs of 192.9 referred individuals and identify services needed to maintain 192.10 these persons in the least restrictive environments; 192.11 (4) determine if the individual screened needs nursing 192.12 facility level of care; 192.13 (5) assess specialized service needs based upon an 192.14 evaluation by: 192.15 (i) a qualified independent mental health professional for 192.16 persons with a primary or secondary diagnosis of a serious 192.17 mental illness; and 192.18 (ii) a qualified mental retardation professional for 192.19 persons with a primary or secondary diagnosis of mental 192.20 retardation or related conditions. For purposes of this clause, 192.21 a qualified mental retardation professional must meet the 192.22 standards for a qualified mental retardation professional in 192.23 Code of Federal Regulations, title 42, section 483.430; 192.24 (6) make recommendations for individuals screened regarding 192.25 cost-effective community services which are available to the 192.26 individual; 192.27 (7) make recommendations for individuals screened regarding 192.28 nursing home placement when there are no cost-effective 192.29 community services available; 192.30 (8) develop an individual's community care plan and provide 192.31 follow-up services as needed; and 192.32 (9) prepare and submit reports that may be required by the 192.33 commissioner of human services. 192.34 (b) The screener shall document that the most 192.35 cost-effective alternatives available were offered to the 192.36 individual or the individual's legal representative. For 193.1 purposes of this section, "cost-effective alternatives" means 193.2 community services and living arrangements that cost the same or 193.3 less than nursing facility care. 193.4 (c)Screeners shall adhere to the level of care criteria193.5for admission to a certified nursing facility established under193.6section 144.0721.193.7(d)For persons who are eligible for medical assistance or 193.8 who would be eligible within 180 days of admission to a nursing 193.9 facility and who are admitted to a nursing facility, the nursing 193.10 facility must include a screener or the case manager in the 193.11 discharge planning process for those individuals who the team 193.12 has determined have discharge potential. The screener or the 193.13 case manager must ensure a smooth transition and follow-up for 193.14 the individual's return to the community. 193.15 Screeners shall cooperate with other public and private 193.16 agencies in the community, in order to offer a variety of 193.17 cost-effective services to the disabled and elderly. The 193.18 screeners shall encourage the use of volunteers from families, 193.19 religious organizations, social clubs, and similar civic and 193.20 service organizations to provide services. 193.21 Sec. 35. Minnesota Statutes 1997 Supplement, section 193.22 256B.0911, subdivision 7, is amended to read: 193.23 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 193.24 (a) Medical assistance reimbursement for nursing facilities 193.25 shall be authorized for a medical assistance recipient only if a 193.26 preadmission screening has been conducted prior to admission or 193.27 the local county agency has authorized an exemption. Medical 193.28 assistance reimbursement for nursing facilities shall not be 193.29 provided for any recipient who the local screener has determined 193.30 does not meet the level of care criteria for nursing facility 193.31 placement or, if indicated, has not had a level II PASARR 193.32 evaluation completed unless an admission for a recipient with 193.33 mental illness is approved by the local mental health authority 193.34 or an admission for a recipient with mental retardation or 193.35 related condition is approved by the state mental retardation 193.36 authority.The county preadmission screening team may deny194.1certified nursing facility admission using the level of care194.2criteria established under section 144.0721 and deny medical194.3assistance reimbursement for certified nursing facility care.194.4Persons receiving care in a certified nursing facility or194.5certified boarding care home who are reassessed by the194.6commissioner of health according to section 144.0722 and194.7determined to no longer meet the level of care criteria for a194.8certified nursing facility or certified boarding care home may194.9no longer remain a resident in the certified nursing facility or194.10certified boarding care home and must be relocated to the194.11community if the persons were admitted on or after July 1, 1998.194.12 (b)Persons receiving services under section 256B.0913,194.13subdivisions 1 to 14, or 256B.0915 who are reassessed and found194.14to not meet the level of care criteria for admission to a194.15certified nursing facility or certified boarding care home may194.16no longer receive these services if persons were admitted to the194.17program on or after July 1, 1998.The commissioner shall make a 194.18 request to the health care financing administration for a waiver 194.19 allowing screening team approval of Medicaid payments for 194.20 certified nursing facility care. An individual has a choice and 194.21 makes the final decision between nursing facility placement and 194.22 community placement after the screening team's recommendation, 194.23 except as provided in paragraphs (b) and (c). 194.24 (c) The local county mental health authority or the state 194.25 mental retardation authority under Public Law Numbers 100-203 194.26 and 101-508 may prohibit admission to a nursing facility, if the 194.27 individual does not meet the nursing facility level of care 194.28 criteria or needs specialized services as defined in Public Law 194.29 Numbers 100-203 and 101-508. For purposes of this section, 194.30 "specialized services" for a person with mental retardation or a 194.31 related condition means "active treatment" as that term is 194.32 defined in Code of Federal Regulations, title 42, section 194.33 483.440(a)(1). 194.34 (d) Upon the receipt by the commissioner of approval by the 194.35 Secretary of Health and Human Services of the waiver requested 194.36 under paragraph (a), the local screener shall deny medical 195.1 assistance reimbursement for nursing facility care for an 195.2 individual whose long-term care needs can be met in a 195.3 community-based setting and whose cost of community-based home 195.4 care services is less than 75 percent of the average payment for 195.5 nursing facility care for that individual's case mix 195.6 classification, and who is either: 195.7 (i) a current medical assistance recipient being screened 195.8 for admission to a nursing facility; or 195.9 (ii) an individual who would be eligible for medical 195.10 assistance within 180 days of entering a nursing facility and 195.11 who meets a nursing facility level of care. 195.12 (e) Appeals from the screening team's recommendation or the 195.13 county agency's final decision shall be made according to 195.14 section 256.045, subdivision 3. 195.15 Sec. 36. Minnesota Statutes 1997 Supplement, section 195.16 256B.0913, subdivision 14, is amended to read: 195.17 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 195.18 Reimbursement for expenditures for the alternative care services 195.19 as approved by the client's case manager shall be through the 195.20 invoice processing procedures of the department's Medicaid 195.21 Management Information System (MMIS). To receive reimbursement, 195.22 the county or vendor must submit invoices within 12 months 195.23 following the date of service. The county agency and its 195.24 vendors under contract shall not be reimbursed for services 195.25 which exceed the county allocation. 195.26 (b) If a county collects less than 50 percent of the client 195.27 premiums due under subdivision 12, the commissioner may withhold 195.28 up to three percent of the county's final alternative care 195.29 program allocation determined under subdivisions 10 and 11. 195.30 (c)For fiscal years beginning on or after July 1, 1993,195.31the commissioner of human services shall not provide automatic195.32annual inflation adjustments for alternative care services. The195.33commissioner of finance shall include as a budget change request195.34in each biennial detailed expenditure budget submitted to the195.35legislature under section 16A.11 annual adjustments in195.36reimbursement rates for alternative care services based on the196.1forecasted percentage change in the Home Health Agency Market196.2Basket of Operating Costs, for the fiscal year beginning July 1,196.3compared to the previous fiscal year, unless otherwise adjusted196.4by statute. The Home Health Agency Market Basket of Operating196.5Costs is published by Data Resources, Inc. The forecast to be196.6used is the one published for the calendar quarter beginning196.7January 1, six months prior to the beginning of the fiscal year196.8for which rates are set.196.9(d)The county shall negotiate individual rates with 196.10 vendors and may be reimbursed for actual costs up to the greater 196.11 of the county's current approved rate or 60 percent of the 196.12 maximum rate in fiscal year 1994 and 65 percent of the maximum 196.13 rate in fiscal year 1995 for each alternative care service. 196.14 Notwithstanding any other rule or statutory provision to the 196.15 contrary, the commissioner shall not be authorized to increase 196.16 rates by an annual inflation factor, unless so authorized by the 196.17 legislature. 196.18(e)(d) On July 1, 1993, the commissioner shall increase 196.19 the maximum rate for home delivered meals to $4.50 per meal. 196.20 Sec. 37. Minnesota Statutes 1997 Supplement, section 196.21 256B.0915, subdivision 1d, is amended to read: 196.22 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 196.23 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 196.24 provisions of section 256B.056, the commissioner shall make the 196.25 following amendment to the medical assistance elderly waiver 196.26 program effective July 1,19971999, or upon federal approval, 196.27 whichever is later. 196.28 A recipient's maintenance needs will be an amount equal to 196.29 the Minnesota supplemental aid equivalent rate as defined in 196.30 section 256I.03, subdivision 5, plus the medical assistance 196.31 personal needs allowance as defined in section 256B.35, 196.32 subdivision 1, paragraph (a), when applying posteligibility 196.33 treatment of income rules to the gross income of elderly waiver 196.34 recipients, except for individuals whose income is in excess of 196.35 the special income standard according to Code of Federal 196.36 Regulations, title 42, section 435.236. Recipient maintenance 197.1 needs shall be adjusted under this provision each July 1. 197.2 (b) The commissioner of human services shall secure 197.3 approval of additional elderly waiver slots sufficient to serve 197.4 persons who will qualify under the revised income standard 197.5 described in paragraph (a) before implementing section 197.6 256B.0913, subdivision 16. 197.7 (c) In implementing this subdivision, the commissioner 197.8 shall consider allowing persons who would otherwise be eligible 197.9 for the alternative care program but would qualify for the 197.10 elderly waiver with a spenddown to remain on the alternative 197.11 care program. 197.12 Sec. 38. Minnesota Statutes 1997 Supplement, section 197.13 256B.0915, subdivision 3, is amended to read: 197.14 Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 197.15 FORECASTING.] (a) The number of medical assistance waiver 197.16 recipients that a county may serve must be allocated according 197.17 to the number of medical assistance waiver cases open on July 1 197.18 of each fiscal year. Additional recipients may be served with 197.19 the approval of the commissioner. 197.20 (b) The monthly limit for the cost of waivered services to 197.21 an individual waiver client shall be the statewide average 197.22 payment rate of the case mix resident class to which the waiver 197.23 client would be assigned under the medical assistance case mix 197.24 reimbursement system. If medical supplies and equipment or 197.25 adaptations are or will be purchased for an elderly waiver 197.26 services recipient, the costs may be prorated on a monthly basis 197.27 throughout the year in which they are purchased. If the monthly 197.28 cost of a recipient's other waivered services exceeds the 197.29 monthly limit established in this paragraph, the annual cost of 197.30 the waivered services shall be determined. In this event, the 197.31 annual cost of waivered services shall not exceed 12 times the 197.32 monthly limit calculated in this paragraph. The statewide 197.33 average payment rate is calculated by determining the statewide 197.34 average monthly nursing home rate, effective July 1 of the 197.35 fiscal year in which the cost is incurred, less the statewide 197.36 average monthly income of nursing home residents who are age 65 198.1 or older, and who are medical assistance recipients in the month 198.2 of March of the previous state fiscal year. The annual cost 198.3 divided by 12 of elderly or disabled waivered services for a 198.4 person who is a nursing facility resident at the time of 198.5 requesting a determination of eligibility for elderly or 198.6 disabled waivered services shall be the greater of the monthly 198.7 payment for: (i) the resident class assigned under Minnesota 198.8 Rules, parts 9549.0050 to 9549.0059, for that resident in the 198.9 nursing facility where the resident currently resides; or (ii) 198.10 the statewide average payment of the case mix resident class to 198.11 which the resident would be assigned under the medical 198.12 assistance case mix reimbursement system, provided that the 198.13 limit under this clause only applies to persons discharged from 198.14 a nursing facility and found eligible for waivered services on 198.15 or after July 1, 1997. The following costs must be included in 198.16 determining the total monthly costs for the waiver client: 198.17 (1) cost of all waivered services, including extended 198.18 medical supplies and equipment; and 198.19 (2) cost of skilled nursing, home health aide, and personal 198.20 care services reimbursable by medical assistance. 198.21 (c) Medical assistance funding for skilled nursing 198.22 services, private duty nursing, home health aide, and personal 198.23 care services for waiver recipients must be approved by the case 198.24 manager and included in the individual care plan. 198.25 (d) For both the elderly waiver and the nursing facility 198.26 disabled waiver, a county may purchase extended supplies and 198.27 equipment without prior approval from the commissioner when 198.28 there is no other funding source and the supplies and equipment 198.29 are specified in the individual's care plan as medically 198.30 necessary to enable the individual to remain in the community 198.31 according to the criteria in Minnesota Rules, part 9505.0210, 198.32 items A and B. A county is not required to contract with a 198.33 provider of supplies and equipment if the monthly cost of the 198.34 supplies and equipment is less than $250. 198.35 (e)For the fiscal year beginning on July 1, 1993, and for198.36subsequent fiscal years, the commissioner of human services199.1shall not provide automatic annual inflation adjustments for199.2home and community-based waivered services. The commissioner of199.3finance shall include as a budget change request in each199.4biennial detailed expenditure budget submitted to the199.5legislature under section 16A.11, annual adjustments in199.6reimbursement rates for home and community-based waivered199.7services, based on the forecasted percentage change in the Home199.8Health Agency Market Basket of Operating Costs, for the fiscal199.9year beginning July 1, compared to the previous fiscal year,199.10unless otherwise adjusted by statute. The Home Health Agency199.11Market Basket of Operating Costs is published by Data Resources,199.12Inc. The forecast to be used is the one published for the199.13calendar quarter beginning January 1, six months prior to the199.14beginning of the fiscal year for which rates are set. The adult199.15foster care rate shall be considered a difficulty of care199.16payment and shall not include room and board.199.17(f)The adult foster care daily rate for the elderly and 199.18 disabled waivers shall be negotiated between the county agency 199.19 and the foster care provider. The rate established under this 199.20 section shall not exceed the state average monthly nursing home 199.21 payment for the case mix classification to which the individual 199.22 receiving foster care is assigned; the rate must allow for other 199.23 waiver and medical assistance home care services to be 199.24 authorized by the case manager. 199.25(g)(f) The assisted living and residential care service 199.26 rates for elderly and community alternatives for disabled 199.27 individuals (CADI) waivers shall be made to the vendor as a 199.28 monthly rate negotiated with the county agency based on an 199.29 individualized service plan for each resident. The rate shall 199.30 not exceed the nonfederal share of the greater of either the 199.31 statewide or any of the geographic groups' weighted average 199.32 monthly medical assistance nursing facility payment rate of the 199.33 case mix resident class to which the elderly or disabled client 199.34 would be assigned under Minnesota Rules, parts 9549.0050 to 199.35 9549.0059, unless the services are provided by a home care 199.36 provider licensed by the department of health and are provided 200.1 in a building that is registered as a housing with services 200.2 establishment under chapter 144D and that provides 24-hour 200.3 supervision. For alternative care assisted living projects 200.4 established under Laws 1988, chapter 689, article 2, section 200.5 256, monthly rates may not exceed 65 percent of the greater of 200.6 either the statewide or any of the geographic groups' weighted 200.7 average monthly medical assistance nursing facility payment rate 200.8 for the case mix resident class to which the elderly or disabled 200.9 client would be assigned under Minnesota Rules, parts 9549.0050 200.10 to 9549.0059. The rate may not cover direct rent or food costs. 200.11(h)(g) The county shall negotiate individual rates with 200.12 vendors and may be reimbursed for actual costs up to the greater 200.13 of the county's current approved rate or 60 percent of the 200.14 maximum rate in fiscal year 1994 and 65 percent of the maximum 200.15 rate in fiscal year 1995 for each service within each program. 200.16(i)(h) On July 1, 1993, the commissioner shall increase 200.17 the maximum rate for home-delivered meals to $4.50 per meal. 200.18(j)(i) Reimbursement for the medical assistance recipients 200.19 under the approved waiver shall be made from the medical 200.20 assistance account through the invoice processing procedures of 200.21 the department's Medicaid Management Information System (MMIS), 200.22 only with the approval of the client's case manager. The budget 200.23 for the state share of the Medicaid expenditures shall be 200.24 forecasted with the medical assistance budget, and shall be 200.25 consistent with the approved waiver. 200.26(k)(j) Beginning July 1, 1991, the state shall reimburse 200.27 counties according to the payment schedule in section 256.025 200.28 for the county share of costs incurred under this subdivision on 200.29 or after January 1, 1991, for individuals who are receiving 200.30 medical assistance. 200.31(l)(k) For the community alternatives for disabled 200.32 individuals waiver, and nursing facility disabled waivers, 200.33 county may use waiver funds for the cost of minor adaptations to 200.34 a client's residence or vehicle without prior approval from the 200.35 commissioner if there is no other source of funding and the 200.36 adaptation: 201.1 (1) is necessary to avoid institutionalization; 201.2 (2) has no utility apart from the needs of the client; and 201.3 (3) meets the criteria in Minnesota Rules, part 9505.0210, 201.4 items A and B. 201.5 For purposes of this subdivision, "residence" means the client's 201.6 own home, the client's family residence, or a family foster 201.7 home. For purposes of this subdivision, "vehicle" means the 201.8 client's vehicle, the client's family vehicle, or the client's 201.9 family foster home vehicle. 201.10(m)(l) The commissioner shall establish a maximum rate 201.11 unit for baths provided by an adult day care provider that are 201.12 not included in the provider's contractual daily or hourly rate. 201.13 This maximum rate must equal the home health aide extended rate 201.14 and shall be paid for baths provided to clients served under the 201.15 elderly and disabled waivers. 201.16 Sec. 39. Minnesota Statutes 1996, section 256B.0916, is 201.17 amended to read: 201.18 256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 201.19 MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 201.20 (a) The commissioner shall expand availability of home and 201.21 community-based services for persons with mental retardation and 201.22 related conditions to the extent allowed by federal law and 201.23 regulation and shall assist counties in transferring persons 201.24 from semi-independent living services to home and 201.25 community-based services. The commissioner may transfer funds 201.26 from the state semi-independent living services account 201.27 available under section 252.275, subdivision 8, and state 201.28 community social services aids available under section 256E.15 201.29 to the medical assistance account to pay for the nonfederal 201.30 share of nonresidential and residential home and community-based 201.31 services authorized under section 256B.092 for persons 201.32 transferring from semi-independent living services. 201.33 (b) Upon federal approval, county boards are not 201.34 responsible for funding semi-independent living services as a 201.35 social service for those persons who have transferred to the 201.36 home and community-based waiver program as a result of the 202.1 expansion under this subdivision. The county responsibility for 202.2 those persons transferred shall be assumed under section 202.3 256B.092. Notwithstanding the provisions of section 252.275, 202.4 the commissioner shall continue to allocate funds under that 202.5 section for semi-independent living services and county boards 202.6 shall continue to fund services under sections 256E.06 and 202.7 256E.14 for those persons who cannot access home and 202.8 community-based services under section 256B.092. 202.9 (c) Eighty percent of the state funds made available to the 202.10 commissioner under section 252.275 as a result of persons 202.11 transferring from the semi-independent living services program 202.12 to the home and community-based services program shall be used 202.13 to fund additional persons in the semi-independent living 202.14 services program. 202.15 (d) Beginning August 1, 1998, the commissioner shall issue 202.16 an annual report on the home and community-based waiver for 202.17 persons with mental retardation or related conditions, that 202.18 includes a list of the counties in which less than 95 percent of 202.19 the allocation provided, excluding the county waivered services 202.20 reserve, has been committed for two or more quarters during the 202.21 previous state fiscal year. For each listed county, the report 202.22 shall include the amount of funds allocated but not used, the 202.23 number and ages of individuals screened and waiting for 202.24 services, the services needed, a description of the technical 202.25 assistance provided by the commissioner to assist the counties 202.26 in jointly planning with other counties in order to serve more 202.27 persons, and additional actions which will be taken to serve 202.28 those screened and waiting for services. 202.29 (e) The commissioner shall make available to interested 202.30 parties, upon request, financial information by county including 202.31 the amount of resources allocated for the home and 202.32 community-based waiver for persons with mental retardation and 202.33 related conditions, the resources committed, the number of 202.34 persons screened and waiting for services, the type of services 202.35 requested by those waiting, and the amount of allocated 202.36 resources not committed. 203.1 Sec. 40. Minnesota Statutes 1997 Supplement, section 203.2 256B.0951, is amended by adding a subdivision to read: 203.3 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 203.4 exempt residents of intermediate care facilities for persons 203.5 with mental retardation (ICFs/MR) who participate in the 203.6 three-year quality assurance pilot project established in 203.7 section 256B.095 from the requirements of Minnesota Rules, 203.8 chapter 4665, upon approval by the federal government of a 203.9 waiver of federal certification requirements for ICFs/MR. The 203.10 commissioners of health and human services shall apply for any 203.11 necessary waivers as soon as practicable and shall submit the 203.12 concept paper to the federal government by June 1, 1998. 203.13 Sec. 41. Minnesota Statutes 1996, section 256B.41, 203.14 subdivision 1, is amended to read: 203.15 Subdivision 1. [AUTHORITY.] The commissioner shall 203.16 establish, by rule, procedures for determining rates for care of 203.17 residents of nursing facilities which qualify as vendors of 203.18 medical assistance, and for implementing the provisions of this 203.19 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 203.20 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 203.21be based on methods and standards that the commissioner finds203.22are adequate to provide for the costs that must be incurred for203.23the care of residents in efficiently and economically operated203.24nursing facilities and shallspecify the costs that are 203.25 allowable for establishing payment rates through medical 203.26 assistance. 203.27 Sec. 42. Minnesota Statutes 1996, section 256B.431, 203.28 subdivision 2b, is amended to read: 203.29 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 203.30 rate years beginning on or after July 1, 1985, the commissioner 203.31 shall establish procedures for determining per diem 203.32 reimbursement for operating costs. 203.33 (b) The commissioner shall contract with an econometric 203.34 firm with recognized expertise in and access to national 203.35 economic change indices that can be applied to the appropriate 203.36 cost categories when determining the operating cost payment rate. 204.1 (c) The commissioner shall analyze and evaluate each 204.2 nursing facility's cost report of allowable operating costs 204.3 incurred by the nursing facility during the reporting year 204.4 immediately preceding the rate year for which the payment rate 204.5 becomes effective. 204.6 (d) The commissioner shall establish limits on actual 204.7 allowable historical operating cost per diems based on cost 204.8 reports of allowable operating costs for the reporting year that 204.9 begins October 1, 1983, taking into consideration relevant 204.10 factors including resident needs, geographic location, and size 204.11 of the nursing facility, and the costs that must be incurred for204.12the care of residents in an efficiently and economically204.13operated nursing facility. In developing the geographic groups 204.14 for purposes of reimbursement under this section, the 204.15 commissioner shall ensure that nursing facilities in any county 204.16 contiguous to the Minneapolis-St. Paul seven-county metropolitan 204.17 area are included in the same geographic group. The limits 204.18 established by the commissioner shall not be less, in the 204.19 aggregate, than the 60th percentile of total actual allowable 204.20 historical operating cost per diems for each group of nursing 204.21 facilities established under subdivision 1 based on cost reports 204.22 of allowable operating costs in the previous reporting year. 204.23 For rate years beginning on or after July 1, 1989, facilities 204.24 located in geographic group I as described in Minnesota Rules, 204.25 part 9549.0052, on January 1, 1989, may choose to have the 204.26 commissioner apply either the care related limits or the other 204.27 operating cost limits calculated for facilities located in 204.28 geographic group II, or both, if either of the limits calculated 204.29 for the group II facilities is higher. The efficiency incentive 204.30 for geographic group I nursing facilities must be calculated 204.31 based on geographic group I limits. The phase-in must be 204.32 established utilizing the chosen limits. For purposes of these 204.33 exceptions to the geographic grouping requirements, the 204.34 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 204.35 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 204.36 established under this paragraph remain in effect until the 205.1 commissioner establishes a new base period. Until the new base 205.2 period is established, the commissioner shall adjust the limits 205.3 annually using the appropriate economic change indices 205.4 established in paragraph (e). In determining allowable 205.5 historical operating cost per diems for purposes of setting 205.6 limits and nursing facility payment rates, the commissioner 205.7 shall divide the allowable historical operating costs by the 205.8 actual number of resident days, except that where a nursing 205.9 facility is occupied at less than 90 percent of licensed 205.10 capacity days, the commissioner may establish procedures to 205.11 adjust the computation of the per diem to an imputed occupancy 205.12 level at or below 90 percent. The commissioner shall establish 205.13 efficiency incentives as appropriate. The commissioner may 205.14 establish efficiency incentives for different operating cost 205.15 categories. The commissioner shall consider establishing 205.16 efficiency incentives in care related cost categories. The 205.17 commissioner may combine one or more operating cost categories 205.18 and may use different methods for calculating payment rates for 205.19 each operating cost category or combination of operating cost 205.20 categories. For the rate year beginning on July 1, 1985, the 205.21 commissioner shall: 205.22 (1) allow nursing facilities that have an average length of 205.23 stay of 180 days or less in their skilled nursing level of care, 205.24 125 percent of the care related limit and 105 percent of the 205.25 other operating cost limit established by rule; and 205.26 (2) exempt nursing facilities licensed on July 1, 1983, by 205.27 the commissioner to provide residential services for the 205.28 physically handicapped under Minnesota Rules, parts 9570.2000 to 205.29 9570.3600, from the care related limits and allow 105 percent of 205.30 the other operating cost limit established by rule. 205.31 For the purpose of calculating the other operating cost 205.32 efficiency incentive for nursing facilities referred to in 205.33 clause (1) or (2), the commissioner shall use the other 205.34 operating cost limit established by rule before application of 205.35 the 105 percent. 205.36 (e) The commissioner shall establish a composite index or 206.1 indices by determining the appropriate economic change 206.2 indicators to be applied to specific operating cost categories 206.3 or combination of operating cost categories. 206.4 (f) Each nursing facility shall receive an operating cost 206.5 payment rate equal to the sum of the nursing facility's 206.6 operating cost payment rates for each operating cost category. 206.7 The operating cost payment rate for an operating cost category 206.8 shall be the lesser of the nursing facility's historical 206.9 operating cost in the category increased by the appropriate 206.10 index established in paragraph (e) for the operating cost 206.11 category plus an efficiency incentive established pursuant to 206.12 paragraph (d) or the limit for the operating cost category 206.13 increased by the same index. If a nursing facility's actual 206.14 historic operating costs are greater than the prospective 206.15 payment rate for that rate year, there shall be no retroactive 206.16 cost settle-up. In establishing payment rates for one or more 206.17 operating cost categories, the commissioner may establish 206.18 separate rates for different classes of residents based on their 206.19 relative care needs. 206.20 (g) The commissioner shall include the reported actual real 206.21 estate tax liability or payments in lieu of real estate tax of 206.22 each nursing facility as an operating cost of that nursing 206.23 facility. Allowable costs under this subdivision for payments 206.24 made by a nonprofit nursing facility that are in lieu of real 206.25 estate taxes shall not exceed the amount which the nursing 206.26 facility would have paid to a city or township and county for 206.27 fire, police, sanitation services, and road maintenance costs 206.28 had real estate taxes been levied on that property for those 206.29 purposes. For rate years beginning on or after July 1, 1987, 206.30 the reported actual real estate tax liability or payments in 206.31 lieu of real estate tax of nursing facilities shall be adjusted 206.32 to include an amount equal to one-half of the dollar change in 206.33 real estate taxes from the prior year. The commissioner shall 206.34 include a reported actual special assessment, and reported 206.35 actual license fees required by the Minnesota department of 206.36 health, for each nursing facility as an operating cost of that 207.1 nursing facility. For rate years beginning on or after July 1, 207.2 1989, the commissioner shall include a nursing facility's 207.3 reported public employee retirement act contribution for the 207.4 reporting year as apportioned to the care-related operating cost 207.5 categories and other operating cost categories multiplied by the 207.6 appropriate composite index or indices established pursuant to 207.7 paragraph (e) as costs under this paragraph. Total adjusted 207.8 real estate tax liability, payments in lieu of real estate tax, 207.9 actual special assessments paid, the indexed public employee 207.10 retirement act contribution, and license fees paid as required 207.11 by the Minnesota department of health, for each nursing facility 207.12 (1) shall be divided by actual resident days in order to compute 207.13 the operating cost payment rate for this operating cost 207.14 category, (2) shall not be used to compute the care-related 207.15 operating cost limits or other operating cost limits established 207.16 by the commissioner, and (3) shall not be increased by the 207.17 composite index or indices established pursuant to paragraph 207.18 (e), unless otherwise indicated in this paragraph. 207.19 (h) For rate years beginning on or after July 1, 1987, the 207.20 commissioner shall adjust the rates of a nursing facility that 207.21 meets the criteria for the special dietary needs of its 207.22 residents and the requirements in section 31.651. The 207.23 adjustment for raw food cost shall be the difference between the 207.24 nursing facility's allowable historical raw food cost per diem 207.25 and 115 percent of the median historical allowable raw food cost 207.26 per diem of the corresponding geographic group. 207.27 The rate adjustment shall be reduced by the applicable 207.28 phase-in percentage as provided under subdivision 2h. 207.29(i) For the cost report year ending September 30, 1996, and207.30for all subsequent reporting years, certified nursing facilities207.31must identify, differentiate, and record resident day statistics207.32for residents in case mix classification A who, on or after July207.331, 1996, meet the modified level of care criteria in section207.34144.0721. The resident day statistics shall be separated into207.35case mix classification A-1 for any resident day meeting the207.36high-function class A level of care criteria and case mix208.1classification A-2 for other case mix class A resident days.208.2 Sec. 43. Minnesota Statutes 1996, section 256B.501, 208.3 subdivision 2, is amended to read: 208.4 Subd. 2. [AUTHORITY.] The commissioner shall establish 208.5 procedures and rules for determining rates for care of residents 208.6 of intermediate care facilities for persons with mental 208.7 retardation or related conditions which qualify as providers of 208.8 medical assistance and waivered services.Approved rates shall208.9be established on the basis of methods and standards that the208.10commissioner finds adequate to provide for the costs that must208.11be incurred for the quality care of residents in efficiently and208.12economically operated facilities and services.The procedures 208.13 shall specify the costs that are allowable for payment through 208.14 medical assistance. The commissioner may use experts from 208.15 outside the department in the establishment of the procedures. 208.16 Sec. 44. Minnesota Statutes 1997 Supplement, section 208.17 256B.69, subdivision 2, is amended to read: 208.18 Subd. 2. [DEFINITIONS.] For the purposes of this section, 208.19 the following terms have the meanings given. 208.20 (a) "Commissioner" means the commissioner of human services. 208.21 For the remainder of this section, the commissioner's 208.22 responsibilities for methods and policies for implementing the 208.23 project will be proposed by the project advisory committees and 208.24 approved by the commissioner. 208.25 (b) "Demonstration provider" means a health maintenance 208.26 organizationor, community integrated service network, or 208.27 accountable provider network authorized and operating under 208.28 chapter 62Dor, 62N, or 62T that participates in the 208.29 demonstration project according to criteria, standards, methods, 208.30 and other requirements established for the project and approved 208.31 by the commissioner. Notwithstanding the above, Itasca county 208.32 may continue to participate as a demonstration provider until 208.33 July 1, 2000. 208.34 (c) "Eligible individuals" means those persons eligible for 208.35 medical assistance benefits as defined in sections 256B.055, 208.36 256B.056, and 256B.06. 209.1 (d) "Limitation of choice" means suspending freedom of 209.2 choice while allowing eligible individuals to choose among the 209.3 demonstration providers. 209.4 (e) This paragraph supersedes paragraph (c) as long as the 209.5 Minnesota health care reform waiver remains in effect. When the 209.6 waiver expires, this paragraph expires and the commissioner of 209.7 human services shall publish a notice in the State Register and 209.8 notify the revisor of statutes. "Eligible individuals" means 209.9 those persons eligible for medical assistance benefits as 209.10 defined in sections 256B.055, 256B.056, and 256B.06. 209.11 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 209.12 individual who becomes ineligible for the program because of 209.13 failure to submit income reports or recertification forms in a 209.14 timely manner, shall remain enrolled in the prepaid health plan 209.15 and shall remain eligible to receive medical assistance coverage 209.16 through the last day of the month following the month in which 209.17 the enrollee became ineligible for the medical assistance 209.18 program. 209.19 Sec. 45. Minnesota Statutes 1997 Supplement, section 209.20 256B.69, subdivision 3a, is amended to read: 209.21 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 209.22 implementing the general assistance medical care, or medical 209.23 assistance prepayment program within a county, must include the 209.24 county board in the process of development, approval, and 209.25 issuance of the request for proposals to provide services to 209.26 eligible individuals within the proposed county. County boards 209.27 must be given reasonable opportunity to make recommendations 209.28 regarding the development, issuance, review of responses, and 209.29 changes needed in the request for proposals. The commissioner 209.30 must provide county boards the opportunity to review each 209.31 proposal based on the identification of community needs under 209.32 chapters 145A and 256E and county advocacy activities. If a 209.33 county board finds that a proposal does not address certain 209.34 community needs, the county board and commissioner shall 209.35 continue efforts for improving the proposal and network prior to 209.36 the approval of the contract. The county board shall make 210.1 recommendations regarding the approval of local networks and 210.2 their operations to ensure adequate availability and access to 210.3 covered services. The provider or health plan must respond 210.4 directly to county advocates and the state prepaid medical 210.5 assistance ombudsperson regarding service delivery and must be 210.6 accountable to the state regarding contracts with medical 210.7 assistance and general assistance medical care funds. The 210.8 county board may recommend a maximum number of participating 210.9 health plans after considering the size of the enrolling 210.10 population; ensuring adequate access and capacity; considering 210.11 the client and county administrative complexity; and considering 210.12 the need to promote the viability of locally developed health 210.13 plans. The county board or a single entity representing a group 210.14 of county boards and the commissioner shall mutually select 210.15 health plans for participation at the time of initial 210.16 implementation of the prepaid medical assistance program in that 210.17 county or group of counties and at the time of contract renewal. 210.18 The commissioner shall also seek input for contract requirements 210.19 from the county or single entity representing a group of county 210.20 boards at each contract renewal and incorporate those 210.21 recommendations into the contract negotiation process. The 210.22 commissioner, in conjunction with the county board, shall 210.23 actively seek to develop a mutually agreeable timetable prior to 210.24 the development of the request for proposal, but counties must 210.25 agree to initial enrollment beginning on or before January 1, 210.26 1999, in either the prepaid medical assistance and general 210.27 assistance medical care programs or county-based purchasing 210.28 under section 256B.692. At least 90 days before enrollment in 210.29 the medical assistance and general assistance medical care 210.30 prepaid programs begins in a county in which the prepaid 210.31 programs have not been established, the commissioner shall 210.32 provide a report to the chairs of senate and house committees 210.33 having jurisdiction over state health care programs which 210.34 verifies that the commissioner complied with the requirements 210.35 for county involvement that are specified in this subdivision. 210.36 (b) The commissioner shall seek a federal waiver to allow a 211.1 fee-for-service plan option to MinnesotaCare enrollees. The 211.2 commissioner shall develop an increase of the premium fees 211.3 required under section 256L.06 up to 20 percent of the premium 211.4 fees for the enrollees who elect the fee-for-service option. 211.5 Prior to implementation, the commissioner shall submit this fee 211.6 schedule to the chair and ranking minority member of the senate 211.7 health care committee, the senate health care and family 211.8 services funding division, the house of representatives health 211.9 and human services committee, and the house of representatives 211.10 health and human services finance division. 211.11 (c) At the option of the county board, the board may 211.12 develop contract requirements related to the achievement of 211.13 local public health goals to meet the health needs of medical 211.14 assistance and general assistance medical care enrollees. These 211.15 requirements must be reasonably related to the performance of 211.16 health plan functions and within the scope of the medical 211.17 assistance and general assistance medical care benefit sets. If 211.18 the county board and the commissioner mutually agree to such 211.19 requirements, the department shall include such requirements in 211.20 all health plan contracts governing the prepaid medical 211.21 assistance and general assistance medical care programs in that 211.22 county at initial implementation of the program in that county 211.23 and at the time of contract renewal. The county board may 211.24 participate in the enforcement of the contract provisions 211.25 related to local public health goals. 211.26 (d) For counties in which prepaid medical assistance and 211.27 general assistance medical care programs have not been 211.28 established, the commissioner shall not implement those programs 211.29 if a county board submits acceptable and timely preliminary and 211.30 final proposals under section 256B.692, until county-based 211.31 purchasing is no longer operational in that county. For 211.32 counties in which prepaid medical assistance and general 211.33 assistance medical care programs are in existence on or after 211.34 September 1, 1997, the commissioner must terminate contracts 211.35 with health plans according to section 256B.692, subdivision 5, 211.36 if the county board submits and the commissioner accepts 212.1 preliminary and final proposals according to that subdivision. 212.2 The commissioner is not required to terminate contracts that 212.3 begin on or after September 1, 1997, according to section 212.4 256B.692 until two years have elapsed from the date of initial 212.5 enrollment. 212.6 (e) In the event that a county board or a single entity 212.7 representing a group of county boards and the commissioner 212.8 cannot reach agreement regarding: (i) the selection of 212.9 participating health plans in that county; (ii) contract 212.10 requirements; or (iii) implementation and enforcement of county 212.11 requirements including provisions regarding local public health 212.12 goals, the commissioner shall resolve all disputes after taking 212.13 into account the recommendations of a three-person mediation 212.14 panel. The panel shall be composed of one designee of the 212.15 president of the association of Minnesota counties, one designee 212.16 of the commissioner of human services, and one designee of the 212.17 commissioner of health. 212.18 (f) If a county which elects to implement county-based 212.19 purchasing ceases to implement county-based purchasing, it is 212.20 prohibited from assuming the responsibility of county-based 212.21 purchasing for a period of five years from the date it 212.22 discontinues purchasing. 212.23 (g) Notwithstanding the requirement in this subdivision 212.24 that a county must agree to initial enrollment on or before 212.25 January 1, 1999, the commissioner shall grant a delay of up to 212.26 nine months in the implementation of the county-based purchasing 212.27 authorized in section 256B.692 if the county or group of 212.28 counties has submitted a preliminary proposal for county-based 212.29 purchasing by September 1, 1997, has not already implemented the 212.30 prepaid medical assistance program before January 1, 1998, and 212.31 has submitted a written request for the delay to the 212.32 commissioner by July 1, 1998. In order for the delay to be 212.33 continued, the county or group of counties must also submit to 212.34 the commissioner the following information by December 1, 1998. 212.35 The information must: 212.36 (1) identify the proposed date of implementation, not later 213.1 than October 1, 1999; 213.2 (2) include copies of the county board resolutions which 213.3 demonstrate the continued commitment to the implementation of 213.4 county-based purchasing by the proposed date. County board 213.5 authorization may remain contingent on the submission of a final 213.6 proposal which meets the requirements of section 256B.692, 213.7 subdivision 5, paragraph (b); 213.8 (3) demonstrate actions taken for the establishment of a 213.9 governance structure between the participating counties and 213.10 describe how the fiduciary responsibilities of county-based 213.11 purchasing will be allocated between the counties, if more than 213.12 one county is involved in the proposal; 213.13 (4) describe how the risk of a deficit will be managed in 213.14 the event expenditures are greater than total capitation 213.15 payments. This description must identify how any of the 213.16 following strategies will be used: 213.17 (i) risk contracts with licensed health plans; 213.18 (ii) risk arrangements with providers who are not licensed 213.19 health plans; 213.20 (iii) risk arrangements with other licensed insurance 213.21 entities; and 213.22 (iv) funding from other county resources; 213.23 (5) include, if county-based purchasing will not contract 213.24 with licensed health plans or provider networks, letters of 213.25 interest from local providers in at least the categories of 213.26 hospital, physician, mental health, and pharmacy which express 213.27 interest in contracting for services. These letters must 213.28 recognize any risk transfer identified in clause (4), item (ii); 213.29 and 213.30 (6) describe the options being considered to obtain the 213.31 administrative services required in section 256B.692, 213.32 subdivision 3, clauses (3) and (5). 213.33 (h) For counties which receive a delay under this 213.34 subdivision, the final proposals required under section 213.35 256B.692, subdivision 5, paragraph (b), must be submitted at 213.36 least six months prior to the requested implementation date. 214.1 Authority to implement county-based purchasing remains 214.2 contingent on approval of the final proposal as required under 214.3 section 256B.692. 214.4 (i) If the commissioner is unable to provide 214.5 county-specific, individual-level fee-for-service claims to 214.6 counties by June 4, 1998, the commissioner shall grant a delay 214.7 under paragraph (g) of up to 12 months in the implementation of 214.8 county-based purchasing, and shall require implementation not 214.9 later than January 1, 2000. In order to receive an extension of 214.10 the proposed date of implementation under this paragraph, a 214.11 county or group of counties must submit a written request for 214.12 the extension to the commissioner by August 1, 1998, must submit 214.13 the information required under paragraph (g) by December 1, 214.14 1998, and must submit a final proposal as provided under 214.15 paragraph (h). 214.16 Sec. 46. Minnesota Statutes 1996, section 256B.69, 214.17 subdivision 22, is amended to read: 214.18 Subd. 22. [IMPACT ON PUBLIC OR TEACHING HOSPITALS AND 214.19 COMMUNITY CLINICS.] (a) Before implementing prepaid programs in 214.20 counties with a county operated or affiliated public teaching 214.21 hospital or a hospital or clinic operated by the University of 214.22 Minnesota, the commissioner shall consider the risks the prepaid 214.23 program creates for the hospital and allow the county or 214.24 hospital the opportunity to participate in the program, provided 214.25 the terms of participation in the program are competitive with 214.26 the terms of other participants. 214.27 (b) Prepaid health plans serving counties with a nonprofit 214.28 community clinic or community health services agency must 214.29 contract with the clinic or agency to provide services to 214.30 clients who choose to receive services from the clinic or 214.31 agency, if the clinic or agency agrees to payment rates that are 214.32 competitive with rates paid to other health plan providers for 214.33 the same or similar services. 214.34 (c) For purposes of this subdivision, "nonprofit community 214.35 clinic" includes, but is not limited to, a community mental 214.36 health center as defined in sections 245.62 and 256B.0625, 215.1 subdivision 5. 215.2 Sec. 47. Minnesota Statutes 1996, section 256B.69, is 215.3 amended by adding a subdivision to read: 215.4 Subd. 25. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 215.5 or after January 1, 1999, for American Indian recipients of 215.6 medical assistance who are required to enroll with a 215.7 demonstration provider under subdivision 4 or in a county-based 215.8 purchasing entity, if applicable, under section 256B.692, 215.9 medical assistance shall cover health care services provided at 215.10 American Indian health services facilities and facilities 215.11 operated by a tribe or tribal organization under funding 215.12 authorized by United States Code, title 25, sections 450f to 215.13 450n, or title III of the Indian Self-Determination and 215.14 Education Assistance Act, Public Law Number 93-638, if those 215.15 services would otherwise be covered under section 256B.0625. 215.16 Payments for services provided under this subdivision shall be 215.17 made on a fee-for-service basis, and may, at the option of the 215.18 tribe or tribal organization, be made according to rates 215.19 authorized under sections 256.969, subdivision 16, and 215.20 256B.0625, subdivision 34. Implementation of this purchasing 215.21 model is contingent on federal approval. 215.22 (b) The commissioner of human services, in consultation 215.23 with the tribal governments, shall develop a plan for tribes to 215.24 assist in the enrollment process for American Indian recipients 215.25 enrolled in the prepaid medical assistance program under this 215.26 section or the prepaid general assistance medical care program 215.27 under section 256D.03, subdivision 4, paragraph (d). This plan 215.28 also shall address how tribes will be included in ensuring the 215.29 coordination of care for American Indian recipients between 215.30 Indian health service or tribal providers and other providers. 215.31 (c) For purposes of this subdivision, "American Indian" has 215.32 the meaning given to persons to whom services will be provided 215.33 for in Code of Federal Regulations, title 42, section 36.12. 215.34 (d) This subdivision also applies to American Indian 215.35 recipients of general assistance medical care and to the prepaid 215.36 general assistance medical care program under section 256D.03, 216.1 subdivision 4, paragraph (d). 216.2 Sec. 48. Minnesota Statutes 1996, section 256B.69, is 216.3 amended by adding a subdivision to read: 216.4 Subd. 26. [INFORMATION FOR PERSONS WITH LIMITED 216.5 ENGLISH-LANGUAGE PROFICIENCY.] Managed care contracts entered 216.6 into under this section and sections 256D.03, subdivision 4, 216.7 paragraph (d), and 256L.12 must require demonstration providers 216.8 to inform enrollees that upon request the enrollee can obtain a 216.9 certificate of coverage in the following languages: Spanish, 216.10 Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian. Upon 216.11 request, the demonstration provider must provide the enrollee 216.12 with a certificate of coverage in the specified language of 216.13 preference. 216.14 Sec. 49. Minnesota Statutes 1997 Supplement, section 216.15 256B.692, subdivision 2, is amended to read: 216.16 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 216.17 Notwithstanding chapters 62D and 62N, a county that elects to 216.18 purchase medical assistance and general assistance medical care 216.19 in return for a fixed sum without regard to the frequency or 216.20 extent of services furnished to any particular enrollee is not 216.21 required to obtain a certificate of authority under chapter 62D 216.22 or 62N. A county that elects to purchase medical assistance and 216.23 general assistance medical care services under this section must 216.24 satisfy the commissioner of health that the requirements of 216.25 chapter 62D, applicable to health maintenance organizations, or 216.26 chapter 62N, applicable to community integrated service 216.27 networks, will be met. A county must also assure the 216.28 commissioner of health that the requirements ofsectionsections 216.29 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 216.30 applicable provisions of chapter 62Q, including sections 62Q.07; 216.31 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 216.32 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 216.33 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 216.34 will be met. All enforcement and rulemaking powers available 216.35 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 216.36 granted to the commissioner of health with respect to counties 217.1 that purchase medical assistance and general assistance medical 217.2 care services under this section. 217.3 Sec. 50. Minnesota Statutes 1997 Supplement, section 217.4 256B.692, subdivision 5, is amended to read: 217.5 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 217.6 1997, a county board that wishes to purchase or provide health 217.7 care under this section must submit a preliminary proposal that 217.8 substantially demonstrates the county's ability to meet all the 217.9 requirements of this section in response to criteria for 217.10 proposals issued by the department on or before July 1, 1997. 217.11 Counties submitting preliminary proposals must establish a local 217.12 planning process that involves input from medical assistance and 217.13 general assistance medical care recipients, recipient advocates, 217.14 providers and representatives of local school districts, labor, 217.15 and tribal government to advise on the development of a final 217.16 proposal and its implementation. 217.17 (b) The county board must submit a final proposal on or 217.18 before July 1, 1998, that demonstrates the ability to meet all 217.19 the requirements of this section, including beginning enrollment 217.20 on January 1, 1999, unless a delay has been granted under 217.21 section 256B.69, subdivision 3a, paragraph (g). 217.22 (c) After January 1, 1999, for a county in which the 217.23 prepaid medical assistance program is in existence, the county 217.24 board must submit a preliminary proposal at least 15 months 217.25 prior to termination of health plan contracts in that county and 217.26 a final proposal six months prior to the health plan contract 217.27 termination date in order to begin enrollment after the 217.28 termination. Nothing in this section shall impede or delay 217.29 implementation or continuation of the prepaid medical assistance 217.30 and general assistance medical care programs in counties for 217.31 which the board does not submit a proposal, or submits a 217.32 proposal that is not in compliance with this section. 217.33 (d) The commissioner is not required to terminate contracts 217.34 for the prepaid medical assistance and prepaid general 217.35 assistance medical care programs that begin on or after 217.36 September 1, 1997, in a county for which a county board has 218.1 submitted a proposal under this paragraph, until two years have 218.2 elapsed from the date of initial enrollment in the prepaid 218.3 medical assistance and prepaid general assistance medical care 218.4 programs. 218.5 Sec. 51. Minnesota Statutes 1997 Supplement, section 218.6 256B.77, subdivision 3, is amended to read: 218.7 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 218.8 county authority that elects to participate in a demonstration 218.9 project for people with disabilities under this section is not 218.10 required to obtain a certificate of authority under chapter 62D 218.11 or 62N. A county authority that elects to participate in a 218.12 demonstration project for people with disabilities under this 218.13 section must assure the commissioner of health that the 218.14 requirements of chapters 62D and 62N, and section 256B.692, 218.15 subdivision 2, are met. All enforcement and rulemaking powers 218.16 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 218.17 granted to the commissioner of health with respect to the county 218.18 authorities that contract with the commissioner to purchase 218.19 services in a demonstration project for people with disabilities 218.20 under this section. 218.21 Sec. 52. Minnesota Statutes 1997 Supplement, section 218.22 256B.77, subdivision 7a, is amended to read: 218.23 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 218.24 for the demonstration project as provided in this subdivision. 218.25 (b) "Eligible individuals" means those persons living in 218.26 the demonstration site who are eligible for medical assistance 218.27 and are disabled based on a disability determination under 218.28 section 256B.055, subdivisions 7 and 12, or who are eligible for 218.29 medical assistance and have been diagnosed as having: 218.30 (1) serious and persistent mental illness as defined in 218.31 section 245.462, subdivision 20; 218.32 (2) severe emotional disturbance as defined in section 218.33 245.487, subdivision 6; or 218.34 (3) mental retardation, or being a mentally retarded person 218.35 as defined in section 252A.02, or a related condition as defined 218.36 in section 252.27, subdivision 1a. 219.1 Other individuals may be included at the option of the county 219.2 authority based on agreement with the commissioner. 219.3 (c) Eligible individuals residing on a federally recognized 219.4 Indian reservation may be excluded from participation in the 219.5 demonstration project at the discretion of the tribal government 219.6 based on agreement with the commissioner, in consultation with 219.7 the county authority. 219.8 (d) Eligible individuals include individuals in excluded 219.9 time status, as defined in chapter 256G. Enrollees in excluded 219.10 time at the time of enrollment shall remain in excluded time 219.11 status as long as they live in the demonstration site and shall 219.12 be eligible for 90 days after placement outside the 219.13 demonstration site if they move to excluded time status in a 219.14 county within Minnesota other than their county of financial 219.15 responsibility. 219.16 (e) A person who is a sexual psychopathic personality as 219.17 defined in section 253B.02, subdivision 18a, or a sexually 219.18 dangerous person as defined in section 253B.02, subdivision 18b, 219.19 is excluded from enrollment in the demonstration project. 219.20 Sec. 53. Minnesota Statutes 1997 Supplement, section 219.21 256B.77, subdivision 10, is amended to read: 219.22 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 219.23 pay a capitation payment to the county authority and, when 219.24 applicable under subdivision 6, paragraph (a), to the service 219.25 delivery organization for each medical assistance eligible 219.26 enrollee. The commissioner shall develop capitation payment 219.27 rates for the initial contract period for each demonstration 219.28 site in consultation with an independent actuary, to ensure that 219.29 the cost of services under the demonstration project does not 219.30 exceed the estimated cost for medical assistance services for 219.31 the covered population under the fee-for-service system for the 219.32 demonstration period. For each year of the demonstration 219.33 project, the capitation payment rate shall be based on 96 219.34 percent of the projected per person costs that would otherwise 219.35 have been paid under medical assistance fee-for-service during 219.36 each of those years. Rates shall be adjusted within the limits 220.1 of the available risk adjustment technology, as mandated by 220.2 section 62Q.03. In addition, the commissioner shall implement 220.3 appropriate risk and savings sharing provisions with county 220.4 administrative entities and, when applicable under subdivision 220.5 6, paragraph (a), service delivery organizations within the 220.6 projected budget limits. Capitation rates shall be adjusted, at 220.7 least annually, to include any rate increases and payments for 220.8 expanded or newly covered services for eligible individuals. 220.9 The initial demonstration project rate shall include an amount 220.10 in addition to the fee-for-service payments to adjust for 220.11 underutilization of dental services. Any savings beyond those 220.12 allowed for the county authority, county administrative entity, 220.13 or service delivery organization shall be first used to meet the 220.14 unmet needs of eligible individuals. Payments to providers 220.15 participating in the project are exempt from the requirements of 220.16 sections 256.966 and 256B.03, subdivision 2. 220.17 (b) The commissioner shall monitor and evaluate annually 220.18 the effect of the discount on consumers, the county authority, 220.19 and providers of disability services. Findings shall be 220.20 reported and recommendations made, as appropriate, to ensure 220.21 that the discount effect does not adversely affect the ability 220.22 of the county administrative entity or providers of services to 220.23 provide appropriate services to eligible individuals, and does 220.24 not result in cost shifting of eligible individuals to the 220.25 county authority. 220.26 Sec. 54. Minnesota Statutes 1997 Supplement, section 220.27 256B.77, subdivision 12, is amended to read: 220.28 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 220.29 section, "service coordinator" means an individual selected by 220.30 the enrollee or the enrollee's legal representative and 220.31 authorized by the county administrative entity or service 220.32 delivery organization to work in partnership with the enrollee 220.33 to develop, coordinate, and in some instances, provide supports 220.34 and services identified in the personal support plan. Service 220.35 coordinators may only provide services and supports if the 220.36 enrollee is informed of potential conflicts of interest, is 221.1 given alternatives, and gives informed consent. Eligible 221.2 service coordinators are individuals age 18 or older who meet 221.3 the qualifications as described in paragraph (b). Enrollees, 221.4 their legal representatives, or their advocates are eligible to 221.5 be service coordinators if they have the capabilities to perform 221.6 the activities and functions outlined in paragraph (b). 221.7 Providers licensed under chapter 245A to provide residential 221.8 services, or providers who are providing residential services 221.9 covered under the group residential housing program may not act 221.10 as service coordinator for enrollees for whom they provide 221.11 residential services. This does not apply to providers of 221.12 short-term detoxification services. Each county administrative 221.13 entity or service delivery organization may develop further 221.14 criteria for eligible vendors of service coordination during the 221.15 demonstration period and shall determine whom it contracts with 221.16 or employs to provide service coordination. County 221.17 administrative entities and service delivery organizations may 221.18 pay enrollees or their advocates or legal representatives for 221.19 service coordination activities. 221.20 (b) The service coordinator shall act as a facilitator, 221.21 working in partnership with the enrollee to ensure that their 221.22 needs are identified and addressed. The level of involvement of 221.23 the service coordinator shall depend on the needs and desires of 221.24 the enrollee. The service coordinator shall have the knowledge, 221.25 skills, and abilities to, and is responsible for: 221.26 (1) arranging for an initial assessment, and periodic 221.27 reassessment as necessary, of supports and services based on the 221.28 enrollee's strengths, needs, choices, and preferences in life 221.29 domain areas; 221.30 (2) developing and updating the personal support plan based 221.31 on relevant ongoing assessment; 221.32 (3) arranging for and coordinating the provisions of 221.33 supports and services, including knowledgeable and skilled 221.34 specialty services and prevention and early intervention 221.35 services, within the limitations negotiated with the county 221.36 administrative entity or service delivery organization; 222.1 (4) assisting the enrollee and the enrollee's legal 222.2 representative, if any, to maximize informed choice of and 222.3 control over services and supports and to exercise the 222.4 enrollee's rights and advocate on behalf of the enrollee; 222.5 (5) monitoring the progress toward achieving the enrollee's 222.6 outcomes in order to evaluate and adjust the timeliness and 222.7 adequacy of the implementation of the personal support plan; 222.8 (6) facilitating meetings and effectively collaborating 222.9 with a variety of agencies and persons, including attending 222.10 individual family service plan and individual education plan 222.11 meetings when requested by the enrollee or the enrollee's legal 222.12 representative; 222.13 (7) soliciting and analyzing relevant information; 222.14 (8) communicating effectively with the enrollee and with 222.15 other individuals participating in the enrollee's plan; 222.16 (9) educating and communicating effectively with the 222.17 enrollee about good health care practices and risk to the 222.18 enrollee's health with certain behaviors; 222.19 (10) having knowledge of basic enrollee protection 222.20 requirements, including data privacy; 222.21 (11) informing, educating, and assisting the enrollee in 222.22 identifying available service providers and accessing needed 222.23 resources and services beyond the limitations of the medical 222.24 assistance benefit set covered services; and 222.25 (12) providing other services as identified in the personal 222.26 support plan. 222.27 (c) For the demonstration project, the qualifications and 222.28 standards for service coordination in this section shall replace 222.29 comparable existing provisions of existing statutes and rules 222.30 governing case management for eligible individuals. 222.31 (d) The provisions of this subdivision apply only to the 222.32 demonstration sitesthat begin implementation on July 1,222.331998designated by the commissioner under subdivision 5. All 222.34 other demonstration sites must comply with laws and rules 222.35 governing case management services for eligible individuals in 222.36 effect when the site begins the demonstration project. 223.1 Sec. 55. Minnesota Statutes 1996, section 256D.03, 223.2 subdivision 4, is amended to read: 223.3 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 223.4 For a person who is eligible under subdivision 3, paragraph (a), 223.5 clause (3), general assistance medical care covers, except as 223.6 provided in paragraph (c): 223.7 (1) inpatient hospital services; 223.8 (2) outpatient hospital services; 223.9 (3) services provided by Medicare certified rehabilitation 223.10 agencies; 223.11 (4) prescription drugs and other products recommended 223.12 through the process established in section 256B.0625, 223.13 subdivision 13; 223.14 (5) equipment necessary to administer insulin and 223.15 diagnostic supplies and equipment for diabetics to monitor blood 223.16 sugar level; 223.17 (6) eyeglasses and eye examinations provided by a physician 223.18 or optometrist; 223.19 (7) hearing aids; 223.20 (8) prosthetic devices; 223.21 (9) laboratory and X-ray services; 223.22 (10) physician's services; 223.23 (11) medical transportation; 223.24 (12) chiropractic services as covered under the medical 223.25 assistance program; 223.26 (13) podiatric services; 223.27 (14) dental services; 223.28 (15) outpatient services provided by a mental health center 223.29 or clinic that is under contract with the county board and is 223.30 established under section 245.62; 223.31 (16) day treatment services for mental illness provided 223.32 under contract with the county board; 223.33 (17) prescribed medications for persons who have been 223.34 diagnosed as mentally ill as necessary to prevent more 223.35 restrictive institutionalization; 223.36 (18)case management services for a person with serious and224.1persistent mental illness who would be eligible for medical224.2assistance except that the person resides in an institution for224.3mental diseases;224.4(19)psychological services, medical supplies and 224.5 equipment, and Medicare premiums, coinsurance and deductible 224.6 payments; 224.7(20)(19) medical equipment not specifically listed in this 224.8 paragraph when the use of the equipment will prevent the need 224.9 for costlier services that are reimbursable under this 224.10 subdivision; 224.11(21)(20) services performed by a certified pediatric nurse 224.12 practitioner, a certified family nurse practitioner, a certified 224.13 adult nurse practitioner, a certified obstetric/gynecological 224.14 nurse practitioner, or a certified geriatric nurse practitioner 224.15 in independent practice, if the services are otherwise covered 224.16 under this chapter as a physician service, and if the service is 224.17 within the scope of practice of the nurse practitioner's license 224.18 as a registered nurse, as defined in section 148.171; and 224.19(22)(21) services of a certified public health nurse or a 224.20 registered nurse practicing in a public health nursing clinic 224.21 that is a department of, or that operates under the direct 224.22 authority of, a unit of government, if the service is within the 224.23 scope of practice of the public health nurse's license as a 224.24 registered nurse, as defined in section 148.171. 224.25 (b) Except as provided in paragraph (c), for a recipient 224.26 who is eligible under subdivision 3, paragraph (a), clause (1) 224.27 or (2), general assistance medical care covers the services 224.28 listed in paragraph (a) with the exception of special 224.29 transportation services. 224.30 (c) Gender reassignment surgery and related services are 224.31 not covered services under this subdivision unless the 224.32 individual began receiving gender reassignment services prior to 224.33 July 1, 1995. 224.34 (d) In order to contain costs, the commissioner of human 224.35 services shall select vendors of medical care who can provide 224.36 the most economical care consistent with high medical standards 225.1 and shall where possible contract with organizations on a 225.2 prepaid capitation basis to provide these services. The 225.3 commissioner shall consider proposals by counties and vendors 225.4 for prepaid health plans, competitive bidding programs, block 225.5 grants, or other vendor payment mechanisms designed to provide 225.6 services in an economical manner or to control utilization, with 225.7 safeguards to ensure that necessary services are provided. 225.8 Before implementing prepaid programs in counties with a county 225.9 operated or affiliated public teaching hospital or a hospital or 225.10 clinic operated by the University of Minnesota, the commissioner 225.11 shall consider the risks the prepaid program creates for the 225.12 hospital and allow the county or hospital the opportunity to 225.13 participate in the program in a manner that reflects the risk of 225.14 adverse selection and the nature of the patients served by the 225.15 hospital, provided the terms of participation in the program are 225.16 competitive with the terms of other participants considering the 225.17 nature of the population served. Payment for services provided 225.18 pursuant to this subdivision shall be as provided to medical 225.19 assistance vendors of these services under sections 256B.02, 225.20 subdivision 8, and 256B.0625. For payments made during fiscal 225.21 year 1990 and later years, the commissioner shall consult with 225.22 an independent actuary in establishing prepayment rates, but 225.23 shall retain final control over the rate methodology. 225.24 Notwithstanding the provisions of subdivision 3, an individual 225.25 who becomes ineligible for general assistance medical care 225.26 because of failure to submit income reports or recertification 225.27 forms in a timely manner, shall remain enrolled in the prepaid 225.28 health plan and shall remain eligible for general assistance 225.29 medical care coverage through the last day of the month in which 225.30 the enrollee became ineligible for general assistance medical 225.31 care. 225.32 (e) The commissioner of human services may reduce payments 225.33 provided under sections 256D.01 to 256D.21 and 261.23 in order 225.34 to remain within the amount appropriated for general assistance 225.35 medical care, within the following restrictions.: 225.36 (i) For the period July 1, 1985 to December 31, 1985, 226.1 reductions below the cost per service unit allowable under 226.2 section 256.966, are permitted only as follows: payments for 226.3 inpatient and outpatient hospital care provided in response to a 226.4 primary diagnosis of chemical dependency or mental illness may 226.5 be reduced no more than 30 percent; payments for all other 226.6 inpatient hospital care may be reduced no more than 20 percent. 226.7 Reductions below the payments allowable under general assistance 226.8 medical care for the remaining general assistance medical care 226.9 services allowable under this subdivision may be reduced no more 226.10 than ten percent. 226.11 (ii) For the period January 1, 1986 to December 31, 1986, 226.12 reductions below the cost per service unit allowable under 226.13 section 256.966 are permitted only as follows: payments for 226.14 inpatient and outpatient hospital care provided in response to a 226.15 primary diagnosis of chemical dependency or mental illness may 226.16 be reduced no more than 20 percent; payments for all other 226.17 inpatient hospital care may be reduced no more than 15 percent. 226.18 Reductions below the payments allowable under general assistance 226.19 medical care for the remaining general assistance medical care 226.20 services allowable under this subdivision may be reduced no more 226.21 than five percent. 226.22 (iii) For the period January 1, 1987 to June 30, 1987, 226.23 reductions below the cost per service unit allowable under 226.24 section 256.966 are permitted only as follows: payments for 226.25 inpatient and outpatient hospital care provided in response to a 226.26 primary diagnosis of chemical dependency or mental illness may 226.27 be reduced no more than 15 percent; payments for all other 226.28 inpatient hospital care may be reduced no more than ten 226.29 percent. Reductions below the payments allowable under medical 226.30 assistance for the remaining general assistance medical care 226.31 services allowable under this subdivision may be reduced no more 226.32 than five percent. 226.33 (iv) For the period July 1, 1987 to June 30, 1988, 226.34 reductions below the cost per service unit allowable under 226.35 section 256.966 are permitted only as follows: payments for 226.36 inpatient and outpatient hospital care provided in response to a 227.1 primary diagnosis of chemical dependency or mental illness may 227.2 be reduced no more than 15 percent; payments for all other 227.3 inpatient hospital care may be reduced no more than five percent. 227.4 Reductions below the payments allowable under medical assistance 227.5 for the remaining general assistance medical care services 227.6 allowable under this subdivision may be reduced no more than 227.7 five percent. 227.8 (v) For the period July 1, 1988 to June 30, 1989, 227.9 reductions below the cost per service unit allowable under 227.10 section 256.966 are permitted only as follows: payments for 227.11 inpatient and outpatient hospital care provided in response to a 227.12 primary diagnosis of chemical dependency or mental illness may 227.13 be reduced no more than 15 percent; payments for all other 227.14 inpatient hospital care may not be reduced. Reductions below 227.15 the payments allowable under medical assistance for the 227.16 remaining general assistance medical care services allowable 227.17 under this subdivision may be reduced no more than five percent. 227.18 (f) There shall be no copayment required of any recipient 227.19 of benefits for any services provided under this subdivision. A 227.20 hospital receiving a reduced payment as a result of this section 227.21 may apply the unpaid balance toward satisfaction of the 227.22 hospital's bad debts. 227.23(f)(g) Any county may, from its own resources, provide 227.24 medical payments for which state payments are not made. 227.25(g)(h) Chemical dependency services that are reimbursed 227.26 under chapter 254B must not be reimbursed under general 227.27 assistance medical care. 227.28(h)(i) The maximum payment for new vendors enrolled in the 227.29 general assistance medical care program after the base year 227.30 shall be determined from the average usual and customary charge 227.31 of the same vendor type enrolled in the base year. 227.32(i)(j) The conditions of payment for services under this 227.33 subdivision are the same as the conditions specified in rules 227.34 adopted under chapter 256B governing the medical assistance 227.35 program, unless otherwise provided by statute or rule. 227.36 Sec. 56. Minnesota Statutes 1996, section 256D.03, is 228.1 amended by adding a subdivision to read: 228.2 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 228.3 services rendered on or after July 1, 1999, general assistance 228.4 medical care payments for ambulance services shall be increased 228.5 by five percent. 228.6 Sec. 57. Laws 1997, chapter 195, section 5, is amended to 228.7 read: 228.8 Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.] 228.9 The commissioner of health shall create a unique category 228.10 of licensure as appropriate for providers offering, providing, 228.11 or arranging personal care assistant services to more than one 228.12 individual. The commissioner shall work with the department of 228.13 human services, providers, consumers, and advocates in 228.14 developing the licensure standards. The licensure standards 228.15 must include requirements for providers to provide consumers 228.16 advance written notice of service termination, a service 228.17 transition plan, and an appeal process. If the commissioner 228.18 determines there are costs related to rulemaking under this 228.19 section, the commissioner shall include a budget request for 228.20 this item in the 2000-2001 biennial budget. Prior to 228.21 promulgating the rule, the commissioner shall submit the 228.22 proposed rule to the legislature by January 15, 1999. 228.23 Sec. 58. Laws 1997, chapter 203, article 4, section 64, is 228.24 amended to read: 228.25 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 228.26 The commissioner of human services shall appoint a task 228.27 force that includes representatives of counties, health plans, 228.28 consumers, and legislators to study the impact of the expansion 228.29 of the elderly waiver program under section 4 and to make 228.30 recommendations for any changes in law necessary to facilitate 228.31 an efficient and equitable relationship between the elderly 228.32 waiver program and the Minnesota senior health options project. 228.33 Based on the results of the task force study, the commissioner 228.34 may seek any federal waivers needed to improve the relationship 228.35 between the elderly waiver and the Minnesota senior health 228.36 options project. The commissioner shall report the results of 229.1 the task force study to the legislature byJanuary 15, 1998July 229.2 1, 2000. 229.3 Sec. 59. [OFFSET OF HMO SURCHARGE.] 229.4 Beginning October 1, 1998, and ending December 31, 1998, 229.5 the commissioner of human services shall offset monthly charges 229.6 for the health maintenance organization surcharge by the monthly 229.7 amount the health maintenance organization overpaid from August 229.8 1, 1997, to September 30, 1998, due to taxation of Medicare 229.9 revenues prohibited by Minnesota Statutes, section 256.9657, 229.10 subdivision 3. 229.11 Sec. 60. [MR/RC WAIVER PROPOSAL.] 229.12 By November 15, 1998, the commissioner of human services 229.13 shall provide to the chairs of the house health and human 229.14 services finance division and the senate health and family 229.15 security finance division a detailed budget proposal for 229.16 providing services under the home and community-based waiver for 229.17 persons with mental retardation or related conditions to those 229.18 individuals who are screened and waiting for services. 229.19 Sec. 61. [HIV HEALTH CARE ACCESS STUDY.] 229.20 The commissioner of human services shall study, in 229.21 consultation with the commissioner of health and a task force of 229.22 affected community stakeholders, the impact of positive patient 229.23 responses to new HIV treatment on re-entry to the workplace, 229.24 including, but not limited to, addressing continued access to 229.25 health care and disability benefits. The commissioner shall 229.26 submit a report on the study with recommendations to the 229.27 legislature by January 15, 1999. 229.28 Sec. 62. [MENTAL HEALTH REPORT.] 229.29 (a) By December 1, 1998, the commissioner of human services 229.30 shall report to the legislature on recommendations to maximize 229.31 federal funding for mental health services for children and 229.32 adults. In developing the recommendations, the commissioner 229.33 shall seek advice from a children's and adults' mental health 229.34 services stakeholders advisory group including representatives 229.35 of state and county government, private and state-operated 229.36 mental health providers, mental health consumers, family 230.1 members, and advocates. 230.2 (b) The report shall include a proposal developed in 230.3 conjunction with the counties that does not shift caseload 230.4 growth to counties after July 1, 1999, and recommendations on 230.5 whether the state should directly participate in medical 230.6 assistance mental health case management by funding a portion of 230.7 the nonfederal share of Medicaid. 230.8 Sec. 63. [CONSUMER PRICE INDEX REPORT.] 230.9 By January 15, 1999, and each year thereafter, the 230.10 commissioner of human services shall report to the chair of the 230.11 senate health and family security budget division and the chair 230.12 of the house health and human services budget division on the 230.13 cost of increasing the income standard under Minnesota Statutes, 230.14 section 256B.056, subdivision 4, and the provider rates under 230.15 Minnesota Statutes, section 256B.038, by an amount equal to the 230.16 percent change in the Consumer Price Index for all urban 230.17 consumers for the previous October compared to one year earlier. 230.18 Sec. 64. [TRANSLATING AND INTERPRETING INFORMATION FOR 230.19 PERSONS WITH LIMITED ENGLISH-LANGUAGE PROFICIENCY.] 230.20 (a) The commissioner shall develop a plan to serve public 230.21 assistance applicants and recipients who have limited 230.22 English-language proficiency that ensures that the state is in 230.23 compliance with title VI of the Civil Rights Act and Minnesota 230.24 Statutes, section 363.073, and any other laws or regulations 230.25 that prohibit discrimination. 230.26 (b) The commissioner shall convene an advisory committee 230.27 that consists of members of bilingual community groups, county 230.28 human service agencies, health plans, health care providers, 230.29 advocacy groups, and other state agencies to assist in 230.30 developing the plan. 230.31 (c) The commissioner shall submit the plan and any fiscal 230.32 estimates necessary to implement the plan to the chairs of the 230.33 health and human services policy and finance divisions by 230.34 December 15, 1998. 230.35 (d) Until the plan under paragraph (c) is implemented, the 230.36 commissioner is required to include a language block on notices 231.1 from county agencies that deny, reduce, or terminate benefits 231.2 which states: 231.3 "IMPORTANT! This notice affects your rights and should be 231.4 translated immediately. If you need help translating this 231.5 notice, call your county worker." 231.6 Notices from MinnesotaCare that deny, reduce, or terminate 231.7 benefits must include a language block which states: 231.8 "IMPORTANT! This notice affects your rights and should be 231.9 translated immediately. If you need help translating this 231.10 notice, call your enrollment representative." 231.11 The notice must include a telephone number for the MinnesotaCare 231.12 enrollment representative. 231.13 (e) Until the plan under paragraph (c) is implemented, the 231.14 commissioner shall require a managed care plan under contract 231.15 with the commissioner of human services that issues a notice 231.16 that denies, reduces, or terminates coverage to include a 231.17 language block, which states: 231.18 "IMPORTANT! This notice affects your rights and should be 231.19 translated immediately." 231.20 The notice shall include the telephone number of a person to 231.21 contact who can assist the enrollee in translating the notice. 231.22 Sec. 65. [UNCOMPENSATED CARE STUDY.] 231.23 The commissioner of health, in consultation with the 231.24 commissioner of human services, associations representing 231.25 Minnesota counties, consumer advocates, associations 231.26 representing health care providers and institutions, and 231.27 representatives of institutions providing a disproportionate 231.28 share of uncompensated medical care shall submit to the 231.29 legislature by January 15, 1999, a report and recommendations on 231.30 the provision and financing of uncompensated care in Minnesota. 231.31 The report must: 231.32 (1) document the extent of uncompensated care provided in 231.33 Minnesota; 231.34 (2) discuss the feasibility of and evaluate options for 231.35 financing uncompensated care, including but not limited to: 231.36 (i) modifying the eligibility standards for the 232.1 MinnesotaCare and general assistance medical care programs; and 232.2 (ii) allowing providers to bill other counties for 232.3 uncompensated care provided to residents of those counties; 232.4 (3) evaluate approaches used by other states to monitor and 232.5 finance uncompensated care; and 232.6 (4) describe alternative approaches to encourage health 232.7 care coverage. 232.8 Sec. 66. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC 232.9 SERVICES.] 232.10 (a) The threshold limits for fee-for-service medical 232.11 assistance rehabilitative and therapeutic services for January 232.12 1, 1998 through June 30, 1999, shall be the limits prescribed in 232.13 the department of human services health care programs provider 232.14 manual for calendar year 1997. Rehabilitative and therapeutic 232.15 services are: occupational therapy services provided to medical 232.16 assistance recipients pursuant to Minnesota Statutes, section 232.17 256B.0625, subdivision 8a; physical therapy services provided to 232.18 medical assistance recipients pursuant to Minnesota Statutes, 232.19 section 256B.0625, subdivision 8; and speech language pathology 232.20 services provided to medical assistance recipients pursuant to 232.21 Minnesota Rules, part 9505.0390. 232.22 (b) The commissioner of human services, in consultation 232.23 with the department of human services rehabilitative work group, 232.24 shall report to the chair of the senate health and family 232.25 security committee and the chair of the house health and human 232.26 services committee by January 15, 1999, recommendations and 232.27 proposed legislation for the appropriate level of rehabilitative 232.28 services delivered to medical assistance recipients before prior 232.29 authorization. The recommendations shall also include proposed 232.30 legislation to clarify the rehabilitative and therapeutic 232.31 benefit set for medical assistance, as well as the appropriate 232.32 response time for requests for prior authorization. 232.33 Sec. 67. [DENTAL SERVICES REIMBURSEMENT AND ACCESS STUDY.] 232.34 (a) The commissioner of human services, in consultation 232.35 with the commissioner of health, shall report to the legislature 232.36 by December 15, 1998, on the costs of providing dental care 233.1 services to recipients of the medical assistance, general 233.2 assistance medical care and MinnesotaCare programs and the 233.3 reimbursement level of those programs under fee-for-service and 233.4 under managed care plans. Costs shall include both base level 233.5 and incremental costs of providing services to public program 233.6 recipients. In completing the study, the commissioner shall 233.7 review existing dental practice literature on dental practice 233.8 expenses, and conduct a random survey of dental practices in the 233.9 state to establish usual and customary fees for a subset of 233.10 common dental procedures. The commissioner shall compare 233.11 private insurance reimbursement for a subset of common dental 233.12 procedures with reimbursement levels for public programs. In 233.13 determining private insurance reimbursement, the commissioner 233.14 may obtain reimbursement data from health plans insuring or 233.15 providing dental care services. Data obtained by the 233.16 commissioner shall be nonpublic and subject to Minnesota 233.17 Statutes, section 62J.321. The commissioner may include in the 233.18 report related information on the costs of other health care 233.19 professionals and reimbursement levels by public and private 233.20 payers. 233.21 (b) The commissioner of human services shall present 233.22 recommendations to the legislature by February 1, 1999, on how 233.23 access to dental services for medical assistance, general 233.24 assistance medical care, and MinnesotaCare recipients can be 233.25 expanded. The commissioner shall also determine which areas of 233.26 the state are experiencing a significant access problem. In 233.27 developing recommendations, the commissioner shall evaluate the 233.28 feasibility of a disproportionate share adjustment for dental 233.29 services. 233.30 Sec. 68. [RECYCLING PILOT PROJECT.] 233.31 The commissioner of human services, in cooperation with the 233.32 system of technology to achieve results (STAR) program, shall 233.33 award a grant on a competitive basis to a qualified agency for 233.34 the establishment of a pilot project to: 233.35 (1) obtain, refurbish, and recycle augmentative and 233.36 alternative communication systems in order to allow their reuse 234.1 for trials and short-term use by persons with severe expressive 234.2 communication limitations; and 234.3 (2) provide training related to the use of augmentative and 234.4 alternative communication systems. 234.5 The commissioner shall award the grant as soon as possible after 234.6 July 1, 1998, and shall report to the legislature by January 15, 234.7 1999, on the activities of the grantee. 234.8 Sec. 69. [REPEALER.] 234.9 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 234.10 and Minnesota Statutes 1997 Supplement, sections 144.0721, 234.11 subdivision 3; and 256B.0913, subdivision 15, are repealed. 234.12 Sec. 70. [EFFECTIVE DATES.] 234.13 (a) Sections 5, 31, 40, 45, 50, and 66 are effective the 234.14 day following final enactment. 234.15 (b) Sections 10 and 48 are effective January 1, 1999. 234.16 (c) Sections 23, 25, 55, and 56 are effective July 1, 1999. 234.17 (d) Sections 14 and 19 are effective retroactive to July 1, 234.18 1997. 234.19 (e) Section 7 is effective retroactive to August 1, 1997. 234.20 (f) Sections 3 and 44 are effective 30 days following final 234.21 enactment. 234.22 (g) Section 32 is effective for changes in eligibility that 234.23 occur on or after July 1, 1998. 234.24 ARTICLE 5 234.25 MINNESOTACARE 234.26 Section 1. Minnesota Statutes 1997 Supplement, section 234.27 60A.15, subdivision 1, is amended to read: 234.28 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 234.29 before April 1, June 1, and December 1 of each year, every 234.30 domestic and foreign company, including town and farmers' mutual 234.31 insurance companies, domestic mutual insurance companies, marine 234.32 insurance companies, health maintenance organizations, community 234.33 integrated service networks, and nonprofit health service plan 234.34 corporations, shall pay to the commissioner of revenue 234.35 installments equal to one-third of the insurer's total estimated 234.36 tax for the current year. Except as provided in paragraphs (d), 235.1 (e), (h), and (i), installments must be based on a sum equal to 235.2 two percent of the premiums described in paragraph (b). 235.3 (b) Installments under paragraph (a), (d), or (e) are 235.4 percentages of gross premiums less return premiums on all direct 235.5 business received by the insurer in this state, or by its agents 235.6 for it, in cash or otherwise, during such year. 235.7 (c) Failure of a company to make payments of at least 235.8 one-third of either (1) the total tax paid during the previous 235.9 calendar year or (2) 80 percent of the actual tax for the 235.10 current calendar year shall subject the company to the penalty 235.11 and interest provided in this section, unless the total tax for 235.12 the current tax year is $500 or less. 235.13 (d) For health maintenance organizations, nonprofit health 235.14 service plan corporations, and community integrated service 235.15 networks, the installments must be based on an amount determined 235.16 under paragraph (h) or (i). 235.17 (e) For purposes of computing installments for town and 235.18 farmers' mutual insurance companies and for mutual property 235.19 casualty companies with total assets on December 31, 1989, of 235.20 $1,600,000,000 or less, the following rates apply: 235.21 (1) for all life insurance, two percent; 235.22 (2) for town and farmers' mutual insurance companies and 235.23 for mutual property and casualty companies with total assets of 235.24 $5,000,000 or less, on all other coverages, one percent; and 235.25 (3) for mutual property and casualty companies with total 235.26 assets on December 31, 1989, of $1,600,000,000 or less, on all 235.27 other coverages, 1.26 percent. 235.28 (f) If the aggregate amount of premium tax payments under 235.29 this section and the fire marshal tax payments under section 235.30 299F.21 made during a calendar year is equal to or exceeds 235.31 $120,000, all tax payments in the subsequent calendar year must 235.32 be paid by means of a funds transfer as defined in section 235.33 336.4A-104, paragraph (a). The funds transfer payment date, as 235.34 defined in section 336.4A-401, must be on or before the date the 235.35 payment is due. If the date the payment is due is not a funds 235.36 transfer business day, as defined in section 336.4A-105, 236.1 paragraph (a), clause (4), the payment date must be on or before 236.2 the funds transfer business day next following the date the 236.3 payment is due. 236.4 (g) Premiums under medical assistance, general assistance 236.5 medical care, the MinnesotaCare program, and the Minnesota 236.6 comprehensive health insurance plan and all payments, revenues, 236.7 and reimbursements received from the federal government for 236.8 Medicare-related coverage as defined in section 62A.31, 236.9 subdivision 3, paragraph (e), are not subject to tax under this 236.10 section. 236.11 (h) For calendar years 1998 and 1999, the installments for 236.12 health maintenance organizations, community integrated service 236.13 networks, and nonprofit health service plan corporations must be 236.14 based on an amount equal to one percent of premiums described 236.15 under paragraph (b). Health maintenance organizations, 236.16 community integrated service networks, and nonprofit health 236.17 service plan corporations that have met the cost containment 236.18 goals established under section 62J.04 in the individual and 236.19 small employer market for calendar year 1996 are exempt from 236.20 payment of the tax imposed under this section for premiums paid 236.21 after March 30, 1997, and before April 1, 1998. Health 236.22 maintenance organizations, community integrated service 236.23 networks, and nonprofit health service plan corporations that 236.24 have met the cost containment goals established under section 236.25 62J.04 in the individual and small employer market for calendar 236.26 year 1997 are exempt from payment of the tax imposed under this 236.27 section for premiums paid after March 30, 1998, and before April 236.28 1, 1999. 236.29 (i) For calendar years after 1999, the commissioner of 236.30 finance shall determine the balance of the health care access 236.31 fund on September 1 of each year beginning September 1, 1999. 236.32 If the commissioner determines that there is no structural 236.33 deficit for the next fiscal year, no tax shall be imposed under 236.34 paragraph (d) for the following calendar year. If the 236.35 commissioner determines that there will be a structural deficit 236.36 in the fund for the following fiscal year, then the 237.1 commissioner, in consultation with the commissioner of revenue, 237.2 shall determine the amount needed to eliminate the structural 237.3 deficit and a tax shall be imposed under paragraph (d) for the 237.4 following calendar year. The commissioner shall determine the 237.5 rate of the tax as either one-quarter of one percent, one-half 237.6 of one percent, three-quarters of one percent, or one percent of 237.7 premiums described in paragraph (b), whichever is the lowest of 237.8 those rates that the commissioner determines will produce 237.9 sufficient revenue to eliminate the projected structural 237.10 deficit. The commissioner of finance shall publish in the State 237.11 Register by October 1 of each year the amount of tax to be 237.12 imposed for the following calendar year. In determining the 237.13 structural balance of the health care access fund for fiscal 237.14 years 2000 and 2001, the commissioner shall disregard the 237.15 transfer amount from the health care access fund to the general 237.16 fund for expenditures associated with the services provided to 237.17 pregnant women and children under the age of two enrolled in the 237.18 MinnesotaCare program. 237.19 (j) In approving the premium rates as required in sections 237.20 62L.08, subdivision 8, and 62A.65, subdivision 3, the 237.21 commissioners of health and commerce shall ensure that any 237.22 exemption from the tax as described in paragraphs (h) and (i) is 237.23 reflected in the premium rate. 237.24 Sec. 2. Minnesota Statutes 1997 Supplement, section 237.25 256B.04, subdivision 18, is amended to read: 237.26 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 237.27 agency may take applications for medical assistance and conduct 237.28 eligibility determinations for MinnesotaCare enrolleeswho are237.29required to apply for medical assistance according to section237.30256L.03, subdivision 3, paragraph (b). 237.31 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 237.32 amended by adding a subdivision to read: 237.33 Subd. 1c. [NO ASSET TEST FOR PREGNANT WOMEN.] Beginning 237.34 September 30, 1998, eligibility for medical assistance for a 237.35 pregnant woman must be determined without regard to asset 237.36 standards established in section 256B.056, subdivision 3. 238.1 Sec. 4. Minnesota Statutes 1996, section 256B.057, is 238.2 amended by adding a subdivision to read: 238.3 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT 238.4 REQUIREMENT.] Unless a federal waiver of the maintenance of 238.5 effort requirement of section 2105(d) of title XXI of the 238.6 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 238.7 at Large, volume 111, page 251, is granted by the federal 238.8 Department of Health and Human Services by September 30, 1998, 238.9 eligibility for children under age 21 must be determined without 238.10 regard to asset standards established in section 256B.056, 238.11 subdivision 3. The commissioner of human services shall publish 238.12 a notice in the State Register upon receipt of a federal waiver. 238.13 Sec. 5. Minnesota Statutes 1996, section 256B.057, is 238.14 amended by adding a subdivision to read: 238.15 Subd. 8. [CHILDREN UNDER AGE TWO.] Medical assistance may 238.16 be paid for a child under two years of age whose countable 238.17 family income is above 275 percent of the federal poverty 238.18 guidelines for the same size family but less than or equal to 238.19 280 percent of the federal poverty guidelines for the same size 238.20 family. 238.21 Sec. 6. Minnesota Statutes 1997 Supplement, section 238.22 256D.03, subdivision 3, is amended to read: 238.23 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 238.24 (a) General assistance medical care may be paid for any person 238.25 who is not eligible for medical assistance under chapter 256B, 238.26 including eligibility for medical assistance based on a 238.27 spenddown of excess income according to section 256B.056, 238.28 subdivision 5, or MinnesotaCare as defined inclause238.29(4)paragraph (b), except as provided in paragraph(b)(c); and: 238.30 (1) who is receiving assistance under section 256D.05, 238.31 except for families with children who are eligible under 238.32 Minnesota family investment program-statewide (MFIP-S), who is 238.33 having a payment made on the person's behalf under sections 238.34 256I.01 to 256I.06, or who resides in group residential housing 238.35 as defined in chapter 256I and can meet a spenddown using the 238.36 cost of remedial services received through group residential 239.1 housing; or 239.2 (2)(i) who is a resident of Minnesota; and whose equity in 239.3 assets is not in excess of $1,000 per assistance unit. Exempt 239.4 assets, the reduction of excess assets, and the waiver of excess 239.5 assets must conform to the medical assistance program in chapter 239.6 256B, with the following exception: the maximum amount of 239.7 undistributed funds in a trust that could be distributed to or 239.8 on behalf of the beneficiary by the trustee, assuming the full 239.9 exercise of the trustee's discretion under the terms of the 239.10 trust, must be applied toward the asset maximum; and 239.11 (ii) who has countable income not in excess of the 239.12 assistance standards established in section 256B.056, 239.13 subdivision 4, or whose excess income is spent down according to 239.14 section 256B.056, subdivision 5, using a six-month budget 239.15 period. The method for calculating earned income disregards and 239.16 deductions for a person who resides with a dependent child under 239.17 age 21 shall follow section 256B.056, subdivision 1a. However, 239.18 if a disregard of $30 and one-third of the remainder has been 239.19 applied to the wage earner's income, the disregard shall not be 239.20 applied again until the wage earner's income has not been 239.21 considered in an eligibility determination for general 239.22 assistance, general assistance medical care, medical assistance, 239.23 or MFIP-S for 12 consecutive months. The earned income and work 239.24 expense deductions for a person who does not reside with a 239.25 dependent child under age 21 shall be the same as the method 239.26 used to determine eligibility for a person under section 239.27 256D.06, subdivision 1, except the disregard of the first $50 of 239.28 earned income is not allowed;or239.29 (3) who would be eligible for medical assistance except 239.30 that the person resides in a facility that is determined by the 239.31 commissioner or the federal Health Care Financing Administration 239.32 to be an institution for mental diseases.; or 239.33 (4) who is ineligible for medical assistance under chapter 239.34 256B or general assistance medical care under any other 239.35 provision of this section, and is receiving care and 239.36 rehabilitation services from a nonprofit center established to 240.1 serve victims of torture. These individuals are eligible for 240.2 general assistance medical care only for the period during which 240.3 they are receiving services from the center. During this period 240.4 of eligibility, individuals eligible under this clause shall not 240.5 be required to participate in prepaid general assistance medical 240.6 care. 240.7(4)(b) BeginningJuly 1, 1998January 1, 2000, applicants 240.8 or recipients who meet all eligibility requirements of 240.9 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 240.10 (i) adults with dependent children under 21 whose gross 240.11 family income is equal to or less than 275 percent of the 240.12 federal poverty guidelines; or 240.13 (ii) adults without children with earned income and whose 240.14 family gross income is between 75 percent of the federal poverty 240.15 guidelines and the amount set by section 256L.04, subdivision 7, 240.16 shall be terminated from general assistance medical care upon 240.17 enrollment in MinnesotaCare. 240.18(b)(c) For services rendered on or after July 1, 1997, 240.19 eligibility is limited to one month prior to application if the 240.20 person is determined eligible in the prior month. A 240.21 redetermination of eligibility must occur every 12 months. 240.22 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 240.23 program applications completed by recipients and applicants who 240.24 are persons described in paragraph(a)(b),clause (4),may be 240.25 returned to the county agency to be forwarded to the department 240.26 of human services or sent directly to the department of human 240.27 services for enrollment in MinnesotaCare. If all other 240.28 eligibility requirements of this subdivision are met, 240.29 eligibility for general assistance medical care shall be 240.30 available in any month during which a MinnesotaCare eligibility 240.31 determination and enrollment are pending. Upon notification of 240.32 eligibility for MinnesotaCare, notice of termination for 240.33 eligibility for general assistance medical care shall be sent to 240.34 an applicant or recipient. If all other eligibility 240.35 requirements of this subdivision are met, eligibility for 240.36 general assistance medical care shall be available until 241.1 enrollment in MinnesotaCare subject to the provisions of 241.2 paragraph(d)(e). 241.3(c)(d) The date of an initial Minnesota health care 241.4 program application necessary to begin a determination of 241.5 eligibility shall be the date the applicant has provided a name, 241.6 address, and social security number, signed and dated, to the 241.7 county agency or the department of human services. If the 241.8 applicant is unable to provide an initial application when 241.9 health care is delivered due to a medical condition or 241.10 disability, a health care provider may act on the person's 241.11 behalf to complete the initial application. The applicant must 241.12 complete the remainder of the application and provide necessary 241.13 verification before eligibility can be determined. The county 241.14 agency must assist the applicant in obtaining verification if 241.15 necessary. 241.16(d)(e) County agencies are authorized to use all automated 241.17 databases containing information regarding recipients' or 241.18 applicants' income in order to determine eligibility for general 241.19 assistance medical care or MinnesotaCare. Such use shall be 241.20 considered sufficient in order to determine eligibility and 241.21 premium payments by the county agency. 241.22(e)(f) General assistance medical care is not available 241.23 for a person in a correctional facility unless the person is 241.24 detained by law for less than one year in a county correctional 241.25 or detention facility as a person accused or convicted of a 241.26 crime, or admitted as an inpatient to a hospital on a criminal 241.27 hold order, and the person is a recipient of general assistance 241.28 medical care at the time the person is detained by law or 241.29 admitted on a criminal hold order and as long as the person 241.30 continues to meet other eligibility requirements of this 241.31 subdivision. 241.32(f)(g) General assistance medical care is not available 241.33 for applicants or recipients who do not cooperate with the 241.34 county agency to meet the requirements of medical assistance. 241.35 General assistance medical care is limited to payment of 241.36 emergency services only for applicants or recipients as 242.1 described in paragraph(a)(b),clause (4),whose MinnesotaCare 242.2 coverage is denied or terminated for nonpayment of premiums as 242.3 required by sections 256L.06to 256L.08and 256L.07. 242.4(g)(h) In determining the amount of assets of an 242.5 individual, there shall be included any asset or interest in an 242.6 asset, including an asset excluded under paragraph (a), that was 242.7 given away, sold, or disposed of for less than fair market value 242.8 within the 60 months preceding application for general 242.9 assistance medical care or during the period of eligibility. 242.10 Any transfer described in this paragraph shall be presumed to 242.11 have been for the purpose of establishing eligibility for 242.12 general assistance medical care, unless the individual furnishes 242.13 convincing evidence to establish that the transaction was 242.14 exclusively for another purpose. For purposes of this 242.15 paragraph, the value of the asset or interest shall be the fair 242.16 market value at the time it was given away, sold, or disposed 242.17 of, less the amount of compensation received. For any 242.18 uncompensated transfer, the number of months of ineligibility, 242.19 including partial months, shall be calculated by dividing the 242.20 uncompensated transfer amount by the average monthly per person 242.21 payment made by the medical assistance program to skilled 242.22 nursing facilities for the previous calendar year. The 242.23 individual shall remain ineligible until this fixed period has 242.24 expired. The period of ineligibility may exceed 30 months, and 242.25 a reapplication for benefits after 30 months from the date of 242.26 the transfer shall not result in eligibility unless and until 242.27 the period of ineligibility has expired. The period of 242.28 ineligibility begins in the month the transfer was reported to 242.29 the county agency, or if the transfer was not reported, the 242.30 month in which the county agency discovered the transfer, 242.31 whichever comes first. For applicants, the period of 242.32 ineligibility begins on the date of the first approved 242.33 application. 242.34(h)(i) When determining eligibility for any state benefits 242.35 under this subdivision, the income and resources of all 242.36 noncitizens shall be deemed to include their sponsor's income 243.1 and resources as defined in the Personal Responsibility and Work 243.2 Opportunity Reconciliation Act of 1996, title IV, Public Law 243.3 Number 104-193, sections 421 and 422, and subsequently set out 243.4 in federal rules. 243.5(i)(j)(1) An undocumented noncitizen or a nonimmigrant is 243.6 ineligible for general assistance medical care other than 243.7 emergency services. For purposes of this subdivision, a 243.8 nonimmigrant is an individual in one or more of the classes 243.9 listed in United States Code, title 8, section 1101(a)(15), and 243.10 an undocumented noncitizen is an individual who resides in the 243.11 United States without the approval or acquiescence of the 243.12 Immigration and Naturalization Service. 243.13(j)(2) This paragraph does not apply to a child under age 243.14 18, to a Cuban or Haitian entrant as defined in Public Law 243.15 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 243.16 who is aged, blind, or disabled as defined in Code of Federal 243.17 Regulations, title 42, sections 435.520, 435.530, 435.531, 243.18 435.540, and 435.541, or effective October 1, 1998, to an 243.19 individual eligible for general assistance medical care under 243.20 paragraph (a), clause (4), who cooperates with the Immigration 243.21 and Naturalization Service to pursue any applicable immigration 243.22 status, including citizenship, that would qualify the individual 243.23 for medical assistance with federal financial participation. 243.24(k)(3) For purposes ofparagraphs (f) and (i)this 243.25 paragraph, "emergency services" has the meaning given in Code of 243.26 Federal Regulations, title 42, section 440.255(b)(1), except 243.27 that it also means services rendered because of suspected or 243.28 actual pesticide poisoning. 243.29(l)(k) Notwithstanding any other provision of law, a 243.30 noncitizen who is ineligible for medical assistance due to the 243.31 deeming of a sponsor's income and resources, is ineligible for 243.32 general assistance medical care. 243.33 Sec. 7. Minnesota Statutes 1997 Supplement, section 243.34 256L.01, is amended to read: 243.35 256L.01 [DEFINITIONS.] 243.36 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 244.1 to256L.10256L.18, the following terms shall have the meanings 244.2 given them. 244.3 Subd. 1a. [CHILD.] "Child" means an individual under 21 244.4 years of age, including the unborn child of a pregnant woman, an 244.5 emancipated minor, and an emancipated minor's spouse. 244.6 Subd. 2. [COMMISSIONER.] "Commissioner" means the 244.7 commissioner of human services. 244.8 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 244.9 those health care providers who provide covered health services 244.10 to medical assistance recipients under rules established by the 244.11 commissioner for that program. 244.12 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 244.13 children" means: 244.14 (1) parents, their children, and dependent siblings 244.15 residing in the same household; or 244.16 (2) grandparents, foster parents, relative caretakers as 244.17 defined in the medical assistance program, or legal guardians; 244.18 their wards who are children; and dependent siblings residing in 244.19 the same household. 244.20 (b) The term includes children and dependent siblings who 244.21 are temporarily absent from the household in settings such as 244.22 schools, camps, or visitation with noncustodial parents. 244.23 (c) For purposes of this subdivision, a dependent sibling 244.24 means an unmarried child who is a full-time student under the 244.25 age of 25 years who is financially dependent upon a parent, 244.26 grandparent, foster parent, relative caretaker, or legal 244.27 guardian. Proof of school enrollment is required. 244.28 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 244.29 individual or gross family income" for farm and nonfarm 244.30 self-employed means income calculated using as the baseline the 244.31 adjusted gross income reported on the applicant's federal income 244.32 tax form for the previous year and adding back in reported 244.33 depreciation, carryover loss, and net operating loss amounts 244.34 that apply to the business in which the family is currently 244.35 engaged. Applicants shall report the most recent financial 244.36 situation of the family if it has changed from the period of 245.1 time covered by the federal income tax form. The report may be 245.2 in the form of percentage increase or decrease. 245.3 Subd. 5. [INCOME.] "Income" has the meaning given for 245.4 earned and unearned income for families and children in the 245.5 medical assistance program, according to the state's aid to 245.6 families with dependent children plan in effect as of July 16, 245.7 1996. The definition does not include medical assistance income 245.8 methodologies and deeming requirements. The earned income of 245.9 full-time and part-time students under age 19 is not counted as 245.10 income. Public assistance payments and supplemental security 245.11 income are not excluded income. 245.12 Sec. 8. Minnesota Statutes 1997 Supplement, section 245.13 256L.02, subdivision 3, is amended to read: 245.14 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 245.15 shall manage spending for the MinnesotaCare program in a manner 245.16 that maintains a minimum reserve in accordance with section 245.17 16A.76. As part of each state revenue and expenditure forecast, 245.18 the commissioner must makea quarterlyan assessment of the 245.19 expected expenditures for the covered services for the remainder 245.20 of the current biennium and for the following biennium. The 245.21 estimated expenditure, including the reserve requirements 245.22 described in section 16A.76, shall be compared to an estimate of 245.23 the revenues that will bedepositedavailable in the health care 245.24 access fund. Based on this comparison, and after consulting 245.25 with the chairs of the house ways and means committee and the 245.26 senate finance committee, and the legislative commission on 245.27 health care access, the commissioner shall, as necessary, make 245.28 the adjustments specified in paragraph (b) to ensure that 245.29 expenditures remain within the limits of available revenues for 245.30 the remainder of the current biennium and for the following 245.31 biennium. The commissioner shall not hire additional staff 245.32 using appropriations from the health care access fund until the 245.33 commissioner of finance makes a determination that the 245.34 adjustments implemented under paragraph (b) are sufficient to 245.35 allow MinnesotaCare expenditures to remain within the limits of 245.36 available revenues for the remainder of the current biennium and 246.1 for the following biennium. 246.2 (b) The adjustments the commissioner shall use must be 246.3 implemented in this order: first, stop enrollment of single 246.4 adults and households without children; second, upon 45 days' 246.5 notice, stop coverage of single adults and households without 246.6 children already enrolled in the MinnesotaCare program; third, 246.7 upon 90 days' notice, decrease the premium subsidy amounts by 246.8 ten percent for families with gross annual income above 200 246.9 percent of the federal poverty guidelines; fourth, upon 90 days' 246.10 notice, decrease the premium subsidy amounts by ten percent for 246.11 families with gross annual income at or below 200 percent; and 246.12 fifth, require applicants to be uninsured for at least six 246.13 months prior to eligibility in the MinnesotaCare program. If 246.14 these measures are insufficient to limit the expenditures to the 246.15 estimated amount of revenue, the commissioner shall further 246.16 limit enrollment or decrease premium subsidies. 246.17 Sec. 9. Minnesota Statutes 1997 Supplement, section 246.18 256L.02, is amended by adding a subdivision to read: 246.19 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER 246.20 AGE TWO.] For fiscal years beginning on or after July 1, 1999, 246.21 the state cost of health care services provided to MinnesotaCare 246.22 enrollees who are pregnant women or children under age two shall 246.23 be paid out of the general fund rather than the health care 246.24 access fund. If the commissioner of finance decides to pay for 246.25 these costs using a source other than the general fund, the 246.26 commissioner shall include the change as a budget initiative in 246.27 the biennial or supplemental budget, and shall not change the 246.28 funding source through a forecast modification. 246.29 Sec. 10. Minnesota Statutes 1997 Supplement, section 246.30 256L.03, subdivision 1, is amended to read: 246.31 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 246.32 services" means the health services reimbursed under chapter 246.33 256B, with the exception of inpatient hospital services, special 246.34 education services, private duty nursing services, adult dental 246.35 care services other than preventive services, orthodontic 246.36 services, nonemergency medical transportation services, personal 247.1 care assistant and case management services, nursing home or 247.2 intermediate care facilities services, inpatient mental health 247.3 services, and chemical dependency services. Effective July 1, 247.4 1998, adult dental care for nonpreventive services with the 247.5 exception of orthodontic services is available to persons who 247.6 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,247.7 with family gross income equal to or less than 175 percent of 247.8 the federal poverty guidelines. Outpatient mental health 247.9 services covered under the MinnesotaCare program are limited to 247.10 diagnostic assessments, psychological testing, explanation of 247.11 findings, medication management by a physician, day treatment, 247.12 partial hospitalization, and individual, family, and group 247.13 psychotherapy. 247.14 No public funds shall be used for coverage of abortion 247.15 under MinnesotaCare except where the life of the female would be 247.16 endangered or substantial and irreversible impairment of a major 247.17 bodily function would result if the fetus were carried to term; 247.18 or where the pregnancy is the result of rape or incest. 247.19 Covered health services shall be expanded as provided in 247.20 this section. 247.21 Sec. 11. Minnesota Statutes 1997 Supplement, section 247.22 256L.03, is amended by adding a subdivision to read: 247.23 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 247.24 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.] 247.25 Beginning January 1, 1999, children and pregnant women are 247.26 eligible for coverage of all services that are eligible for 247.27 reimbursement under the medical assistance program according to 247.28 chapter 256B, except that abortion services under MinnesotaCare 247.29 shall be limited as provided under section 256L.03, subdivision 247.30 1. Pregnant women and children are exempt from the provisions 247.31 of subdivision 5, regarding copayments. Pregnant women and 247.32 children who are lawfully residing in the United States but who 247.33 are not "qualified noncitizens" under title IV of the Personal 247.34 Responsibility and Work Opportunity Reconciliation Act of 1996, 247.35 Public Law Number 104-193, Statutes at Large, volume 110, page 247.36 2105, are eligible for coverage of all services provided under 248.1 the medical assistance program according to chapter 256B. 248.2 Sec. 12. Minnesota Statutes 1997 Supplement, section 248.3 256L.03, is amended by adding a subdivision to read: 248.4 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 248.5 ASSISTANCE SERVICES.] Beginning January 1, 1999, a woman who is 248.6 enrolled in MinnesotaCare when her pregnancy is diagnosed is 248.7 eligible for coverage of all services provided under the medical 248.8 assistance program according to chapter 256B retroactive to the 248.9 date the pregnancy is medically diagnosed. Copayments totaling 248.10 $30 or more, paid after the date the pregnancy is diagnosed, 248.11 shall be refunded. 248.12 Sec. 13. Minnesota Statutes 1997 Supplement, section 248.13 256L.03, subdivision 3, is amended to read: 248.14 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July248.151, 1993,Covered health services shall include inpatient 248.16 hospital services, including inpatient hospital mental health 248.17 services and inpatient hospital and residential chemical 248.18 dependency treatment, subject to those limitations necessary to 248.19 coordinate the provision of these services with eligibility 248.20 under the medical assistance spenddown. Prior to July 1, 1997, 248.21 the inpatient hospital benefit for adult enrollees is subject to 248.22 an annual benefit limit of $10,000.Effective July 1, 1997,The 248.23 inpatient hospital benefit for adult enrollees who qualify under 248.24 section 256L.04, subdivision 7, or who qualify under section 248.25 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 248.26 income that exceeds 175 percent of the federal poverty 248.27 guidelines and who are not pregnant, is subject to an annual 248.28 limit of $10,000. 248.29 (b)Enrollees who qualify under section 256L.04,248.30subdivision 7, or who qualify under section 256L.04,248.31subdivisions 1 to 6, or 256L.13 with family gross income that248.32exceeds 175 percent of the federal poverty guidelines and who248.33are not pregnant, and are determined by the commissioner to have248.34a basis of eligibility for medical assistance shall apply for248.35and cooperate with the requirements of medical assistance by the248.36last day of the third month following admission to an inpatient249.1hospital. If an enrollee fails to apply for medical assistance249.2within this time period, the enrollee and the enrollee's family249.3shall be disenrolled from the plan and they may not reenroll249.4until 12 calendar months have elapsed. Enrollees and enrollees'249.5families disenrolled for not applying for or not cooperating249.6with medical assistance may not reenroll.249.7(c)Admissions for inpatient hospital services paid for 249.8 under section 256L.11, subdivision 3, must be certified as 249.9 medically necessary in accordance with Minnesota Rules, parts 249.10 9505.0500 to 9505.0540, except as provided in clauses (1) and 249.11 (2): 249.12 (1) all admissions must be certified, except those 249.13 authorized under rules established under section 254A.03, 249.14 subdivision 3, or approved under Medicare; and 249.15 (2) payment under section 256L.11, subdivision 3, shall be 249.16 reduced by five percent for admissions for which certification 249.17 is requested more than 30 days after the day of admission. The 249.18 hospital may not seek payment from the enrollee for the amount 249.19 of the payment reduction under this clause. 249.20(d) Any enrollee or family member of an enrollee who has249.21previously been permanently disenrolled from MinnesotaCare for249.22not applying for and cooperating with medical assistance shall249.23be eligible to reenroll if 12 calendar months have elapsed since249.24the date of disenrollment.249.25 Sec. 14. Minnesota Statutes 1997 Supplement, section 249.26 256L.03, is amended by adding a subdivision to read: 249.27 Subd. 3a. [INTERPRETER SERVICES.] Covered services include 249.28 sign and spoken language interpreter services that assist an 249.29 enrollee in obtaining covered health care services. 249.30 Sec. 15. Minnesota Statutes 1997 Supplement, section 249.31 256L.03, subdivision 4, is amended to read: 249.32 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 249.33 commissioner shall coordinate the provision of hospital 249.34 inpatient services under the MinnesotaCare program with enrollee 249.35 eligibility under the medical assistance spenddown, and shall249.36apply to the secretary of health and human services for any250.1necessary federal waivers or approvals. 250.2 Sec. 16. Minnesota Statutes 1997 Supplement, section 250.3 256L.03, subdivision 5, is amended to read: 250.4 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 250.5 benefit plan shall include the following copayments and 250.6 coinsurance requirements: 250.7 (1) ten percent of the paid charges for inpatient hospital 250.8 services for adult enrolleesnot eligible for medical250.9assistance, subject to an annual inpatient out-of-pocket maximum 250.10 of $1,000 per individual and $3,000 per family; 250.11 (2) $3 per prescription for adult enrollees; 250.12 (3) $25 for eyeglasses for adult enrollees; and 250.13 (4) effective July 1, 1998, 50 percent of the 250.14 fee-for-service rate for adult dental care services other than 250.15 preventive care services for persons eligible under section 250.16 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 250.17 or less than 175 percent of the federal poverty guidelines. 250.18Prior to July 1, 1997, enrollees who are not eligible for250.19medical assistance with or without a spenddown shall be250.20financially responsible for the coinsurance amount and amounts250.21which exceed the $10,000 benefit limit.Effective July 1, 1997, 250.22 adult enrolleeswho qualify under section 256L.04, subdivision250.237, or who qualify under section 256L.04, subdivisions 1 to 6, or250.24256L.13with family gross income that exceeds 175 percent of the 250.25 federal poverty guidelines and who are not pregnant, and who are250.26not eligible for medical assistance with or without a spenddown,250.27 shall be financially responsible for the coinsurance amount and 250.28 amounts which exceed the $10,000 inpatient hospital benefit 250.29 limit. 250.30 When a MinnesotaCare enrollee becomes a member of a prepaid 250.31 health plan, or changes from one prepaid health plan to another 250.32 during a calendar year, any charges submitted towards the 250.33 $10,000 annual inpatient benefit limit, and any out-of-pocket 250.34 expenses incurred by the enrollee for inpatient services, that 250.35 were submitted or incurred prior to enrollment, or prior to the 250.36 change in health plans, shall be disregarded. 251.1 Sec. 17. Minnesota Statutes 1997 Supplement, section 251.2 256L.04, subdivision 1, is amended to read: 251.3 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF251.4ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to251.5October 1, 1992, "eligible persons" means children who are one251.6year of age or older but less than 18 years of age who have251.7gross family incomes that are equal to or less than 185 percent251.8of the federal poverty guidelines and who are not eligible for251.9medical assistance without a spenddown under chapter 256B and251.10who are not otherwise insured for the covered services. The251.11period of eligibility extends from the first day of the month in251.12which the child's first birthday occurs to the last day of the251.13month in which the child becomes 18 years old.Families with 251.14 children with family income equal to or less than 275 percent of 251.15 the federal poverty guidelines for the applicable family size 251.16 shall be eligible for MinnesotaCare according to this section. 251.17 All other provisions of sections 256L.01 to 256L.18, including 251.18 the insurance-related barriers to enrollment under section 251.19 256L.07, shall apply unless otherwise specified. 251.20 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for251.21MinnesotaCare shall be expanded as provided in subdivisions 3 to251.227, except children who meet the criteria in this subdivision251.23shall continue to be enrolled pursuant to this subdivision. The251.24enrollment requirements in this paragraph apply to enrollment251.25under subdivisions 1 to 7.Parents who enroll in the 251.26 MinnesotaCare program must also enroll their children and 251.27 dependent siblings, if the children and their dependent siblings 251.28 are eligible. Children and dependent siblings may be enrolled 251.29 separately without enrollment by parents. However, if one 251.30 parent in the household enrolls, both parents must enroll, 251.31 unless other insurance is available. If one child from a family 251.32 is enrolled, all children must be enrolled, unless other 251.33 insurance is available. If one spouse in a household enrolls, 251.34 the other spouse in the household must also enroll, unless other 251.35 insurance is available. Families cannot choose to enroll only 251.36 certain uninsured members.For purposes of this section, a252.1"dependent sibling" means an unmarried child who is a full-time252.2student under the age of 25 years who is financially dependent252.3upon a parent. Proof of school enrollment will be required.252.4(c) [CONTINUATION OF ELIGIBILITY.] Individuals who252.5initially enroll in the MinnesotaCare program under the252.6eligibility criteria in subdivisions 3 to 7 remain eligible for252.7the MinnesotaCare program, regardless of age, place of252.8residence, or the presence or absence of children in the same252.9household, as long as all other eligibility criteria are met and252.10residence in Minnesota and continuous enrollment in the252.11MinnesotaCare program or medical assistance are maintained. In252.12order for either parent or either spouse in a household to252.13remain enrolled, both must remain enrolled, unless other252.14insurance is available.252.15 Sec. 18. Minnesota Statutes 1997 Supplement, section 252.16 256L.04, subdivision 2, is amended to read: 252.17 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 252.18 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 252.19 eligible for MinnesotaCare, individuals and families must 252.20 cooperate with the state agency to identify potentially liable 252.21 third party payers and assist the state in obtaining third party 252.22 payments. "Cooperation" includes, but is not limited to, 252.23 identifying any third party who may be liable for care and 252.24 services provided under MinnesotaCare to the enrollee, providing 252.25 relevant information to assist the state in pursuing a 252.26 potentially liable third party, and completing forms necessary 252.27 to recover third party payments. 252.28 (b) A parent, guardian, or child enrolled in the 252.29 MinnesotaCare program must cooperate with the department of 252.30 human services and the local agency in establishing the 252.31 paternity of an enrolled child and in obtaining medical care 252.32 support and payments for the child and any other person for whom 252.33 the person can legally assign rights, in accordance with 252.34 applicable laws and rules governing the medical assistance 252.35 program. A child shall not be ineligible for or disenrolled 252.36 from the MinnesotaCare program solely because the child's parent 253.1 or guardian fails to cooperate in establishing paternity or 253.2 obtaining medical support. 253.3 Sec. 19. Minnesota Statutes 1997 Supplement, section 253.4 256L.04, subdivision 7, is amended to read: 253.5 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 253.6 CHILDREN.](a) Beginning October 1, 1994, the definition of253.7"eligible persons" is expanded to include all individuals and253.8households with no children who have gross family incomes that253.9are equal to or less than 125 percent of the federal poverty253.10guidelines and who are not eligible for medical assistance253.11without a spenddown under chapter 256B.253.12(b) Beginning July 1, 1997,The definition of eligible 253.13 personsis expanded to includeincludes all individuals and 253.14 households with no children who have gross family incomes that 253.15 are equal to or less than 175 percent of the federal poverty 253.16 guidelinesand who are not eligible for medical assistance253.17without a spenddown under chapter 256B. 253.18(c) All eligible persons under paragraphs (a) and (b) are253.19eligible for coverage through the MinnesotaCare program but must253.20pay a premium as determined under sections 256L.07 and 256L.08.253.21Individuals and families whose income is greater than the limits253.22established under section 256L.08 may not enroll in the253.23MinnesotaCare program.253.24 Sec. 20. Minnesota Statutes 1997 Supplement, section 253.25 256L.04, is amended by adding a subdivision to read: 253.26 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 253.27 greater than the limits established under this section may not 253.28 enroll in the MinnesotaCare program. 253.29 Sec. 21. Minnesota Statutes 1997 Supplement, section 253.30 256L.04, subdivision 8, is amended to read: 253.31 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 253.32 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 253.33 supplemental security income or retirement, survivors, or 253.34 disability benefits due to a disability, or other 253.35 disability-based pension, who qualify under section 256L.04, 253.36 subdivision 7, but who are potentially eligible for medical 254.1 assistance without a spenddown shall be allowed to enroll in 254.2 MinnesotaCare for a period of 60 days, so long as the applicant 254.3 meets all other conditions of eligibility. The commissioner 254.4 shall identify and refer the applications of such individuals to 254.5 their county social service agency. The county and the 254.6 commissioner shall cooperate to ensure that the individuals 254.7 obtain medical assistance coverage for any months for which they 254.8 are eligible. 254.9 (b) The enrollee must cooperate with the county social 254.10 service agency in determining medical assistance eligibility 254.11 within the 60-day enrollment period. Enrollees who do notapply254.12for andcooperate with medical assistance within the 60-day 254.13 enrollment period, and their other family members,shall be 254.14 disenrolled from the plan within one calendar month. Persons 254.15 disenrolled for nonapplication for medical assistance may not 254.16 reenroll until they have obtained a medical assistance 254.17 eligibility determinationfor the family member or members who254.18were referred to the county agency. Persons disenrolled for 254.19 noncooperation with medical assistance may not reenroll until 254.20 they have cooperated with the county agency and have obtained a 254.21 medical assistance eligibility determination. 254.22 (c) Beginning January 1, 2000, counties that choose to 254.23 become MinnesotaCare enrollment sites shall consider 254.24 MinnesotaCare applications of individuals described in paragraph 254.25 (a) to also be applications for medical assistance and shall 254.26 first determine whether medical assistance eligibility exists. 254.27 Adults with children with family income under 175 percent of the 254.28 federal poverty guidelines for the applicable family size, 254.29 pregnant women, and children who qualify under subdivision 1 who 254.30 are potentially eligible for medical assistance without a 254.31 spenddown may choose to enroll in either MinnesotaCare or 254.32 medical assistance. 254.33 (d) The commissioner shall redetermine provider payments 254.34 made under MinnesotaCare to the appropriate medical assistance 254.35 payments for those enrollees who subsequently become eligible 254.36 for medical assistance. 255.1 Sec. 22. Minnesota Statutes 1997 Supplement, section 255.2 256L.04, subdivision 9, is amended to read: 255.3 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 255.4 cannot have coverage under both MinnesotaCare and general 255.5 assistance medical care in the same month. Eligibility for 255.6 MinnesotaCare cannot be replaced by eligibility for general 255.7 assistance medical care, and eligibility for general assistance 255.8 medical care cannot be replaced by eligibility for MinnesotaCare. 255.9 Sec. 23. Minnesota Statutes 1997 Supplement, section 255.10 256L.04, subdivision 10, is amended to read: 255.11 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 255.12 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 255.13 federal or state benefits under sections 256L.01 to256L.16255.14 256L.18, the income and resources of all noncitizens whose 255.15 sponsor signed an affidavit of support as defined under United 255.16 States Code, title 8, section 1183a, shall be deemed to include 255.17 their sponsors' income and resources as defined in the Personal 255.18 Responsibility and Work Opportunity Reconciliation Act of 1996, 255.19 title IV, Public Law Number 104-193, sections 421 and 422, and 255.20 subsequently set out in federal rules. To be eligible for the 255.21 program, noncitizens must provide documentation of their 255.22 immigration status. 255.23 Sec. 24. Minnesota Statutes 1997 Supplement, section 255.24 256L.04, is amended by adding a subdivision to read: 255.25 Subd. 12. [PERSONS IN DETENTION.] Beginning January 1, 255.26 1999, an applicant residing in a correctional or detention 255.27 facility is not eligible for MinnesotaCare. An enrollee 255.28 residing in a correctional or detention facility is not eligible 255.29 at renewal of eligibility under section 256L.05, subdivision 3b. 255.30 Sec. 25. Minnesota Statutes 1997 Supplement, section 255.31 256L.04, is amended by adding a subdivision to read: 255.32 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 255.33 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 255.34 January 1, 1999, in families that include a grandparent, 255.35 relative caretaker as defined in the medical assistance program, 255.36 foster parent, or legal guardian, the grandparent, relative 256.1 caretaker, foster parent, or legal guardian may apply as a 256.2 family or may apply separately for the children. If the 256.3 caretaker applies separately for the children, only the 256.4 children's income is counted. If the grandparent, relative 256.5 caretaker, foster parent, or legal guardian applies with the 256.6 children, their income is included in the gross family income 256.7 for determining eligibility and premium amount. 256.8 Sec. 26. Minnesota Statutes 1997 Supplement, section 256.9 256L.05, is amended by adding a subdivision to read: 256.10 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 256.11 BEHALF.] Beginning January 1, 1999, a family member who is age 256.12 18 or over or who is an authorized representative, as defined in 256.13 the medical assistance program, may apply on an applicant's 256.14 behalf. 256.15 Sec. 27. Minnesota Statutes 1997 Supplement, section 256.16 256L.05, subdivision 2, is amended to read: 256.17 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 256.18 use individuals' social security numbers as identifiers for 256.19 purposes of administering the plan and conduct data matches to 256.20 verify income. Applicants shall submit evidence of individual 256.21 and family income, earned and unearned,includingsuch as the 256.22 most recent income tax return, wage slips, or other 256.23 documentation that is determined by the commissioner as 256.24 necessary to verify income eligibility. The commissioner shall 256.25 perform random audits to verify reported income and 256.26 eligibility. The commissioner may execute data sharing 256.27 arrangements with the department of revenue and any other 256.28 governmental agency in order to perform income verification 256.29 related to eligibility and premium payment under the 256.30 MinnesotaCare program. 256.31 Sec. 28. Minnesota Statutes 1997 Supplement, section 256.32 256L.05, subdivision 3, is amended to read: 256.33 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 256.34 of coverage is the first day of the month following the month in 256.35 which eligibility is approved and the first premium payment has 256.36 been received. As provided in section 256B.057, coverage for 257.1 newborns is automatic from the date of birth and must be 257.2 coordinated with other health coverage. The effective date of 257.3 coverage foreligible newborns oreligible newly adoptive 257.4 children added to a family receiving covered health services is 257.5 the date of entry into the family. The effective date of 257.6 coverage for other new recipients added to the family receiving 257.7 covered health services is the first day of the month following 257.8 the month in which eligibility is approvedand the first premium257.9payment has been receivedor at renewal, whichever the family 257.10 receiving covered health services prefers. All eligibility 257.11 criteria must be met by the family at the time the new family 257.12 member is added. The income of the new family member is 257.13 included with the family's gross income and the adjusted premium 257.14 begins in the month the new family member is added. The premium 257.15 must be received eight working days prior to the end of the 257.16 month for coverage to begin the following month. Benefits are 257.17 not available until the day following discharge if an enrollee 257.18 is hospitalized on the first day of coverage. Notwithstanding 257.19 any other law to the contrary, benefits under sections 256L.01 257.20 to256L.10256L.18 are secondary to a plan of insurance or 257.21 benefit program under which an eligible person may have coverage 257.22 and the commissioner shall use cost avoidance techniques to 257.23 ensure coordination of any other health coverage for eligible 257.24 persons. The commissioner shall identify eligible persons who 257.25 may have coverage or benefits under other plans of insurance or 257.26 who become eligible for medical assistance. 257.27 Sec. 29. Minnesota Statutes 1997 Supplement, section 257.28 256L.05, is amended by adding a subdivision to read: 257.29 Subd. 3a. [RENEWAL OF ELIGIBILITY.] Beginning January 1, 257.30 1999, an enrollee's eligibility must be renewed every 12 257.31 months. The 12-month period begins in the month after the month 257.32 the application is approved. 257.33 Sec. 30. Minnesota Statutes 1997 Supplement, section 257.34 256L.05, is amended by adding a subdivision to read: 257.35 Subd. 3b. [REAPPLICATION.] Beginning January 1, 1999, 257.36 families and individuals must reapply after a lapse in coverage 258.1 of one calendar month or more and must meet all eligibility 258.2 criteria. 258.3 Sec. 31. Minnesota Statutes 1997 Supplement, section 258.4 256L.05, subdivision 4, is amended to read: 258.5 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 258.6 human services shall determine an applicant's eligibility for 258.7 MinnesotaCare no more than 30 days from the date that the 258.8 application is received by the department of human services. 258.9 Beginning January 1, 2000, this requirement also applies to 258.10 local county human services agencies that determine eligibility 258.11 for MinnesotaCare. To prevent processing delays, applicants 258.12 who, from the information provided on the application, appear to 258.13 meet eligibility requirements shall be enrolled. The enrollee 258.14 must provide all required verifications within 30 days of 258.15 enrollment or coverage from the program shall be terminated. 258.16 Enrollees who are determined to be ineligible when verifications 258.17 are provided shall be disenrolled from the program. 258.18 Sec. 32. Minnesota Statutes 1997 Supplement, section 258.19 256L.06, subdivision 3, is amended to read: 258.20 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 258.21 Premiums are dedicated to the commissioner for MinnesotaCare. 258.22The commissioner shall make an annual redetermination of258.23continued eligibility and identify people who may become258.24eligible for medical assistance.258.25 (b) The commissioner shall develop and implement procedures 258.26 to: (1) require enrollees to report changes in income; (2) 258.27 adjust sliding scale premium payments, based upon changes in 258.28 enrollee income; and (3) disenroll enrollees from MinnesotaCare 258.29 for failure to pay required premiums. Beginning July 1, 1998, 258.30 failure to pay includes payment with a dishonored check and the 258.31 commissioner may demand a guaranteed form of payment as the only 258.32 means to replace a dishonored check. 258.33 (c) Premiums are calculated on a calendar month basis and 258.34 may be paid on a monthly, quarterly, or annual basis, with the 258.35 first payment due upon notice from the commissioner of the 258.36 premium amount required. The commissioner shall inform 259.1 applicants and enrollees of these premium payment options. 259.2 Premium payment is required before enrollment is complete and to 259.3 maintain eligibility in MinnesotaCare. 259.4 (d) Nonpayment of the premium will result in disenrollment 259.5 from the plan within one calendar month after the due date. 259.6 Persons disenrolled for nonpayment or who voluntarily terminate 259.7 coverage from the program may not reenroll until four calendar 259.8 months have elapsed. Persons disenrolled for nonpayment or who 259.9 voluntarily terminate coverage from the program may not reenroll 259.10 for four calendar months unless the person demonstrates good 259.11 cause for nonpayment. Good cause does not exist if a person 259.12 chooses to pay other family expenses instead of the premium. 259.13 The commissioner shall define good cause in rule. 259.14 Sec. 33. Minnesota Statutes 1997 Supplement, section 259.15 256L.07, is amended to read: 259.16 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 259.17 SLIDING SCALE.] 259.18 Subdivision 1. [GENERAL REQUIREMENTS.]Families and259.19individuals who enroll on or after October 1, 1992, are eligible259.20for subsidized premium payments based on a sliding scale under259.21section 256L.08 only if the family or individual meets the259.22requirements in subdivisions 2 and 3. Children already enrolled259.23in the children's health plan as of September 30, 1992, eligible259.24under section 256L.04, subdivision 1, paragraph (a), children259.25who enroll in the MinnesotaCare program after September 30,259.261992, pursuant to Laws 1992, chapter 549, article 4, section 17,259.27and children who enroll under section 256L.04, subdivision 6,259.28are eligible for subsidized premium payments without meeting259.29these requirements, as long as they maintain continuous coverage259.30in the MinnesotaCare plan or medical assistance.(a) Children 259.31 enrolled in the original children's health plan as of September 259.32 30, 1992, children who enrolled in the MinnesotaCare program 259.33 after September 30, 1992, pursuant to Laws 1992, chapter 549, 259.34 article 4, section 17, and children who have family gross 259.35 incomes that are equal to or less than 150 percent of the 259.36 federal poverty guidelines are eligible for subsidized premium 260.1 payments without meeting the requirements of subdivision 2, as 260.2 long as they maintain continuous coverage in the MinnesotaCare 260.3 program or medical assistance. Children who apply for 260.4 MinnesotaCare on or after the implementation date of the 260.5 employer-subsidized health coverage program as described in 260.6 section 45, who have family gross incomes that are equal to or 260.7 less than 150 percent of the federal poverty guidelines, must 260.8 meet the requirements of subdivision 2 to be eligible for 260.9 MinnesotaCare. 260.10 (b)Families and individuals who initially enrolled in260.11MinnesotaCare under section 256L.04, and whose income increases260.12above the limits established in section 256L.08, may continue260.13enrollment and pay the full cost of coverage.Families enrolled 260.14 in MinnesotaCare under section 256L.04, subdivision 1, whose 260.15 income increases above 275 percent of the federal poverty 260.16 guidelines, are no longer eligible for the program and shall be 260.17 disenrolled by the commissioner. Individuals enrolled in 260.18 MinnesotaCare under section 256L.04, subdivision 7, whose income 260.19 increases above 175 percent of the federal poverty guidelines 260.20 are no longer eligible for the program and shall be disenrolled 260.21 by the commissioner. For persons disenrolled under this 260.22 subdivision, MinnesotaCare coverage terminates the last day of 260.23 the calendar month following the month in which the commissioner 260.24 determines that the income of a family or individual, determined 260.25 over a four-month period as required by section 256L.15, 260.26 subdivision 2, exceeds program income limits. 260.27 (c) Notwithstanding paragraph (b), individuals and families 260.28 may remain enrolled in MinnesotaCare if ten percent of their 260.29 annual income is less than the annual premium for a policy with 260.30 a $500 deductible available through the Minnesota comprehensive 260.31 health association. Individuals and families who are no longer 260.32 eligible for MinnesotaCare under this subdivision shall be given 260.33 an 18-month notice period from the date that ineligibility is 260.34 determined before disenrollment. 260.35 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 260.36 COVERAGE.] (a) To be eligible for subsidized premium payments 261.1 based on a sliding scale, a family or individual must not have 261.2 access to subsidized health coverage through an employer, and261.3must not have had access to subsidized health coverage through261.4an employer for the 18 months prior to application for261.5subsidized coverage under the MinnesotaCare program. The261.6requirement that the family or individual must not have had261.7access to employer-subsidized coverage during the previous 18261.8months does not apply if: (1) employer-subsidized coverage was261.9lost due to the death of an employee or divorce; (2)261.10employer-subsidized coverage was lost because an individual261.11became ineligible for coverage as a child or dependent; or (3)261.12employer-subsidized coverage was lost for reasons that would not261.13disqualify the individual for unemployment benefits under261.14section 268.09 and the family or individual has not had access261.15to employer-subsidized coverage since the loss of coverage. If261.16employer-subsidized coverage was lost for reasons that261.17disqualify an individual for unemployment benefits under section261.18268.09, children of that individual are exempt from the261.19requirement of no access to employer subsidized coverage for the261.2018 months prior to application, as long as the children have not261.21had access to employer subsidized coverage since the261.22disqualifying event. The requirement that the. A family or 261.23 individualmust not have had access to employer-subsidized261.24coverage during the previous 18 months does apply ifwhose 261.25 employer-subsidized coverage is lost due to an employer 261.26 terminating health care coverage as an employee benefit during 261.27 the previous 18 months is not eligible. 261.28 (b) For purposes of this requirement, subsidized health 261.29 coverage means health coverage for which the employer pays at 261.30 least 50 percent of the cost of coverage for the employee,261.31excluding dependent coverageor dependent, or a higher 261.32 percentage as specified by the commissioner. Children are 261.33 eligible for employer-subsidized coverage through either parent, 261.34 including the noncustodial parent. The commissioner must treat 261.35 employer contributions to Internal Revenue Code Section 125 261.36 plans and any other employer benefits intended to pay health 262.1 care costs as qualified employer subsidies toward the cost of 262.2 health coverage for employees for purposes of this subdivision. 262.3 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be262.4eligible for subsidized premium payments based on a sliding262.5scale,(a) Families and individualsinitiallyenrolled in the 262.6 MinnesotaCare programunder section 256L.04, subdivisions 5 and262.77,must havehadno health coverage while enrolled or for at 262.8 least four months prior to application and renewal. Children 262.9 enrolled in the original children's health plan and children in 262.10 families with income equal to or less than 150 percent of the 262.11 federal poverty guidelines, who have other health insurance, are 262.12 eligible if the other health coverage meets the requirements of 262.13 Minnesota Rules, part 9506.0020, subpart 3, item B. The 262.14 commissioner may change this eligibility criterion for sliding 262.15 scale premiums in order to remain within the limits of available 262.16 appropriations. The requirement ofat least four months ofno 262.17 health coverageprior to application for the MinnesotaCare262.18programdoes not apply to:newborns. 262.19(1) families, children, and individuals who apply for the262.20MinnesotaCare program upon termination from or as required by262.21the medical assistance program, general assistance medical care262.22program, or coverage under a regional demonstration project for262.23the uninsured funded under section 256B.73, the Hennepin county262.24assured care program, or the Group Health, Inc., community262.25health plan;262.26(2) families and individuals initially enrolled under262.27section 256L.04, subdivisions 1, paragraph (a), and 3;262.28(3) children enrolled pursuant to Laws 1992, chapter 549,262.29article 4, section 17; or262.30(4) individuals currently serving or who have served in the262.31military reserves, and dependents of these individuals, if these262.32individuals: (i) reapply for MinnesotaCare coverage after a262.33period of active military service during which they had been262.34covered by the Civilian Health and Medical Program of the262.35Uniformed Services (CHAMPUS); (ii) were covered under262.36MinnesotaCare immediately prior to obtaining coverage under263.1CHAMPUS; and (iii) have maintained continuous coverage.263.2 (b) For purposes of this section, medical assistance, 263.3 general assistance medical care, and civilian health and medical 263.4 program of the uniformed service, CHAMPUS, are not considered 263.5 insurance or health coverage. 263.6 (c) For purposes of this section, Medicare part A or B 263.7 coverage under title XVIII of the Social Security Act, United 263.8 States Code, title 42, sections 1395c to 1395w-4, is considered 263.9 health coverage. An applicant or enrollee may not refuse 263.10 Medicare coverage to establish eligibility for MinnesotaCare. 263.11 Sec. 34. Minnesota Statutes 1997 Supplement, section 263.12 256L.09, subdivision 2, is amended to read: 263.13 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,263.141997, to be eligible for health coverage under the MinnesotaCare263.15program, families and individuals must be permanent residents of263.16Minnesota.263.17(b) Effective July 1, 1997,To be eligible for health 263.18 coverage under the MinnesotaCare program, adults without 263.19 children must be permanent residents of Minnesota. 263.20(c) Effective July 1, 1997,(b) To be eligible for health 263.21 coverage under the MinnesotaCare program, pregnant women, 263.22 families, and children must meet the residency requirements as 263.23 provided by Code of Federal Regulations, title 42, section 263.24 435.403, except that the provisions of section 256B.056, 263.25 subdivision 1, shall apply upon receipt of federal approval. 263.26 Sec. 35. Minnesota Statutes 1997 Supplement, section 263.27 256L.09, subdivision 4, is amended to read: 263.28 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 263.29 purposes of this section, a permanent Minnesota resident is a 263.30 person who has demonstrated, through persuasive and objective 263.31 evidence, that the person is domiciled in the state and intends 263.32 to live in the state permanently. 263.33 (b) To be eligible as a permanent resident,all applicants263.34 an applicant must demonstrate the requisite intent to live in 263.35 the state permanently by: 263.36 (1) showing that the applicant maintains a residence at a 264.1 verified address other than a place of public accommodation, 264.2 through the use of evidence of residence described in section 264.3 256D.02, subdivision 12a, clause (1); 264.4 (2) demonstrating that the applicant has been continuously 264.5 domiciled in the state for no less than 180 days immediately 264.6 before the application; and 264.7 (3) signing an affidavit declaring that (A) the applicant 264.8 currently resides in the state and intends to reside in the 264.9 state permanently; and (B) the applicant did not come to the 264.10 state for the primary purpose of obtaining medical coverage or 264.11 treatment. 264.12 (c) A person who is temporarily absent from the state does 264.13 not lose eligibility for MinnesotaCare. "Temporarily absent 264.14 from the state" means the person is out of the state for a 264.15 temporary purpose and intends to return when the purpose of the 264.16 absence has been accomplished. A person is not temporarily 264.17 absent from the state if another state has determined that the 264.18 person is a resident for any purpose. If temporarily absent 264.19 from the state, the person must follow the requirements of the 264.20 health plan in which he or she is enrolled to receive services. 264.21 Sec. 36. Minnesota Statutes 1997 Supplement, section 264.22 256L.09, subdivision 6, is amended to read: 264.23 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 264.24 requirement in subdivision 4, paragraph (b), clause (2), is 264.25 determined by a court to be unconstitutional, the commissioner 264.26 of human services shall impose a 12-month preexisting condition 264.27 exclusion on coverage for persons who have been domiciled in the 264.28 state for less than 180 days. 264.29 Sec. 37. Minnesota Statutes 1997 Supplement, section 264.30 256L.11, subdivision 6, is amended to read: 264.31 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 264.32 MinnesotaCare program for inpatient hospital services provided 264.33 to MinnesotaCare enrollees eligible under section 256L.04, 264.34 subdivision 7, or who qualify under section 256L.04, 264.35 subdivisions 1to 6and 2,or 256L.13with family gross income 264.36 that exceeds 175 percent of the federal poverty guidelines and 265.1 who are not pregnant, who are 18 years old or older on the date 265.2 of admission to the inpatient hospital must be in accordance 265.3 with paragraphs (a) and (b). Payment for adults who are not 265.4 pregnant and are eligible under section 256L.04, subdivisions 265.5 1to 6and 2,or 256L.13,and whose incomes are equal to or less 265.6 than 175 percent of the federal poverty guidelines, shall be as 265.7 provided for under paragraph (c). 265.8 (a) If the medical assistance rate minus any copayment 265.9 required under section 256L.03, subdivision 4, is less than or 265.10 equal to the amount remaining in the enrollee's benefit limit 265.11 under section 256L.03, subdivision 3, payment must be the 265.12 medical assistance rate minus any copayment required under 265.13 section 256L.03, subdivision 4. The hospital must not seek 265.14 payment from the enrollee in addition to the copayment. The 265.15 MinnesotaCare payment plus the copayment must be treated as 265.16 payment in full. 265.17 (b) If the medical assistance rate minus any copayment 265.18 required under section 256L.03, subdivision 4, is greater than 265.19 the amount remaining in the enrollee's benefit limit under 265.20 section 256L.03, subdivision 3, payment must be the lesser of: 265.21 (1) the amount remaining in the enrollee's benefit limit; 265.22 or 265.23 (2) charges submitted for the inpatient hospital services 265.24 less any copayment established under section 256L.03, 265.25 subdivision 4. 265.26 The hospital may seek payment from the enrollee for the 265.27 amount by which usual and customary charges exceed the payment 265.28 under this paragraph. If payment is reduced under section 265.29 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 265.30 seek payment from the enrollee for the amount of the reduction. 265.31 (c) For admissions occurring during the period of July 1, 265.32 1997, through June 30, 1998, for adults who are not pregnant and 265.33 are eligible under section 256L.04, subdivisions 1to 6and 265.34 2,or 256L.13,and whose incomes are equal to or less than 175 265.35 percent of the federal poverty guidelines, the commissioner 265.36 shall pay hospitals directly, up to the medical assistance 266.1 payment rate, for inpatient hospital benefits in excess of the 266.2 $10,000 annual inpatient benefit limit. 266.3 Sec. 38. Minnesota Statutes 1997 Supplement, section 266.4 256L.12, subdivision 5, is amended to read: 266.5 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 266.6 MinnesotaCare enrollees who become eligible for medical 266.7 assistance or general assistance medical care will remain in the 266.8 same managed care plan if the managed care plan has a contract 266.9 for that population. Effective January 1, 1998, MinnesotaCare 266.10 enrollees who were formerly eligible for general assistance 266.11 medical care pursuant to section 256D.03, subdivision 3, within 266.12 six months of MinnesotaCare enrollment and were enrolled in a 266.13 prepaid health plan pursuant to section 256D.03, subdivision 4, 266.14 paragraph (d), must remain in the same managed care plan if the 266.15 managed care plan has a contract for that population.Contracts266.16between the department of human services and managed care plans266.17must include MinnesotaCare, and medical assistance and may, at266.18the option of the commissioner of human services, also include266.19general assistance medical care.Managed care plans must 266.20 participate in the MinnesotaCare and general assistance medical 266.21 care programs under a contract with the department of human 266.22 services in service areas where they participate in the medical 266.23 assistance program. 266.24 Sec. 39. Minnesota Statutes 1997 Supplement, section 266.25 256L.15, is amended to read: 266.26 256L.15 [PREMIUMS.] 266.27 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 266.28 childrenenrolled according to sections 256L.13 to 256L.16and 266.29 individuals shall pay a premium determined according to a 266.30 sliding fee based on the cost of coverage as a percentage of the 266.31 family's gross family income. Pregnant women and children under 266.32 age two are exempt from the provisions of section 256L.06, 266.33 subdivision 3, paragraph (b), clause (3), requiring 266.34 disenrollment for failure to pay premiums. For pregnant women, 266.35 this exemption continues until the first day of the month 266.36 following the 60th day postpartum. Women who remain enrolled 267.1 during pregnancy or the postpartum period, despite nonpayment of 267.2 premiums, shall be disenrolled on the first of the month 267.3 following the 60th day postpartum for the penalty period that 267.4 otherwise applies under section 256L.06, unless they begin 267.5 paying premiums. 267.6 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 267.7 the following payment options to an enrollee: 267.8 (1) payment by check; 267.9 (2) payment by credit card; 267.10 (3) payment by recurring automatic checking withdrawal; 267.11 (4) payment by one-time electronic transfer of funds; 267.12 (5) payment by wage withholding with the consent of the 267.13 employer and the employee; or 267.14 (6) payment by using state tax refund payments. 267.15 At application or reapplication, a MinnesotaCare applicant 267.16 or enrollee may authorize the commissioner to use the Revenue 267.17 Recapture Act in chapter 270A to collect funds from the 267.18 applicant's or enrollee's state income tax refund for the 267.19 purposes of meeting all or part of the applicant's or enrollee's 267.20 MinnesotaCare premium obligation for the forthcoming year. The 267.21 applicant or enrollee may authorize the commissioner to apply 267.22 for the state working family tax credit on behalf of the 267.23 applicant or enrollee. The setoff due under this subdivision 267.24 shall not be subject to the $10 fee under section 270A.07, 267.25 subdivision 1. 267.26 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 267.27 are not refundable. 267.28 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 267.29 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 267.30 sliding fee scale to determine the percentage of 267.31 gross individual or family income that households at different 267.32 income levels must pay to obtain coverage through the 267.33 MinnesotaCare program. The sliding fee scale must be based on 267.34 the enrollee's gross individual or family income during the 267.35 previous four months. The sliding fee scale begins with a 267.36 premium of 1.5 percent of gross individual or family income for 268.1 individuals or families with incomes below the limits for the 268.2 medical assistance program for families and children and 268.3 proceeds through the following evenly spaced steps: 1.8, 2.3, 268.4 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 268.5 matched to evenly spaced income steps ranging from the medical 268.6 assistance income limit for families and children to 275 percent 268.7 of the federal poverty guidelines for the applicable family 268.8 size. The sliding fee scale and percentages are not subject to 268.9 the provisions of chapter 14. If a family or individual reports 268.10 increased income after enrollment, premiums shall not be 268.11 adjusted until eligibility renewal. 268.12 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 268.13 of $48 is required for all childrenwho are eligible according268.14to section 256L.13, subdivision 4in families with income at or 268.15 less than 150 percent of federal poverty guidelines. 268.16 Sec. 40. Minnesota Statutes 1997 Supplement, section 268.17 256L.17, is amended by adding a subdivision to read: 268.18 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 268.19 REQUIREMENT.] Unless a federal waiver of the maintenance of 268.20 effort requirements of section 2105(d) of title XXI of the 268.21 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 268.22 at Large, volume 111, page 251, is granted by the federal 268.23 Department of Health and Human Services by September 30, 1998, 268.24 this section does not apply to children. The commissioner shall 268.25 publish a notice in the State Register upon receipt of a federal 268.26 waiver. 268.27 Sec. 41. Minnesota Statutes 1997 Supplement, section 268.28 270A.03, subdivision 5, is amended to read: 268.29 Subd. 5. [DEBT.] "Debt" means a legal obligation of a 268.30 natural person to pay a fixed and certain amount of money, which 268.31 equals or exceeds $25 and which is due and payable to a claimant 268.32 agency. The term includes criminal fines imposed under section 268.33 609.10 or 609.125 and restitution. A debt may arise under a 268.34 contractual or statutory obligation, a court order, or other 268.35 legal obligation, but need not have been reduced to judgment. 268.36 A debt includes any legal obligation of a current recipient 269.1 of assistance which is based on overpayment of an assistance 269.2 grant where that payment is based on a client waiver or an 269.3 administrative or judicial finding of an intentional program 269.4 violation; or where the debt is owed to a program wherein the 269.5 debtor is not a client at the time notification is provided to 269.6 initiate recovery under this chapter and the debtor is not a 269.7 current recipient of food stamps, transitional child care, or 269.8 transitional medical assistance. 269.9 A debt does not include any legal obligation to pay a 269.10 claimant agency for medical care, including hospitalization if 269.11 the income of the debtor at the time when the medical care was 269.12 rendered does not exceed the following amount: 269.13 (1) for an unmarried debtor, an income of $6,400 or less; 269.14 (2) for a debtor with one dependent, an income of $8,200 or 269.15 less; 269.16 (3) for a debtor with two dependents, an income of $9,700 269.17 or less; 269.18 (4) for a debtor with three dependents, an income of 269.19 $11,000 or less; 269.20 (5) for a debtor with four dependents, an income of $11,600 269.21 or less; and 269.22 (6) for a debtor with five or more dependents, an income of 269.23 $12,100 or less. 269.24 The income amounts in this subdivision shall be adjusted 269.25 for inflation for debts incurred in calendar years 1991 and 269.26 thereafter. The dollar amount of each income level that applied 269.27 to debts incurred in the prior year shall be increased in the 269.28 same manner as provided in section 290.06, subdivision 2d, for 269.29 the expansion of the tax rate brackets. 269.30 Debt also includes an agreement to pay a MinnesotaCare 269.31 premium, regardless of the dollar amount of the premium 269.32 authorized under section 256L.15, subdivision 1a. 269.33 Sec. 42. Laws 1997, chapter 225, article 2, section 64, is 269.34 amended to read: 269.35 Sec. 64. [EFFECTIVE DATE.] 269.36 Section 8 is effective for payments made for MinnesotaCare 270.1 services on or after July 1, 1996. Section 23 is effective the 270.2 day following final enactment. Section 46 is effective January 270.3 1, 1998, and applies to high deductible health plans issued or 270.4 renewed on or after that date. 270.5 Sec. 43. [FEDERAL EARNED INCOME TAX CREDIT.] 270.6 The commissioner of human services shall seek a federal 270.7 waiver from the appropriate federal agency to allow the state to 270.8 use the federal earned income tax credit for payment of state 270.9 subsidized health care premiums. 270.10 Sec. 44. [INPATIENT HOSPITAL COPAYMENT.] 270.11 If federal approval of a waiver to obtain federal Medicaid 270.12 funding for coverage provided to parents enrolled in the 270.13 MinnesotaCare program is contingent upon not applying the 270.14 inpatient hospital services copayment under Minnesota Statutes, 270.15 section 256L.03, subdivision 5, clause (1), then the inpatient 270.16 hospital services copayment shall not be applied to enrollees 270.17 for whom the state receives federal Medicaid funding. 270.18 Sec. 45. [EMPLOYER-SUBSIDIZED HEALTH COVERAGE PROGRAM.] 270.19 Subdivision 1. [PLAN SUBMITTAL.] The commissioner of human 270.20 services shall submit to the health care financing 270.21 administration a plan to obtain federal funding, according to 270.22 section 2105(c)(3) of the Balanced Budget Act of 1997, Public 270.23 Law Number 105-33, to subsidize health insurance coverage for 270.24 families who are ineligible for the MinnesotaCare program, due 270.25 to the availability of employer-subsidized insurance as defined 270.26 in Minnesota Statutes, section 256L.07, subdivision 2. The 270.27 program shall pay the difference between: 270.28 (1) what the family would have paid under the sliding 270.29 premium scale specified in Minnesota Statutes, section 256L.15, 270.30 subdivision 2, up to a maximum of five percent of the family's 270.31 income, had the family been covered under MinnesotaCare; and 270.32 (2) the required employee contribution for 270.33 employer-subsidized health coverage. 270.34 Subd. 2. [CONSULTATION AND PLAN SUBMITTAL.] In developing 270.35 the plan, the commissioner shall consult with the legislative 270.36 commission on health care access. The commissioner shall submit 271.1 the plan and draft legislation to the legislature by December 271.2 15, 1998, and shall not implement the plan without legislative 271.3 approval. 271.4 Subd. 3. [PHASE-OUT OF MINNESOTACARE ELIGIBILITY.] As part 271.5 of the plan submitted to the legislature under subdivision 2, 271.6 the commissioner shall include a process to phase out 271.7 MinnesotaCare eligibility for children who have access to 271.8 employer-subsidized health coverage as defined under Minnesota 271.9 Statutes, section 256L.07, subdivision 2, and who: 271.10 (1) enrolled in the original children's health plan as of 271.11 September 30, 1992; 271.12 (2) enrolled in the MinnesotaCare program after September 271.13 30, 1992, according to Laws 1992, chapter 549, article 4, 271.14 section 17; or 271.15 (3) have family gross incomes that are equal to or less 271.16 than 150 percent of the federal poverty guidelines. 271.17 Sec. 46. [STATE CHILDREN'S HEALTH INSURANCE PROGRAM.] 271.18 Subdivision 1. [AUTHORITY.] The commissioner is authorized 271.19 to claim enhanced federal matching funds under sections 271.20 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 271.21 Law Number 105-33, for any and all state or local expenditures 271.22 eligible as child health assistance for targeted low-income 271.23 children and health service initiatives for low-income 271.24 children. If required by federal law or regulations, the 271.25 commissioner is authorized to establish accounts, make 271.26 appropriate payments, and receive reimbursement from state and 271.27 local entities providing child health assistance or health 271.28 services for low-income children, in order to obtain enhanced 271.29 federal matching funds. Enhanced federal matching funds 271.30 received as a result of providing health care coverage 271.31 authorized under this section shall be deposited in the health 271.32 care access fund. Enhanced federal matching funds received as a 271.33 result of outreach activities described in subdivision 2, clause 271.34 (2), shall be dedicated to the commissioner of human services to 271.35 be used for those outreach purposes. 271.36 Subd. 2. [ENHANCED MATCHING FUNDS FOR CHILDREN'S HEALTH 272.1 CARE INITIATIVES.] The commissioner shall submit to the health 272.2 care financing administration all plans and waiver requests 272.3 necessary to obtain enhanced matching funds under the state 272.4 children's health insurance program established as Title 21 of 272.5 the Balanced Budget Act of 1997, Public Law Number 105-33, for: 272.6 (1) expenditures made under Minnesota Statutes, section 272.7 256B.057, subdivision 8; 272.8 (2) MinnesotaCare outreach activities authorized by Laws 272.9 1997, chapter 225, article 7, section 2, subdivision 1; and 272.10 (3) expenditures made under the MinnesotaCare program, the 272.11 medical assistance program, or any initiative authorized by the 272.12 legislature including an initiative to subsidize health 272.13 insurance coverage for families who are ineligible for 272.14 MinnesotaCare due to the availability of employer-subsidized 272.15 insurance. 272.16 The commissioner shall submit to the legislature, by 272.17 January 15, 1999, all statutory changes necessary to receive 272.18 enhanced federal matching funds. 272.19 Sec. 47. [REVISOR'S INSTRUCTION.] 272.20 In each section of Minnesota Statutes referred to in column 272.21 A, the revisor of statutes shall delete the reference in column 272.22 B and insert the reference in column C. 272.23 Column A Column B Column C 272.24 256B.057, subd. 1a 256L.08 256L.15 272.25 256B.0645 256L.14 256L.03, subd. 1a 272.26 256L.16 256L.14 256L.03, subd. 1a 272.27 Sec. 48. [REPEALER.] 272.28 Minnesota Statutes 1997 Supplement, sections 256B.057, 272.29 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 272.30 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 272.31 and 256L.14, are repealed. 272.32 Sec. 49. [EFFECTIVE DATES.] 272.33 (a) Sections 2, 7, 8, 10, 13, 15, 16, 17 to 23, 27, 28, 31 272.34 to 39, 41, 47, and 48 are effective January 1, 1999. 272.35 (b) Sections 4, 5, and 40 are effective September 30, 1998. 272.36 (c) Section 6 is effective July 1, 1998, except paragraph 273.1 (a), clause (4), which is effective October 1, 1998. 273.2 (d) Sections 14 and 42 to 46 are effective the day 273.3 following final enactment. 273.4 ARTICLE 6 273.5 WELFARE REFORM; WORK FIRST; ASSISTANCE PROGRAM 273.6 AND CHILD SUPPORT CHANGES; AND LICENSING 273.7 Section 1. Minnesota Statutes 1997 Supplement, section 273.8 119B.01, subdivision 16, is amended to read: 273.9 Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year 273.10 families" means families who have received AFDC, or who were 273.11 eligible to receive AFDC after choosing to discontinue receipt 273.12 of the cash portion of MFIP-S assistance under section 256J.31, 273.13 subdivision 12, for at least three of the last six months before 273.14 losing eligibility for AFDC due to increased hours of 273.15 employment, or increased income from employment or child or 273.16 spousal support, or the loss of income disregards due to time273.17limitations. 273.18 Sec. 2. Minnesota Statutes 1997 Supplement, section 273.19 119B.02, is amended to read: 273.20 119B.02 [DUTIES OF COMMISSIONER.] 273.21 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 273.22 shall develop standards for county and human services boards to 273.23 provide child care services to enable eligible families to 273.24 participate in employment, training, or education programs. 273.25 Within the limits of available appropriations, the commissioner 273.26 shall distribute money to counties to reduce the costs of child 273.27 care for eligible families. The commissioner shall adopt rules 273.28 to govern the program in accordance with this section. The 273.29 rules must establish a sliding schedule of fees for parents 273.30 receiving child care services. The rules shall provide that 273.31 funds received as a lump sum payment of child support arrearages 273.32 shall not be counted as income to a family in the month received 273.33 but shall be prorated over the 12 months following receipt and 273.34 added to the family income during those months. In the rules 273.35 adopted under this section, county and human services boards 273.36 shall be authorized to establish policies for payment of child 274.1 care spaces for absent children, when the payment is required by 274.2 the child's regular provider. The rules shall not set a maximum 274.3 number of days for which absence payments can be made, but 274.4 instead shall direct the county agency to set limits and pay for 274.5 absences according to the prevailing market practice in the 274.6 county. County policies for payment of absences shall be 274.7 subject to the approval of the commissioner. The commissioner 274.8 shall maximize the use of federal money in section 256.736 and 274.9 other programs that provide federal or state reimbursement for 274.10 child care services for low-income families who are in 274.11 education, training, job search, or other activities allowed 274.12 under those programs. Money appropriated under this section 274.13 must be coordinated with the programs that provide federal 274.14 reimbursement for child care services to accomplish this 274.15 purpose. Federal reimbursement obtained must be allocated to 274.16 the county that spent money for child care that is federally 274.17 reimbursable under programs that provide federal reimbursement 274.18 for child care services. The counties shall use the federal 274.19 money to expand child care services. The commissioner may adopt 274.20 rules under chapter 14 to implement and coordinate federal 274.21 program requirements. 274.22 Subd. 2. [CONTRACTUAL AGREEMENTS WITH TRIBES.] The 274.23 commissioner may enter into contractual agreements with a 274.24 federally recognized Indian tribe with a reservation in 274.25 Minnesota to carry out the responsibilities of county human 274.26 service agencies to the extent necessary for the tribe to 274.27 operate child care assistance programs under sections 119B.03 274.28 and 119B.05. An agreement may allow for the tribe to be 274.29 reimbursed for child care assistance services provided under 274.30 section 119B.05. The commissioner shall consult with the 274.31 affected county or counties in the contractual agreement 274.32 negotiations, if the county or counties wish to be included, in 274.33 order to avoid the duplication of county and tribal child care 274.34 services. Funding to support services under section 119B.03 may 274.35 be transferred to the federally recognized Indian tribe with a 274.36 reservation in Minnesota from allocations available to counties 275.1 in which reservation boundaries lie. When funding is 275.2 transferred under section 119B.03, the amount shall be 275.3 commensurate to estimates of the proportion of reservation 275.4 residents with characteristics identified in section 119B.03, 275.5 subdivision 6, to the total population of county residents with 275.6 those same characteristics. 275.7 Sec. 3. Minnesota Statutes 1996, section 245A.03, is 275.8 amended by adding a subdivision to read: 275.9 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 275.10 clause (2), does not apply to: 275.11 (1) a child care provider who as an applicant for licensure 275.12 or as a license holder has received a license denial under 275.13 section 245A.05, a fine under section 245A.06, or a sanction 275.14 under section 245A.07 from the commissioner that has not been 275.15 reversed on appeal; or 275.16 (2) a child care provider, or a child care provider who has 275.17 a household member who, as a result of a licensing process, has 275.18 a disqualification under this chapter that has not been set 275.19 aside by the commissioner. 275.20 Sec. 4. Minnesota Statutes 1996, section 245A.03, is 275.21 amended by adding a subdivision to read: 275.22 Subd. 4. [EXCLUDED CHILD CARE PROGRAMS; RIGHT TO SEEK 275.23 LICENSURE.] Nothing in this section shall prohibit a child care 275.24 program that is excluded from licensure under subdivision 2, 275.25 clause (2), or under Laws 1997, chapter 248, section 46, as 275.26 amended by Laws 1997, First Special Session chapter 5, section 275.27 10, from seeking a license under this chapter. The commissioner 275.28 shall ensure that any application received from such an excluded 275.29 provider is processed in the same manner as all other 275.30 applications for licensed family day care. 275.31 Sec. 5. Minnesota Statutes 1996, section 245A.14, 275.32 subdivision 4, is amended to read: 275.33 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential 275.34 child care programs serving 14 or fewer children that are 275.35 conducted at a location other than the license holder's own 275.36 residence shall be licensed under this section and the rules 276.1 governing family day care or group family day care if: 276.2 (a) the license holder is the primary provider of care;276.3(b)and the nonresidential child care program is conducted 276.4 in a dwelling that is located on a residential lot;andor 276.5(c) the license holder complies with all other requirements276.6of sections 245A.01 to 245A.15 and the rules governing family276.7day care or group family day care.276.8 (b) the license holder is an employer who may or may not be 276.9 the primary provider of care, and the purpose for the child care 276.10 program is to provide child care services to children of the 276.11 license holder's employees. 276.12 Sec. 6. Minnesota Statutes 1997 Supplement, section 276.13 245B.06, subdivision 2, is amended to read: 276.14 Subd. 2. [RISK MANAGEMENT PLAN.] The license holder must 276.15 develop and document in writing a risk management plan that 276.16 incorporates the individual abuse prevention plan as required in 276.17chapter 245Csection 245A.65. License holders jointly providing 276.18 services to a consumer shall coordinate and use the resulting 276.19 assessment of risk areas for the development of this plan. Upon 276.20 initiation of services, the license holder will have in place an 276.21 initial risk management plan that identifies areas in which the 276.22 consumer is vulnerable, including health, safety, and 276.23 environmental issues and the supports the provider will have in 276.24 place to protect the consumer and to minimize these risks. The 276.25 plan must be changed based on the needs of the individual 276.26 consumer and reviewed at least annually. 276.27 Sec. 7. Minnesota Statutes 1997 Supplement, section 276.28 256.01, subdivision 2, is amended to read: 276.29 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 276.30 section 241.021, subdivision 2, the commissioner of human 276.31 services shall: 276.32 (1) Administer and supervise all forms of public assistance 276.33 provided for by state law and other welfare activities or 276.34 services as are vested in the commissioner. Administration and 276.35 supervision of human services activities or services includes, 276.36 but is not limited to, assuring timely and accurate distribution 277.1 of benefits, completeness of service, and quality program 277.2 management. In addition to administering and supervising human 277.3 services activities vested by law in the department, the 277.4 commissioner shall have the authority to: 277.5 (a) require county agency participation in training and 277.6 technical assistance programs to promote compliance with 277.7 statutes, rules, federal laws, regulations, and policies 277.8 governing human services; 277.9 (b) monitor, on an ongoing basis, the performance of county 277.10 agencies in the operation and administration of human services, 277.11 enforce compliance with statutes, rules, federal laws, 277.12 regulations, and policies governing welfare services and promote 277.13 excellence of administration and program operation; 277.14 (c) develop a quality control program or other monitoring 277.15 program to review county performance and accuracy of benefit 277.16 determinations; 277.17 (d) require county agencies to make an adjustment to the 277.18 public assistance benefits issued to any individual consistent 277.19 with federal law and regulation and state law and rule and to 277.20 issue or recover benefits as appropriate; 277.21 (e) delay or deny payment of all or part of the state and 277.22 federal share of benefits and administrative reimbursement 277.23 according to the procedures set forth in section 256.017;and277.24 (f) make contracts with and grants to public and private 277.25 agencies and organizations, both profit and nonprofit, and 277.26 individuals, using appropriated funds; and 277.27 (g) enter into contractual agreements with federally 277.28 recognized Indian tribes with a reservation in Minnesota to the 277.29 extent necessary for the tribe to operate a federally approved 277.30 family assistance program or any other program under the 277.31 supervision of the commissioner. The commissioner shall consult 277.32 with the affected county or counties in the contractual 277.33 agreement negotiations, if the county or counties wish to be 277.34 included, in order to avoid the duplication of county and tribal 277.35 assistance program services. The commissioner may establish 277.36 necessary accounts for the purposes of receiving and disbursing 278.1 funds as necessary for the operation of the programs. 278.2 (2) Inform county agencies, on a timely basis, of changes 278.3 in statute, rule, federal law, regulation, and policy necessary 278.4 to county agency administration of the programs. 278.5 (3) Administer and supervise all child welfare activities; 278.6 promote the enforcement of laws protecting handicapped, 278.7 dependent, neglected and delinquent children, and children born 278.8 to mothers who were not married to the children's fathers at the 278.9 times of the conception nor at the births of the children; 278.10 license and supervise child-caring and child-placing agencies 278.11 and institutions; supervise the care of children in boarding and 278.12 foster homes or in private institutions; and generally perform 278.13 all functions relating to the field of child welfare now vested 278.14 in the state board of control. 278.15 (4) Administer and supervise all noninstitutional service 278.16 to handicapped persons, including those who are visually 278.17 impaired, hearing impaired, or physically impaired or otherwise 278.18 handicapped. The commissioner may provide and contract for the 278.19 care and treatment of qualified indigent children in facilities 278.20 other than those located and available at state hospitals when 278.21 it is not feasible to provide the service in state hospitals. 278.22 (5) Assist and actively cooperate with other departments, 278.23 agencies and institutions, local, state, and federal, by 278.24 performing services in conformity with the purposes of Laws 278.25 1939, chapter 431. 278.26 (6) Act as the agent of and cooperate with the federal 278.27 government in matters of mutual concern relative to and in 278.28 conformity with the provisions of Laws 1939, chapter 431, 278.29 including the administration of any federal funds granted to the 278.30 state to aid in the performance of any functions of the 278.31 commissioner as specified in Laws 1939, chapter 431, and 278.32 including the promulgation of rules making uniformly available 278.33 medical care benefits to all recipients of public assistance, at 278.34 such times as the federal government increases its participation 278.35 in assistance expenditures for medical care to recipients of 278.36 public assistance, the cost thereof to be borne in the same 279.1 proportion as are grants of aid to said recipients. 279.2 (7) Establish and maintain any administrative units 279.3 reasonably necessary for the performance of administrative 279.4 functions common to all divisions of the department. 279.5 (8) Act as designated guardian of both the estate and the 279.6 person of all the wards of the state of Minnesota, whether by 279.7 operation of law or by an order of court, without any further 279.8 act or proceeding whatever, except as to persons committed as 279.9 mentally retarded. For children under the guardianship of the 279.10 commissioner whose interests would be best served by adoptive 279.11 placement, the commissioner may contract with a licensed 279.12 child-placing agency to provide adoption services. A contract 279.13 with a licensed child-placing agency must be designed to 279.14 supplement existing county efforts and may not replace existing 279.15 county programs, unless the replacement is agreed to by the 279.16 county board and the appropriate exclusive bargaining 279.17 representative or the commissioner has evidence that child 279.18 placements of the county continue to be substantially below that 279.19 of other counties. 279.20 (9) Act as coordinating referral and informational center 279.21 on requests for service for newly arrived immigrants coming to 279.22 Minnesota. 279.23 (10) The specific enumeration of powers and duties as 279.24 hereinabove set forth shall in no way be construed to be a 279.25 limitation upon the general transfer of powers herein contained. 279.26 (11) Establish county, regional, or statewide schedules of 279.27 maximum fees and charges which may be paid by county agencies 279.28 for medical, dental, surgical, hospital, nursing and nursing 279.29 home care and medicine and medical supplies under all programs 279.30 of medical care provided by the state and for congregate living 279.31 care under the income maintenance programs. 279.32 (12) Have the authority to conduct and administer 279.33 experimental projects to test methods and procedures of 279.34 administering assistance and services to recipients or potential 279.35 recipients of public welfare. To carry out such experimental 279.36 projects, it is further provided that the commissioner of human 280.1 services is authorized to waive the enforcement of existing 280.2 specific statutory program requirements, rules, and standards in 280.3 one or more counties. The order establishing the waiver shall 280.4 provide alternative methods and procedures of administration, 280.5 shall not be in conflict with the basic purposes, coverage, or 280.6 benefits provided by law, and in no event shall the duration of 280.7 a project exceed four years. It is further provided that no 280.8 order establishing an experimental project as authorized by the 280.9 provisions of this section shall become effective until the 280.10 following conditions have been met: 280.11 (a) The secretary of health, education, and welfare of the 280.12 United States has agreed, for the same project, to waive state 280.13 plan requirements relative to statewide uniformity. 280.14 (b) A comprehensive plan, including estimated project 280.15 costs, shall be approved by the legislative advisory commission 280.16 and filed with the commissioner of administration. 280.17 (13) According to federal requirements, establish 280.18 procedures to be followed by local welfare boards in creating 280.19 citizen advisory committees, including procedures for selection 280.20 of committee members. 280.21 (14) Allocate federal fiscal disallowances or sanctions 280.22 which are based on quality control error rates for the aid to 280.23 families with dependent children, Minnesota family investment 280.24 program-statewide, medical assistance, or food stamp program in 280.25 the following manner: 280.26 (a) One-half of the total amount of the disallowance shall 280.27 be borne by the county boards responsible for administering the 280.28 programs. For the medical assistance, MFIP-S, and AFDC 280.29 programs, disallowances shall be shared by each county board in 280.30 the same proportion as that county's expenditures for the 280.31 sanctioned program are to the total of all counties' 280.32 expenditures for the AFDC, MFIP-S, and medical assistance 280.33 programs. For the food stamp program, sanctions shall be shared 280.34 by each county board, with 50 percent of the sanction being 280.35 distributed to each county in the same proportion as that 280.36 county's administrative costs for food stamps are to the total 281.1 of all food stamp administrative costs for all counties, and 50 281.2 percent of the sanctions being distributed to each county in the 281.3 same proportion as that county's value of food stamp benefits 281.4 issued are to the total of all benefits issued for all 281.5 counties. Each county shall pay its share of the disallowance 281.6 to the state of Minnesota. When a county fails to pay the 281.7 amount due hereunder, the commissioner may deduct the amount 281.8 from reimbursement otherwise due the county, or the attorney 281.9 general, upon the request of the commissioner, may institute 281.10 civil action to recover the amount due. 281.11 (b) Notwithstanding the provisions of paragraph (a), if the 281.12 disallowance results from knowing noncompliance by one or more 281.13 counties with a specific program instruction, and that knowing 281.14 noncompliance is a matter of official county board record, the 281.15 commissioner may require payment or recover from the county or 281.16 counties, in the manner prescribed in paragraph (a), an amount 281.17 equal to the portion of the total disallowance which resulted 281.18 from the noncompliance, and may distribute the balance of the 281.19 disallowance according to paragraph (a). 281.20 (15) Develop and implement special projects that maximize 281.21 reimbursements and result in the recovery of money to the 281.22 state. For the purpose of recovering state money, the 281.23 commissioner may enter into contracts with third parties. Any 281.24 recoveries that result from projects or contracts entered into 281.25 under this paragraph shall be deposited in the state treasury 281.26 and credited to a special account until the balance in the 281.27 account reaches $1,000,000. When the balance in the account 281.28 exceeds $1,000,000, the excess shall be transferred and credited 281.29 to the general fund. All money in the account is appropriated 281.30 to the commissioner for the purposes of this paragraph. 281.31 (16) Have the authority to make direct payments to 281.32 facilities providing shelter to women and their children 281.33 according to section 256D.05, subdivision 3. Upon the written 281.34 request of a shelter facility that has been denied payments 281.35 under section 256D.05, subdivision 3, the commissioner shall 281.36 review all relevant evidence and make a determination within 30 282.1 days of the request for review regarding issuance of direct 282.2 payments to the shelter facility. Failure to act within 30 days 282.3 shall be considered a determination not to issue direct payments. 282.4 (17) Have the authority to establish and enforce the 282.5 following county reporting requirements: 282.6 (a) The commissioner shall establish fiscal and statistical 282.7 reporting requirements necessary to account for the expenditure 282.8 of funds allocated to counties for human services programs. 282.9 When establishing financial and statistical reporting 282.10 requirements, the commissioner shall evaluate all reports, in 282.11 consultation with the counties, to determine if the reports can 282.12 be simplified or the number of reports can be reduced. 282.13 (b) The county board shall submit monthly or quarterly 282.14 reports to the department as required by the commissioner. 282.15 Monthly reports are due no later than 15 working days after the 282.16 end of the month. Quarterly reports are due no later than 30 282.17 calendar days after the end of the quarter, unless the 282.18 commissioner determines that the deadline must be shortened to 282.19 20 calendar days to avoid jeopardizing compliance with federal 282.20 deadlines or risking a loss of federal funding. Only reports 282.21 that are complete, legible, and in the required format shall be 282.22 accepted by the commissioner. 282.23 (c) If the required reports are not received by the 282.24 deadlines established in clause (b), the commissioner may delay 282.25 payments and withhold funds from the county board until the next 282.26 reporting period. When the report is needed to account for the 282.27 use of federal funds and the late report results in a reduction 282.28 in federal funding, the commissioner shall withhold from the 282.29 county boards with late reports an amount equal to the reduction 282.30 in federal funding until full federal funding is received. 282.31 (d) A county board that submits reports that are late, 282.32 illegible, incomplete, or not in the required format for two out 282.33 of three consecutive reporting periods is considered 282.34 noncompliant. When a county board is found to be noncompliant, 282.35 the commissioner shall notify the county board of the reason the 282.36 county board is considered noncompliant and request that the 283.1 county board develop a corrective action plan stating how the 283.2 county board plans to correct the problem. The corrective 283.3 action plan must be submitted to the commissioner within 45 days 283.4 after the date the county board received notice of noncompliance. 283.5 (e) The final deadline for fiscal reports or amendments to 283.6 fiscal reports is one year after the date the report was 283.7 originally due. If the commissioner does not receive a report 283.8 by the final deadline, the county board forfeits the funding 283.9 associated with the report for that reporting period and the 283.10 county board must repay any funds associated with the report 283.11 received for that reporting period. 283.12 (f) The commissioner may not delay payments, withhold 283.13 funds, or require repayment under paragraph (c) or (e) if the 283.14 county demonstrates that the commissioner failed to provide 283.15 appropriate forms, guidelines, and technical assistance to 283.16 enable the county to comply with the requirements. If the 283.17 county board disagrees with an action taken by the commissioner 283.18 under paragraph (c) or (e), the county board may appeal the 283.19 action according to sections 14.57 to 14.69. 283.20 (g) Counties subject to withholding of funds under 283.21 paragraph (c) or forfeiture or repayment of funds under 283.22 paragraph (e) shall not reduce or withhold benefits or services 283.23 to clients to cover costs incurred due to actions taken by the 283.24 commissioner under paragraph (c) or (e). 283.25 (18) Allocate federal fiscal disallowances or sanctions for 283.26 audit exceptions when federal fiscal disallowances or sanctions 283.27 are based on a statewide random sample for the foster care 283.28 program under title IV-E of the Social Security Act, United 283.29 States Code, title 42, in direct proportion to each county's 283.30 title IV-E foster care maintenance claim for that period. 283.31 (19) Be responsible for ensuring the detection, prevention, 283.32 investigation, and resolution of fraudulent activities or 283.33 behavior by applicants, recipients, and other participants in 283.34 the human services programs administered by the department. 283.35 (20) Require county agencies to identify overpayments, 283.36 establish claims, and utilize all available and cost-beneficial 284.1 methodologies to collect and recover these overpayments in the 284.2 human services programs administered by the department. 284.3 (21) Have the authority to administer a drug rebate program 284.4 for drugs purchased pursuant to the senior citizen drug program 284.5 established under section 256.955 after the beneficiary's 284.6 satisfaction of any deductible established in the program. The 284.7 commissioner shall require a rebate agreement from all 284.8 manufacturers of covered drugs as defined in section 256B.0625, 284.9 subdivision 13. For each drug, the amount of the rebate shall 284.10 be equal to the basic rebate as defined for purposes of the 284.11 federal rebate program in United States Code, title 42, section 284.12 1396r-8(c)(1). This basic rebate shall be applied to 284.13 single-source and multiple-source drugs. The manufacturers must 284.14 provide full payment within 30 days of receipt of the state 284.15 invoice for the rebate within the terms and conditions used for 284.16 the federal rebate program established pursuant to section 1927 284.17 of title XIX of the Social Security Act. The manufacturers must 284.18 provide the commissioner with any information necessary to 284.19 verify the rebate determined per drug. The rebate program shall 284.20 utilize the terms and conditions used for the federal rebate 284.21 program established pursuant to section 1927 of title XIX of the 284.22 Social Security Act. 284.23 Sec. 8. Minnesota Statutes 1996, section 256.014, 284.24 subdivision 1, is amended to read: 284.25 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 284.26 commissioner of human services shall establish and enhance 284.27 computer systems necessary for the efficient operation of the 284.28 programs the commissioner supervises, including: 284.29 (1) management and administration of the food stamp and 284.30 income maintenance programs, including the electronic 284.31 distribution of benefits; 284.32 (2) management and administration of the child support 284.33 enforcement program; and 284.34 (3) administration of medical assistance and general 284.35 assistance medical care. 284.36 The commissioner shall distribute the nonfederal share of 285.1 the costs of operating and maintaining the systems to the 285.2 commissioner and to the counties participating in the system in 285.3 a manner that reflects actual system usage, except that the 285.4 nonfederal share of the costs of the MAXIS computer system and 285.5 child support enforcement systems shall be borne entirely by the 285.6 commissioner. Development costs must not be assessed against 285.7 county agencies. 285.8 The commissioner may enter into contractual agreements with 285.9 federally recognized Indian tribes with a reservation in 285.10 Minnesota to participate in state-operated computer systems 285.11 related to the management and administration of the food stamp, 285.12 income maintenance, child support enforcement, and medical 285.13 assistance and general assistance medical care programs to the 285.14 extent necessary for the tribe to operate a federally approved 285.15 family assistance program or any other program under the 285.16 supervision of the commissioner. 285.17 Sec. 9. Minnesota Statutes 1997 Supplement, section 285.18 256.031, subdivision 6, is amended to read: 285.19 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 285.20 the federal government, the field trials of the Minnesota family 285.21 investment plan will end June 30, 1998. 285.22 (b) Families in the comparison group under subdivision 3, 285.23 paragraph (d), clause (i), receiving aid to families with 285.24 dependent children under sections 256.72 to 256.87, and STRIDE 285.25 services under section 256.736 will continue in those programs 285.26 until June 30, 1998. After June 30, 1998, families who cease 285.27 receiving assistance under the Minnesota family investment plan 285.28 and comparison group families who cease receiving assistance 285.29 under AFDC and STRIDE who are eligible for the Minnesota family 285.30 investment program-statewide (MFIP-S), medical assistance, 285.31 general assistance medical care, or the food stamp program shall 285.32 be placed with their consent on the programs for which they are 285.33 eligible. 285.34 (c) Families who cease receiving assistance under the MFIP 285.35 and comparison families who cease receiving assistance under 285.36 AFDC and STRIDE who are ineligible for MFIP-S due to increased 286.1 income from employment, or increased child or spousal support or 286.2 a combination of employment income and child or spousal support, 286.3 shall be eligible for transition year child care under section 286.4 119B.05, and extended medical assistance under section 286.5 256B.0635. For the purpose of assistance for transition year 286.6 child care and determining receipt of extended medical 286.7 assistance, receipt of AFDC and MFIP shall be considered to be 286.8 the same as receipt of MFIP-S. 286.9 Sec. 10. Minnesota Statutes 1997 Supplement, section 286.10 256.741, is amended by adding a subdivision to read: 286.11 Subd. 2a. [FAMILIES-FIRST DISTRIBUTION OF CHILD SUPPORT 286.12 ARREARAGES.] When the public authority collects support 286.13 arrearages on behalf of an individual who is receiving 286.14 assistance provided under MFIP or MFIP-R under this chapter, 286.15 MFIP-S under chapter 256J, or work first under chapter 256K, and 286.16 the public authority has the option of applying the collection 286.17 to arrears permanently assigned to the state or to arrears 286.18 temporarily assigned to the state, the public authority shall 286.19 first apply the collection to satisfy those arrears that are 286.20 permanently assigned to the state. 286.21 Sec. 11. Minnesota Statutes 1997 Supplement, section 286.22 256.9864, is amended to read: 286.23 256.9864 [REPORTS BY RECIPIENT.] 286.24 (a) An assistance unit with a recent work history or with 286.25 earned income shall report monthly to the county agency on 286.26 income received and other circumstances affecting eligibility or 286.27 assistance amounts. All other assistance units shall report on 286.28 income and other circumstances affecting eligibility and 286.29 assistance amounts, as specified by the state agency. 286.30 (b) An assistance unit required to submit a report on the 286.31 form designated by the commissioner and within ten days of the 286.32 due date or the date of the significant change, whichever is 286.33 later, or otherwise report significant changes which would 286.34 affect eligibility or assistance amounts, is considered to have 286.35 continued its application for assistance effective the date the 286.36 required report is received by the county agency, if a complete 287.1 report is received within a calendar month in which assistance 287.2 was received, except that no assistance shall be paid for the287.3period beginning with the end of the month in which the report287.4was due and ending with the date the report was received by the287.5county agency. 287.6 Sec. 12. Minnesota Statutes 1997 Supplement, section 287.7 256B.062, is amended to read: 287.8 256B.062 [CONTINUED ELIGIBILITY.] 287.9 Medical assistance may be paid for persons who received aid 287.10 to families with dependent children in at least three of the six 287.11 months preceding the month in which the person became ineligible 287.12 for aid to families with dependent children, if the 287.13 ineligibility was due to an increase in hours of employment or 287.14 employment income or due to the loss of an earned income 287.15 disregard. A person who is eligible for extended medical 287.16 assistance is entitled to six months of assistance without 287.17 reapplication, unless the assistance unit ceases to include a 287.18 dependent child. For a person under 21 years of age, medical 287.19 assistance may not be discontinued within the six-month period 287.20 of extended eligibility until it has been determined that the 287.21 person is not otherwise eligible for medical assistance. 287.22 Medical assistance may be continued for an additional six months 287.23 if the person meets all requirements for the additional six 287.24 months, according to Title XIX of the Social Security Act, as 287.25 amended by section 303 of the Family Support Act of 1988, Public 287.26 Law Number 100-485. This section is repealed effectiveMarch 31287.27 July 1, 1998. 287.28 Sec. 13. Minnesota Statutes 1997 Supplement, section 287.29 256B.0635, is amended by adding a subdivision to read: 287.30 Subd. 3. [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 287.31 OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.] Upon federal 287.32 approval, medical assistance is available to persons who 287.33 received MFIP-S in at least three of the six months preceding 287.34 the month in which the person opted to discontinue receiving 287.35 MFIP-S cash assistance under section 256J.31, subdivision 12. A 287.36 person who is eligible for medical assistance under this section 288.1 may receive medical assistance without reapplication as long as 288.2 the person meets MFIP-S eligibility requirements, unless the 288.3 assistance unit does not include a dependent child. Medical 288.4 assistance may be paid pursuant to subdivisions 1 and 2 for 288.5 persons who are no longer eligible for MFIP-S due to increased 288.6 employment or child support. A person may be eligible for 288.7 MinnesotaCare due to increased employment or child support, and 288.8 as such must be informed of the option to transition onto 288.9 MinnesotaCare. 288.10 Sec. 14. Minnesota Statutes 1997 Supplement, section 288.11 256D.05, subdivision 8, is amended to read: 288.12 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 288.13 citizenship requirements for applicants and recipients under 288.14 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 288.15 256D.21 shall be determined the same as under section 256J.11,288.16except that legal noncitizens who are applicants or recipients288.17must have been residents of Minnesota on March 1, 1997. Legal288.18noncitizens who arrive in Minnesota after March 1, 1997, and288.19become elderly or disabled after that date, and are otherwise288.20eligible for general assistance can receive benefits under this288.21section. The income and assets of sponsors of noncitizens shall 288.22 be deemed available to general assistance applicants and 288.23 recipients according to the Personal Responsibility and Work 288.24 Opportunity Reconciliation Act of 1996, Public Law Number 288.25 104-193, title IV, sections 421 and 422, and subsequently set 288.26 out in federal rules. 288.27 (b) As a condition of eligibility, each legal adult 288.28 noncitizen in the assistance unit who has resided in the country 288.29 for four years or more and who is under 70 years of age must: 288.30 (1) be enrolled in a literacy class, English as a second 288.31 language class, or a citizen class; 288.32 (2) be applying for admission to a literacy class, English 288.33 as a second language class, and is on a waiting list; 288.34 (3) be in the process of applying for a waiver from the 288.35 Immigration and Naturalization Service of the English language 288.36 or civics requirements of the citizenship test; 289.1 (4) have submitted an application for citizenship to the 289.2 Immigration and Naturalization Service and is waiting for a 289.3 testing date or a subsequent swearing in ceremony; or 289.4 (5) have been denied citizenship due to a failure to pass 289.5 the test after two attempts or because of an inability to 289.6 understand the rights and responsibilities of becoming a United 289.7 States citizen, as documented by the Immigration and 289.8 Naturalization Service or the county. 289.9 If the county social service agency determines that a legal 289.10 noncitizen subject to the requirements of this subdivision will 289.11 require more than one year of English language training, then 289.12 the requirements of clause (1) or (2) shall be imposed after the 289.13 legal noncitizen has resided in the country for three years. 289.14 Individuals who reside in a facility licensed under chapter 289.15 144A, 144D, 245A, or 256I are exempt from the requirements of 289.16 this section. 289.17 Sec. 15. Minnesota Statutes 1996, section 256D.051, is 289.18 amended by adding a subdivision to read: 289.19 Subd. 18. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 289.20 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] 289.21 (a) To the extent of available resources, the commissioner 289.22 may waive the $400 service cost limit specified in subdivision 6 289.23 for county agencies who propose to provide enhanced services 289.24 under the food stamp employment and training program to 289.25 hard-to-employ individuals. A "hard-to-employ individual" is 289.26 defined as: 289.27 (1) a recipient of general assistance under chapter 256D; 289.28 or 289.29 (2) an individual with at least one of the following three 289.30 barriers to employment: 289.31 (i) the individual has not completed secondary school or 289.32 obtained a general equivalency development diploma or an adult 289.33 diploma, and has low skills in reading or mathematics; 289.34 (ii) the individual requires substance abuse treatment for 289.35 employment; and 289.36 (iii) the individual has a poor work history. 290.1 (b) To obtain a waiver, the county agency must submit a 290.2 waiver request to the commissioner. The request must specify: 290.3 (1) the number of hard-to-employ individuals the agency 290.4 plans to serve; 290.5 (2) the nature of the enhanced employment and training 290.6 services the agency will provide; and 290.7 (3) the agency's plan for providing referrals for substance 290.8 abuse assessment and treatment for hard-to-employ individuals 290.9 who require substance abuse treatment for employment. 290.10 Sec. 16. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 290.11 Subdivision 1. [PROGRAM ESTABLISHED.] For the period of 290.12 July 1, 1998, to June 30, 1999, the Minnesota food assistance 290.13 program is established to provide food assistance to legal 290.14 noncitizens residing in this state who are ineligible to 290.15 participate in the federal Food Stamp Program solely due to the 290.16 provisions of section 402 or 403 of Public Law Number 104-193, 290.17 as authorized by Title VII of the 1997 Emergency Supplemental 290.18 Appropriations Act, Public Law Number 105-18. 290.19 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 290.20 the Minnesota food assistance program, all of the following 290.21 conditions must be met: 290.22 (1) the applicant must meet the initial and ongoing 290.23 eligibility requirements for the federal Food Stamp Program, 290.24 except for the applicant's ineligible immigration status; 290.25 (2) the applicant must be either a qualified noncitizen as 290.26 defined in section 256J.08, subdivision 73, or a noncitizen 290.27 otherwise residing lawfully in the United States; 290.28 (3) the applicant must be a resident of the state; and 290.29 (4) the applicant must not be receiving assistance under 290.30 the MFIP-S or the work first program. 290.31 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 290.32 Minnesota food assistance program shall follow exactly the 290.33 regulations for the federal Food Stamp Program, except for the 290.34 provisions pertaining to immigration status under sections 402 290.35 or 403 of Public Law Number 104-193. 290.36 (b) The county agency shall use the income, budgeting, and 291.1 benefit allotment regulations of the federal Food Stamp Program 291.2 to calculate an eligible recipient's monthly Minnesota food 291.3 assistance program benefit. Until September 30, 1998, eligible 291.4 recipients under this subdivision shall receive the average per 291.5 person food stamp issuance in Minnesota in the fiscal year 291.6 ending June 30, 1997. Beginning October 1, 1998, eligible 291.7 recipients shall receive the same level of benefits as those 291.8 provided by the federal Food Stamp Program to similarly situated 291.9 citizen recipients. The monthly Minnesota food assistance 291.10 program benefits shall not exceed an amount equal to the amount 291.11 of federal Food Stamp Program benefits the household would 291.12 receive if all members of the household were eligible for the 291.13 federal Food Stamp Program. 291.14 (c) Minnesota food assistance program benefits must be 291.15 disregarded as income in all programs that do not count food 291.16 stamps as income. 291.17 (d) The county agency must redetermine a Minnesota food 291.18 assistance program recipient's eligibility for the federal Food 291.19 Stamp Program when the agency receives information that the 291.20 recipient's legal immigration status has changed in such a way 291.21 that would make the recipient potentially eligible for the 291.22 federal Food Stamp Program. 291.23 (e) Until October 1, 1998, the commissioner may provide 291.24 benefits under this section in cash. 291.25 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 291.26 submit a state plan to the secretary of agriculture to allow the 291.27 commissioner to purchase federal Food Stamp Program benefits for 291.28 each Minnesota food assistance program recipient who is 291.29 ineligible to participate in the federal Food Stamp Program 291.30 solely due to the provisions of section 402 or 403 of Public Law 291.31 Number 104-193, as authorized by Title VII of the 1997 Emergency 291.32 Supplemental Appropriations Act, Public Law Number 105-18. The 291.33 commissioner shall enter into a contract as necessary with the 291.34 secretary to use the existing federal Food Stamp Program 291.35 benefits delivery system for the purposes of administering the 291.36 Minnesota food assistance program under this section. 292.1 Sec. 17. Minnesota Statutes 1996, section 256D.46, 292.2 subdivision 2, is amended to read: 292.3 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 292.4 resources available to the recipient must be considered in 292.5 determining the recipient's ability to meet the emergency need. 292.6 Property that can be liquidated in time to resolve the emergency 292.7 and income,(excludingMinnesota supplemental aid issued for292.8current month's need)an amount equal to the Minnesota 292.9 supplemental aid standard of assistance, that is normally 292.10 disregarded or excluded under the Minnesota supplemental aid 292.11 program must be considered available to meet the emergency need. 292.12 Sec. 18. Minnesota Statutes 1997 Supplement, section 292.13 256J.02, subdivision 4, is amended to read: 292.14 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 292.15 of title I of Public Law Number 104-193, the Personal 292.16 Responsibility and Work Opportunity Reconciliation Act of 292.17 1996, as amended, the legislature may transfer money from the 292.18 TANF block grant to the child care fund under chapter 119B, or 292.19 the Title XX block grant under section 256E.07. 292.20 Sec. 19. Minnesota Statutes 1997 Supplement, section 292.21 256J.03, is amended to read: 292.22 256J.03 [TANF RESERVE ACCOUNT.] 292.23 Subdivision 1. TheMinnesota family investment292.24program-statewide/TANFTANF reserve account is created in the 292.25 state treasury. Funds retained or deposited in the TANF reserve 292.26 shall include: (1) funds designated by the legislatureand; (2) 292.27 unexpended state funds resulting from the acceleration of TANF 292.28 expenditures under subdivision 2; (3) earnings available from 292.29 the federal TANF block grant appropriated to the commissioner 292.30 but not expended in the biennium beginning July 1, 1997, shall292.31be retained; and (4) TANF funds available in fiscal years 1998, 292.32 1999, 2000, and 2001 that are not spent or not budgeted to be 292.33 spent in those years. 292.34 Funds deposited in the reserve accounttomust be expended 292.35 for the Minnesota family investment program-statewidein fiscal292.36year 2000 and subsequent fiscal yearsand directly related state 293.1 programs for the purposes in subdivision 3. 293.2 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 293.3 FUNDS.] The commissioner may expend federal TANF block grant 293.4 funds in excess of appropriated levels for the purpose of 293.5 accelerating federal funding of the MFIP program. By the end of 293.6 the fiscal year in which the additional federal expenditures are 293.7 made, the commissioner must deposit into the reserve account an 293.8 amount of unexpended state funds appropriated for assistance to 293.9 families grants, AFDC, and MFIP equal to the additional federal 293.10 expenditures. Reserve funds may be spent as TANF appropriations 293.11 if insufficient TANF funds are available because of acceleration. 293.12 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 293.13 reserve account may be used for the following purposes: 293.14 (1) unanticipated TANF block grant maintenance of effort 293.15 shortfalls; 293.16 (2) MFIP cost increases due to reduced federal revenues and 293.17 federal law changes; 293.18 (3) one-half of the MFIP general fund cost increase in 293.19 fiscal year 2000 and subsequent fiscal years due to caseload 293.20 increases over fiscal year 1999; and 293.21 (4) transfers allowed under section 256J.02, subdivision 4. 293.22 Sec. 20. Minnesota Statutes 1997 Supplement, section 293.23 256J.08, subdivision 11, is amended to read: 293.24 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 293.25 natural or adoptive parent or parents and stepparent who live in 293.26 the home with the minor child. For purposes of determining 293.27 eligibility for this program, caregiver also means any of the 293.28 following individuals, if adults, who live with and provide care 293.29 and support to a minor child when the minor child's natural or 293.30 adoptive parent or parents or stepparents do not reside in the 293.31 same home: legalcustodianscustodian or guardian, grandfather, 293.32 grandmother, brother, sister,stepfather, stepmother,293.33 stepbrother, stepsister, uncle, aunt, first cousin or first 293.34 cousin once removed, nephew, niece, person of preceding 293.35 generation as denoted by prefixes of "great," "great-great," or 293.36 "great-great-great," or a spouse of any person named in the 294.1 above groups even after the marriage ends by death or divorce. 294.2 Sec. 21. Minnesota Statutes 1997 Supplement, section 294.3 256J.08, is amended by adding a subdivision to read: 294.4 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 294.5 ineligible to receive MFIP-S due to noncooperation with program 294.6 requirements. Except for persons whose disqualification is 294.7 based on fraud, a disqualified person can take action to correct 294.8 the reason for ineligibility. 294.9 Sec. 22. Minnesota Statutes 1997 Supplement, section 294.10 256J.08, subdivision 26, is amended to read: 294.11 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 294.12 in-kind income earned through the receipt of wages, salary, 294.13 commissions, profit from employment activities, net profit from 294.14 self-employment activities, payments made by an employer for 294.15 regularly accrued vacation or sick leave, and any other profit 294.16 from activity earned through effort or labor. The income must 294.17 be in return for, or as a result of, legal activity. 294.18 Sec. 23. Minnesota Statutes 1997 Supplement, section 294.19 256J.08, subdivision 28, is amended to read: 294.20 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 294.21 set of circumstances that causes or threatens to cause 294.22 destitution to aminor childfamily with a child under age 21. 294.23 Sec. 24. Minnesota Statutes 1997 Supplement, section 294.24 256J.08, subdivision 40, is amended to read: 294.25 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 294.26 means earned income from employment before mandatory and 294.27 voluntary payroll deductions. Gross earned income includes 294.28 salaries, wages, tips, gratuities, commissions, incentive 294.29 payments from work or training programs, payments made by an 294.30 employer for regularly accrued vacation or sick leave, and 294.31 profits from other activity earned by an individual's effort or 294.32 labor. Gross earned income includes uniform and meal allowances 294.33 if federal income tax is deducted from the allowance. Gross 294.34 earned income includes flexible work benefits received from an 294.35 employer if the employee has the option of receiving the benefit 294.36 or benefits in cash. For self-employment, gross earned income 295.1 is the nonexcluded income minus expenses for the business. 295.2 Sec. 25. Minnesota Statutes 1997 Supplement, section 295.3 256J.08, is amended by adding a subdivision to read: 295.4 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 295.5 transitional standard" means a combination of the cash 295.6 assistance a family with no other income would have received in 295.7 the state of previous residence and the Minnesota food portion 295.8 for the appropriate size family. 295.9 Sec. 26. Minnesota Statutes 1997 Supplement, section 295.10 256J.08, is amended by adding a subdivision to read: 295.11 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 295.12 person who is under a legal obligation to provide care for a 295.13 minor and who is in fact providing care for a minor. For an 295.14 Indian child, "custodian" means any Indian person who has legal 295.15 custody of an Indian child under tribal law or custom, under 295.16 state law, or to whom temporary physical care, custody, and 295.17 control has been transferred by the parent of the child, as 295.18 provided in section 257.351, subdivision 8. 295.19 Sec. 27. Minnesota Statutes 1997 Supplement, section 295.20 256J.08, subdivision 60, is amended to read: 295.21 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 295.22 is living in the same home of a parent or other caregiver, is 295.23 not the parent of a child in the home, and is either less than 295.24 18 years of age or is under the age of 19 years and isregularly295.25attending asa full-time studentand is expected to complete a295.26high school orin a secondary school or pursuing a full-time 295.27 secondary level course of vocational or technical training 295.28 designed to fit students for gainful employmentbefore reaching295.29age 19. 295.30 Sec. 28. Minnesota Statutes 1997 Supplement, section 295.31 256J.08, is amended by adding a subdivision to read: 295.32 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 295.33 means a minor child's parent who does not live in the same home 295.34 as the child. 295.35 Sec. 29. Minnesota Statutes 1997 Supplement, section 295.36 256J.08, subdivision 68, is amended to read: 296.1 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 296.2 an item of value that is not real property, including the value 296.3 of a contract for deed held by a seller, assets held in trust on 296.4 behalf of members of an assistance unit,cash surrender value of296.5life insurance,value of a prepaid burial, savings account, 296.6 value of stocks and bonds, and value of retirement accounts. 296.7 Sec. 30. Minnesota Statutes 1997 Supplement, section 296.8 256J.08, subdivision 73, is amended to read: 296.9 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 296.10 means a person: 296.11 (1) who was lawfully admitted for permanent residence 296.12 pursuant to United States Code, title 8; 296.13 (2) who was admitted to the United States as a refugee 296.14 pursuant to United States Code, title 8; section 1157; 296.15 (3) whose deportation is being withheld pursuant to United 296.16 States Code, title 8, section 1253(h); 296.17 (4) who was paroled for a period of at least one year 296.18 pursuant to United States Code, title 8, section 1182(d)(5); 296.19 (5) who was granted conditional entry pursuant to United 296.20 State Code, title 8, section 1153(a)(7); 296.21 (6) who was granted asylum pursuant to United States Code, 296.22 title 8, section 1158;or296.23 (7) determined to be a battered noncitizen by the United 296.24 States Attorney General according to the Illegal Immigration 296.25 Reform and Immigrant Responsibility Act of 1996, Title V of the 296.26 Omnibus Consolidated Appropriations Bill, Public Law Number 296.27 104-208; 296.28 (8) who is a child of a noncitizen determined to be a 296.29 battered noncitizen by the United States Attorney General 296.30 according to the Illegal Immigration Reform and Responsibility 296.31 Act of 1996, title V, Public Law Number 104-200; or 296.32 (9) who was admitted as a Cuban or Haitian entrant. 296.33 Sec. 31. Minnesota Statutes 1997 Supplement, section 296.34 256J.08, is amended by adding a subdivision to read: 296.35 Subd. 82a. [SHARED HOUSEHOLD STANDARD.] "Shared household 296.36 standard" means the basic standard used when the household 297.1 includes an unrelated member. The cash portion of the shared 297.2 household standard is equal to 90 percent of the cash portion of 297.3 the transitional standard. The cash portion of the shared 297.4 household standard plus the food portion equals the full shared 297.5 household standard. 297.6 Sec. 32. Minnesota Statutes 1997 Supplement, section 297.7 256J.08, is amended by adding a subdivision to read: 297.8 Subd. 82b. [SHELTER COSTS.] "Shelter costs" means rent, 297.9 manufactured home lot rental costs, or monthly principal, 297.10 interest, insurance premiums, and property taxes due for 297.11 mortgages or contracts for deed. 297.12 Sec. 33. Minnesota Statutes 1997 Supplement, section 297.13 256J.08, subdivision 83, is amended to read: 297.14 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 297.15 a decline in gross income of3536 percent or more from the 297.16 income used to determine the grant for the current month. 297.17 Sec. 34. Minnesota Statutes 1997 Supplement, section 297.18 256J.08, is amended by adding a subdivision to read: 297.19 Subd. 86a. [UNRELATED MEMBER.] "Unrelated member" means an 297.20 individual in the household who does not meet the definition of 297.21 an eligible caregiver, but does not include an individual who 297.22 provides child care to a child in the assistance unit. 297.23 Sec. 35. Minnesota Statutes 1997 Supplement, section 297.24 256J.09, subdivision 6, is amended to read: 297.25 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 297.26 not delay a decision on eligibility or delay issuing the 297.27 assistance payment except to establish state residence as 297.28 provided in section 256J.12 by: 297.29 (1) treating the 30-day processing period as a waiting 297.30 period; 297.31 (2) delaying approval or issuance of the assistance payment 297.32 pending the decision of the county board; or 297.33 (3) awaiting the result of a referral to a county agency in 297.34 another county when the county receiving the application does 297.35 not believe it is the county of financial responsibility. 297.36 Sec. 36. Minnesota Statutes 1997 Supplement, section 298.1 256J.09, subdivision 9, is amended to read: 298.2 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 298.3 addendum to an existing application must be used to add persons 298.4 to an assistance unit regardless of whether the persons being 298.5 added are required to be in the assistance unit. When a person 298.6 is added by addendum to an assistance unit, eligibility for that 298.7 person begins on the first of the month the addendum was filed 298.8 except as provided in section 256J.74, subdivision 2, clause (1). 298.9 (b) An overpayment must be determined when a change in 298.10 household composition is not reported within the deadlines in 298.11 section 256J.30, subdivision 9. Any overpayment must be 298.12 calculated from the month of the change including the needs, 298.13 income, and assets of any individual who is required to be 298.14 included in the assistance unit under section 256J.24, 298.15 subdivision 2. Individuals not included in the assistance unit 298.16 who are identified in section 256J.37, subdivisions 1 to 2, must 298.17 have their income and assets considered when determining the 298.18 amount of the overpayment. 298.19 Sec. 37. Minnesota Statutes 1997 Supplement, section 298.20 256J.11, subdivision 2, as amended by Laws 1997, Third Special 298.21 Session chapter 1, is amended to read: 298.22 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 298.23 September 1, 1997, to October 31, 1997, noncitizens who do not 298.24 meet one of the exemptions in section 412 of the Personal 298.25 Responsibility and Work Opportunity Reconciliation Act of 1996, 298.26 but were residing in this state as of July 1, 1997, are eligible 298.27 for the 6/10 of the average value of food stamps for the same 298.28 family size and composition until MFIP-S is operative in the 298.29 noncitizen's county of financial responsibility and thereafter, 298.30 the 6/10 of the food portion of MFIP-S. However, federal food 298.31 stamp dollars cannot be used to fund the food portion of MFIP-S 298.32 benefits for an individual under this subdivision. 298.33 (b) For the period November 1, 1997, to June 30,19981999, 298.34 noncitizens who do not meet one of the exemptions in section 412 298.35 of the Personal Responsibility and Work Opportunity 298.36 Reconciliation Act of 1996,but were residing in this state as299.1of July 1, 1997,and are receiving cash assistance under the 299.2 AFDC, family general assistance, MFIP or MFIP-S programs are 299.3 eligible for the average value of food stamps for the same 299.4 family size and composition until MFIP-S is operative in the 299.5 noncitizen's county of financial responsibility and thereafter, 299.6 the food portion of MFIP-S. However, federal food stamp dollars 299.7 cannot be used to fund the food portion of MFIP-S benefits for 299.8 an individual under this subdivision. The assistance provided 299.9 under this subdivision, which is designated as a supplement to 299.10 replace lost benefits under the federal food stamp program, must 299.11 be disregarded as income in all programs that do not count food 299.12 stamps as income where the commissioner has the authority to 299.13 make the income disregard determination for the program. 299.14 (c) The commissioner shall submit a state plan to the 299.15 secretary of agriculture to allow the commissioner to purchase 299.16 federal Food Stamp Program benefits in an amount equal to the 299.17 MFIP-S food portion for each legal noncitizen receiving MFIP-S 299.18 assistance who is ineligible to participate in the federal Food 299.19 Stamp Program solely due to the provisions of section 402 or 403 299.20 of Public Law Number 104-193, as authorized by Title VII of the 299.21 1997 Emergency Supplemental Appropriations Act, Public Law 299.22 Number 105-18. The commissioner shall enter into a contract as 299.23 necessary with the secretary to use the existing federal Food 299.24 Stamp Program benefits delivery system for the purposes of 299.25 administering the food portion of MFIP-S under this subdivision. 299.26 Sec. 38. Minnesota Statutes 1997 Supplement, section 299.27 256J.12, is amended to read: 299.28 256J.12 [MINNESOTA RESIDENCE.] 299.29 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 299.30 or MFIP-S, whichever is in effect,a familyan assistance unit 299.31 must have established residency in this state which means 299.32 thefamilyassistance unit is present in the state and intends 299.33 to remain here. A person who lives in this state and who 299.34 entered this state with a job commitment or to seek employment 299.35 in this state, whether or not that person is currently employed, 299.36 meets the criteria in this subdivision. 300.1 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 300.2 assistance unit is considered to have established residency in 300.3 this state only when a child or caregiver has resided in this 300.4 state for at least 30 days with the intention of making the 300.5 person's home here and not for any temporary purpose. The birth 300.6 of a child in Minnesota to a member of the assistance unit does 300.7 not automatically establish the residency in this state under 300.8 this subdivision of the other members of the assistance unit. 300.9 Time spent in a shelter for battered women shall count toward 300.10 satisfying the 30-day residency requirement. 300.11 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 300.12 residency requirement where unusual hardship would result from 300.13 denial of assistance. 300.14 (b) For purposes of this section, unusual hardship meansa300.15familyan assistance unit: 300.16 (1) is without alternative shelter; or 300.17 (2) is without available resources for food. 300.18 (c) For purposes of this subdivision, the following 300.19 definitions apply (1) "metropolitan statistical area" is as 300.20 defined by the U.S. Census Bureau; (2) "alternative shelter" 300.21 includes any shelter that is located within the metropolitan 300.22 statistical area containing the county and for which the family 300.23 is eligible, provided thefamilyassistance unit does not have 300.24 to travel more than 20 miles to reach the shelter and has access 300.25 to transportation to the shelter. Clause (2) does not apply to 300.26 counties in the Minneapolis-St. Paul metropolitan statistical 300.27 area. 300.28 (d) Applicants are considered to meet the residency 300.29 requirement under subdivision 1a if they once resided in 300.30 Minnesota and: 300.31 (1) joined the United States armed services, returned to 300.32 Minnesota within 30 days of leaving the armed services, and 300.33 intend to remain in Minnesota; or 300.34 (2) left to attend school in another state, paid 300.35 nonresident tuition or Minnesota tuition rates under a 300.36 reciprocity agreement, and returned to Minnesota within 30 days 301.1 of graduation with the intent to remain in Minnesota. 301.2 (e) The 30-day residence requirement is met when: 301.3 (1) a minor child or a minor caregiver moves from another 301.4 state to the residence of a relative caregiver; 301.5 (2) the minor caregiver applies for and receives family 301.6 cash assistance; 301.7 (3) the relative caregiver chooses not to be part of the 301.8 MFIP-S assistance unit; and 301.9 (4) the relative caregiver has resided in Minnesota for at 301.10 least 30 days prior to the date the assistance unit applies for 301.11 cash assistance. 301.12 (f) Ineligible mandatory unit members who have resided in 301.13 Minnesota for 12 months immediately before the unit's date of 301.14 application establish the other assistance unit members' 301.15 eligibility for the MFIP-S transitional standard. 301.16 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 301.17 in section 256J.08, and their immediate families are exempt from 301.18 the requirements of subdivisions 1 and 1a, provided the migrant 301.19 worker provides verification that the migrant family worked in 301.20 this state within the last 12 months and earned at least $1,000 301.21 in gross wages during the time the migrant worker worked in this 301.22 state. 301.23 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 301.24 to an eligiblefamilyassistance unit in which all members have 301.25 resided in this state for fewer than 12 consecutive calendar 301.26 months immediately preceding the date of application shall be at 301.27 the standard and in the form specified in section 256J.43. 301.28 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 301.29 section is enjoined from implementation or found 301.30 unconstitutional by any court of competent jurisdiction, the 301.31 remaining subdivisions shall remain valid and shall be given 301.32 full effect. 301.33 Sec. 39. Minnesota Statutes 1997 Supplement, section 301.34 256J.14, is amended to read: 301.35 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 301.36 (a) The definitions in this paragraph only apply to this 302.1 subdivision. 302.2 (1) "Household of a parent, legal guardian, or other adult 302.3 relative" means the place of residence of: 302.4 (i) a natural or adoptive parent; 302.5 (ii) a legal guardian according to appointment or 302.6 acceptance under section 260.242, 525.615, or 525.6165, and 302.7 related laws;or302.8 (iii) a caregiver as defined in section 256J.08, 302.9 subdivision 11; or 302.10 (iv) an appropriate adult relative designated by a county 302.11 agency. 302.12 (2) "Adult-supervised supportive living arrangement" means 302.13 a private family setting which assumes responsibility for the 302.14 care and control of the minor parent and minor child, or other 302.15 living arrangement, not including a public institution, licensed 302.16 by the commissioner of human services which ensures that the 302.17 minor parent receives adult supervision and supportive services, 302.18 such as counseling, guidance, independent living skills 302.19 training, or supervision. 302.20 (b) A minor parent and the minor child who is in the care 302.21 of the minor parent must reside in the household of a parent, 302.22 legal guardian, otherappropriateadult relative,or other302.23caregiver,or in an adult-supervised supportive living 302.24 arrangement in order to receive MFIP-S unless: 302.25 (1) the minor parent has no living parent, other 302.26appropriateadult relative, or legal guardian whose whereabouts 302.27 is known; 302.28 (2) no living parent, otherappropriateadult relative, or 302.29 legal guardian of the minor parent allows the minor parent to 302.30 live in the parent's,appropriateother adult relative's, or 302.31 legal guardian's home; 302.32 (3) the minor parent lived apart from the minor parent's 302.33 own parent or legal guardian for a period of at least one year 302.34 before either the birth of the minor child or the minor parent's 302.35 application for MFIP-S; 302.36 (4) the physical or emotional health or safety of the minor 303.1 parent or minor child would be jeopardized if the minor parent 303.2 and the minor child resided in the same residence with the minor 303.3 parent's parent, otherappropriateadult relative, or legal 303.4 guardian; or 303.5 (5) an adult supervised supportive living arrangement is 303.6 not available for the minor parent andthe dependentchild in 303.7 the county in which the minor parent and child currentlyresides303.8 reside. If an adult supervised supportive living arrangement 303.9 becomes available within the county, the minor parent and child 303.10 must reside in that arrangement. 303.11 (c) Minor applicants must be informed orally and in writing 303.12 about the eligibility requirements and their rights and 303.13 obligations under the MFIP-S program. The county must advise 303.14 the minor of the possible exemptions and specifically ask 303.15 whether one or more of these exemptions is applicable. If the 303.16 minor alleges one or more of these exemptions, then the county 303.17 must assist the minor in obtaining the necessary verifications 303.18 to determine whether or not these exemptions apply. 303.19 (d) If the county worker has reason to suspect that the 303.20 physical or emotional health or safety of the minor parent or 303.21 minor child would be jeopardized if they resided with the minor 303.22 parent's parent, other adult relative, or legal guardian, then 303.23 the county worker must make a referral to child protective 303.24 services to determine if paragraph (b), clause (4), applies. A 303.25 new determination by the county worker is not necessary if one 303.26 has been made within the last six months, unless there has been 303.27 a significant change in circumstances which justifies a new 303.28 referral and determination. 303.29 (e) If a minor parent is not living with a parentor, legal 303.30 guardian, or other adult relative due to paragraph (b), clause 303.31 (1), (2), or (4), the minor parent must reside, when possible, 303.32 in a living arrangement that meets the standards of paragraph 303.33 (a), clause (2). 303.34 (f) When a minor parent and minor child live withanothera 303.35 parent, other adult relative, legal guardian, or in an 303.36 adult-supervised supportive living arrangement, MFIP-S must be 304.1 paid, when possible, in the form of a protective payment on 304.2 behalf of the minor parent and minor childin accordance with304.3 according to section 256J.39, subdivisions 2 to 4. 304.4 Sec. 40. Minnesota Statutes 1997 Supplement, section 304.5 256J.15, subdivision 2, is amended to read: 304.6 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.] To receive 304.7 assistanceunder MFIP-S,when a member of an assistance unitwho304.8 is on strike, or when an individual identified under section 304.9 256J.37, subdivisions 1 to 2, whose income and assets must be 304.10 considered when determining the unit's eligibility is on strike, 304.11 the assistance unit must have beenanreceiving MFIP-S 304.12participant on the day before the strike,or have been eligible 304.13 for MFIP-S on the day before the strike. 304.14 The county agency must count the striker's prestrike 304.15 earnings as current earnings.WhenA significant change cannot 304.16 be invoked when a member of an assistance unit, or an individual 304.17 identified under section 256J.37, subdivisions 1 to 2, is on 304.18 strike. A member of an assistance unitwho, or an individual 304.19 identified under section 256J.37, subdivisions 1 to 2, is not 304.20 considered a striker when that person is not in the bargaining 304.21 unit that voted for the strike and does not cross the picket 304.22 line for fear of personal injury, the assistance unit member is304.23not a striker. Except for a member of an assistance unit who is304.24not in the bargaining unit that voted for the strike and who304.25does not cross the picket line for fear of personal injury, a304.26significant change cannot be invoked as a result of a labor304.27dispute. 304.28 Sec. 41. Minnesota Statutes 1997 Supplement, section 304.29 256J.20, subdivision 2, is amended to read: 304.30 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 304.31 property by an applicant or participant is subject to the 304.32 limitations in paragraphs (a) and (b). 304.33 (a) A county agency shall exclude the homestead of an 304.34 applicant or participant according to clauses (1) to(4)(5): 304.35 (1) an applicant or participant who is purchasing real 304.36 property through a contract for deed and using that property as 305.1 a home is considered the owner of real property; 305.2 (2) the total amount of land that can be excluded under 305.3 this subdivision is limited to surrounding property which is not 305.4 separated from the home by intervening property owned by 305.5 others. Additional property must be assessed as to its legal 305.6 and actual availability according to subdivision 1; 305.7 (3) when real property that has been used as a home by a 305.8 participant is sold, the county agency must treat the cash 305.9 proceeds from the sale as excluded property for six months when 305.10 the participant intends to reinvest the proceeds in another home 305.11 and maintains those proceeds, unused for other purposes, in a 305.12 separate account;and305.13 (4) when the homestead is jointly owned, but the client 305.14 does not reside in it because of legal separation, pending 305.15 divorce, or battering or abuse by the spouse or partner, the 305.16 homestead is excluded.; and 305.17 (5) the homestead shall continue to be excluded if it is 305.18 temporarily unoccupied due to employment, illness, or as the 305.19 result of compliance with a county-approved employability plan. 305.20 The education, training, or job search must be within the state, 305.21 but can be outside the immediate geographic area. A homestead 305.22 temporarily unoccupied because it is not habitable due to a 305.23 casualty or natural disaster is excluded. The homestead is 305.24 excluded during periods only if the client intends to return to 305.25 it. 305.26 (b) The equity value of real property that is not excluded 305.27 under paragraph (a) and which is legally available must be 305.28 applied against the limits in subdivision 3. When the equity 305.29 value of the real property exceeds the limits under subdivision 305.30 3, the applicant or participant may qualify to receive 305.31 assistance when the applicant or participant continues to make a 305.32 good faith effort to sell the property and signs a legally 305.33 binding agreement to repay the amount of assistance, less child 305.34 support collected by the agency. Repayment must be made within 305.35 five working days after the property is sold. Repayment to the 305.36 county agency must be in the amount of assistance received or 306.1 the proceeds of the sale, whichever is less. 306.2 Sec. 42. Minnesota Statutes 1997 Supplement, section 306.3 256J.20, subdivision 3, is amended to read: 306.4 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 306.5 MFIP-S, the equity value of all nonexcluded real and personal 306.6 property of the assistance unit must not exceed $2,000 for 306.7 applicants and $5,000 for ongoingrecipientsparticipants. The 306.8 value of assets in clauses (1) to(18)(20) must be excluded 306.9 when determining the equity value of real and personal property: 306.10 (1) a licensedvehiclesvehicle up to atotal marketloan 306.11 value of less than or equal to $7,500. The county agency shall 306.12 apply any excessmarketloan value as if it were equity value to 306.13 the asset limit described in this section. If the assistance 306.14 unit owns more than one licensed vehicle, the county agency 306.15 shall determine the vehicle with the highestmarketloan value 306.16 and count only themarketloan value over $7,500. The county 306.17 agency shall count themarketloan value of all other vehicles 306.18 and apply this amount as if it were equity value to the asset 306.19 limit described in this section. The value of special equipment 306.20 for a handicapped member of the assistance unit is excluded. To 306.21 establish themarketloan value of vehicles, a county agency 306.22 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 306.23 for newer model cars.The N.A.D.A. Official Used Car Guide,306.24Midwest Edition, is incorporated by reference.When a vehicle 306.25 is not listed in the guidebook, or when the applicant or 306.26 participant disputes the loan value listed in the guidebook as 306.27 unreasonable given the condition of the particular vehicle, the 306.28 county agency may require the applicant or participantto306.29 document the loan value by securing a written statement from a 306.30 motor vehicle dealer licensed under section 168.27, stating the 306.31 amount that the dealer would pay to purchase the vehicle. The 306.32 county agency shall reimburse the applicant or participant for 306.33 the cost of a written statement that documents a lower loan 306.34 value; 306.35 (2) the value of life insurance policies for members of the 306.36 assistance unit; 307.1 (3) one burial plot per member of an assistance unit; 307.2 (4) the value of personal property needed to produce earned 307.3 income, including tools, implements, farm animals, inventory, 307.4 business loans, business checking and savings accounts used at 307.5 least annually and used exclusively for the operation of a 307.6 self-employment business, and any motor vehicles if the vehicles 307.7 are essential for the self-employment business; 307.8 (5) the value of personal property not otherwise specified 307.9 which is commonly used by household members in day-to-day living 307.10 such as clothing, necessary household furniture, equipment, and 307.11 other basic maintenance items essential for daily living; 307.12 (6) the value of real and personal property owned by a 307.13 recipient of Supplemental Security Income or Minnesota 307.14 supplemental aid; 307.15 (7) the value of corrective payments, but only for the 307.16 month in which the payment is received and for the following 307.17 month; 307.18 (8) a mobile home used by an applicant or participant as 307.19 the applicant's or participant's home; 307.20 (9) money in a separate escrow account that is needed to 307.21 pay real estate taxes or insurance and that is used for this 307.22 purpose; 307.23 (10) money held in escrow to cover employee FICA, employee 307.24 tax withholding, sales tax withholding, employee worker 307.25 compensation, business insurance, property rental, property 307.26 taxes, and other costs that are paid at least annually, but less 307.27 often than monthly; 307.28 (11) monthly assistanceand, emergency assistance, and 307.29 diversionary payments for the current month's needs; 307.30 (12) the value of school loans, grants, or scholarships for 307.31 the period they are intended to cover; 307.32 (13) payments listed in section 256J.21, subdivision 2, 307.33 clause (9), which are held in escrow for a period not to exceed 307.34 three months to replace or repair personal or real property; 307.35 (14) income received in a budget month through the end of 307.36 thebudgetpayment month; 308.1 (15) savings from earned income of a minor child or a minor 308.2 parent that are set aside in a separate account designated 308.3 specifically for future education or employment costs; 308.4 (16) the federal earned incometaxcreditand, Minnesota 308.5 working family credit, state and federal income tax refunds, 308.6 state homeowners and renters credits under chapter 290A, 308.7 property tax rebates under Laws 1997, chapter 231, article 1, 308.8 section 16, and other federal or state tax rebates in the month 308.9 received and the following month; 308.10 (17) payments excluded under federal law as long as those 308.11 payments are held in a separate account from any nonexcluded 308.12 funds;and308.13 (18) money received by a participant of the corps to career 308.14 program under section 84.0887, subdivision 2, paragraph (b), as 308.15 a postservice benefit under the federal Americorps Act; 308.16 (19) the assets of children ineligible to receive MFIP-S 308.17 benefits because foster care or adoption assistance payments are 308.18 made on their behalf; and 308.19 (20) the assets of persons whose income is excluded under 308.20 section 256J.21, subdivision 2, clause 43. 308.21 Sec. 43. Minnesota Statutes 1997 Supplement, section 308.22 256J.21, is amended to read: 308.23 256J.21 [INCOME LIMITATIONS.] 308.24 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 308.25 eligibility, the county agency must evaluate income received by 308.26 members of an assistance unit, or by other persons whose income 308.27 is considered available to the assistance unit, and only count 308.28 income that is available to the member of the assistance unit. 308.29 Income is available if the individual has legal access to the 308.30 income. All payments, unless specifically excluded in 308.31 subdivision 2, must be counted as income. 308.32 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 308.33 excluded in determining a family's available income: 308.34 (1) payments for basic care, difficulty of care, and 308.35 clothing allowances received for providing family foster care to 308.36 children or adults under Minnesota Rules, parts 9545.0010 to 309.1 9545.0260 and 9555.5050 to 9555.6265, and payments received and 309.2 used for care and maintenance of a third-party beneficiary who 309.3 is not a household member; 309.4 (2) reimbursements for employment training received through 309.5 the Job Training Partnership Act, United States Code, title 29, 309.6 chapter 19, sections 1501 to 1792b; 309.7 (3) reimbursement for out-of-pocket expenses incurred while 309.8 performing volunteer services, jury duty, or employment; 309.9 (4) all educational assistance, except the county agency 309.10 must count graduate student teaching assistantships, 309.11 fellowships, and other similar paid work as earned income and, 309.12 after allowing deductions for any unmet and necessary 309.13 educational expenses, shall count scholarships or grants awarded 309.14 to graduate students that do not require teaching or research as 309.15 unearned income; 309.16 (5) loans, regardless of purpose, from public or private 309.17 lending institutions, governmental lending institutions, or 309.18 governmental agencies; 309.19 (6) loans from private individuals, regardless of purpose, 309.20 provided an applicant or participant documents that the lender 309.21 expects repayment; 309.22 (7)(i) stateand federalincome tax refunds; and 309.23 (ii) federal income tax refunds; 309.24 (8)(i)state andfederal earned income credits; 309.25 (ii) Minnesota working family credits; 309.26 (iii) state homeowners and renters credits under chapter 309.27 290A; 309.28 (iv) property tax rebates under Laws 1997, chapter 231, 309.29 article 1, section 16; and 309.30 (v) other federal or state tax rebates; 309.31 (9) funds received for reimbursement, replacement, or 309.32 rebate of personal or real property when these payments are made 309.33 by public agencies, awarded by a court, solicited through public 309.34 appeal, or made as a grant by a federal agency, state or local 309.35 government, or disaster assistance organizations, subsequent to 309.36 a presidential declaration of disaster; 310.1 (10) the portion of an insurance settlement that is used to 310.2 pay medical, funeral, and burial expenses, or to repair or 310.3 replace insured property; 310.4 (11) reimbursements for medical expenses that cannot be 310.5 paid by medical assistance; 310.6 (12) payments by a vocational rehabilitation program 310.7 administered by the state under chapter 268A, except those 310.8 payments that are for current living expenses; 310.9 (13) in-kind income, including any payments directly made 310.10 by a third party to a provider of goods and services; 310.11 (14) assistance payments to correct underpayments, but only 310.12 for the month in which the payment is received; 310.13 (15) emergency assistance payments; 310.14 (16) funeral and cemetery payments as provided by section 310.15 256.935; 310.16 (17) nonrecurring cash gifts of $30 or less, not exceeding 310.17 $30 per participant in a calendar month; 310.18 (18) any form of energy assistance payment made through 310.19 Public Law Number 97-35, Low-Income Home Energy Assistance Act 310.20 of 1981, payments made directly to energy providers by other 310.21 public and private agencies, and any form of credit or rebate 310.22 payment issued by energy providers; 310.23 (19) Supplemental Security Income, including retroactive 310.24 payments; 310.25 (20) Minnesota supplemental aid, including retroactive 310.26 payments; 310.27 (21) proceeds from the sale of real or personal property; 310.28 (22) adoption assistance payments under section 259.67; 310.29 (23) state-funded family subsidy program payments made 310.30 under section 252.32 to help families care for children with 310.31 mental retardation or related conditions; 310.32 (24) interest payments and dividends from property that is 310.33 not excluded from and that does not exceed the asset limit; 310.34 (25) rent rebates; 310.35 (26) income earned by a minor caregiver or minor child who 310.36 is at least a half-time student in an approved secondary 311.1 education program; 311.2 (27) income earned by a caregiver under age 20 who is at 311.3 least a half-time student in an approved secondary education 311.4 program; 311.5 (28) MFIP-S child care payments under section 119B.05; 311.6 (29) all other payments made through MFIP-S to support a 311.7 caregiver's pursuit of greater self-support; 311.8 (30) income a participant receives related to shared living 311.9 expenses; 311.10 (31) reverse mortgages; 311.11 (32) benefits provided by the Child Nutrition Act of 1966, 311.12 United States Code, title 42, chapter 13A, sections 1771 to 311.13 1790; 311.14 (33) benefits provided by the women, infants, and children 311.15 (WIC) nutrition program, United States Code, title 42, chapter 311.16 13A, section 1786; 311.17 (34) benefits from the National School Lunch Act, United 311.18 States Code, title 42, chapter 13, sections 1751 to 1769e; 311.19 (35) relocation assistance for displaced persons under the 311.20 Uniform Relocation Assistance and Real Property Acquisition 311.21 Policies Act of 1970, United States Code, title 42, chapter 61, 311.22 subchapter II, section 4636, or the National Housing Act, United 311.23 States Code, title 12, chapter 13, sections 1701 to 1750jj; 311.24 (36) benefits from the Trade Act of 1974, United States 311.25 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 311.26 (37) war reparations payments to Japanese Americans and 311.27 Aleuts under United States Code, title 50, sections 1989 to 311.28 1989d; 311.29 (38) payments to veterans or their dependents as a result 311.30 of legal settlements regarding Agent Orange or other chemical 311.31 exposure under Public Law Number 101-239, section 10405, 311.32 paragraph (a)(2)(E); 311.33 (39) income that is otherwise specifically excluded from 311.34 the MFIP-S program consideration in federal law, state law, or 311.35 federal regulation; 311.36 (40) security and utility deposit refunds; 312.1 (41) American Indian tribal land settlements excluded under 312.2 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 312.3 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 312.4 reservations and payments to members of the White Earth Band, 312.5 under United States Code, title 25, chapter 9, section 331, and 312.6 chapter 16, section 1407; 312.7 (42) all income of the minor parent's parent and stepparent 312.8 when determining the grant for the minor parent in households 312.9 that include a minor parent living with a parent or stepparent 312.10 on MFIP-S with otherdependentchildren; and 312.11 (43) income of the minor parent's parent and stepparent 312.12 equal to 200 percent of the federal poverty guideline for a 312.13 family size not including the minor parent and the minor 312.14 parent's child in households that include a minor parent living 312.15 with a parent or stepparent not on MFIP-S when determining the 312.16 grant for the minor parent. The remainder of income is deemed 312.17 as specified in section 256J.37, subdivision11b; 312.18 (44) payments made to children eligible for relative 312.19 custody assistance under section 257.85; 312.20 (45) vendor payments for goods and services made on behalf 312.21 of a client unless the client has the option of receiving the 312.22 payment in cash; and 312.23 (46) the principal portion of a contract for deed payment. 312.24 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 312.25 determine initial eligibility by considering all earned and 312.26 unearned income that is not excluded under subdivision 2. To be 312.27 eligible for MFIP-S, the assistance unit's countable income 312.28 minus the disregards in paragraphs (a) and (b) must be below the 312.29 transitional standard of assistance according to section 256J.24 312.30 for that size assistance unit. 312.31 (a) The initial eligibility determination must disregard 312.32 the following items: 312.33 (1) the employment disregard is 18 percent of the gross 312.34 earned income whether or not the member is working full time or 312.35 part time; 312.36 (2) dependent care costs must be deducted from gross earned 313.1 income for the actual amount paid for dependent care up tothea 313.2 maximumdisregard allowedof $200 per month for each child less 313.3 than two years of age, and $175 per month for each child two 313.4 years of age and older under this chapter and chapter 119B;and313.5 (3) all payments made according to a court order 313.6 for spousal support or the support of children not living in the 313.7 assistance unit's household shall be disregarded from the income 313.8 of the person with the legal obligation to pay support, provided 313.9 that, if there has been a change in the financial circumstances 313.10 of the person with the legal obligation to pay support since the 313.11 support order was entered, the person with the legal obligation 313.12 to pay support has petitioned for a modification of the support 313.13 order; and 313.14 (4) an allocation for the unmet need of an ineligible 313.15 spouse or an ineligible child under the age of 21 for whom the 313.16 caregiver is financially responsible and who lives with the 313.17 caregiver according to section 256J.36. 313.18 (b) Notwithstanding paragraph (a), when determining initial 313.19 eligibility forapplicants who haveapplicant units when at 313.20 least one member has received AFDC, family general assistance, 313.21 MFIP, MFIP-R, work first, or MFIP-S in this state within four 313.22 months of the most recent application for MFIP-S, the employment 313.23 disregard for all unit members is 36 percent of the gross earned 313.24 income. 313.25 After initial eligibility is established, the assistance 313.26 payment calculation is based on the monthly income test. 313.27 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 313.28 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 313.29 eligibility and the assistance payment amount according to the 313.30 monthly income test. To be eligible for MFIP-S, the result of 313.31 the computations in paragraphs (a) to (e) must be at least $1. 313.32 (a) Apply a 36 percent income disregard to gross earnings 313.33 and subtract this amount from the family wage level. If the 313.34 difference is equal to or greater than the transitional 313.35 standard, the assistance payment is equal to the transitional 313.36 standard. If the difference is less than the transitional 314.1 standard, the assistance payment is equal to the difference. 314.2 The employment disregard in this paragraph must be deducted 314.3 every month there is earned income. 314.4 (b) All payments made according to a court order 314.5 for spousal support or the support of children not living in the 314.6 assistance unit's household must be disregarded from the income 314.7 of the person with the legal obligation to pay support, provided 314.8 that, if there has been a change in the financial circumstances 314.9 of the person with the legal obligation to pay support since the 314.10 support order was entered, the person with the legal obligation 314.11 to pay support has petitioned for a modification of the court 314.12 order. 314.13 (c) An allocation for the unmet need of an ineligible 314.14 spouse or an ineligible child under the age of 21 for whom the 314.15 caregiver is financially responsible and who lives with the 314.16 caregiver must be made according to section 256J.36. 314.17 (d) Subtract unearned income dollar for dollar from the 314.18 transitional standard to determine the assistance payment amount. 314.19(d)(e) When income is both earned and unearned, the amount 314.20 of the assistance payment must be determined by first treating 314.21 gross earned income as specified in paragraph (a). After 314.22 determining the amount of the assistance payment under paragraph 314.23 (a), unearned income must be subtracted from that amount dollar 314.24 for dollar to determine the assistance payment amount. 314.25(e)(f) When the monthly income is greater than the 314.26 transitional or family wage level standard after applicable 314.27 deductions and the income will only exceed the standard for one 314.28 month, the county agency must suspend the assistance payment for 314.29 the payment month. 314.30 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 314.31 members of the assistance unit must be counted. Income may also 314.32 be deemed from ineligible persons to the assistance unit. 314.33 Income must be attributed to the person who earns it or to the 314.34 assistance unit according to paragraphs (a) to (c). 314.35 (a) Funds distributed from a trust, whether from the 314.36 principal holdings or sale of trust property or from the 315.1 interest and other earnings of the trust holdings, must be 315.2 considered income when the income is legally available to an 315.3 applicant or participant. Trusts are presumed legally available 315.4 unless an applicant or participant can document that the trust 315.5 is not legally available. 315.6 (b) Income from jointly owned property must be divided 315.7 equally among property owners unless the terms of ownership 315.8 provide for a different distribution. 315.9 (c) Deductions are not allowed from the gross income of a 315.10 financially responsible household member or by the members of an 315.11 assistance unit to meet a current or prior debt. 315.12 Sec. 44. Minnesota Statutes 1997 Supplement, section 315.13 256J.24, subdivision 1, is amended to read: 315.14 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 315.15 assistance unit is either a group of individuals with at least 315.16 one minor child who live together whose needs, assets, and 315.17 income are considered together and who receive MFIP-S 315.18 assistance, or a pregnant woman and her spouse whoreceives315.19 receive MFIP-S assistance. 315.20 Individuals identified in subdivision 2 must be included in 315.21 the MFIP-S assistance unit. Individuals identified in 315.22 subdivision 3must be excluded from the assistance unitare 315.23 ineligible to receive MFIP-S. Individuals identified in 315.24 subdivision 4 may be included in the assistance unit at their 315.25 option. Individuals not included in the assistance unit who are 315.26 identified in section 256J.37,subdivisionsubdivisions 1orto 315.27 2, must have their income and assets considered when determining 315.28 eligibility and benefits for an MFIP-S assistance unit. All 315.29 assistance unit members, whether mandatory or elective, who live 315.30 together and for whom one caregiver or two caregivers apply must 315.31 be included in a single assistance unit. 315.32 Sec. 45. Minnesota Statutes 1997 Supplement, section 315.33 256J.24, subdivision 2, is amended to read: 315.34 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 315.35 for minor caregivers and their children whoaremust be in a 315.36 separate assistance unit from the other persons in the 316.1 household, when the following individuals live together, they 316.2 must be included in the assistance unit: 316.3 (1) a minor child, including a pregnant minor; 316.4 (2) the minor child's siblings, half-siblings, and 316.5 step-siblings;and316.6 (3) the minor child's natural, adoptive parents, and 316.7 stepparents; and 316.8 (4) the spouse of a pregnant woman. 316.9 Sec. 46. Minnesota Statutes 1997 Supplement, section 316.10 256J.24, subdivision 3, is amended to read: 316.11 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 316.12 ASSISTANCE UNIT.] (a) The following individualsmust be excluded316.13from an assistance unitwho are part of the assistance unit 316.14 determined under subdivision 2 are ineligible to receive MFIP-S: 316.15 (1) individuals receiving Supplemental Security Income or 316.16 Minnesota supplemental aid; 316.17 (2) individuals living at home while performing 316.18 court-imposed, unpaid community service work due to a criminal 316.19 conviction; 316.20 (3) individuals disqualified from the food stamp program or 316.21 MFIP-S, until the disqualification ends; 316.22 (4) children on whose behalf federal, state or local foster 316.23 care paymentsunder title IV-E of the Social Security Actare 316.24 made, except as provided insectionsections 256J.13, 316.25 subdivision 2, and 256J.74, subdivision 2; and 316.26 (5) children receiving ongoing monthly adoption assistance 316.27 payments under section269.67259.67. 316.28 (b) The exclusion of a person under this subdivision does 316.29 not alter the mandatory assistance unit composition. 316.30 Sec. 47. Minnesota Statutes 1997 Supplement, section 316.31 256J.24, subdivision 4, is amended to read: 316.32 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 316.33 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 316.34 choose to be in the assistance unit, if the caregiver is not 316.35 required to be in the assistance unit under subdivision 2. If 316.36 therelativeeligible caregiver chooses to be in the assistance 317.1 unit, that person's spouse must also be in the unit. 317.2 (b) Any minor child not related as a sibling, stepsibling, 317.3 or adopted sibling to the minor child in the unit, but for whom 317.4 there is an eligible caregiver may elect to be in the unit. 317.5 (c) A foster care provider of a minor child who is 317.6 receiving federal, state, or local foster care maintenance 317.7 payments may elect to receive MFIP-S if the provider meets the 317.8 definition of caregiver under section 256J.08, subdivision 11. 317.9 If the provider chooses to receive MFIP-S, the spouse of the 317.10 provider must also be included in the assistance unit with the 317.11 provider. The provider and spouse are eligible for assistance 317.12 even if the only minor child living in the provider's home is 317.13 receiving foster care maintenance payments. 317.14 (d) The adult caregiver or caregivers of a minor parent are 317.15 eligible to be a separate assistance unit from the minor parent 317.16 and the minor parent's child when: 317.17 (1) the adult caregiver or caregivers have no other minor 317.18 children in the household; 317.19 (2) the minor parent and the minor parent's child are 317.20 living together with the adult caregiver or caregivers; and 317.21 (3) the minor parent and the minor parent's child receive 317.22 MFIP-S, or would be eligible to receive MFIP-S, if they were not 317.23 receiving SSI benefits. 317.24 Sec. 48. Minnesota Statutes 1997 Supplement, section 317.25 256J.24, is amended by adding a subdivision to read: 317.26 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 317.27 STANDARD.] The commissioner shall adjust the food portion of the 317.28 MFIP-S transitional standard by October 1 each year beginning 317.29 October 1998 to reflect the cost-of-living adjustments to the 317.30 Food Stamp Program. The commissioner shall annually publish in 317.31 the State Register the transitional standard for an assistance 317.32 unit of sizes 1 to 10. 317.33 Sec. 49. Minnesota Statutes 1997 Supplement, section 317.34 256J.24, subdivision 7, is amended to read: 317.35 Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage 317.36 level standard is 110 percent of the transitional standard under 318.1 subdivision 5 and is the standard used when there is earned 318.2 income in the assistance unit. As specified in section 256J.21, 318.3 earned income is subtracted from the family wage level to 318.4 determine the amount of the assistance payment. Assistance 318.5 payments may not exceed the shared household standard or the 318.6 transitional standard for the assistance unit, whichever is less. 318.7 Sec. 50. Minnesota Statutes 1997 Supplement, section 318.8 256J.24, is amended by adding a subdivision to read: 318.9 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 318.10 UNITS.] Payments for shelter up to the amount of the cash 318.11 portion of MFIP-S benefits for which the assistance unit is 318.12 eligible shall be vendor paid for as many months as the 318.13 assistance unit is eligible or six months, whichever comes 318.14 first. The residual amount of the grant after vendor payment, 318.15 if any, must be paid to the MFIP-S caregiver. 318.16 Sec. 51. Minnesota Statutes 1997 Supplement, section 318.17 256J.24, is amended by adding a subdivision to read: 318.18 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP-S.] (a) Except 318.19 as prohibited in paragraph (b), the county agency must use the 318.20 shared household standard when the household includes one or 318.21 more unrelated members, as that term is defined in section 318.22 256J.08, subdivision 86a. The county agency must use the shared 318.23 household standard, unless a member of the assistance unit is a 318.24 victim of domestic violence and has an approved safety plan, 318.25 regardless of the number of unrelated members in the household. 318.26 (b) The county agency must not use the shared household 318.27 standard when all unrelated members are one of the following: 318.28 (1) a recipient of public assistance benefits, including 318.29 food stamps, Supplemental Security Income, adoption assistance, 318.30 relative custody assistance, or foster care payments; 318.31 (2) a roomer or boarder, or a person to whom the assistance 318.32 unit is paying room or board; 318.33 (3) a minor; 318.34 (4) a minor caregiver living with the minor caregiver's 318.35 parents or in an approved supervised living arrangement; or 318.36 (5) a caregiver who is not the parent of the minor child in 319.1 the assistance unit. 319.2 (c) The shared household standard must be discontinued if 319.3 it is not approved by the United States Department of 319.4 Agriculture under the MFIP-S waiver. 319.5 Sec. 52. Minnesota Statutes 1997 Supplement, section 319.6 256J.26, subdivision 1, is amended to read: 319.7 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 319.8 Applicants orrecipientsparticipants who have been convicted of 319.9 a drug offense after July 1, 1997, may, if otherwise eligible, 319.10 receive AFDC or MFIP-S benefits subject to the following 319.11 conditions: 319.12 (1) Benefits for the entire assistance unit must be paid in 319.13 vendor form for shelter and utilities during any time the 319.14 applicant is part of the assistance unit;. 319.15 (2) The convicted applicant orrecipientparticipant shall 319.16 be subject to random drug testing as a condition of continued 319.17 eligibility andis subject to sanctions under section 256J.46319.18 following any positive test for an illegal controlled substance,319.19except that the grant must continue to be vendor paid under319.20clause (1).319.21For purposes of this subdivision, section 256J.46 is319.22effective July 1, 1997.319.23This subdivision also applies to persons who receive food319.24stamps under section 115 of the Personal Responsibility and Work319.25Opportunity Reconciliation Act of 1996.is subject to the 319.26 following sanctions: 319.27 (i) for failing a drug test the first time, the 319.28 participant's grant shall be reduced by ten percent of the 319.29 MFIP-S transitional standard, the shared household standard, or 319.30 the interstate transitional standard, whichever is applicable 319.31 prior to making vendor payments for shelter and utility costs; 319.32 or 319.33 (ii) for failing a drug test two or more times, the 319.34 residual amount of the participant's grant after making vendor 319.35 payments for shelter and utility costs, if any, must be reduced 319.36 by an amount equal to 30 percent of the MFIP-S transitional 320.1 standard, the shared household standard, or the interstate 320.2 transitional standard, whichever is applicable. 320.3 (b) Applicants or participants who have been convicted of a 320.4 drug offense after July 1, 1997, may, if otherwise eligible, 320.5 receive food stamps if the convicted applicant or participant is 320.6 subject to random drug testing as a condition of continued 320.7 eligibility. Following a positive test for an illegal 320.8 controlled substance, the applicant is subject to the following 320.9 sanctions: 320.10 (1) for failing a drug test the first time, food stamps 320.11 shall be reduced by ten percent of the applicable food stamp 320.12 allotment; and 320.13 (2) for failing a drug test two or more times, food stamps 320.14 shall be reduced by an amount equal to 30 percent of the 320.15 applicable food stamp allotment. 320.16(b)(c) For the purposes of this subdivision, "drug offense" 320.17 means a conviction that occurred after July 1, 1997, of sections 320.18 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 320.19 means a conviction in another jurisdiction of the possession, 320.20 use, or distribution of a controlled substance, or conspiracy to 320.21 commit any of these offenses, if the offense occurred after July 320.22 1, 1997, and the conviction is a felony offense in that 320.23 jurisdiction, or in the case of New Jersey, a high misdemeanor. 320.24 Sec. 53. Minnesota Statutes 1997 Supplement, section 320.25 256J.26, subdivision 2, is amended to read: 320.26 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 320.27 condition of probation or parole or supervised release imposed 320.28 under federal law or the law of any state isineligible to320.29receivedisqualified from receiving AFDC or MFIP-S. 320.30 Sec. 54. Minnesota Statutes 1997 Supplement, section 320.31 256J.26, subdivision 3, is amended to read: 320.32 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 320.33 avoid prosecution, or custody, or confinement after conviction 320.34 for a crime that is a felony under the laws of the jurisdiction 320.35 from which the individual flees, or in the case of New Jersey, 320.36 is a high misdemeanor, isineligible to receivedisqualified 321.1 from receiving AFDC or MFIP-S. 321.2 Sec. 55. Minnesota Statutes 1997 Supplement, section 321.3 256J.26, subdivision 4, is amended to read: 321.4 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 321.5 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 321.6 individual who is convicted in federal or state court of having 321.7 made a fraudulent statement or representation with respect to 321.8 the place of residence of the individual in order to receive 321.9 assistance simultaneously from two or more states isineligible321.10to receivedisqualified from receiving AFDC or MFIP-S for ten 321.11 years beginning on the date of the conviction. 321.12 Sec. 56. Minnesota Statutes 1997 Supplement, section 321.13 256J.28, subdivision 1, is amended to read: 321.14 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 321.15 ASSISTANCE.] The following households are entitled to expedited 321.16 issuance of food stamp assistance: 321.17 (1) households with less than $150 in monthly gross income 321.18 provided their liquid assets do not exceed $100; 321.19 (2) migrant or seasonal farm worker households who are 321.20 destitute as defined in Code of Federal Regulations, title 7, 321.21 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 321.22 paragraph (e)(3), provided their liquid assets do not exceed 321.23 $100; and 321.24 (3) eligible households whose combined monthly gross income 321.25 and liquid resources are less than the household's monthly rent 321.26 or mortgage and utilities. 321.27The benefits issued through expedited issuance of food321.28stamp assistance must be deducted from the amount of the full321.29monthly MFIP-S assistance payment and a supplemental payment for321.30the difference must be issued.For any month an individual 321.31 receives expedited Food Stamp Program benefits, the individual 321.32 is not eligible for the MFIP-S food portion of assistance. 321.33 Sec. 57. Minnesota Statutes 1997 Supplement, section 321.34 256J.28, subdivision 2, is amended to read: 321.35 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 321.36 ASSISTANCE UNIT.] (a) For household members who purchase and 322.1 prepare food with the MFIP-S assistance unit but are not part of 322.2 the assistance unit, the county agency must determine a separate 322.3 food stamp benefit based on regulations agreed upon with the 322.4 United States Department of Agriculture. 322.5(b) This subdivision does not apply to optional members who322.6have chosen not to be in the assistance unit.322.7(c)(b) Fair hearing requirements for persons who receive 322.8 food stamps under this subdivision are governed by section 322.9 256.045, and Code of Federal Regulations, title 7, subtitle B, 322.10 chapter II, part 273, section 273.15. 322.11 Sec. 58. Minnesota Statutes 1997 Supplement, section 322.12 256J.28, is amended by adding a subdivision to read: 322.13 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 322.14 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 322.15 in a battered woman's shelter may receive food stamps or the 322.16 food portion twice in a month if the unit that initially 322.17 received the food stamps or food portion included the alleged 322.18 abuser. 322.19 Sec. 59. Minnesota Statutes 1997 Supplement, section 322.20 256J.30, subdivision 10, is amended to read: 322.21 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 322.22 caregiver of a minor child must cooperate with the county agency 322.23 to identify and provide information to assist the county agency 322.24 in pursuing third-party liability for medical services. 322.25 (b) A caregiver must assign to the department any rights to 322.26 health insurance policy benefits the caregiver has during the 322.27 period of MFIP-S eligibility. 322.28 (c) A caregiver must identify any third party who may be 322.29 liable for care and services available under the medical 322.30 assistance program on behalf of the applicant or participant and 322.31 all other assistance unit members. 322.32 (d) When a participant refuses to identify any third party 322.33 who may be liable for care and services, the recipient must be 322.34 sanctioned as provided in section 256J.46, subdivision 1. The 322.35 recipient is also ineligible for medical assistancefor a322.36minimum of one month anduntil the recipient cooperates with the 323.1 requirements of this subdivision. 323.2 Sec. 60. Minnesota Statutes 1997 Supplement, section 323.3 256J.30, subdivision 11, is amended to read: 323.4 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 323.5 RIGHTS.]To be eligibleAn assistance unit is ineligible for 323.6 MFIP-S,unless the caregivermust assignassigns all rights to 323.7 child support and spousal maintenance benefits according 323.8 tosections 256.74, subdivision 5, andsection 256.741, if323.9enacted. 323.10 Sec. 61. Minnesota Statutes 1997 Supplement, section 323.11 256J.31, subdivision 5, is amended to read: 323.12 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 323.13 shall be issued according to paragraphs (a) to (c). 323.14 (a) A county agency shall mail a notice of adverse action 323.15 at least ten days before the effective date of the adverse 323.16 action, except as provided in paragraphs (b) and (c). 323.17 (b) A county agency must mail a notice of adverse action at 323.18 least five days before the effective date of the adverse action 323.19 when the county agency has factual information that requires an 323.20 action to reduce, suspend, or terminate assistance based on 323.21 probable fraud. 323.22 (c) A county agency shall mail a notice of adverse action 323.23 before or on the effective date of the adverse action when the 323.24 county agency: 323.25 (1) receives the caregiver's signed monthly MFIP-S 323.26 household report form that includes information that requires 323.27 payment reduction, suspension, or termination; 323.28 (2) is informed of the death of a participant or the payee; 323.29 (3) receives a signed statement from the caregiver that 323.30 assistance is no longer wanted; 323.31 (4) receives a signed statement from the caregiver that 323.32 provides information that requires the termination or reduction 323.33 of assistance; 323.34 (5) verifies that a member of the assistance unit is absent 323.35 from the home and does not meet temporary absence provisions in 323.36 section 256J.13; 324.1 (6) verifies that a member of the assistance unit has 324.2 entered a regional treatment center or a licensed residential 324.3 facility for medical or psychological treatment or 324.4 rehabilitation; 324.5 (7) verifies that a member of an assistance unit has been 324.6 placed in foster care, and the provisions of section 256J.13, 324.7 subdivision 2, paragraph(b)(c), clause (2), do not apply; 324.8 (8) verifies that a member of an assistance unit has been 324.9 approved to receive assistance by another state; or 324.10 (9) cannot locate a caregiver. 324.11 Sec. 62. Minnesota Statutes 1997 Supplement, section 324.12 256J.31, subdivision 10, is amended to read: 324.13 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 324.14 earnings of a caregiverwhile participating in full or part-time324.15employment or trainingshall be protected from garnishment. 324.16 This protection for earnings shall extend for a period of six 324.17 months from the date of termination from MFIP-S. 324.18 Sec. 63. Minnesota Statutes 1997 Supplement, section 324.19 256J.31, is amended by adding a subdivision to read: 324.20 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 324.21 participant may discontinue receipt of the cash assistance 324.22 portion of MFIP-S assistance and retain eligibility for child 324.23 care assistance under section 119B.05 and for medical assistance 324.24 under sections 256B.055, subdivision 3a, and 256B.0635. 324.25 Sec. 64. Minnesota Statutes 1997 Supplement, section 324.26 256J.32, subdivision 4, is amended to read: 324.27 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 324.28 verify the following at application: 324.29 (1) identity of adults; 324.30 (2) presence of the minor child in the home, if 324.31 questionable; 324.32 (3) relationship of a minor child to caregivers in the 324.33 assistance unit; 324.34 (4) age, if necessary to determine MFIP-S eligibility; 324.35 (5) immigration status; 324.36 (6) social security numberin accordance withaccording to 325.1 the requirements of section 256J.30, subdivision 12; 325.2 (7) income; 325.3 (8) self-employment expenses used as a deduction; 325.4 (9) source and purpose of deposits and withdrawals from 325.5 business accounts; 325.6 (10) spousal support and child support payments made to 325.7 persons outside the household; 325.8 (11) real property; 325.9 (12) vehicles; 325.10 (13) checking and savings accounts; 325.11 (14) savings certificates, savings bonds, stocks, and 325.12 individual retirement accounts; 325.13 (15) pregnancy, if related to eligibility; 325.14 (16) inconsistent information, if related to eligibility; 325.15 (17) medical insurance; 325.16 (18) anticipated graduation date of an 18-year-old; 325.17 (19) burial accounts; 325.18 (20) school attendance, if related to eligibility;and325.19 (21) residence; 325.20 (22) a claim of domestic violence if used as a basis for a 325.21 deferral or exemption from the 60-month time limit in section 325.22 256J.42 or employment and training services requirements in 325.23 section 256J.56; and 325.24 (23) disability if used as an exemption from employment and 325.25 training services requirements under section 256J.56. 325.26 Sec. 65. Minnesota Statutes 1997 Supplement, section 325.27 256J.32, subdivision 6, is amended to read: 325.28 Subd. 6. [RECERTIFICATION.] The county agency shall 325.29 recertify eligibility in an annual face-to-face interview with 325.30 the participant and verify the following: 325.31 (1) presence of the minor child in the home, if 325.32 questionable; 325.33 (2) income, unless excluded, including self-employment 325.34 expenses used as a deduction or deposits or withdrawals from 325.35 business accounts; 325.36 (3) assets when the value is within $200 of the asset 326.1 limit; and 326.2 (4) inconsistent information, if related to eligibility. 326.3 Sec. 66. Minnesota Statutes 1997 Supplement, section 326.4 256J.32, is amended by adding a subdivision to read: 326.5 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 326.6 PRIVATE DATA.] County agencies in consultation with the 326.7 commissioner of human services shall provide notification to 326.8 undocumented persons regarding the release of personal data to 326.9 the Immigration and Naturalization Service and develop protocol 326.10 regarding the release or sharing of data about undocumented 326.11 persons with the Immigration and Naturalization Service as 326.12 required under sections 404, 434, and 411A of the Personal 326.13 Responsibility and Work Opportunity Reconciliation Act of 1996. 326.14 Sec. 67. Minnesota Statutes 1997 Supplement, section 326.15 256J.33, subdivision 1, is amended to read: 326.16 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 326.17 agency must determine MFIP-S eligibility prospectively for a 326.18 payment month based on retrospectively assessing income and the 326.19 county agency's best estimate of the circumstances that will 326.20 exist in the payment month. 326.21 Except as described in section 256J.34, subdivision 1, when 326.22 prospective eligibility exists, a county agency must calculate 326.23 the amount of the assistance payment using retrospective 326.24 budgeting. To determine MFIP-S eligibility and the assistance 326.25 payment amount, a county agency must apply countable income, 326.26 described in section 256J.37, subdivisions 3 to 10, received by 326.27 members of an assistance unit or by other persons whose income 326.28 is counted for the assistance unit, described under sections 326.29 256J.21 and 256J.37, subdivisions 1andto 2. 326.30 This income must be applied to the transitional standard, 326.31 shared household standard, or family wage standard subject to 326.32 this section and sections 256J.34 to 256J.36. Income received 326.33 in a calendar month and not otherwise excluded under section 326.34 256J.21, subdivision 2, must be applied to the needs of an 326.35 assistance unit. 326.36 Sec. 68. Minnesota Statutes 1997 Supplement, section 327.1 256J.33, subdivision 4, is amended to read: 327.2 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 327.3 the monthly income test retrospectively for each month of MFIP-S 327.4 eligibility. An assistance unit is not eligible when the 327.5 countable income equals or exceeds the transitional standard, 327.6 the shared household standard, or the family wage level for the 327.7 assistance unit. The income applied against the monthly income 327.8 test must include: 327.9 (1) gross earned income from employment, prior to mandatory 327.10 payroll deductions, voluntary payroll deductions, wage 327.11 authorizations, and after the disregards in section 256J.21, 327.12 subdivision34, and the allocations in section 256J.36, unless 327.13 the employment income is specifically excluded under section 327.14 256J.21, subdivision 2; 327.15 (2) gross earned income from self-employment less 327.16 deductions for self-employment expenses in section 256J.37, 327.17 subdivision 5, but prior to any reductions for personal or 327.18 business state and federal income taxes, personal FICA, personal 327.19 health and life insurance, and after the disregards in section 327.20 256J.21, subdivision34, and the allocations in section 327.21 256J.36; 327.22 (3) unearned income after deductions for allowable expenses 327.23 in section 256J.37, subdivision 9, and allocations in section 327.24 256J.36, unless the income has been specifically excluded in 327.25 section 256J.21, subdivision 2; 327.26 (4) gross earned income from employment as determined under 327.27 clause (1) which is received by a member of an assistance unit 327.28 who is a minor child or minor caregiver and less than a 327.29 half-time student; 327.30 (5) child support and spousal support received or 327.31 anticipated to be received by an assistance unit; 327.32 (6) the income of a parent when that parent is not included 327.33 in the assistance unit; 327.34 (7) the income of an eligible relative and spouse who seek 327.35 to be included in the assistance unit; and 327.36 (8) the unearned income of a minor child included in the 328.1 assistance unit. 328.2 Sec. 69. Minnesota Statutes 1997 Supplement, section 328.3 256J.35, is amended to read: 328.4 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 328.5 Except as provided in paragraphs (a) to(c)(d), the amount 328.6 of an assistance payment is equal to the difference between the 328.7 transitional standard, shared household standard, or the 328.8 Minnesota family wage level in section 256J.24, whichever is 328.9 less, and countable income. 328.10 (a) When MFIP-S eligibility exists for the month of 328.11 application, the amount of the assistance payment for the month 328.12 of application must be prorated from the date of application or 328.13 the date all other eligibility factors are met for that 328.14 applicant, whichever is later. This provision applies when an 328.15 applicant loses at least one day of MFIP-S eligibility. 328.16 (b) MFIP-S overpayments to an assistance unit must be 328.17 recouped according to section 256J.38, subdivision 4. 328.18 (c) An initial assistance payment must not be made to an 328.19 applicant who is not eligible on the date payment is made. 328.20 (d) An individual whose needs have been otherwise provided 328.21 for in another state, in whole or in part by county, state, or 328.22 federal dollars during a month, is ineligible to receive MFIP-S 328.23 for the month. 328.24 Sec. 70. Minnesota Statutes 1997 Supplement, section 328.25 256J.36, is amended to read: 328.26 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 328.27 MEMBERS.] 328.28 Except as prohibited in paragraphs (a) and (b), an 328.29 allocation of income is allowed from the caregiver's income to 328.30 meet the unmet need of an ineligible spouse or an ineligible 328.31 child under the age of 21 for whom the caregiver is financially 328.32 responsible who also lives with the caregiver.An allocation is328.33allowed from the caregiver's income to meet the need of an328.34ineligible or excluded person.That allocation is allowed in an 328.35 amount up to the difference between the MFIP-Sfamily allowance328.36 transitional standard for the assistance unit when thatexcluded329.1orineligible person is included in the assistance unit and the 329.2 MFIP-S family allowance for the assistance unit when 329.3 theexcluded orineligible person is not included in the 329.4 assistance unit. These allocations must be deducted from the 329.5 caregiver's counted earnings and from unearned income subject to 329.6 paragraphs (a) and (b). 329.7 (a) Income of a minor child in the assistance unit must not 329.8 be allocated to meet the need ofaan ineligible personwho is329.9not a member of the assistance unit, including the child's 329.10 parent, even when that parent is the payee of the child's income. 329.11 (b) Income ofan assistance unita caregiver must not be 329.12 allocated to meet the needs of a disqualified personineligible329.13for failure to cooperate with program requirements including329.14child support requirements, a person ineligible due to fraud, or329.15a relative caregiver and the caregiver's spouse who opt out of329.16the assistance unit. 329.17 Sec. 71. Minnesota Statutes 1997 Supplement, section 329.18 256J.37, subdivision 1, is amended to read: 329.19 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 329.20 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 329.21 the income of ineligible household members must be deemed after 329.22 allowing the following disregards: 329.23 (1) the first 18 percent of theexcludedineligible family 329.24 member's gross earned income; 329.25 (2) amounts the ineligible person actually paid to 329.26 individuals not living in the same household but whom the 329.27 ineligible person claims or could claim as dependents for 329.28 determining federal personal income tax liability; 329.29 (3)child or spousal support paid to a person who lives329.30outside of the householdall payments made by the ineligible 329.31 person according to a court order for spousal support or the 329.32 support of children not living in the assistance unit's 329.33 household, provided that, if there has been a change in the 329.34 financial circumstances of the ineligible person since the 329.35 support order was entered, the ineligible person has petitioned 329.36 for a modification of the support order; and 330.1 (4) an amount for the needs of the ineligible person and 330.2 other persons who live in the household but are not included in 330.3 the assistance unit and are or could be claimed by an ineligible 330.4 person as dependents for determining federal personal income tax 330.5 liability. This amount is equal to the difference between the 330.6 MFIP-Sneedtransitional standard when theexcludedineligible 330.7 person is included in the assistance unit and the MFIP-Sneed330.8 transitional standard when theexcludedineligible person is not 330.9 included in the assistance unit. 330.10 Sec. 72. Minnesota Statutes 1997 Supplement, section 330.11 256J.37, is amended by adding a subdivision to read: 330.12 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 330.13 income of disqualified members must be deemed after allowing the 330.14 following disregards: 330.15 (1) the first 18 percent of the disqualified member's gross 330.16 earned income; 330.17 (2) amounts the disqualified member actually paid to 330.18 individuals not living in the same household but whom the 330.19 disqualified member claims or could claim as dependents for 330.20 determining federal personal income tax liability; 330.21 (3) all payments made by the disqualified member according 330.22 to a court order for spousal support or the support of children 330.23 not living in the assistance unit's household, provided that, if 330.24 there has been a change in the financial circumstances of the 330.25 disqualified member's legal obligation to pay support since the 330.26 support order was entered, the disqualified member has 330.27 petitioned for a modification of the support order; and 330.28 (4) an amount for the needs of other persons who live in 330.29 the household but are not included in the assistance unit and 330.30 are or could be claimed by the disqualified member as dependents 330.31 for determining federal personal income tax liability. This 330.32 amount is equal to the difference between the MFIP-S 330.33 transitional standard when the ineligible person is included in 330.34 the assistance unit and the MFIP-S transitional standard when 330.35 the ineligible person is not included in the assistance unit. 330.36 An amount shall not be allowed for the needs of a disqualified 331.1 member. 331.2 Sec. 73. Minnesota Statutes 1997 Supplement, section 331.3 256J.37, is amended by adding a subdivision to read: 331.4 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 331.5 CAREGIVERS.] In households where minor caregivers live with a 331.6 parent or parents who do not receive MFIP-S, the income of the 331.7 parents must be deemed after allowing the following disregards: 331.8 (1) income of the parents equal to 200 percent of the 331.9 federal poverty guideline for a family size not including the 331.10 minor parent and the minor parent's child in the household 331.11 according to section 256J.21, subdivision 2, clause (43); 331.12 (2) 18 percent of the parents' gross earned income; 331.13 (3) amounts the parents actually paid to individuals not 331.14 living in the same household but whom the parents claim or could 331.15 claim as dependents for determining federal personal income tax 331.16 liability; and 331.17 (4) all payments made by parents according to a court order 331.18 for spousal support or the support of children not living in the 331.19 parent's household, provided that, if there has been a change in 331.20 the financial circumstances of the parent's legal obligation to 331.21 pay support since the support order was entered, the parents 331.22 have petitioned for a modification of the support order. 331.23 Sec. 74. Minnesota Statutes 1997 Supplement, section 331.24 256J.37, subdivision 2, is amended to read: 331.25 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 331.26 NONCITIZENS.]All income and assets of a sponsor, or sponsor's331.27spouse, who executed an affidavit of support for a noncitizen331.28must be deemed to be unearned income of the noncitizen as331.29specified in the Personal Responsibility and Work Opportunity331.30Reconciliation Act of 1996, title IV, Public Law Number 104-193,331.31sections 421 and 422, and subsequently set out in federal331.32rules.If a noncitizen applies for or receives MFIP-S, the 331.33 county must deem the income and assets of the noncitizen's 331.34 sponsor and the sponsor's spouse who have signed an affidavit of 331.35 support for the noncitizen as specified in Public Law Number 331.36 104-193, title IV, sections 421 and 422, the Personal 332.1 Responsibility and Work Opportunity Reconciliation Act of 1996. 332.2 The income of a sponsor and the sponsor's spouse is considered 332.3 unearned income of the noncitizen. The assets of a sponsor and 332.4 the sponsor's spouse are considered available assets of the 332.5 noncitizen. 332.6 Sec. 75. Minnesota Statutes 1997 Supplement, section 332.7 256J.37, subdivision 9, is amended to read: 332.8 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 332.9 apply unearned income, including housing subsidies as in332.10paragraph (b),to the transitional standard. When determining 332.11 the amount of unearned income, the county agency must deduct the 332.12 costs necessary to secure payments of unearned income. These 332.13 costs include legal fees, medical fees, and mandatory deductions 332.14 such as federal and state income taxes. 332.15 (b) Effective July 1,19981999, the county agency shall 332.16 count $100 of the value of public and assisted rental subsidies 332.17 provided through the Department of Housing and Urban Development 332.18 (HUD) as unearned income. The full amount of the subsidy must 332.19 be counted as unearned income when the subsidy is less than $100. 332.20 Sec. 76. Minnesota Statutes 1997 Supplement, section 332.21 256J.38, subdivision 1, is amended to read: 332.22 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 332.23 or former participant receives an overpayment due to agency, 332.24 client, or ATM error, or due to assistance received while an 332.25 appeal is pending and the participant or former participant is 332.26 determined ineligible for assistance or for less assistance than 332.27 was received, the county agency must recoup or recover the 332.28 overpaymentunderusing theconditions of this332.29section.following methods: 332.30 (1) reconstruct each affected budget month and 332.31 corresponding payment month; 332.32 (2) use the policies and procedures that were in effect for 332.33 the payment month; and 332.34 (3) do not allow employment disregards in section 256J.21, 332.35 subdivision 3 or 4, in the calculation of the overpayment when 332.36 the unit has not reported within two calendar months following 333.1 the end of the month in which the income was received. 333.2 Sec. 77. Minnesota Statutes 1997 Supplement, section 333.3 256J.39, subdivision 2, is amended to read: 333.4 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 333.5 paying assistance directly to a participant may be used when: 333.6 (1) a county agency determines that a vendor payment is the 333.7 most effective way to resolve an emergency situation pertaining 333.8 to basic needs; 333.9 (2) a caregiver makes a written request to the county 333.10 agency asking that part or all of the assistance payment be 333.11 issued by protective or vendor payments for shelter and utility 333.12 service only. The caregiver may withdraw this request in 333.13 writing at any time; 333.14 (3)a caregiver has exhibited a continuing pattern of333.15mismanaging funds as determined by the county agency;333.16(4)the vendor payment is part of a sanction under section 333.17 256J.46, subdivision 2;or333.18(5)(4) the vendor payment is required under section 333.19 256J.24, subdivision 8, 256J.26, or 256J.43; 333.20 (5) protective payments are required for minor parents 333.21 under section 256J.14; or 333.22 (6) a caregiver has exhibited a continuing pattern of 333.23 mismanaging funds as determined by the county agency. 333.24 The director of a county agency must approve a proposal for 333.25 protective or vendor payment for money mismanagement when there 333.26 is a pattern of mismanagement under clause (6). During the time 333.27 a protective or vendor payment is being made, the county agency 333.28 must provide services designed to alleviate the causes of the 333.29 mismanagement. 333.30 The continuing need for and method of payment must be 333.31 documented and reviewed every 12 months. The director of a 333.32 county agency must approve the continuation of protective or 333.33 vendor payments. when it appears that the need for protective or 333.34 vendor payments will continue or is likely to continue beyond 333.35 two years because the county agency's efforts have not resulted 333.36 in sufficiently improved use of assistance on behalf of the 334.1 minor child, judicial appointment of a legal guardian or other 334.2 legal representative must be sought by the county agency. 334.3 Sec. 78. Minnesota Statutes 1997 Supplement, section 334.4 256J.395, is amended to read: 334.5 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 334.6 UTILITIES.] 334.7 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 334.8 1997, when a county is required to provide assistance to 334.9 arecipientparticipant in vendor form forrentshelter costs 334.10 and utilities under this chapter, or chapter 256, 256D, or 256K, 334.11 the cost of utilities for a given family may be assumed to be: 334.12 (1) the average of the actual monthly cost of utilities for 334.13 that family for the prior 12 months at the family's current 334.14 residence, if applicable; 334.15 (2) the monthly plan amount, if any, set by the local 334.16 utilities for that family at the family's current residence; or 334.17 (3) the estimated monthly utility costs for the dwelling in 334.18 which the family currently resides. 334.19 (b) For purposes of this section, "utility" means any of 334.20 the following: municipal water and sewer service; electric, 334.21 gas, or heating fuel service; or wood, if that is the heating 334.22 source. 334.23 (c) In any instance where a vendor payment for rent is 334.24 directed to a landlord not legally entitled to the payment, the 334.25 county social services agency shall immediately institute 334.26 proceedings to collect the amount of the vendored rent payment, 334.27 which shall be considered a debt under section 270A.03, 334.28 subdivision 5. 334.29 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 334.30 agency is required to provide assistance to a participant in 334.31 vendor payment form for shelter costs or utilities under 334.32 subdivision 1, and the participant does not give the agency the 334.33 information needed to pay the vendor, the county agency shall 334.34 notify the participant of the intent to terminate assistance by 334.35 mail at least ten days before the effective date of the adverse 334.36 action. 335.1 (b) The notice of action shall include a request for 335.2 information about: 335.3 (1) the amount of the participant's shelter costs or 335.4 utilities; 335.5 (2) the due date of the shelter costs or utilities; and 335.6 (3) the name and address of the landlord, contract for deed 335.7 holder, mortgage company, and utility vendor. 335.8 (c) If the participant fails to provide the requested 335.9 information by the effective date of the adverse action, the 335.10 county must terminate the MFIP-S grant. If the applicant or 335.11 participant verifies they do not have shelter costs or utility 335.12 obligations, the county shall not terminate assistance if the 335.13 assistance unit is otherwise eligible. 335.14 Subd. 3. [DISCONTINUING VENDOR PAYMENTS DUE TO DISPUTE 335.15 WITH LANDLORD.] The county agency shall discontinue vendor 335.16 payments for shelter costs imposed under this chapter when the 335.17 vendor payment interferes with the participant's right to 335.18 withhold rent due to a dispute with the participant's landlord 335.19 in accordance with federal, state, or local housing laws. 335.20 Sec. 79. Minnesota Statutes 1997 Supplement, section 335.21 256J.42, is amended to read: 335.22 256J.42 [60-MONTH TIME LIMIT.] 335.23 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 335.24 in this section and in section 256J.11, subdivision 2, an 335.25 assistance unit in which any adult caregiver has received 60 335.26 months of cash assistance funded in whole or in part by the TANF 335.27 block grant in this or any other state or United States 335.28 territory, MFIP-S, AFDC, or family general assistance, funded in 335.29 whole or in part by state appropriations, is ineligible to 335.30 receive MFIP-S. Any cash assistance funded with TANF dollars in 335.31 this or any other state or United States territory, or MFIP-S 335.32 assistance funded in whole or in part by state appropriations, 335.33 that was received by the unit on or after the date TANF was 335.34 implemented, including any assistance received in states or 335.35 United States territories of prior residence, counts toward the 335.36 60-month limitation. The 60-month limit applies to a minor who 336.1 is the head of a household or who is married to the head of a 336.2 household except under subdivision 5. The 60-month time period 336.3 does not need to be consecutive months for this provision to 336.4 apply. 336.5 (b) Months before July 1998 in which individuals receive 336.6 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 336.7 comparison group family under sections 256.031 to 256.0361 or 336.8 sections 256.047 to 256.048 are not included in the 60-month 336.9 time limit. 336.10Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual336.11whose needs have been otherwise provided for in another state,336.12in whole or in part by the TANF block grant during a month, is336.13ineligible to receive MFIP-S for the month.336.14 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 336.15 determining the number of months for which an adult has received 336.16 assistance under MFIP-S, the county agency must disregard any 336.17 month during which the adult lived on an Indian reservation if,336.18 during the month:336.19(1) at least 1,000 individuals were living on the336.20reservation; and336.21(2)at least 50 percent of the adults living on the 336.22 reservation wereunemployednot employed. 336.23 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 336.24 assistance received by an assistance unit in a month when a 336.25 caregiver is complying with a safety plan under the MFIP-S 336.26 employment and training component does not count toward the 336.27 60-month limitation on assistance. 336.28 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 336.29 assistance received by an assistance unit does not count toward 336.30 the 60-month limit on assistance during a month in which 336.31 theparentalcaregiver is in the category in section 256J.56, 336.32 clause (1). The exemption applies for the period of time the 336.33 caregiver belongs to one of the categories specified in this 336.34 subdivision. 336.35 (b) From July 1, 1997, until the date MFIP-S is operative 336.36 in the caregiver's county of financial responsibility, any cash 337.1 assistance received by a caregiver who is complying with 337.2 sections 256.73, subdivision 5a, and 256.736, if applicable, 337.3 does not count toward the 60-month limit on assistance. 337.4 Thereafter, any cash assistance received by a minor caregiver 337.5 who is complying with the requirements of sections 256J.14 and 337.6 256J.54, if applicable, does not count towards the 60-month 337.7 limit on assistance. 337.8 (c) Any diversionary assistance or emergency assistance 337.9 received does not count toward the 60-month limit. 337.10 (d) Any cash assistance received by an 18- or 19-year-old 337.11 caregiver who is complying with the requirements of section 337.12 256J.54 does not count toward the 60-month limit. 337.13 Sec. 80. Minnesota Statutes 1997 Supplement, section 337.14 256J.43, is amended to read: 337.15 256J.43 [INTERSTATE PAYMENT STANDARDS.] 337.16 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 337.17 amount of assistance paid to an eligiblefamilyunit in which 337.18 all members have resided in this state for fewer than 12 337.19 consecutive calendar months immediately preceding the date of 337.20 application shall be the lesser of either thepaymentinterstate 337.21 transitional standard that would have been received by 337.22 thefamilyassistance unit from the state of immediate prior 337.23 residence, or the amount calculated in accordance with AFDC or 337.24 MFIP-S standards. The lesser payment must continue until 337.25 thefamilyassistance unit meets the 12-month requirement. An 337.26 assistance unit that has not resided in Minnesota for 12 months 337.27 from the date of application is not exempt from the interstate 337.28 payment provisions solely because a child is born in Minnesota 337.29 to a member of the assistance unit. Payment must be calculated 337.30 by applying this state's budgeting policies, and the unit's net 337.31 income must be deducted from the payment standard in the other 337.32 state or in this state, whichever is lower. Payment shall be 337.33 made in vendor form forrentshelter and utilities, up to the 337.34 limit of the grant amount, and residual amounts, if any, shall 337.35 be paid directly to the assistance unit. 337.36 (b) During the first 12 monthsa familyan assistance unit 338.1 resides in this state, the number of months that afamilyunit 338.2 is eligible to receive AFDC or MFIP-S benefits is limited to the 338.3 number of months thefamilyassistance unit would have been 338.4 eligible to receive similar benefits in the state of immediate 338.5 prior residence. 338.6 (c) This policy applies whether or not thefamily338.7 assistance unit received similar benefits while residing in the 338.8 state of previous residence. 338.9 (d) Whena familyan assistance unit moves to this state 338.10 from another state where thefamilyassistance unit has 338.11 exhausted that state's time limit for receiving benefits under 338.12 that state's TANF program, thefamilyunit will not be eligible 338.13 to receive any AFDC or MFIP-S benefits in this state for 12 338.14 months from the date thefamilyassistance unit moves here. 338.15 (e) For the purposes of this section, "state of immediate 338.16 prior residence" means: 338.17 (1) the state in which the applicant declares the applicant 338.18 spent the most time in the 30 days prior to moving to this 338.19 state; or 338.20 (2) the state in which an applicant who is a migrant worker 338.21 maintains a home. 338.22 (f) The commissioner shall annually verify and update all 338.23 other states' payment standards as they are to be in effect in 338.24 July of each year. 338.25 (g) Applicants must provide verification of their state of 338.26 immediate prior residence, in the form of tax statements, a 338.27 driver's license, automobile registration, rent receipts, or 338.28 other forms of verification approved by the commissioner. 338.29 (h) Migrant workers, as defined in section 256J.08, and 338.30 their immediate families are exempt from this section, provided 338.31 the migrant worker provides verification that the migrant family 338.32 worked in this state within the last 12 months and earned at 338.33 least $1,000 in gross wages during the time the migrant worker 338.34 worked in this state. 338.35 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 338.36 assistance unit that has met the requirements of section 339.1 256J.12, the number of months that the assistance unit receives 339.2 benefits under the interstate payment standards in this section 339.3 is not affected by an absence from Minnesota for fewer than 30 339.4 consecutive days. 339.5 (b) For an assistance unit that has met the requirements of 339.6 section 256J.12, the number of months that the assistance unit 339.7 receives benefits under the interstate payment standards in this 339.8 section is not affected by an absence from Minnesota for more 339.9 than 30 consecutive days but fewer than 90 consecutive days, 339.10 provided the assistance unit continues to maintain a residence 339.11 in Minnesota during the period of absence. 339.12 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 339.13 POLICY.] Applicants who lived in another state in the 12 months 339.14 prior to applying for assistance are exempt from the interstate 339.15 payment policy for the months that a member of the unit: 339.16 (1) served in the United States armed services, provided 339.17 the person returned to Minnesota within 30 days of leaving the 339.18 armed forces, and intends to remain in Minnesota; 339.19 (2) attended school in another state, paid nonresident 339.20 tuition or Minnesota tuition rates under a reciprocity 339.21 agreement, provided the person left Minnesota specifically to 339.22 attend school and returned to Minnesota within 30 days of 339.23 graduation with the intent to remain in Minnesota; or 339.24 (3) meets the following criteria: 339.25 (i) a minor child or a minor caregiver moves from another 339.26 state to the residence of a relative caregiver; 339.27 (ii) the minor caregiver applies for and receives family 339.28 cash assistance; 339.29 (iii) the relative caregiver chooses not to be part of the 339.30 MFIP-S assistance unit; and 339.31 (iv) the relative caregiver has resided in Minnesota for at 339.32 least 12 months from the date the assistance unit applies for 339.33 cash assistance. 339.34 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 339.35 mandatory unit members who have resided in Minnesota for 12 339.36 months immediately before the unit's date of application 340.1 establish the other assistance unit members' eligibility for the 340.2 MFIP-S transitional standard. 340.3 Sec. 81. Minnesota Statutes 1997 Supplement, section 340.4 256J.45, subdivision 1, is amended to read: 340.5 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 340.6 county agency must provide each MFIP-S caregiver with a 340.7 face-to-face orientation. The caregiver must attend the 340.8 orientation. The county agency must inform the caregiver that 340.9 failure to attend the orientation is considereda firstan 340.10 occurrence of noncompliance with program requirements, and will 340.11 result in the imposition of a sanction under section 340.12 256J.46. If the client complies with the orientation 340.13 requirement prior to the first day of the month in which the 340.14 grant reduction is proposed to occur, the orientation sanction 340.15 shall be lifted. 340.16 Sec. 82. Minnesota Statutes 1997 Supplement, section 340.17 256J.45, subdivision 2, is amended to read: 340.18 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 340.19 must consist of a presentation that informs caregivers of: 340.20 (1) the necessity to obtain immediate employment; 340.21 (2) the work incentives under MFIP-S; 340.22 (3) the requirement to comply with the employment plan and 340.23 other requirements of the employment and training services 340.24 component of MFIP-S, including a description of the range of 340.25 work and training activities that are allowable under MFIP-S to 340.26 meet the individual needs of participants; 340.27 (4) the consequences for failing to comply with the 340.28 employment plan and other program requirements, and that the 340.29 county agency may not impose a sanction when failure to comply 340.30 is due to the unavailability of child care or other 340.31 circumstances where the participant has good cause under section 340.32 256J.45, subdivision 3; 340.33 (5) the rights, responsibilities, and obligations of 340.34 participants; 340.35 (6) the types and locations of child care services 340.36 available through the county agency; 341.1 (7) the availability and the benefits of the early 341.2 childhood health and developmental screening under sections 341.3 123.701 to 123.74; 341.4 (8) the caregiver's eligibility for transition year child 341.5 care assistance under section 119B.05; 341.6 (9) the caregiver's eligibility for extended medical 341.7 assistance when the caregiver loses eligibility for MFIP-S due 341.8 to increased earnings or increased child or spousal support;and341.9 (10) the caregiver's option to choose an employment and 341.10 training provider and information about each provider, including 341.11 but not limited to, services offered, program components, job 341.12 placement rates, job placement wages, and job retention rates; 341.13 (11) the caregiver's option to request approval of an 341.14 education and training plan according to section 256J.52; and 341.15 (12) the work study programs available under the higher 341.16 educational system. 341.17 Sec. 83. Minnesota Statutes 1997 Supplement, section 341.18 256J.45, is amended by adding a subdivision to read: 341.19 Subd. 3. [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING 341.20 ORIENTATION.] (a) The county agency shall not impose the 341.21 sanction under section 256J.46 if it determines that the 341.22 participant has good cause for failing to attend orientation. 341.23 Good cause exists when: 341.24 (1) appropriate child care is not available; 341.25 (2) the participant is ill or injured; 341.26 (3) a family member is ill and needs care by the 341.27 participant that prevents the participant from attending 341.28 orientation; 341.29 (4) the caregiver is unable to secure necessary 341.30 transportation; 341.31 (5) the caregiver is in an emergency situation that 341.32 prevents orientation attendance; 341.33 (6) the orientation conflicts with the caregiver's work, 341.34 training, or school schedule; or 341.35 (7) the caregiver documents other verifiable impediments to 341.36 orientation attendance beyond the caregiver's control. 342.1 (b) Counties must work with clients to provide child care 342.2 and transportation necessary to ensure a caregiver has every 342.3 opportunity to attend orientation. 342.4 Sec. 84. Minnesota Statutes 1997 Supplement, section 342.5 256J.46, subdivision 1, is amended to read: 342.6 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 342.7 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 342.8 good cause to comply with the requirements of this chapter, and 342.9 who is not subject to a sanction under subdivision 2, shall be 342.10 subject to a sanction as provided in this subdivision. 342.11 A sanction under this subdivision becomes effectiveten342.12days afterthe month following the month in which a required 342.13 notice is given. A sanction must not be imposed when a 342.14 participant comes into compliance with the requirements for 342.15 orientation under section 256J.45 or third party liability for 342.16 medical services under section 256J.30, subdivision 10, prior to 342.17 the effective date of the sanction. A sanction must not be 342.18 imposed when a participant comes into compliance with the 342.19 requirements for employment and training services under sections 342.20 256J.49 to 256J.72 ten days prior to the effective date of the 342.21 sanction. For purposes of this subdivision, each month that a 342.22 participant fails to comply with a requirement of this chapter 342.23 shall be considered a separate occurrence of noncompliance. A 342.24 participant who has had one or more sanctions imposed must 342.25 remain in compliance with the provisions of this chapter for six 342.26 months in order for a subsequent occurrence of noncompliance to 342.27 be considered a first occurrence. 342.28 (b) Sanctions for noncompliance shall be imposed as follows: 342.29 (1) For the first occurrence of noncompliance by a 342.30 participant in a single-parent household or by one participant 342.31 in a two-parent household, theparticipant'sassistance unit's 342.32 grant shall be reduced by ten percent of theapplicableMFIP-S 342.33 transitional standard, the shared household standard, or the 342.34 interstate transitional standard for an assistance unit of the 342.35 same size, whichever is applicable, with the residual paid to 342.36 the participant. The reduction in the grant amount must be in 343.1 effect for a minimum of one month and shall be removed in the 343.2 month following the month that the participant returns to 343.3 compliance. 343.4 (2) For a second or subsequent occurrence of noncompliance, 343.5 or when both participants in a two-parent household are out of 343.6 compliance at the same time, theparticipant's rentassistance 343.7 unit's shelter costs shall be vendor paid up to the amount of 343.8 the cash portion of the MFIP-S grant for which the participant's 343.9 assistance unit is eligible. At county option, 343.10 theparticipant'sassistance unit's utilities may also be vendor 343.11 paid up to the amount of the cash portion of the MFIP-S grant 343.12 remaining after vendor payment of theparticipant's rent343.13 assistance unit's shelter costs.The vendor payment of rent343.14and, if in effect, utilities, must be in effect for six months343.15from the date that a sanction is imposed under this clause.The 343.16 residual amount of the grant after vendor payment, if any, must 343.17 be reduced by an amount equal to 30 percent of theapplicable343.18 MFIP-S transitional standard, the shared household standard, or 343.19 the interstate transitional standard for an assistance unit of 343.20 the same size, whichever is applicable, before the residual is 343.21 paid to theparticipantassistance unit. The reduction in the 343.22 grant amount must be in effect for a minimum of one month and 343.23 shall be removed in the month following the month thatthea 343.24 participant in a one-parent household returns to compliance. In 343.25 a two-parent household, the grant reduction must be in effect 343.26 for a minimum of one month and shall be removed in the month 343.27 following the month both participants return to compliance. The 343.28 vendor payment ofrentshelter costs and, if applicable, 343.29 utilities shall be removed six months after the month in which 343.30 the participantreturnsor participants return to compliance. 343.31 (c) No later than during the second month that a sanction 343.32 under paragraph (b), clause (2), is in effect due to 343.33 noncompliance with employment services, the participant's case 343.34 file must be reviewed to determine if: 343.35 (i) the continued noncompliance can be explained and 343.36 mitigated by providing a needed preemployment activity, as 344.1 defined in section 256J.49, subdivision 13, clause (16); 344.2 (ii) the participant qualifies for a good cause exception 344.3 under section 256J.57; or 344.4 (iii) the participant qualifies for an exemption under 344.5 section 256J.56. 344.6 If the lack of an identified activity can explain the 344.7 noncompliance, the county must work with the participant to 344.8 provide the identified activity, and the county must restore the 344.9 participant's grant amount to the full amount for which the 344.10 assistance unit is eligible. The grant must be restored 344.11 retroactively to the first day of the month in which the 344.12 participant was found to lack preemployment activities or to 344.13 qualify for an exemption or good cause exception. 344.14 If the participant is found to qualify for a good cause 344.15 exception or an exemption, the county must restore the 344.16 participant's grant to the full amount for which the assistance 344.17 unit is eligible.If the participant's grant is restored under344.18this paragraph, the vendor payment of rent and if applicable,344.19utilities, shall be removed six months after the month in which344.20the sanction was imposed and the county must consider a344.21subsequent occurrence of noncompliance to be a first occurrence.344.22 Sec. 85. Minnesota Statutes 1997 Supplement, section 344.23 256J.46, subdivision 2, is amended to read: 344.24 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 344.25 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 344.26 cooperate, as determined by the child support enforcement 344.27 agency, with support requirements under section 256.741,if344.28enacted,shall be subject to sanction as specified in this 344.29 subdivision. The assistance unit's grant must be reduced by 25 344.30 percent of the applicable transitional standard. The residual 344.31 amount of the grant, if any, must be paid to the caregiver. A 344.32 sanction under this subdivision becomes effectiveten days after344.33 the first month following the month in which a required notice 344.34 is given. A sanction must not be imposed when a caregiver comes 344.35 into compliance with the requirements under section 256.741 344.36 prior to the effective date of the sanction. The sanctionmust345.1be in effect for a minimum of one month andshall be removed 345.2only whenin the month following the month that the caregiver 345.3 cooperates with the support requirements. Each month that an 345.4 MFIP-S caregiver fails to comply with the requirements of 345.5 section 256.741 must be considered a separate occurrence of 345.6 noncompliance. An MFIP-S caregiver who has had one or more 345.7 sanctions imposed must remain in compliance with the 345.8 requirements of section 256.741 for six months in order for a 345.9 subsequent sanction to be considered a first occurrence. 345.10 Sec. 86. Minnesota Statutes 1997 Supplement, section 345.11 256J.46, subdivision 2a, is amended to read: 345.12 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 345.13 provisions of subdivisions 1 and 2, for a participant subject to 345.14 a sanction for refusal to comply with child support requirements 345.15 under subdivision 2 and subject to a concurrent sanction for 345.16 refusal to cooperate with other program requirements under 345.17 subdivision 1, sanctions shall be imposed in the manner 345.18 prescribed in this subdivision. 345.19 A participant who has had one or more sanctions imposed 345.20 under this subdivision must remain in compliance with the 345.21 provisions of this chapter for six months in order for a 345.22 subsequent occurrence of noncompliance to be considered a first 345.23 occurrence. Any vendor payment ofrentshelter costs or 345.24 utilities under this subdivision must remain in effect for six 345.25 months after the month in which the participant is no longer 345.26 subject to sanction under subdivision 1. 345.27 (b) If the participant was subject to sanction for: 345.28 (i) noncompliance under subdivision 1 before being subject 345.29 to sanction for noncooperation under subdivision 2; or 345.30 (ii) noncooperation under subdivision 2 before being 345.31 subject to sanction for noncompliance under subdivision 1; 345.32 the participant shall be sanctioned as provided in subdivision 345.33 1, paragraph (b), clause (2), and the requirement that the 345.34 county conduct a review as specified in subdivision 1, paragraph 345.35 (c), remains in effect. 345.36 (c) A participant who first becomes subject to sanction 346.1 under both subdivisions 1 and 2 in the same month is subject to 346.2 sanction as follows: 346.3 (i) in the first month of noncompliance and noncooperation, 346.4 the participant's grant must be reduced by 25 percent of the 346.5 applicable transitional standard, with any residual amount paid 346.6 to the participant; 346.7 (ii) in the second and subsequent months of noncompliance 346.8 and noncooperation, the participant shall be sanctioned as 346.9 provided in subdivision 1, paragraph (b), clause (2). 346.10 The requirement that the county conduct a review as 346.11 specified in subdivision 1, paragraph (c), remains in effect. 346.12 (d) A participant remains subject to sanction under 346.13 subdivision 2 if the participant: 346.14 (i) returns to compliance and is no longer subject to 346.15 sanction under subdivision 1; or 346.16 (ii) has the sanction under subdivision 1, paragraph (b), 346.17 removed upon completion of the review under subdivision 1, 346.18 paragraph (c). 346.19 A participant remains subject to sanction under subdivision 346.20 1, paragraph (b), if the participant cooperates and is no longer 346.21 subject to sanction under subdivision 2. 346.22 Sec. 87. Minnesota Statutes 1997 Supplement, section 346.23 256J.47, subdivision 4, is amended to read: 346.24 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 346.25 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 346.26 assistance, the family is ineligible for MFIP-S, emergency 346.27 assistance, and emergency general assistance for a period of 346.28 time. To determine the period of ineligibility, the county 346.29 shall use the following formula: regardless of household 346.30 changes, the county agency must calculate the number of days of 346.31 ineligibility by dividing the diversionary assistance issued by 346.32 the transitional standard a family of the same size and 346.33 composition would have received under MFIP-S, or if applicable 346.34 the interstate transitional standard, multiplied by 30, 346.35 truncating the result. The ineligibility period begins the date 346.36 the diversionary assistance is issued. 347.1 Sec. 88. Minnesota Statutes 1997 Supplement, section 347.2 256J.48, subdivision 2, is amended to read: 347.3 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 347.4 provisions of this chapter, any family without resources 347.5 immediately available to meet emergency needs identified in 347.6 subdivision 3 shall be eligible for an emergency grant under the 347.7 following conditions: 347.8 (1) a family member has resided in this state for at least 347.9 30 days; 347.10 (2) the family is without resources immediately available 347.11 to meet emergency needs; 347.12 (3) assistance is necessary to avoid destitution or provide 347.13 emergency shelter arrangements;and347.14 (4) the family's destitution or need for shelter or 347.15 utilities did not arise because the child or relative caregiver 347.16 refused without good cause under section 256J.57 to accept 347.17 employment or training for employment in this state or another 347.18 state; and 347.19 (5) at least one child or pregnant woman in the emergency 347.20 assistance unit meets MFIP-S citizenship requirements in section 347.21 256J.11. 347.22 Sec. 89. Minnesota Statutes 1997 Supplement, section 347.23 256J.48, subdivision 3, is amended to read: 347.24 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 347.25 the following: 347.26 (a) [RENT.] A county agency may deny assistance to prevent 347.27 eviction from rented or leased shelter of an otherwise eligible 347.28 applicant when the county agency determines that an applicant's 347.29 anticipated income will not cover continued payment for shelter, 347.30 subject to conditions in clauses (1) to (3): 347.31 (1) a county agency must not deny assistance when an 347.32 applicant can document that the applicant is unable to locate 347.33 habitable shelter, unless the county agency can document that 347.34 one or more habitable shelters are available in the community 347.35 that will result in at least a 20 percent reduction in monthly 347.36 expense for shelter and that this shelter will be cost-effective 348.1 for the applicant; 348.2 (2) when no alternative shelter can be identified by either 348.3 the applicant or the county agency, the county agency shall not 348.4 deny assistance because anticipated income will not cover rental 348.5 obligation; and 348.6 (3) when cost-effective alternative shelter is identified, 348.7 the county agency shall issue assistance for moving expenses as 348.8 provided in paragraph(d)(e). 348.9 (b) [DEFINITIONS.] For purposes of paragraph (a), the 348.10 following definitions apply (1) "metropolitan statistical area" 348.11 is as defined by the United States Census Bureau; (2) 348.12 "alternative shelter" includes any shelter that is located 348.13 within the metropolitan statistical area containing the county 348.14 and for which the applicant is eligible, provided the applicant 348.15 does not have to travel more than 20 miles to reach the shelter 348.16 and has access to transportation to the shelter. Clause (2) 348.17 does not apply to counties in the Minneapolis-St. Paul 348.18 metropolitan statistical area. 348.19 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 348.20 agency shall issue assistance for mortgage or contract for deed 348.21 arrearages on behalf of an otherwise eligible applicant 348.22 according to clauses (1) to (4): 348.23 (1) assistance for arrearages must be issued only when a 348.24 home is owned, occupied, and maintained by the applicant; 348.25 (2) assistance for arrearages must be issued only when no 348.26 subsequent foreclosure action is expected within the 12 months 348.27 following the issuance; 348.28 (3) assistance for arrearages must be issued only when an 348.29 applicant has been refused refinancing through a bank or other 348.30 lending institution and the amount payable, when combined with 348.31 any payments made by the applicant, will be accepted by the 348.32 creditor as full payment of the arrearage; 348.33 (4) costs paid by a family which are counted toward the 348.34 payment requirements in this clause are: principal and interest 348.35 payments on mortgages or contracts for deed, balloon payments, 348.36 homeowner's insurance payments, manufactured home lot rental 349.1 payments, and tax or special assessment payments related to the 349.2 homestead. Costs which are not counted include closing costs 349.3 related to the sale or purchase of real property. 349.4 To be eligible for assistance for costs specified in clause 349.5 (4) which are outstanding at the time of foreclosure, an 349.6 applicant must have paid at least 40 percent of the family's 349.7 gross income toward these costs in the month of application and 349.8 the 11-month period immediately preceding the month of 349.9 application. 349.10 When an applicant is eligible under clause (4), a county 349.11 agency shall issue assistance up to a maximum of four times the 349.12 MFIP-S transitional standard for a comparable assistance unit. 349.13 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 349.14 issue assistance for damage or utility deposits when necessary 349.15 to alleviate the emergency. The county may require that 349.16 assistance paid in the form of a damage depositor a utility349.17deposit, less any amount retained by the landlord to remedy a 349.18 tenant's default in payment of rent or other funds due to the 349.19 landlord under a rental agreement, or to restore the premises to 349.20 the condition at the commencement of the tenancy, ordinary wear 349.21 and tear excepted, be returned to the county when the individual 349.22 vacates the premises or be paid to the recipient's new landlord 349.23 as a vendor payment. The county may require that assistance 349.24 paid in the form of a utility deposit less any amount retained 349.25 to satisfy outstanding utility costs be returned to the county 349.26 when the person vacates the premises, or be paid for the 349.27 person's new housing unit as a vendor payment. The vendor 349.28 payment of returned funds shall not be considered a new use of 349.29 emergency assistance. 349.30 (e) [MOVING EXPENSES.] A county agency shall issue 349.31 assistance for expenses incurred when a family must move to a 349.32 different shelter according to clauses (1) to (4): 349.33 (1) moving expenses include the cost to transport personal 349.34 property belonging to a family, the cost for utility connection, 349.35 and the cost for securing different shelter; 349.36 (2) moving expenses must be paid only when the county 350.1 agency determines that a move is cost-effective; 350.2 (3) moving expenses must be paid at the request of an 350.3 applicant, but only when destitution or threatened destitution 350.4 exists; and 350.5 (4) moving expenses must be paid when a county agency 350.6 denies assistance to prevent an eviction because the county 350.7 agency has determined that an applicant's anticipated income 350.8 will not cover continued shelter obligation in paragraph (a). 350.9 (f) [HOME REPAIRS.] A county agency shall pay for repairs 350.10 to the roof, foundation, wiring, heating system, chimney, and 350.11 water and sewer system of a home that is owned and lived in by 350.12 an applicant. 350.13 The applicant shall document, and the county agency shall 350.14 verify the need for and method of repair. 350.15 The payment must be cost-effective in relation to the 350.16 overall condition of the home and in relation to the cost and 350.17 availability of alternative housing. 350.18 (g) [UTILITY COSTS.] Assistance for utility costs must be 350.19 made when an otherwise eligible family has had a termination or 350.20 is threatened with a termination of municipal water and sewer 350.21 service, electric, gas or heating fuel service, or lacks wood 350.22 when that is the heating source, subject to the conditions in 350.23 clauses (1) and (2): 350.24 (1) a county agency must not issue assistance unless the 350.25 county agency receives confirmation from the utility provider 350.26 that assistance combined with payment by the applicant will 350.27 continue or restore the utility; and 350.28 (2) a county agency shall not issue assistance for utility 350.29 costs unless a family paid at least eight percent of the 350.30 family's gross income toward utility costs due during the 350.31 preceding 12 months. 350.32 Clauses (1) and (2) must not be construed to prevent the 350.33 issuance of assistance when a county agency must take immediate 350.34 and temporary action necessary to protect the life or health of 350.35 a child. 350.36 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 351.1 shall pay for special diets or dietary items for MFIP-S 351.2 participants. Persons receiving emergency assistance funds for 351.3 special diets or dietary items are also eligible to receive 351.4 emergency assistance for shelter and utility emergencies, if 351.5 otherwise eligible. The need for special diets or dietary items 351.6 must be prescribed by a licensed physician. Costs for special 351.7 diets shall be determined as percentages of the allotment for a 351.8 one-person household under the Thrifty Food Plan as defined by 351.9 the United States Department of Agriculture. The types of diets 351.10 and the percentages of the Thrifty Food Plan that are covered 351.11 are as follows: 351.12 (1) high protein diet, at least 80 grams daily, 25 percent 351.13 of Thrifty Food Plan; 351.14 (2) controlled protein diet, 40 to 60 grams and requires 351.15 special products, 100 percent of Thrifty Food Plan; 351.16 (3) controlled protein diet, less than 40 grams and 351.17 requires special products, 125 percent of Thrifty Food Plan; 351.18 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 351.19 (5) high residue diet, 20 percent of Thrifty Food Plan; 351.20 (6) pregnancy and lactation diet, 35 percent of Thrifty 351.21 Food Plan; 351.22 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 351.23 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 351.24 (9) antidumping diet, 15 percent of Thrifty Food Plan; 351.25 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 351.26 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 351.27 Sec. 90. Minnesota Statutes 1997 Supplement, section 351.28 256J.49, subdivision 4, is amended to read: 351.29 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 351.30 "Employment and training service provider" means: 351.31 (1) a public, private, or nonprofit employment and training 351.32 agency certified by the commissioner of economic security under 351.33 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 351.34 is approved under section 256J.51 and is included in the county 351.35 plan submitted under section 256J.50, subdivision 7;or351.36 (2) a public, private, or nonprofit agency that is not 352.1 certified by the commissioner under clause (1), but with which a 352.2 county has contracted to provide employment and training 352.3 services and which is included in the county's plan submitted 352.4 under section 256J.50, subdivision 7; or 352.5 (3) a county agency, if the countyis certified under352.6clause (1)has opted to provide employment and training services 352.7 and the county has indicated that fact in the plan submitted 352.8 under section 256J.50, subdivision 7. 352.9 Notwithstanding section 268.871, an employment and training 352.10 services provider meeting this definition may deliver employment 352.11 and training services under this chapter. 352.12 Sec. 91. Minnesota Statutes 1997 Supplement, section 352.13 256J.50, subdivision 5, is amended to read: 352.14 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 352.15 TWO-PARENT CASES.] (a) A county must establish a uniform 352.16 schedule for requiring participation by single parents. 352.17 Mandatory participation must be required within six months of 352.18 eligibility for cash assistance. For two-parent cases, 352.19 participation is required concurrent with the receipt of MFIP-S 352.20 cash assistance. 352.21 (b) Beginning January 1, 1998, with the exception of 352.22 caregivers required to attend high school under the provisions 352.23 of section 256J.54, subdivision 5, MFIP caregivers, upon 352.24 completion of the secondary assessment, must develop an 352.25 employment plan and participate in work activities. 352.26 (c) Upon completion of the secondary assessment: 352.27 (1) In single-parent families with no children under six 352.28 years of age, the job counselor and the caregiver must develop 352.29 an employment plan that includes 20 to 35 hours per week of work 352.30 activities for the period January 1, 1998, to September 30, 352.31 1998; 25 to 35 hours of work activities per week in federal 352.32 fiscal year 1999; and 30 to 35 hours per week of work activities 352.33 in federal fiscal year 2000 and thereafter. 352.34 (2) In single-parent families with a child under six years 352.35 of age, the job counselor and the caregiver must develop an 352.36 employment plan that includes 20 to 35 hours per week of work 353.1 activities. 353.2 (3) In two-parent families, the job counselor and the 353.3 caregivers must develop employment plans which result in a 353.4 combined total of at least 55 hours per week of work activities. 353.5 Sec. 92. Minnesota Statutes 1997 Supplement, section 353.6 256J.50, is amended by adding a subdivision to read: 353.7 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC 353.8 VIOLENCE.] County agencies and their contractors must provide 353.9 universal notification to all applicants and recipients of 353.10 MFIP-S that: 353.11 (1) referrals to counseling and supportive services are 353.12 available for victims of domestic violence; 353.13 (2) nonpermanent resident battered individuals married to 353.14 United States citizens or permanent residents may be eligible to 353.15 petition for permanent residency under the federal Violence 353.16 Against Women Act, and that referrals to appropriate legal 353.17 services are available; 353.18 (3) victims of domestic violence are exempt from the 353.19 60-month limit on assistance while the individual is complying 353.20 with an approved safety plan, as defined in section 256J.49, 353.21 subdivision 11; and 353.22 (4) victims of domestic violence may choose to be exempt or 353.23 deferred from work requirements for up to 12 months while the 353.24 individual is complying with an approved safety plan as defined 353.25 in section 256J.49, subdivision 11. 353.26 Notification must be in writing and orally at the time of 353.27 application and recertification, when the individual is referred 353.28 to the title IV-D child support agency, and at the beginning of 353.29 any job training or work placement assistance program. 353.30 Sec. 93. Minnesota Statutes 1997 Supplement, section 353.31 256J.50, is amended by adding a subdivision to read: 353.32 Subd. 11. [COORDINATION.] The county agency and the county 353.33 agency's employment and training providers must consult and 353.34 coordinate with other providers of employment and training 353.35 services to identify existing resources, in order to prevent 353.36 duplication of services, to assure that other programs' services 354.1 are available to enable participants to achieve 354.2 self-sufficiency, and to assure that costs for these other 354.3 services for which participants are eligible are not incurred by 354.4 MFIP-S. At a minimum, the county agency and its providers must 354.5 coordinate with Jobs Training and Partnership Act providers and 354.6 with any other relevant employment, training, and education 354.7 programs in the county. 354.8 Sec. 94. Minnesota Statutes 1997 Supplement, section 354.9 256J.515, is amended to read: 354.10 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 354.11 During the first meeting with participants, job counselors 354.12 must ensure that an overview of employment and training services 354.13 is provided that: (1) stresses the necessity and opportunity of 354.14 immediate employment,; (2) outlines the job search resources 354.15 offered,; (3) outlines education or training opportunities 354.16 available; (4) describes the range of work activities, including 354.17 activities under section 256J.49, subdivision 13, clause (18), 354.18 that are allowable under MFIP-S to meet the individual needs of 354.19 participants; (5) explains the requirements to comply with an 354.20 employment planand; (6) explains the consequences for failing 354.21 to comply,; and (7) explains the services that are available to 354.22 support job search and work and education. 354.23 Sec. 95. Minnesota Statutes 1997 Supplement, section 354.24 256J.52, subdivision 4, is amended to read: 354.25 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 354.26 must conduct a secondary assessment for those participants who: 354.27 (1) in the judgment of the job counselor, have barriers to 354.28 obtaining employment that will not be overcome with a job search 354.29 support plan under subdivision 3; 354.30 (2) have completed eight weeks of job search under 354.31 subdivision 3 without obtaining suitable employment;or354.32 (3) have not received a secondary assessment, are working 354.33 at least 20 hours per week, and the participant, job counselor, 354.34 or county agency requests a secondary assessment; or 354.35 (4) have an existing job search plan or employment plan 354.36 developed for another program or are already involved in 355.1 training or education activities under section 256J.55, 355.2 subdivision 5. 355.3 (b) In the secondary assessment the job counselor must 355.4 evaluate the participant's skills and prior work experience, 355.5 family circumstances, interests and abilities, need for 355.6 preemployment activities, supportive or educational services, 355.7 and the extent of any barriers to employment. The job counselor 355.8 must use the information gathered through the secondary 355.9 assessment to develop an employment plan under subdivision 5. 355.10 (c) The provider shall make available to participants 355.11 information regarding additional vendors or resources which 355.12 provide employment and training services that may be available 355.13 to the participant under a plan developed under this section. 355.14 The information must include a brief summary of services 355.15 provided and related performance indicators. Performance 355.16 indicators must include, but are not limited to, the average 355.17 time to complete program offerings, placement rates, entry and 355.18 average wages, and retention rates. To be included in the 355.19 information given to participants, a vendor or resource must 355.20 provide counties with relevant information in the format 355.21 required by the county. 355.22 Sec. 96. Minnesota Statutes 1997 Supplement, section 355.23 256J.52, is amended by adding a subdivision to read: 355.24 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 355.25 EDUCATION AND TRAINING.] After a caregiver receiving MFIP-S has 355.26 been employed for six consecutive months, during which time the 355.27 caregiver works on average more than 20 hours per week, the 355.28 caregiver's job counselor shall inform the caregiver that the 355.29 caregiver may request a secondary assessment described in 355.30 subdivision 4 and shall provide information about: 355.31 (1) part-time education and training options available to 355.32 the caregiver; and 355.33 (2) child care and transportation resources available to 355.34 support postemployment education and training. 355.35 Sec. 97. Minnesota Statutes 1997 Supplement, section 355.36 256J.52, is amended by adding a subdivision to read: 356.1 Subd. 9. [TRAINING CONCURRENT WITH EMPLOYMENT.] An MFIP 356.2 caregiver who is meeting the minimum hourly work participation 356.3 requirements under the Personal Responsibility and Work 356.4 Opportunity Reconciliation Act of 1996 through employment must 356.5 be allowed to meet any additional MFIP-S hourly work 356.6 participation requirements through training or education that 356.7 meets the requirements of section 256J.53. 356.8 Sec. 98. Minnesota Statutes 1997 Supplement, section 356.9 256J.54, subdivision 2, is amended to read: 356.10 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 356.11 PLAN.] For caregivers who are under age 18 without a high school 356.12 diploma or its equivalent, the assessment under subdivision 1 356.13 and the employment plan under subdivision 3 must be completed by 356.14 the social services agency under section 257.33. For caregivers 356.15 who are age 18 or 19 without a high school diploma or its 356.16 equivalent, the assessment under subdivision 1 and the 356.17 employment plan under subdivision 3 must be completed by the job 356.18 counselor. The social services agency or the job counselor 356.19 shall consult with representatives of educational agencies that 356.20 are required to assist in developing educational plans under 356.21 section 126.235. 356.22 Sec. 99. Minnesota Statutes 1997 Supplement, section 356.23 256J.54, subdivision 3, is amended to read: 356.24 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 356.25 counselor or county social services agency identifies an 356.26 appropriate educational option for a caregiver under the age of 356.27 20 without a high school diploma or its equivalent,itthe job 356.28 counselor or agency must develop an employment plan which 356.29 reflects the identified option. The plan must specify that 356.30 participation in an educational activity is required, what 356.31 school or educational program is most appropriate, the services 356.32 that will be provided, the activities the caregiver will take 356.33 part in, including child care and supportive services, the 356.34 consequences to the caregiver for failing to participate or 356.35 comply with the specified requirements, and the right to appeal 356.36 any adverse action. The employment plan must, to the extent 357.1 possible, reflect the preferences of the caregiver. 357.2 Sec. 100. Minnesota Statutes 1997 Supplement, section 357.3 256J.54, subdivision 4, is amended to read: 357.4 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 357.5 counselor determines that there is no appropriate educational 357.6 option for a caregiver who is age 18 or 19 without a high school 357.7 diploma or its equivalent, the job counselor must develop an 357.8 employment plan, as defined in section 256J.49, subdivision 5, 357.9 for the caregiver. If the county social services agency 357.10 determines that school attendance is not appropriate for a 357.11 caregiver under age 18 without a high school diploma or its 357.12 equivalent, the county agency shall refer the caregiver to 357.13 social services for services as provided in section 257.33. 357.14 Sec. 101. Minnesota Statutes 1997 Supplement, section 357.15 256J.54, subdivision 5, is amended to read: 357.16 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 357.17 the provisions of section 256J.56, minor parents, or 18- or 357.18 19-year-old parents without a high school diploma or its 357.19 equivalent must attend school unless: 357.20 (1) transportation services needed to enable the caregiver 357.21 to attend school are not available; 357.22 (2) appropriate child care services needed to enable the 357.23 caregiver to attend school are not available; 357.24 (3) the caregiver is ill or incapacitated seriously enough 357.25 to prevent attendance at school; or 357.26 (4) the caregiver is needed in the home because of the 357.27 illness or incapacity of another member of the household. This 357.28 includes a caregiver of a child who is younger than six weeks of 357.29 age. 357.30 (b) The caregiver must be enrolled in a secondary school 357.31 and meeting the school's attendance requirements. The county, 357.32 social service agency, or job counselor must verify at least 357.33 once per quarter that the caregiver is meeting the school's 357.34 attendance requirements. An enrolled caregiver is considered to 357.35 be meeting the attendance requirements when the school is not in 357.36 regular session, including during holiday and summer breaks. 358.1 Sec. 102. Minnesota Statutes 1997 Supplement, section 358.2 256J.55, subdivision 5, is amended to read: 358.3 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 358.4 counselor approval, if a participant is already complying with a 358.5 job search support or employment plan that was developed for a 358.6 different program or is already involved in education or 358.7 training activities, the participant mayutilizecontinue that 358.8 planand that program's services, subject to the requirements of358.9subdivision 3, to be in compliance with sections 256J.52 to358.10256J.57 so long asor activity if the plan meets, or is modified 358.11 to meet, the requirements ofthosesections 256J.52 to 256J.57, 358.12 and if the participant is concurrently employed and the 358.13 combination of the hours spent in education or training and 358.14 employment meets the hourly participation requirements. The 358.15 participant is not required to be employed if the number of 358.16 hours per week the participant is in education or training meets 358.17 the hourly work participation requirements. 358.18 Sec. 103. Minnesota Statutes 1997 Supplement, section 358.19 256J.56, is amended to read: 358.20 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 358.21 EXEMPTIONS.] 358.22 (a) An MFIP-S caregiver is exempt from the requirements of 358.23 sections 256J.52 to 256J.55 if the caregiver belongs to any of 358.24 the following groups: 358.25 (1) individuals who are age 60 or older; 358.26 (2) individuals who are suffering from a professionally 358.27 certified permanent or temporary illness, injury, or incapacity 358.28 which is expected to continue for more than 30 days and which 358.29 prevents the person from obtaining or retaining employment. 358.30 Persons in this category with a temporary illness, injury, or 358.31 incapacity must be reevaluated at least quarterly; 358.32 (3) caregivers whose presence in the home is required 358.33 because of the professionally certified illness or incapacity of 358.34 another member in the assistance unit, a relative in the 358.35 household, or a foster child in the household; 358.36 (4) women who are pregnant, if the pregnancy has resulted 359.1 in a professionally certified incapacity that prevents the woman 359.2 from obtaining or retaining employment; 359.3 (5) caregivers of a child under the age of one year who 359.4 personally provide full-time care for the child. This exemption 359.5 may be used for only 12 months in a lifetime. In two-parent 359.6 households, only one parent or other relative may qualify for 359.7 this exemption; 359.8 (6) individuals who are single parents, or one parent in a 359.9 two-parent family, employed at least40 hours per week or at359.10least 30 hours per week and engaged in job search for at least359.11an additional ten35 hours per week; 359.12 (7) individuals experiencing a personal or family crisis 359.13 that makes them incapable of participating in the program, as 359.14 determined by the county agency. If the participant does not 359.15 agree with the county agency's determination, the participant 359.16 may seek professional certification, as defined in section 359.17 256J.08, that the participant is incapable of participating in 359.18 the program. 359.19 Persons in this exemption category must be reevaluated 359.20 every 60 days; or 359.21 (8) second parents in two-parent families, provided the359.22second parent isemployed for 20 or more hours per week, 359.23 provided the first parent is employed at least 35 hours per week. 359.24 A caregiver who is exempt under clause (5) must enroll in 359.25 and attend an early childhood and family education class, a 359.26 parenting class, or some similar activity, if available, during 359.27 the period of time the caregiver is exempt under this section. 359.28 Notwithstanding section 256J.46, failure to attend the required 359.29 activity shall not result in the imposition of a sanction. 359.30 (b) The county agency must provide employment and training 359.31 services to MFIP-S caregivers who are exempt under this section, 359.32 but who volunteer to participate. Exempt volunteers may request 359.33 approval for any work activity under section 256J.49, 359.34 subdivision 13. The hourly participation requirements for 359.35 nonexempt caregivers under section 256J.50, subdivision 5, do 359.36 not apply to exempt caregivers who volunteer to participate. 360.1 Sec. 104. Minnesota Statutes 1997 Supplement, section 360.2 256J.57, subdivision 1, is amended to read: 360.3 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 360.4 county agency shall not impose the sanction under section 360.5 256J.46 if it determines that the participant has good cause for 360.6 failing to comply with the requirements ofsection 256J.45 or360.7 sections 256J.52 to 256J.55. Good cause exists when: 360.8 (1) appropriate child care is not available; 360.9 (2) the job does not meet the definition of suitable 360.10 employment; 360.11 (3) the participant is ill or injured; 360.12 (4) afamilymember of the assistance unit, a relative in 360.13 the household, or a foster child in the household is ill and 360.14 needs care by the participant that prevents the participant from 360.15 complying with the job search support plan or employment plan; 360.16 (5) the parental caregiver is unable to secure necessary 360.17 transportation; 360.18 (6) the parental caregiver is in an emergency situation 360.19 that prevents compliance with the job search support plan or 360.20 employment plan; 360.21 (7) the schedule of compliance with the job search support 360.22 plan or employment plan conflicts with judicial proceedings; 360.23 (8) the parental caregiver is already participating in 360.24 acceptable work activities; 360.25 (9) the employment plan requires an educational program for 360.26 a caregiver under age 20, but the educational program is not 360.27 available; 360.28 (10) activities identified in the job search support plan 360.29 or employment plan are not available; 360.30 (11) the parental caregiver is willing to accept suitable 360.31 employment, but suitable employment is not available; or 360.32 (12) the parental caregiver documents other verifiable 360.33 impediments to compliance with the job search support plan or 360.34 employment plan beyond the parental caregiver's control. 360.35 Sec. 105. Minnesota Statutes 1997 Supplement, section 360.36 256J.645, subdivision 3, is amended to read: 361.1 Subd. 3. [FUNDING.] If the commissioner and an Indian 361.2 tribe are parties to an agreement under this subdivision, the 361.3 agreement may annually provide to the Indian tribe the funding 361.4 amount in clause (1) or (2): 361.5 (1) if the Indian tribe operated a tribal STRIDE program 361.6 during state fiscal year 1997, the amount to be provided is the 361.7 amount the Indian tribe received from the state for operation of 361.8 its tribal STRIDE program in state fiscal year 1997, except that 361.9 the amount provided for a fiscal year may increase or decrease 361.10 in the same proportion that the total amount of state and 361.11 federal funds available for MFIP-S employment and training 361.12 services increased or decreased that fiscal year; or 361.13 (2) if the Indian tribe did not operate a tribal STRIDE 361.14 program during state fiscal year 1997, the commissioner may 361.15 provide to the Indian tribe for the first year of operations the 361.16 amount determined by multiplying the state allocation for MFIP-S 361.17 employment and training services to each county agency in the 361.18 Indian tribe's service delivery area by the percentage of MFIP-S 361.19 recipients in that county who were members of the Indian tribe 361.20 during the previous state fiscal year. The resulting amount 361.21 shall also be the amount that the commissioner may provide to 361.22 the Indian tribe annually thereafter through an agreement under 361.23 this subdivision, except that the amount provided for a fiscal 361.24 year may increase or decrease in the same proportion that the 361.25 total amount of state and federal funds available for MFIP-S 361.26 employment and training services increased or decreased that 361.27 fiscal year. 361.28 Sec. 106. Minnesota Statutes 1997 Supplement, section 361.29 256J.74, subdivision 2, is amended to read: 361.30 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 361.31 agency must not count an applicant or participant as a member of 361.32 more than one assistance unit in a given payment month, except 361.33 as provided in clauses (1) and (2). 361.34 (1) A participant who is a member of an assistance unit in 361.35 this state is eligible to be included in a second assistance 361.36 unitinthe first full monththatafter the month the 362.1 participantleaves the first assistance unit and lives with362.2ajoins the secondassistanceunit. 362.3 (2) An applicant whose needs are met through foster care 362.4 that is reimbursed under title IV-E of the Social Security Act 362.5 for the first part of an application month is eligible to 362.6 receive assistance for the remaining part of the month in which 362.7 the applicant returns home. Title IV-E payments and adoption 362.8 assistance payments must be considered prorated payments rather 362.9 than a duplication of MFIP-S need. 362.10 Sec. 107. Minnesota Statutes 1997 Supplement, section 362.11 256J.74, is amended by adding a subdivision to read: 362.12 Subd. 5. [FOOD STAMPS.] For any month an individual 362.13 receives Food Stamp Program benefits, the individual is not 362.14 eligible for the MFIP-S food portion of assistance, except as 362.15 provided under section 256J.28, subdivision 5. 362.16 Sec. 108. [256J.77] [AGING OF CASH BENEFITS.] 362.17 Cash benefits under chapters 256D, 256J, and 256K by 362.18 warrants or electronic benefit transfer that have not been 362.19 accessed within 90 days of issuance shall be canceled. Cash 362.20 benefits may be replaced after they are canceled, for up to one 362.21 year after the date of issuance, if failure to do so would place 362.22 the client or family at risk. For purposes of this section, 362.23 "accessed" means cashing a warrant or making at least one 362.24 withdrawal from benefits deposited in an electronic benefit 362.25 account. 362.26 Sec. 109. Minnesota Statutes 1997 Supplement, section 362.27 256K.03, subdivision 5, is amended to read: 362.28 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 362.29 exempt from the job search requirements and development of a job 362.30 search plan and an employability development plan under 362.31 subdivisions 3, 4, and 8 if the applicant belongs to any of the 362.32 following groups: 362.33 (1)caregivers under age 20 who have not completed a high362.34school education and are attending high school on a full-time362.35basis;362.36(2)individuals who are age 60 or older; 363.1(3)(2) individuals who are suffering from a professionally 363.2 certified permanent or temporary illness, injury, or incapacity 363.3 which is expected to continue for more than 30 days and which 363.4 prevents the person from obtaining or retaining employment. 363.5 Persons in this category with a temporary illness, injury, or 363.6 incapacity must be reevaluated at least quarterly; 363.7(4)(3) caregivers whose presence in the home is needed 363.8 because of the professionally certified illness or incapacity of 363.9 another member in the assistance unit, a relative in the 363.10 household, or a foster child in the household; 363.11(5)(4) women who are pregnant, ifitthe pregnancy has 363.12been medically verifiedresulted in a professionally certified 363.13 incapacity thatthe child is expected to be born within the next363.14six monthsprevents the woman from obtaining and retaining 363.15 employment; 363.16(6)(5) caregiversor other caregiver relativesof a child 363.17 under the age ofthreeone year who personally provide full-time 363.18 care for the child. This exemption may be used for only 12 363.19 months in a lifetime. In two-parent households, only one parent 363.20 or other relative may qualify for this exemption; 363.21(7)(6) individuals who are single parents or one parent in 363.22 a two-parent family employed at least3035 hours per week; 363.23(8) individuals for whom participation would require a363.24round trip commuting time by available transportation of more363.25than two hours, excluding transporting of children for child363.26care;363.27(9) individuals for whom lack of proficiency in English is363.28a barrier to employment, provided such individuals are363.29participating in an intensive program which lasts no longer than363.30six months and is designed to remedy their language deficiency;363.31(10) individuals who, because of advanced age or lack of363.32ability, are incapable of gaining proficiency in English, as363.33determined by the county social worker, shall continue to be363.34exempt under this subdivision and are not subject to the363.35requirement that they be participating in a language program;363.36(11)(7) individualsunder such duress that they are364.1incapable of participating in the program, as determined by the364.2county social workerexperiencing a personal or family crisis 364.3 that makes them incapable of participating in the program, as 364.4 determined by the county agency. If the participant does not 364.5 agree with the county agency's determination, the participant 364.6 may seek professional certification, as defined in section 364.7 256J.08, that the participant is incapable of participating in 364.8 the program. Persons in this exemption category must be 364.9 reevaluated every 60 days; or 364.10(12) individuals in need of refresher courses for purposes364.11of obtaining professional certification or licensure.364.12(b) In a two-parent family, only one caregiver may be364.13exempted under paragraph (a), clauses (4) and (6).364.14 (8) second parents in two-parent families employed for 20 364.15 or more hours per week provided the first parent is employed at 364.16 least 35 hours per week. 364.17 (b) A caregiver who is exempt under clause (5) must enroll 364.18 in and attend an early childhood and family education class, a 364.19 parenting class, or some similar activity, if available, during 364.20 the period of time the caregiver is exempt under this section. 364.21 Notwithstanding section 256J.46, failure to attend the required 364.22 activity shall not result in the imposition of a sanction. 364.23 Sec. 110. Minnesota Statutes 1996, section 268.88, is 364.24 amended to read: 364.25 268.88 [LOCAL SERVICE UNIT PLANS.] 364.26 (a) By April 15,19911999, and by April 15 of each second 364.27 year thereafter, local service units shall prepare and submit to 364.28 the commissioner a plan that covers the next two state fiscal 364.29 years. At least 30 days prior to submission of the plan, the 364.30 local service unit shall solicit comments from the public on the 364.31 contents of the proposed plan. The commissioner shall notify 364.32 each local service unit within 60 days of receipt of its plan 364.33 that the plan has been approved or disapproved. The plan must 364.34 include: 364.35 (1) a statement of objectives for the employment and 364.36 training services the local service unit administers; 365.1 (2) the establishment of job placement and job retention 365.2 goals, the establishment of public assistance caseload reduction 365.3 goals, and the strategies and programs that will be used to 365.4 achieve these goals; 365.5 (3) a statement of whether the goals from the preceding 365.6 year were met and an explanation if the local service unit 365.7 failed to meet the goals; 365.8 (4) the amount proposed to be allocated to each employment 365.9 and training service; 365.10 (5) the proposed types of employment and training services 365.11 the local service unit plans to utilize; 365.12 (6) a description of how the local service unit will use 365.13 funds provided undersection 256.736 to meet the requirements of365.14that section. The description must include the two work365.15programs required by section 256.736, subdivision 10, paragraph365.16(a), clause (13), what services will be provided, number of365.17clients served, per service expenditures, type of clients365.18served, and projected outcomeschapter 256J to meet the 365.19 requirements of that chapter. The description must include what 365.20 services will be provided, per service expenditures, an estimate 365.21 of how many employment and training slots the local service unit 365.22 will provide, how many dollars the local service unit will 365.23 provide per slot per provider, how many participants per slot, 365.24 an estimate of the ratio of participants per job counselor, and 365.25 proposed uses for any residual funds not included in slot 365.26 allocations to providers; 365.27 (7) a report on the use of wage subsidies, grant 365.28 diversions, community investment programs, and other services 365.29 administered under this chapter; 365.30 (8) a performance review of the employment and training 365.31 service providers delivering employment and training services 365.32 for the local service unit; 365.33 (9) a copy of any contract between the local service unit 365.34 and an employment and training service provider including 365.35 expected outcomes and service levels for public assistance 365.36 clients;and366.1 (10) a copy of any other agreements between educational 366.2 institutions, family support services, and child care providers; 366.3 and 366.4 (11) a description of how the local service unit ensures 366.5 compliance with section 256J.06, requiring community involvement 366.6 in the administration of MFIP-S. 366.7 (b) In counties with a city of the first class, the county 366.8 and the city shall develop and submit a joint plan. The plan 366.9 may not be submitted until agreed to by both the city and the 366.10 county. The plan must provide for the direct allocation of 366.11 employment and training money to the city and the county unless 366.12 waived by either. If the county and the city cannot concur on a 366.13 plan, the commissioner shall resolve their dispute. In counties 366.14 in which a federally recognized Indian tribe is operating an 366.15 employment and training program under an agreement with the 366.16 commissioner of human services, the plan must provide that the 366.17 county will coordinate its employment and training programs, 366.18 including developing a system for referrals, sanctions, and the 366.19 provision of supporting services such as access to child care 366.20 funds and transportation with programs operated by the Indian 366.21 tribe. The plan may not be given final approval by the 366.22 commissioner until the tribal unit and county have submitted 366.23 written agreement on these provisions in the plan. If the 366.24 county and Indian tribe cannot agree on these provisions, the 366.25 local service unit shall notify the commissioner of economic 366.26 security and the commissioners of economic security and human 366.27 services shall resolve the dispute. 366.28 (c) The commissioner may withhold the distribution of 366.29 employment and training money from a local service unit that 366.30 does not submit a plan to the commissioner by the date set by 366.31 this section, and shall withhold the distribution of employment 366.32 and training money from a local service unit whose plan has been 366.33 disapproved by the commissioner until an acceptable amended plan 366.34 has been submitted. 366.35 (d) Beginning April 15, 1992, and by April 15 of each 366.36 second year thereafter, local service units must prepare and 367.1 submit to the commissioner an interim year plan update that 367.2 deals with performance in that state fiscal year and changes 367.3 anticipated for the second year of the biennium. The update 367.4 must include information about employment and training programs 367.5 addressed in the local service unit's two-year plan and shall be 367.6 completed in accordance with criteria established by the 367.7 commissioner. 367.8 Sec. 111. Laws 1997, chapter 203, article 9, section 21, 367.9 is amended to read: 367.10 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 367.11 (a) Beginning July 1,19992000, the following persons will 367.12 be ineligible for general assistance and general assistance 367.13 medical care under Minnesota Statutes, chapter 256D, group 367.14 residential housing under Minnesota Statutes, chapter 256I, and 367.15 MFIP-S assistance under Minnesota Statutes, chapter 256J, funded 367.16 with state money: 367.17 (1) persons who are terminated from or denied Supplemental 367.18 Security Income due to the 1996 changes in the federal law 367.19 making persons whose alcohol or drug addiction is a material 367.20 factor contributing to the person's disability ineligible for 367.21 Supplemental Security Income, and are eligible for general 367.22 assistance under Minnesota Statutes, section 256D.05, 367.23 subdivision 1, paragraph (a), clause (17), general assistance 367.24 medical care under Minnesota Statutes, chapter 256D, or group 367.25 residential housing under Minnesota Statutes, chapter 256I; 367.26 (2) legal noncitizens who are ineligible for Supplemental 367.27 Security Income due to the 1996 changes in federal law making 367.28 certain noncitizens ineligible for these programs due to their 367.29 noncitizen status; and 367.30 (3) legal noncitizens who are eligible for MFIP-S 367.31 assistance, either the cash assistance portion or the food 367.32 assistance portion, funded entirely with state money. 367.33 (b) State money that remains unspenton June 30, 1999,due 367.34 to changes in federal law enacted after May 12, 1997, that 367.35 reduce state spending for legal noncitizens or for persons whose 367.36 alcohol or drug addiction is a material factor contributing to 368.1 the person's disability, or enacted after February 1, 1998, that 368.2 reduce state spending for food benefits for legal noncitizens 368.3 shall not cancel and shall be deposited in the TANF reserve 368.4 account. 368.5 Sec. 112. Laws 1997, chapter 248, section 46, as amended 368.6 by Laws 1997, First Special Session chapter 5, section 10, is 368.7 amended to read: 368.8 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 368.9 EXPANSION.] 368.10 (a) Notwithstanding Minnesota Statutes, section 245A.03, 368.11 subdivision 2, clause (2), until June 30, 1999, nonresidential 368.12 child care programs or services that are provided by an 368.13 unrelated individual to persons from two or three other 368.14 unrelated families are excluded from the licensure provisions of 368.15 Minnesota Statutes, chapter 245A, provided that: 368.16 (1) the individual provides services at any one time to no 368.17 more than four children who are unrelated to the individual; 368.18 (2) no more than two of the children are under two years of 368.19 age; and 368.20 (3) the total number of children being cared for at any one 368.21 time does not exceed five. 368.22 (b) Paragraph (a), clauses (1) to (3), do not apply to: 368.23 (1) nonresidential programs that are provided by an 368.24 unrelated individual to persons from a single related family.; 368.25 (2) a child care provider whose child care services meet 368.26 the criteria in paragraph (a), clauses (1) to (3), but who 368.27 chooses to apply for licensure; 368.28 (3) a child care provider who, as an applicant for 368.29 licensure or as a license holder, has received a license denial 368.30 under Minnesota Statutes, section 245A.05, a fine under 368.31 Minnesota Statutes, section 245A.06, or a sanction under 368.32 Minnesota Statutes, section 245A.07, from the commissioner that 368.33 has not been reversed on appeal; or 368.34 (4) a child care provider, or a child care provider who has 368.35 a household member who, as a result of a licensing process, has 368.36 a disqualification under Minnesota Statutes, chapter 245A, that 369.1 has not been set aside by the commissioner. 369.2 Sec. 113. [REPORT REQUIRED.] 369.3 Beginning January 1, 1999, the commissioner shall report 369.4 annually to the legislature on January 15 on the percent, for 369.5 each of the four quarters of the immediate preceding year, of 369.6 the MFIP-S caseload participants who are exempt from work under 369.7 the provisions of Minnesota Statutes, section 256J.56, clause 369.8 (2) or (3). 369.9 Sec. 114. [REPORT; NONCERTIFIED PROVIDERS.] 369.10 Beginning January 15, 1999, the commissioner of economic 369.11 security, in conjunction with the commissioner of human 369.12 services, shall report annually on the use in MFIP-S of 369.13 employment and training providers. The report shall include 369.14 information on the number and types of noncertified providers. 369.15 Sec. 115. [SCREENING AND REFERRAL GUIDELINES FOR 369.16 PARTICIPANTS WITH DRUG AND ALCOHOL PROBLEMS.] 369.17 The commissioner of human services shall develop guidelines 369.18 for county agencies and their contractors to identify 369.19 participants who have alcohol or drug problems that require 369.20 treatment. The guidelines must provide for: 369.21 (1) the use of simplified written and verbal screening 369.22 tools as part of the intake process; 369.23 (2) referral for clinical assessment and appropriate 369.24 treatment, if needed; and 369.25 (3) training for caseworkers to administer the screening 369.26 protocols and refer participants to services. 369.27 Sec. 116. [EBT TRANSACTION COSTS; APPROVAL FROM 369.28 LEGISLATURE.] 369.29 The commissioner of human services shall request and 369.30 receive approval from the legislature before adjusting the 369.31 payment to retailers for electronic benefit transfer transaction 369.32 costs. 369.33 Sec. 117. [STUDY; MFIP-S EXIT LEVEL; ELIMINATION OF 369.34 SHELTER EXPENSE DEDUCTION.] 369.35 The commissioner shall consider recommending to the 1999 369.36 legislature: 370.1 (1) adjustments to the MFIP-S earned income disregard, 370.2 family wage level, or transitional standard, which will ensure 370.3 that participants do not lose eligibility for MFIP-S until their 370.4 income reaches at least 120 percent of the 1999 federal poverty 370.5 level; and 370.6 (2) proposals responding to the effect of the elimination 370.7 of the food stamp shelter expense deduction on food spending and 370.8 food sufficiency of MFIP-S families paying greater than 50 370.9 percent of their income toward housing costs. The 370.10 commissioner's recommendations should include information on the 370.11 number of families losing greater than 20 percent of their food 370.12 benefits, the number losing between ten percent and 20 percent 370.13 and the number losing zero percent to ten percent, and the 370.14 characteristics of families receiving less food assistance under 370.15 MFIP-S. The commissioner may collaborate with private or 370.16 nonprofit entities, if necessary, to provide this information. 370.17 Sec. 118. [REPEALER.] 370.18 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 370.19 subdivision 4, is repealed effective January 1, 1998. 370.20 (b) Minnesota Statutes 1997 Supplement, section 256J.25; 370.21 and Laws 1997, chapter 85, article 1, sections 61 and 71, and 370.22 article 3, section 55, are repealed. 370.23 (c) Minnesota Statutes 1996, sections 256.031, subdivisions 370.24 1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 370.25 6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475; 370.26 256.048; and 256.049; and Minnesota Statutes 1997 Supplement, 370.27 sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 370.28 and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34, 370.29 subdivision 5, are repealed effective July 1, 1998. 370.30 (d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 370.31 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 370.32 9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 370.33 9500.9220, are repealed effective July 1, 1998. 370.34 Sec. 119. [EFFECTIVE DATES.] 370.35 (a) Sections 2, 4, 7, 8, 19, 90, 95, and 102 are effective 370.36 the day following final enactment. 371.1 (b) Section 9 is effective June 1, 1998. 371.2 (c) Section 10 is effective October 1, 1998. 371.3 (d) Section 50 is effective for all applications for MFIP-S 371.4 made on or after July 1, 1998. 371.5 (e) Section 12 is effective March 30, 1998. 371.6 (f) Section 51 is effective for MFIP-S applications 371.7 received on or after January 1, 1999, and for all MFIP-S 371.8 recertifications occurring on or after January 1, 1999. 371.9 ARTICLE 7 371.10 REGIONAL TREATMENT CENTERS 371.11 Section 1. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 371.12 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 371.13 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 371.14 subdivision 3, or any other law to the contrary, the 371.15 commissioner of administration may convey all, or any part of, 371.16 the land and associated buildings described in subdivision 3 to 371.17 Anoka county after the commissioner of human services declares 371.18 said property surplus to its needs. 371.19 Subd. 2. [FORM.] (a) The conveyance shall be in a form 371.20 approved by the attorney general. 371.21 (b) The conveyance is subject to a scenic easement, as 371.22 defined in Minnesota Statutes, section 103F.311, subdivision 6, 371.23 to be under the custodial control of the commissioner of natural 371.24 resources, on that portion of the conveyed land that is 371.25 designated for inclusion in the wild and scenic river system 371.26 under Minnesota Statutes, section 103F.325. The scenic easement 371.27 shall allow for continued use of the structures located within 371.28 the easement and for development of a walking path within the 371.29 easement. 371.30 (c) The conveyance shall restrict use of the land to 371.31 governmental, including recreational, purposes and shall provide 371.32 that ownership of any portion of the land that ceases to be used 371.33 for such purposes shall revert to the state of Minnesota. 371.34 (d) The commissioner of administration may convey any part 371.35 of the property described in subdivision 3 any time after the 371.36 land is declared surplus by the commissioner of human services 372.1 and the execution and recording of the scenic easement under 372.2 paragraph (b) has been completed. 372.3 (e) Notwithstanding any law, regulation, or ordinance to 372.4 the contrary, the instrument of conveyance to Anoka county may 372.5 be recorded in the office of the Anoka county recorder without 372.6 compliance with any subdivision requirement. 372.7 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 372.8 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 372.9 state trunk highway No. 288, also known as 4th Avenue, the land 372.10 to be conveyed may include all, or part of, that which is 372.11 described as follows: 372.12 (1) all that part of Government Lots 3 and 4 and that part 372.13 of the Southeast Quarter of the Southwest Quarter, all in 372.14 Section 31, Township 32 North, Range 24 West, Anoka county, 372.15 Minnesota, described as follows: 372.16 Beginning at the southwest corner of said Southeast Quarter 372.17 of the Southwest Quarter of Section 31; thence North 13 372.18 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 372.19 feet; thence North 07 degrees 54 minutes 43 seconds East 372.20 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 372.21 West 154.77 feet; thence North 62 degrees 46 minutes 44 372.22 seconds West 526.92 feet; thence North 25 degrees 45 372.23 minutes 30 seconds East 74.43 feet; thence northerly 88.30 372.24 feet along a tangential curve concave to the west having a 372.25 radius of 186.15 feet and a central angle of 27 degrees 10 372.26 minutes 50 seconds; thence North 01 degrees 25 minutes 20 372.27 seconds West, tangent to said curve, 140.53 feet; thence 372.28 North 71 degrees 56 minutes 34 seconds West to the 372.29 southeasterly shoreline of the Rum river; thence 372.30 southwesterly along said shoreline to the south line of 372.31 said Government Lot 4; thence easterly along said south 372.32 line to the point of beginning. For the purpose of this 372.33 description the south line of said Southeast Quarter of the 372.34 Southwest Quarter of Section 31 has an assumed bearing of 372.35 North 89 degrees 08 minutes 19 seconds East; 372.36 (2) Government Lot 1, Section 6, Township 31 North, Range 373.1 24 West, Anoka county, Minnesota; EXCEPT that part platted as 373.2 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 373.3 lying southerly of the westerly extension of the south line of 373.4 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 373.5 Minnesota, and lying westerly of the west line of said plat of 373.6 Grant Properties, said line also being the centerline of 4th 373.7 Avenue; 373.8 (3) all that part of said Block 6, Woodbury's Addition to 373.9 the city of Anoka lying westerly of Northview 1st Addition, 373.10 Anoka county, Minnesota; 373.11 (4) all that part of said Northview 1st Addition lying 373.12 westerly of the east line of Lots 11 through 20, Block 1, 373.13 inclusive, thereof; and 373.14 (5) all that part of the Northeast Quarter of the Northwest 373.15 Quarter of said Section 6, Township 31 North, Range 24 West, 373.16 Anoka county, Minnesota, lying northerly of the centerline of 373.17 Grant Street as defined by said plat of Grant Properties and 373.18 lying westerly of said east line of Lots 11 through 20, Block 1, 373.19 inclusive, Northview 1st Addition and said line's extension 373.20 north and south. 373.21 Subd. 4. [DETERMINATION.] The commissioner of human 373.22 services has determined that the land described in subdivision 3 373.23 will no longer be needed for the Anoka metro regional treatment 373.24 center upon the completion of the state facilities currently 373.25 under construction and the completion of renovation work to 373.26 state buildings that are not located on the land described in 373.27 subdivision 3. The state's land and building management 373.28 interests may best be served by conveying all, or part of, the 373.29 land and associated buildings located on the land described in 373.30 subdivision 3. 373.31 Sec. 2. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 373.32 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 373.33 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 373.34 subdivision 3, or any other law to the contrary, the 373.35 commissioner of administration may convey all, or any part of, 373.36 the land and the state building located on the land described in 374.1 subdivision 3, to Crow Wing county after the commissioner of 374.2 human services declares the property surplus to its needs. 374.3 Subd. 2. [FORM.] (a) The conveyance shall be in a form 374.4 approved by the attorney general. 374.5 (b) The conveyance shall restrict use of the land to county 374.6 governmental purposes, including community corrections programs, 374.7 and shall provide that ownership of any portion of the land or 374.8 building that ceases to be used for such purposes shall revert 374.9 to the state of Minnesota. 374.10 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 374.11 Quarter (NE l/4) of Section 30, Township 45 North, Range 30 374.12 West, Crow Wing county, Minnesota, described as follows: 374.13 Commencing at the southeast corner of said Northeast 374.14 quarter; thence North 00 degrees 46 minutes 05 seconds 374.15 West, bearing based on the Crow Wing county Coordinate 374.16 Database NAD 83/94, 1520.06 feet along the east line of 374.17 said Northeast quarter to the point of beginning; thence 374.18 continue North 00 degrees 46 minutes 05 seconds West 634.14 374.19 feet along said east line of the Northeast quarter; thence 374.20 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 374.21 thence South 18 degrees 57 minutes 23 seconds East 115.59 374.22 feet; thence South 42 degrees 44 minutes 39 seconds East 374.23 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 374.24 East 20.24 feet; thence North 89 degrees 13 minutes 55 374.25 seconds East 33.00 feet to the point of beginning. 374.26 Containing 4.69 acres, more or less. Subject to the 374.27 right-of-way of the Township road along the east side 374.28 thereof, subject to other easements, reservations, and 374.29 restrictions of record, if any. 374.30 Subd. 4. [DETERMINATION.] The commissioner of human 374.31 services has determined that the land described in subdivision 3 374.32 and the building on the land will not be needed for future 374.33 operations of the Brainerd regional human services center. The 374.34 state's land management interests would best be served by 374.35 conveying the land to Crow Wing county for governmental use. 374.36 ARTICLE 8 375.1 COMPULSIVE GAMBLING AND MISCELLANEOUS 375.2 Section 1. Minnesota Statutes 1996, section 62A.65, 375.3 subdivision 5, is amended to read: 375.4 Subd. 5. [PORTABILITY OF COVERAGE.] (a) No individual 375.5 health plan may be offered, sold, issued, or with respect to 375.6 children age 18 or under renewed, to a Minnesota resident that 375.7 contains a preexisting condition limitation, preexisting 375.8 condition exclusion, or exclusionary rider, unless the 375.9 limitation or exclusion is permitted under this subdivision, 375.10 provided that, except for children age 18 or under, underwriting 375.11 restrictions may be retained on individual contracts that are 375.12 issued without evidence of insurability as a replacement for 375.13 prior individual coverage that was sold before May 17, 1993. 375.14 The individual may be subjected to an 18-month preexisting 375.15 condition limitation, unless the individual has maintained 375.16 continuous coverage as defined in section 62L.02. The 375.17 individual must not be subjected to an exclusionary rider. An 375.18 individual who has maintained continuous coverage may be 375.19 subjected to a one-time preexisting condition limitation of up 375.20 to 12 months, with credit for time covered under qualifying 375.21 coverage as defined in section 62L.02, at the time that the 375.22 individual first is covered under an individual health plan by 375.23 any health carrier. Credit must be given for all qualifying 375.24 coverage with respect to all preexisting conditions, regardless 375.25 of whether the conditions were preexisting with respect to any 375.26 previous qualifying coverage. The individual must not be 375.27 subjected to an exclusionary rider. Thereafter, the individual 375.28 must not be subject to any preexisting condition limitation, 375.29 preexisting condition exclusion, or exclusionary rider under an 375.30 individual health plan by any health carrier, except an 375.31 unexpired portion of a limitation under prior coverage, so long 375.32 as the individual maintains continuous coverage as defined in 375.33 section 62L.02. 375.34 (b) A health carrier must offer an individual health plan 375.35 to any individual previously covered under a group health plan 375.36 issued by that health carrier, regardless of the size of the 376.1 group, so long as the individual maintained continuous coverage 376.2 as defined in section 62L.02. Beginning January 1, 1999, if the 376.3 individual has available any continuation coverage provided 376.4 under sections 62A.146; 62A.148; 62A.17, subdivisions 1 and 2; 376.5 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or continuation 376.6 coverage provided under federal law, the health carrier need not 376.7 offer coverage under this paragraph until the individual has 376.8 exhausted the continuation coverage. The offer must not be 376.9 subject to underwriting, except as permitted under this 376.10 paragraph. A health plan issued under this paragraph must be a 376.11 qualified plan as defined in section 62E.02 and must not contain 376.12 any preexisting condition limitation, preexisting condition 376.13 exclusion, or exclusionary rider, except for any unexpired 376.14 limitation or exclusion under the previous coverage. The 376.15 individual health plan must cover pregnancy on the same basis as 376.16 any other covered illness under the individual health plan. The 376.17 initial premium rate for the individual health plan must comply 376.18 with subdivision 3. The premium rate upon renewal must comply 376.19 with subdivision 2. In no event shall the premium rate exceed 376.20 90 percent of the premium charged for comparable individual 376.21 coverage by the Minnesota comprehensive health association, and 376.22 the premium rate must be less than that amount if necessary to 376.23 otherwise comply with this section. An individual health plan 376.24 offered under this paragraph to a person satisfies the health 376.25 carrier's obligation to offer conversion coverage under section 376.26 62E.16, with respect to that person. Coverage issued under this 376.27 paragraph must provide that it cannot be canceled or nonrenewed 376.28 as a result of the health carrier's subsequent decision to leave 376.29 the individual, small employer, or other group market. Section 376.30 72A.20, subdivision 28, applies to this paragraph. 376.31 Sec. 2. Minnesota Statutes 1996, section 62D.042, 376.32 subdivision 2, is amended to read: 376.33 Subd. 2. [BEGINNING ORGANIZATIONSNET WORTH REQUIREMENTS.] 376.34 (a) Beginning organizations shall maintain net worth of at least 376.35 8-1/3 percent of the sum of all expenses expected to be incurred 376.36 in the 12 months following the date the certificate of authority 377.1 is granted, or $1,500,000, whichever is greater. 377.2 (b) After the first full calendar year of operation, 377.3 organizations shall maintain net worth of at least 8-1/3 percent 377.4 and at most16-2/325 percent of the sum of all expenses 377.5 incurred during the most recent calendar year, but in no case 377.6 shall net worth fall below $1,000,000. 377.7 (c) Notwithstanding paragraphs (a) and (b), any health 377.8 maintenance organization owned by a political subdivision of 377.9 this state, which has a higher than average percentage of 377.10 enrollees who are enrolled in medical assistance or general 377.11 assistance medical care, may exceed the maximum net worth limits 377.12 provided in paragraphs (a) and (b), with the advance approval of 377.13 the commissioner. 377.14 Sec. 3. Minnesota Statutes 1996, section 62E.16, is 377.15 amended to read: 377.16 62E.16 [POLICY CONVERSION RIGHTS.] 377.17 Every program of self-insurance, policy of group accident 377.18 and health insurance or contract of coverage by a health 377.19 maintenance organization written or renewed in this state, shall 377.20 include, in addition to the provisions required by section 377.21 62A.17, the right to convert to an individual coverage qualified 377.22 plan without the addition of underwriting restrictionsifafter 377.23 the individual insured has exhausted any continuation coverage 377.24 provided under section 62A.146; 62A.148; 62A.17, subdivisions 1 377.25 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or 377.26 continuation coverage provided under federal law, if any 377.27 continuation coverage is available to the individual, and then 377.28 leaves the group regardless of the reason for leaving the group 377.29 or if an employer member of a group ceases to remit payment so 377.30 as to terminate coverage for its employees, or upon cancellation 377.31 or termination of the coverage for the group except where 377.32 uninterrupted and continuous group coverage is otherwise 377.33 provided to the group. If the health maintenance organization 377.34 has canceled coverage for the group because of a loss of 377.35 providers in a service area, the health maintenance organization 377.36 shall arrange for other health maintenance or indemnity 378.1 conversion options that shall be offered to enrollees without 378.2 the addition of underwriting restrictions. The required 378.3 conversion contract must treat pregnancy the same as any other 378.4 covered illness under the conversion contract. The person may 378.5 exercise this right to conversion within 30 days of exhausting 378.6 any continuation coverage provided under section 62A.146; 378.7 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; or 62A.21, or 378.8 continuation coverage provided under federal law, and then 378.9 leaving the group or within 30 days following receipt of due 378.10 notice of cancellation or termination of coverage of the group 378.11 or of the employer member of the group and upon payment of 378.12 premiums from the date of termination or cancellation. Due 378.13 notice of cancellation or termination of coverage for a group or 378.14 of the employer member of the group shall be provided to each 378.15 employee having coverage in the group by the insurer, 378.16 self-insurer or health maintenance organization canceling or 378.17 terminating the coverage except where reasonable evidence 378.18 indicates that uninterrupted and continuous group coverage is 378.19 otherwise provided to the group. Every employer having a policy 378.20 of group accident and health insurance, group subscriber or 378.21 contract of coverage by a health maintenance organization shall, 378.22 upon request, provide the insurer or health maintenance 378.23 organization a list of the names and addresses of covered 378.24 employees. Plans of health coverage shall also include a 378.25 provision which, upon the death of the individual in whose name 378.26 the contract was issued, permits every other individual then 378.27 covered under the contract to elect, within the period specified 378.28 in the contract, to continue coverage under the same or a 378.29 different contract without the addition of underwriting 378.30 restrictions until the individual would have ceased to have been 378.31 entitled to coverage had the individual in whose name the 378.32 contract was issued lived. An individual conversion contract 378.33 issued by a health maintenance organization shall not be deemed 378.34 to be an individual enrollment contract for the purposes of 378.35 section 62D.10. An individual health plan offered under section 378.36 62A.65, subdivision 5, paragraph (b), to a person satisfies the 379.1 health carrier's obligation to offer conversion coverage under 379.2 this section with respect to that person. 379.3 Sec. 4. [62Q.096] [CREDENTIALING OF PROVIDERS.] 379.4 If a health plan company has initially credentialed, as 379.5 providers in its provider network, individual providers employed 379.6 by or under contract with an entity that: (1) is authorized to 379.7 bill under section 256B.0625, subdivision 5; (2) meets the 379.8 requirements of Minnesota Rules, parts 9520.0750 to 9520.0870; 379.9 (3) is designated an essential community provider under section 379.10 62Q.19; and (4) is under contract with the health plan company 379.11 to provide mental health services, the health plan company must 379.12 continue to credential at least the same number of providers 379.13 from that entity, as long as those providers meet the health 379.14 plan company's credentialing standards. A health plan company 379.15 shall not refuse to credential these providers on the grounds 379.16 that their provider network has a sufficient number of providers 379.17 of that type. 379.18 Sec. 5. [245.982] [PROGRAM SUPPORT.] 379.19 In order to address the problem of gambling in this state, 379.20 the compulsive gambling fund should attempt to assess the 379.21 beneficiaries of gambling, on a percentage basis according to 379.22 the revenue they receive from gambling, for the costs of 379.23 programs to help problem gamblers and their families. In that 379.24 light, the governor is requested to contact the chairs of the 11 379.25 tribal governments in this state and request a contribution of 379.26 funds for the compulsive gambling program. The governor should 379.27 seek a total supplemental contribution of $643,000. Funds 379.28 received from the tribal governments in this state shall be 379.29 deposited in the Indian gaming revolving account. 379.30 Sec. 6. Minnesota Statutes 1997 Supplement, section 379.31 256F.05, subdivision 8, is amended to read: 379.32 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 379.33 county which has not demonstrated that year that its family 379.34 preservation core services are developed as provided in 379.35 subdivision 1a, must use its family preservation fund grant 379.36 exclusively for family preservation services defined in section 380.1 256F.03, subdivision 5, paragraphs (a), (b), (c), and (e). 380.2 (b) A county which has demonstrated that year that its 380.3 family preservation core services are developed becomes eligible 380.4 either to continue using its family preservation fund grant as 380.5 provided in paragraph (a), or to exercise the expanded service 380.6 option under paragraph (c). 380.7 (c) The expanded service option permits an eligible county 380.8 to use its family preservation fund grant for child welfare 380.9 preventive services. For purposes of this section, child 380.10 welfare preventive services are those services directed toward a 380.11 specific child or family that further the goals of section 380.12 256F.01 and include assessments, family preservation services, 380.13 service coordination, community-based treatment, crisis nursery 380.14 services when the parents retain custody and there is no 380.15 voluntary placement agreement with a child-placing agency, 380.16 respite care except when it is provided under a medical 380.17 assistance waiver, home-based services, and other related 380.18 services. For purposes of this section, child welfare 380.19 preventive services shall not include shelter care or other 380.20 placement services under the authority of the court or public 380.21 agency to address an emergency. To exercise this option, an 380.22 eligible county must notify the commissioner in writing of its 380.23 intention to do so no later than 30 days into the quarter during 380.24 which it intends to begin or in its county plan, as provided in 380.25 section 256F.04, subdivision 2. Effective with the first day of 380.26 that quarter, the county must maintain its base level of 380.27 expenditures for child welfare preventive services and use the 380.28 family preservation fund to expand them. The base level of 380.29 expenditures for a county shall be that established under 380.30 section 256F.10, subdivision 7. For counties which have no such 380.31 base established, a comparable base shall be established with 380.32 the base year being the calendar year ending at least two 380.33 calendar quarters before the first calendar quarter in which the 380.34 county exercises its expanded service option. The commissioner 380.35 shall, at the request of the counties, reduce, suspend, or 380.36 eliminate either or both of a county's obligations to continue 381.1 the base level of expenditures and to expand child welfare 381.2 preventive services under extraordinary circumstances. 381.3 (d) Notwithstanding paragraph (a), a county that is 381.4 participating in the child protection assessments or 381.5 investigations community collaboration pilot program under 381.6 section 626.5560, or in the concurrent permanency planning pilot 381.7 program under section 257.0711, may use its family preservation 381.8 fund grant for those programs. 381.9 Sec. 7. Minnesota Statutes 1996, section 609.115, 381.10 subdivision 9, is amended to read: 381.11 Subd. 9. [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If 381.12 a person is convicted ofa felony fortheft under section 381.13 609.52, embezzlement of public funds under section 609.54, or 381.14 forgery under section 609.625, 609.63, or 609.631, the probation 381.15 officer shall determine in the report prepared under subdivision 381.16 1 whether or not compulsive gambling contributed to the 381.17 commission of the offense. If so, the report shall contain the 381.18 results of a compulsive gambling assessment conducted in 381.19 accordance with this subdivision. The probation officer shall 381.20 make an appointment for the offender to undergo the assessment 381.21 if so indicated. 381.22 (b) The compulsive gambling assessment report must include 381.23 a recommended level of treatment for the offender if the 381.24 assessor concludes that the offender is in need of compulsive 381.25 gambling treatment. The assessment must be conducted by an 381.26 assessor qualified under section 245.98, subdivision 2a, to 381.27 perform these assessments or to provide compulsive gambling 381.28 treatment. An assessor providing a compulsive gambling 381.29 assessment may not have any direct or shared financial interest 381.30 or referral relationship resulting in shared financial gain with 381.31 a treatment provider. If an independent assessor is not 381.32 available, the probation officer may use the services of an 381.33 assessor with a financial interest or referral relationship as 381.34 authorized under rules adopted by the commissioner of human 381.35 services under section 245.98, subdivision 2a. 381.36 (c) The commissioner of human services shall reimburse the 382.1 assessor for the costs associated with a compulsive gambling 382.2 assessment at a rate established by the commissioner up to a 382.3 maximum of $100 for each assessment. The commissioner shall 382.4 reimburse these costs after receiving written verification from 382.5 the probation officer that the assessment was performed and 382.6 found acceptable. 382.7 Sec. 8. Laws 1994, chapter 633, article 7, section 3, is 382.8 amended to read: 382.9 Sec. 3. [INDIAN GAMING REVOLVING ACCOUNT.] 382.10 Funds received from theattorney generalIndian tribal 382.11 governments and the Minnesota state lottery shalldepositbe 382.12 deposited in a separate account in the state treasuryall money382.13received from Indian tribal governmentsfor the purpose of 382.14defraying the attorney general's costs in providing legal382.15services with respect to Indian gaming. Money in the account is382.16appropriated to the attorney general for that382.17purposecontributing to the compulsive gambling program. 382.18 Sec. 9. [PREVALENCE STUDY.] 382.19 If funding is available, the compulsive gambling program 382.20 shall provide baseline prevalence studies to identify those at 382.21 highest risk of developing a compulsive gambling problem, 382.22 including a replication in 1999 of the 1994 adult prevalence 382.23 survey. 382.24 Sec. 10. [EXTENDING ASSESSMENTS TO BANKRUPTCY AND FAMILY 382.25 COURT PROCEEDINGS.] 382.26 If funding is available, the commissioner of human services 382.27 shall study whether problem gambling assessments should be 382.28 provided or required for individuals involved in bankruptcy or 382.29 family court proceedings, and report to the legislature by 382.30 December 15, 1998. 382.31 Sec. 11. [COMPULSIVE GAMBLING APPROPRIATION.] 382.32 (a) In addition to any other appropriations, $340,000 is 382.33 appropriated annually from the Minnesota lottery prize fund to 382.34 the Indian gaming revolving account in Laws 1994, chapter 633, 382.35 article 7, section 3, and transferred to the commissioner of 382.36 human services for the compulsive gambling program. The funds 383.1 provided under Minnesota Statutes, section 245.982, are to be 383.2 transferred from the Indian gaming revolving account to the 383.3 commissioner of human services for purposes of paragraph (d). 383.4 (b) Of the funds appropriated under this section, $290,000 383.5 in fiscal year 1999 is appropriated for the establishment of 383.6 fee-for-service projects. Fee-for-service funds under this 383.7 appropriation may be awarded on a per-client basis to existing 383.8 treatment centers and may be in addition to grants the centers 383.9 currently receive. Baseline grants based on the last fiscal 383.10 year client numbers and units of services provided constitute 383.11 minimum appropriations to existing treatment centers, and upon 383.12 meeting the contracted level of services, the treatment centers 383.13 are eligible for fee-for-service funds on a per-client basis in 383.14 addition to grants. 383.15 (c) Of the funds appropriated under this section, $50,000 383.16 in fiscal year 1999 is appropriated for the operation of 383.17 prevention and education programs aimed at helping adult and 383.18 adolescent gamblers. 383.19 (d) Of the funds provided under Minnesota Statutes, section 383.20 245.982, up to $30,000 in fiscal year 1999 may be used for the 383.21 completion of the prevalence study in section 9, up to $10,000 383.22 in fiscal year 1999 may be used for the study in section 10 383.23 related to extending assessments to bankruptcy and family court 383.24 proceedings, and up to $50,000 in fiscal year 1999 may be used 383.25 for the operation of the hotline. The commissioner may 383.26 prioritize the initiatives under this paragraph as the 383.27 commissioner deems appropriate. Any funding remaining must be 383.28 used for purposes of treatment under paragraph (b) and 383.29 prevention under paragraph (c), and the funds must be 383.30 appropriated at a two-to-one ratio, respectively. 383.31 Sec. 12. [TOWN OF WHITE, ST. LOUIS COUNTY.] 383.32 Subdivision 1. [TRANSFER.] Notwithstanding any provision 383.33 of Minnesota Statutes to the contrary, the town of White is 383.34 hereby authorized to transfer the following property and any 383.35 buildings, equipment, and other improvements located thereon to 383.36 the White community hospital corporation, a nonprofit 384.1 corporation organized and existing under Minnesota Statutes, 384.2 chapter 317: 384.3 That part of the southeast quarter of southwest quarter (SE 384.4 1/4 of SW 1/4), section 10, township 58 north of range 15 west 384.5 of the fourth principal meridian, according to the United States 384.6 government survey thereof, St. Louis county, Minnesota, 384.7 described as follows: 384.8 Commencing at the southeast corner of said SE 1/4 of SW 384.9 1/4, section 10, township 58, range 15, thence proceeding north 384.10 along the east line thereof for a distance of 550 feet; thence 384.11 west and parallel to the south line thereof for a distance of 384.12 800 feet; thence south and parallel to the east line thereof, 384.13 for a distance of 550 feet to the south line; thence east along 384.14 said south line thereof, for a distance of 800 feet to the point 384.15 of beginning. 384.16 Subd. 2. [NO CONSIDERATION OR ELECTION REQUIRED.] The 384.17 transfer authorized by subdivision 1 shall be without 384.18 consideration and no vote of the electors of the town of White 384.19 or city of Aurora shall be required. 384.20 Subd. 3. [USE; PUBLIC PROPERTY.] The property legally 384.21 described in subdivision 1 shall be used for health care and 384.22 related purposes and shall be considered public property for 384.23 purposes of Minnesota Statutes, section 16A.695. The activities 384.24 conducted on the property described in subdivision 1 by the 384.25 White community hospital corporation, its successors and assigns 384.26 shall be considered a governmental program as authorized by 384.27 Minnesota Statutes, chapter 447. 384.28 Subd. 4. [NAME.] The public name of the buildings and 384.29 improvements located on the real property legally described in 384.30 subdivision 1 shall always include the words "White community." 384.31 Sec. 13. [CITY OF EVELETH; LOAN FORGIVENESS.] 384.32 Notwithstanding the provisions of any other law or charter, 384.33 the city of Eveleth may, by resolution of its city council, 384.34 forgive all or any portion of the principal and interest due or 384.35 to become due to the city, pursuant to any loan or loans made by 384.36 the city, in an amount not exceeding $100,000, prior to January 385.1 1, 1998, to any hospital, nursing home, other health care 385.2 facility or corporation, partnership, or limited liability 385.3 company operating such a facility within the city of Eveleth. 385.4 Sec. 14. [REPEALER.] 385.5 (a) Minnesota Rules, part 2740.1600, subpart 1, is repealed. 385.6 (b) Minnesota Statutes 1997 Supplement, section 62D.042, 385.7 subdivision 3, is repealed. 385.8 Sec. 15. [EFFECTIVE DATES.] 385.9 (a) Sections 2 and 4 are effective January 1, 1999. 385.10 (b) Section 3 is effective January 1, 1999, and applies to 385.11 any individual who has continuation coverage available on or 385.12 after that date. 385.13 (c) Section 12 is effective upon compliance with Minnesota 385.14 Statutes, section 645.021, subdivision 2. 385.15 (d) Section 13 is effective the day following final 385.16 enactment without local approval according to Minnesota 385.17 Statutes, section 645.023, subdivision 1, clause (a). 385.18 (e) Section 14, paragraph (a), is effective January 1, 1999. 385.19 (f) Section 14, paragraph (b), is effective the day 385.20 following final enactment. 385.21 ARTICLE 9 385.22 CHILD WELFARE MODIFICATIONS 385.23 Section 1. Minnesota Statutes 1997 Supplement, section 385.24 144.218, subdivision 2, is amended to read: 385.25 Subd. 2. [ADOPTION OF FOREIGN PERSONS.] In proceedings for 385.26 the adoption of a person who was born in a foreign country, the 385.27 court, upon evidence presented by the commissioner of human 385.28 services from information secured at the port of entry, or upon 385.29 evidence from other reliable sources, may make findings of fact 385.30 as to the date and place of birth and parentage. Upon receipt 385.31 of certified copies of the court findings and the order or 385.32 decree of adoption or a certified copy of a decree issued under 385.33 section 259.60, the state registrar shall register a birth 385.34 certificate in the new name of the adopted person. The 385.35 certified copies of the court findings and the orderor, decree 385.36 of adoption, or decree issued under section 259.60 are 386.1 confidential, pursuant to section 13.02, subdivision 3, and 386.2 shall not be disclosed except pursuant to court order or section 386.3 144.1761. The birth certificate shall state the place of birth 386.4 as specifically as possible, and that the certificate is not 386.5 evidence of United States citizenship. 386.6 Sec. 2. Minnesota Statutes 1996, section 144.226, 386.7 subdivision 3, is amended to read: 386.8 Subd. 3. [BIRTH CERTIFICATE COPY SURCHARGE.] In addition 386.9 to any fee prescribed under subdivision 1, there shall be a 386.10 surcharge of $3 for each certified copy of a birth certificate, 386.11 and for a certification that the record cannot be found. The 386.12 local or state registrar shall forward this amount to the 386.13 commissioner of finance for deposit into the account for the 386.14 children's trust fund for the prevention of child abuse 386.15 established under section 119A.12. This surcharge shall not be 386.16 charged under those circumstances in which no fee for a 386.17 certified copy of a birth certificate is permitted under 386.18 subdivision 1, paragraph (a). Upon certification by the 386.19 commissioner of finance that the assets in that fund exceed 386.20 $20,000,000, this surcharge shall be discontinued. 386.21 Sec. 3. Minnesota Statutes 1997 Supplement, section 386.22 144.226, subdivision 4, is amended to read: 386.23 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 386.24 prescribed under subdivision 1, there is a nonrefundable 386.25 surcharge of $3 for each certified and noncertified birth or 386.26 death record, and for a certification that the record cannot be 386.27 found. The local or state registrar shall forward this amount 386.28 to the state treasurer to be deposited into the state government 386.29 special revenue fund. This surcharge shall not be charged under 386.30 those circumstances in which no fee for a birth or death record 386.31 is permitted under subdivision 1, paragraph (a). This surcharge 386.32 requirement expires June 30, 2002. 386.33 Sec. 4. Minnesota Statutes 1997 Supplement, section 386.34 245A.03, subdivision 2, is amended to read: 386.35 Subd. 2. [EXCLUSION FROM LICENSURE.] Sections 245A.01 to 386.36 245A.16 do not apply to: 387.1 (1) residential or nonresidential programs that are 387.2 provided to a person by an individual who is related unless the 387.3 residential program is a child foster care placement made by a 387.4 local social services agency or a licensed child-placing agency, 387.5 except as provided in subdivision 2a; 387.6 (2) nonresidential programs that are provided by an 387.7 unrelated individual to persons from a single related family; 387.8 (3) residential or nonresidential programs that are 387.9 provided to adults who do not abuse chemicals or who do not have 387.10 a chemical dependency, a mental illness, mental retardation or a 387.11 related condition, a functional impairment, or a physical 387.12 handicap; 387.13 (4) sheltered workshops or work activity programs that are 387.14 certified by the commissioner of economic security; 387.15 (5) programs for children enrolled in kindergarten to the 387.16 12th grade and prekindergarten special education in a school as 387.17 defined in section 120.101, subdivision 4, and programs serving 387.18 children in combined special education and regular 387.19 prekindergarten programs that are operated or assisted by the 387.20 commissioner of children, families, and learning; 387.21 (6) nonresidential programs primarily for children that 387.22 provide care or supervision, without charge for ten or fewer 387.23 days a year, and for periods of less than three hours a day 387.24 while the child's parent or legal guardian is in the same 387.25 building as the nonresidential program or present within another 387.26 building that is directly contiguous to the building in which 387.27 the nonresidential program is located; 387.28 (7) nursing homes or hospitals licensed by the commissioner 387.29 of health except as specified under section 245A.02; 387.30 (8) board and lodge facilities licensed by the commissioner 387.31 of health that provide services for five or more persons whose 387.32 primary diagnosis is mental illness who have refused an 387.33 appropriate residential program offered by a county agency. 387.34 This exclusion expires on July 1, 1990; 387.35 (9) homes providing programs for persons placed there by a 387.36 licensed agency for legal adoption, unless the adoption is not 388.1 completed within two years; 388.2 (10) programs licensed by the commissioner of corrections; 388.3 (11) recreation programs for children or adults that 388.4 operate for fewer than 40 calendar days in a calendar year or 388.5 programs operated by a park and recreation board of a city of 388.6 the first class whose primary purpose is to provide social and 388.7 recreational activities to school age children, provided the 388.8 program is approved by the park and recreation board; 388.9 (12) programs operated by a school as defined in section 388.10 120.101, subdivision 4, whose primary purpose is to provide 388.11 child care to school-age children, provided the program is 388.12 approved by the district's school board; 388.13 (13) Head Start nonresidential programs which operate for 388.14 less than 31 days in each calendar year; 388.15 (14) noncertified boarding care homes unless they provide 388.16 services for five or more persons whose primary diagnosis is 388.17 mental illness or mental retardation; 388.18 (15) nonresidential programs for nonhandicapped children 388.19 provided for a cumulative total of less than 30 days in any 388.20 12-month period; 388.21 (16) residential programs for persons with mental illness, 388.22 that are located in hospitals, until the commissioner adopts 388.23 appropriate rules; 388.24 (17) the religious instruction of school-age children; 388.25 Sabbath or Sunday schools; or the congregate care of children by 388.26 a church, congregation, or religious society during the period 388.27 used by the church, congregation, or religious society for its 388.28 regular worship; 388.29 (18) camps licensed by the commissioner of health under 388.30 Minnesota Rules, chapter 4630; 388.31 (19) mental health outpatient services for adults with 388.32 mental illness or children with emotional disturbance; 388.33 (20) residential programs serving school-age children whose 388.34 sole purpose is cultural or educational exchange, until the 388.35 commissioner adopts appropriate rules; 388.36 (21) unrelated individuals who provide out-of-home respite 389.1 care services to persons with mental retardation or related 389.2 conditions from a single related family for no more than 90 days 389.3 in a 12-month period and the respite care services are for the 389.4 temporary relief of the person's family or legal representative; 389.5 (22) respite care services provided as a home and 389.6 community-based service to a person with mental retardation or a 389.7 related condition, in the person's primary residence; 389.8 (23) community support services programs as defined in 389.9 section 245.462, subdivision 6, and family community support 389.10 services as defined in section 245.4871, subdivision 17; 389.11 (24) the placement of a child by a birth parent or legal 389.12 guardian in a preadoptive home for purposes of adoption as 389.13 authorized by section 259.47; or 389.14 (25) settings registered under chapter 144D which provide 389.15 home care services licensed by the commissioner of health to 389.16 fewer than seven adults. 389.17 For purposes of clause (6), a building is directly 389.18 contiguous to a building in which a nonresidential program is 389.19 located if it shares a common wall with the building in which 389.20 the nonresidential program is located or is attached to that 389.21 building by skyway, tunnel, atrium, or common roof. 389.22 Sec. 5. Minnesota Statutes 1996, section 245A.035, 389.23 subdivision 4, is amended to read: 389.24 Subd. 4. [APPLICANT STUDY.] When the county agency has 389.25 received the information required by section 245A.04, 389.26 subdivision 3, paragraph (b), the county agency shall begin an 389.27 applicant study according to the procedures in section 245A.04, 389.28 subdivision 3. The commissioner may issue an emergency license 389.29 upon recommendation of the county agency once the initial 389.30 inspection has been successfully completed and the information 389.31 necessary to begin the applicant background study has been 389.32 provided. If the county agency does not recommend that the 389.33 emergency license be granted, the agency shall notify the 389.34 relative in writing that the agency is recommending denial to 389.35 the commissioner; shall remove any child who has been placed in 389.36 the home prior to licensure; and shall inform the relative in 390.1 writing of the procedure to request review pursuant to 390.2 subdivision 6. An emergency license shall be effective until a 390.3 child foster care license is granted or denied, but shall in no 390.4 case remain in effect more than90120 days from the date of 390.5 placement. 390.6 Sec. 6. Minnesota Statutes 1997 Supplement, section 390.7 245A.04, subdivision 3b, is amended to read: 390.8 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 390.9 individual who is the subject of the disqualification may 390.10 request a reconsideration of the disqualification. 390.11 The individual must submit the request for reconsideration 390.12 to the commissioner in writing. A request for reconsideration 390.13 for an individual who has been sent a notice of disqualification 390.14 under subdivision 3a, paragraph (b), clause (1) or (2), must be 390.15 submitted within 30 calendar days of the disqualified 390.16 individual's receipt of the notice of disqualification. A 390.17 request for reconsideration for an individual who has been sent 390.18 a notice of disqualification under subdivision 3a, paragraph 390.19 (b), clause (3), must be submitted within 15 calendar days of 390.20 the disqualified individual's receipt of the notice of 390.21 disqualification. Removal of a disqualified individual from 390.22 direct contact shall be ordered if the individual does not 390.23 request reconsideration within the prescribed time, and for an 390.24 individual who submits a timely request for reconsideration, if 390.25 the disqualification is not set aside. The individual must 390.26 present information showing that: 390.27 (1) the information the commissioner relied upon is 390.28 incorrect or inaccurate. If the basis of a reconsideration 390.29 request is that a maltreatment determination or disposition 390.30 under section 626.556 or 626.557 is incorrect, and the 390.31 commissioner has issued a final order in an appeal of that 390.32 determination or disposition under section 256.045, the 390.33 commissioner's order is conclusive on the issue of maltreatment; 390.34 or 390.35 (2) the subject of the study does not pose a risk of harm 390.36 to any person served by the applicant or license holder. 391.1 (b) The commissioner may set aside the disqualification 391.2 under this section if the commissioner finds that the 391.3 information the commissioner relied upon is incorrect or the 391.4 individual does not pose a risk of harm to any person served by 391.5 the applicant or license holder. In determining that an 391.6 individual does not pose a risk of harm, the commissioner shall 391.7 consider the consequences of the event or events that lead to 391.8 disqualification, whether there is more than one disqualifying 391.9 event, the vulnerability of the victim at the time of the event, 391.10 the time elapsed without a repeat of the same or similar event, 391.11 documentation of successful completion by the individual studied 391.12 of training or rehabilitation pertinent to the event, and any 391.13 other information relevant to reconsideration. In reviewing a 391.14 disqualification under this section, the commissioner shall give 391.15 preeminent weight to the safety of each person to be served by 391.16 the license holder or applicant over the interests of the 391.17 license holder or applicant. 391.18 (c) Unless the information the commissioner relied on in 391.19 disqualifying an individual is incorrect, the commissioner may 391.20 not set aside the disqualification of an individual in 391.21 connection with a license to provide family day care for 391.22 children, foster care for children in the provider's own home, 391.23 or foster care or day care services for adults in the provider's 391.24 own home if: 391.25 (1) less than ten years have passed since the discharge of 391.26 the sentence imposed for the offense; and the individual has 391.27 been convicted of a violation of any offense listed in sections 391.28 609.20 (manslaughter in the first degree), 609.205 (manslaughter 391.29 in the second degree), criminal vehicular homicide under 609.21 391.30 (criminal vehicular homicide and injury), 609.215 (aiding 391.31 suicide or aiding attempted suicide), felony violations under 391.32 609.221 to 609.2231 (assault in the first, second, third, or 391.33 fourth degree), 609.713 (terroristic threats), 609.235 (use of 391.34 drugs to injure or to facilitate crime), 609.24 (simple 391.35 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 391.36 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 392.1 first or second degree), 609.71 (riot), burglary in the first or 392.2 second degree under 609.582 (burglary), 609.66 (dangerous 392.3 weapon), 609.665 (spring guns), 609.67 (machine guns and 392.4 short-barreled shotguns), 609.749 (harassment; stalking), 392.5 152.021 or 152.022 (controlled substance crime in the first or 392.6 second degree), 152.023, subdivision 1, clause (3) or (4), or 392.7 subdivision 2, clause (4) (controlled substance crime in the 392.8 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 392.9 (controlled substance crime in the fourth degree), 609.224, 392.10 subdivision 2, paragraph (c) (fifth-degree assault by a 392.11 caregiver against a vulnerable adult), 609.228 (great bodily 392.12 harm caused by distribution of drugs), 609.23 (mistreatment of 392.13 persons confined), 609.231 (mistreatment of residents or 392.14 patients), 609.2325 (criminal abuse of a vulnerable adult), 392.15 609.233 (criminal neglect of a vulnerable adult), 609.2335 392.16 (financial exploitation of a vulnerable adult), 609.234 (failure 392.17 to report), 609.265 (abduction), 609.2664 to 609.2665 392.18 (manslaughter of an unborn child in the first or second degree), 392.19 609.267 to 609.2672 (assault of an unborn child in the first, 392.20 second, or third degree), 609.268 (injury or death of an unborn 392.21 child in the commission of a crime), 617.293 (disseminating or 392.22 displaying harmful material to minors), 609.378 (neglect or 392.23 endangerment of a child), a gross misdemeanor offense under 392.24 609.377 (malicious punishment of a child), 609.72, subdivision 3 392.25 (disorderly conduct against a vulnerable adult); or an attempt 392.26 or conspiracy to commit any of these offenses, as each of these 392.27 offenses is defined in Minnesota Statutes; or an offense in any 392.28 other state, the elements of which are substantially similar to 392.29 the elements of any of the foregoing offenses; 392.30 (2) regardless of how much time has passed since the 392.31 discharge of the sentence imposed for the offense, the 392.32 individual was convicted of a violation of any offense listed in 392.33 sections 609.185 to 609.195 (murder in the first, second, or 392.34 third degree), 609.2661 to 609.2663 (murder of an unborn child 392.35 in the first, second, or third degree), a felony offense under 392.36 609.377 (malicious punishment of a child), 609.322 393.1 (solicitation, inducement, and promotion of prostitution), 393.2 609.323 (receiving profit derived from prostitution), 609.342 to 393.3 609.345 (criminal sexual conduct in the first, second, third, or 393.4 fourth degree), 609.352 (solicitation of children to engage in 393.5 sexual conduct), 617.246 (use of minors in a sexual 393.6 performance), 617.247 (possession of pictorial representations 393.7 of a minor), 609.365 (incest), a felony offense under 609.2242 393.8 and 609.2243 (domestic assault), a felony offense of spousal 393.9 abuse, a felony offense of child abuse or neglect, a felony 393.10 offense of a crime against children, or an attempt or conspiracy 393.11 to commit any of these offenses as defined in Minnesota 393.12 Statutes, or an offense in any other state, the elements of 393.13 which are substantially similar to any of the foregoing 393.14 offenses; 393.15 (3) within the seven years preceding the study, the 393.16 individual committed an act that constitutes maltreatment of a 393.17 child under section 626.556, subdivision 10e, and that resulted 393.18 in substantial bodily harm as defined in section 609.02, 393.19 subdivision 7a, or substantial mental or emotional harm as 393.20 supported by competent psychological or psychiatric evidence; or 393.21 (4) within the seven years preceding the study, the 393.22 individual was determined under section 626.557 to be the 393.23 perpetrator of a substantiated incident of maltreatment of a 393.24 vulnerable adult that resulted in substantial bodily harm as 393.25 defined in section 609.02, subdivision 7a, or substantial mental 393.26 or emotional harm as supported by competent psychological or 393.27 psychiatric evidence. 393.28 In the case of any ground for disqualification under 393.29 clauses (1) to (4), if the act was committed by an individual 393.30 other than the applicant or license holder residing in the 393.31 applicant's or license holder's home, the applicant or license 393.32 holder may seek reconsideration when the individual who 393.33 committed the act no longer resides in the home. 393.34 The disqualification periods provided under clauses (1), 393.35 (3), and (4) are the minimum applicable disqualification 393.36 periods. The commissioner may determine that an individual 394.1 should continue to be disqualified from licensure because the 394.2 license holder or applicant poses a risk of harm to a person 394.3 served by that individual after the minimum disqualification 394.4 period has passed. 394.5 (d) The commissioner shall respond in writing or by 394.6 electronic transmission to all reconsideration requests for 394.7 which the basis for the request is that the information relied 394.8 upon by the commissioner to disqualify is incorrect or 394.9 inaccurate within 30 working days of receipt of a request and 394.10 all relevant information. If the basis for the request is that 394.11 the individual does not pose a risk of harm, the commissioner 394.12 shall respond to the request within 15 working days after 394.13 receiving the request for reconsideration and all relevant 394.14 information. If the disqualification is set aside, the 394.15 commissioner shall notify the applicant or license holder in 394.16 writing or by electronic transmission of the decision. 394.17 (e) Except as provided in subdivision 3c, the 394.18 commissioner's decision to disqualify an individual, including 394.19 the decision to grant or deny a rescission or set aside a 394.20 disqualification under this section, is the final administrative 394.21 agency action and shall not be subject to further review in a 394.22 contested case under chapter 14 involving a negative licensing 394.23 appeal taken in response to the disqualification or involving an 394.24 accuracy and completeness appeal under section 13.04. 394.25 Sec. 7. Minnesota Statutes 1997 Supplement, section 394.26 245A.04, subdivision 3d, is amended to read: 394.27 Subd. 3d. [DISQUALIFICATION.] When a background study 394.28 completed under subdivision 3 shows any of the following: a 394.29 conviction of one or more crimes listed in clauses (1) to (4); 394.30 the individual has admitted to or a preponderance of the 394.31 evidence indicates the individual has committed an act or acts 394.32 that meet the definition of any of the crimes listed in clauses 394.33 (1) to (4); or an administrative determination listed under 394.34 clause (4), the individual shall be disqualified from any 394.35 position allowing direct contact with persons receiving services 394.36 from the license holder: 395.1 (1) regardless of how much time has passed since the 395.2 discharge of the sentence imposed for the offense, and unless 395.3 otherwise specified, regardless of the level of the conviction, 395.4 the individual was convicted of any of the following offenses: 395.5 sections 609.185 (murder in the first degree); 609.19 (murder in 395.6 the second degree); 609.195 (murder in the third degree); 395.7 609.2661 (murder of an unborn child in the first degree); 395.8 609.2662 (murder of an unborn child in the second degree); 395.9 609.2663 (murder of an unborn child in the third degree); 395.10 609.322 (solicitation, inducement, and promotion of 395.11 prostitution); 609.323 (receiving profit derived from 395.12 prostitution); 609.342 (criminal sexual conduct in the first 395.13 degree); 609.343 (criminal sexual conduct in the second degree); 395.14 609.344 (criminal sexual conduct in the third degree); 609.345 395.15 (criminal sexual conduct in the fourth degree); 609.352 395.16 (solicitation of children to engage in sexual conduct); 609.365 395.17 (incest); felony offense under 609.377 (malicious punishment of 395.18 a child); 617.246 (use of minors in sexual performance 395.19 prohibited); 617.247 (possession of pictorial representations of 395.20 minors); a felony offense under 609.2242 and 609.2243 (domestic 395.21 assault), a felony offense of spousal abuse, a felony offense of 395.22 child abuse or neglect, a felony offense of a crime against 395.23 children; or attempt or conspiracy to commit any of these 395.24 offenses as defined in Minnesota Statutes, or an offense in any 395.25 other state or country, where the elements are substantially 395.26 similar to any of the offenses listed in this clause; 395.27 (2) if less than 15 years have passed since the discharge 395.28 of the sentence imposed for the offense; and the individual has 395.29 received a felony conviction for a violation of any of these 395.30 offenses: sections 609.20 (manslaughter in the first degree); 395.31 609.205 (manslaughter in the second degree); 609.21 (criminal 395.32 vehicular homicide and injury); 609.215 (suicide); 609.221 to 395.33 609.2231 (assault in the first, second, third, or fourth 395.34 degree); repeat offenses under 609.224 (assault in the fifth 395.35 degree);609.2242 and 609.2243 (domestic assault; sentencing;395.36repeat domestic assault);repeat offenses under 609.3451 396.1 (criminal sexual conduct in the fifth degree); 609.713 396.2 (terroristic threats); 609.235 (use of drugs to injure or 396.3 facilitate crime); 609.24 (simple robbery); 609.245 (aggravated 396.4 robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 396.5 609.561 (arson in the first degree); 609.562 (arson in the 396.6 second degree); 609.563 (arson in the third degree); repeat 396.7 offenses under 617.23 (indecent exposure; penalties); repeat 396.8 offenses under 617.241 (obscene materials and performances; 396.9 distribution and exhibition prohibited; penalty); 609.71 (riot); 396.10 609.66 (dangerous weapons); 609.67 (machine guns and 396.11 short-barreled shotguns); 609.749 (harassment; stalking; 396.12 penalties); 609.228 (great bodily harm caused by distribution of 396.13 drugs); 609.2325 (criminal abuse of a vulnerable adult); 396.14 609.2664 (manslaughter of an unborn child in the first degree); 396.15 609.2665 (manslaughter of an unborn child in the second degree); 396.16 609.267 (assault of an unborn child in the first degree); 396.17 609.2671 (assault of an unborn child in the second degree); 396.18 609.268 (injury or death of an unborn child in the commission of 396.19 a crime); 609.378 (neglect or endangerment of a child); 609.324, 396.20 subdivision 1 (other prohibited acts); 609.52 (theft); 609.2335 396.21 (financial exploitation of a vulnerable adult); 609.521 396.22 (possession of shoplifting gear); 609.582 (burglary); 609.625 396.23 (aggravated forgery); 609.63 (forgery); 609.631 (check forgery; 396.24 offering a forged check); 609.635 (obtaining signature by false 396.25 pretense); 609.27 (coercion); 609.275 (attempt to coerce); 396.26 609.687 (adulteration); 260.221 (grounds for termination of 396.27 parental rights); and chapter 152 (drugs; controlled 396.28 substance). An attempt or conspiracy to commit any of these 396.29 offenses, as each of these offenses is defined in Minnesota 396.30 Statutes; or an offense in any other state or country, the 396.31 elements of which are substantially similar to the elements of 396.32 the offenses in this clause. If the individual studied is 396.33 convicted of one of the felonies listed in this clause, but the 396.34 sentence is a gross misdemeanor or misdemeanor disposition, the 396.35 look-back period for the conviction is the period applicable to 396.36 the disposition, that is the period for gross misdemeanors or 397.1 misdemeanors; 397.2 (3) if less than ten years have passed since the discharge 397.3 of the sentence imposed for the offense; and the individual has 397.4 received a gross misdemeanor conviction for a violation of any 397.5 of the following offenses: sections 609.224 (assault in the 397.6 fifth degree); 609.2242 and 609.2243 (domestic assault); 397.7 violation of an order for protection under 518B.01, subdivision 397.8 14; 609.3451 (criminal sexual conduct in the fifth degree); 397.9 repeat offenses under 609.746 (interference with privacy); 397.10 repeat offenses under 617.23 (indecent exposure); 617.241 397.11 (obscene materials and performances); 617.243 (indecent 397.12 literature, distribution); 617.293 (harmful materials; 397.13 dissemination and display to minors prohibited); 609.71 (riot); 397.14 609.66 (dangerous weapons); 609.749 (harassment; stalking; 397.15 penalties); 609.224, subdivision 2, paragraph (c) (assault in 397.16 the fifth degree by a caregiver against a vulnerable adult); 397.17 609.23 (mistreatment of persons confined); 609.231 (mistreatment 397.18 of residents or patients); 609.2325 (criminal abuse of a 397.19 vulnerable adult); 609.233 (criminal neglect of a vulnerable 397.20 adult); 609.2335 (financial exploitation of a vulnerable adult); 397.21 609.234 (failure to report maltreatment of a vulnerable adult); 397.22 609.72, subdivision 3 (disorderly conduct against a vulnerable 397.23 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 397.24 a child); 609.377 (malicious punishment of a child); 609.324, 397.25 subdivision 1a (other prohibited acts; minor engaged in 397.26 prostitution); 609.33 (disorderly house); 609.52 (theft); 397.27 609.582 (burglary); 609.631 (check forgery; offering a forged 397.28 check); 609.275 (attempt to coerce); or an attempt or conspiracy 397.29 to commit any of these offenses, as each of these offenses is 397.30 defined in Minnesota Statutes; or an offense in any other state 397.31 or country, the elements of which are substantially similar to 397.32 the elements of any of the offenses listed in this clause. If 397.33 the defendant is convicted of one of the gross misdemeanors 397.34 listed in this clause, but the sentence is a misdemeanor 397.35 disposition, the look-back period for the conviction is the 397.36 period applicable to misdemeanors; or 398.1 (4) if less than seven years have passed since the 398.2 discharge of the sentence imposed for the offense; and the 398.3 individual has received a misdemeanor conviction for a violation 398.4 of any of the following offenses: sections 609.224 (assault in 398.5 the fifth degree); 609.2242 (domestic assault); violation of an 398.6 order for protection under 518B.01 (Domestic Abuse Act); 398.7 violation of an order for protection under 609.3232 (protective 398.8 order authorized; procedures; penalties); 609.746 (interference 398.9 with privacy); 609.79 (obscene or harassing phone calls); 398.10 609.795 (letter, telegram, or package; opening; harassment); 398.11 617.23 (indecent exposure; penalties); 609.2672 (assault of an 398.12 unborn child in the third degree); 617.293 (harmful materials; 398.13 dissemination and display to minors prohibited); 609.66 398.14 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 398.15 exploitation of a vulnerable adult); 609.234 (failure to report 398.16 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 398.17 (coercion); or an attempt or conspiracy to commit any of these 398.18 offenses, as each of these offenses is defined in Minnesota 398.19 Statutes; or an offense in any other state or country, the 398.20 elements of which are substantially similar to the elements of 398.21 any of the offenses listed in this clause; failure to make 398.22 required reports under section 626.556, subdivision 3, or 398.23 626.557, subdivision 3, for incidents in which: (i) the final 398.24 disposition under section 626.556 or 626.557 was substantiated 398.25 maltreatment, and (ii) the maltreatment was recurring or 398.26 serious; or substantiated serious or recurring maltreatment of a 398.27 minor under section 626.556 or of a vulnerable adult under 398.28 section 626.557 for which there is a preponderance of evidence 398.29 that the maltreatment occurred, and that the subject was 398.30 responsible for the maltreatment. For the purposes of this 398.31 section, serious maltreatment means sexual abuse; maltreatment 398.32 resulting in death; or maltreatment resulting in serious injury 398.33 or harm which reasonably requires the care of a physician 398.34 whether or not the care of a physician was sought, including:; 398.35 or abuse resulting in serious injury. For purposes of this 398.36 section, abuse resulting in serious injury means: bruises, 399.1 bites, skin laceration or tissue damage; fractures; 399.2 dislocations; evidence of internal injuries; head injuries with 399.3 loss of consciousness; extensive second-degree or third-degree 399.4 burns and other burns for which complications are 399.5 present; extensive second-degree or third-degree frostbite, and 399.6 others for which complications are present; irreversible 399.7 mobility or avulsion of teeth; injuries to the eyeball; 399.8 ingestion of foreign substances and objects that are harmful; 399.9 near drowning; and heat exhaustion or sunstroke. For purposes 399.10 of this section, "care of a physician" is treatment received or 399.11 ordered by a physician, but does not include diagnostic testing, 399.12 assessment, or observation. For the purposes of this section, 399.13 recurring maltreatment means more than one incident of 399.14 maltreatment for which there is a preponderance of evidence that 399.15 the maltreatment occurred, and that the subject was responsible 399.16 for the maltreatment. 399.17 Sec. 8. Minnesota Statutes 1996, section 256.01, 399.18 subdivision 12, is amended to read: 399.19 Subd. 12. [CHILD MORTALITY REVIEW PANEL.] (a) The 399.20 commissioner shall establish a child mortality review panelfor399.21reviewingto review<