Minnesota Legislature
SF 3346
3rd Unofficial Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; changing provisions for 1.3 health insurance, health programs, and health 1.4 professions; providing for recording and providing of 1.5 abortion data; prohibiting partial-birth abortions; 1.6 changing provisions in long-term care, MA, GAMC, 1.7 MinnesotaCare, welfare provisions, Work First 1.8 assistance programs, child support licensing, and 1.9 tribal child care assistance; providing for the 1.10 conveyance of state land; providing for criminal 1.11 penalties; appropriating money; amending Minnesota 1.12 Statutes 1996, sections 62A.65, subdivision 5; 1.13 62D.042, subdivision 2; 62E.16; 144.343, subdivision 1.14 1; 144.701, subdivisions 1, 2, and 4; 144.702, 1.15 subdivisions 1, 2, and 8; 144.9501, subdivisions 1, 1.16 17, 18, 20, 23, 30, 32, and by adding subdivisions; 1.17 144.9502, subdivisions 3, 4, and 9; 144.9503, 1.18 subdivisions 4, 6, and 7; 144.9504, subdivisions 1, 3, 1.19 4, 5, 6, 7, 8, 9, and 10; 144.9505, subdivisions 1, 4, 1.20 and 5; 144.9506, subdivision 2; 144.9507, subdivisions 1.21 2, 3, and 4; 144.9508, subdivisions 1, 3, 4, and by 1.22 adding a subdivision; 144.9509, subdivision 2; 144.99, 1.23 subdivision 1; 144A.04, subdivision 5; 144A.09, 1.24 subdivision 1; 144A.44, subdivision 2; 145.411, by 1.25 adding a subdivision; 145A.15, subdivision 2; 148.66; 1.26 148.67; 148.70; 148.705; 148.71; 148.72, subdivisions 1.27 1, 2, and 4; 148.73; 148.74; 148.75; 148.76; 148.78; 1.28 214.01, subdivision 2; 214.03; 245.462, subdivisions 4 1.29 and 8; 245.4871, subdivision 4; 245A.03, by adding 1.30 subdivisions; 245A.14, subdivision 4; 254A.17, 1.31 subdivision 1, and by adding a subdivision; 256.014, 1.32 subdivision 1; 256.969, subdivisions 16, 17, and by 1.33 adding a subdivision; 256B.03, subdivision 3; 1.34 256B.055, by adding a subdivision; 256B.057, 1.35 subdivision 3a, and by adding subdivisions; 256B.0625, 1.36 subdivisions 20, 34, 38, and by adding subdivisions; 1.37 256B.0911, subdivision 4; 256B.41, subdivision 1; 1.38 256B.431, subdivisions 2b, 2i, 11, and by adding 1.39 subdivisions; 256B.501, subdivision 2; 256B.69, by 1.40 adding a subdivision; 256D.03, subdivision 4, and by 1.41 adding a subdivision; 256D.051, by adding a 1.42 subdivision; 256D.46, subdivision 2; 268.88; 268.92, 1.43 subdivision 4; and 617.23; Minnesota Statutes 1997 1.44 Supplement, sections 62D.11, subdivision 1; 62J.69, 1.45 subdivisions 1, 2, and by adding a subdivision; 1.46 62J.70, subdivision 3; 62J.71, subdivisions 1, 3, and 2.1 4; 62J.72, subdivision 1; 62Q.105, subdivision 1; 2.2 62Q.30; 103I.208, subdivision 2; 119B.01, subdivision 2.3 16; 119B.02; 144.1494, subdivision 1; 144.9504, 2.4 subdivision 2; 144.9506, subdivision 1; 144A.071, 2.5 subdivision 4a; 144A.46, subdivision 2; 144A.4605, 2.6 subdivision 4; 171.29, subdivision 2; 214.32, 2.7 subdivision 1; 256.01, subdivision 2; 256.031, 2.8 subdivision 6; 256.741, by adding a subdivision; 2.9 256.9657, subdivision 3; 256.9685, subdivision 1; 2.10 256.9864; 256B.04, subdivision 18; 256B.056, 2.11 subdivision 4; 256B.06, subdivision 4; 256B.062; 2.12 256B.0625, subdivision 31a; 256B.0627, subdivisions 5 2.13 and 8; 256B.0635, by adding a subdivision; 256B.0645; 2.14 256B.0911, subdivisions 2 and 7; 256B.0915, 2.15 subdivision 1d; 256B.0951, by adding a subdivision; 2.16 256B.431, subdivisions 3f and 26; 256B.69, 2.17 subdivisions 2 and 3a; 256B.692, subdivisions 2 and 5; 2.18 256B.77, subdivisions 3, 7a, 10, and 12; 256D.03, 2.19 subdivision 3; 256D.05, subdivision 8; 256F.05, 2.20 subdivision 8; 256J.02, subdivision 4; 256J.03; 2.21 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 73, 83, 2.22 and by adding subdivisions; 256J.09, subdivisions 6 2.23 and 9; 256J.11, subdivision 2, as amended; 256J.12; 2.24 256J.14; 256J.15, subdivision 2; 256J.20, subdivisions 2.25 2 and 3; 256J.21; 256J.24, subdivisions 1, 2, 3, 4, 7, 2.26 and by adding subdivisions; 256J.26, subdivisions 1, 2.27 2, 3, and 4; 256J.28, subdivisions 1, 2, and by adding 2.28 a subdivision; 256J.30, subdivisions 10 and 11; 2.29 256J.31, subdivisions 5, 10, and by adding a 2.30 subdivision; 256J.32, subdivisions 4, 6, and by adding 2.31 a subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.32 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.33 subdivisions; 256J.38, subdivision 1; 256J.39, 2.34 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.44, by 2.35 adding a subdivision; 256J.45, subdivisions 1, 2, and 2.36 by adding a subdivision; 256J.46, subdivisions 1 and 2.37 2; 256J.47, subdivision 4; 256J.48, subdivisions 2 and 2.38 3; 256J.49, subdivision 4; 256J.50, subdivisions 5, 8, 2.39 and by adding a subdivision; 256J.515; 256J.52, 2.40 subdivisions 2, 3, 4, and by adding subdivisions; 2.41 256J.54, subdivisions 2, 3, 4, and 5; 256J.55, 2.42 subdivision 5; 256J.56; 256J.57, subdivision 1; 2.43 256J.74, subdivision 2, and by adding a subdivision; 2.44 256K.03, subdivision 5; 256L.01; 256L.02, subdivision 2.45 3, and by adding a subdivision; 256L.03, subdivisions 2.46 1, 3, 4, 5, and by adding subdivisions; 256L.04, 2.47 subdivisions 1, 2, 7, 8, 9, 10, and by adding 2.48 subdivisions; 256L.05, subdivisions 2, 3, 4, and by 2.49 adding subdivisions; 256L.06, subdivision 3; 256L.07, 2.50 subdivisions 2 and 3; 256L.09, subdivisions 2, 4, and 2.51 6; 256L.11, subdivision 6; 256L.12, subdivision 5; 2.52 256L.15; 256L.17, by adding a subdivision; and 259.50, 2.53 subdivision 4; Laws 1997, chapter 195, section 5; 2.54 chapter 203, article 1, section 2, subdivisions 5 and 2.55 12; article 4, section 64; chapter 207, section 7; 2.56 chapter 225, article 2, section 64; chapter 248, 2.57 section 46, as amended; proposing coding for new law 2.58 in Minnesota Statutes, chapters 62J; 62Q; 144; 145; 2.59 148; 256; 256B; 256D; 256J; and 256L; proposing coding 2.60 for new law as Minnesota Statutes, chapter 256M; 2.61 repealing Minnesota Statutes 1996, sections 144.0721, 2.62 subdivision 3a; 144.491; 144.9501, subdivisions 12, 2.63 14, and 16; 144.9503, subdivisions 5, 8, and 9; 2.64 256.031, as amended; 256.032; 256.033, as amended; 2.65 256.034; 256.035; 256.036; 256.0361; 256.047; 2.66 256.0475; 256.048; and 256.049; Minnesota Statutes 2.67 1997 Supplement, sections 62D.042, subdivision 3; 2.68 144.0721, subdivision 3; 256B.057, subdivision 1a; 2.69 256B.062; 256B.0913, subdivision 15; 256J.25; 256J.28, 2.70 subdivision 4; 256J.32, subdivision 5; 256J.34, 2.71 subdivision 5; 256L.04, subdivisions 3, 4, 5, and 6; 3.1 256L.06, subdivisions 1 and 2; 256L.08; 256L.09, 3.2 subdivision 3; 256L.13; 256L.14; and 256L.15, 3.3 subdivision 3; Laws 1997, chapter 85, article 1, 3.4 sections 61 and 71; article 3, section 55; Minnesota 3.5 Rules (exempt), parts 2740.1600, subpart 1; and 3.6 9500.9100 to 9500.9220. 3.7 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.8 ARTICLE 1 3.9 APPROPRIATIONS 3.10 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.11 The sums in the columns headed "APPROPRIATIONS" are 3.12 appropriated or reductions from appropriations from the general 3.13 fund, or another named fund, to the agencies and for the 3.14 purposes specified to be available for the fiscal years 3.15 indicated for each purpose. 3.16 SUMMARY BY FUND 3.17 1998 1999 3.18 General $ (138,610,000)$ (156,278,000) 3.19 State Government Special 3.20 Revenue Fund 113,000 90,000 3.21 Health Care Access (3,130,000) (15,277,000) 3.22 APPROPRIATIONS 3.23 Available for the Year 3.24 Ending June 30 3.25 1998 1999 3.26 Sec. 2. COMMISSIONER OF HUMAN SERVICES 3.27 Subdivision 1. Total 3.28 Appropriation (141,740,000) (191,207,000) 3.29 Summary by Fund 3.30 1998 1999 3.31 General (138,610,000) (175,671,000) 3.32 Health Care Access (3,130,000) (15,536,000) 3.33 Subd. 2. Children's Grants 3.34 General -0- 1,731,000 3.35 [CHILDREN'S MENTAL HEALTH SERVICES.] 3.36 (a) Of this appropriation, $200,000 in 3.37 fiscal year 1999 is from the general 3.38 fund for the commissioner to award 3.39 grants to counties that have a 3.40 relatively low net tax capacity to 3.41 provide children's mental health 3.42 services to children and families 3.43 residing outside of a metropolitan 3.44 statistical area, as that term is 3.45 defined by the United States Census 3.46 Bureau. Funds shall be used to provide 3.47 services according to an individual 4.1 family community support plan as 4.2 described in Minnesota Statutes, 4.3 section 245.4881, subdivision 4. The 4.4 plan must be developed using a process 4.5 that enhances consumer empowerment. 4.6 Counties with an approved children's 4.7 mental health collaborative may 4.8 integrate funds appropriated for fiscal 4.9 years 1998 and 1999 with existing funds 4.10 to meet the needs identified in the 4.11 child's individual family community 4.12 support plan. 4.13 (b) In awarding grants to counties 4.14 under this provision, the commissioner 4.15 shall follow the process established in 4.16 Minnesota Statutes, section 245.4886, 4.17 subdivision 2. The commissioner shall 4.18 give priority for funding to counties 4.19 that continued to spend for mental 4.20 health services specified in Minnesota 4.21 Statutes, sections 245.461 to 245.486 4.22 and 245.487 to 245.4888, according to 4.23 generally accepted accounting 4.24 principles, in an amount equal to the 4.25 total expenditures shown in the 4.26 county's approved 1987 CSSA plan for 4.27 services to persons with mental illness 4.28 plus the comparable figure for 4.29 facilities licensed under Minnesota 4.30 Rules, chapter 9545, for target 4.31 populations other than mental illness 4.32 in the county's approved 1989 CSSA 4.33 plan. The commissioner shall ensure 4.34 that grant funds are not used to 4.35 replace existing funds. 4.36 [TECHNICAL ASSISTANCE FOR CRISIS 4.37 NURSERIES.] Of this appropriation, 4.38 $200,000 in fiscal year 1999 is from 4.39 the general fund for the commissioner 4.40 to contract for technical assistance 4.41 with counties that are interested in 4.42 developing a crisis nursery program. 4.43 The technical assistance must be 4.44 designed to assist interested counties 4.45 in building capacity to develop and 4.46 maintain a crisis nursery program in 4.47 the county. The grant amount to a 4.48 county must range from $10,000 to 4.49 $20,000. To be eligible to receive a 4.50 grant under this program, the county 4.51 must not have an existing crisis 4.52 nursery program and must not be a 4.53 metropolitan county, as that term is 4.54 defined in Minnesota Statutes 1996, 4.55 section 473.121. This appropriation 4.56 shall not become part of the base for 4.57 the 2000-2001 biennial budget. 4.58 [PRIMARY SUPPORT TO IMPLEMENT THE 4.59 INDIAN FAMILY PRESERVATION ACT.] For 4.60 fiscal year 1998, $100,000 of federal 4.61 funds are transferred from the state's 4.62 federal TANF block grant and added to 4.63 the state's allocation of federal Title 4.64 XX block grant funds. Notwithstanding 4.65 the provisions of Minnesota Statutes 4.66 1997 Supplement, section 256E.07, the 4.67 commissioner shall use $100,000 of the 4.68 state's Title XX block grant funds for 5.1 a grant under Minnesota Statutes, 5.2 section 257.3571, subdivision 1, to an 5.3 Indian organization licensed as an 5.4 adoption agency. The grant must be 5.5 used to provide primary support for 5.6 implementation of the Minnesota Indian 5.7 Family Preservation Act and compliance 5.8 with the Indian Child Welfare Act. 5.9 This appropriation must be used 5.10 according to the requirements of the 5.11 amendments to section 404(d)(3)(B) of 5.12 Part A of Title IV of the Social 5.13 Security Act in Public Law Number 5.14 104-193. This appropriation is 5.15 available until June 30, 1999. 5.16 [ADOPTION ASSISTANCE CARRYFORWARD.] Of 5.17 the appropriation in Laws 1997, chapter 5.18 203, section 2, subdivision 3, for 5.19 children's grants for fiscal year 1998, 5.20 $600,000 of the amount appropriated for 5.21 the adoption assistance program is 5.22 available for the same purpose in 5.23 fiscal year 1999. The amount carried 5.24 forward shall become part of the base 5.25 for the adoption assistance program in 5.26 the 2000-2001 biennial budget. 5.27 [FAMILY PRESERVATION PROGRAM FUNDING.] 5.28 $10,000,000 is transferred in fiscal 5.29 year 1999 from the state's federal TANF 5.30 block grant to the state's federal 5.31 Title XX block grant. Notwithstanding 5.32 the provisions of Minnesota Statutes 5.33 1997 Supplement, section 256E.07, in 5.34 fiscal year 1999 the commissioner shall 5.35 transfer $10,000,000 of the state's 5.36 Title XX block grant funds to the 5.37 family preservation program under 5.38 Minnesota Statutes, chapter 256F. Of 5.39 the total amount transferred, the 5.40 commissioner shall allocate $8,800,000 5.41 to counties for the purposes of the 5.42 child protection assessments or 5.43 investigations community collaboration 5.44 pilot program under Minnesota Statutes, 5.45 section 626.5560. The commissioner 5.46 shall allocate $750,000 to counties for 5.47 the concurrent permanency planning 5.48 pilot program under Minnesota Statutes, 5.49 section 257.0711. The commissioner 5.50 shall transfer $200,000 to the 5.51 commissioner of health for the program 5.52 under Minnesota Statutes, section 5.53 145A.15, that funds home visiting 5.54 projects. The commissioner may retain 5.55 up to $250,000 of the total amount 5.56 transferred to conduct evaluations of 5.57 these pilot programs. The 5.58 commissioners shall ensure that money 5.59 allocated to counties under this 5.60 provision must be used in accordance 5.61 with the requirements of the amendments 5.62 to section 404(d)(3)(B) of Part A of 5.63 Title IV of the Social Security Act in 5.64 Public Law Number 104-193. This is a 5.65 one-time appropriation that shall not 5.66 be added to the base for the family 5.67 preservation program for the 2000-2001 5.68 biennial budget. 6.1 Subd. 3. Children's Services 6.2 Management 6.3 General -0- -0- 6.4 [SOCIAL SERVICES INFORMATION SYSTEM.] 6.5 Of the appropriation authorized under 6.6 Minnesota Statutes, section 256.014, 6.7 subdivision 2, $400,000 in fiscal year 6.8 1999 is for the purposes of the 6.9 training and implementation costs 6.10 associated with the social services 6.11 information system project. 6.12 Subd. 4. Basic Health Care 6.13 Grants 6.14 General (94,591,000) (119,462,000) 6.15 Health Care Access (2,938,000) (18,394,000) 6.16 The amounts that may be spent from this 6.17 appropriation for each purpose are as 6.18 follows: 6.19 (aa) MinnesotaCare Grants 6.20 Health Care Access (2,938,000) (18,394,000) 6.21 (bb) MA Basic Health Care Grants; 6.22 Families and Children 6.23 General (32,047,000) (57,312,000) 6.24 Of this appropriation, $100,000 in 6.25 fiscal year 1999 is from the general 6.26 fund to the commissioner for the 6.27 post-kidney transplant drug program. 6.28 This appropriation shall not cancel, 6.29 but is available until expended. 6.30 [JANUARY 1, 1999 PROVIDER RATE INCREASE 6.31 FOR CERTAIN SERVICES.] (a) Effective 6.32 for services rendered on or after 6.33 January 1, 1999, the commissioner shall 6.34 increase reimbursement or allocation 6.35 rates by five percent, and county 6.36 boards shall adjust provider contracts 6.37 as needed, for mental health services 6.38 provided by community mental health 6.39 centers under Minnesota Statutes, 6.40 sections 245.62 and 256B.0625, 6.41 subdivision 5, and for community 6.42 support services for deaf and 6.43 hard-of-hearing adults with mental 6.44 illness who use or wish to use sign 6.45 language as their primary means of 6.46 communication. The commissioner shall 6.47 also increase prepaid medical 6.48 assistance program capitation rates as 6.49 appropriate to reflect the rate 6.50 increases in this provision. Section 6.51 10, sunset of uncodified language, does 6.52 not apply to this provision. 6.53 (b) It is the intention of the 6.54 legislature that the compensation 6.55 packages of staff within each service 6.56 be increased by five percent. 6.57 (cc) MA Basic Health Care Grants; 7.1 Elderly and Disabled 7.2 General (25,643,000) (42,182,000) 7.3 [REGION 10 COMMISSION CARRYOVER 7.4 AUTHORITY.] Any unspent portion of the 7.5 appropriation to the commissioner of 7.6 human services in Laws 1997, chapter 7.7 203, article 1, section 2, subdivision 7.8 9, for the region 10 quality assurance 7.9 commission for fiscal year 1998 shall 7.10 not cancel but shall be available for 7.11 the commission for fiscal year 1999. 7.12 [DD CRISIS INTERVENTION PROJECT.] Of 7.13 this appropriation, $150,000 in fiscal 7.14 year 1999 is from the general fund to 7.15 the commissioner for start-up operating 7.16 and training costs for the action, 7.17 support, and prevention project of 7.18 southeastern Minnesota. This 7.19 appropriation is to provide crisis 7.20 intervention through community-based 7.21 services in the private sector to 7.22 persons with developmental disabilities 7.23 under Laws 1995, chapter 207, article 7.24 3, section 22. 7.25 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 7.26 September 15, 1998, federal approval is 7.27 obtained to provide a prescription drug 7.28 benefit for qualified Medicare 7.29 beneficiaries at no less than 100 7.30 percent of the federal poverty 7.31 guidelines and service-limited Medicare 7.32 beneficiaries under Minnesota Statutes, 7.33 section 256B.057, subdivision 3a, at no 7.34 less than 120 percent of federal 7.35 poverty guidelines, the commissioner of 7.36 human services shall not implement the 7.37 senior citizen drug program under 7.38 Minnesota Statutes, section 256.955, 7.39 but shall implement a drug benefit in 7.40 accordance with the approved waiver. 7.41 Upon approval of this waiver, the total 7.42 appropriation for the senior citizen 7.43 drug program under Laws 1997, chapter 7.44 225, article 7, section 2, shall be 7.45 transferred to the medical assistance 7.46 account to fund the federally approved 7.47 coverage for eligible persons for 7.48 fiscal year 1999. 7.49 (b) The commissioner may seek approval 7.50 for a higher copayment for eligible 7.51 persons above 100 percent of the 7.52 federal poverty guidelines. 7.53 (c) The commissioner shall report by 7.54 October 15, 1998, to the chairs of the 7.55 health and human services policy and 7.56 fiscal committees of the house and 7.57 senate whether the waiver referred to 7.58 in paragraph (a) has been approved and 7.59 will be implemented or whether the 7.60 state senior citizen drug program will 7.61 be implemented. 7.62 (d) If the commissioner does not 7.63 receive federal waiver approval at or 7.64 above the level of eligibility defined 8.1 in paragraph (a), the commissioner 8.2 shall implement the program under 8.3 Minnesota Statutes, section 256.955. 8.4 (dd) General Assistance 8.5 Medical Care 8.6 General (36,901,000) (19,968,000) 8.7 Subd. 5. Basic Health Care 8.8 Management 8.9 General -0- 286,000 8.10 Health Care Access (192,000) 1,774,000 8.11 The amounts that may be spent from this 8.12 appropriation for each purpose are as 8.13 follows: 8.14 (aa) Health Care Policy 8.15 Administration 8.16 General -0- 198,000 8.17 Health Care Access (192,000) 37,000 8.18 [DELAY IN TRANSFERRING GAMC CLIENTS.] 8.19 Due to delaying the transfer of GAMC 8.20 clients to MinnesotaCare until January 8.21 1, 2000, $192,000 in fiscal year 1998 8.22 health care access fund administrative 8.23 funds, appropriated in Laws 1997, 8.24 chapter 225, article 7, section 2, 8.25 subdivision 1, are canceled. 8.26 [MINNESOTACARE OUTREACH.] Unexpended 8.27 money in fiscal year 1998 for 8.28 MinnesotaCare outreach activities 8.29 appropriated in Laws 1997, chapter 225, 8.30 article 7, section 2, subdivision 1, 8.31 does not cancel, but is available for 8.32 those purposes in fiscal year 1999. 8.33 [HEALTH CARE MANUAL PRODUCTION COSTS.] 8.34 For the biennium ending June 30, 1999, 8.35 the money difference between the cost 8.36 of producing and distributing the 8.37 department of human services health 8.38 care manual, and the fees paid by 8.39 individuals and private entities on 8.40 January 1, 1998, is appropriated to the 8.41 commissioner to defray manual 8.42 production and distribution costs. The 8.43 commissioner must provide the health 8.44 care manual to government agencies and 8.45 nonprofit agencies serving the legal 8.46 and social service needs of clients at 8.47 no cost to those agencies. 8.48 [TRANSFER.] For fiscal years 2000 and 8.49 2001, the commissioner of finance shall 8.50 transfer from the health care access 8.51 fund to the general fund an amount to 8.52 cover the expenditures associated with 8.53 the services provided to pregnant women 8.54 and children under the age of two 8.55 enrolled in the MinnesotaCare program. 8.56 Notwithstanding section 10, this 8.57 provision expires on July 1, 2001. 9.1 [FEDERAL CONTINGENCY RESERVE LIMIT.] 9.2 Notwithstanding Minnesota Statutes, 9.3 section 16A.76, subdivision 2, the 9.4 federal contingency reserve limit shall 9.5 be reduced for fiscal years 2000 and 9.6 2001 by the cumulative amount of the 9.7 expenditures associated with services 9.8 provided to pregnant women and children 9.9 enrolled in the MinnesotaCare program 9.10 in these fiscal years. Notwithstanding 9.11 section 10, this provision expires on 9.12 July 1, 2001. 9.13 (bb) Health Care Operations 9.14 General -0- 88,000 9.15 Health Care Access -0- 1,737,000 9.16 Subd. 6. State-Operated 9.17 Services 9.18 General -0- 501,000 9.19 The amounts that may be spent from this 9.20 appropriation for each purpose are as 9.21 follows: 9.22 RTC Facilities 9.23 General -0- 700,000 9.24 [LEAVE LIABILITIES.] The accrued leave 9.25 liabilities of state employees 9.26 transferred to state-operated community 9.27 services programs may be paid from the 9.28 appropriation for state-operated 9.29 services in Laws 1997, chapter 203, 9.30 article 1, section 2, subdivision 7, 9.31 paragraph (a). Funds set aside for 9.32 this purpose shall not exceed the 9.33 amount of the actual leave liability 9.34 calculated as of June 30, 1999, and 9.35 shall be available until expended. 9.36 This provision is effective the day 9.37 following final enactment. 9.38 State Operated Services/Developmental 9.39 Disabilities 9.40 General -0- (199,000) 9.41 Subd. 7. Continuing Care and 9.42 Community Support Grants 9.43 General (36,606,000) (15,972,000) 9.44 The amounts that may be spent from this 9.45 appropriation for each purpose are as 9.46 follows: 9.47 (aa) Community Services Block 9.48 Grant 9.49 General 130,000 176,000 9.50 [WILKIN COUNTY.] Of this appropriation, 9.51 $130,000 for fiscal year 1998 is to 9.52 reimburse Wilkin county for 9.53 flood-related human services and public 9.54 health costs which cannot be reimbursed 10.1 through any other source. 10.2 (bb) Mental Health Grants 10.3 General 300,000 2,100,000 10.4 [PLANNING GRANT FOR PROSTITUTION 10.5 RECOVERY CENTER.] Of this 10.6 appropriation, $50,000 in fiscal year 10.7 1999 is from the general fund to the 10.8 commissioner for a planning grant to 10.9 enable an organization to develop a 10.10 long-term treatment program for women 10.11 escaping systems of prostitution. 10.12 [COMPULSIVE GAMBLING CARRYFORWARD.] 10.13 Unexpended funds appropriated to the 10.14 commissioner for compulsive gambling 10.15 programs for fiscal year 1998 do not 10.16 cancel but are available for these 10.17 purposes for fiscal year 1999. 10.18 [FLOOD COSTS.] Of this appropriation, 10.19 $300,000 in fiscal year 1998 and 10.20 $1,000,000 in fiscal year 1999 is from 10.21 the general fund to the commissioner 10.22 for the purpose of continuing 10.23 initiatives funded by Federal Emergency 10.24 Management Agency (FEMA) mental health 10.25 care grants beyond April 15, 1998. 10.26 Persons who are faced with a current 10.27 farm crisis are also eligible for 10.28 services covered under this provision. 10.29 This appropriation is available until 10.30 June 30, 1999. This provision is 10.31 effective April 15, 1998, if FEMA does 10.32 not extend these mental health care 10.33 grants beyond April 15, 1998. 10.34 (cc) Deaf and Hard-of-hearing 10.35 Grants 10.36 General -0- 81,000 10.37 [SERVICES TO DEAF PERSONS WITH MENTAL 10.38 ILLNESS.] Of this appropriation, 10.39 $65,000 in fiscal year 1999 is from the 10.40 general fund to the commissioner for a 10.41 grant to a nonprofit agency that 10.42 currently serves deaf and 10.43 hard-of-hearing adults with mental 10.44 illness through residential programs 10.45 and supported housing outreach 10.46 activities. The grant must be used to 10.47 continue or maintain community support 10.48 services for deaf and hard-of-hearing 10.49 adults with mental illness who use or 10.50 wish to use sign language as their 10.51 primary means of communication. This 10.52 appropriation is in addition to the 10.53 appropriation in Laws 1997, chapter 10.54 203, article 1, section 2, subdivision 10.55 8, paragraph (d), for a grant to this 10.56 nonprofit agency. 10.57 (dd) DD Community Support Grants 10.58 General -0- 41,000 10.59 (ee) Aging and Adult 10.60 Services 11.1 General -0- 100,000 11.2 (ff) Medical Assistance Long-term 11.3 Care Waivers and Home Care 11.4 General (3,936,000) (8,340,000) 11.5 [JANUARY 1, 1999, PROVIDER RATE 11.6 INCREASE.] (a) Effective for services 11.7 rendered on or after January 1, 1999, 11.8 the commissioner shall increase 11.9 reimbursement or allocation rates by 11.10 1.25 percent, and county boards shall 11.11 adjust provider contracts as needed, 11.12 for home and community-based waiver 11.13 services for persons with mental 11.14 retardation or related conditions under 11.15 Minnesota Statutes, section 256B.501; 11.16 home and community-based waiver 11.17 services for the elderly under 11.18 Minnesota Statutes, section 256B.0915; 11.19 nursing services and home health 11.20 services under Minnesota Statutes, 11.21 section 256B.0625, subdivision 6a; 11.22 personal care services and nursing 11.23 supervision of personal care services 11.24 under Minnesota Statutes, section 11.25 256B.0625, subdivision 19a; private 11.26 duty nursing services under Minnesota 11.27 Statutes, section 256B.0625, 11.28 subdivision 7; day training and 11.29 habilitation services for adults with 11.30 mental retardation or related 11.31 conditions under Minnesota Statutes, 11.32 sections 252.40 to 252.47; physical 11.33 therapy services under Minnesota 11.34 Statutes, sections 256B.0625, 11.35 subdivision 8, and 256D.03, subdivision 11.36 4; occupational therapy services under 11.37 Minnesota Statutes, sections 256B.0625, 11.38 subdivision 8a, and 256D.03, 11.39 subdivision 4; speech-language therapy 11.40 services under Minnesota Statutes, 11.41 section 256D.03, subdivision 4, and 11.42 Minnesota Rules, part 9505.0390; 11.43 respiratory therapy services under 11.44 Minnesota Statutes, section 256D.03, 11.45 subdivision 4, and Minnesota Rules, 11.46 part 9505.0295; family community 11.47 support grants under Minnesota Rules, 11.48 parts 9535.1700 to 9535.1760; and 11.49 semi-independent living services under 11.50 Minnesota Statutes, section 252.275, 11.51 including SILS funding under county 11.52 social services grants formerly funded 11.53 under Minnesota Statutes, chapter 11.54 256I. The commissioner shall also 11.55 increase prepaid medical assistance 11.56 program capitation rates as appropriate 11.57 to reflect the rate increases in this 11.58 provision. Section 10, sunset of 11.59 uncodified language, does not apply to 11.60 this provision. 11.61 (b) It is the intention of the 11.62 legislature that the compensation 11.63 packages of staff within each service 11.64 be increased by 1.25 percent. 11.65 (gg) Medical Assistance Long-term 12.1 Care Facilities 12.2 General (24,318,000) (15,404,000) 12.3 [ICF/MR DISALLOWANCES.] Of this 12.4 appropriation, $65,000 in fiscal year 12.5 1999 is from the general fund to the 12.6 commissioner for the purpose of 12.7 reimbursing a 12-bed ICF/MR in Stearns 12.8 county and a 12-bed ICF/MR in Sherburne 12.9 county for disallowances resulting from 12.10 field audit findings. The commissioner 12.11 shall exempt these facilities from the 12.12 provisions of Minnesota Statutes, 12.13 section 256B.501, subdivision 5b, 12.14 paragraph (d), clause (6), for the rate 12.15 years beginning October 1, 1997, and 12.16 October 1, 1998. Section 10, sunset of 12.17 uncodified language, does not apply to 12.18 this provision. 12.19 [NURSING HOME MORATORIUM EXCEPTIONS.] 12.20 Base level funding for medical 12.21 assistance long-term care facilities is 12.22 increased by $255,000 in fiscal year 12.23 2000 and by $278,000 in fiscal year 12.24 2001 for the additional medical 12.25 assistance costs of the nursing home 12.26 moratorium exceptions under Minnesota 12.27 Statutes 1997 Supplement, section 12.28 144A.071, subdivision 4a, paragraphs 12.29 (w) and (x). Notwithstanding the 12.30 provisions of section 10, sunset of 12.31 uncodified language, this provision 12.32 shall not expire. 12.33 [ICFs/MR AND NURSING FACILITY 12.34 FLOOD-RELATED REPORTING.] For the 12.35 reporting year ending December 31, 12.36 1997, for ICFs/MR that temporarily 12.37 admitted victims of the flood of 1997, 12.38 the resident days related to those 12.39 temporary placements (persons not 12.40 formally admitted which continued to be 12.41 billed under the evacuated facility's 12.42 provider number) shall not be counted 12.43 in the cost report submitted to 12.44 calculate October 1, 1998, rates, and 12.45 the additional expenditures shall be 12.46 considered nonallowable. 12.47 For the reporting year ending September 12.48 30, 1997, for nursing facilities that 12.49 temporarily admitted victims of the 12.50 flood of 1997, the resident days 12.51 related to those temporary placements 12.52 (persons not formally admitted which 12.53 continued to be billed under the 12.54 evacuated facility's provider number) 12.55 shall not be counted in the cost report 12.56 submitted to calculate July 1, 1998, 12.57 rates, and the additional expenditures 12.58 shall be considered nonallowable. 12.59 (hh) Alternative Care Grants 12.60 General -0- 21,463,000 12.61 (ii) Group Residential Housing 12.62 General (8,782,000) (8,696,000) 13.1 (jj) Chemical Dependency 13.2 Entitlement Grants 13.3 General -0- (7,893,000) 13.4 (kk) Chemical Dependency 13.5 Nonentitlement Grants 13.6 General -0- 400,000 13.7 [MATCHING GRANT FOR YOUTH ALCOHOL 13.8 TREATMENT.] Of this appropriation, 13.9 $400,000 in fiscal year 1999 is from 13.10 the general fund for the commissioner 13.11 to provide a grant to the board of 13.12 directors of the Minnesota Indian 13.13 Primary Residential Treatment Center, 13.14 Inc., to build a youth alcohol 13.15 treatment wing at the Mash-Ka-Wisen 13.16 Treatment Center. This appropriation 13.17 is available only if matched by a 13.18 $1,500,000 federal grant and a $100,000 13.19 grant from state Indian bands. 13.20 [MATCHING GRANT FOR PROJECT TURNABOUT.] 13.21 If money is appropriated in fiscal year 13.22 1999 to the commissioner from the 13.23 lottery prize fund, the money shall be 13.24 used to provide a grant for capital 13.25 improvements to Project Turnabout in 13.26 Granite Falls. A local match is 13.27 required before the commissioner may 13.28 release this appropriation to the 13.29 facility. The facility shall receive 13.30 state funds equal to the amount of 13.31 local matching funds provided, up to 13.32 the limit of this appropriation. 13.33 Subd. 8. Economic Support Grants 13.34 General (7,462,000) (42,861,000) 13.35 The amounts that may be spent from this 13.36 appropriation for each purpose are as 13.37 follows: 13.38 (aa) Assistance to Families 13.39 Grants 13.40 General 2,273,000 (32,282,000) 13.41 [TRANSFER OF STATE MONEY FROM TANF 13.42 RESERVE.] For fiscal year 1999, 13.43 $10,014,000 is appropriated from the 13.44 state money in the TANF reserve to the 13.45 commissioner for the purposes of 13.46 funding the families-first distribution 13.47 of child support arrearages under 13.48 Minnesota Statutes, section 256.741, 13.49 subdivision 2a; the Minnesota food 13.50 assistance program under Minnesota 13.51 Statutes, section 256D.053; and the 13.52 MFIP-S noncitizen food portion under 13.53 Minnesota Statutes, section 256J.11, 13.54 subdivision 2. 13.55 [TRANSFER OF FEDERAL TANF FUNDS TO 13.56 CHILD CARE DEVELOPMENT FUND.] $391,000 13.57 is transferred in fiscal year 1999 from 13.58 the state's federal TANF block grant to 13.59 the state's child care development 14.1 fund, and is appropriated to the 14.2 commissioner of children, families, and 14.3 learning for the purposes of Minnesota 14.4 Statutes, section 119B.05. 14.5 (bb) General Assistance 14.6 General (6,933,000) (6,321,000) 14.7 (cc) Minnesota Supplemental 14.8 Aid 14.9 General (2,802,000) (4,258,000) 14.10 Subd. 9. Economic Support 14.11 Management 14.12 General 49,000 105,000 14.13 Health Care Access -0- 1,084,000 14.14 [ASSESSMENT OF AFFORDABLE HOUSING 14.15 SUPPLY.] The commissioner of human 14.16 services shall assess the statewide 14.17 supply of affordable housing for all 14.18 MFIP-S and GA recipients, and report to 14.19 the legislature by January 15, 1999, on 14.20 the results of this assessment. 14.21 The amounts that may be spent from this 14.22 appropriation for each purpose are as 14.23 follows: 14.24 Economic Support 14.25 Operations 14.26 General 49,000 105,000 14.27 Health Care Access -0- 1,084,000 14.28 Sec. 3. COMMISSIONER OF HEALTH 14.29 Subdivision 1. Total 14.30 Appropriation -0- 19,381,000 14.31 Summary by Fund 14.32 General -0- 19,115,000 14.33 State Government Special 14.34 Revenue -0- 7,000 14.35 Health Care 14.36 Access -0- 259,000 14.37 Subd. 2. Health Systems and 14.38 Special Populations -0- 13,759,000 14.39 Summary by Fund 14.40 General -0- 13,500,000 14.41 Health Care 14.42 Access -0- 259,000 14.43 [FETAL ALCOHOL SYNDROME.] (a) Of this 14.44 appropriation, $3,500,000 in fiscal 14.45 year 1999 is from the general fund to 14.46 the commissioner for the fetal alcohol 14.47 syndrome/fetal alcohol effect (FAS/FAE) 14.48 initiatives specified in paragraphs (b) 15.1 to (k). 15.2 (b) Of the amount in paragraph (a), 15.3 $100,000 is transferred to the 15.4 commissioner of children, families, and 15.5 learning for school-based pilot 15.6 programs to identify and implement 15.7 effective educational strategies for 15.8 individuals with FAS/FAE. 15.9 (c) Of the amount in paragraph (a), 15.10 $600,000 is for the public awareness 15.11 campaign under Minnesota Statutes, 15.12 section 145.9266, subdivision 1. 15.13 (d) Of the amount in paragraph (a), 15.14 $300,000 is to develop a statewide 15.15 network of regional FAS diagnostic 15.16 clinics under Minnesota Statutes, 15.17 section 145.9266, subdivision 2. 15.18 (e) Of the amount in paragraph (a), 15.19 $150,000 is for professional training 15.20 about FAS under Minnesota Statutes, 15.21 section 145.9266, subdivision 3. 15.22 (f) Of the amount in paragraph (a), 15.23 $200,000 is for the fetal alcohol 15.24 coordinating board under Minnesota 15.25 Statutes, section 145.9266, subdivision 15.26 6. 15.27 (g) Of the amount in paragraph (a), 15.28 $500,000 is transferred to the 15.29 commissioner of human services to 15.30 expand the maternal and child health 15.31 social service programs under Minnesota 15.32 Statutes, section 254A.17, subdivision 15.33 1. 15.34 (h) Of the amount in paragraph (a), 15.35 $200,000 is for the commissioner to 15.36 study the extent of fetal alcohol 15.37 syndrome in the state. 15.38 (i) Of the amount in paragraph (a), 15.39 $300,000 is transferred to the 15.40 commissioner of human services for the 15.41 intervention and advocacy program under 15.42 Minnesota Statutes, section 254A.17, 15.43 subdivision 1b. 15.44 (j) Of the amount in paragraph (a), 15.45 $700,000 is for the FAS community grant 15.46 program under Minnesota Statutes, 15.47 section 145.9266, subdivision 4. 15.48 (k) Of the amount in paragraph (a), 15.49 $450,000 is transferred to the 15.50 commissioner of human services to 15.51 expand treatment services and halfway 15.52 houses for pregnant women and women 15.53 with children who abuse alcohol during 15.54 pregnancy. 15.55 [RURAL PHYSICIAN LOAN FORGIVENESS 15.56 BUDGET REQUEST.] The budget request for 15.57 the rural physician loan forgiveness 15.58 program in the 2000-2001 biennial 15.59 budget shall detail the amount of funds 15.60 carried forward and obligations 16.1 canceled. 16.2 [GRANTS FROM HEALTH CARE ACCESS FUND.] 16.3 Of any grants made from the health care 16.4 access fund to the commissioner of 16.5 health for purposes of Minnesota 16.6 Statutes, section 145.925, priority 16.7 shall be given for grants to entities 16.8 providing natural family planning 16.9 services that did not receive funding 16.10 under Minnesota Statutes, section 16.11 145.925, in fiscal year 1998. 16.12 [GRANTS TO MEDICAL CLINICS.] A medical 16.13 clinic, including its affiliated 16.14 clinics, that counsels, refers, or 16.15 performs abortions and that receives 16.16 federal funds under Public Law Number 16.17 91-572, title X of the Public Health 16.18 Service Act is not eligible for family 16.19 planning grant funds from the health 16.20 care access fund. 16.21 Subd. 3. Health Protection -0- 5,615,000 16.22 Summary by Fund 16.23 General -0- 5,615,000 16.24 State Government 16.25 Special Revenue -0- 7,000 16.26 [OCCUPATIONAL RESPIRATORY DISEASE 16.27 INFORMATION SYSTEM.] Of the general 16.28 fund appropriation, $300,000 in fiscal 16.29 year 1999 is to design an occupational 16.30 respiratory disease information 16.31 system. This appropriation is 16.32 available until expended. This 16.33 appropriation is added to the base for 16.34 the 2000-2001 biennial budget. 16.35 [INFECTION CONTROL.] Of the general 16.36 fund appropriation, $300,000 in fiscal 16.37 year 1999 is for infection control 16.38 activities, including training and 16.39 technical assistance of health care 16.40 personnel to prevent and control 16.41 disease outbreaks, and for hospital and 16.42 public health laboratory testing and 16.43 other activities to monitor trends in 16.44 drug-resistant infections. Start-up 16.45 costs shall not become part of the base 16.46 for the 2000-2001 biennial budget. 16.47 [CANCER SCREENING.] Of the general fund 16.48 appropriation, $1,373,100 in fiscal 16.49 year 1999 is for increased cancer 16.50 screening and diagnostic services for 16.51 women, particularly underserved women, 16.52 and to improve cancer screening rates 16.53 for the general population. Of this 16.54 amount, at least $854,500 is for grants 16.55 to support local boards of health in 16.56 providing outreach and coordination and 16.57 to reimburse health care providers for 16.58 screening and diagnostic tests, and up 16.59 to $518,600 is for technical 16.60 assistance, consultation, and outreach. 16.61 [SEXUALLY TRANSMITTED DISEASE 17.1 PREVENTION INITIATIVES.] (a) Of this 17.2 appropriation, $300,000 in fiscal year 17.3 1999 is from the general fund to the 17.4 commissioner for the sexually 17.5 transmitted disease prevention 17.6 initiatives specified in paragraphs (b) 17.7 to (d). 17.8 (b) $100,000 is for the commissioner, 17.9 in consultation with the HIV/STD 17.10 prevention task force and the 17.11 commissioner of children, families, and 17.12 learning, to conduct a statewide 17.13 assessment of need and capacity to 17.14 prevent and treat sexually transmitted 17.15 diseases and to prepare a comprehensive 17.16 plan for how to prevent and treat 17.17 sexually transmitted diseases, 17.18 including strategies for reducing 17.19 infection and for increasing access to 17.20 treatment. This appropriation shall 17.21 not become part of the base level 17.22 funding for this activity for the 17.23 2000-2001 biennial budget. 17.24 (c) $100,000 is for the commissioner to 17.25 conduct research on the prevalence of 17.26 sexually transmitted diseases among 17.27 populations at highest risk for 17.28 infection. The research may be done in 17.29 collaboration with the University of 17.30 Minnesota and nonprofit community 17.31 health clinics. This appropriation 17.32 shall not become part of the base level 17.33 funding for this activity for the 17.34 2000-2001 biennial budget. 17.35 (d) $100,000 is for the commissioner to 17.36 conduct laboratory screenings for 17.37 sexually transmitted diseases and to 17.38 overcome barriers to diagnostic 17.39 screening and treatment services, 17.40 particularly in populations at highest 17.41 risk for acquiring a sexually 17.42 transmitted disease. 17.43 [LEAD-SAFE PROPERTY CERTIFICATION 17.44 PROGRAM.] Of this appropriation, 17.45 $100,000 in fiscal year 1999 is from 17.46 the general fund to the commissioner 17.47 for the purposes of the lead-safe 17.48 property certification program under 17.49 Minnesota Statutes, section 144.9511. 17.50 Sec. 4. HEALTH-RELATED BOARDS 17.51 Subdivision 1. Total 17.52 Appropriation 113,000 83,000 17.53 The appropriations in this section are 17.54 from the state government special 17.55 revenue fund. 17.56 Subd. 2. Board of Medical 17.57 Practice 80,000 (110,000) 17.58 This appropriation is added to the 17.59 appropriation in Laws 1997, chapter 17.60 203, article 1, section 5, subdivision 17.61 6, and is for the health professional 17.62 services activity. 18.1 Subd. 3. Board of Physical 18.2 Therapy -0- 160,000 18.3 Subd. 4. Board of 18.4 Veterinary Medicine 33,000 33,000 18.5 This appropriation is added to the 18.6 appropriation in Laws 1997, chapter 18.7 203, article 1, section 5, subdivision 18.8 14, and is for national examination 18.9 costs. 18.10 Sec. 5. EMERGENCY MEDICAL 18.11 SERVICES BOARD 18.12 General -0- 78,000 18.13 [EMERGENCY MEDICAL SERVICES 18.14 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 18.15 Of this appropriation, $78,000 in 18.16 fiscal year 1999 is from the general 18.17 fund to the board to conduct an 18.18 emergency medical services needs 18.19 assessment for areas outside the 18.20 seven-county metropolitan area. The 18.21 assessment shall determine the current 18.22 status of and need for emergency 18.23 medical services communications 18.24 equipment. All regional emergency 18.25 medical services programs designated by 18.26 the board under Minnesota Statutes 1997 18.27 Supplement, section 144E.50, shall 18.28 cooperate in the preparation of the 18.29 assessment. 18.30 (b) The appropriation for this project 18.31 shall be distributed through the 18.32 emergency medical services system fund 18.33 under Minnesota Statutes, section 18.34 144E.50, through a request-for-proposal 18.35 process. The board must select a 18.36 regional EMS program that receives at 18.37 least 20 percent of its funding from 18.38 nonstate sources to conduct the 18.39 assessment. The request for proposals 18.40 must be issued by August 1, 1998. 18.41 (c) A final report with recommendations 18.42 shall be presented to the board and the 18.43 legislature by July 1, 1999. 18.44 (d) This appropriation shall not become 18.45 part of base level funding for the 18.46 2000-2001 biennium. 18.47 Sec. 6. OMBUDSMAN FOR MENTAL 18.48 HEALTH AND MENTAL RETARDATION 18.49 General -0- 200,000 18.50 Sec. 7. Laws 1997, chapter 203, article 1, section 2, 18.51 subdivision 5, is amended to read: 18.52 Subd. 5. Basic Health Care Grants 18.53 Summary by Fund 18.54 General 834,098,000 938,504,000 18.55 The amounts that may be spent from this 19.1 appropriation for each purpose are as 19.2 follows: 19.3 (aa) MA Basic Health Care Grants- 19.4 Families and Children 19.5 General 322,970,000 367,726,000 19.6[NOTICE ON CHANGES IN ASSET TEST.] The19.7commissioner shall provide a notice by19.8July 15, 1997, to all recipients19.9affected by the changes in this act in19.10asset standards for families with19.11children notifying them:19.12(1) what asset limits will apply to19.13them;19.14(2) when the new limits will apply;19.15(3) what options they have to spenddown19.16assets; and19.17(4) what options they have to enroll in19.18MinnesotaCare, including an explanation19.19of the MinnesotaCare premium structure.19.20 (bb) MA Basic Health Care Grants- 19.21 Elderly & Disabled 19.22 General 337,659,000 400,408,000 19.23 [PUBLIC HEALTH NURSE ASSESSMENT.] The 19.24 reimbursement for public health nurse 19.25 visits relating to the provision of 19.26 personal care services under Minnesota 19.27 Statutes, sections 256B.0625, 19.28 subdivision 19a, and 256B.0627, is 19.29 $204.36 for the initial assessment 19.30 visit and $102.18 for each reassessment 19.31 visit. 19.32 [SURCHARGE COMPLIANCE.] In the event 19.33 that federal financial participation in 19.34 the Minnesota medical assistance 19.35 program is reduced as a result of a 19.36 determination that Minnesota is out of 19.37 compliance with Public Law Number 19.38 102-234 or its implementing regulations 19.39 or with any other federal law designed 19.40 to restrict provider tax programs or 19.41 intergovernmental transfers, the 19.42 commissioner shall appeal the 19.43 determination to the fullest extent 19.44 permitted by law and may ratably reduce 19.45 all medical assistance and general 19.46 assistance medical care payments to 19.47 providers other than the state of 19.48 Minnesota in order to eliminate any 19.49 shortfall resulting from the reduced 19.50 federal funding. Any amount later 19.51 recovered through the appeals process 19.52 shall be used to reimburse providers 19.53 for any ratable reductions taken. 19.54 [BLOOD PRODUCTS LITIGATION.] To the 19.55 extent permitted by federal law, 19.56 Minnesota Statutes, sections 256.015, 19.57 256B.042, 256B.056, and 256B.15 are 19.58 waived as necessary for the limited 19.59 purpose of resolving the state's claims 20.1 in connection with In re Factor VIII or 20.2 IX Concentrate Blood Products 20.3 Litigation, MDL-986, No. 93-C7452 20.4 (N.D.III.). 20.5 [DISTRIBUTION TO MEDICAL ASSISTANCE 20.6 PROVIDERS.] (a) Of the amount 20.7 appropriated to the medical assistance 20.8 account in fiscal year 1998, $5,000,000 20.9 plus the federal financial 20.10 participation amount shall be 20.11 distributed to medical assistance 20.12 providers according to the distribution 20.13 methodology of the medical education 20.14 research trust fund established under 20.15 Minnesota Statutes, section 62J.69. 20.16 (b) In fiscal year 1999, the prepaid 20.17 medical assistance and prepaid general 20.18 assistance medical care capitation rate 20.19 reduction amounts under Minnesota 20.20 Statutes, section 256B.69, subdivision 20.21 5c, and the federal financial 20.22 participation amount associated with 20.23 the medical assistance reduction, shall 20.24 be distributed to medical assistance 20.25 providers according to the distribution 20.26 methodology of the trust fund. 20.27[AUGMENTATIVE AND ALTERNATIVE20.28COMMUNICATION SYSTEMS.] Augmentative20.29and alternative communication systems20.30and related components that are prior20.31authorized by the department through20.32pass through vendors during the period20.33from January 1, 1997, until the20.34augmentative and alternative20.35communication system purchasing program20.36or other alternatives are operational20.37shall be paid under the medical20.38assistance program at the actual price20.39charged the pass through vendor plus 2020.40percent to cover administrative costs20.41of prior authorization and billing and20.42shipping charges.20.43 (cc) General Assistance Medical Care 20.44 General 173,469,000 170,370,000 20.45 [HEALTH CARE ACCESS TRANSFERS TO 20.46 GENERAL FUND.] Funds shall be 20.47 transferred from the health care access 20.48 fund to the general fund in an amount 20.49 equal to the projected savings to 20.50 general assistance medical care (GAMC) 20.51 that would result from the transition 20.52 of GAMC parents and adults without 20.53 children to MinnesotaCare. Based on 20.54 this projection, for state fiscal year 20.55 1998, the amount transferred from the 20.56 health care access fund to the general 20.57 fund shall be $13,700,000. The amount 20.58 of transfer, if any, necessary for 20.59 state fiscal year 1999 shall be 20.60determined on a pro rata20.61basis$2,659,000. 20.62 [TUBERCULOSIS COST OF CARE.] Of the 20.63 general fund appropriation, $89,000 for 20.64 the biennium is for the cost of care 21.1 that is required to be paid by the 21.2 commissioner under Minnesota Statutes, 21.3 section 144.4872, to diagnose or treat 21.4 tuberculosis carriers. 21.5 Sec. 8. Laws 1997, chapter 203, article 1, section 2, 21.6 subdivision 12, is amended to read: 21.7 Subd. 12. Federal TANF Funds 21.8 [FEDERAL TANF FUNDS.] (a) Federal 21.9 Temporary Assistance for Needy Families 21.10 block grant funds authorized under 21.11 title I of Public Law Number 104-193, 21.12 the Personal Responsibility and Work 21.13 Opportunity Reconciliation Act of 1996, 21.14 are appropriated to the commissioner in 21.15 amounts up to$276,741,000$230,300,000 21.16 in fiscal year 1998 21.17 and$265,795,000$267,110,000 in fiscal 21.18 year 1999. Additional TANF funds may 21.19 be expended, but only to the extent 21.20 that an equal amount of state funds 21.21 have been transferred to the TANF 21.22 reserve under Minnesota Statutes 1997 21.23 Supplement, section 256J.03. 21.24 (b) The commissioner may use TANF 21.25 reserve funds to offset any future 21.26 reductions in the amount of the state's 21.27 allocation of federal TANF block grant 21.28 funds. 21.29 Sec. 9. [CARRYOVER LIMITATION.] 21.30 The appropriations in this article which are allowed to be 21.31 carried forward from fiscal year 1998 to fiscal year 1999 shall 21.32 not become part of the base level funding for the 2000-2001 21.33 biennial budget, unless specifically directed by the legislature. 21.34 Sec. 10. [SUNSET OF UNCODIFIED LANGUAGE.] 21.35 All uncodified language contained in this article expires 21.36 on June 30, 1999, unless a different expiration date is 21.37 specified. 21.38 Sec. 11. [EFFECTIVE DATE.] 21.39 (a) The appropriations and reductions for fiscal year 1998 21.40 in this article are effective the day following final enactment. 21.41 (b) Section 8 (the amendments to Laws 1997, chapter 203, 21.42 article 1, section 2, subdivision 12) is effective the day 21.43 following final enactment. 21.44 ARTICLE 2 21.45 HEALTH DEPARTMENT AND HEALTH PROFESSIONALS 21.46 Section 1. Minnesota Statutes 1997 Supplement, section 21.47 62D.11, subdivision 1, is amended to read: 22.1 Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health 22.2 maintenance organization shall establish and maintain a 22.3 complaint system, as required under section 62Q.105 to provide 22.4 reasonable procedures for the resolution of written complaints 22.5 initiated by or on behalf of enrollees concerning the provision 22.6 of health care services. "Provision of health services" 22.7 includes, but is not limited to, questions of the scope of 22.8 coverage, quality of care, and administrative operations. The 22.9 health maintenance organization must inform enrollees that they 22.10 may choose to usealternative dispute resolutionarbitration to 22.11 appeal a health maintenance organization's internal appeal 22.12 decision. The health maintenance organization must also inform 22.13 enrollees that they have the right to use arbitration to appeal 22.14 a health maintenance organization's internal appeal decision not 22.15 to certify an admission, procedure, service, or extension of 22.16 stay under section 62M.06. If an enrollee chooses to usean22.17alternative dispute resolution processarbitration, the health 22.18 maintenance organization must participate. 22.19 Sec. 2. Minnesota Statutes 1997 Supplement, section 22.20 62J.70, subdivision 3, is amended to read: 22.21 Subd. 3. [HEALTH PLAN COMPANY.] "Health plan company" 22.22 means a health plan company as defined in section 62Q.01, 22.23 subdivision 4, the medical assistance program, the MinnesotaCare 22.24 program, the general assistance medical care program, the state 22.25 employee group insurance program, the public employees insurance 22.26 program under section 43A.316, and coverage provided by 22.27 political subdivisions under section 471.617. 22.28 Sec. 3. Minnesota Statutes 1997 Supplement, section 22.29 62J.71, subdivision 1, is amended to read: 22.30 Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.] The 22.31 following types of agreements and directives are contrary to 22.32 state public policy, are prohibited under this section, and are 22.33 null and void: 22.34 (1) any agreement or directive that prohibits a health care 22.35 provider from communicating with an enrollee with respect to the 22.36 enrollee's health status, health care, or treatment options, if 23.1 the health care provider is acting in good faith and within the 23.2 provider's scope of practice as defined by law; 23.3 (2) any agreement or directive that prohibits a health care 23.4 provider from making a recommendation regarding the suitability 23.5 or desirability of a health plan company, health insurer, or 23.6 health coverage plan for an enrollee, unless the provider has a 23.7 financial conflict of interest in the enrollee's choice of 23.8 health plan company, health insurer, or health coverage plan; 23.9 (3) any agreement or directive that prohibits a provider 23.10 from providing testimony, supporting or opposing legislation, or 23.11 making any other contact with state or federal legislators or 23.12 legislative staff or with state and federal executive branch 23.13 officers or staff; 23.14 (4) any agreement or directive that prohibits a health care 23.15 provider from disclosing accurate information about whether 23.16 services or treatment will be paid for by a patient's health 23.17 plan company or health insurer or health coverage plan; and 23.18 (5) any agreement or directive that prohibits a health care 23.19 provider from informing an enrollee about the nature of the 23.20 reimbursement methodology used by an enrollee's health plan 23.21 company, health insurer, or health coverage plan to pay the 23.22 provider. 23.23 Sec. 4. Minnesota Statutes 1997 Supplement, section 23.24 62J.71, subdivision 3, is amended to read: 23.25 Subd. 3. [RETALIATION PROHIBITED.] No person, health plan 23.26 company, or other organization may take retaliatory action 23.27 against a health care provider solely on the grounds that the 23.28 provider: 23.29 (1) refused to enter into an agreement or provide services 23.30 or information in a manner that is prohibited under this section 23.31 or took any of the actions listed in subdivision 1; 23.32 (2) disclosed accurate information about whether a health 23.33 care service or treatment is covered by an enrollee's health 23.34 plan company, health insurer, or health coverage plan;or23.35 (3) discussed diagnostic, treatment, or referral options 23.36 that are not covered or are limited by the enrollee's health 24.1 plan company, health insurer, or health coverage plan; 24.2 (4) criticized coverage of the enrollee's health plan 24.3 company, health insurer, or health coverage plan; or 24.4 (5) expressed personal disagreement with a decision made by 24.5 a person, organization, or health care provider regarding 24.6 treatment or coverage provided to a patient of the provider, or 24.7 assisted or advocated for the patient in seeking reconsideration 24.8 of such a decision, provided the health care provider makes it 24.9 clear that the provider is acting in a personal capacity and not 24.10 as a representative of or on behalf of the entity that made the 24.11 decision. 24.12 Sec. 5. Minnesota Statutes 1997 Supplement, section 24.13 62J.71, subdivision 4, is amended to read: 24.14 Subd. 4. [EXCLUSION.] (a) Nothing in this section 24.15 prohibitsa health planan entity that is subject to this 24.16 section from taking action against a provider if thehealth plan24.17 entity has evidence that the provider's actions are illegal, 24.18 constitute medical malpractice, or are contrary to accepted 24.19 medical practices. 24.20 (b) Nothing in this section prohibits a contract provision 24.21 or directive that requires any contracting party to keep 24.22 confidential or to not use or disclose the specific amounts paid 24.23 to a provider, provider fee schedules, provider salaries, and 24.24 other similar provider-specific proprietary information of a 24.25 specifichealth plan or health plan companyentity that is 24.26 subject to this section. 24.27 Sec. 6. Minnesota Statutes 1997 Supplement, section 24.28 62J.72, subdivision 1, is amended to read: 24.29 Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan 24.30 company, as defined under section 62J.70, subdivision 3, a 24.31 health care network cooperative as defined under section 62R.04, 24.32 subdivision 3, and a health care provider as defined under 24.33 section 62J.70, subdivision 2, shall, during open enrollment, 24.34 upon enrollment, and annually thereafter, provide enrollees with 24.35 a description of the general nature of the reimbursement 24.36 methodologies used by the health plan company, health insurer, 25.1 or health coverage plan to pay providers. The description must 25.2 explain clearly any aspect of the reimbursement methodology that 25.3 in any way may tend to make it advantageous for the health care 25.4 provider to minimize or restrict the health care provided to 25.5 enrollees. This description may be incorporated into the member 25.6 handbook, subscriber contract, certificate of coverage, or other 25.7 written enrollee communication. The general reimbursement 25.8 methodology shall be made available to employers at the time of 25.9 open enrollment. 25.10 (b) Health plan companies, health care network 25.11 cooperatives, and providers must, upon request, provide an 25.12 enrollee with specific information regarding the reimbursement 25.13 methodology, including, but not limited to, the following 25.14 information: 25.15 (1) a concise written description of the provider payment 25.16 plan, including any incentive plan applicable to the enrollee; 25.17 (2) a written description of any incentive to the provider 25.18 relating to the provision of health care services to enrollees, 25.19 including any compensation arrangement that is dependent on the 25.20 amount of health coverage or health care services provided to 25.21 the enrollee, or the number of referrals to or utilization of 25.22 specialists; and 25.23 (3) a written description of any incentive plan that 25.24 involves the transfer of financial risk to the health care 25.25 provider. 25.26 (c) The disclosure statement describing the general nature 25.27 of the reimbursement methodologies must comply with the 25.28 Readability of Insurance Policies Act in chapter 72C.25.29Notwithstanding any other law to the contrary, the disclosure25.30statement may voluntarily be filed with the commissioner for25.31approvaland must be filed with and approved by the commissioner 25.32 prior to its use. 25.33 (d) A disclosure statement that hasvoluntarilybeen filed 25.34 with the commissioner for approval underchapter 72C or25.35voluntarily filed with the commissioner for approval for25.36purposes other than pursuant to chapter 72Cparagraph (c) is 26.1 deemed approved 30 days after the date of filing, unless 26.2 approved or disapproved by the commissioner on or before the end 26.3 of that 30-day period. 26.4 (e) The disclosure statement describing the general nature 26.5 of the reimbursement methodologies must be provided upon request 26.6 in English, Spanish, Vietnamese, and Hmong. In addition, 26.7 reasonable efforts must be made to provide information contained 26.8 in the disclosure statement to other non-English-speaking 26.9 enrollees. 26.10 (f) Health plan companies and providers may enter into 26.11 agreements to determine how to respond to enrollee requests 26.12 received by either the provider or the health plan 26.13 company. Health plan companies may also enter into agreements 26.14 to determine how to respond to enrollee requests. This 26.15 subdivision does not require disclosure of specific amounts paid 26.16 to a provider, provider fee schedules, provider salaries, or 26.17 other proprietary information of a specific health plan company 26.18 or health insurer or health coverage plan or provider. 26.19 Sec. 7. [62J.77] [DEFINITIONS.] 26.20 Subdivision 1. [APPLICABILITY.] For purposes of sections 26.21 62J.77 to 62J.80, the terms defined in this section have the 26.22 meanings given them. 26.23 Subd. 2. [ENROLLEE.] "Enrollee" means a natural person 26.24 covered by a health plan company, health insurance, or health 26.25 coverage plan and includes an insured, policyholder, subscriber, 26.26 contract holder, member, covered person, or certificate holder. 26.27 Subd. 3. [PATIENT.] "Patient" means a former, current, or 26.28 prospective patient of a health care provider. 26.29 Sec. 8. [62J.78] [ESTABLISHMENT; ORGANIZATION.] 26.30 Subdivision 1. [GENERAL.] The office of health care 26.31 consumer assistance, advocacy, and information is established to 26.32 provide assistance, advocacy, and information to all health care 26.33 consumers within the state. The office shall have no regulatory 26.34 power or authority and shall not provide legal representation in 26.35 a court of law. 26.36 Subd. 2. [EXECUTIVE DIRECTOR.] An executive director shall 27.1 be appointed by the governor, in consultation with the consumer 27.2 advisory board, for a three-year term and may be removed only 27.3 for just cause. The executive director must be selected without 27.4 regard to political affiliation and must be a person who has 27.5 knowledge and experience concerning the needs and rights of 27.6 health care consumers and must be qualified to analyze questions 27.7 of law, administrative functions, and public policy. No person 27.8 may serve as executive director while holding another public 27.9 office. The director shall serve in the unclassified service. 27.10 Subd. 3. [STAFF.] The executive director shall appoint at 27.11 least nine consumer advocates to discharge the responsibilities 27.12 and duties of the office. The executive director and full-time 27.13 staff shall be included in the Minnesota state retirement 27.14 association. 27.15 Subd. 4. [DELEGATION.] The executive director may delegate 27.16 to staff any of the authority or duties of the director, except 27.17 the duty of formally making recommendations to the legislature. 27.18 Subd. 5. [TRAINING.] The executive director shall ensure 27.19 that the consumer advocates are adequately trained. 27.20 Subd. 6. [STATEWIDE ADVOCACY.] The executive director 27.21 shall assign a consumer advocate to represent each regional 27.22 coordinating board's geographic area. 27.23 Subd. 7. [FINANCIAL INTEREST.] The executive director and 27.24 staff must not have any direct personal financial interest in 27.25 the health care system, except as an individual consumer of 27.26 health care services. 27.27 Subd. 8. [ADMINISTRATION.] The office of the ombudsman for 27.28 mental health and mental retardation shall coordinate and share 27.29 administrative services with the office of health care consumer 27.30 assistance, advocacy, and information. To the extent practical, 27.31 all ombudsman offices with health care responsibilities shall 27.32 have their telephone systems linked in order to facilitate 27.33 immediate referrals. 27.34 Sec. 9. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF 27.35 HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.] 27.36 Subdivision 1. [DUTIES.] (a) The executive director shall 28.1 provide information and assistance to all health care consumers 28.2 by: 28.3 (1) assisting patients and enrollees in understanding and 28.4 asserting their contractual and legal rights, including the 28.5 rights under an alternative dispute resolution process. This 28.6 assistance may include advocacy for enrollees in administrative 28.7 proceedings or other formal or informal dispute resolution 28.8 processes; 28.9 (2) assisting enrollees in obtaining health care referrals 28.10 under their health plan company, health insurance, or health 28.11 coverage plan; 28.12 (3) assisting patients and enrollees in accessing the 28.13 services of governmental agencies, regulatory boards, and other 28.14 state consumer assistance programs, ombudsman, or advocacy 28.15 services whenever appropriate so that the patient or enrollee 28.16 can take full advantage of existing mechanisms for resolving 28.17 complaints; 28.18 (4) referring patients and enrollees to governmental 28.19 agencies and regulatory boards for the investigation of health 28.20 care complaints and for enforcement action; 28.21 (5) educating and training enrollees about their health 28.22 plan company, health insurance, or health coverage plan in order 28.23 to enable them to assert their rights and to understand their 28.24 responsibilities; 28.25 (6) assisting enrollees in receiving a timely resolution of 28.26 their complaints; 28.27 (7) monitoring health care complaints addressed by the 28.28 office to identify specific complaint patterns or areas of 28.29 potential improvement; 28.30 (8) recommending to health plan companies ways to identify 28.31 and remove any barriers that might delay or impede the health 28.32 plan company's effort to resolve consumer complaints; and 28.33 (9) in performing the duties specified in clauses (1) to 28.34 (8), taking into consideration the special situations of 28.35 patients and enrollees who have unique culturally defined needs. 28.36 (b) The executive director shall prioritize the duties 29.1 listed in this subdivision within the appropriations allocated. 29.2 Subd. 2. [COMMUNICATION.] The executive director shall 29.3 meet at least six times per year with the consumer advisory 29.4 board. The executive director shall share all public 29.5 information obtained by the office of health care consumer 29.6 assistance, advocacy, and information with the consumer advisory 29.7 board in order to assist the consumer advisory board in its role 29.8 of advising the commissioners of health and commerce and the 29.9 legislature in accordance with section 62J.75. 29.10 Subd. 3. [REPORTS.] Beginning January 15, 1999, the 29.11 executive director, on at least a quarterly basis, shall provide 29.12 data from the health care complaints addressed by the office to 29.13 the commissioners of health and commerce, the consumer advisory 29.14 board, the Minnesota council of health plans, the Insurance 29.15 Federation of Minnesota, and the information clearinghouse. 29.16 Beginning January 15, 1999, the executive director must make an 29.17 annual written report to the legislature regarding activities of 29.18 the office, including recommendations on improving health care 29.19 consumer assistance and complaint resolution processes. 29.20 Sec. 10. [62J.80] [RETALIATION.] 29.21 A health plan company or health care provider shall not 29.22 retaliate or take adverse action against an enrollee or patient 29.23 who, in good faith, makes a complaint against a health plan 29.24 company or health care provider. If retaliation is suspected, 29.25 the executive director may report it to the appropriate 29.26 regulatory authority. 29.27 Sec. 11. Minnesota Statutes 1997 Supplement, section 29.28 62Q.105, subdivision 1, is amended to read: 29.29 Subdivision 1. [ESTABLISHMENT.] Each health plan company 29.30 shall establish and make available to enrollees, by July 1,199829.31 1999, an informal complaint resolution process that meets the 29.32 requirements of this section. A health plan company must make 29.33 reasonable efforts to resolve enrollee complaints, and must 29.34 inform complainants in writing of the company's decision within 29.35 30 days of receiving the complaint. The complaint resolution 29.36 process must treat the complaint and information related to it 30.1 as required under sections 72A.49 to 72A.505. 30.2 Sec. 12. [62Q.107] [PROHIBITED PROVISION; EFFECT OF DENIAL 30.3 OF CLAIM.] 30.4 No health plan, including the coverages described in 30.5 section 62A.011, subdivision 3, clauses (7) and (10), may 30.6 specify a standard of review upon which a court may review 30.7 denial of a claim or of any other decision made by a health plan 30.8 company with respect to an enrollee. This section prohibits 30.9 limiting court review to a determination of whether the health 30.10 plan company's decision is arbitrary and capricious, an abuse of 30.11 discretion, or any other standard less favorable to the enrollee 30.12 than a preponderance of the evidence. 30.13 Sec. 13. Minnesota Statutes 1997 Supplement, section 30.14 62Q.30, is amended to read: 30.15 62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 30.16 PROCESS.] 30.17 The commissioner shall establish an expedited fact finding 30.18 and dispute resolution process to assist enrollees of health 30.19 plan companies with contested treatment, coverage, and service 30.20 issues to be in effect July 1,19981999. If the disputed issue 30.21 relates to whether a service is appropriate and necessary, the 30.22 commissioner shall issue an order only after consulting with 30.23 appropriate experts knowledgeable, trained, and practicing in 30.24 the area in dispute, reviewing pertinent literature, and 30.25 considering the availability of satisfactory alternatives. The 30.26 commissioner shall take steps including but not limited to 30.27 fining, suspending, or revoking the license of a health plan 30.28 company that is the subject of repeated orders by the 30.29 commissioner that suggests a pattern of inappropriate 30.30 underutilization. 30.31 Sec. 14. Minnesota Statutes 1997 Supplement, section 30.32 103I.208, subdivision 2, is amended to read: 30.33 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 30.34 property owner is: 30.35 (1) for a well that is not in use under a maintenance 30.36 permit, $100 annually; 31.1 (2) for construction of a monitoring well, $120, which 31.2 includes the state core function fee; 31.3 (3) for a monitoring well that is unsealed under a 31.4 maintenance permit, $100 annually; 31.5 (4) for monitoring wells used as a leak detection device at 31.6 a single motor fuel retail outletor, a single petroleum bulk 31.7 storage site excluding tank farms, or a single agricultural 31.8 chemical facility site, the construction permit fee is $120, 31.9 which includes the state core function fee, per site regardless 31.10 of the number of wells constructed on the site, and the annual 31.11 fee for a maintenance permit for unsealed monitoring wells is 31.12 $100 per site regardless of the number of monitoring wells 31.13 located on site; 31.14 (5) for a groundwater thermal exchange device, in addition 31.15 to the notification fee for wells, $120, which includes the 31.16 state core function fee; 31.17 (6) for a vertical heat exchanger, $120; 31.18 (7) for a dewatering well that is unsealed under a 31.19 maintenance permit, $100 annually for each well, except a 31.20 dewatering project comprising more than five wells shall be 31.21 issued a single permit for $500 annually for wells recorded on 31.22 the permit; and 31.23 (8) for excavating holes for the purpose of installing 31.24 elevator shafts, $120 for each hole. 31.25 Sec. 15. Minnesota Statutes 1997 Supplement, section 31.26 144.1494, subdivision 1, is amended to read: 31.27 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 31.28 education account is established in the health care access 31.29 fund. The commissioner shall use money from the account to 31.30 establish a loan forgiveness program for medical residents 31.31 agreeing to practice in designated rural areas, as defined by 31.32 the commissioner. Appropriations made to this account do not 31.33 cancel and are available until expended, except that at the end 31.34 of each biennium the commissioner shall cancel to the health 31.35 care access fund any remaining unobligated balance in this 31.36 account. 32.1 Sec. 16. Minnesota Statutes 1996, section 144.343, 32.2 subdivision 1, is amended to read: 32.3 Subdivision 1. [MINOR'S CONSENT VALID.] Any minor may give 32.4 effective consent for medical, mental and other health services 32.5 to determine the presence of or to treat pregnancy and 32.6 conditions associated therewith, venereal disease, alcohol and 32.7 other drug abuse, and the consent of no other person is required. 32.8 This section does not preclude parents from having access to the 32.9 medical records of their unemancipated minor children. 32.10 Sec. 17. [144.6905] [OCCUPATIONAL RESPIRATORY DISEASE 32.11 INFORMATION SYSTEM ADVISORY GROUP.] 32.12 Subdivision 1. [ADVISORY GROUP.] The commissioner of 32.13 health shall convene an occupational respiratory disease 32.14 advisory group and shall consult with the group on the 32.15 development, implementation, and ongoing operation of an 32.16 occupational respiratory disease information system. Membership 32.17 in the group shall include representatives of academia, 32.18 government, industry, labor, medicine, and consumers from areas 32.19 of the state targeted by the information system. From members 32.20 of the advisory group, the commissioner shall form a technical 32.21 and medical committee to create information system protocols and 32.22 a legal and policy committee to address data privacy issues. 32.23 The advisory group is governed by section 15.059, except that 32.24 members shall not receive per diem compensation. 32.25 Subd. 2. [DATA PROVISIONS.] No individually identifying 32.26 data shall be collected or entered into the occupational 32.27 respiratory disease information system without further action of 32.28 the legislature. 32.29 Sec. 18. Minnesota Statutes 1996, section 144.701, 32.30 subdivision 1, is amended to read: 32.31 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 32.32 health shall ensure that the total costs, total 32.33 revenues, overall utilization, and total services of each 32.34 hospital and each outpatient surgical center are reported to the 32.35 public in a form understandable to consumers. 32.36 Sec. 19. Minnesota Statutes 1996, section 144.701, 33.1 subdivision 2, is amended to read: 33.2 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 33.3 health shall compile relevant financial and accounting, 33.4 utilization, and services data concerning hospitals and 33.5 outpatient surgical centers in order to have statistical 33.6 information available for legislative policy making. 33.7 Sec. 20. Minnesota Statutes 1996, section 144.701, 33.8 subdivision 4, is amended to read: 33.9 Subd. 4. [FILING FEES.] Each report which is required to 33.10 be submitted to the commissioner of health under sections 33.11 144.695 to 144.703 and which is not submitted to a voluntary, 33.12 nonprofit reporting organization in accordance with section 33.13 144.702 shall be accompanied by a filing fee in an amount 33.14 prescribed by rule of the commissioner of health.Fees received33.15pursuant to this subdivision shall be deposited in the general33.16fund of the state treasury.Upon the withdrawal of approval of 33.17 a reporting organization, or the decision of the commissioner to 33.18 not renew a reporting organization, fees collected under section 33.19 144.702 shall be submitted to the commissionerand deposited in33.20the general fund. Fees received under this subdivision shall be 33.21 deposited in a revolving fund and are appropriated to the 33.22 commissioner of health for the purposes of sections 144.695 to 33.23 144.703. The commissioner shall report the termination or 33.24 nonrenewal of the voluntary reporting organization to the chair 33.25 of the health and human services subdivision of the 33.26 appropriations committee of the house of representatives, to the 33.27 chair of the health and human services division of the finance 33.28 committee of the senate, and the commissioner of finance. 33.29 Sec. 21. Minnesota Statutes 1996, section 144.702, 33.30 subdivision 1, is amended to read: 33.31 Subdivision 1. [REPORTING THROUGH A REPORTING 33.32 ORGANIZATION.] A hospital or outpatient surgical center may 33.33 agree to submit its financial, utilization, and services reports 33.34 to a voluntary, nonprofit reporting organization whose reporting 33.35 procedures have been approved by the commissioner of health in 33.36 accordance with this section. Each report submitted to the 34.1 voluntary, nonprofit reporting organization under this section 34.2 shall be accompanied by a filing fee. 34.3 Sec. 22. Minnesota Statutes 1996, section 144.702, 34.4 subdivision 2, is amended to read: 34.5 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 34.6 PROCEDURES.] The commissioner of health may approve voluntary 34.7 reporting procedures consistent with written operating 34.8 requirements for the voluntary, nonprofit reporting organization 34.9 which shall be established annually by the commissioner. These 34.10 written operating requirements shall specify reports, analyses, 34.11 and other deliverables to be produced by the voluntary, 34.12 nonprofit reporting organization, and the dates on which those 34.13 deliverables must be submitted to the commissioner. These 34.14 written operating requirements shall specify deliverable dates 34.15 sufficient to enable the commissioner of health to process and 34.16 report health care cost information system data to the 34.17 commissioner of human services by August 15 of each year. The 34.18 commissioner of health shall, by rule, prescribe standards for 34.19 submission of data by hospitals and outpatient surgical centers 34.20 to the voluntary, nonprofit reporting organization or to the 34.21 commissioner. These standards shall provide for: 34.22 (a) The filing of appropriate financial, utilization, and 34.23 services information with the reporting organization; 34.24 (b) Adequate analysis and verification of that financial, 34.25 utilization, and services information; and 34.26 (c) Timely publication of the costs, revenues, and rates of 34.27 individual hospitals and outpatient surgical centers prior to 34.28 the effective date of any proposed rate increase. The 34.29 commissioner of health shall annually review the procedures 34.30 approved pursuant to this subdivision. 34.31 Sec. 23. Minnesota Statutes 1996, section 144.702, 34.32 subdivision 8, is amended to read: 34.33 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 34.34 ORGANIZATION.] The commissioner may withdraw approval of any 34.35 voluntary, nonprofit reporting organization for failure on the 34.36 part of the voluntary, nonprofit reporting organization to 35.1 comply with the written operating requirements under subdivision 35.2 2. Upon the effective date of the withdrawal, all funds 35.3 collected by the voluntary, nonprofit reporting organization 35.4 undersection 144.701,subdivision41, but not expended shall 35.5 be deposited inthe general funda revolving fund and are 35.6 appropriated to the commissioner of health for the purposes of 35.7 sections 144.695 to 144.703. 35.8 The commissioner may choose not to renew approval of a 35.9 voluntary, nonprofit reporting organization if the organization 35.10 has failed to perform its obligations satisfactorily under the 35.11 written operating requirements under subdivision 2. 35.12 Sec. 24. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 35.13 REPORTING ORGANIZATIONS.] 35.14 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 35.15 an order to the voluntary, nonprofit reporting organization 35.16 requiring violations to be corrected and administratively 35.17 assessing monetary penalties for violations of sections 144.695 35.18 to 144.703 or rules, written operating requirements, orders, 35.19 stipulation agreements, settlements, or compliance agreements 35.20 adopted, enforced, or issued by the commissioner. 35.21 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 35.22 administrative penalty under this section must include: 35.23 (1) a concise statement of the facts alleged to constitute 35.24 a violation; 35.25 (2) a reference to the section of law, rule, written 35.26 operating requirement, order, stipulation agreement, settlement, 35.27 or compliance agreement that has been violated; 35.28 (3) a statement of the amount of the administrative penalty 35.29 to be imposed and the factors upon which the penalty is based; 35.30 (4) a statement of the corrective actions necessary to 35.31 correct the violation; and 35.32 (5) a statement of the right to request a hearing pursuant 35.33 to sections 14.57 to 14.62. 35.34 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 35.35 may issue an order assessing an administrative penalty and 35.36 requiring the violations cited in the order to be corrected 36.1 within 30 calendar days from the date the order is received. 36.2 Before the 31st day after the order was received, the voluntary, 36.3 nonprofit reporting organization that is subject to the order 36.4 shall provide the commissioner with information demonstrating 36.5 that the violation has been corrected or that a corrective plan, 36.6 acceptable to the commissioner, has been developed. The 36.7 commissioner shall determine whether the violation has been 36.8 corrected and notify the voluntary, nonprofit reporting 36.9 organization of the commissioner's determination. 36.10 Subd. 4. [PENALTY.] If the commissioner determines that 36.11 the violation has been corrected or an acceptable corrective 36.12 plan has been developed, the penalty may be forgiven, except 36.13 where there are repeated or serious violations, the commissioner 36.14 may issue an order with a penalty that will not be forgiven 36.15 after corrective action is taken. Unless there is a request for 36.16 review of the order under subdivision 6 before the penalty is 36.17 due, the penalty is due and payable: 36.18 (1) on the 31st calendar day after the order was received, 36.19 if the voluntary, nonprofit reporting organization fails to 36.20 provide information to the commissioner showing that the 36.21 violation has been corrected or that appropriate steps have been 36.22 taken toward correcting the violation; 36.23 (2) on the 20th day after the voluntary, nonprofit 36.24 reporting organization receives the commissioner's determination 36.25 that the information provided is not sufficient to show that 36.26 either the violation has been corrected or that appropriate 36.27 steps have been taken toward correcting the violation; or 36.28 (3) on the 31st day after the order was received where the 36.29 penalty is for repeated or serious violations and according to 36.30 the order issued, the penalty will not be forgiven after 36.31 corrective action is taken. 36.32 All penalties due under this section are payable to the 36.33 treasurer, state of Minnesota, and shall be deposited in the 36.34 general fund. 36.35 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 36.36 maximum amount for an administrative penalty is $5,000 for each 37.1 specific violation identified in an inspection, investigation, 37.2 or compliance review, up to an annual maximum total for all 37.3 violations of ten percent of the fees collected by the 37.4 voluntary, nonprofit reporting organization under section 37.5 144.702, subdivision 1. The annual total is based upon the 37.6 reporting year. 37.7 (b) In determining the amount of the administrative 37.8 penalty, the commissioner shall consider the following: 37.9 (1) the willfulness of the violation; 37.10 (2) the gravity of the violation; 37.11 (3) the history of past violations; 37.12 (4) the number of violations; 37.13 (5) the economic benefit gained by the person allowing or 37.14 committing the violation; and 37.15 (6) other factors as justice may require, if the 37.16 commissioner specifically identifies the additional factors in 37.17 the commissioner's order. 37.18 (c) In determining the amount of a penalty for a violation 37.19 committed after an initial violation, the commissioner shall 37.20 also consider: 37.21 (1) the similarity of the most recent previous violation 37.22 and the current violation; 37.23 (2) the time elapsed since the last violation; and 37.24 (3) the response of the voluntary, nonprofit reporting 37.25 organization to the most recent previous violation. 37.26 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 37.27 ORDER.] A request for hearing must be in writing, delivered to 37.28 the commissioner by certified mail within 20 calendar days after 37.29 the receipt of the order, and specifically state the reasons for 37.30 seeking review of the order. The commissioner must initiate a 37.31 hearing within 30 calendar days from the date of receipt of the 37.32 written request for hearing. The hearing shall be conducted 37.33 pursuant to the contested case procedures in sections 14.57 to 37.34 14.62. No earlier than ten calendar days after and within 30 37.35 calendar days of receipt of the presiding administrative law 37.36 judge's report, the commissioner shall, based on all relevant 38.1 facts, issue a final order modifying, vacating, or making the 38.2 original order permanent. If, within 20 calendar days of 38.3 receipt of the original order, the voluntary, nonprofit 38.4 reporting organization fails to request a hearing in writing, 38.5 the order becomes the final order of the commissioner. 38.6 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 38.7 PENALTY.] Once the commissioner issues a final order, any 38.8 penalty due under that order shall be paid within 30 calendar 38.9 days after the date of the final order, unless review of the 38.10 final order is requested. The final order of the commissioner 38.11 may be appealed in the manner prescribed in sections 14.63 to 38.12 14.69. If the final order is reviewed and upheld, the penalty 38.13 shall be paid 30 calendar days after the date of the decision of 38.14 the reviewing court. Failure to request an administrative 38.15 hearing pursuant to subdivision 6 shall constitute a waiver of 38.16 the right to further agency or judicial review of the final 38.17 order. 38.18 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If 38.19 upon reinspection, or in the determination of the commissioner, 38.20 it is found that any deficiency specified in the order has not 38.21 been corrected or an acceptable corrective plan has not been 38.22 developed, the voluntary, nonprofit reporting organization is in 38.23 noncompliance. The commissioner shall issue a notice of 38.24 noncompliance and may impose any additional remedy available 38.25 under sections 144.695 to 144.703. 38.26 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 38.27 on behalf of the commissioner to enforce penalties that are due 38.28 and payable under this section in any manner provided by law for 38.29 the collection of debts. 38.30 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 38.31 ORGANIZATION.] The commissioner may withdraw or not renew 38.32 approval of any voluntary, nonprofit reporting organization for 38.33 failure on the part of the voluntary, nonprofit reporting 38.34 organization to pay penalties owed under this section. 38.35 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 38.36 commissioner to issue an administrative penalty order is in 39.1 addition to other lawfully available remedies. 39.2 Subd. 12. [MEDIATION.] In addition to review under 39.3 subdivision 6, the commissioner is authorized to enter into 39.4 mediation concerning an order issued under this section if the 39.5 commissioner and the voluntary, nonprofit reporting organization 39.6 agree to mediation. 39.7 Sec. 25. Minnesota Statutes 1996, section 144.9501, 39.8 subdivision 1, is amended to read: 39.9 Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509 39.10 may be cited as the "childhoodLead Poisoning Prevention Act." 39.11 Sec. 26. Minnesota Statutes 1996, section 144.9501, is 39.12 amended by adding a subdivision to read: 39.13 Subd. 4a. [ASSESSING AGENCY.] "Assessing agency" means the 39.14 commissioner or a board of health with authority and 39.15 responsibility to conduct lead risk assessments in response to 39.16 reports of children or pregnant women with elevated blood lead 39.17 levels. 39.18 Sec. 27. Minnesota Statutes 1996, section 144.9501, is 39.19 amended by adding a subdivision to read: 39.20 Subd. 6b. [CLEARANCE INSPECTION.] "Clearance inspection" 39.21 means a visual identification of deteriorated paint and bare 39.22 soil and a resampling and analysis of interior dust lead 39.23 concentrations in a residence to ensure that the lead standards 39.24 established in rules adopted under section 144.9508 are not 39.25 exceeded. 39.26 Sec. 28. Minnesota Statutes 1996, section 144.9501, 39.27 subdivision 17, is amended to read: 39.28 Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard reduction" 39.29 means action undertakenin response to a lead orderto make a 39.30 residence, child care facility, school, or playground lead-safe 39.31 by complying with the lead standards and methods adopted under 39.32 section 144.9508, by: 39.33 (1) a property owner orlead contractor complyingpersons 39.34 hired by the property owner to comply with a lead order issued 39.35 under section 144.9504;or39.36 (2) a swab team service provided in response to a lead 40.1 order issued under section 144.9504; or 40.2 (3) a renter residing at a rental property or one or more 40.3 volunteers to comply with a lead order issued under section 40.4 144.9504. 40.5 Sec. 29. Minnesota Statutes 1996, section 144.9501, is 40.6 amended by adding a subdivision to read: 40.7 Subd. 17a. [LEAD HAZARD SCREEN.] "Lead hazard screen" 40.8 means visual identification of the existence and location of any 40.9 deteriorated paint, collection and analysis of dust samples, and 40.10 visual identification of the existence and location of bare soil. 40.11 Sec. 30. Minnesota Statutes 1996, section 144.9501, 40.12 subdivision 18, is amended to read: 40.13 Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a 40.14qualitative orquantitativeanalytical inspection of a residence40.15for deteriorated paint or bare soil and the collection of40.16samples of deteriorated paint, bare soil, dust, or drinking40.17water for analysis to determine if the lead concentrations in40.18the samples exceed standards adopted under section 144.9508.40.19Lead inspection includes the clearance inspection after the40.20completion of a lead ordermeasurement of the lead content of 40.21 paint and a visual identification of the existence and location 40.22 of bare soil. 40.23 Sec. 31. Minnesota Statutes 1996, section 144.9501, 40.24 subdivision 20, is amended to read: 40.25 Subd. 20. [LEAD ORDER.] "Lead order" means a legal 40.26 instrument to compel a property owner to engage in lead hazard 40.27 reduction according to the specifications given by the 40.28inspectingassessing agency. 40.29 Sec. 32. Minnesota Statutes 1996, section 144.9501, is 40.30 amended by adding a subdivision to read: 40.31 Subd. 20a. [LEAD PROJECT DESIGNER.] "Lead project designer" 40.32 means an individual who is responsible for planning the 40.33 site-specific performance of lead abatement or lead hazard 40.34 reduction and who has been licensed by the commissioner under 40.35 section 144.9505. 40.36 Sec. 33. Minnesota Statutes 1996, section 144.9501, is 41.1 amended by adding a subdivision to read: 41.2 Subd. 20b. [LEAD RISK ASSESSMENT.] "Lead risk assessment" 41.3 means a quantitative measurement of the lead content of paint, 41.4 interior dust, and bare soil to determine compliance with the 41.5 standards established under section 144.9508. 41.6 Sec. 34. Minnesota Statutes 1996, section 144.9501, is 41.7 amended by adding a subdivision to read: 41.8 Subd. 20c. [LEAD RISK ASSESSOR.] "Lead risk assessor" 41.9 means an individual who performs lead risk assessments or lead 41.10 inspections and who has been licensed by the commissioner under 41.11 section 144.9506. 41.12 Sec. 35. Minnesota Statutes 1996, section 144.9501, is 41.13 amended by adding a subdivision to read: 41.14 Subd. 22a. [LEAD SUPERVISOR.] "Lead supervisor" means an 41.15 individual who is responsible for the on-site performance of 41.16 lead abatement or lead hazard reduction and who has been 41.17 licensed by the commissioner under section 144.9505. 41.18 Sec. 36. Minnesota Statutes 1996, section 144.9501, 41.19 subdivision 23, is amended to read: 41.20 Subd. 23. [LEAD WORKER.] "Lead worker" meansany person41.21who is certifiedan individual who performs lead abatement or 41.22 lead hazard reduction and who has been licensed by the 41.23 commissioner under section 144.9505. 41.24 Sec. 37. Minnesota Statutes 1996, section 144.9501, is 41.25 amended by adding a subdivision to read: 41.26 Subd. 25a. [PLAY AREA.] "Play area" means any established 41.27 area where children play, or on residential property, any 41.28 established area where children play or bare soil is accessible 41.29 to children. 41.30 Sec. 38. Minnesota Statutes 1996, section 144.9501, is 41.31 amended by adding a subdivision to read: 41.32 Subd. 28a. [STANDARD.] "Standard" means a quantitative 41.33 assessment of lead in any environmental media or consumer 41.34 product or a work practice or method that reduces the likelihood 41.35 of lead exposure. 41.36 Sec. 39. Minnesota Statutes 1996, section 144.9501, 42.1 subdivision 30, is amended to read: 42.2 Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" meansa42.3person who is certifiedan individual who performs swab team 42.4 services and who has been licensed by the commissioner as a lead 42.5 worker under section 144.9505. 42.6 Sec. 40. Minnesota Statutes 1996, section 144.9501, 42.7 subdivision 32, is amended to read: 42.8 Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary 42.9 lead hazard reduction" meansaction undertaken by a property42.10owner with the intention to engage in lead hazard reduction or42.11abatementlead hazard reduction activities defined in 42.12 subdivision 17, but not undertaken in response to the issuance 42.13 of a lead order. 42.14 Sec. 41. Minnesota Statutes 1996, section 144.9502, 42.15 subdivision 3, is amended to read: 42.16 Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a) 42.17 Every hospital, medical clinic, medical laboratory,orother 42.18 facility, or individual performing blood lead analysis shall 42.19 report the results after the analysis of each specimen analyzed, 42.20 for both capillary and venous specimens, and epidemiologic 42.21 information required in this section to the commissioner of 42.22 health, within the time frames set forth in clauses (1) and (2): 42.23 (1) within two working days by telephone, fax, or 42.24 electronic transmission, with written or electronic confirmation 42.25 within one month, for a venous blood lead level equal to or 42.26 greater than 15 micrograms of lead per deciliter of whole blood; 42.27 or 42.28 (2) within one month in writing or by electronic 42.29 transmission, foraany capillary result or for a venous blood 42.30 lead level less than 15 micrograms of lead per deciliter of 42.31 whole blood. 42.32 (b) If a blood lead analysis is performed outside of 42.33 Minnesota and the facility performing the analysis does not 42.34 report the blood lead analysis results and epidemiological 42.35 information required in this section to the commissioner, the 42.36 provider who collected the blood specimen must satisfy the 43.1 reporting requirements of this section. For purposes of this 43.2 section, "provider" has the meaning given in section 62D.02, 43.3 subdivision 9. 43.4 (c) The commissioner shall coordinate with hospitals, 43.5 medical clinics, medical laboratories, and other facilities 43.6 performing blood lead analysis to develop a universal reporting 43.7 form and mechanism. 43.8The reporting requirements of this subdivision shall expire43.9on December 31, 1997. Beginning January 1, 1998, every43.10hospital, medical clinic, medical laboratory, or other facility43.11performing blood lead analysis shall report the results within43.12two working days by telephone, fax, or electronic transmission,43.13with written or electronic confirmation within one month, for43.14capillary or venous blood lead level equal to the level for43.15which reporting is recommended by the Center for Disease Control.43.16 Sec. 42. Minnesota Statutes 1996, section 144.9502, 43.17 subdivision 4, is amended to read: 43.18 Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC 43.19 INFORMATION.] The blood lead analysis reports required in this 43.20 section must specify: 43.21 (1) whether the specimen was collected as a capillary or 43.22 venous sample; 43.23 (2) the date the sample was collected; 43.24 (3) the results of the blood lead analysis; 43.25 (4) the date the sample was analyzed; 43.26 (5) the method of analysis used; 43.27 (6) the full name, address, and phone number of the 43.28 laboratory performing the analysis; 43.29 (7) the full name, address, and phone number of the 43.30 physician or facility requesting the analysis; 43.31 (8) the full name, address, and phone number of the person 43.32 with theelevatedblood lead level, and the person's birthdate, 43.33 gender, and race. 43.34 Sec. 43. Minnesota Statutes 1996, section 144.9502, 43.35 subdivision 9, is amended to read: 43.36 Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any law 44.1 to the contrary, including section 13.05, subdivision 9, data 44.2 collected by the commissioner of health about persons with 44.3elevatedblood lead levels, including analytic results from 44.4 samples of paint, soil, dust, and drinking water taken from the 44.5 individual's home and immediate property, shall be private and 44.6 may only be used by the commissioner of health, the commissioner 44.7 of labor and industry, authorized agents of Indian tribes, and 44.8 authorized employees of local boards of health for the purposes 44.9 set forth in this section. 44.10 Sec. 44. Minnesota Statutes 1996, section 144.9503, 44.11 subdivision 4, is amended to read: 44.12 Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must 44.13 include the use of swab team services in census tracts 44.14 identified at high risk for toxic lead exposure as identified by 44.15 the commissioner under this section. The swab team services may 44.16 be provided based onvisual inspectionslead hazard screens 44.17 whenever possible and must at least include lead 44.18 hazardmanagementreduction for deteriorated interior lead-based 44.19 paint, bare soil, and dust. 44.20 Sec. 45. Minnesota Statutes 1996, section 144.9503, 44.21 subdivision 6, is amended to read: 44.22 Subd. 6. [VOLUNTARY LEAD ABATEMENT OR LEAD HAZARD 44.23 REDUCTION.] The commissioner shall monitor the lead abatement or 44.24 lead hazard reduction methods adopted under section 144.9508 in 44.25 cases of voluntary lead abatement or lead hazard reduction. All 44.26contractorspersons hired to do voluntary lead abatement or lead 44.27 hazard reduction must be licensedlead contractorsby the 44.28 commissioner under section 144.9505 or 144.9506. Renters and 44.29 volunteers performing lead abatement or lead hazard reduction 44.30 must be trained and licensed as lead supervisors or lead 44.31 workers. If a property owner does notuse a lead contractor44.32 hire a person for voluntary lead abatement or lead hazard 44.33 reduction, the property owner shall provide the commissioner 44.34 with a work plan for lead abatement or lead hazard reduction at 44.35 least ten working days before beginning the lead abatement or 44.36 lead hazard reduction. The work plan must include the details 45.1 required in section 144.9505, and notice as to when 45.2 lead abatement or lead hazard reduction activities will begin. 45.3 Within the limits of appropriations, the commissioner shall 45.4 review work plans and shall approve or disapprove them as to 45.5 compliance with the requirements in section 144.9505. No 45.6 penalty shall be assessed against a property owner for 45.7 discontinuing voluntary lead hazard reduction before completion 45.8 of the work plan, provided that the property owner discontinues 45.9 theplanlead hazard reduction in a manner that leaves the 45.10 property in a condition no more hazardous than its condition 45.11 before the work plan implementation. 45.12 Sec. 46. Minnesota Statutes 1996, section 144.9503, 45.13 subdivision 7, is amended to read: 45.14 Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July 45.15 1, 1995, and amended and updated as necessary, the commissioner 45.16 shall develop in cooperation with the commissioner of 45.17 administration provisions and procedures to define 45.18 lead-safe informational directives for residential remodeling, 45.19 renovation, installation, and rehabilitation activities that are 45.20 not lead hazard reduction, but may disrupt lead-based paint 45.21 surfaces. 45.22 (b) The provisions and procedures shall define lead-safe 45.23 directives for nonlead hazard reduction activities including 45.24 preparation, cleanup, and disposal procedures. The directives 45.25 shall be based on the different levels and types of work 45.26 involved and the potential for lead hazards. The directives 45.27 shall address activities including painting; remodeling; 45.28 weatherization; installation of cable, wire, plumbing, and gas; 45.29 and replacement of doors and windows. The commissioners of 45.30 health and administration shall consult with representatives of 45.31 builders, weatherization providers, nonprofit rehabilitation 45.32 organizations, each of the affected trades, and housing and 45.33 redevelopment authorities in developing the directives and 45.34 procedures. This group shall also make recommendations for 45.35 consumer and contractor education and training. The 45.36 commissioner of health shall report to the legislature by 46.1 February 15, 1996, regarding development of the provisions 46.2 required under thissubdivisionparagraph. 46.3 (c) By January 1, 1999, the commissioner, in cooperation 46.4 with interested and informed persons and using the meeting 46.5 structure and format developed in paragraph (b), shall develop 46.6 lead-safe informational directives on the following topics: 46.7 (1) maintaining floors, walls, and ceilings; 46.8 (2) maintaining and repairing porches; 46.9 (3) conducting a risk evaluation for lead; and 46.10 (4) prohibited practices when working with lead. 46.11 The commissioner shall report to the legislature by January 1, 46.12 1999, regarding development of the provisions required under 46.13 this paragraph. 46.14 Sec. 47. Minnesota Statutes 1996, section 144.9504, 46.15 subdivision 1, is amended to read: 46.16 Subdivision 1. [JURISDICTION.] (a) A board of health 46.17 serving cities of the first class must conduct leadinspections46.18 risk assessments for purposes of secondary prevention, according 46.19 to the provisions of this section. A board of health not 46.20 serving cities of the first class must conduct leadinspections46.21 risk assessments for the purposes of secondary prevention, 46.22 unless theycertifycertified in writing to the commissioner by 46.23 January 1, 1996, that theydesiredesired to relinquish these 46.24 duties back to the commissioner. At the discretion of the 46.25 commissioner, a board of health may relinquish the authority and 46.26 duty to perform lead risk assessments for secondary prevention 46.27 by so certifying in writing to the commissioner by December 31, 46.28 1999. At the discretion of the commissioner, a board of health 46.29 may, upon written request to the commissioner, resume these 46.30 duties. 46.31 (b)InspectionsLead risk assessments must be conducted by 46.32 a board of health serving a city of the first class. The 46.33 commissioner must conduct leadinspectionsrisk assessments in 46.34 any area not including cities of the first class where a board 46.35 of health has relinquished to the commissioner the 46.36 responsibility for leadinspectionsrisk assessments. The 47.1 commissioner shall coordinate with the board of health to ensure 47.2 that the requirements of this section are met. 47.3 (c) The commissioner may assist boards of health by 47.4 providing technical expertise, equipment, and personnel to 47.5 boards of health. The commissioner may provide laboratory or 47.6 field lead-testing equipment to a board of health or may 47.7 reimburse a board of health for direct costs associated with 47.8 leadinspectionsrisk assessments. 47.9 (d) The commissioner shall enforce the rules under section 47.10 144.9508 in cases of voluntary lead hazard reduction. 47.11 Sec. 48. Minnesota Statutes 1997 Supplement, section 47.12 144.9504, subdivision 2, is amended to read: 47.13 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT.] (a) 47.14 Aninspectingassessing agency shall conduct a leadinspection47.15 risk assessment of a residence according to the venous blood 47.16 lead level and time frame set forth in clauses (1) to (5) for 47.17 purposes of secondary prevention: 47.18 (1) within 48 hours of a child or pregnant female in the 47.19 residence being identified to the agency as having a venous 47.20 blood lead level equal to or greater than 70 micrograms of lead 47.21 per deciliter of whole blood; 47.22 (2) within five working days of a child or pregnant female 47.23 in the residence being identified to the agency as having a 47.24 venous blood lead level equal to or greater than 45 micrograms 47.25 of lead per deciliter of whole blood; 47.26 (3) within ten working days of a child in the residence 47.27 being identified to the agency as having a venous blood lead 47.28 level equal to or greater than 20 micrograms of lead per 47.29 deciliter of whole blood; 47.30 (4) within ten working days of a child in the residence 47.31 being identified to the agency as having a venous blood lead 47.32 level that persists in the range of 15 to 19 micrograms of lead 47.33 per deciliter of whole blood for 90 days after initial 47.34 identification; or 47.35 (5) within ten working days of a pregnant female in the 47.36 residence being identified to the agency as having a venous 48.1 blood lead level equal to or greater than ten micrograms of lead 48.2 per deciliter of whole blood. 48.3 (b) Within the limits of available state and federal 48.4 appropriations, aninspectingassessing agency may also conduct 48.5 a leadinspectionrisk assessment for children with any elevated 48.6 blood lead level. 48.7 (c) In a building with two or more dwelling units, an 48.8inspectingassessing agency shall inspect the individual unit in 48.9 which the conditions of this section are met and shall also 48.10 inspect all common areas. If a child visits one or more other 48.11 sites such as another residence, or a residential or commercial 48.12 child care facility, playground, or school, theinspecting48.13 assessing agency shall also inspect the other sites. 48.14 Theinspectingassessing agency shall have one additional day 48.15 added to the time frame set forth in this subdivision to 48.16 complete the leadinspectionrisk assessment for each additional 48.17 site. 48.18 (d) Within the limits of appropriations, theinspecting48.19 assessing agency shall identify the known addresses for the 48.20 previous 12 months of the child or pregnant female with venous 48.21 blood lead levels of at least 20 micrograms per deciliter for 48.22 the child or at least ten micrograms per deciliter for the 48.23 pregnant female; notify the property owners, landlords, and 48.24 tenants at those addresses that an elevated blood lead level was 48.25 found in a person who resided at the property; and give them a 48.26 copy of the leadinspectionrisk assessment guide. The 48.27inspectingassessing agency shall provide the notice required by 48.28 this subdivision without identifying the child or pregnant 48.29 female with the elevated blood lead level. Theinspecting48.30 assessing agency is not required to obtain the consent of the 48.31 child's parent or guardian or the consent of the pregnant female 48.32 for purposes of this subdivision. This information shall be 48.33 classified as private data on individuals as defined under 48.34 section 13.02, subdivision 12. 48.35 (e) Theinspectingassessing agency shall conduct the lead 48.36inspectionrisk assessment according to rules adopted by the 49.1 commissioner under section 144.9508. Aninspectingassessing 49.2 agency shall have leadinspectionsrisk assessments performed by 49.3 leadinspectorsrisk assessors licensed by the commissioner 49.4 according to rules adopted under section 144.9508. If a 49.5 property owner refuses to allowan inspectiona lead risk 49.6 assessment, theinspectingassessing agency shall begin legal 49.7 proceedings to gain entry to the property and the time frame for 49.8 conducting a leadinspectionrisk assessment set forth in this 49.9 subdivision no longer applies.An inspectorA lead risk 49.10 assessor orinspectingassessing agency may observe the 49.11 performance of lead hazard reduction in progress and shall 49.12 enforce the provisions of this section under section 144.9509. 49.13 Deteriorated painted surfaces, bare soil, and dust, and drinking49.14watermust be tested with appropriate analytical equipment to 49.15 determine the lead content, except that deteriorated painted 49.16 surfaces or bare soil need not be tested if the property owner 49.17 agrees to engage in lead hazard reduction on those 49.18 surfaces. The lead content of drinking water must be measured 49.19 if a probable source of lead exposure is not identified by 49.20 measurement of lead in paint, bare soil, or dust. Within a 49.21 standard metropolitan statistical area, an assessing agency may 49.22 order lead hazard reduction of bare soil without measuring the 49.23 lead content of the bare soil if the property is in a census 49.24 tract in which soil sampling has been performed according to 49.25 rules established by the commissioner and at least 25 percent of 49.26 the soil samples contain lead concentrations above the standard 49.27 in section 144.9508. 49.28 (f) A leadinspectorrisk assessor shall notify the 49.29 commissioner and the board of health of all violations of lead 49.30 standards under section 144.9508, that are identified in a 49.31 leadinspectionrisk assessment conducted under this section. 49.32 (g) Eachinspectingassessing agency shall establish an 49.33 administrative appeal procedure which allows a property owner to 49.34 contest the nature and conditions of any lead order issued by 49.35 theinspectingassessing agency.InspectingAssessing agencies 49.36 must consider appeals that propose lower cost methods that make 50.1 the residence lead safe. 50.2 (h) Sections 144.9501 to 144.9509 neither authorize nor 50.3 prohibit aninspectingassessing agency from charging a property 50.4 owner for the cost of a leadinspectionrisk assessment. 50.5 Sec. 49. Minnesota Statutes 1996, section 144.9504, 50.6 subdivision 3, is amended to read: 50.7 Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a 50.8 leadinspectionrisk assessment or following a lead order, the 50.9inspectingassessing agency shall ensure that a family will 50.10 receive a visit at their residence by a swab team worker or 50.11 public health professional, such as a nurse, sanitarian, public 50.12 health educator, or other public health professional. The swab 50.13 team worker or public health professional shall inform the 50.14 property owner, landlord, and the tenant of the health-related 50.15 aspects of lead exposure; nutrition; safety measures to minimize 50.16 exposure; methods to be followed before, during, and after the 50.17 lead hazard reduction process; and community, legal, and housing 50.18 resources. If a family moves to a temporary residence during 50.19 the lead hazard reduction process, lead education services 50.20 should be provided at the temporary residence whenever feasible. 50.21 Sec. 50. Minnesota Statutes 1996, section 144.9504, 50.22 subdivision 4, is amended to read: 50.23 Subd. 4. [LEADINSPECTIONRISK ASSESSMENT GUIDES.] (a) The 50.24 commissioner of health shall develop or purchase leadinspection50.25 risk assessment guides that enable parents and other caregivers 50.26 to assess the possible lead sources present and that suggest 50.27 lead hazard reduction actions. The guide must provide 50.28 information on lead hazard reduction and disposal methods, 50.29 sources of equipment, and telephone numbers for additional 50.30 information to enable the persons to either selecta lead50.31contractorpersons licensed by the commissioner under section 50.32 144.9505 or 144.9506 to perform lead hazard reduction or perform 50.33 the lead hazard reduction themselves. The guides must explain: 50.34 (1) the requirements of this section and rules adopted 50.35 under section 144.9508; 50.36 (2) information on the administrative appeal procedures 51.1 required under this section; 51.2 (3) summary information on lead-safe directives; 51.3 (4) be understandable at an eighth grade reading level; and 51.4 (5) be translated for use by non-English-speaking persons. 51.5 (b) Aninspectingassessing agency shall provide the lead 51.6inspectionrisk assessment guides at no cost to: 51.7 (1) parents and other caregivers of children who are 51.8 identified as having blood lead levels of at least ten 51.9 micrograms of lead per deciliter of whole blood; 51.10 (2) all property owners who are issued housing code or lead 51.11 orders requiring lead hazard reduction of lead sources and all 51.12 occupants of those properties; and 51.13 (3) occupants of residences adjacent to the inspected 51.14 property. 51.15 (c) Aninspectingassessing agency shall provide the lead 51.16inspectionrisk assessment guides on request to owners or 51.17 occupants of residential property, builders, contractors, 51.18 inspectors, and the public within the jurisdiction of 51.19 theinspectingassessing agency. 51.20 Sec. 51. Minnesota Statutes 1996, section 144.9504, 51.21 subdivision 5, is amended to read: 51.22 Subd. 5. [LEAD ORDERS.] Aninspectingassessing agency, 51.23 after conducting a leadinspectionrisk assessment, shall order 51.24 a property owner to perform lead hazard reduction on all lead 51.25 sources that exceed a standard adopted according to section 51.26 144.9508. If leadinspectionsrisk assessments and lead orders 51.27 are conducted at times when weather or soil conditions do not 51.28 permit the leadinspectionrisk assessment or lead hazard 51.29 reduction, external surfaces and soil lead shall be inspected, 51.30 and lead orders complied with, if necessary, at the first 51.31 opportunity that weather and soil conditions allow. If the 51.32 paint standard under section 144.9508 is violated, but the paint 51.33 is intact, theinspectingassessing agency shall not order the 51.34 paint to be removed unless the intact paint is a known source of 51.35 actual lead exposure to a specific person. Before the 51.36inspectingassessing agency may order the intact paint to be 52.1 removed, a reasonable effort must be made to protect the child 52.2 and preserve the intact paint by the use of guards or other 52.3 protective devices and methods. Whenever windows and doors or 52.4 other components covered with deteriorated lead-based paint have 52.5 sound substrate or are not rotting, those components should be 52.6 repaired, sent out for stripping or be planed down to remove 52.7 deteriorated lead-based paint or covered with protective guards 52.8 instead of being replaced, provided that such an activity is the 52.9 least cost method. However, a property owner who has been 52.10 ordered to perform lead hazard reduction may choose any method 52.11 to address deteriorated lead-based paint on windows, doors, or 52.12 other components, provided that the method is approved in rules 52.13 adopted under section 144.9508 and that it is appropriate to the 52.14 specific property. Lead orders must require that any source of 52.15 damage, such as leaking roofs, plumbing, and windows, be 52.16 repaired or replaced, as needed, to prevent damage to 52.17 lead-containing interior surfaces. Theinspectingassessing 52.18 agency is not required to pay for lead hazard reduction. Lead 52.19 orders must be issued within 30 days of receiving the blood lead 52.20 level analysis. Theinspectingassessing agency shall enforce 52.21 the lead orders issued to a property owner under this section. 52.22 A copy of the lead order must be forwarded to the commissioner. 52.23 Sec. 52. Minnesota Statutes 1996, section 144.9504, 52.24 subdivision 6, is amended to read: 52.25 Subd. 6. [SWAB TEAM SERVICES.] After a leadinspection52.26 risk assessment or after issuing lead orders, theinspecting52.27 assessing agency, within the limits of appropriations and 52.28 availability, shall offer the property owner the services of a 52.29 swab team free of charge and, if accepted, shall send a swab 52.30 team within ten working days to the residence to perform swab 52.31 team services as defined in section 144.9501. If theinspecting52.32 assessing agency provides swab team services after a 52.33 leadinspectionrisk assessment, but before the issuance of a 52.34 lead order, swab team services do not need to be repeated after 52.35 the issuance of the lead order if the swab team services 52.36 fulfilled the lead order. Swab team services are not considered 53.1 completed until the clearance inspection required under this 53.2 section shows that the property is lead safe. 53.3 Sec. 53. Minnesota Statutes 1996, section 144.9504, 53.4 subdivision 7, is amended to read: 53.5 Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits 53.6 of appropriations, theinspectingassessing agency shall ensure 53.7 that residents are relocated from rooms or dwellings during a 53.8 lead hazard reduction process that generates leaded dust, such 53.9 as removal or disruption of lead-based paint or plaster that 53.10 contains lead. Residents shall not remain in rooms or dwellings 53.11 where the lead hazard reduction process is occurring. An 53.12inspectingassessing agency is not required to pay for 53.13 relocation unless state or federal funding is available for this 53.14 purpose. Theinspectingassessing agency shall make an effort 53.15 to assist the resident in locating resources that will provide 53.16 assistance with relocation costs. Residents shall be allowed to 53.17 return to the residence or dwelling after completion of the lead 53.18 hazard reduction process. Aninspectingassessing agency shall 53.19 use grant funds under section 144.9507 if available, in 53.20 cooperation with local housing agencies, to pay for moving costs 53.21 and rent for a temporary residence for any low-income resident 53.22 temporarily relocated during lead hazard reduction. For 53.23 purposes of this section, "low-income resident" means any 53.24 resident whose gross household income is at or below 185 percent 53.25 of federal poverty level. 53.26 (b) A resident of rental property who is notified by an 53.27inspectingassessing agency to vacate the premises during lead 53.28 hazard reduction, notwithstanding any rental agreement or lease 53.29 provisions: 53.30 (1) shall not be required to pay rent due the landlord for 53.31 the period of time the tenant vacates the premises due to lead 53.32 hazard reduction; 53.33 (2) may elect to immediately terminate the tenancy 53.34 effective on the date the tenant vacates the premises due to 53.35 lead hazard reduction; and 53.36 (3) shall not, if the tenancy is terminated, be liable for 54.1 any further rent or other charges due under the terms of the 54.2 tenancy. 54.3 (c) A landlord of rental property whose tenants vacate the 54.4 premises during lead hazard reduction shall: 54.5 (1) allow a tenant to return to the dwelling unit after 54.6 lead hazard reduction and clearance inspection, required under 54.7 this section, is completed, unless the tenant has elected to 54.8 terminate the tenancy as provided for in paragraph (b); and 54.9 (2) return any security deposit due under section 504.20 54.10 within five days of the date the tenant vacates the unit, to any 54.11 tenant who terminates tenancy as provided for in paragraph (b). 54.12 Sec. 54. Minnesota Statutes 1996, section 144.9504, 54.13 subdivision 8, is amended to read: 54.14 Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners 54.15 shall comply with lead orders issued under this section within 54.16 60 days or be subject to enforcement actions as provided under 54.17 section 144.9509. For orders or portions of orders concerning 54.18 external lead hazards, property owners shall comply within 60 54.19 days, or as soon thereafter as weather permits. If the property 54.20 owner does notuse a lead contractorhire a person licensed by 54.21 the commissioner under section 144.9505 for compliance with the 54.22 lead orders, the property owner shall submit a work plan to 54.23 theinspectingassessing agency within 30 days after receiving 54.24 the orders. The work plan must include the details required in 54.25 section 144.9505 as to how the property owner intends to comply 54.26 with the lead orders and notice as to when lead hazard reduction 54.27 activities will begin. Within the limits of appropriations, the 54.28 commissioner shall review plans and shall approve or disapprove 54.29 them as to compliance with the requirements in section 144.9505, 54.30 subdivision 5. Renters and volunteers performing lead abatement 54.31 or lead hazard reduction must be trained and licensed as lead 54.32 supervisors or lead workers under section 144.9505. 54.33 Sec. 55. Minnesota Statutes 1996, section 144.9504, 54.34 subdivision 9, is amended to read: 54.35 Subd. 9. [CLEARANCE INSPECTION.] After completion of swab 54.36 team services and compliance with the lead orders by the 55.1 property owner, including any repairs ordered by a local housing 55.2 or building inspector, theinspectingassessing agency shall 55.3 conduct a clearance inspection byvisually inspecting the55.4residence forvisual identification of deteriorated paint and 55.5 bare soil and retest the dust lead concentration in the 55.6 residence to assure that violations of the lead standards under 55.7 section 144.9508 no longer exist. Theinspectingassessing 55.8 agency is not required to test a dwelling unit after lead hazard 55.9 reduction that was not ordered by theinspectingassessing 55.10 agency. 55.11 Sec. 56. Minnesota Statutes 1996, section 144.9504, 55.12 subdivision 10, is amended to read: 55.13 Subd. 10. [CASE CLOSURE.] A leadinspectionrisk 55.14 assessment is completed and the responsibility of theinspecting55.15 assessing agency ends when all of the following conditions are 55.16 met: 55.17 (1) lead orders are written on all known sources of 55.18 violations of lead standards under section 144.9508; 55.19 (2) compliance with all lead orders has been completed; and 55.20 (3) clearance inspections demonstrate that no deteriorated 55.21 lead paint, bare soil, or lead dust levels exist that exceed the 55.22 standards adopted under section 144.9508. 55.23 Sec. 57. Minnesota Statutes 1996, section 144.9505, 55.24 subdivision 1, is amended to read: 55.25 Subdivision 1. [LICENSING AND CERTIFICATION.] (a)Lead55.26contractorsA person shall, before performing abatement or lead 55.27 hazard reduction or providing planning services for lead 55.28 abatement or lead hazard reduction, obtain a license from the 55.29 commissioner as a lead supervisor, lead worker, or lead project 55.30 designer.Workers for lead contractors shall obtain55.31certification from the commissioner.The commissioner shall 55.32 specify training and testing requirements for licensure and 55.33 certification as required in section 144.9508 and shall charge a 55.34 fee for the cost of issuing a license or certificate and for 55.35 training provided by the commissioner.Fees collected under55.36this section shall be set in amounts to be determined by the56.1commissioner to cover but not exceed the costs of adopting rules56.2under section 144.9508, the costs of licensure, certification,56.3and training, and the costs of enforcing licenses and56.4certificates under this section.License fees shall be 56.5 nonrefundable and must be submitted with each application in the 56.6 amount of $50 for each lead supervisor, lead worker, or lead 56.7 inspector and $100 for each lead project designer, lead risk 56.8 assessor, or certified firm. All fees received shall be paid 56.9 into the state treasury and credited to the lead abatement 56.10 licensing and certification account and are appropriated to the 56.11 commissioner to cover costs incurred under this section and 56.12 section 144.9508. 56.13 (b)ContractorsPersons shall not advertise or otherwise 56.14 present themselves as leadcontractorssupervisors, lead 56.15 workers, or lead project designers unless they havelead56.16contractorlicenses issued by thedepartment of health56.17 commissioner under section 144.9505. 56.18 Sec. 58. Minnesota Statutes 1996, section 144.9505, 56.19 subdivision 4, is amended to read: 56.20 Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD 56.21 REDUCTION WORK.] (a) At least five working days before starting 56.22 work at each lead abatement or lead hazard reduction worksite, 56.23 the person performing the lead abatement or lead hazard 56.24 reduction work shall give written notice and an approved work 56.25 plan as required in this section to the commissioner and the 56.26 appropriate board of health. Within the limits of 56.27 appropriations, the commissioner shall review plans and shall 56.28 approve or disapprove them as to compliance with the 56.29 requirements in subdivision 5. 56.30 (b) This provision does not apply to swab team workers 56.31 performing work under an order of aninspectingassessing agency. 56.32 Sec. 59. Minnesota Statutes 1996, section 144.9505, 56.33 subdivision 5, is amended to read: 56.34 Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.] 56.35 (a) Alead contractorperson who performs lead abatement or lead 56.36 hazard reduction shall present a lead abatement or lead hazard 57.1 reduction work plan to the property owner with each bid or 57.2 estimate for lead abatement or lead hazard reduction work. 57.3 The work plan does not replace or supersede more stringent 57.4 contractual agreements. A written lead abatement or lead hazard 57.5 reduction work plan must be prepared which describes the 57.6 equipment and procedures to be used throughout the lead 57.7 abatement or lead hazard reduction work project. At a minimum, 57.8 the work plan must describe: 57.9 (1) the building area and building components to be worked 57.10 on; 57.11 (2) the amount of lead-containing material to be removed, 57.12 encapsulated, or enclosed; 57.13 (3) the schedule to be followed for each work stage; 57.14 (4) the workers' personal protection equipment and 57.15 clothing; 57.16 (5) the dust suppression and debris containment methods; 57.17 (6) the lead abatement or lead hazard reduction methods to 57.18 be used on each building component; 57.19 (7) cleaning methods; 57.20 (8) temporary, on-site waste storage, if any; and 57.21 (9) the methods for transporting waste material and its 57.22 destination. 57.23 (b)A lead contractorThe work plan shall itemize the costs 57.24 for each item listed in paragraph (a) and for any other expenses 57.25 associated with the lead abatement or lead hazard reduction work 57.26 and shallpresent these costsbe presented to the property owner 57.27 with any bid or estimate for lead abatement or lead hazard 57.28 reduction work. 57.29 (c)A lead contractorThe person performing the lead 57.30 abatement or lead hazard reduction shall keep a copy of the work 57.31 plan readily available at the worksite for the duration of the 57.32 project and present it to theinspectingassessing agency on 57.33 demand. 57.34 (d)A lead contractorThe person performing the lead 57.35 abatement or lead hazard reduction shall keep a copy of the work 57.36 plan on record for one year after completion of the project and 58.1 shall present it to theinspectingassessing agency on demand. 58.2 (e) This provision does not apply to swab team workers 58.3 performing work under an order of aninspectingassessing agency 58.4 or providing services at no cost to a property owner with 58.5 funding under a state or federal grant. 58.6 Sec. 60. Minnesota Statutes 1997 Supplement, section 58.7 144.9506, subdivision 1, is amended to read: 58.8 Subdivision 1. [LICENSE REQUIRED.] (a) Alead58.9inspectorperson shall obtain a license as a lead inspector or a 58.10 lead risk assessor before performing lead inspections, lead 58.11 hazard screens, or lead risk assessments and shall renew 58.12 itannuallyas required in rules adopted under section 144.9508. 58.13 The commissioner shall charge a fee and requireannualrefresher 58.14 training, as specified in this section. A lead inspector or 58.15 lead risk assessor shall have the lead inspector's license or 58.16 lead risk assessor's license readily available at all times 58.17 atana lead inspection site or lead risk assessment site and 58.18 make it available, on request, forinspectionexamination by the 58.19inspectingassessing agency with jurisdiction over the site. A 58.20 license shall not be transferred. License fees shall be 58.21 nonrefundable and must be submitted with each application in the 58.22 amount of $50 for each lead inspector and $100 for each lead 58.23 risk assessor. 58.24 (b) Individuals shall not advertise or otherwise present 58.25 themselves as lead inspectors or lead risk assessors unless 58.26 licensed by the commissioner. 58.27 (c) An individual may use sodium rhodizonate to test paint 58.28 for the presence of lead without obtaining a lead inspector or 58.29 lead risk assessor license, but must not represent the test as a 58.30 lead inspection or lead risk assessment. 58.31 Sec. 61. Minnesota Statutes 1996, section 144.9506, 58.32 subdivision 2, is amended to read: 58.33 Subd. 2. [LICENSE APPLICATION.] An application for a 58.34 license or license renewal shall be on a form provided by the 58.35 commissioner and shall include: 58.36 (1) a$50nonrefundable fee, in a form approved by the 59.1 commissioner; and 59.2 (2) evidence that the applicant has successfully completed 59.3 a lead inspector training course approved under this section or 59.4 from another state with which the commissioner has established 59.5 reciprocity. The fee required in this section is waived for 59.6 federal, state, or local government employees within Minnesota. 59.7 Sec. 62. Minnesota Statutes 1996, section 144.9507, 59.8 subdivision 2, is amended to read: 59.9 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT CONTRACTS.] The 59.10 commissioner shall, within available federal or state 59.11 appropriations, contract with boards of health to conduct 59.12 leadinspectionsrisk assessments to determine sources of lead 59.13 contamination and to issue and enforce lead orders according to 59.14 section 144.9504. 59.15 Sec. 63. Minnesota Statutes 1996, section 144.9507, 59.16 subdivision 3, is amended to read: 59.17 Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The 59.18 commissioner shall, within the limits of available 59.19 appropriations, contract with boards of health for temporary 59.20 housing, to be used in meeting relocation requirements in 59.21 section 144.9504, and award grants to boards of health for the 59.22 purposes of paying housing and relocation costs under section 59.23 144.9504. The commissioner may use up to 15 percent of the 59.24 available appropriations to provide temporary lead-safe housing 59.25 in areas of the state in which the commissioner has the duty 59.26 under section 144.9504 to perform secondary prevention. 59.27 Sec. 64. Minnesota Statutes 1996, section 144.9507, 59.28 subdivision 4, is amended to read: 59.29 Subd. 4. [LEAD CLEANUP EQUIPMENT AND MATERIALGRANTS TO 59.30 NONPROFIT ORGANIZATIONS.] (a) The commissioner shall, within the 59.31 limits of available state or federal appropriations, provide 59.32 funds for lead cleanup equipment and materials under a grant 59.33 program to nonprofit community-based organizations in areas at 59.34 high risk for toxic lead exposure, as provided for in section 59.35 144.9503. 59.36 (b) Nonprofit community-based organizations in areas at 60.1 high risk for toxic lead exposure may apply for grants from the 60.2 commissioner to purchase lead cleanup equipment and materials 60.3 and to pay for training for staff and volunteers for lead 60.4 licensure under sections 144.9505 and 144.9506. 60.5 (c) For purposes of this section, lead cleanup equipment 60.6 and materials means high efficiency particle accumulator (HEPA) 60.7 and wet vacuum cleaners, wash water filters, mops, buckets, 60.8 hoses, sponges, protective clothing, drop cloths, wet scraping 60.9 equipment, secure containers, dust and particle containment 60.10 material, and other cleanup and containment materials to remove 60.11 loose paint and plaster, patch plaster, control household dust, 60.12 wax floors, clean carpets and sidewalks, and cover bare soil. 60.13 (d) The grantee's staff and volunteers may make lead 60.14 cleanup equipment and materials available to residents and 60.15 property owners and instruct them on the proper use of the 60.16 equipment. Lead cleanup equipment and materials must be made 60.17 available to low-income households, as defined by federal 60.18 guidelines, on a priority basis at no fee. Other households may 60.19 be charged on a sliding fee scale. 60.20 (e) The grantee shall not charge a fee for services 60.21 performed using the equipment or materials. 60.22 (f) Any funds appropriated for purposes of this subdivision 60.23 that are not awarded, due to a lack of acceptable proposals for 60.24 the full amount appropriated, may be used for any purpose 60.25 authorized in this section. 60.26 Sec. 65. Minnesota Statutes 1996, section 144.9508, 60.27 subdivision 1, is amended to read: 60.28 Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner 60.29 shall adopt, by rule,visual inspection and sampling and60.30analysismethods for: 60.31 (1) lead inspectionsunder section 144.9504, lead hazard 60.32 screens, lead risk assessments, and clearance inspections; 60.33 (2) environmental surveys of lead in paint, soil, dust, and 60.34 drinking water to determine census tracts that are areas at high 60.35 risk for toxic lead exposure; 60.36 (3) soil sampling for soil used as replacement soil;and61.1 (4) drinking water sampling, which shall be done in 61.2 accordance with lab certification requirements and analytical 61.3 techniques specified by Code of Federal Regulations, title 40, 61.4 section 141.89; and 61.5 (5) sampling to determine whether at least 25 percent of 61.6 the soil samples collected from a census tract within a standard 61.7 metropolitan statistical area contain lead in concentrations 61.8 that exceed 100 parts per million. 61.9 Sec. 66. Minnesota Statutes 1996, section 144.9508, is 61.10 amended by adding a subdivision to read: 61.11 Subd. 2a. [LEAD STANDARDS FOR EXTERIOR SURFACES AND STREET 61.12 DUST.] The commissioner may, by rule, establish lead standards 61.13 for exterior horizontal surfaces, concrete or other impervious 61.14 surfaces, and street dust on residential property to protect the 61.15 public health and the environment. 61.16 Sec. 67. Minnesota Statutes 1996, section 144.9508, 61.17 subdivision 3, is amended to read: 61.18 Subd. 3. [LEAD CONTRACTORS AND WORKERSLICENSURE AND 61.19 CERTIFICATION.] The commissioner shall adopt rules to license 61.20 leadcontractors and to certifysupervisors, lead workersof61.21lead contractors who perform lead abatement or lead hazard61.22reduction, lead project designers, lead inspectors, and lead 61.23 risk assessors. The commissioner shall also adopt rules 61.24 requiring certification of firms that perform lead abatement, 61.25 lead hazard reduction, lead hazard screens, or lead risk 61.26 assessments. The commissioner shall require periodic renewal of 61.27 licenses and certificates and shall establish the renewal 61.28 periods. 61.29 Sec. 68. Minnesota Statutes 1996, section 144.9508, 61.30 subdivision 4, is amended to read: 61.31 Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall 61.32 establish by rule a permit fee to be paid by a training course 61.33 provider on application for a training course permit or renewal 61.34 period for each lead-related training course required for 61.35 certification or licensure. The commissioner shall establish 61.36 criteria in rules for the content and presentation of training 62.1 courses intended to qualify trainees for licensure under 62.2 subdivision 3. Training course permit fees shall be 62.3 nonrefundable and must be submitted with each application in the 62.4 amount of $500 for an initial training course, $250 for renewal 62.5 of a permit for an initial training course, $250 for a refresher 62.6 training course, and $125 for renewal of a permit of a refresher 62.7 training course. 62.8 Sec. 69. Minnesota Statutes 1996, section 144.9509, 62.9 subdivision 2, is amended to read: 62.10 Subd. 2. [DISCRIMINATION.] A person who discriminates 62.11 against or otherwise sanctions an employee who complains to or 62.12 cooperates with theinspectingassessing agency in administering 62.13 sections 144.9501 to 144.9509 is guilty of a petty misdemeanor. 62.14 Sec. 70. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.] 62.15 Subdivision 1. [LEAD-SAFE PROPERTY CERTIFICATION PROGRAM 62.16 ESTABLISHED.] (a) The commissioner shall establish, within the 62.17 limits of available appropriations, a voluntary lead-safe 62.18 property certification program for residential properties. This 62.19 program shall involve an initial property certification process, 62.20 a property condition report, and a lead-safe property 62.21 certification booklet. 62.22 (b) The commissioner shall establish an initial property 62.23 certification process composed of the following: 62.24 (1) a lead hazard screen, which shall include a visual 62.25 evaluation of a residential property for both deteriorated paint 62.26 and bare soil; and 62.27 (2) a quantitative measure of lead in dust within the 62.28 structure and in common areas as determined by rule adopted 62.29 under authority of section 144.9508. 62.30 (c) The commissioner shall establish forms and checklists 62.31 for conducting a property condition report. A property 62.32 condition report is an evaluation of property components, 62.33 without regard to aesthetic considerations, to determine whether 62.34 any of the following conditions are likely to occur within one 62.35 year of the report: 62.36 (1) paint will become chipped, flaked, or cracked; 63.1 (2) structural defects in the roof, windows, or plumbing 63.2 will fail and cause paint to deteriorate; 63.3 (3) window wells or window troughs will not be cleanable 63.4 and washable; 63.5 (4) windows will generate dust due to friction; 63.6 (5) cabinet, room, and threshold doors will rub against 63.7 casings or have repeated contact with painted surfaces; 63.8 (6) floors will not be smooth and cleanable and carpeted 63.9 floors will not be cleanable; 63.10 (7) soil will not remain covered; 63.11 (8) bare soil in vegetable and flower gardens will not (i) 63.12 be inaccessible to children or (ii) be tested to determine if it 63.13 is below the soil standard under section 144.9508; 63.14 (9) parking areas will not remain covered by an impervious 63.15 surface or gravel; 63.16 (10) covered soil will erode, particularly in play areas; 63.17 and 63.18 (11) gutters and down spouts will not function correctly. 63.19 (d) The commissioner shall develop a lead-safe property 63.20 certification booklet that contains the following: 63.21 (1) information on how property owners and their 63.22 maintenance personnel can perform essential maintenance 63.23 practices to correct any of the property component conditions 63.24 listed in paragraph (c) that may occur; 63.25 (2) the lead-safe work practices fact sheets created under 63.26 section 144.9503, subdivision 7; 63.27 (3) forms, checklists, and copies of recommended lead-safe 63.28 property certification certificates; and 63.29 (4) an educational sheet for landlords to give to tenants 63.30 on the importance of having tenants inform property owners or 63.31 designated maintenance staff of one or more of the conditions 63.32 listed in paragraph (c). 63.33 Subd. 2. [CONDITIONS FOR CERTIFICATION.] A property shall 63.34 be certified as lead-safe only if the following conditions are 63.35 met: 63.36 (1) the property passes the initial certification process 64.1 in subdivision 1; 64.2 (2) the property owner agrees in writing to perform 64.3 essential maintenance practices; 64.4 (3) the property owner agrees in writing to use lead-safe 64.5 work practices, as provided for under section 144.9503, 64.6 subdivision 7; 64.7 (4) the property owner performs essential maintenance as 64.8 the need arises or uses maintenance personnel who have completed 64.9 a United States Environmental Protection Agency- or Minnesota 64.10 department of health-approved maintenance training program or 64.11 course to perform essential maintenance; 64.12 (5) the lead-safe property certification booklet is 64.13 distributed to the property owner, maintenance personnel, and 64.14 tenants at the completion of the initial certification process; 64.15 and 64.16 (6) a copy of the lead-safe property certificate is filed 64.17 with the commissioner along with a $5 filing fee. 64.18 Subd. 3. [LEAD STANDARDS.] Lead standards used in this 64.19 section shall be those approved by the commissioner under 64.20 section 144.9508. 64.21 Subd. 4. [LEAD RISK ASSESSORS.] Lead-safe property 64.22 certifications shall only be performed by lead risk assessors 64.23 licensed by the commissioner under section 144.9506. 64.24 Subd. 5. [EXPIRATION.] Lead-safe property certificates are 64.25 valid for one year. 64.26 Subd. 6. [LIST OF CERTIFIED PROPERTIES.] Within the limits 64.27 of available appropriations, the commissioner shall maintain a 64.28 list of all properties certified as lead-safe under this section 64.29 and make it freely available to the public. 64.30 Subd. 7. [REAPPLICATION.] Properties failing the initial 64.31 property certification may reapply for a lead-safe property 64.32 certification by having a new initial certification process 64.33 performed and by correcting any condition listed by the licensed 64.34 lead risk assessor in the property condition report. Properties 64.35 that fail the initial property certification process must have 64.36 the condition corrected by the property owner, by trained 65.1 maintenance staff, or by a contractor with personnel licensed 65.2 for lead hazard reduction or lead abatement work by the 65.3 commissioner under section 144.9505, in order to have the 65.4 property certified. 65.5 Sec. 71. Minnesota Statutes 1996, section 144.99, 65.6 subdivision 1, is amended to read: 65.7 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 65.8 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 65.9 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 65.10 (14), and (15); 144.121; 144.1222; 144.35; 144.381 to 144.385; 65.11 144.411 to 144.417;144.491;144.495; 144.71 to 144.74; 144.9501 65.12 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 65.13 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, 65.14 stipulation agreements, settlements, compliance agreements, 65.15 licenses, registrations, certificates, and permits adopted or 65.16 issued by the department or under any other law now in force or 65.17 later enacted for the preservation of public health may, in 65.18 addition to provisions in other statutes, be enforced under this 65.19 section. 65.20 Sec. 72. Minnesota Statutes 1996, section 144A.44, 65.21 subdivision 2, is amended to read: 65.22 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 65.23 rights are established for the benefit of persons who receive 65.24 home care services. "Home care services" means home care 65.25 services as defined in section 144A.43, subdivision 3. A home 65.26 care provider may not require a person to surrender these rights 65.27 as a condition of receiving services. A guardian or conservator 65.28 or, when there is no guardian or conservator, a designated 65.29 person, may seek to enforce these rights. This statement of 65.30 rights does not replace or diminish other rights and liberties 65.31 that may exist relative to persons receiving home care services, 65.32 persons providing home care services, or providers licensed 65.33 under Laws 1987, chapter 378. A copy of these rights must be 65.34 provided to an individual at the time home care services are 65.35 initiated. The copy shall also contain the address and phone 65.36 number of the office of health facility complaints and the 66.1 office of the ombudsman for older Minnesotans and a brief 66.2 statement describing how to file a complaint withthat office66.3 these offices. Information about how to contact the office of 66.4 the ombudsman for older Minnesotans shall be included in notices 66.5 of change in client fees and in notices where home care 66.6 providers initiate transfer or discontinuation of services. 66.7 Sec. 73. Minnesota Statutes 1997 Supplement, section 66.8 144A.46, subdivision 2, is amended to read: 66.9 Subd. 2. [EXEMPTIONS.] The following individuals or 66.10 organizations are exempt from the requirement to obtain a home 66.11 care provider license: 66.12 (1) a person who is licensed as a registered nurse under 66.13 sections 148.171 to 148.285 and who independently provides 66.14 nursing services in the home without any contractual or 66.15 employment relationship to a home care provider or other 66.16 organization; 66.17 (2) a personal care assistant who provides services to only 66.18 one individual under the medical assistance program as 66.19 authorized under sections 256B.0625, subdivision 19, and 66.20 256B.04, subdivision 16; 66.21 (3) a person or organization that exclusively offers, 66.22 provides, or arranges for personal care assistant services to 66.23 only one individual under the medical assistance program as 66.24 authorized under sections 256B.0625, subdivision 19, and 66.25 256B.04, subdivision 16; 66.26 (4) a person who isregisteredlicensed under sections 66.27 148.65 to 148.78 and who independently provides physical therapy 66.28 services in the home without any contractual or employment 66.29 relationship to a home care provider or other organization; 66.30 (5) a provider that is licensed by the commissioner of 66.31 human services to provide semi-independent living services under 66.32 Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 66.33 home care services to a person with a developmental disability; 66.34 (6) a provider that is licensed by the commissioner of 66.35 human services to provide home and community-based services 66.36 under Minnesota Rules, parts 9525.2000 to 9525.2140 when 67.1 providing home care services to a person with a developmental 67.2 disability; 67.3 (7) a person or organization that provides only home 67.4 management services, if the person or organization is registered 67.5 under section 144A.461; or 67.6 (8) a person who is licensed as a social worker under 67.7 sections 148B.18 to 148B.289 and who provides social work 67.8 services in the home independently and not through any 67.9 contractual or employment relationship with a home care provider 67.10 or other organization. 67.11 An exemption under this subdivision does not excuse the 67.12 individual from complying with applicable provisions of the home 67.13 care bill of rights. 67.14 Sec. 74. Minnesota Statutes 1997 Supplement, section 67.15 144A.4605, subdivision 4, is amended to read: 67.16 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 67.17 establishment registered under chapter 144D that is required to 67.18 obtain a home care license must obtain an assisted living home 67.19 care license according to this section or a class A or class E 67.20 license according to rule. A housing with services 67.21 establishment that obtains a class E license under this 67.22 subdivision remains subject to the payment limitations in 67.23 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 67.24 subdivision 3, paragraph (g). 67.25 (b) A board and lodging establishment registered for 67.26 special services as of December 31, 1996, and also registered as 67.27 a housing with services establishment under chapter 144D, must 67.28 deliver home care services according to sections 144A.43 to 67.29 144A.49, and may apply for a waiver from requirements under 67.30 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 67.31 licensed agency under the standards of section 157.17. Such 67.32 waivers as may be granted by the department will expire upon 67.33 promulgation of home care rules implementing section 144A.4605. 67.34 (c) An adult foster care provider licensed by the 67.35 department of human services and registered under chapter 144D 67.36 may continue to provide health-related services under its foster 68.1 care license until the promulgation of home care rules 68.2 implementing this section. 68.3 Sec. 75. Minnesota Statutes 1996, section 145.411, is 68.4 amended by adding a subdivision to read: 68.5 Subd. 6. [COMMISSIONER.] "Commissioner" means the 68.6 commissioner of health. 68.7 Sec. 76. [145.4131] [RECORDING AND REPORTING ABORTION 68.8 DATA.] 68.9 Subdivision 1. [FORMS.] (a) Within 90 days of the 68.10 effective date of this section, the commissioner shall prepare a 68.11 reporting form for physicians performing abortions. A copy of 68.12 this section shall be attached to the form. A physician 68.13 performing an abortion shall obtain a form from the commissioner. 68.14 (b) The form shall require the following information: 68.15 (1) the number of abortions performed by the physician in 68.16 the previous calendar year, reported by month; 68.17 (2) the method used for each abortion; 68.18 (3) the approximate gestational age of each child subject 68.19 to abortion, expressed in one of the following increments: 68.20 (i) less than nine weeks; 68.21 (ii) nine to ten weeks; 68.22 (iii) 11 to 12 weeks; 68.23 (iv) 13 to 15 weeks; 68.24 (v) 16 to 20 weeks; 68.25 (vi) 21 to 24 weeks; 68.26 (vii) 25 to 30 weeks; 68.27 (viii) 31 to 36 weeks; or 68.28 (ix) 37 weeks to term; 68.29 (4) the age of the mother on whom the abortion was 68.30 performed at the time the abortion was performed; 68.31 (5) the specific reason for the abortion, including, but 68.32 not limited to, the following: 68.33 (i) the pregnancy was a result of rape; 68.34 (ii) the pregnancy was a result of incest; 68.35 (iii) the mother cannot afford the child; 68.36 (iv) the mother does not want the child; 69.1 (v) the mother's emotional health is at stake; 69.2 (vi) the mother will suffer substantial and irreversible 69.3 impairment of a major bodily function if the pregnancy 69.4 continues; or 69.5 (vii) other; 69.6 (6) the number of prior induced abortions; 69.7 (7) the number of prior spontaneous abortions; 69.8 (8) whether the abortion was paid for by: 69.9 (i) private insurance; 69.10 (ii) a public health plan; or 69.11 (iii) another form of payment; 69.12 (9) whether coverage was under: 69.13 (i) a fee-for-service insurance company; 69.14 (ii) a managed care company; or 69.15 (iii) another type of health carrier; 69.16 (10) complications, if any, for each abortion and for the 69.17 aftermath of each abortion. Space for a description of any 69.18 complications shall be available on the form; 69.19 (11) the fee collected for each abortion; 69.20 (12) the type of anesthetic used, if any, for each 69.21 abortion; 69.22 (13) the method used to dispose of fetal tissue and 69.23 remains; 69.24 (14) the medical specialty of the physician performing the 69.25 abortion; and 69.26 (15) whether the physician performing the abortion has had 69.27 a physician's license suspended or revoked or has had other 69.28 professional sanctions in this or another state. 69.29 Subd. 2. [SUBMISSION.] A physician performing an abortion 69.30 shall complete and submit the form to the commissioner no later 69.31 than April 1 for abortions performed in the previous calendar 69.32 year. 69.33 Subd. 3. [ADDITIONAL REPORTING.] Nothing in this section 69.34 shall be construed to preclude the voluntary or required 69.35 submission of other reports or forms regarding abortions. 69.36 Sec. 77. [145.4132] [RECORDING AND REPORTING ABORTION 70.1 COMPLICATION DATA.] 70.2 Subdivision 1. [FORMS.] (a) Within 90 days of the 70.3 effective date of this section, the commissioner shall prepare 70.4 an abortion complication reporting form for all physicians 70.5 licensed and practicing in the state. A copy of this section 70.6 shall be attached to the form. 70.7 (b) The board of medical practice shall ensure that the 70.8 abortion complication reporting form is distributed: 70.9 (1) to all physicians licensed to practice in the state, 70.10 within 120 days after the effective date of this section and by 70.11 December 1 of each subsequent year; and 70.12 (2) to a physician who is newly licensed to practice in the 70.13 state, at the same time as official notification to the 70.14 physician that the physician is so licensed. 70.15 Subd. 2. [REQUIRED REPORTING.] A physician licensed and 70.16 practicing in the state who encounters an illness or injury that 70.17 is related to an induced abortion shall complete and submit an 70.18 abortion complication reporting form to the commissioner. 70.19 Subd. 3. [SUBMISSION.] A physician required to submit an 70.20 abortion complication reporting form to the commissioner shall 70.21 do so as soon as practicable after the encounter with the 70.22 abortion related illness or injury, but in no case more than 60 70.23 days after the encounter. 70.24 Subd. 4. [ADDITIONAL REPORTING.] Nothing in this section 70.25 shall be construed to preclude the voluntary or required 70.26 submission of other reports or forms regarding abortion 70.27 complications. 70.28 Sec. 78. [145.4133] [REPORTING OUT-OF-STATE ABORTIONS.] 70.29 The commissioner of human services shall report to the 70.30 commissioner by April 1 each year the following information 70.31 regarding abortions paid for with state funds and performed out 70.32 of state in the previous calendar year: 70.33 (1) the total number of abortions performed out of state 70.34 and partially or fully paid for with state funds through the 70.35 medical assistance, general assistance medical care, or 70.36 MinnesotaCare program, or any other program; 71.1 (2) the total amount of state funds used to pay for the 71.2 abortions and expenses incidental to the abortions; and 71.3 (3) the gestational age of each unborn child at the time of 71.4 abortion. 71.5 Sec. 79. [145.4134] [COMMISSIONER'S PUBLIC REPORT.] 71.6 (a) By July 1 of each year, the commissioner shall issue a 71.7 public report providing statistics for the previous calendar 71.8 year compiled from the data submitted under sections 145.4131 to 71.9 145.4133. Each report shall provide the statistics for all 71.10 previous calendar years, adjusted to reflect any additional 71.11 information from late or corrected reports. The commissioner 71.12 shall ensure that none of the information included in the public 71.13 reports can reasonably lead to identification of an individual 71.14 having performed or having had an abortion. All data included 71.15 on the forms under sections 145.4131 to 145.4133 must be 71.16 included in the public report. The commissioner shall submit 71.17 the report to the senate health care committee and the house 71.18 health and human services committee. 71.19 (b) The commissioner may, by rules adopted under chapter 71.20 14, alter the submission dates established under sections 71.21 145.4131 to 145.4133 for administrative convenience, fiscal 71.22 savings, or other valid reason, provided that physicians and the 71.23 commissioner of health submit the required information once each 71.24 year and the commissioner issues a report once each year. 71.25 Sec. 80. [145.4135] [ENFORCEMENT; PENALTIES.] 71.26 (a) A physician who fails to submit the required forms 71.27 under sections 145.4131 and 145.4132 within 30 days following 71.28 the due date is subject to a late fee of $500 for each 30-day 71.29 period, or portion thereof, that the forms are overdue. A 71.30 physician required to report under this section who does not 71.31 submit a report, or submits only an incomplete report, more than 71.32 one year following the due date, may be fined and, in an action 71.33 brought by the commissioner, be directed by a court of competent 71.34 jurisdiction to submit a complete report within a period stated 71.35 by court order or be subject to sanctions for civil contempt. 71.36 (b) If the commissioner fails to issue the public report 72.1 required under this section, or fails in any way to enforce this 72.2 section, a group of ten or more citizens of the state may seek 72.3 an injunction in a court of competent jurisdiction against the 72.4 commissioner requiring that a complete report be issued within a 72.5 period stated by court order or requiring that enforcement 72.6 action be taken. Failure to abide by an injunction shall 72.7 subject the commissioner to sanctions for civil contempt. 72.8 (c) A physician who knowingly or recklessly submits a false 72.9 report under this section is guilty of a misdemeanor. 72.10 (d) The commissioner may take reasonable steps to ensure 72.11 compliance with sections 145.4131 to 145.4133 and to verify data 72.12 provided, including but not limited to, inspection of places 72.13 where abortions are performed in accordance with chapter 14. 72.14 Sec. 81. [145.4136] [SEVERABILITY.] 72.15 If any one or more provision, section, subdivision, 72.16 sentence, clause, phrase, or word in sections 145.4131 to 72.17 145.4135, or the application thereof to any person or 72.18 circumstance is found to be unconstitutional, the same is hereby 72.19 declared to be severable and the balance of sections 145.4131 to 72.20 145.4135 shall remain effective notwithstanding such 72.21 unconstitutionality. The legislature hereby declares that it 72.22 would have passed sections 145.4131 to 145.4135, and each 72.23 provision, section, subdivision, sentence, clause, phrase, or 72.24 word thereof, irrespective of the fact that any one or more 72.25 provision, section, subdivision, sentence, clause, phrase, or 72.26 word be declared unconstitutional. 72.27 Sec. 82. [145.4201] [PARTIAL-BIRTH ABORTION; DEFINITIONS.] 72.28 Subdivision 1. [TERMS.] As used in sections 145.4201 to 72.29 145.4206, the terms defined in this section have the meanings 72.30 given them. 72.31 Subd. 2. [ABORTION.] "Abortion" means the use of any means 72.32 to intentionally terminate the pregnancy of a female known to be 72.33 pregnant with knowledge that the termination with those means 72.34 will, with reasonable likelihood, cause the death of the fetus. 72.35 Subd. 3. [FETUS.] "Fetus" is used to refer to the 72.36 biological offspring of human parents. 73.1 Subd. 4. [PARTIAL-BIRTH ABORTION.] "Partial-birth abortion" 73.2 means an abortion in which the person performing the abortion 73.3 partially vaginally delivers a living fetus before killing the 73.4 fetus and completing the delivery. 73.5 Subd. 5. [PARTIALLY VAGINALLY DELIVERS A LIVING FETUS 73.6 BEFORE KILLING THE FETUS.] "Partially vaginally delivers a 73.7 living fetus before killing the fetus" means deliberately and 73.8 intentionally delivers into the vagina a living fetus, or a 73.9 substantial portion thereof, for the purpose of performing a 73.10 procedure the physician knows will kill the fetus, and kills the 73.11 fetus. 73.12 Sec. 83. [145.4202] [PARTIAL-BIRTH ABORTIONS PROHIBITED.] 73.13 No person shall knowingly perform a partial-birth abortion. 73.14 Sec. 84. [145.4203] [LIFE OF THE MOTHER EXCEPTION.] 73.15 The prohibition under section 145.4202 shall not apply to a 73.16 partial-birth abortion that is necessary to save the life of the 73.17 mother because her life is endangered by a physical disorder, 73.18 physical illness, or physical injury. 73.19 Sec. 85. [145.4204] [CIVIL REMEDIES.] 73.20 Subdivision 1. [STANDING.] The woman upon whom a 73.21 partial-birth abortion has been performed in violation of 73.22 section 145.4202, the father if married to the mother at the 73.23 time she receives a partial birth abortion procedure, and the 73.24 maternal grandparents of the fetus if the mother has not 73.25 attained the age of 18 years at the time of the abortion, may 73.26 obtain appropriate relief in a civil action, unless the 73.27 pregnancy resulted from the plaintiff's criminal conduct or the 73.28 plaintiff consented to the abortion. 73.29 Subd. 2. [TYPE OF RELIEF.] Relief shall include: 73.30 (1) money damages for all injuries, psychological and 73.31 physical, occasioned by the violation of sections 145.4201 to 73.32 145.4206; and 73.33 (2) statutory damages equal to three times the cost of the 73.34 partial-birth abortion. 73.35 Subd. 3. [ATTORNEY'S FEE.] If judgment is rendered in 73.36 favor of the plaintiff in an action described in this section, 74.1 the court shall also render judgment for a reasonable attorney's 74.2 fee in favor of the plaintiff against the defendant. If the 74.3 judgment is rendered in favor of the defendant and the court 74.4 finds that the plaintiff's suit was frivolous and brought in bad 74.5 faith, the court shall also render judgment for a reasonable 74.6 attorney's fee in favor of the defendant against the plaintiff. 74.7 Sec. 86. [145.4205] [CRIMINAL PENALTY.] 74.8 Subdivision 1. [FELONY.] A person who performs a 74.9 partial-birth abortion in knowing or reckless violation of 74.10 sections 145.4201 to 145.4206 is guilty of a felony and may be 74.11 sentenced to imprisonment for not more than two years or to 74.12 payment of a fine of not more than $10,000. 74.13 Subd. 2. [ADMINISTRATIVE FINDING.] (a) A defendant accused 74.14 of an offense under this section may seek a hearing before the 74.15 state board of medical practice on whether the physician's 74.16 conduct was necessary to save the life of the mother whose life 74.17 was endangered by the physical disorder, illness, or injury. 74.18 (b) The findings of the state board of medical practice on 74.19 that issue are admissible at the trial of the defendant. Upon 74.20 motion of the defendant, the court shall delay the beginning of 74.21 the trial for not more than 30 days to permit the hearing to 74.22 take place. 74.23 Subd. 3. [PROSECUTION OF MOTHER PROHIBITED.] A woman upon 74.24 whom a partial-birth abortion is performed may not be prosecuted 74.25 under this section for violating sections 145.4201 to 145.4206, 74.26 or any provision thereof, or for conspiracy to violate sections 74.27 145.4201 to 145.4206, or any provision thereof. 74.28 Sec. 87. [145.4206] [SEVERABILITY.] 74.29 (a) If any provision, word, phrase, or clause of section 74.30 145.4203, or the application thereof to any person or 74.31 circumstance is found to be unconstitutional, the same is hereby 74.32 declared to be inseverable. 74.33 (b) If any provision, section, subdivision, sentence, 74.34 clause, phrase, or word in section 145.4201, 145.4202, 145.4204, 74.35 145.4205, or 145.4206 or the application thereof to any person 74.36 or circumstance is found to be unconstitutional, the same is 75.1 hereby declared to be severable and the balance of sections 75.2 145.4201 to 145.4206 shall remain effective notwithstanding such 75.3 unconstitutionality. The legislature hereby declares that it 75.4 would have passed sections 145.4201 to 145.4206, and each 75.5 provision, section, subdivision, sentence, clause, phrase, or 75.6 word thereto, with the exception of section 145.4203, 75.7 irrespective of the fact that a provision, section, subdivision, 75.8 sentence, clause, phrase, or word be declared unconstitutional. 75.9 Sec. 88. [145.905] [BREAST-FEEDING.] 75.10 Subdivision 1. [LOCATION.] A mother may breast-feed in any 75.11 location, public or private, where the mother is otherwise 75.12 authorized to be, irrespective of whether the nipple of the 75.13 mother's breast is uncovered during or incidental to the 75.14 breast-feeding. 75.15 Subd. 2. [FACILITIES; BREAST-FEEDING POLICY AND 75.16 TRAINING.] (a) It is recommended that a facility providing 75.17 maternity services or newborn infant care have a written 75.18 breast-feeding policy that may include the following elements: 75.19 (1) informs all pregnant women about the benefits and 75.20 management of breast-feeding; 75.21 (2) gives newborn infants of mothers who choose to 75.22 breast-feed no food or drink other than breast milk, unless 75.23 medically indicated; 75.24 (3) practices "rooming in" by allowing mothers and infants 75.25 to remain together 24 hours a day; 75.26 (4) encourages breast-feeding on demand for mothers who 75.27 choose to breast-feed; 75.28 (5) gives no artificial teats or pacifiers to 75.29 breast-feeding infants; and 75.30 (6) encourages the establishment of breast-feeding support 75.31 groups and refers mothers who choose to breast-feed to them on 75.32 discharge from the hospital or clinic. 75.33 (b) It is recommended that a facility providing maternity 75.34 services or newborn infant care provide the following training 75.35 and assistance to its health care staff and mothers: 75.36 (1) training for all health care staff in the skills 76.1 necessary to implement the facility's breast-feeding policy; 76.2 (2) assistance to help mothers who choose to breast-feed 76.3 begin breast-feeding within half an hour of birth; and 76.4 (3) training for mothers who choose to breast-feed on how 76.5 to breast-feed and how to maintain lactation, even if separated 76.6 from their infants. 76.7 Sec. 89. [145.926] [ABSTINENCE EDUCATION GRANT PROGRAM.] 76.8 The commissioner of health shall expend federal funds for 76.9 abstinence education programs provided under United States Code, 76.10 title 42, section 710, and state matching funds for abstinence 76.11 education programs only to an abstinence education program that 76.12 has all of the following components: 76.13 (1) the exclusive purpose of teaching the social, 76.14 psychological, and health gains to be realized by abstaining 76.15 from sexual activity; 76.16 (2) teaching abstinence from sexual activity outside of 76.17 marriage as the expected standard for all school-age children; 76.18 (3) teaching that abstinence from sexual activity is the 76.19 only certain way to avoid out-of-wedlock pregnancy, sexually 76.20 transmitted diseases, and other associated health problems; 76.21 (4) teaching that a mutually faithful, monogamous 76.22 relationship in the context of marriage is the expected standard 76.23 of human sexual activity; 76.24 (5) teaching that sexual activity outside of marriage is 76.25 likely to have harmful psychological and physical effects; 76.26 (6) teaching that bearing children out-of-wedlock is likely 76.27 to have harmful consequences for the child, the child's parents, 76.28 and society; 76.29 (7) teaching young people how to reject sexual advances and 76.30 how alcohol and drug use increases vulnerability to sexual 76.31 advances; and 76.32 (8) teaching the importance of attaining self-sufficiency 76.33 before engaging in sexual activity. 76.34 Sec. 90. [145.9266] [FETAL ALCOHOL SYNDROME.] 76.35 Subdivision 1. [PUBLIC AWARENESS.] The commissioner of 76.36 health shall design and implement an ongoing statewide campaign 77.1 to raise public awareness about fetal alcohol syndrome and other 77.2 effects of prenatal alcohol exposure. The campaign shall 77.3 include messages directed to the general population as well as 77.4 culturally specific and community-based messages. A toll-free 77.5 resource and referral telephone line shall be included in the 77.6 messages. The commissioner of health shall conduct an 77.7 evaluation to determine the effectiveness of the campaign. 77.8 Subd. 2. [STATEWIDE NETWORK OF FAS DIAGNOSTIC CLINICS.] A 77.9 statewide network of regional fetal alcohol syndrome diagnostic 77.10 clinics shall be developed between the department of health and 77.11 the University of Minnesota. This collaboration shall be based 77.12 on a statewide needs assessment and shall include involvement 77.13 from consumers, providers, and payors. By the end of calendar 77.14 year 1998, a plan shall be developed for the clinic network, and 77.15 shall include a comprehensive evaluation component. Sites shall 77.16 be established in calendar year 1999. The commissioner shall 77.17 not access or collect individually identifiable data for the 77.18 statewide network of regional fetal alcohol syndrome diagnostic 77.19 clinics. Data collected at the clinics shall be maintained 77.20 according to applicable data privacy laws, including section 77.21 144.335. 77.22 Subd. 3. [PROFESSIONAL TRAINING ABOUT FAS.] (a) The 77.23 commissioner of health, in collaboration with the board of 77.24 medical practice, the board of nursing, and other professional 77.25 boards and state agencies, shall develop curricula and materials 77.26 about fetal alcohol syndrome for professional training of health 77.27 care providers, social service providers, educators, and 77.28 judicial and corrections systems professionals. The training 77.29 and curricula shall increase knowledge and develop practical 77.30 skills of professionals to help them address the needs of 77.31 at-risk pregnant women and the needs of individuals affected by 77.32 fetal alcohol syndrome or fetal alcohol effects and their 77.33 families. 77.34 (b) Training for health care providers shall focus on skill 77.35 building for screening, counseling, referral, and follow-up for 77.36 women using or at risk of using alcohol while pregnant. 78.1 Training for health care professionals shall include methods for 78.2 diagnosis and evaluation of fetal alcohol syndrome and fetal 78.3 alcohol effects. Training for education, judicial, and 78.4 corrections professionals shall involve effective education 78.5 strategies, methods to identify the behaviors and learning 78.6 styles of children with alcohol-related birth defects, and 78.7 methods to identify available referral and community resources. 78.8 (c) Training for social service providers shall focus on 78.9 resources for assessing, referring, and treating at-risk 78.10 pregnant women, changes in the mandatory reporting and 78.11 commitment laws, and resources for affected children and their 78.12 families. 78.13 Subd. 4. [FAS COMMUNITY GRANT PROGRAM.] The commissioner 78.14 of health shall administer a grant program to provide money to 78.15 community organizations and coalitions to collaborate on fetal 78.16 alcohol syndrome prevention and intervention strategies and 78.17 activities. The commissioner shall disburse grant money through 78.18 a request for proposal process or sole-source distribution where 78.19 appropriate, and shall include at least one grant award for 78.20 transitional skills and services for individuals with fetal 78.21 alcohol syndrome or fetal alcohol effects. 78.22 Subd. 5. [SCHOOL PILOT PROGRAMS.] (a) The commissioner of 78.23 children, families, and learning shall award up to four grants 78.24 to schools for pilot programs to identify and implement 78.25 effective educational strategies for individuals with fetal 78.26 alcohol syndrome and other alcohol-related birth defects. 78.27 (b) One grant shall be awarded in each of the following age 78.28 categories: 78.29 (1) birth to three years; 78.30 (2) three to five years; 78.31 (3) six to 12 years; and 78.32 (4) 13 to 18 years. 78.33 (c) Grant proposals must include an evaluation plan, 78.34 demonstrate evidence of a collaborative or multisystem approach, 78.35 provide parent education and support, and show evidence of a 78.36 child- and family-focused approach consistent with 79.1 research-based educational practices and other guidelines 79.2 developed by the department of children, families, and learning. 79.3 (d) Children participating in the pilot program sites may 79.4 be identified through child find activities or a diagnostic 79.5 clinic. No identification activity may be undertaken without 79.6 the consent of a child's parent or guardian. 79.7 Subd. 6. [FETAL ALCOHOL COORDINATING BOARD; DUTIES.] (a) 79.8 The fetal alcohol coordinating board consists of: 79.9 (1) the commissioners of health, human services, 79.10 corrections, public safety, economic security, and children, 79.11 families, and learning; 79.12 (2) the director of the office of strategic and long-range 79.13 planning; 79.14 (3) the chair of the maternal and child health advisory 79.15 task force established by section 145.881, or the chair's 79.16 designee; 79.17 (4) a representative of the University of Minnesota 79.18 academic health center, appointed by the provost; 79.19 (5) five members from the general public appointed by the 79.20 governor, one of whom must be a family member of an individual 79.21 with fetal alcohol syndrome or fetal alcohol effect; and 79.22 (6) one member from the judiciary appointed by the chief 79.23 justice of the supreme court. 79.24 Terms, compensation, removal, and filling of vacancies of 79.25 appointed members are governed by section 15.0575. The board 79.26 shall elect a chair from its membership to serve a one-year 79.27 term. The commissioner of health shall provide staff and 79.28 consultant support for the board. Support must be provided 79.29 based on an annual budget and work plan developed by the board. 79.30 The board shall contract with the department of health for 79.31 necessary administrative services. Administrative services 79.32 include personnel, budget, payroll, and contract 79.33 administration. The board shall adopt an annual budget and work 79.34 program. 79.35 (b) Board duties include: 79.36 (1) reviewing programs of state agencies that involve fetal 80.1 alcohol syndrome and coordinating those that are 80.2 interdepartmental in nature; 80.3 (2) providing an integrated and comprehensive approach to 80.4 fetal alcohol syndrome prevention and intervention strategies 80.5 both at a local and statewide level; 80.6 (3) approving on an annual basis the statewide public 80.7 awareness campaign as designed and implemented by the 80.8 commissioner of health under subdivision 1; 80.9 (4) reviewing fetal alcohol syndrome community grants 80.10 administered by the commissioner of health under subdivision 4; 80.11 and 80.12 (5) submitting a report to the governor on January 15 of 80.13 each odd-numbered year summarizing board operations, activities, 80.14 findings, and recommendations, and fetal alcohol syndrome 80.15 activities throughout the state. 80.16 (c) The board expires on January 1, 2001. 80.17 Subd. 7. [FEDERAL FUNDS; CONTRACTS; DONATIONS.] The fetal 80.18 alcohol coordinating board may apply for, receive, and disburse 80.19 federal funds made available to the state by federal law or 80.20 rules adopted for any purpose related to the powers and duties 80.21 of the board. The board shall comply with any requirements of 80.22 federal law, rules, and regulations in order to apply for, 80.23 receive, and disburse funds. The board may contract with or 80.24 provide grants to public and private nonprofit entities. The 80.25 board may accept donations or grants from any public or private 80.26 entity. Money received by the board must be deposited in a 80.27 separate account in the state treasury and invested by the state 80.28 board of investment. The amount deposited, including investment 80.29 earnings, is appropriated to the board to carry out its duties. 80.30 Money deposited in the state treasury shall not cancel. 80.31 Sec. 91. Minnesota Statutes 1996, section 145A.15, 80.32 subdivision 2, is amended to read: 80.33 Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is 80.34 authorized to award grants to programs that meet the 80.35 requirements of subdivision 3 and include a strong child abuse 80.36 and neglect prevention focus for families in need of services. 81.1 Priority will be given to families considered to be in need of 81.2 additional services. These families include, but are not 81.3 limited to, families with: 81.4 (1) adolescent parents; 81.5 (2) a history of alcohol and other drug abuse; 81.6 (3) a history of child abuse, domestic abuse, or other 81.7 types of violence in the family of origin; 81.8 (4) a history of domestic abuse, rape, or other forms of 81.9 victimization; 81.10 (5) reduced cognitive functioning; 81.11 (6) a lack of knowledge of child growth and development 81.12 stages; 81.13 (7) low resiliency to adversities and environmental 81.14 stresses; or 81.15 (8) lack of sufficient financial resources to meet their 81.16 needs. 81.17 (b) Grants made under this section shall be used to fund 81.18 existing home visiting programs and to establish new programs. 81.19 The commissioner shall award grants to home visiting programs 81.20 that meet the program requirements in subdivision 3, regardless 81.21 of the number of years an existing program has received grant 81.22 funds in the past. 81.23 Sec. 92. Minnesota Statutes 1996, section 148.66, is 81.24 amended to read: 81.25 148.66 [STATE BOARD OFMEDICAL PRACTICEPHYSICAL THERAPY, 81.26 DUTIES.] 81.27 The state board ofmedical practice, as now or hereafter81.28constituted, hereinafter termed "the board," in the manner81.29hereinafter provided,physical therapy established under section 81.30 148.67 shall administerthe provisions of this lawsections 81.31 148.65 to 148.78. As used in sections 148.65 to 148.78, "board" 81.32 means the state board of physical therapy. 81.33 The board shall: 81.34 (1) adopt rules necessary to administer and enforce 81.35 sections 148.65 to 148.78; 81.36 (2) administer, coordinate, and enforce sections 148.65 to 82.1 148.78; 82.2 (3) evaluate the qualifications of applicants; 82.3 (4) issue subpoenas, examine witnesses, and administer 82.4 oaths; 82.5 (5) conduct hearings and keep records and minutes necessary 82.6 to the orderly administration of sections 148.65 to 148.78; 82.7 (6) investigate persons engaging in practices that violate 82.8 sections 148.65 to 148.78; and 82.9 (7) adopt rules under chapter 14 prescribing a code of 82.10 ethics for licensees. 82.11 Sec. 93. Minnesota Statutes 1996, section 148.67, is 82.12 amended to read: 82.13 148.67 [STATE BOARD OF PHYSICAL THERAPYCOUNCIL; MEMBERSHIP 82.14 APPOINTMENTS, VACANCIES, REMOVALS.] 82.15 Subdivision 1. [BOARD OF PHYSICAL THERAPY APPOINTED.] The 82.16board of medical practicegovernor shall appoint a state board 82.17 of physical therapycouncil in carrying out the provisions of82.18this lawto administer sections 148.65 to 148.78, regarding the 82.19 qualifications and examination of physical therapists. 82.20 Thecouncilboard shall consist ofsevennine members, citizens 82.21 and residents of the state of Minnesota, composed ofthreefive 82.22 physical therapists,twoone licensed and registereddoctors82.23 doctor of medicineand surgery, one being a professor or82.24associate or assistant professor from a program in physical82.25therapy approved by the board of medical practice, one aide or82.26assistant to a physical therapist and one public member. The82.27council shall expire, and the terms, compensation and removal of82.28members shall be as provided in section 15.059., one physical 82.29 therapy assistant and two public members. The five physical 82.30 therapist members must be licensed physical therapists in this 82.31 state. Each of the five physical therapist members must have at 82.32 least five years experience in physical therapy practice, 82.33 physical therapy administration, or physical therapy education. 82.34 The five years experience must immediately precede appointment. 82.35 Membership terms, compensation of members, removal of members, 82.36 filling of membership vacancies, and fiscal year and reporting 83.1 requirements shall be as provided in sections 214.07 to 214.09. 83.2 The provision of staff, administrative services, and office 83.3 space; the review and processing of complaints; the setting of 83.4 board fees; and other provisions relating to board operations 83.5 shall be as provided in chapter 214. Each member of the board 83.6 shall file with the secretary of state the constitutional oath 83.7 of office before beginning the term of office. 83.8 Subd. 2. [REPLACEMENT OF PHYSICAL THERAPISTS AND PHYSICIAN 83.9 MEMBERS.] When a member's term expires and the member is a 83.10 licensed physical therapist, the governor may appoint a licensed 83.11 physical therapist from a list submitted by the Minnesota 83.12 chapter of the American Physical Therapy Association. When a 83.13 member who is a licensed physical therapist leaves the board 83.14 before the member's term expires, the governor may appoint a 83.15 member for the remainder of the term from a list submitted by 83.16 the Minnesota chapter of the American Physical Therapy 83.17 Association. When a member who is a physician leaves the board 83.18 before the member's term expires, the governor may appoint a 83.19 member for the remainder of the term from lists submitted by the 83.20 state board of medical practice or the Minnesota Medical 83.21 Association. 83.22 Sec. 94. [148.691] [OFFICERS; EXECUTIVE DIRECTOR.] 83.23 Subdivision 1. [OFFICERS OF THE BOARD.] The board shall 83.24 elect from its members a president, a vice-president, and a 83.25 secretary-treasurer. Each shall serve for one year or until a 83.26 successor is elected and qualifies. The board shall appoint and 83.27 employ an executive secretary. A majority of the board, 83.28 including one officer, constitutes a quorum at a meeting. 83.29 Subd. 2. [BOARD AUTHORITY TO HIRE.] The board may employ 83.30 persons needed to carry out its work. 83.31 Sec. 95. Minnesota Statutes 1996, section 148.70, is 83.32 amended to read: 83.33 148.70 [APPLICANTS, QUALIFICATIONS.] 83.34It shall be the duty ofThe board ofmedical practice with83.35the advice and assistance of the physical therapy council to83.36pass uponphysical therapy must: 84.1 (1) establish the qualifications of applicants for 84.2registration,licensing and continuing education requirements 84.3 forreregistration,relicensing; 84.4 (2) provide for and conduct all examinations following 84.5 satisfactory completion of all didactic requirements,; 84.6 (3) determine the applicants who successfully pass the 84.7 examination,; and 84.8 (4) dulyregister such applicantslicense an applicant 84.9 after the applicant has presented evidence satisfactory to the 84.10 board that the applicant has completedaan accredited physical 84.11 therapy educational program of education or continuing education 84.12 approved by the board. 84.13 The passing score for examinations taken after July 1, 84.14 1995, shall be based on objective, numerical standards, as 84.15 established by a nationally recognized board approved testing 84.16 service. 84.17 Sec. 96. Minnesota Statutes 1996, section 148.705, is 84.18 amended to read: 84.19 148.705 [APPLICATION.] 84.20 An applicant forregistrationlicensing as a physical 84.21 therapist shall file a written application on forms provided by 84.22 the board together with a fee in the amount set by the board, no84.23portion of which shall be returned. No portion of the fee is 84.24 refundable. 84.25 An approved program for physical therapists shall include 84.26 the following: 84.27(a)(1) a minimum of 60 academic semester credits or its 84.28 equivalent from an accredited college, including courses in the 84.29 biological and physical sciences; and 84.30(b)(2) an accredited course in physical therapy education 84.31 which has provided adequate instruction in the basic sciences, 84.32 clinical sciences, and physical therapy theory and procedures, 84.33 as determined by the board. In determining whether or not a 84.34 course in physical therapy is approved, the board may take into 84.35 consideration the accreditation of such schools by the 84.36 appropriate council of the American Medical Association, the 85.1 American Physical Therapy Association, or the Canadian Medical 85.2 Association. 85.3 Sec. 97. Minnesota Statutes 1996, section 148.71, is 85.4 amended to read: 85.5 148.71 [REGISTRATIONLICENSING.] 85.6 Subdivision 1. [QUALIFIED APPLICANT.] The state board 85.7 ofmedical practicephysical therapy shallregisterlicense as a 85.8 physical therapist and shall furnish acertificate of85.9registrationlicense toeachan applicant who successfully 85.10 passes an examination provided for in sections 148.65 to 148.78 85.11 forregistrationlicensing as a physical therapist and who is 85.12 otherwise qualified as requiredhereinin sections 148.65 to 85.13 148.78. 85.14 Subd. 2. [TEMPORARY PERMIT.] (a) The board may, upon 85.15 payment of a fee set by the board, issue a temporary permit to 85.16 practice physical therapy under supervision to a physical 85.17 therapist who is a graduate of an approved school of physical 85.18 therapy and qualified for admission to examination for 85.19registrationlicensing as a physical therapist. A temporary 85.20 permit to practice physical therapy under supervision may be 85.21 issued only once and cannot be renewed. It expires 90 days 85.22 after the next examination forregistrationlicensing given by 85.23 the board or on the date on which the board, after examination 85.24 of the applicant, grants or denies the applicant aregistration85.25 license to practice, whichever occurs first. A temporary permit 85.26 expires on the first day the board begins its next examination 85.27 forregistrationlicense after the permit is issued if the 85.28 holder does not submit to examination on that date. The holder 85.29 of a temporary permit to practice physical therapy under 85.30 supervision may practice physical therapy as defined in section 85.31 148.65 if the entire practice is under the supervision of a 85.32 person holding a validregistrationlicense to practice physical 85.33 therapy in this state. The supervision shall be direct, 85.34 immediate, and on premises. 85.35 (b) A physical therapist from another state who is licensed 85.36 or otherwise registered in good standing as a physical therapist 86.1 by that state and meets the requirements forregistration86.2 licensing under section 148.72 does not require supervision to 86.3 practice physical therapy while holding a temporary permit in 86.4 this state. The temporary permit remains valid only until the 86.5 meeting of the board at which the application forregistration86.6 licensing is considered. 86.7 Subd. 3. [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 86.8 PERMITS.] (a) The board of medical practice may issue a 86.9 temporary permit to a foreign-trained physical therapist who: 86.10 (1) is enrolled in a supervised physical therapy 86.11 traineeship that meets the requirements under paragraph (b); 86.12 (2) has completed a physical therapy education program 86.13 equivalent to that under section 148.705 and Minnesota Rules, 86.14 part 5601.0800, subpart 2; 86.15 (3) has achieved a score of at least 550 on the test of 86.16 English as a foreign language or a score of at least 85 on the 86.17 Minnesota battery test; and 86.18 (4) has paid a nonrefundable fee set by the board. 86.19 A foreign-trained physical therapist must have the 86.20 temporary permit before beginning a traineeship. 86.21 (b) A supervised physical therapy traineeship must: 86.22 (1) be at least six months; 86.23 (2) be at a board-approved facility; 86.24 (3) provide a broad base of clinical experience to the 86.25 foreign-trained physical therapist including a variety of 86.26 physical agents, therapeutic exercises, evaluation procedures, 86.27 and patient diagnoses; 86.28 (4) be supervised by a physical therapist who has at least 86.29 three years of clinical experience and isregisteredlicensed 86.30 under subdivision 1; and 86.31 (5) be approved by the board before the foreign-trained 86.32 physical therapist begins the traineeship. 86.33 (c) A temporary permit is effective on the first day of a 86.34 traineeship and expires 90 days after the next examination for 86.35registrationlicensing given by the board following successful 86.36 completion of the traineeship or on the date on which the board, 87.1 after examination of the applicant, grants or denies the 87.2 applicant aregistrationlicense to practice, whichever occurs 87.3 first. 87.4 (d) A foreign-trained physical therapist must successfully 87.5 complete a traineeship to beregisteredlicensed as a physical 87.6 therapist under subdivision 1. The traineeship may be waived 87.7 for a foreign-trained physical therapist who is licensed or 87.8 otherwise registered in good standing in another state and has 87.9 successfully practiced physical therapy in that state under the 87.10 supervision of a licensed or registered physical therapist for 87.11 at least six months at a facility that meets the requirements 87.12 under paragraph (b), clauses (2) and (3). 87.13 (e) A temporary permit will not be issued to a 87.14 foreign-trained applicant who has been issued a temporary permit 87.15 for longer than six months in any other state. 87.16 Sec. 98. Minnesota Statutes 1996, section 148.72, 87.17 subdivision 1, is amended to read: 87.18 Subdivision 1. [ISSUANCE OFREGISTRATIONLICENSE WITHOUT 87.19 EXAMINATION.] On payment to the board of a fee in the amount set 87.20 by the board and on submission of a written application on forms 87.21 provided by the board, the board shall issueregistrationa 87.22 license without examination to a person who is licensed or 87.23 otherwise registered as a physical therapist by another state of 87.24 the United States of America, its possessions, or the District 87.25 of Columbia, if the board determines that the requirements for 87.26licensurelicensing or registration in the state, possession, or 87.27 District are equal to, or greater than, the requirementsset87.28forthin sections 148.65 to 148.78. 87.29 Sec. 99. Minnesota Statutes 1996, section 148.72, 87.30 subdivision 2, is amended to read: 87.31 Subd. 2. [CERTIFICATE OF REGISTRATIONLICENSE.] The board 87.32 may issue acertificate of registration to a physical therapist87.33 license without examination to an applicant who presents 87.34 evidence satisfactory to the board of having passed an 87.35 examination recognized by the board, if the board determines the 87.36 standards of the other state or foreign country aredetermined88.1by the board to be as high asequal to those of this state.At88.2the time of making anUpon application, the applicant shall pay 88.3 to the board a fee in the amount set by the board,. No portion 88.4 ofwhich shall be returnedthe fee is refundable. 88.5 Sec. 100. Minnesota Statutes 1996, section 148.72, 88.6 subdivision 4, is amended to read: 88.7 Subd. 4. [ISSUANCE OFREGISTRATIONLICENSE AFTER 88.8 EXAMINATION.] The board shall issue acertificate of88.9registrationlicense toeachan applicant who passes the 88.10 examinationin accordance withaccording to standards 88.11 established by the board and who is not disqualified to 88.12 receiveregistrationa license underthe provisions ofsection 88.13 148.75. 88.14 Sec. 101. Minnesota Statutes 1996, section 148.73, is 88.15 amended to read: 88.16 148.73 [RENEWALS.] 88.17 Everyregisteredlicensed physical therapist shall, during 88.18 each January, apply to the board for an extension 88.19 ofregistrationa license and pay a fee in the amount set by the 88.20 board. The extension ofregistrationthe license is contingent 88.21 upon demonstration that the continuing education requirements 88.22 set by the board under section 148.70 have been satisfied. 88.23 Sec. 102. Minnesota Statutes 1996, section 148.74, is 88.24 amended to read: 88.25 148.74 [RULES.] 88.26 The boardis authorized tomay adopt rulesas may be88.27necessaryneeded to carry outthe purposes ofsections 148.65 to 88.28 148.78. Thesecretarysecretary-treasurer of the board shall 88.29 keep a record of proceedings under these sections and a register 88.30 of all personsregisteredlicensed under it. The register shall 88.31 show the name, address, date and number ofregistrationthe 88.32 license, and the renewalthereofof the license. Any other 88.33 interested person in the state may obtain a copy ofsuchthe 88.34 list on request to the board uponpayment ofpaying an amountas88.35may befixed by the board, which. The amount shall not exceed 88.36 the cost of the listsofurnished. The board shall provide 89.1 blanks, books, certificates, and stationery and assistanceas is89.2 necessaryfor the transaction of theto transact business of the 89.3 boardand the physical therapy council hereunder, and. All 89.4 money received by the board under sections 148.65 to 148.78 89.5 shall be paid into the state treasury as provided for by law. 89.6 The board shall set by rule the amounts of the application fee 89.7 and the annualregistrationlicensing fee. The fees collected 89.8 by the board must be sufficient to cover the costs of 89.9 administering sections 148.65 to 148.78. 89.10 Sec. 103. Minnesota Statutes 1996, section 148.75, is 89.11 amended to read: 89.12 148.75 [CERTIFICATESLICENSES; DENIAL, SUSPENSION, 89.13 REVOCATION.] 89.14 (a) The state board ofmedical practicephysical therapy 89.15 may refuse to grantregistrationa license to any physical 89.16 therapist, or may suspend or revoke theregistrationlicense of 89.17 any physical therapist for any of the following grounds: 89.18(a)(1) using drugs or intoxicating liquors to an extent 89.19 which affects professional competence; 89.20(b) been convicted(2) conviction of a felony; 89.21(c)(3) conviction for violating any state or federal 89.22 narcotic law; 89.23(d) procuring, aiding or abetting a criminal abortion;89.24(e) registration(4) obtaining a license orattempted89.25registrationattempting to obtain a license by fraud or 89.26 deception; 89.27(f)(5) conduct unbecoming a personregisteredlicensed as 89.28 a physical therapist or conduct detrimental to the best 89.29 interests of the public; 89.30(g)(6) gross negligence in the practice of physical 89.31 therapy as a physical therapist; 89.32(h)(7) treating human ailments by physical therapy after 89.33 an initial 30-day period of patient admittance to treatment has 89.34 lapsed, except by the order or referral of a person licensed in 89.35 this statetoin the practice of medicine as defined in section 89.36 147.081, the practice of chiropractic as defined in section 90.1 148.01, the practice of podiatry as defined in section 153.01, 90.2 or the practice of dentistry as defined in section 150A.05 and 90.3 whose license is in good standing; or when a previous diagnosis 90.4 exists indicating an ongoing condition warranting physical 90.5 therapy treatment, subject to periodic review defined by board 90.6 ofmedical practicephysical therapy rule; 90.7(i)(8) treating human ailments, without referral, by 90.8 physical therapy treatment without first having practiced one 90.9 year under a physician's orders as verified by the board's 90.10 records; 90.11(j) failure(9) failing to consult with the patient's 90.12 health care provider who prescribed the physical therapy 90.13 treatment if the treatment is altered by the physical therapist 90.14 from the original written order. The provision does not include 90.15 written ordersspecifying ordersto "evaluate and treat"; 90.16(k)(10) treating human ailments other than by physical 90.17 therapy unless duly licensed or registered to do so under the 90.18 laws of this state; 90.19(l)(11) inappropriate delegation to a physical therapist 90.20 assistant or inappropriate task assignment to an aide or 90.21 inadequate supervision of either level of supportive personnel; 90.22(m) treating human ailments other than by performing90.23physical therapy procedures unless duly licensed or registered90.24to do so under the laws of this state;90.25(n)(12) practicing as a physical therapist performing 90.26 medical diagnosis, the practice of medicine as defined in 90.27 section 147.081, or the practice of chiropractic as defined in 90.28 section 148.01; 90.29(o) failure(13) failing to comply with a reasonable 90.30 request to obtain appropriate clearance for mental or physical 90.31 conditionswhichthat would interfere with the ability to 90.32 practice physical therapy, andwhichthat may be potentially 90.33 harmful to patients; 90.34(p)(14) dividing fees with, or paying or promising to pay 90.35 a commission or part of the fee to, any person who contacts the 90.36 physical therapist for consultation or sends patients to the 91.1 physical therapist for treatment; 91.2(q)(15) engaging in an incentive payment arrangement, 91.3 other than that prohibited by clause(p)(14), that tends to 91.4 promote physical therapyoverutilizationoveruse,wherebythat 91.5 allows the referring person or person who controls the 91.6 availability of physical therapy services to a clientprofitsto 91.7 profit unreasonably as a result of patient treatment; 91.8(r)(16) practicing physical therapy and failing to refer 91.9 to a licensed health care professionalanya patient whose 91.10 medical condition at the time of evaluation has been determined 91.11 by the physical therapist to be beyond the scope of practice of 91.12 a physical therapist; and 91.13(s) failure(17) failing to report to the board other 91.14registeredlicensed physical therapists who violate this section. 91.15 (b) Acertificate of registrationlicense to practice as a 91.16 physical therapist is suspended if (1) a guardian of the person 91.17 of the physical therapist is appointed by order of a court 91.18 pursuant to sections 525.54 to 525.61, for reasons other than 91.19 the minority of the physical therapist; or (2) the physical 91.20 therapist is committed by order of a court pursuant to chapter 91.21 253B. Thecertificate of registrationlicense remains suspended 91.22 until the physical therapist is restored to capacity by a court 91.23 and, upon petition by the physical therapist, the suspension is 91.24 terminated by the board ofmedical practicephysical therapy 91.25 after a hearing. 91.26 Sec. 104. Minnesota Statutes 1996, section 148.76, is 91.27 amended to read: 91.28 148.76 [PROHIBITED CONDUCT.] 91.29 Subdivision 1. No person shall: 91.30(a)(1) use the title of physical therapist without a 91.31certificate of registrationlicense as a physical therapist 91.32 issuedpursuant to the provisions ofunder sections 148.65 to 91.33 148.78; 91.34(b)(2) in any manner hold out as a physical therapist, or 91.35 use in connection with the person's name the words or letters 91.36 Physical Therapist, Physiotherapist, Physical Therapy 92.1 Technician, Registered Physical Therapist, Licensed Physical 92.2 Therapist, P.T., P.T.T., R.P.T., L.P.T., or any letters, words, 92.3 abbreviations or insignia indicating or implying that the person 92.4 is a physical therapist, without acertificate of92.5registrationlicense as a physical therapist issuedpursuant to92.6the provisions ofunder sections 148.65 to 148.78. To do so is 92.7 a gross misdemeanor; 92.8(c)(3) employ fraud or deception in applying for or 92.9 securing acertificate of registrationlicense as a physical 92.10 therapist. 92.11 Nothingcontainedin sections 148.65 to 148.78shall92.12prohibit anyprohibits a person licensed or registered in this 92.13 state under another law from carrying out the therapy or 92.14 practice for which the person is duly licensed or registered. 92.15 Subd. 2. No physical therapist shall: 92.16(a)(1) treat human ailments by physical therapy after an 92.17 initial 30-day period of patient admittance to treatment has 92.18 lapsed, except by the order or referral of a person licensed in 92.19 this state to practice medicine as defined in section 147.081, 92.20 the practice of chiropractic as defined in section 148.01, the 92.21 practice of podiatry as defined in section 153.01, or the 92.22 practice of dentistry as defined in section 150A.05 and whose 92.23 license is in good standing; or when a previous diagnosis exists 92.24 indicating an ongoing condition warranting physical therapy 92.25 treatment, subject to periodic review defined by board of 92.26medical practicephysical therapy rule; 92.27(b)(2) treat human ailments by physical therapy treatment 92.28 without first having practiced one year under a physician's 92.29 orders as verified by the board's records; 92.30(c) utilize(3) use any chiropractic manipulative technique 92.31 whose end is the chiropractic adjustment of an abnormal 92.32 articulation of the body; and 92.33(d)(4) treat human ailments other than by physical therapy 92.34 unless duly licensed or registered to do so under the laws of 92.35 this state. 92.36 Sec. 105. Minnesota Statutes 1996, section 148.78, is 93.1 amended to read: 93.2 148.78 [PROSECUTION, ALLEGATIONS.] 93.3 In the prosecution of any person for violation of sections 93.4 148.65 to 148.78 as specified in section 148.76, it shall not be 93.5 necessary to allege or prove want of a validcertificate of93.6registrationlicense as a physical therapist, but shall be a 93.7 matter of defense to be established by the accused. 93.8 Sec. 106. Minnesota Statutes 1996, section 214.01, 93.9 subdivision 2, is amended to read: 93.10 Subd. 2. [HEALTH-RELATED LICENSING BOARD.] "Health-related 93.11 licensing board" means the board of examiners of nursing home 93.12 administrators established pursuant to section 144A.19, the 93.13 board of medical practice created pursuant to section 147.01, 93.14 the board of nursing created pursuant to section 148.181, the 93.15 board of chiropractic examiners established pursuant to section 93.16 148.02, the board of optometry established pursuant to section 93.17 148.52, the board of physical therapy established pursuant to 93.18 section 148.67, the board of psychology established pursuant to 93.19 section 148.90, the board of social work pursuant to section 93.20 148B.19, the board of marriage and family therapy pursuant to 93.21 section 148B.30, the office of mental health practice 93.22 established pursuant to section 148B.61, the alcohol and drug 93.23 counselors licensing advisory council established pursuant to 93.24 section 148C.02, the board of dietetics and nutrition practice 93.25 established under section 148.622, the board of dentistry 93.26 established pursuant to section 150A.02, the board of pharmacy 93.27 established pursuant to section 151.02, the board of podiatric 93.28 medicine established pursuant to section 153.02, and the board 93.29 of veterinary medicine, established pursuant to section 156.01. 93.30 Sec. 107. Minnesota Statutes 1996, section 214.03, is 93.31 amended to read: 93.32 214.03 [STANDARDIZED TESTS.] 93.33 Subdivision 1. [STANDARDIZED TESTS USED.] All state 93.34 examining and licensing boards, other than the state board of 93.35 law examiners, the state board of professional responsibility or 93.36 any other board established by the supreme court to regulate the 94.1 practice of law and judicial functions, shall use national 94.2 standardized tests for the objective, nonpractical portion of 94.3 any examination given to prospective licensees to the extent 94.4 that such national standardized tests are appropriate, except 94.5 when the subject matter of the examination relates to the 94.6 application of Minnesota law to the profession or calling being 94.7 licensed. 94.8 Subd. 2. [HEALTH-RELATED BOARDS; SPECIAL ACCOUNT.] There 94.9 is established an account in the special revenue fund where a 94.10 health-related licensing board may deposit applicants' payments 94.11 for national or regional standardized tests. Money in the 94.12 account is appropriated to each board that has deposited monies 94.13 into the account, in an amount equal to the amount deposited by 94.14 the board, to pay for the use of national or regional 94.15 standardized tests. 94.16 Sec. 108. Minnesota Statutes 1997 Supplement, section 94.17 214.32, subdivision 1, is amended to read: 94.18 Subdivision 1. [MANAGEMENT.] (a) A health professionals 94.19 services program committee is established, consisting of one 94.20 person appointed by each participating board, with each 94.21 participating board having one vote. The committee shall 94.22 designate one board to provide administrative management of the 94.23 program, set the program budget and the pro rata share of 94.24 program expenses to be borne by each participating board, 94.25 provide guidance on the general operation of the program, 94.26 including hiring of program personnel, and ensure that the 94.27 program's direction is in accord with its authority. No more 94.28 than half plus one of the members of the committee may be of one 94.29 gender. If the participating boards change which board is 94.30 designated to provide administrative management of the program, 94.31 any appropriation remaining for the program shall transfer to 94.32 the newly designated board on the effective date of the change. 94.33 The participating boards must inform the appropriate legislative 94.34 committees and the commissioner of finance of any change in the 94.35 administrative management of the program, and the amount of any 94.36 appropriation transferred under this provision. 95.1 (b) The designated board, upon recommendation of the health 95.2 professional services program committee, shall hire the program 95.3 manager and employees and pay expenses of the program from funds 95.4 appropriated for that purpose. The designated board may apply 95.5 for grants to pay program expenses and may enter into contracts 95.6 on behalf of the program to carry out the purposes of the 95.7 program. The participating boards shall enter into written 95.8 agreements with the designated board. 95.9 (c) An advisory committee is established to advise the 95.10 program committee consisting of: 95.11 (1) one member appointed by each of the following: the 95.12 Minnesota Academy of Physician Assistants, the Minnesota Dental 95.13 Association, the Minnesota Chiropractic Association, the 95.14 Minnesota Licensed Practical Nurse Association, the Minnesota 95.15 Medical Association, the Minnesota Nurses Association, and the 95.16 Minnesota Podiatric Medicine Association; 95.17 (2) one member appointed by each of the professional 95.18 associations of the other professions regulated by a 95.19 participating board not specified in clause (1); and 95.20 (3) two public members, as defined by section 214.02. 95.21 Members of the advisory committee shall be appointed for two 95.22 years and members may be reappointed. 95.23 No more than half plus one of the members of the committee 95.24 may be of one gender. 95.25 The advisory committee expires June 30, 2001. 95.26 Sec. 109. Minnesota Statutes 1996, section 254A.17, 95.27 subdivision 1, is amended to read: 95.28 Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a) 95.29 The commissioner shall fund maternal and child health and social 95.30 service programs designed to improve the health and functioning 95.31 of children born to mothers using alcohol and controlled 95.32 substances. Comprehensive programs shall include immediate and 95.33 ongoing intervention, treatment, and coordination of medical, 95.34 educational, and social services through a child's preschool 95.35 years. Programs shall also include research and evaluation to 95.36 identify methods most effective in improving outcomes among this 96.1 high-risk population. The commissioner shall ensure that the 96.2 programs are available on a statewide basis to the extent 96.3 possible with available funds. 96.4 (b) The commissioner of human services shall develop models 96.5 for the treatment of children ages 6 to 12 who are in need of 96.6 chemical dependency treatment. The commissioner shall fund at 96.7 least two pilot projects with qualified providers to provide 96.8 nonresidential treatment for children in this age group. Model 96.9 programs must include a component to monitor and evaluate 96.10 treatment outcomes. 96.11 Sec. 110. Minnesota Statutes 1996, section 254A.17, is 96.12 amended by adding a subdivision to read: 96.13 Subd. 1b. [INTERVENTION AND ADVOCACY PROGRAM.] Within the 96.14 limits of money available, the commissioner of human services 96.15 shall fund voluntary hospital-based outreach programs targeted 96.16 at women who deliver children affected by prenatal alcohol or 96.17 drug use. The program shall help women obtain treatment, stay 96.18 in recovery, and plan any future pregnancies. An advocate shall 96.19 be assigned to each woman in the program to provide guidance and 96.20 advice with respect to treatment programs, child safety and 96.21 parenting, housing, family planning, and any other personal 96.22 issues that are barriers to remaining free of chemical 96.23 dependence. The commissioner shall develop an evaluation 96.24 component and provide centralized coordination of the evaluation 96.25 process. 96.26 Sec. 111. Minnesota Statutes 1997 Supplement, section 96.27 256B.692, subdivision 2, is amended to read: 96.28 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 96.29 Notwithstanding chapters 62D and 62N, a county that elects to 96.30 purchase medical assistance and general assistance medical care 96.31 in return for a fixed sum without regard to the frequency or 96.32 extent of services furnished to any particular enrollee is not 96.33 required to obtain a certificate of authority under chapter 62D 96.34 or 62N. A county that elects to purchase medical assistance and 96.35 general assistance medical care services under this section must 96.36 satisfy the commissioner of health that the requirements of 97.1 chapter 62D, applicable to health maintenance organizations, or 97.2 chapter 62N, applicable to community integrated service 97.3 networks, will be met. A county must also assure the 97.4 commissioner of health that the requirements ofsectionsections 97.5 62J.041; 62J.48; 62J.71 to 62J.73; all applicable provisions of 97.6 chapter 62Q, including sections 62Q.07; 62Q.075; 62Q.105; 97.7 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 97.8 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 97.9 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. All 97.10 enforcement and rulemaking powers available under chapters 62D, 97.11 62J, and 62N are hereby granted to the commissioner of health 97.12 with respect to counties that purchase medical assistance and 97.13 general assistance medical care services under this section. 97.14 Sec. 112. Minnesota Statutes 1996, section 268.92, 97.15 subdivision 4, is amended to read: 97.16 Subd. 4. [LEADCONTRACTORSSUPERVISOR OR CERTIFIED FIRM.] 97.17 (a) Eligible organizations and leadcontractorssupervisors or 97.18 certified firms may participate in the swab team program. An 97.19 eligible organization receiving a grant under this section must 97.20 assure that all participating leadcontractorssupervisors or 97.21 certified firms are licensed and that all swab team workers are 97.22 certified by the department of health under section 144.9505. 97.23 Eligible organizations and leadcontractorssupervisors or 97.24 certified firms may distinguish between interior and exterior 97.25 services in assigning duties and may participate in the program 97.26 by: 97.27 (1) providing on-the-job training for swab team workers; 97.28 (2) providing swab team services to meet the requirements 97.29 of sections 144.9503, subdivision 4, and 144.9504, subdivision 97.30 6; 97.31 (3) providing a removal and replacement component using 97.32 skilled craft workers under subdivision 7; 97.33 (4) providing lead testing according to subdivision 7a; 97.34 (5) providing lead dust cleaning supplies, as described in 97.35 section144.9503144.9507, subdivision54, 97.36 paragraph(b)(c), to residents; or 98.1 (6) having a swab team worker instruct residents and 98.2 property owners on appropriate lead control techniques, 98.3 including the lead-safe directives developed by the commissioner 98.4 of health. 98.5 (b) Participating leadcontractorssupervisors or certified 98.6 firms must: 98.7 (1) demonstrate proof of workers' compensation and general 98.8 liability insurance coverage; 98.9 (2) be knowledgeable about lead abatement requirements 98.10 established by the Department of Housing and Urban Development 98.11 and the Occupational Safety and Health Administration and lead 98.12 hazard reduction requirements and lead-safe directives of the 98.13 commissioner of health; 98.14 (3) demonstrate experience with on-the-job training 98.15 programs; 98.16 (4) demonstrate an ability to recruit employees from areas 98.17 at high risk for toxic lead exposure; and 98.18 (5) demonstrate experience in working with low-income 98.19 clients. 98.20 Sec. 113. Minnesota Statutes 1996, section 617.23, is 98.21 amended to read: 98.22 617.23 [INDECENT EXPOSURE; PENALTIES.] 98.23 (a) A person is guilty of a misdemeanor who in any public 98.24 place, or in any place where others are present: 98.25 (1) willfully and lewdly exposes the person's body, or the 98.26 private parts thereof; 98.27 (2) procures another to expose private parts; or 98.28 (3) engages in any open or gross lewdness or lascivious 98.29 behavior, or any public indecency other than behavior specified 98.30 in clause (1) or (2) or this clause. 98.31 (b) A person is guilty of a gross misdemeanor if: 98.32 (1) the person violates this section in the presence of a 98.33 minor under the age of 16; or 98.34 (2) the person violates this section after having been 98.35 previously convicted of violating this section, sections 609.342 98.36 to 609.3451, or a statute from another state in conformity with 99.1 any of those sections. 99.2 (c) A person is guilty of a felony and may be sentenced to 99.3 imprisonment for not more than five years or to payment of a 99.4 fine of not more than $10,000, or both, if the person violates 99.5 paragraph (b), clause (1), after having been previously 99.6 convicted of or adjudicated delinquent for violating paragraph 99.7 (b), clause (1); section 609.3451, subdivision 1, clause (2); or 99.8 a statute from another state in conformity with paragraph (b), 99.9 clause (1), or section 609.3451, subdivision 1, clause (2). 99.10 (d) Notwithstanding any other provision of law, a woman may 99.11 breast-feed in any public or private location where she is 99.12 otherwise authorized to be, irrespective of whether the nipple 99.13 of the mother's breast is uncovered during or incidental to the 99.14 breast-feeding. 99.15 Sec. 114. [COMPLAINT PROCESS STUDY.] 99.16 The complaint process work group established by the 99.17 commissioners of health and commerce as required under Laws 99.18 1997, chapter 237, section 20, shall continue to meet to develop 99.19 a complaint resolution process for health plan companies to make 99.20 available to enrollees as required under Minnesota Statutes, 99.21 sections 62Q.105, 62Q.11, and 62Q.30. The commissioners of 99.22 health and commerce shall submit a progress report to the 99.23 legislative commission on health care access by September 15, 99.24 1998, and shall submit final recommendations to the legislature, 99.25 including draft legislation on developing such a process by 99.26 November 15, 1998. The recommendations must also include, in 99.27 consultation with the work group, a permanent method of 99.28 financing the office of health care consumer assistance, 99.29 advocacy, and information. 99.30 Sec. 115. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.] 99.31 The commissioner of health shall convene an advisory task 99.32 force to study issues related to the building codes and safety 99.33 standards that residential hospice facilities must meet for 99.34 licensure and to make recommendations on changes to these 99.35 standards. Task force membership shall include representatives 99.36 of residential hospices, pediatric residential hospices, the 100.1 Minnesota hospice organization, the Minnesota department of 100.2 health, and other interested parties. The task force is 100.3 governed by Minnesota Statutes, section 15.059, subdivision 6. 100.4 The task force shall submit recommendations and any draft 100.5 legislation to the legislature by January 15, 1999. 100.6 Sec. 116. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.] 100.7 Until October 31, 1998, the board of dietetics and 100.8 nutrition practice may waive the requirements for licensure as a 100.9 dietitian established in Minnesota Statutes, section 148.624, 100.10 subdivision 1, clause (1), and may issue a license to an 100.11 applicant who meets the qualifications for licensure specified 100.12 in Minnesota Statutes, section 148.627, subdivision 1. A waiver 100.13 may be granted in cases in which unusual or extraordinary 100.14 job-related circumstances prevented an applicant from applying 100.15 for licensure during the transition period specified in 100.16 Minnesota Statutes, section 148.627, subdivision 1. An 100.17 applicant must request a waiver in writing and must explain the 100.18 circumstances that prevented the applicant from applying for 100.19 licensure during the transition period. 100.20 Sec. 117. [ADVICE AND RECOMMENDATIONS.] 100.21 The commissioners of health and commerce shall convene an 100.22 ad hoc advisory panel of selected representatives of health plan 100.23 companies, purchasers, and provider groups engaged in the 100.24 practice of health care in Minnesota, and interested 100.25 legislators. This advisory panel shall meet and assist the 100.26 commissioners in developing measures to prevent discrimination 100.27 against providers and provider groups in managed care in 100.28 Minnesota and clarify the requirements of Minnesota Statutes, 100.29 section 62Q.23, paragraph (c). Any such measures shall be 100.30 reported to the legislature prior to November 15, 1998. 100.31 Sec. 118. [AGREEMENT AUTHORIZED.] 100.32 In order to have a comprehensive program to protect the 100.33 public from radiation hazards, the governor may enter into an 100.34 agreement with the United States Nuclear Regulatory Commission, 100.35 under the Atomic Energy Act of 1954, United States Code, title 100.36 42, section 2021, paragraph (b). The agreement may allow the 101.1 state to assume regulation over nonpower plant radiation hazards 101.2 including certain by-product, source, and special nuclear 101.3 materials not sufficient to form a critical mass. The agreement 101.4 must be approved in law prior to being implemented. 101.5 Sec. 119. [HEALTH DEPARTMENT DESIGNATED LEAD.] 101.6 The department of health is designated as the lead agency 101.7 to pursue an agreement on behalf of the governor, and for any 101.8 assumption of specified licensing and regulatory authority from 101.9 the Nuclear Regulatory Commission under an agreement. The 101.10 department may enter into negotiations with the Nuclear 101.11 Regulatory Commission for that purpose. The commissioner of 101.12 health shall establish an advisory group to assist the 101.13 department in preparing the state to meet the requirements for 101.14 achieving an agreement. 101.15 Sec. 120. [RULES.] 101.16 The department of health may adopt rules for the state 101.17 assumption of regulation under an agreement under this act, 101.18 including the licensing and regulation of by-product, source, 101.19 and special nuclear material not sufficient to form a critical 101.20 mass. 101.21 Sec. 121. [TRANSITION.] 101.22 A person who, on the effective date of an agreement under 101.23 this act, possesses a Nuclear Regulatory Commission license that 101.24 is subject to the agreement shall be deemed to possess a similar 101.25 license issued by the department of health. Licenses shall 101.26 expire on the expiration date specified in the federal license. 101.27 Sec. 122. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.] 101.28 The commissioner of health shall conduct a study of the 101.29 incidence and prevalence of fetal alcohol syndrome in Minnesota. 101.30 The commissioner shall not collect individually identifiable 101.31 data for this study. 101.32 Sec. 123. [INITIAL APPOINTMENTS TO BOARD.] 101.33 Notwithstanding Minnesota Statutes, section 148.67, the 101.34 first physical therapist members appointed to the board may be 101.35 registered physical therapists. 101.36 Sec. 124. [SUNSET.] 102.1 An agreement entered into before August 2, 2002, shall 102.2 remain in effect until terminated or suspended under the Atomic 102.3 Energy Act of 1954, United States Code, title 42, section 2021, 102.4 paragraph (j). The governor may not enter into an initial 102.5 agreement with the Nuclear Regulatory Commission after August 1, 102.6 2002. If an agreement is not entered into, any rules adopted 102.7 under this act are repealed on that date. 102.8 Sec. 125. [REPEALER.] 102.9 Minnesota Statutes 1996, sections 144.491; 144.9501, 102.10 subdivisions 12, 14, and 16; and 144.9503, subdivisions 5, 8, 102.11 and 9, are repealed. 102.12 Sec. 126. [EFFECTIVE DATES.] 102.13 Sections 24 to 38, 40 to 59, 61 to 70, 107 (214.03), 108 102.14 (214.32, subdivision 1), 116 (temporary licensure), 117 (advice 102.15 and recommendations), and 125 (Repealer) are effective the day 102.16 following final enactment. 102.17 Sections 1 and 7 to 10 are effective January 1, 1999, and 102.18 apply to coverage issued, renewed, or continued as defined in 102.19 section 60A.02, subdivision 2a, on or after that date. 102.20 ARTICLE 3 102.21 LONG-TERM CARE 102.22 Section 1. Minnesota Statutes 1996, section 144A.04, 102.23 subdivision 5, is amended to read: 102.24 Subd. 5. [ADMINISTRATORS.] Except as otherwise provided by 102.25 this subdivision, a nursing home must have a full time licensed 102.26 nursing home administrator serving the facility. In any nursing 102.27 home of less than2531 beds, the director of nursing services 102.28 may also serve as the licensed nursing home administrator. Two 102.29 nursing homes under common ownership having a total of 150 beds 102.30 or less and located within 75 miles of each other may share the 102.31 services of a licensed administrator if the administrator 102.32 divides full-time work week between the two facilities in 102.33 proportion to the number of beds in each facility. Every 102.34 nursing home shall have a person-in-charge on the premises at 102.35 all times in the absence of the licensed administrator. The 102.36 name of the person in charge must be posted in a conspicuous 103.1 place in the facility. The commissioner of health shall by rule 103.2 promulgate minimum education and experience requirements for 103.3 persons-in-charge, and may promulgate rules specifying the times 103.4 of day during which a licensed administrator must be on the 103.5 nursing home's premises. In the absence of rules adopted by the 103.6 commissioner governing the division of an administrator's time 103.7 between two nursing homes, the administrator shall designate and 103.8 post the times the administrator will be on site in each home on 103.9 a regular basis. A nursing home may employ as its administrator 103.10 the administrator of a hospital licensed pursuant to sections 103.11 144.50 to 144.56 if the individual is licensed as a nursing home 103.12 administrator pursuant to section 144A.20 and the nursing home 103.13 and hospital have a combined total of 150 beds or less and are 103.14 located within one mile of each other. A nonproprietary 103.15 retirement home having fewer than 15 licensed nursing home beds 103.16 may share the services of a licensed administrator with a 103.17 nonproprietary nursing home, having fewer than 150 licensed 103.18 nursing home beds, that is located within 25 miles of the 103.19 retirement home. A nursing home which is located in a facility 103.20 licensed as a hospital pursuant to sections 144.50 to 144.56, 103.21 may employ as its administrator the administrator of the 103.22 hospital if the individual meets minimum education and long term 103.23 care experience criteria set by rule of the commissioner of 103.24 health. 103.25 Sec. 2. Minnesota Statutes 1997 Supplement, section 103.26 144A.071, subdivision 4a, is amended to read: 103.27 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 103.28 best interest of the state to ensure that nursing homes and 103.29 boarding care homes continue to meet the physical plant 103.30 licensing and certification requirements by permitting certain 103.31 construction projects. Facilities should be maintained in 103.32 condition to satisfy the physical and emotional needs of 103.33 residents while allowing the state to maintain control over 103.34 nursing home expenditure growth. 103.35 The commissioner of health in coordination with the 103.36 commissioner of human services, may approve the renovation, 104.1 replacement, upgrading, or relocation of a nursing home or 104.2 boarding care home, under the following conditions: 104.3 (a) to license or certify beds in a new facility 104.4 constructed to replace a facility or to make repairs in an 104.5 existing facility that was destroyed or damaged after June 30, 104.6 1987, by fire, lightning, or other hazard provided: 104.7 (i) destruction was not caused by the intentional act of or 104.8 at the direction of a controlling person of the facility; 104.9 (ii) at the time the facility was destroyed or damaged the 104.10 controlling persons of the facility maintained insurance 104.11 coverage for the type of hazard that occurred in an amount that 104.12 a reasonable person would conclude was adequate; 104.13 (iii) the net proceeds from an insurance settlement for the 104.14 damages caused by the hazard are applied to the cost of the new 104.15 facility or repairs; 104.16 (iv) the new facility is constructed on the same site as 104.17 the destroyed facility or on another site subject to the 104.18 restrictions in section 144A.073, subdivision 5; 104.19 (v) the number of licensed and certified beds in the new 104.20 facility does not exceed the number of licensed and certified 104.21 beds in the destroyed facility; and 104.22 (vi) the commissioner determines that the replacement beds 104.23 are needed to prevent an inadequate supply of beds. 104.24 Project construction costs incurred for repairs authorized under 104.25 this clause shall not be considered in the dollar threshold 104.26 amount defined in subdivision 2; 104.27 (b) to license or certify beds that are moved from one 104.28 location to another within a nursing home facility, provided the 104.29 total costs of remodeling performed in conjunction with the 104.30 relocation of beds does not exceed $750,000; 104.31 (c) to license or certify beds in a project recommended for 104.32 approval under section 144A.073; 104.33 (d) to license or certify beds that are moved from an 104.34 existing state nursing home to a different state facility, 104.35 provided there is no net increase in the number of state nursing 104.36 home beds; 105.1 (e) to certify and license as nursing home beds boarding 105.2 care beds in a certified boarding care facility if the beds meet 105.3 the standards for nursing home licensure, or in a facility that 105.4 was granted an exception to the moratorium under section 105.5 144A.073, and if the cost of any remodeling of the facility does 105.6 not exceed $750,000. If boarding care beds are licensed as 105.7 nursing home beds, the number of boarding care beds in the 105.8 facility must not increase beyond the number remaining at the 105.9 time of the upgrade in licensure. The provisions contained in 105.10 section 144A.073 regarding the upgrading of the facilities do 105.11 not apply to facilities that satisfy these requirements; 105.12 (f) to license and certify up to 40 beds transferred from 105.13 an existing facility owned and operated by the Amherst H. Wilder 105.14 Foundation in the city of St. Paul to a new unit at the same 105.15 location as the existing facility that will serve persons with 105.16 Alzheimer's disease and other related disorders. The transfer 105.17 of beds may occur gradually or in stages, provided the total 105.18 number of beds transferred does not exceed 40. At the time of 105.19 licensure and certification of a bed or beds in the new unit, 105.20 the commissioner of health shall delicense and decertify the 105.21 same number of beds in the existing facility. As a condition of 105.22 receiving a license or certification under this clause, the 105.23 facility must make a written commitment to the commissioner of 105.24 human services that it will not seek to receive an increase in 105.25 its property-related payment rate as a result of the transfers 105.26 allowed under this paragraph; 105.27 (g) to license and certify nursing home beds to replace 105.28 currently licensed and certified boarding care beds which may be 105.29 located either in a remodeled or renovated boarding care or 105.30 nursing home facility or in a remodeled, renovated, newly 105.31 constructed, or replacement nursing home facility within the 105.32 identifiable complex of health care facilities in which the 105.33 currently licensed boarding care beds are presently located, 105.34 provided that the number of boarding care beds in the facility 105.35 or complex are decreased by the number to be licensed as nursing 105.36 home beds and further provided that, if the total costs of new 106.1 construction, replacement, remodeling, or renovation exceed ten 106.2 percent of the appraised value of the facility or $200,000, 106.3 whichever is less, the facility makes a written commitment to 106.4 the commissioner of human services that it will not seek to 106.5 receive an increase in its property-related payment rate by 106.6 reason of the new construction, replacement, remodeling, or 106.7 renovation. The provisions contained in section 144A.073 106.8 regarding the upgrading of facilities do not apply to facilities 106.9 that satisfy these requirements; 106.10 (h) to license as a nursing home and certify as a nursing 106.11 facility a facility that is licensed as a boarding care facility 106.12 but not certified under the medical assistance program, but only 106.13 if the commissioner of human services certifies to the 106.14 commissioner of health that licensing the facility as a nursing 106.15 home and certifying the facility as a nursing facility will 106.16 result in a net annual savings to the state general fund of 106.17 $200,000 or more; 106.18 (i) to certify, after September 30, 1992, and prior to July 106.19 1, 1993, existing nursing home beds in a facility that was 106.20 licensed and in operation prior to January 1, 1992; 106.21 (j) to license and certify new nursing home beds to replace 106.22 beds in a facilitycondemnedacquired by the Minneapolis 106.23 community development agency as part ofan economic106.24 redevelopmentplanactivities in a city of the first class, 106.25 provided the new facility is located withinone milethree miles 106.26 of the site of the old facility. Operating and property costs 106.27 for the new facility must be determined and allowed 106.28 underexisting reimbursement rulessection 256B.431 or 256B.434; 106.29 (k) to license and certify up to 20 new nursing home beds 106.30 in a community-operated hospital and attached convalescent and 106.31 nursing care facility with 40 beds on April 21, 1991, that 106.32 suspended operation of the hospital in April 1986. The 106.33 commissioner of human services shall provide the facility with 106.34 the same per diem property-related payment rate for each 106.35 additional licensed and certified bed as it will receive for its 106.36 existing 40 beds; 107.1 (l) to license or certify beds in renovation, replacement, 107.2 or upgrading projects as defined in section 144A.073, 107.3 subdivision 1, so long as the cumulative total costs of the 107.4 facility's remodeling projects do not exceed $750,000; 107.5 (m) to license and certify beds that are moved from one 107.6 location to another for the purposes of converting up to five 107.7 four-bed wards to single or double occupancy rooms in a nursing 107.8 home that, as of January 1, 1993, was county-owned and had a 107.9 licensed capacity of 115 beds; 107.10 (n) to allow a facility that on April 16, 1993, was a 107.11 106-bed licensed and certified nursing facility located in 107.12 Minneapolis to layaway all of its licensed and certified nursing 107.13 home beds. These beds may be relicensed and recertified in a 107.14 newly-constructed teaching nursing home facility affiliated with 107.15 a teaching hospital upon approval by the legislature. The 107.16 proposal must be developed in consultation with the interagency 107.17 committee on long-term care planning. The beds on layaway 107.18 status shall have the same status as voluntarily delicensed and 107.19 decertified beds, except that beds on layaway status remain 107.20 subject to the surcharge in section 256.9657. This layaway 107.21 provision expires July 1, 1998; 107.22 (o) to allow a project which will be completed in 107.23 conjunction with an approved moratorium exception project for a 107.24 nursing home in southern Cass county and which is directly 107.25 related to that portion of the facility that must be repaired, 107.26 renovated, or replaced, to correct an emergency plumbing problem 107.27 for which a state correction order has been issued and which 107.28 must be corrected by August 31, 1993; 107.29 (p) to allow a facility that on April 16, 1993, was a 107.30 368-bed licensed and certified nursing facility located in 107.31 Minneapolis to layaway, upon 30 days prior written notice to the 107.32 commissioner, up to 30 of the facility's licensed and certified 107.33 beds by converting three-bed wards to single or double 107.34 occupancy. Beds on layaway status shall have the same status as 107.35 voluntarily delicensed and decertified beds except that beds on 107.36 layaway status remain subject to the surcharge in section 108.1 256.9657, remain subject to the license application and renewal 108.2 fees under section 144A.07 and shall be subject to a $100 per 108.3 bed reactivation fee. In addition, at any time within three 108.4 years of the effective date of the layaway, the beds on layaway 108.5 status may be: 108.6 (1) relicensed and recertified upon relocation and 108.7 reactivation of some or all of the beds to an existing licensed 108.8 and certified facility or facilities located in Pine River, 108.9 Brainerd, or International Falls; provided that the total 108.10 project construction costs related to the relocation of beds 108.11 from layaway status for any facility receiving relocated beds 108.12 may not exceed the dollar threshold provided in subdivision 2 108.13 unless the construction project has been approved through the 108.14 moratorium exception process under section 144A.073; 108.15 (2) relicensed and recertified, upon reactivation of some 108.16 or all of the beds within the facility which placed the beds in 108.17 layaway status, if the commissioner has determined a need for 108.18 the reactivation of the beds on layaway status. 108.19 The property-related payment rate of a facility placing 108.20 beds on layaway status must be adjusted by the incremental 108.21 change in its rental per diem after recalculating the rental per 108.22 diem as provided in section 256B.431, subdivision 3a, paragraph 108.23 (d). The property-related payment rate for a facility 108.24 relicensing and recertifying beds from layaway status must be 108.25 adjusted by the incremental change in its rental per diem after 108.26 recalculating its rental per diem using the number of beds after 108.27 the relicensing to establish the facility's capacity day 108.28 divisor, which shall be effective the first day of the month 108.29 following the month in which the relicensing and recertification 108.30 became effective. Any beds remaining on layaway status more 108.31 than three years after the date the layaway status became 108.32 effective must be removed from layaway status and immediately 108.33 delicensed and decertified; 108.34 (q) to license and certify beds in a renovation and 108.35 remodeling project to convert 12 four-bed wards into 24 two-bed 108.36 rooms, expand space, and add improvements in a nursing home 109.1 that, as of January 1, 1994, met the following conditions: the 109.2 nursing home was located in Ramsey county; had a licensed 109.3 capacity of 154 beds; and had been ranked among the top 15 109.4 applicants by the 1993 moratorium exceptions advisory review 109.5 panel. The total project construction cost estimate for this 109.6 project must not exceed the cost estimate submitted in 109.7 connection with the 1993 moratorium exception process; 109.8 (r) to license and certify up to 117 beds that are 109.9 relocated from a licensed and certified 138-bed nursing facility 109.10 located in St. Paul to a hospital with 130 licensed hospital 109.11 beds located in South St. Paul, provided that the nursing 109.12 facility and hospital are owned by the same or a related 109.13 organization and that prior to the date the relocation is 109.14 completed the hospital ceases operation of its inpatient 109.15 hospital services at that hospital. After relocation, the 109.16 nursing facility's status under section 256B.431, subdivision 109.17 2j, shall be the same as it was prior to relocation. The 109.18 nursing facility's property-related payment rate resulting from 109.19 the project authorized in this paragraph shall become effective 109.20 no earlier than April 1, 1996. For purposes of calculating the 109.21 incremental change in the facility's rental per diem resulting 109.22 from this project, the allowable appraised value of the nursing 109.23 facility portion of the existing health care facility physical 109.24 plant prior to the renovation and relocation may not exceed 109.25 $2,490,000; 109.26 (s) to license and certify two beds in a facility to 109.27 replace beds that were voluntarily delicensed and decertified on 109.28 June 28, 1991; 109.29 (t) to allow 16 licensed and certified beds located on July 109.30 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 109.31 facility in Minneapolis, notwithstanding the licensure and 109.32 certification after July 1, 1995, of the Minneapolis facility as 109.33 a 147-bed nursing home facility after completion of a 109.34 construction project approved in 1993 under section 144A.073, to 109.35 be laid away upon 30 days' prior written notice to the 109.36 commissioner. Beds on layaway status shall have the same status 110.1 as voluntarily delicensed or decertified beds except that they 110.2 shall remain subject to the surcharge in section 256.9657. The 110.3 16 beds on layaway status may be relicensed as nursing home beds 110.4 and recertified at any time within five years of the effective 110.5 date of the layaway upon relocation of some or all of the beds 110.6 to a licensed and certified facility located in Watertown, 110.7 provided that the total project construction costs related to 110.8 the relocation of beds from layaway status for the Watertown 110.9 facility may not exceed the dollar threshold provided in 110.10 subdivision 2 unless the construction project has been approved 110.11 through the moratorium exception process under section 144A.073. 110.12 The property-related payment rate of the facility placing 110.13 beds on layaway status must be adjusted by the incremental 110.14 change in its rental per diem after recalculating the rental per 110.15 diem as provided in section 256B.431, subdivision 3a, paragraph 110.16 (d). The property-related payment rate for the facility 110.17 relicensing and recertifying beds from layaway status must be 110.18 adjusted by the incremental change in its rental per diem after 110.19 recalculating its rental per diem using the number of beds after 110.20 the relicensing to establish the facility's capacity day 110.21 divisor, which shall be effective the first day of the month 110.22 following the month in which the relicensing and recertification 110.23 became effective. Any beds remaining on layaway status more 110.24 than five years after the date the layaway status became 110.25 effective must be removed from layaway status and immediately 110.26 delicensed and decertified; 110.27 (u) to license and certify beds that are moved within an 110.28 existing area of a facility or to a newly constructed addition 110.29 which is built for the purpose of eliminating three- and 110.30 four-bed rooms and adding space for dining, lounge areas, 110.31 bathing rooms, and ancillary service areas in a nursing home 110.32 that, as of January 1, 1995, was located in Fridley and had a 110.33 licensed capacity of 129 beds; 110.34 (v) to relocate 36 beds in Crow Wing county and four beds 110.35 from Hennepin county to a 160-bed facility in Crow Wing county, 110.36 provided all the affected beds are under common ownership; 111.1 (w) to license and certify a total replacement project of 111.2 up to 49 beds located in Norman county that are relocated from a 111.3 nursing home destroyed by flood and whose residents were 111.4 relocated to other nursing homes. The operating cost payment 111.5 rates for the new nursing facility shall be determined based on 111.6 the interim and settle-up payment provisions of Minnesota Rules, 111.7 part 9549.0057, and the reimbursement provisions of section 111.8 256B.431, except that subdivision 26, paragraphs (a) and (b), 111.9 shall not apply until the second rate year after the settle-up 111.10 cost report is filed. Property-related reimbursement rates 111.11 shall be determined under section 256B.431, taking into account 111.12 any federal or state flood-related loans or grants provided to 111.13 the facility; 111.14 (x) to license and certify a total replacement project of 111.15 up to 129 beds located in Polk county that are relocated from a 111.16 nursing home destroyed by flood and whose residents were 111.17 relocated to other nursing homes. The operating cost payment 111.18 rates for the new nursing facility shall be determined based on 111.19 the interim and settle-up payment provisions of Minnesota Rules, 111.20 part 9549.0057, and the reimbursement provisions of section 111.21 256B.431, except that subdivision 26, paragraphs (a) and (b), 111.22 shall not apply until the second rate year after the settle-up 111.23 cost report is filed. Property-related reimbursement rates 111.24 shall be determined under section 256B.431, taking into account 111.25 any federal or state flood-related loans or grants provided to 111.26 the facility;or111.27 (y) to license and certify beds in a renovation and 111.28 remodeling project to convert 13 three-bed wards into 13 two-bed 111.29 rooms and 13 single-bed rooms, expand space, and add 111.30 improvements in a nursing home that, as of January 1, 1994, met 111.31 the following conditions: the nursing home was located in 111.32 Ramsey county, was not owned by a hospital corporation, had a 111.33 licensed capacity of 64 beds, and had been ranked among the top 111.34 15 applicants by the 1993 moratorium exceptions advisory review 111.35 panel. The total project construction cost estimate for this 111.36 project must not exceed the cost estimate submitted in 112.1 connection with the 1993 moratorium exception process.; 112.2 (z) to allow a 285-bed nursing facility in St. Paul that 112.3 provides for the special dietary needs of its residents under 112.4 the requirements in section 31.651 to undertake a construction 112.5 project that will improve some of the existing structures, 112.6 create new buildings, and reduce the licensed and certified beds 112.7 to 150; or 112.8 (aa) to allow the commissioner of human services to license 112.9 an additional 36 beds to provide residential services for the 112.10 physically handicapped under Minnesota Rules, parts 9570.2000 to 112.11 9570.3400, in a 198-bed nursing home located in Red Wing, 112.12 provided that the total number of licensed and certified beds at 112.13 the facility does not increase. 112.14 Sec. 3. Minnesota Statutes 1996, section 144A.09, 112.15 subdivision 1, is amended to read: 112.16 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule112.17establishedSections 144A.04, subdivision 5, and 144A.18 to 112.18 144A.27, and rules adopted under sections 144A.01 to 144A.16 112.19 other than a rule relating to sanitation and safety of premises, 112.20 to cleanliness of operation, or to physical equipmentshalldo 112.21 not apply to a nursing home conducted by and for the adherents 112.22 of any recognized church or religious denomination for the 112.23 purpose of providing care and treatment for those who select and 112.24 depend upon spiritual means through prayer alone, in lieu of 112.25 medical care, for healing. 112.26 Sec. 4. Minnesota Statutes 1997 Supplement, section 112.27 256B.0951, is amended by adding a subdivision to read: 112.28 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 112.29 exempt residents of intermediate care facilities for persons 112.30 with mental retardation (ICFs/MR) who participate in the 112.31 three-year quality assurance pilot project established in 112.32 section 256B.095 from the requirements of Minnesota Rules, 112.33 chapter 4665, upon approval by the federal government of a 112.34 waiver of federal certification requirements for ICFs/MR. The 112.35 commissioners of health and human services shall apply for any 112.36 necessary waivers as soon as practicable and shall submit the 113.1 concept paper to the federal government by June 1, 1998. 113.2 Sec. 5. Minnesota Statutes 1996, section 256B.431, 113.3 subdivision 2i, is amended to read: 113.4 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 113.5 [OTHER OPERATING COST LIMITS.] For the rate year beginning July 113.6 1, 1988, the commissioner shall increase the other operating 113.7 cost limits established in Minnesota Rules, part 9549.0055, 113.8 subpart 2, item E, to 110 percent of the median of the array of 113.9 allowable historical other operating cost per diems and index 113.10 these limits as in Minnesota Rules, part 9549.0056, subparts 3 113.11 and 4. The limits must be established in accordance with 113.12 subdivision 2b, paragraph (d). For rate years beginning on or 113.13 after July 1, 1989, the adjusted other operating cost limits 113.14 must be indexed as in Minnesota Rules, part 9549.0056, subparts 113.15 3 and 4. For the rate period beginning October 1, 1992, and for 113.16 rate years beginning after June 30, 1993, the amount of the 113.17 surcharge under section 256.9657, subdivision 1, shall be 113.18 included in the plant operations and maintenance operating cost 113.19 category. The surcharge shall be an allowable cost for the 113.20 purpose of establishing the payment rate. 113.21 (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate 113.22 year beginning July 1, 1988, the commissioner shall increase the 113.23 care-related operating cost limits established in Minnesota 113.24 Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 113.25 of the median of the array of the allowable historical case mix 113.26 operating cost standardized per diems and the allowable 113.27 historical other care-related operating cost per diems and index 113.28 those limits as in Minnesota Rules, part 9549.0056, subparts 1 113.29 and 2. The limits must be established in accordance with 113.30 subdivision 2b, paragraph (d). For rate years beginning on or 113.31 after July 1, 1989, the adjusted care-related limits must be 113.32 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 113.33 (c) [SALARY ADJUSTMENT PER DIEM.]For the rate period113.34 EffectiveOctoberJuly 1,19881998, to June 30,1990113.35 2000, the commissioner shalladd the appropriatemake available 113.36 the salary adjustment per diem calculated in clause (1) or (2) 114.1 to the total operating cost payment rate of each nursing 114.2 facility reimbursed under this section or section 256B.434. The 114.3 salary adjustment per diem for each nursing facility must be 114.4 determined as follows: 114.5 (1) For each nursing facility that reports salaries for 114.6 registered nurses, licensed practical nurses, and aides, 114.7 orderlies and attendants separately, the commissioner shall 114.8 determine the salary adjustment per diem by multiplying the 114.9 total salaries, payroll taxes, and fringe benefits allowed in 114.10 each operating cost category, except management fees and 114.11 administrator and central office salaries and the related 114.12 payroll taxes and fringe benefits, by3.54.25 percent and then 114.13 dividing the resulting amount by the nursing facility's actual 114.14 resident days; and. 114.15 (2) For each nursing facility that does not report salaries 114.16 for registered nurses, licensed practical nurses, aides, 114.17 orderlies, and attendants separately, the salary adjustment per 114.18 diem is the weighted average salary adjustment per diem increase 114.19 determined under clause (1). 114.20Each nursing facility that receives a salary adjustment per114.21diem pursuant to this subdivision shall adjust nursing facility114.22employee salaries by a minimum of the amount determined in114.23clause (1) or (2). The commissioner shall review allowable114.24salary costs, including payroll taxes and fringe benefits, for114.25the reporting year ending September 30, 1989, to determine114.26whether or not each nursing facility complied with this114.27requirement. The commissioner shall report the extent to which114.28each nursing facility complied with the legislative commission114.29on long-term care by August 1, 1990.114.30 (3) A nursing facility may apply for the salary adjustment 114.31 per diem calculated under clauses (1) and (2). The application 114.32 must be made to the commissioner and contain a plan by which the 114.33 nursing facility will distribute the salary adjustment to 114.34 employees of the nursing facility. For nursing facilities in 114.35 which the employees are represented by an exclusive bargaining 114.36 representative, an agreement negotiated and agreed to by the 115.1 employer and the exclusive bargaining representative, after July 115.2 1, 1998, may constitute the plan for the salary distribution. 115.3 The commissioner shall review the plan to ensure that the salary 115.4 adjustment per diem is used solely to increase the compensation 115.5 of nursing home facility employees. 115.6 (4) Additional costs incurred by nursing facilities as a 115.7 result of this salary adjustment are not allowable costs for 115.8 purposes of the September 30, 1998, cost report. 115.9 (d) [NEW BASE YEAR.] The commissioner shall establish new 115.10 base years for both the reporting year ending September 30, 115.11 1989, and the reporting year ending September 30, 1990. In 115.12 establishing new base years, the commissioner must take into 115.13 account: 115.14 (1) statutory changes made in geographic groups; 115.15 (2) redefinitions of cost categories; and 115.16 (3) reclassification, pass-through, or exemption of certain 115.17 costs such as public employee retirement act contributions. 115.18 (e) [NEW BASE YEAR.] The commissioner shall establish a 115.19 new base year for the reporting years ending September 30, 1991, 115.20 and September 30, 1992. In establishing a new base year, the 115.21 commissioner must take into account: 115.22 (1) statutory changes made in geographic groups; 115.23 (2) redefinitions of cost categories; and 115.24 (3) reclassification, pass-through, or exemption of certain 115.25 costs. 115.26 Sec. 6. Minnesota Statutes 1996, section 256B.431, is 115.27 amended by adding a subdivision to read: 115.28 Subd. 2s. [NONALLOWABLE COST.] Costs incurred for any 115.29 activities which are directed at or are intended to influence or 115.30 dissuade employees in the exercise of their legal rights to 115.31 freely engage in the process of selecting an exclusive 115.32 representative for the purpose of collective bargaining with 115.33 their employer shall not be allowable for purposes of setting 115.34 payment rates. 115.35 Sec. 7. Minnesota Statutes 1997 Supplement, section 115.36 256B.431, subdivision 3f, is amended to read: 116.1 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) [ 116.2 INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 116.3 1988, the replacement-cost-new per bed limit must be $32,571 per 116.4 licensed bed in multiple bedrooms and $48,857 per licensed bed 116.5 in a single bedroom. For the rate year beginning July 1, 1989, 116.6 the replacement-cost-new per bed limit for a single bedroom must 116.7 be $49,907 adjusted according to Minnesota Rules, part 116.8 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 116.9 1990, the replacement-cost-new per bed limits must be adjusted 116.10 annually as specified in Minnesota Rules, part 9549.0060, 116.11 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 116.12 replacement-cost-new per bed limits will be adjusted annually as 116.13 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 116.14 subitem (1), except that the index utilized will be the Bureau 116.15 of the Census: Composite fixed-weighted price index as 116.16 published in the C30 Report, Value of New Construction Put in 116.17 Place. 116.18 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 116.19 1988, the commissioner shall increase the rental factor as 116.20 established in Minnesota Rules, part 9549.0060, subpart 8, item 116.21 A, by 6.2 percent rounded to the nearest 100th percent for the 116.22 purpose of reimbursing nursing facilities for soft costs and 116.23 entrepreneurial profits not included in the cost valuation 116.24 services used by the state's contracted appraisers. For rate 116.25 years beginning on or after July 1, 1989, the rental factor is 116.26 the amount determined under this paragraph for the rate year 116.27 beginning July 1, 1988. 116.28 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 116.29 after July 1, 1988, in order to determine property-related 116.30 payment rates under Minnesota Rules, part 9549.0060, for all 116.31 nursing facilities except those whose average length of stay in 116.32 a skilled level of care within a nursing facility is 180 days or 116.33 less, the commissioner shall use 95 percent of capacity days. 116.34 For a nursing facility whose average length of stay in a skilled 116.35 level of care within a nursing facility is 180 days or less, the 116.36 commissioner shall use the greater of resident days or 80 117.1 percent of capacity days but in no event shall the divisor 117.2 exceed 95 percent of capacity days. 117.3 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 117.4 July 1, 1988, and July 1, 1989, the commissioner shall add ten 117.5 cents per resident per day to each nursing facility's 117.6 property-related payment rate. The ten-cent property-related 117.7 payment rate increase is not cumulative from rate year to rate 117.8 year. For the rate year beginning July 1, 1990, the 117.9 commissioner shall increase each nursing facility's equipment 117.10 allowance as established in Minnesota Rules, part 9549.0060, 117.11 subpart 10, by ten cents per resident per day. For rate years 117.12 beginning on or after July 1, 1991, the adjusted equipment 117.13 allowance must be adjusted annually for inflation as in 117.14 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 117.15 rate period beginning October 1, 1992, the equipment allowance 117.16 for each nursing facility shall be increased by 28 percent. For 117.17 rate years beginning after June 30, 1993, the allowance must be 117.18 adjusted annually for inflation. 117.19 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 117.20 INTEREST EXPENSE.] For rate years beginning on or after July 1, 117.21 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 117.22 not apply to outstanding related organization debt incurred 117.23 prior to May 23, 1983, provided that the debt was an allowable 117.24 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 117.25 debt is subject to repayment through annual principal payments, 117.26 and the nursing facility demonstrates to the commissioner's 117.27 satisfaction that the interest rate on the debt was less than 117.28 market interest rates for similar arms-length transactions at 117.29 the time the debt was incurred. If the debt was incurred due to 117.30 a sale between family members, the nursing facility must also 117.31 demonstrate that the seller no longer participates in the 117.32 management or operation of the nursing facility. Debts meeting 117.33 the conditions of this paragraph are subject to all other 117.34 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 117.35 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 117.36 WITH OPERATING LEASES.] For rate years beginning on or after 118.1 July 1, 1990, a nursing facility with operating lease costs 118.2 incurred for the nursing facility's buildings shall receive its 118.3 building capital allowance computed in accordance with Minnesota 118.4 Rules, part 9549.0060, subpart 8. If an operating lease 118.5 provides that the lessee's rent is adjusted to recognize 118.6 improvements made by the lessor and related debt, the costs for 118.7 capital improvements and related debt shall be allowed in the 118.8 computation of the lessee's building capital allowance, provided 118.9 that reimbursement for these costs under an operating lease 118.10 shall not exceed the rate otherwise paid. 118.11 Sec. 8. Minnesota Statutes 1996, section 256B.431, 118.12 subdivision 11, is amended to read: 118.13 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 118.14 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 118.15 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 118.16 the rate year beginning July 1, 1990, a nursing facility leased 118.17 prior to January 1, 1986, and currently subject to adverse 118.18 licensure action under section 144A.04, subdivision 4, paragraph 118.19 (a), or section 144A.11, subdivision 2, and whose ownership 118.20 changes prior to July 1, 1990, shall be allowed a 118.21 property-related payment equal to the lesser of its current 118.22 lease obligation divided by its capacity days as determined in 118.23 Minnesota Rules, part 9549.0060, subpart 11, as modified by 118.24 subdivision 3f, paragraph (c), or the frozen property-related 118.25 payment rate in effect for the rate year beginning July 1, 118.26 1989. For rate years beginning on or after July 1, 1991, the 118.27 property-related payment rate shall be its rental rate computed 118.28 using the previous owner's allowable principal and interest 118.29 expense as allowed by the department prior to that prior owner's 118.30 sale and lease-back transaction of December 1985. 118.31 (b) Notwithstanding other provisions of applicable law, a 118.32 nursing facility licensed for 122 beds on January 1, 1998, and 118.33 located in Columbia Heights shall have its property-related 118.34 payment rate set under this subdivision. The commissioner shall 118.35 make a rate adjustment by adding $2.41 to the facility's July 1, 118.36 1997, property-related payment rate. The adjusted 119.1 property-related payment rate shall be effective for rate years 119.2 beginning on or after July 1, 1998. The adjustment in this 119.3 paragraph shall remain in effect so long as the facility's rates 119.4 are set under this section. If the facility participates in the 119.5 alternative payment system under section 256B.434, the 119.6 adjustment in this paragraph shall be included in the facility's 119.7 contract payment rate. If historical rates or property costs 119.8 recognized under this section become the basis for future 119.9 medical assistance payments to the facility under a managed 119.10 care, capitation, or other alternative payment system, the 119.11 adjustment in this paragraph shall be included in the 119.12 computation of the facility's payments. 119.13 Sec. 9. Minnesota Statutes 1997 Supplement, section 119.14 256B.431, subdivision 26, is amended to read: 119.15 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 119.16 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 119.17 changes in paragraphs (a) to (f) shall apply in the sequence 119.18 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 119.19 this section, beginning July 1, 1997. 119.20 (a) For rate years beginning on or after July 1, 1997, the 119.21 commissioner shall limit a nursing facility's allowable 119.22 operating per diem for each case mix category for each rate year. 119.23 The commissioner shall group nursing facilities into two groups, 119.24 freestanding and nonfreestanding, within each geographic group, 119.25 using their operating cost per diem for the case mix A 119.26 classification. A nonfreestanding nursing facility is a nursing 119.27 facility whose other operating cost per diem is subject to the 119.28 hospital attached, short length of stay, or the rule 80 limits. 119.29 All other nursing facilities shall be considered freestanding 119.30 nursing facilities. The commissioner shall then array all 119.31 nursing facilities in each grouping by their allowable case mix 119.32 A operating cost per diem. In calculating a nursing facility's 119.33 operating cost per diem for this purpose, the commissioner shall 119.34 exclude the raw food cost per diem related to providing special 119.35 diets that are based on religious beliefs, as determined in 119.36 subdivision 2b, paragraph (h). For those nursing facilities in 120.1 each grouping whose case mix A operating cost per diem: 120.2 (1) is at or below the median of the array, the 120.3 commissioner shall limit the nursing facility's allowable 120.4 operating cost per diem for each case mix category to the lesser 120.5 of the prior reporting year's allowable operating cost per diem 120.6 as specified in Laws 1996, chapter 451, article 3, section 11, 120.7 paragraph (h), plus the inflation factor as established in 120.8 paragraph (d), clause (2), increased by two percentage points, 120.9 or the current reporting year's corresponding allowable 120.10 operating cost per diem; or 120.11 (2) is above the median of the array, the commissioner 120.12 shall limit the nursing facility's allowable operating cost per 120.13 diem for each case mix category to the lesser of the prior 120.14 reporting year's allowable operating cost per diem as specified 120.15 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 120.16 plus the inflation factor as established in paragraph (d), 120.17 clause (2), increased by one percentage point, or the current 120.18 reporting year's corresponding allowable operating cost per diem. 120.19 For purposes of paragraph (a), for rate years beginning on 120.20 or after July 1, 1998, if a nursing facility reports on its cost 120.21 report a reduction in cost due to a refund or credit, the 120.22 commissioner shall increase that facility's spend-up limit for 120.23 the rate year following the current rate year by the amount of 120.24 the cost reduction divided by its resident days for the 120.25 reporting year preceding the rate year in which the adjustment 120.26 is to be made. 120.27 (b) For rate years beginning on or after July 1, 1997, the 120.28 commissioner shall limit the allowable operating cost per diem 120.29 for high cost nursing facilities. After application of the 120.30 limits in paragraph (a) to each nursing facility's operating 120.31 cost per diem, the commissioner shall group nursing facilities 120.32 into two groups, freestanding or nonfreestanding, within each 120.33 geographic group. A nonfreestanding nursing facility is a 120.34 nursing facility whose other operating cost per diem are subject 120.35 to hospital attached, short length of stay, or rule 80 limits. 120.36 All other nursing facilities shall be considered freestanding 121.1 nursing facilities. The commissioner shall then array all 121.2 nursing facilities within each grouping by their allowable case 121.3 mix A operating cost per diem. In calculating a nursing 121.4 facility's operating cost per diem for this purpose, the 121.5 commissioner shall exclude the raw food cost per diem related to 121.6 providing special diets that are based on religious beliefs, as 121.7 determined in subdivision 2b, paragraph (h). For those nursing 121.8 facilities in each grouping whose case mix A operating cost per 121.9 diem exceeds 1.0 standard deviation above the median, the 121.10 commissioner shall reduce their allowable operating cost per 121.11 diem by three percent. For those nursing facilities in each 121.12 grouping whose case mix A operating cost per diem exceeds 0.5 121.13 standard deviation above the median but is less than or equal to 121.14 1.0 standard deviation above the median, the commissioner shall 121.15 reduce their allowable operating cost per diem by two percent. 121.16 However, in no case shall a nursing facility's operating cost 121.17 per diem be reduced below its grouping's limit established at 121.18 0.5 standard deviations above the median. 121.19 (c) For rate years beginning on or after July 1, 1997, the 121.20 commissioner shall determine a nursing facility's efficiency 121.21 incentive by first computing the allowable difference, which is 121.22 the lesser of $4.50 or the amount by which the facility's other 121.23 operating cost limit exceeds its nonadjusted other operating 121.24 cost per diem for that rate year. The commissioner shall 121.25 compute the efficiency incentive by: 121.26 (1) subtracting the allowable difference from $4.50 and 121.27 dividing the result by $4.50; 121.28 (2) multiplying 0.20 by the ratio resulting from clause 121.29 (1), and then; 121.30 (3) adding 0.50 to the result from clause (2); and 121.31 (4) multiplying the result from clause (3) times the 121.32 allowable difference. 121.33 The nursing facility's efficiency incentive payment shall 121.34 be the lesser of $2.25 or the product obtained in clause (4). 121.35 (d) For rate years beginning on or after July 1, 1997, the 121.36 forecasted price index for a nursing facility's allowable 122.1 operating cost per diem shall be determined under clauses (1) 122.2 and (2) using the change in the Consumer Price Index-All Items 122.3 (United States city average) (CPI-U) as forecasted by Data 122.4 Resources, Inc. The commissioner shall use the indices as 122.5 forecasted in the fourth quarter of the calendar year preceding 122.6 the rate year, subject to subdivision 2l, paragraph (c). 122.7 (1) The CPI-U forecasted index for allowable operating cost 122.8 per diem shall be based on the 21-month period from the midpoint 122.9 of the nursing facility's reporting year to the midpoint of the 122.10 rate year following the reporting year. 122.11 (2) For rate years beginning on or after July 1, 1997, the 122.12 forecasted index for operating cost limits referred to in 122.13 subdivision 21, paragraph (b), shall be based on the CPI-U for 122.14 the 12-month period between the midpoints of the two reporting 122.15 years preceding the rate year. 122.16 (e) After applying these provisions for the respective rate 122.17 years, the commissioner shall index these allowable operating 122.18 cost per diem by the inflation factor provided for in paragraph 122.19 (d), clause (1), and add the nursing facility's efficiency 122.20 incentive as computed in paragraph (c). 122.21 (f) For rate years beginning on or after July 1, 1997, the 122.22 total operating cost payment rates for a nursing facility shall 122.23 be the greater of the total operating cost payment rates 122.24 determined under this section or the total operating cost 122.25 payment rates in effect on June 30, 1997, subject to rate 122.26 adjustments due to field audit or rate appeal resolution. This 122.27 provision shall not apply to subsequent field audit adjustments 122.28 of the nursing facility's operating cost rates for rate years 122.29 beginning on or after July 1, 1997. 122.30 (g) For the rate years beginning on July 1, 1997,andJuly 122.31 1, 1998, and July 1, 1999, a nursing facility licensed for 40 122.32 beds effective May 1, 1992, with a subsequent increase of 20 122.33 Medicare/Medicaid certified beds, effective January 26, 1993, in 122.34 accordance with an increase in licensure is exempt from 122.35 paragraphs (a) and (b). 122.36 (h) For a nursing facility whose construction project was 123.1 authorized according to section 144A.073, subdivision 5, 123.2 paragraph (g), the operating cost payment rates for the third 123.3 location shall be determined based on Minnesota Rules, part 123.4 9549.0057. Paragraphs (a) and (b) shall not apply until the 123.5 second rate year after the settle-up cost report is filed. 123.6 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 123.7 and special assessments payable by the third location, a 123.8 501(c)(3) nonprofit corporation, shall be included in the 123.9 payment rates determined under this subdivision for all 123.10 subsequent rate years. 123.11 (i) For the rate year beginning July 1, 1997, the 123.12 commissioner shall compute the payment rate for a nursing 123.13 facility licensed for 94 beds on September 30, 1996, that 123.14 applied in October 1993 for approval of a total replacement 123.15 under the moratorium exception process in section 144A.073, and 123.16 completed the approved replacement in June 1995, with other 123.17 operating cost spend-up limit under paragraph (a), increased by 123.18 $3.98, and after computing the facility's payment rate according 123.19 to this section, the commissioner shall make a one-year positive 123.20 rate adjustment of $3.19 for operating costs related to the 123.21 newly constructed total replacement, without application of 123.22 paragraphs (a) and (b). The facility's per diem, before the 123.23 $3.19 adjustment, shall be used as the prior reporting year's 123.24 allowable operating cost per diem for payment rate calculation 123.25 for the rate year beginning July 1, 1998. A facility described 123.26 in this paragraph is exempt from paragraph (b) for the rate 123.27 years beginning July 1, 1997, and July 1, 1998. 123.28 (j) For the purpose of applying the limit stated in 123.29 paragraph (a), a nursing facility in Kandiyohi county licensed 123.30 for 86 beds that was granted hospital-attached status on 123.31 December 1, 1994, shall have the prior year's allowable 123.32 care-related per diem increased by $3.207 and the prior year's 123.33 other operating cost per diem increased by $4.777 before adding 123.34 the inflation in paragraph (d), clause (2), for the rate year 123.35 beginning on July 1, 1997. 123.36 (k) For the purpose of applying the limit stated in 124.1 paragraph (a), a 117 bed nursing facility located in Pine county 124.2 shall have the prior year's allowable other operating cost per 124.3 diem increased by $1.50 before adding the inflation in paragraph 124.4 (d), clause (2), for the rate year beginning on July 1, 1997. 124.5 (l) For the purpose of applying the limit under paragraph 124.6 (a), a nursing facility in Hibbing licensed for 192 beds shall 124.7 have the prior year's allowable other operating cost per diem 124.8 increased by $2.67 before adding the inflation in paragraph (d), 124.9 clause (2), for the rate year beginning July 1, 1997. 124.10 (m) For the purpose of applying the limit stated in 124.11 paragraph (a), a nursing facility in Hennepin county licensed 124.12 for 181 beds on September 30, 1996, shall have the prior year's 124.13 allowable care-related per diem increased by $1.455 and the 124.14 prior year's other operating cost per diem increased by $0.439 124.15 before adding the inflation in paragraph (d), clause (2), for 124.16 the rate year beginning on July 1, 1998. 124.17 (n) For the purpose of applying the limit stated in 124.18 paragraph (a), a nursing facility in Hennepin county licensed 124.19 for 161 beds on September 30, 1996, shall have the prior year's 124.20 allowable care-related per diem increased by $1.154 and the 124.21 prior year's other operating cost per diem increased by $0.256 124.22 before adding the inflation in paragraph (d), clause (2), for 124.23 the rate year beginning on July 1, 1998. 124.24 (o) For the purpose of applying the limit stated in 124.25 paragraph (a), a nursing facility in Ramsey county licensed for 124.26 176 beds on September 30, 1996, shall have the prior year's 124.27 allowable care-related per diem increased by $0.803 and the 124.28 prior year's other operating cost per diem increased by $0.272 124.29 before adding the inflation in paragraph (d), clause (2), for 124.30 the rate year beginning on July 1, 1998. 124.31 (p) For the purpose of applying the limit stated in 124.32 paragraph (a), a nursing facility in Brown county licensed for 124.33 86 beds on September 30, 1996, shall have the prior year's 124.34 allowable care-related per diem increased by $0.850 and the 124.35 prior year's other operating cost per diem increased by $0.275 124.36 before adding the inflation in paragraph (d), clause (2), for 125.1 the rate year beginning on July 1, 1998. 125.2 (q) For the rate year beginning July 1, 1998, the 125.3 commissioner shall compute the payment rate for a nursing 125.4 facility, which was licensed for 110 beds on May 1, 1997, was 125.5 granted approval in January 1994 for a replacement and 125.6 remodeling project under the moratorium exception process in 125.7 section 144A.073, and completed the approved replacement and 125.8 remodeling project on March 14, 1997, by increasing the other 125.9 operating cost spend-up limit under paragraph (a) by $1.64. 125.10 After computing the facility's payment rate for the rate year 125.11 beginning July 1, 1998, according to this section, the 125.12 commissioner shall make a one-year positive rate adjustment of 125.13 48 cents for increased real estate taxes resulting from 125.14 completion of the moratorium exception project, without 125.15 application of paragraphs (a) and (b). 125.16 Sec. 10. Minnesota Statutes 1996, section 256B.431, is 125.17 amended by adding a subdivision to read: 125.18 Subd. 27. [RULE 80 LIMITED EXEMPTION.] For the rate year 125.19 beginning July 1, 1998, the commissioner shall compute the 125.20 payment rate for a nursing facility exempted from care-related 125.21 limits under subdivision 2b, paragraph (d), clause (2), with a 125.22 minimum of three-quarters of its beds licensed to provide 125.23 residential services for the physically handicapped under 125.24 Minnesota Rules, parts 9570.2000 to 9570.3400, with the care 125.25 related spend-up limit under subdivision 26, paragraph (a), 125.26 increased by $13.21 for the rate year beginning July 1, 1998, 125.27 without application of subdivision 26, paragraph (b). For rate 125.28 years beginning on or after July 1, 1999, the commissioner shall 125.29 exclude that amount in calculating the facility's operating cost 125.30 per diem for purposes of applying subdivision 26, paragraph (b). 125.31 Sec. 11. Minnesota Statutes 1996, section 256B.431, is 125.32 amended by adding a subdivision to read: 125.33 Subd. 28. [CHANGES TO NURSING FACILITY REIMBURSEMENT 125.34 BEGINNING JULY 1, 1998.] The nursing facility reimbursement 125.35 changes in paragraphs (a) and (b) shall apply in the sequence 125.36 specified in this section and Minnesota Rules, parts 9549.0010 126.1 to 9549.0080, beginning July 1, 1998. 126.2 (a) For rate years beginning on or after July 1, 1998, the 126.3 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 126.4 and 22, paragraph (d), and any previously effective 126.5 corresponding limits in law or rule shall not apply, except that 126.6 these cost limits shall still be calculated for purposes of 126.7 determining efficiency incentive per diems. For rate years 126.8 beginning on or after July 1, 1998, the total operating cost 126.9 payment rates for a nursing facility shall be the greater of the 126.10 total operating cost payment rates determined under this section 126.11 or the total operating cost payment rates in effect on June 30, 126.12 1998, subject to rate adjustments due to field audit or rate 126.13 appeal resolution. 126.14 (b) For rate years beginning on or after July 1, 1998, the 126.15 operating cost per diem referred to in subdivision 26, paragraph 126.16 (a), clauses (1) and (2), is the sum of the care related and 126.17 other operating per diems for a given case mix class. Any 126.18 reductions to the combined operating per diem shall be divided 126.19 proportionately between the care related and other operating per 126.20 diems. 126.21 Sec. 12. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 126.22 EFFECTIVE JULY 1, 2000.] 126.23 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 126.24 commissioner shall implement a performance-based contracting 126.25 system to replace the current method of setting operating cost 126.26 payment rates under sections 256B.431 and 256B.434 and Minnesota 126.27 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 126.28 operation on May 1, 1998, with payment rates not established 126.29 under section 256B.431 or 256B.434 on that date, is ineligible 126.30 for this performance-based contracting system. In determining 126.31 prospective payment rates of nursing facility services, the 126.32 commissioner shall distinguish between operating costs and 126.33 property-related costs. The operating cost portion of the 126.34 payment rates shall be indexed annually by an inflation factor 126.35 as specified in subdivision 3, and in accordance with section 126.36 256B.431, subdivision 21, paragraph (c). Property related 127.1 payment rates, including real estate taxes and special 127.2 assessments, shall be determined under section 256B.431 or 127.3 256B.434. 127.4 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 127.5 contract with each nursing facility must include provisions that: 127.6 (1) apply the resident case mix assessment provisions of 127.7 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 127.8 another assessment system, with the goal of moving to a single 127.9 assessment system; 127.10 (2) monitor resident outcomes through various methods, such 127.11 as quality indicators based on the minimum data set and other 127.12 utilization and performance measures; 127.13 (3) require the establishment and use of a continuous 127.14 quality improvement process that integrates information from 127.15 quality indicators and regular resident and family satisfaction 127.16 interviews; 127.17 (4) require annual reporting of facility statistical 127.18 information, including resident days by case mix category, 127.19 productive nursing hours, wages and benefits, and raw food costs 127.20 for use by the commissioner in the development of facility 127.21 profiles that include trends in payment and service utilization; 127.22 (5) require from each nursing facility an annual certified 127.23 audited financial statement consisting of a balance sheet, 127.24 income and expense statements, and an opinion from either a 127.25 licensed or certified public accountant, if a certified audit 127.26 was prepared, or unaudited financial statements if no certified 127.27 audit was prepared; and 127.28 (6) establish additional requirements and penalties for 127.29 nursing facilities not meeting the standards set forth in the 127.30 performance-based contract. 127.31 (b) The commissioner may develop additional incentive-based 127.32 payments for achieving outcomes specified in each contract. The 127.33 specified facility-specific outcomes must be measurable and 127.34 approved by the commissioner. 127.35 (c) The commissioner may also contract with nursing 127.36 facilities in other ways through requests for proposals, 128.1 including contracts on a risk or nonrisk basis, with nursing 128.2 facilities or consortia of nursing facilities, to provide 128.3 comprehensive long-term care coverage on a premium or capitated 128.4 basis. 128.5 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 128.6 beginning on or after July 1, 2000, the commissioner shall 128.7 determine operating cost payment rates for each licensed and 128.8 certified nursing facility by indexing its operating cost 128.9 payment rates in effect on June 30, 2000, for inflation. The 128.10 inflation factor to be used must be based on the change in the 128.11 Consumer Price Index-All Items, United States city average 128.12 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 128.13 quarter preceding the rate year. The CPI-U forecasted index for 128.14 operating cost payment rates shall be based on the 12-month 128.15 period from the midpoint of the nursing facility's prior rate 128.16 year to the midpoint of the rate year for which the operating 128.17 payment rate is being determined. 128.18 (b) Beginning July 1, 2000, each nursing facility subject 128.19 to a performance-based contract under this section shall choose 128.20 one of two methods of payment for property related costs: 128.21 (1) the method established in section 256B.434; or 128.22 (2) the method established in section 256B.431. 128.23 Once the nursing facility has made the election in paragraph 128.24 (b), that election shall remain in effect for at least four 128.25 years or until an alternative property payment system is 128.26 developed. 128.27 Sec. 13. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 128.28 EFFECTIVE OCTOBER 1, 2000.] 128.29 Subdivision 1. [PERFORMANCE-BASED CONTRACTING SYSTEM.] (a) 128.30 Effective October 1, 2000, the commissioner shall implement a 128.31 performance-based contracting system to replace the current 128.32 method of setting total cost payment rates under section 128.33 256B.501 and Minnesota Rules, parts 9553.0010 to 9553.0080. In 128.34 determining prospective payment rates of intermediate care 128.35 facilities for persons with mental retardation or related 128.36 conditions, the commissioner shall index each facility's total 129.1 payment rate by an inflation factor as described in subdivision 129.2 3. The commissioner of finance shall include annual inflation 129.3 adjustments in operating costs for intermediate care facilities 129.4 for persons with mental retardation and related conditions as a 129.5 budget change request in each biennial detailed expenditure 129.6 budget submitted to the legislature under section 16A.11. 129.7 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 129.8 contract with each intermediate care facility must include 129.9 provisions for: 129.10 (1) modifying payments when significant changes occur in 129.11 the needs of the consumers; 129.12 (2) monitoring service quality using performance indicators 129.13 that measure consumer outcomes; 129.14 (3) the establishment and use of continuous quality 129.15 improvement processes using the results attained through service 129.16 quality monitoring; 129.17 (4) the annual reporting of facility statistical 129.18 information on all supervisory personnel, direct care personnel, 129.19 specialized support personnel, hours, wages and benefits, 129.20 staff-to-consumer ratios, and staffing patterns; 129.21 (5) annual aggregate facility financial information or an 129.22 annual certified audited financial statement, including a 129.23 balance sheet and income and expense statements for each 129.24 facility, if a certified audit was prepared; and 129.25 (6) additional requirements and penalties for intermediate 129.26 care facilities not meeting the standards set forth in the 129.27 performance-based contract. 129.28 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 129.29 beginning on or after October 1, 2000, the commissioner shall 129.30 determine the total payment rate for each licensed and certified 129.31 intermediate care facility by indexing the total payment rate in 129.32 effect on September 30, 2000, for inflation. The inflation 129.33 factor to be used must be based on the change in the Consumer 129.34 Price Index-All Items, United States city average (CPI-U) as 129.35 forecasted by Data Resources, Inc. in the first quarter of the 129.36 calendar year during which the rate year begins. The CPI-U 130.1 forecasted index for total payment rates shall be based on the 130.2 12-month period from the midpoint of the ICFs/MR prior rate year 130.3 to the midpoint of the rate year for which the operating payment 130.4 rate is being determined. 130.5 Sec. 14. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 130.6 SYSTEM.] 130.7 (a) By January 15, 1999, the commissioner shall make 130.8 recommendations to the chairs of the health and human services 130.9 policy and fiscal committees on the repeal of specific statutes 130.10 and rules as well as any other additional recommendations 130.11 related to implementation of sections 11 and 12. 130.12 (b) In developing recommendations for nursing facility 130.13 reimbursement, the commissioner shall consider making each 130.14 nursing facility's total payment rates, both operating and 130.15 property rate components, prospective. The commissioner shall 130.16 involve nursing facility industry and consumer representatives 130.17 in the development of these recommendations. 130.18 (c) In making recommendations for ICF/MR reimbursement, the 130.19 commissioner may consider methods of establishing payment rates 130.20 that take into account individual client costs and needs, 130.21 include provisions to establish links between performance 130.22 indicators and reimbursement and other performance incentives, 130.23 and allow local control over resources necessary for local 130.24 agencies to set rates and contract with ICF/MR facilities. In 130.25 addition, the commissioner may establish methods that provide 130.26 information to consumers regarding service quality as measured 130.27 by performance indicators. The commissioner shall involve 130.28 ICF/MR industry and consumer representatives in the development 130.29 of these recommendations. 130.30 Sec. 15. [APPROVAL EXTENDED.] 130.31 Minnesota Statutes, section 144A.073, subdivision 3, 130.32 notwithstanding, the commissioner of health shall grant an 130.33 additional 18 months of approval for a proposed exception to the 130.34 nursing home licensure and certification moratorium, if the 130.35 proposal is to replace a 96-bed nursing home facility in Carlton 130.36 county and if initial approval for the proposal was granted in 131.1 November 1996. 131.2 Sec. 16. [EFFECTIVE DATE.] 131.3 Sections 4 (256B.0951, subd. 7), 9 (256B.431, subd. 26), 131.4 and 15 (approval extended) are effective the day following final 131.5 enactment. 131.6 ARTICLE 4 131.7 HEALTH CARE PROGRAMS, INCLUDING MA AND GAMC 131.8 Section 1. Minnesota Statutes 1997 Supplement, section 131.9 62J.69, subdivision 1, is amended to read: 131.10 Subdivision 1. [DEFINITIONS.] For purposes of this 131.11 section, the following definitions apply: 131.12 (a) "Medical education" means the accredited clinical 131.13 training of physicians (medical students and residents), doctor 131.14 of pharmacy practitioners, doctors of chiropractic, dentists, 131.15 advanced practice nurses (clinical nurse specialist, certified 131.16 registered nurse anesthetists, nurse practitioners, and 131.17 certified nurse midwives), and physician assistants. 131.18 (b) "Clinical training" means accredited training for the 131.19 health care practitioners listed in paragraph (a) that is funded 131.20and was historically fundedin part byinpatientpatient care 131.21 revenues and that occurs inbotheither an inpatientandor 131.22 ambulatory patient caresettingstraining site. 131.23 (c) "Trainee" means students involved in an accredited 131.24 clinical training program for medical education as defined in 131.25 paragraph (a). 131.26 (d) "Eligible trainee" means a student involved in an 131.27 accredited training program for medical education as defined in 131.28 paragraph (a), which meets the definition of clinical training 131.29 in paragraph (b), who is in a training site that is located in 131.30 Minnesota and which has a medical assistance provider number. 131.31 (e) "Health care research" means approved clinical, 131.32 outcomes, and health services investigations that are funded by 131.33 patient out-of-pocket expenses or a third-party payer. 131.34(e)(f) "Commissioner" means the commissioner of health. 131.35(f)(g) "Teaching institutions" means any hospital, medical 131.36 center, clinic, or other organization that currently sponsors or 132.1 conducts accredited medical education programs or clinical 132.2 research in Minnesota. 132.3 (h) "Accredited training" means training provided by a 132.4 program that is accredited through an organization recognized by 132.5 the department of education or the health care financing 132.6 administration as the official accrediting body for that program. 132.7 (i) "Sponsoring institution" means a hospital, school, or 132.8 consortium located in Minnesota that sponsors and maintains 132.9 primary organizational and financial responsibility for an 132.10 accredited medical education program in Minnesota and which is 132.11 accountable to the accrediting body. 132.12 Sec. 2. Minnesota Statutes 1997 Supplement, section 132.13 62J.69, subdivision 2, is amended to read: 132.14 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 132.15 RESEARCH.] (a) The commissioner may establish a trust fund for 132.16 the purposes of funding medical education and research 132.17 activities in the state of Minnesota. 132.18 (b) By January 1, 1997, the commissioner may appoint an 132.19 advisory committee to provide advice and oversight on the 132.20 distribution of funds from the medical education and research 132.21 trust fund. If a committee is appointed, the commissioner 132.22 shall: (1) consider the interest of all stakeholders when 132.23 selecting committee members; (2) select members that represent 132.24 both urban and rural interest; and (3) select members that 132.25 include ambulatory care as well as inpatient perspectives. The 132.26 commissioner shall appoint to the advisory committee 132.27 representatives of the following groups: medical researchers, 132.28 public and private academic medical centers, managed care 132.29 organizations, Blue Cross and Blue Shield of Minnesota, 132.30 commercial carriers, Minnesota Medical Association, Minnesota 132.31 Nurses Association, medical product manufacturers, employers, 132.32 and other relevant stakeholders, including consumers. The 132.33 advisory committee is governed by section 15.059, for membership 132.34 terms and removal of members and will sunset on June 30, 1999. 132.35 (c) Eligible applicants for funds are accredited medical 132.36 education teaching institutions, consortia, and programs 133.1 operating in Minnesota. Applications must be submitted by the 133.2 sponsoring institution on behalf of the teaching program, and 133.3 must be received by September 30 of each year for distribution 133.4 in January of the following year. An application for funds must 133.5 include the following: 133.6 (1) the official name and address of the sponsoring 133.7 institution and the official name and address of the facility or 133.8programprograms on whose behalf the institution is applying for 133.9 funding; 133.10 (2) the name, title, and business address of those persons 133.11 responsible for administering the funds; 133.12 (3)the total number, type, and specialty orientation of133.13eligible Minnesota-based trainees infor each accredited medical 133.14 education program for which funds are being sought the type and 133.15 specialty orientation of trainees in the program, the name, 133.16 address, and medical assistance provider number of each training 133.17 site used in the program, the total number of trainees at each 133.18 site, and the total number of eligible trainees at each training 133.19 site; 133.20 (4) audited clinical training costs per trainee for each 133.21 medical education program where available or estimates of 133.22 clinical training costs based on audited financial data; 133.23 (5) a description of current sources of funding for medical 133.24 education costs including a description and dollar amount of all 133.25 state and federal financial support, including Medicare direct 133.26 and indirect payments; 133.27 (6) other revenue received for the purposes of clinical 133.28 training; and 133.29 (7)a statement identifying unfunded costs; and133.30(8)other supporting information the commissioner, with 133.31 advice from the advisory committee, determines is necessary for 133.32 the equitable distribution of funds. 133.33 (d) The commissioner shall distribute medical education 133.34 funds to all qualifying applicants based on the following basic 133.35 criteria: (1) total medical education funds available; (2) 133.36 total eligible trainees in each eligible education program; and 134.1 (3) the statewide average cost per trainee, by type of trainee, 134.2 in each medical education program. Funds distributed shall not 134.3 be used to displace current funding appropriations from federal 134.4 or state sources. Funds shall be distributed to the sponsoring 134.5 institutions indicating the amount to be paid to each of the 134.6 sponsor's medical education programs based on the criteria in 134.7 this paragraph. Sponsoring institutions which receive funds 134.8 from the trust fund must distribute approved funds to the 134.9 medical education program according to the commissioner's 134.10 approval letter. Further, programs must distribute funds among 134.11 the sites of trainingbased on the percentage of total program134.12training performed at each site.as specified in the 134.13 commissioner's approval letter. Any funds not distributed as 134.14 directed by the commissioner's approval letter shall be returned 134.15 to the medical education and research trust fund within 30 days 134.16 of a notice from the commissioner. The commissioner shall 134.17 distribute returned funds to the appropriate entities in 134.18 accordance with the commissioner's approval letter. Effective 134.19 July 1, 1999, the medical education funds distribution process 134.20 must include as a criterion the historical proportion of 134.21 trainees from each education program that continues to practice 134.22 in Minnesota. The commissioner shall evaluate the previous ten 134.23 year time period to determine the historical proportion of 134.24 trainees that continues to practice in Minnesota. 134.25 (e) Medical education programs receiving funds from the 134.26 trust fund must submitannual cost and program reportsa medical 134.27 education and research grant verification report (GVR) through 134.28 the sponsoring institution based on criteria established by the 134.29 commissioner. If the sponsoring institution fails to submit the 134.30 GVR by the stated deadline, or to request and meet the deadline 134.31 for an extension, the sponsoring institution is required to 134.32 return the full amount of the medical education and research 134.33 trust fund grant to the medical education and research trust 134.34 fund within 30 days of a notice from the commissioner. The 134.35 commissioner shall distribute returned funds to the appropriate 134.36 entities in accordance with the commissioner's approval letter. 135.1 The reports must include: 135.2 (1) the total number of eligible trainees in the program; 135.3 (2) the programs and residencies funded, the amounts of 135.4 trust fund payments to each program, and within each program, 135.5 thepercentagedollar amount distributed to each training site; 135.6 and 135.7 (3)the average cost per trainee and a detailed breakdown135.8of the components of those costs;135.9(4) other state or federal appropriations received for the135.10purposes of clinical training;135.11(5) other revenue received for the purposes of clinical135.12training; and135.13(6)other information the commissioner, with advice from 135.14 the advisory committee, deems appropriate to evaluate the 135.15 effectiveness of the use of funds for clinical training. 135.16 The commissioner, with advice from the advisory committee, 135.17 will provide an annual summary report to the legislature on 135.18 program implementation due February 15 of each year. 135.19 (f) The commissioner is authorized to distribute funds made 135.20 available through: 135.21 (1) voluntary contributions by employers or other entities; 135.22 (2) allocations for the department of human services to 135.23 support medical education and research; and 135.24 (3) other sources as identified and deemed appropriate by 135.25 the legislature for inclusion in the trust fund. 135.26 (g) The advisory committee shall continue to study and make 135.27 recommendations on: 135.28 (1) the funding of medical research consistent with work 135.29 currently mandated by the legislature and under way at the 135.30 department of health; and 135.31 (2) the costs and benefits associated with medical 135.32 education and research. 135.33 Sec. 3. Minnesota Statutes 1997 Supplement, section 135.34 62J.69, is amended by adding a subdivision to read: 135.35 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 135.36 SERVICES.] (a) The amount transferred according to section 136.1 256B.69, subdivision 5c, shall be distributed to qualifying 136.2 applicants based on a distribution formula that reflects a 136.3 summation of two factors: 136.4 (1) an education factor, which is determined by the total 136.5 number of eligible trainees and the total statewide average 136.6 costs per trainee, by type of trainee, in each program; and 136.7 (2) a public program volume factor, which is determined by 136.8 the total volume of public program revenue received by each 136.9 training site as a percentage of all public program revenue 136.10 received by all training sites in the trust fund pool. 136.11 In this formula, the education factor shall be weighted at 136.12 50 percent and the public program volume factor shall be 136.13 weighted at 50 percent. 136.14 (b) Public program revenue for the formula in paragraph (a) 136.15 shall include revenue from medical assistance, prepaid medical 136.16 assistance, general assistance medical care, and prepaid general 136.17 assistance medical care. 136.18 (c) Training sites that receive no public program revenue 136.19 shall be ineligible for payments from the prepaid medical 136.20 assistance program transfer pool. 136.21 Sec. 4. Minnesota Statutes 1996, section 245.462, 136.22 subdivision 4, is amended to read: 136.23 Subd. 4. [CASE MANAGER.] "Case manager" means an 136.24 individual employed by the county or other entity authorized by 136.25 the county board to provide case management services specified 136.26 in section 245.4711. A case manager musthave a bachelor's136.27degree in one of the behavioral sciences or related fields from136.28an accredited college or university and have at least 2,000136.29hours of supervised experience in the delivery of services to136.30adults with mental illness, mustbe skilled in the process of 136.31 identifying and assessing a wide range of client needs,andmust 136.32 be knowledgeable about local community resources and how to use 136.33 those resources for the benefit of the client, and must meet the 136.34 qualifications for mental health practitioners in subdivision 136.35 17. The case manager shall meet in person with a mental health 136.36 professional at least once each month to obtain clinical 137.1 supervision of the case manager's activities. Case managers 137.2 with a bachelor's degree but without 2,000 hours of supervised 137.3 experience in the delivery of services to adults with mental 137.4 illness must complete 40 hours of training approved by the 137.5 commissioner of human services in case management skills and in 137.6 the characteristics and needs of adults with serious and 137.7 persistent mental illness and must receive clinical supervision 137.8 regarding individual service delivery from a mental health 137.9 professional at least once each week until the requirement of 137.10 2,000 hours of supervised experience is met. Case managers 137.11 without a bachelor's degree but with 6,000 hours of supervised 137.12 experience in the delivery of services to adults with mental 137.13 illness must complete 40 hours of training approved by the 137.14 commissioner of human services in case management skills and in 137.15 the characteristics and needs of adults with serious and 137.16 persistent mental illness. Clinical supervision must be 137.17 documented in the client record. 137.18 Until June 30, 1999,a refugeean immigrant who does not 137.19 have the qualifications specified in this subdivision may 137.20 provide case management services to adultrefugeesimmigrants 137.21 with serious and persistent mental illness who are members of 137.22 the same ethnic group as the case manager if the person: (1) is 137.23 actively pursuing credits toward the completion of a bachelor's 137.24 degree in one of the behavioral sciences or a related field from 137.25 an accredited college or university; (2) completes 40 hours of 137.26 training as specified in this subdivision; and (3) receives 137.27 clinical supervision at least once a week until the requirements 137.28 ofobtaining a bachelor's degree and 2,000 hours of supervised137.29experiencethis subdivision are met. 137.30 Sec. 5. Minnesota Statutes 1996, section 245.462, 137.31 subdivision 8, is amended to read: 137.32 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 137.33 treatment services," or "day treatment program" means a 137.34 structured program of treatment and care provided to an adult in 137.35 or by: (1) a hospital accredited by the joint commission on 137.36 accreditation of health organizations and licensed under 138.1 sections 144.50 to 144.55; (2) a community mental health center 138.2 under section 245.62; or (3) an entity that is under contract 138.3 with the county board to operate a program that meets the 138.4 requirements of section 245.4712, subdivision 2, and Minnesota 138.5 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 138.6 group psychotherapy and other intensive therapeutic services 138.7 that are provided at least one day a weekfor a minimum138.8three-hour time blockby a multidisciplinary staff under the 138.9 clinical supervision of a mental health professional. The 138.10 services are aimed at stabilizing the adult's mental health 138.11 status, providing mental health services, and developing and 138.12 improving the adult's independent living and socialization 138.13 skills. The goal of day treatment is to reduce or relieve 138.14 mental illness and to enable the adult to live in the 138.15 community. Day treatment services are not a part of inpatient 138.16 or residential treatment services. Day treatment services are 138.17 distinguished from day care by their structured therapeutic 138.18 program of psychotherapy services. The commissioner may limit 138.19 medical assistance reimbursement for day treatment to 15 hours 138.20 per week per person instead of the three hours per day per 138.21 person specified in Minnesota Rules, part 9505.0323, subpart 15. 138.22 Sec. 6. Minnesota Statutes 1996, section 245.4871, 138.23 subdivision 4, is amended to read: 138.24 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 138.25 individual employed by the county or other entity authorized by 138.26 the county board to provide case management services specified 138.27 in subdivision 3 for the child with severe emotional disturbance 138.28 and the child's family. A case manager must have experience and 138.29 training in working with children. 138.30 (b) A case manager must meet the qualifications for a 138.31 mental health practitioner in subdivision 26: 138.32 (1)have at least a bachelor's degree in one of the138.33behavioral sciences or a related field from an accredited138.34college or university;138.35(2) have at least 2,000 hours of supervised experience in138.36the delivery of mental health services to children;139.1(3)have experience and training in identifying and 139.2 assessing a wide range of children's needs; and 139.3(4)(2) be knowledgeable about local community resources 139.4 and how to use those resources for the benefit of children and 139.5 their families. 139.6 (c) The case manager may be a member of any professional 139.7 discipline that is part of the local system of care for children 139.8 established by the county board. 139.9 (d) The case manager must meet in person with a mental 139.10 health professional at least once each month to obtain clinical 139.11 supervision. 139.12 (e) Case managers with a bachelor's degree but without 139.13 2,000 hours of supervised experience in the delivery of mental 139.14 health services to children with emotional disturbance must: 139.15 (1) begin 40 hours of training approved by the commissioner 139.16 of human services in case management skills and in the 139.17 characteristics and needs of children with severe emotional 139.18 disturbance before beginning to provide case management 139.19 services; and 139.20 (2) receive clinical supervision regarding individual 139.21 service delivery from a mental health professional at least once 139.22 each week until the requirement of 2,000 hours of experience is 139.23 met. 139.24 (f) Clinical supervision must be documented in the child's 139.25 record. When the case manager is not a mental health 139.26 professional, the county board must provide or contract for 139.27 needed clinical supervision. 139.28 (g) The county board must ensure that the case manager has 139.29 the freedom to access and coordinate the services within the 139.30 local system of care that are needed by the child. 139.31 (h) Until June 30, 1999,a refugeean immigrant who does 139.32 not have the qualifications specified in this subdivision may 139.33 provide case management services to childrefugeesimmigrants 139.34 with severe emotional disturbance of the same ethnic group as 139.35 therefugeeimmigrant if the person: 139.36 (1) is actively pursuing credits toward the completion of a 140.1 bachelor's degree in one of the behavioral sciences or related 140.2 fields at an accredited college or university; 140.3 (2) completes 40 hours of training as specified in this 140.4 subdivision; and 140.5 (3) receives clinical supervision at least once a week 140.6 until the requirements ofobtaining a bachelor's degree and140.72,000 hours of supervised experiencethis subdivision are met. 140.8 (i) Case managers without a bachelor's degree but with 140.9 6,000 hours of supervised experience in the delivery of mental 140.10 health services to children with emotional disturbance must 140.11 begin 40 hours of training approved by the commissioner of human 140.12 services in case management skills and in the characteristics 140.13 and needs of children with severe emotional disturbance before 140.14 beginning to provide case management services. 140.15 Sec. 7. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 140.16 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 140.17 services shall establish and administer a program to pay for 140.18 costs of drugs prescribed exclusively for post-kidney transplant 140.19 maintenance when those costs are not otherwise reimbursed by a 140.20 third-party payer. The commissioner may contract with a 140.21 nonprofit entity to administer this program. 140.22 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 140.23 the program, an applicant must satisfy the following 140.24 requirements: 140.25 (1) the applicant's family gross income must not exceed 275 140.26 percent of the federal poverty level; and 140.27 (2) the applicant must be a Minnesota resident who has 140.28 resided in Minnesota for at least 12 months. 140.29 An applicant shall not be excluded because the applicant 140.30 received the transplant outside the state of Minnesota, so long 140.31 as the other requirements are met. 140.32 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 140.33 made for each eligible recipient shall be based on the following: 140.34 (1) available funds; and 140.35 (2) the cost of the post-kidney transplant maintenance 140.36 drugs. 141.1 (b) The payment rate under this program must be no greater 141.2 than the medical assistance reimbursement rate for the 141.3 prescribed drug. 141.4 (c) Payments shall be made to or on behalf of an eligible 141.5 recipient for the cost of the post-kidney transplant maintenance 141.6 drugs that is not covered, reimbursed, or eligible for 141.7 reimbursement by any other third party or government entity, 141.8 including, but not limited to, private or group health 141.9 insurance, medical assistance, Medicare, the Veterans 141.10 Administration, the senior citizen drug program established 141.11 under section 256.955, or under any waiver arrangement received 141.12 by the state to provide a prescription drug benefit for 141.13 qualified Medicare beneficiaries or service-limited Medicare 141.14 beneficiaries. 141.15 (d) The commissioner may restrict or categorize payments to 141.16 meet the appropriation allocated for this program. 141.17 (e) Any cost of the post-kidney transplant maintenance 141.18 drugs that is not reimbursed under this program is the 141.19 responsibility of the program recipient. 141.20 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 141.21 a drug formulary that includes all drugs eligible for 141.22 reimbursement by the program. The commissioner may use the drug 141.23 formulary established under section 256B.0625, subdivision 13. 141.24 The commissioner shall establish an internal review procedure 141.25 for updating the formulary that allows for the addition and 141.26 deletion of drugs to the formulary. The drug formulary must be 141.27 reviewed at least quarterly per fiscal year. 141.28 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 141.29 funding from other public or private sources. 141.30 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 141.31 Sec. 8. Minnesota Statutes 1997 Supplement, section 141.32 256.9657, subdivision 3, is amended to read: 141.33 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 141.34 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 141.35 1992, each health maintenance organization with a certificate of 141.36 authority issued by the commissioner of health under chapter 62D 142.1 and each community integrated service network licensed by the 142.2 commissioner under chapter 62N shall pay to the commissioner of 142.3 human services a surcharge equal to six-tenths of one percent of 142.4 the total premium revenues of the health maintenance 142.5 organization or community integrated service network as reported 142.6 to the commissioner of health according to the schedule in 142.7 subdivision 4. 142.8 (b) For purposes of this subdivision, total premium revenue 142.9 means: 142.10 (1) premium revenue recognized on a prepaid basis from 142.11 individuals and groups for provision of a specified range of 142.12 health services over a defined period of time which is normally 142.13 one month, excluding premiums paid to a health maintenance 142.14 organization or community integrated service network from the 142.15 Federal Employees Health Benefit Program; 142.16 (2) premiums from Medicare wrap-around subscribers for 142.17 health benefits which supplement Medicare coverage; 142.18 (3) Medicare revenue, as a result of an arrangement between 142.19 a health maintenance organization or a community integrated 142.20 service network and the health care financing administration of 142.21 the federal Department of Health and Human Services, for 142.22 services to a Medicare beneficiary, excluding Medicare revenue 142.23 that states are prohibited from taxing under sections 4001 and 142.24 4002 of Public Law Number 105-33 received by a health 142.25 maintenance organization or community integrated service network 142.26 through risk sharing or Medicare Choice + contracts; and 142.27 (4) medical assistance revenue, as a result of an 142.28 arrangement between a health maintenance organization or 142.29 community integrated service network and a Medicaid state 142.30 agency, for services to a medical assistance beneficiary. 142.31 If advance payments are made under clause (1) or (2) to the 142.32 health maintenance organization or community integrated service 142.33 network for more than one reporting period, the portion of the 142.34 payment that has not yet been earned must be treated as a 142.35 liability. 142.36 (c) When a health maintenance organization or community 143.1 integrated service network merges or consolidates with or is 143.2 acquired by another health maintenance organization or community 143.3 integrated service network, the surviving corporation or the new 143.4 corporation shall be responsible for the annual surcharge 143.5 originally imposed on each of the entities or corporations 143.6 subject to the merger, consolidation, or acquisition, regardless 143.7 of whether one of the entities or corporations does not retain a 143.8 certificate of authority under chapter 62D or a license under 143.9 chapter 62N. 143.10 (d) Effective July 1 of each year, the surviving 143.11 corporation's or the new corporation's surcharge shall be based 143.12 on the revenues earned in the second previous calendar year by 143.13 all of the entities or corporations subject to the merger, 143.14 consolidation, or acquisition regardless of whether one of the 143.15 entities or corporations does not retain a certificate of 143.16 authority under chapter 62D or a license under chapter 62N until 143.17 the total premium revenues of the surviving corporation include 143.18 the total premium revenues of all the merged entities as 143.19 reported to the commissioner of health. 143.20 (e) When a health maintenance organization or community 143.21 integrated service network, which is subject to liability for 143.22 the surcharge under this chapter, transfers, assigns, sells, 143.23 leases, or disposes of all or substantially all of its property 143.24 or assets, liability for the surcharge imposed by this chapter 143.25 is imposed on the transferee, assignee, or buyer of the health 143.26 maintenance organization or community integrated service network. 143.27 (f) In the event a health maintenance organization or 143.28 community integrated service network converts its licensure to a 143.29 different type of entity subject to liability for the surcharge 143.30 under this chapter, but survives in the same or substantially 143.31 similar form, the surviving entity remains liable for the 143.32 surcharge regardless of whether one of the entities or 143.33 corporations does not retain a certificate of authority under 143.34 chapter 62D or a license under chapter 62N. 143.35 (g) The surcharge assessed to a health maintenance 143.36 organization or community integrated service network ends when 144.1 the entity ceases providing services for premiums and the 144.2 cessation is not connected with a merger, consolidation, 144.3 acquisition, or conversion. 144.4 Sec. 9. Minnesota Statutes 1997 Supplement, section 144.5 256.9685, subdivision 1, is amended to read: 144.6 Subdivision 1. [AUTHORITY.] The commissioner shall 144.7 establish procedures for determining medical assistance and 144.8 general assistance medical care payment rates under a 144.9 prospective payment system for inpatient hospital services in 144.10 hospitals that qualify as vendors of medical assistance. The 144.11 commissioner shall establish, by rule, procedures for 144.12 implementing this section and sections 256.9686, 256.969, and 144.13 256.9695.The medical assistance payment rates must be based on144.14methods and standards that the commissioner finds are adequate144.15to provide for the costs that must be incurred for the care of144.16recipients in efficiently and economically operated hospitals.144.17 Services must meet the requirements of section 256B.04, 144.18 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 144.19 eligible for payment. 144.20 Sec. 10. Minnesota Statutes 1996, section 256.969, is 144.21 amended by adding a subdivision to read: 144.22 Subd. 9c. [COUNTY BILLING.] Hospitals that have a 144.23 disproportionate population adjustment greater than eight 144.24 percent shall be eligible for a special payment for 144.25 uncompensated care. These hospitals may bill a county of 144.26 residence for services provided to a resident of that county 144.27 provided: 144.28 (1) the patient is from a county other than that in which 144.29 the hospital resides; and 144.30 (2) the hospital has made a preliminary determination at 144.31 the delivery of service that the patient was indigent based on 144.32 current medical assistance guidelines. 144.33 Counties that are billed under this program must pay 144.34 eligible hospitals at the rates established under the medical 144.35 assistance program. If the county can establish eligibility for 144.36 medical assistance after the service has been delivered, the 145.1 state shall reimburse the county for any funds paid to the 145.2 eligible hospital. 145.3 Sec. 11. Minnesota Statutes 1996, section 256.969, 145.4 subdivision 16, is amended to read: 145.5 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian145.6health serviceFacilities of the Indian health service and 145.7 facilities operated by a tribe or tribal organization under 145.8 funding authorized by title III of the Indian Self-Determination 145.9 and Education Assistance Act, Public Law Number 93-638, or by 145.10 United States Code, title 25, chapter 14, subchapter II, 145.11 sections 450f to 450n, are exempt from the rate establishment 145.12 methods required by this section and shall bereimbursed at145.13charges as limited to the amount allowed under federal lawpaid 145.14 according to the rate published by the United States assistant 145.15 secretary for health under authority of United States Code, 145.16 title 42, sections 248A and 248B. 145.17 Sec. 12. Minnesota Statutes 1996, section 256.969, 145.18 subdivision 17, is amended to read: 145.19 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 145.20 Out-of-state hospitals that are located within a Minnesota local 145.21 trade area and that have more than 20 admissions in the base 145.22 year shall have rates established using the same procedures and 145.23 methods that apply to Minnesota hospitals. For this subdivision 145.24 and subdivision 18, local trade area means a county contiguous 145.25 to Minnesota and located in a metropolitan statistical area as 145.26 determined by Medicare for October 1 prior to the most current 145.27 rebased rate year. Hospitals that are not required by law to 145.28 file information in a format necessary to establish rates shall 145.29 have rates established based on the commissioner's estimates of 145.30 the information. Relative values of the diagnostic categories 145.31 shall not be redetermined under this subdivision until required 145.32 by rule. Hospitals affected by this subdivision shall then be 145.33 included in determining relative values. However, hospitals 145.34 that have rates established based upon the commissioner's 145.35 estimates of information shall not be included in determining 145.36 relative values. This subdivision is effective for hospital 146.1 fiscal years beginning on or after July 1, 1988. A hospital 146.2 shall provide the information necessary to establish rates under 146.3 this subdivision at least 90 days before the start of the 146.4 hospital's fiscal year. 146.5 Sec. 13. Minnesota Statutes 1996, section 256B.03, 146.6 subdivision 3, is amended to read: 146.7 Subd. 3. [AMERICAN INDIAN HEALTH FUNDING.] (a) 146.8 Notwithstanding subdivision 1 and sections 256B.0625 and 146.9 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 146.10 make payments to federally recognized Indian tribes with a 146.11 reservation in the state to provide medical assistance and 146.12 general assistance medical care to Indians, as defined under 146.13 federal law, who reside on or near the reservation. The 146.14 payments may be made in the form of a block grant or other 146.15 payment mechanism determined in consultation with the tribe. 146.16 Any alternative payment mechanism agreed upon by the tribes and 146.17 the commissioner under this subdivision is not dependent upon 146.18 county agreement but is intended to create a direct payment 146.19 mechanism between the state and the tribe for the administration 146.20 of the medical assistanceprogramand general assistance medical 146.21 care programs, and for covered services. 146.22 (b) A tribe that implements a purchasing model under this 146.23 subdivision shall report to the commissioner at least annually 146.24 on the operation of the model. The commissioner and the tribe 146.25 shall cooperatively determine the data elements, format, and 146.26 timetable for the report. 146.27 (c) For purposes of this subdivision, "Indian tribe" means 146.28 a tribe, band, or nation, or other organized group or community 146.29 of Indians that is recognized as eligible for the special 146.30 programs and services provided by the United States to Indians 146.31 because of their status as Indians and for which a reservation 146.32 exists as is consistent with Public Law Number 100-485, as 146.33 amended. 146.34 (d) Payments under this subdivision may not result in an 146.35 increase in expenditures that would not otherwise occur in the 146.36 medical assistance program under this chapter or the general 147.1 assistance medical care program under chapter 256D. 147.2 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 147.3 amended by adding a subdivision to read: 147.4 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 147.5 CHILDREN.] Medical assistance may be paid for a person who is 147.6 under age 18 and who meets income and asset eligibility 147.7 requirements of the Supplemental Security Income program if the 147.8 person was receiving Supplemental Security Income payments on 147.9 the date of enactment of section 211(a) of Public Law Number 147.10 104-193, the Personal Responsibility and Work Opportunity Act of 147.11 1996, and the person would have continued to receive the 147.12 payments except for the change in the childhood disability 147.13 criteria in section 211(a) of Public Law Number 104-193. 147.14 Sec. 15. Minnesota Statutes 1997 Supplement, section 147.15 256B.056, subdivision 4, is amended to read: 147.16 Subd. 4. [INCOME.] To be eligible for medical assistance, 147.17 a personmust not have, or anticipate receiving, semiannual147.18income in excess of 120 percent of the income standards by147.19family size used under the aid to families with dependent147.20children state plan as of July 16, 1996, as required by the147.21Personal Responsibility and Work Opportunity Reconciliation Act147.22of 1996 (PRWORA), Public Law Number 104-193, except147.23thateligible under section 256B.055, subdivision 7, and 147.24 families and children may have an income up to 133-1/3 percent 147.25 of the AFDC income standard in effect under the July 16, 1996, 147.26 AFDC state plan. Effective July 1, 1998, the commissioner shall 147.27 increase the base AFDC standard in effect July 16, 1996, by an 147.28 amount equal to the percentage increase in the Consumer Price 147.29 Index for all urban consumers for calendar year 1997. In 147.30 computing income to determine eligibility of persons who are not 147.31 residents of long-term care facilities, the commissioner shall 147.32 disregard increases in income as required by Public Law Numbers 147.33 94-566, section 503; 99-272; and 99-509. Veterans aid and 147.34 attendance benefits and Veterans Administration unusual medical 147.35 expense payments are considered income to the recipient. 147.36 Sec. 16. Minnesota Statutes 1996, section 256B.057, 148.1 subdivision 3a, is amended to read: 148.2 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 148.3 PREMIUMS.] A person who would otherwise be eligible as a 148.4 qualified Medicare beneficiary under subdivision 3, except the 148.5 person's income is in excess of the limit, is eligible for 148.6 medical assistance reimbursement of Medicare Part B premiums if 148.7 the person's income is less than110120 percent of the official 148.8 federal poverty guidelines for the applicable family size.The148.9income limit shall increase to 120 percent of the official148.10federal poverty guidelines for the applicable family size on148.11January 1, 1995.148.12 Sec. 17. Minnesota Statutes 1996, section 256B.057, is 148.13 amended by adding a subdivision to read: 148.14 Subd. 3b. [QUALIFIED INDIVIDUALS.] Beginning July 1, 1998, 148.15 to the extent of the federal allocation to Minnesota, a person, 148.16 who would otherwise be eligible as a qualified Medicare 148.17 beneficiary under subdivision 3, except that the person's income 148.18 is in excess of the limit, is eligible as a qualified individual 148.19 according to the following criteria: 148.20 (1) if the person's income is greater than 120 percent, but 148.21 less than 135 percent of the official federal poverty guidelines 148.22 for the applicable family size, the person is eligible for 148.23 medical assistance reimbursement of Medicare Part B premiums; or 148.24 (2) if the person's income is greater than 135 percent but 148.25 less than 175 percent of the official federal poverty guidelines 148.26 for the applicable family size, the person is eligible for 148.27 medical assistance reimbursement of that portion of the Medicare 148.28 Part B premium attributable to an increase in Part B 148.29 expenditures which resulted from the shift of home care services 148.30 from Medicare Part A to Medicare Part B under section 4732 of 148.31 Public Law Number 105-33, the Balanced Budget Act of 1997. 148.32 The commissioner shall limit enrollment of qualifying 148.33 individuals under this subdivision according to the requirements 148.34 of section 4732 of Public Law Number 105-33. 148.35 Sec. 18. Minnesota Statutes 1997 Supplement, section 148.36 256B.06, subdivision 4, is amended to read: 149.1 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 149.2 medical assistance is limited to citizens of the United States, 149.3 qualified noncitizens as defined in this subdivision, and other 149.4 persons residing lawfully in the United States. 149.5 (b) "Qualified noncitizen" means a person who meets one of 149.6 the following immigration criteria: 149.7 (1) admitted for lawful permanent residence according to 149.8 United States Code, title 8; 149.9 (2) admitted to the United States as a refugee according to 149.10 United States Code, title 8, section 1157; 149.11 (3) granted asylum according to United States Code, title 149.12 8, section 1158; 149.13 (4) granted withholding of deportation according to United 149.14 States Code, title 8, section 1253(h); 149.15 (5) paroled for a period of at least one year according to 149.16 United States Code, title 8, section 1182(d)(5); 149.17 (6) granted conditional entrant status according to United 149.18 States Code, title 8, section 1153(a)(7);or149.19 (7) determined to be a battered noncitizen by the United 149.20 States Attorney General according to the Illegal Immigration 149.21 Reform and Immigrant Responsibility Act of 1996, title V of the 149.22 Omnibus Consolidated Appropriations Bill, Public Law Number 149.23 104-200; 149.24 (8) is a child of a noncitizen determined to be a battered 149.25 noncitizen by the United States Attorney General according to 149.26 the Illegal Immigration Reform and Immigrant Responsibility Act 149.27 of 1996, title V of the Omnibus Consolidated Appropriations 149.28 Bill, Public Law Number 104-200; or 149.29 (9) determined to be a Cuban or Haitian entrant as defined 149.30 in section 501(e) of Public Law Number 96-422, the Refugee 149.31 Education Assistance Act of 1980. 149.32 (c) All qualified noncitizens who were residing in the 149.33 United States before August 22, 1996, who otherwise meet the 149.34 eligibility requirements of chapter 256B, are eligible for 149.35 medical assistance with federal financial participation. 149.36 (d) All qualified noncitizens who entered the United States 150.1 on or after August 22, 1996, and who otherwise meet the 150.2 eligibility requirements of chapter 256B, are eligible for 150.3 medical assistance with federal financial participation through 150.4 November 30, 1996. 150.5 Beginning December 1, 1996, qualified noncitizens who 150.6 entered the United States on or after August 22, 1996, and who 150.7 otherwise meet the eligibility requirements of chapter 256B are 150.8 eligible for medical assistance with federal participation for 150.9 five years if they meet one of the following criteria: 150.10 (i) refugees admitted to the United States according to 150.11 United States Code, title 8, section 1157; 150.12 (ii) persons granted asylum according to United States 150.13 Code, title 8, section 1158; 150.14 (iii) persons granted withholding of deportation according 150.15 to United States Code, title 8, section 1253(h); 150.16 (iv) veterans of the United States Armed Forces with an 150.17 honorable discharge for a reason other than noncitizen status, 150.18 their spouses and unmarried minor dependent children; or 150.19 (v) persons on active duty in the United States Armed 150.20 Forces, other than for training, their spouses and unmarried 150.21 minor dependent children. 150.22 Beginning December 1, 1996, qualified noncitizens who do 150.23 not meet one of the criteria in items (i) to (v) are eligible 150.24 for medical assistance without federal financial participation 150.25 as described in paragraph (j). 150.26 (e) Noncitizens who are not qualified noncitizens as 150.27 defined in paragraph (b), who are lawfully residing in the 150.28 United States and who otherwise meet the eligibility 150.29 requirements of chapter 256B, are eligible for medical 150.30 assistance under clauses (1) to (3). These individuals must 150.31 cooperate with the Immigration and Naturalization Service to 150.32 pursue any applicable immigration status, including citizenship, 150.33 that would qualify them for medical assistance with federal 150.34 financial participation. 150.35 (1) Persons who were medical assistance recipients on 150.36 August 22, 1996, are eligible for medical assistance with 151.1 federal financial participation through December 31, 1996. 151.2 (2) Beginning January 1, 1997, persons described in clause 151.3 (1) are eligible for medical assistance without federal 151.4 financial participation as described in paragraph (j). 151.5 (3) Beginning December 1, 1996, persons residing in the 151.6 United States prior to August 22, 1996, who were not receiving 151.7 medical assistance and persons who arrived on or after August 151.8 22, 1996, are eligible for medical assistance without federal 151.9 financial participation as described in paragraph (j). 151.10 (f) Nonimmigrants who otherwise meet the eligibility 151.11 requirements of chapter 256B are eligible for the benefits as 151.12 provided in paragraphs (g) to (i). For purposes of this 151.13 subdivision, a "nonimmigrant" is a person in one of the classes 151.14 listed in United States Code, title 8, section 1101(a)(15). 151.15 (g) Payment shall also be made for care and services that 151.16 are furnished to noncitizens, regardless of immigration status, 151.17 who otherwise meet the eligibility requirements of chapter 256B, 151.18 if such care and services are necessary for the treatment of an 151.19 emergency medical condition, except for organ transplants and 151.20 related care and services and routine prenatal care. 151.21 (h) For purposes of this subdivision, the term "emergency 151.22 medical condition" means a medical condition that meets the 151.23 requirements of United States Code, title 42, section 1396b(v). 151.24 (i) Pregnant noncitizens who are undocumented or 151.25 nonimmigrants, who otherwise meet the eligibility requirements 151.26 of chapter 256B, are eligible for medical assistance payment 151.27 without federal financial participation for care and services 151.28 through the period of pregnancy, and 60 days postpartum, except 151.29 for labor and delivery. 151.30 (j) Qualified noncitizens as described in paragraph (d), 151.31 and all other noncitizens lawfully residing in the United States 151.32 as described in paragraph (e), who are ineligible for medical 151.33 assistance with federal financial participation and who 151.34 otherwise meet the eligibility requirements of chapter 256B and 151.35 of this paragraph, are eligible for medical assistance without 151.36 federal financial participation. Qualified noncitizens as 152.1 described in paragraph (d) are only eligible for medical 152.2 assistance without federal financial participation for five 152.3 years from their date of entry into the United States. 152.4 (k) The commissioner shall submit to the legislature by 152.5 December 31, 1998, a report on the number of recipients and cost 152.6 of coverage of care and services made according to paragraphs 152.7 (i) and (j). 152.8 Sec. 19. Minnesota Statutes 1996, section 256B.0625, is 152.9 amended by adding a subdivision to read: 152.10 Subd. 3a. [GENDER REASSIGNMENT SURGERY.] Gender 152.11 reassignment surgery and other gender reassignment medical 152.12 procedures including drug therapy for gender reassignment are 152.13 not medically necessary. 152.14 Sec. 20. Minnesota Statutes 1996, section 256B.0625, is 152.15 amended by adding a subdivision to read: 152.16 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 152.17 services rendered on or after July 1, 1999, medical assistance 152.18 payments for ambulance services shall be increased by ten 152.19 percent. 152.20 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 152.21 subdivision 20, is amended to read: 152.22 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 152.23 the extent authorized by rule of the state agency, medical 152.24 assistance covers case management services to persons with 152.25 serious and persistent mental illnessor subject to federal152.26approval,and children with severe emotional disturbance. 152.27 Services provided under this section must meet the relevant 152.28 standards in sections 245.461 to 245.4888, the Comprehensive 152.29 Adult and Children's Mental Health Acts, Minnesota Rules, parts 152.30 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 152.31 (b) Entities meeting program standards set out in rules 152.32 governing family community support services as defined in 152.33 section 245.4871, subdivision 17, are eligible for medical 152.34 assistance reimbursement for case management services for 152.35 children with severe emotional disturbance when these services 152.36 meet the program standards in Minnesota Rules, parts 9520.0900 153.1 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 153.2 10. 153.3(b) In counties where fewer than 50 percent of children153.4estimated to be eligible under medical assistance to receive153.5case management services for children with severe emotional153.6disturbance actually receive these services in state fiscal year153.71995, community mental health centers serving those counties,153.8entities meeting program standards in Minnesota Rules, parts153.99520.0570 to 9520.0870, and other entities authorized by the153.10commissioner are eligible for medical assistance reimbursement153.11for case management services for children with severe emotional153.12disturbance when these services meet the program standards in153.13Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,153.14excluding subpart 6.153.15 (c) Medical assistance and MinnesotaCare payment for mental 153.16 health case management shall be made on a monthly basis. In 153.17 order to receive payment for an eligible child, the provider 153.18 must document at least a face-to-face contact with the child, 153.19 the child's parents, or the child's legal representative. To 153.20 receive payment for an eligible adult, the provider must 153.21 document at least a face-to-face contact with the adult or the 153.22 adult's legal representative. 153.23 (d) Payment for mental health case management provided by 153.24 county or state staff shall be based on the monthly rate 153.25 methodology under section 256B.094, subdivision 6, paragraph 153.26 (b), with separate rates calculated for child welfare and mental 153.27 health, and within mental health, separate rates for children 153.28 and adults. 153.29 (e) Payment for mental health case management provided by 153.30 county-contracted vendors shall be based on a monthly rate 153.31 negotiated by the host county. The negotiated rate must not 153.32 exceed the rate charged by the vendor for the same service to 153.33 other payers. If the service is provided by a team of contracted 153.34 vendors, the county may negotiate a team rate with a vendor who 153.35 is a member of the team. The team shall determine how to 153.36 distribute the rate among its members. No reimbursement 154.1 received by contracted vendors shall be returned to the county, 154.2 except to reimburse the county for advance funding provided by 154.3 the county to the vendor. 154.4 (f) If the service is provided by a team which includes 154.5 contracted vendors and county or state staff, the costs for 154.6 county or state staff participation in the team shall be 154.7 included in the rate for county-provided services. In this 154.8 case, the contracted vendor and the county may each receive 154.9 separate payment for services provided by each entity in the 154.10 same month. In order to prevent duplication of services, the 154.11 county must document, in the recipient's file, the need for team 154.12 case management and a description of the roles of the team 154.13 members. 154.14 (g) The commissioner shall calculate the nonfederal share 154.15 of actual medical assistance and general assistance medical care 154.16 payments for each county, based on the higher of calendar year 154.17 1995 or 1996 by service date, trend that amount forward to 1999, 154.18 and transfer the result from medical assistance and general 154.19 assistance medical care to each county's mental health grants 154.20 under sections 245.4886 and 256E.12 for calendar year 1999. The 154.21 minimum amount added to each county's mental health grant shall 154.22 be $3,000 per year for children and $5,000 per year for adults. 154.23 The commissioner may reduce the statewide growth factor in order 154.24 to fund these minimums. The total amount transferred shall 154.25 become part of the base for future mental health grants for each 154.26 county. 154.27 (h) Any net increase in revenue to the county as a result 154.28 of the change in this section must be used to provide expanded 154.29 mental health services as defined in sections 245.461 to 154.30 245.4888, the Comprehensive Adult and Children's Mental Health 154.31 Acts, excluding inpatient and residential treatment. For 154.32 adults, increased revenue may also be used for services and 154.33 consumer supports which are part of adult mental health projects 154.34 approved under Laws 1997, chapter 203, article 7, section 25. 154.35 For children, increased revenue may also be used for respite 154.36 care and nonresidential individualized rehabilitation services 155.1 as defined in section 245.492, subdivisions 17 and 23. 155.2 "Increased revenue" has the meaning given in Minnesota Rules, 155.3 part 9520.0903, subpart 3. 155.4 (i) Notwithstanding section 256B.19, subdivision 1, the 155.5 nonfederal share of costs for mental health case management 155.6 shall be provided by the recipient's county of responsibility, 155.7 as defined in sections 256G.01 to 256G.12, from sources other 155.8 than federal funds or funds used to match other federal funds. 155.9 (j) The commissioner may suspend, reduce, or terminate the 155.10 reimbursement to a provider that does not meet the reporting or 155.11 other requirements of this section. The county of 155.12 responsibility, as defined in sections 256G.01 to 256G.12, is 155.13 responsible for any federal disallowances. The county may share 155.14 this responsibility with its contracted vendors. 155.15 (k) The commissioner shall set aside a portion of the 155.16 federal funds earned under this section to repay the special 155.17 revenue maximization account under section 256.01, subdivision 155.18 2, clause (15). The repayment is limited to: 155.19 (1) the costs of developing and implementing this section; 155.20 and 155.21 (2) programming the information systems. 155.22 (l) Notwithstanding section 256.025, subdivision 2, 155.23 payments to counties for case management expenditures under this 155.24 section shall only be made from federal earnings from services 155.25 provided under this section. Payments to contracted vendors 155.26 shall include both the federal earnings and the county share. 155.27 (m) Notwithstanding section 256B.041, county payments for 155.28 the cost of mental health case management services provided by 155.29 county or state staff shall not be made to the state treasurer. 155.30 For the purposes of mental health case management services 155.31 provided by county or state staff under this section, the 155.32 centralized disbursement of payments to counties under section 155.33 256B.041 consists only of federal earnings from services 155.34 provided under this section. 155.35 (n) Case management services under this subdivision do not 155.36 include therapy, treatment, legal, or outreach services. 156.1 (o) If the recipient is a resident of a nursing facility, 156.2 intermediate care facility, or hospital, and the recipient's 156.3 institutional care is paid by medical assistance, payment for 156.4 case management services under this subdivision is limited to 156.5 the last 30 days of the recipient's residency in that facility 156.6 and may not exceed more than two months in a calendar year. 156.7 (p) Payment for case management services under this 156.8 subdivision shall not duplicate payments made under other 156.9 program authorities for the same purpose. 156.10 (q) By July 1, 2000, the commissioner shall evaluate the 156.11 effectiveness of the changes required by this section, including 156.12 changes in number of persons receiving mental health case 156.13 management, changes in hours of service per person, and changes 156.14 in caseload size. 156.15 Sec. 22. Minnesota Statutes 1997 Supplement, section 156.16 256B.0625, subdivision 31a, is amended to read: 156.17 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 156.18 SYSTEMS.] (a) Medical assistance covers augmentative and 156.19 alternative communication systems consisting of electronic or 156.20 nonelectronic devices and the related components necessary to 156.21 enable a person with severe expressive communication limitations 156.22 to produce or transmit messages or symbols in a manner that 156.23 compensates for that disability. 156.24 (b)By January 1, 1998, the commissioner, in cooperation156.25with the commissioner of administration, shall establish an156.26augmentative and alternative communication system purchasing156.27program within a state agency or by contract with a qualified156.28private entity. The purpose of this service is to facilitate156.29ready availability of the augmentative and alternative156.30communication systems needed to meet the needs of persons with156.31severe expressive communication limitations in an efficient and156.32cost-effective manner. This program shall:156.33(1) coordinate purchase and rental of augmentative and156.34alternative communication systems;156.35(2) negotiate agreements with manufacturers and vendors for156.36purchase of components of these systems, for warranty coverage,157.1and for repair service;157.2(3) when efficient and cost-effective, maintain and157.3refurbish if needed, an inventory of components of augmentative157.4and alternative communication systems for short- or long-term157.5loan to recipients;157.6(4) facilitate training sessions for service providers,157.7consumers, and families on augmentative and alternative157.8communication systems; and157.9(5) develop a recycling program for used augmentative and157.10alternative communications systems to be reissued and used for157.11trials and short-term use, when appropriate.157.12The availability of components of augmentative and157.13alternative communication systems through this program is157.14subject to prior authorization requirements established under157.15subdivision 25The commissioner shall reimburse augmentative and 157.16 alternative communication manufacturers and vendors at the 157.17 manufacturer's suggested retail price for augmentative and 157.18 alternative communication systems and related components. The 157.19 commissioner shall separately reimburse providers for purchasing 157.20 and integrating individual communication systems which are 157.21 unavailable as a package from an augmentative and alternative 157.22 communication vendor. 157.23 (c) Reimbursement rates established by this purchasing 157.24 program are not subject to Minnesota Rules, part 9505.0445, item 157.25 S or T. 157.26 Sec. 23. Minnesota Statutes 1996, section 256B.0625, 157.27 subdivision 34, is amended to read: 157.28 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 157.29 Medical assistance payments toAmerican Indian health services157.30facilities for outpatient medical services billed after June 30,157.311990, must befacilities of the Indian health service and 157.32 facilities operated by a tribe or tribal organization under 157.33 funding authorized by United States Code, title 25, sections 157.34 450f to 450n, or title III of the Indian Self-Determination and 157.35 Education Assistance Act, Public Law Number 93-638, shall be at 157.36 the option of the facility in accordance with the rate published 158.1 by the United States Assistant Secretary for Health under the 158.2 authority of United States Code, title 42, sections 248(a) and 158.3 249(b). General assistance medical care payments to facilities 158.4 of the American Indian health services and facilities operated 158.5 by a tribe or tribal organization for the provision of 158.6 outpatient medical care services billed after June 30, 1990, 158.7 must be in accordance with the general assistance medical care 158.8 rates paid for the same services when provided in a facility 158.9 other thanan Americana facility of the Indian health 158.10 service or a facility operated by a tribe or tribal organization. 158.11 Sec. 24. Minnesota Statutes 1996, section 256B.0625, 158.12 subdivision 38, is amended to read: 158.13 Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments 158.14 for mental health services covered under the medical assistance 158.15 program that are provided by masters-prepared mental health 158.16 professionals shall be 80 percent of the rate paid to 158.17 doctoral-prepared professionals. Payments for mental health 158.18 services covered under the medical assistance program that are 158.19 provided by masters-prepared mental health professionals 158.20 employed by community mental health centers shall be 100 percent 158.21 of the rate paid to doctoral-prepared professionals. For 158.22 purposes of reimbursement of mental health professionals under 158.23 the medical assistance program, all social workers who: 158.24 (1) have received a master's degree in social work from a 158.25 program accredited by the council on social work education; 158.26 (2) are licensed at the level of graduate social worker or 158.27 independent social worker; and 158.28 (3) are practicing clinical social work under appropriate 158.29 supervision, as defined by section 148B.18; meet all 158.30 requirements under Minnesota Rules, part 9505.0323, subpart 24, 158.31 and shall be paid accordingly. 158.32 Sec. 25. Minnesota Statutes 1997 Supplement, section 158.33 256B.0627, subdivision 5, is amended to read: 158.34 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 158.35 payments for home care services shall be limited according to 158.36 this subdivision. 159.1 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 159.2 recipient may receive the following home care services during a 159.3 calendar year: 159.4 (1) any initial assessment; 159.5 (2) up to two reassessments per year done to determine a 159.6 recipient's need for personal care services; and 159.7 (3) up to five skilled nurse visits. 159.8 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 159.9 services above the limits in paragraph (a) must receive the 159.10 commissioner's prior authorization, except when: 159.11 (1) the home care services were required to treat an 159.12 emergency medical condition that if not immediately treated 159.13 could cause a recipient serious physical or mental disability, 159.14 continuation of severe pain, or death. The provider must 159.15 request retroactive authorization no later than five working 159.16 days after giving the initial service. The provider must be 159.17 able to substantiate the emergency by documentation such as 159.18 reports, notes, and admission or discharge histories; 159.19 (2) the home care services were provided on or after the 159.20 date on which the recipient's eligibility began, but before the 159.21 date on which the recipient was notified that the case was 159.22 opened. Authorization will be considered if the request is 159.23 submitted by the provider within 20 working days of the date the 159.24 recipient was notified that the case was opened; 159.25 (3) a third-party payor for home care services has denied 159.26 or adjusted a payment. Authorization requests must be submitted 159.27 by the provider within 20 working days of the notice of denial 159.28 or adjustment. A copy of the notice must be included with the 159.29 request; 159.30 (4) the commissioner has determined that a county or state 159.31 human services agency has made an error; or 159.32 (5) the professional nurse determines an immediate need for 159.33 up to 40 skilled nursing or home health aide visits per calendar 159.34 year and submits a request for authorization within 20 working 159.35 days of the initial service date, and medical assistance is 159.36 determined to be the appropriate payer. 160.1 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 160.2 authorization will be evaluated according to the same criteria 160.3 applied to prior authorization requests. 160.4 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 160.5 section 256B.0627, subdivision 1, paragraph (a), shall be 160.6 conducted initially, and at least annually thereafter, in person 160.7 with the recipient and result in a completed service plan using 160.8 forms specified by the commissioner. Within 30 days of 160.9 recipient or responsible party request for home care services, 160.10 the assessment, the service plan, and other information 160.11 necessary to determine medical necessity such as diagnostic or 160.12 testing information, social or medical histories, and hospital 160.13 or facility discharge summaries shall be submitted to the 160.14 commissioner. For personal care services: 160.15 (1) The amount and type of service authorized based upon 160.16 the assessment and service plan will follow the recipient if the 160.17 recipient chooses to change providers. 160.18 (2) If the recipient's medical need changes, the 160.19 recipient's provider may assess the need for a change in service 160.20 authorization and request the change from the county public 160.21 health nurse. Within 30 days of the request, the public health 160.22 nurse will determine whether to request the change in services 160.23 based upon the provider assessment, or conduct a home visit to 160.24 assess the need and determine whether the change is appropriate. 160.25 (3) To continue to receive personal care serviceswhen the160.26recipient displays no significant change, the county public160.27health nurse has the option to review with the commissioner, or160.28the commissioner's designee, the service plan on record and160.29receive authorization for up to an additional 12 months at a160.30time for up to three years.after the first year, the recipient 160.31 or the responsible party, in conjunction with the public health 160.32 nurse, may complete a service update on forms developed by the 160.33 commissioner. The service update may substitute for the annual 160.34 reassessment described in subdivision 1. 160.35 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 160.36 commissioner's designee, shall review the assessment, the 161.1 service plan, and any additional information that is submitted. 161.2 The commissioner shall, within 30 days after receiving a 161.3 complete request, assessment, and service plan, authorize home 161.4 care services as follows: 161.5 (1) [HOME HEALTH SERVICES.] All home health services 161.6 provided by a licensed nurse or a home health aide must be prior 161.7 authorized by the commissioner or the commissioner's designee. 161.8 Prior authorization must be based on medical necessity and 161.9 cost-effectiveness when compared with other care options. When 161.10 home health services are used in combination with personal care 161.11 and private duty nursing, the cost of all home care services 161.12 shall be considered for cost-effectiveness. The commissioner 161.13 shall limit nurse and home health aide visits to no more than 161.14 one visit each per day. 161.15 (2) [PERSONAL CARE SERVICES.] (i) All personal care 161.16 services and registered nurse supervision must be prior 161.17 authorized by the commissioner or the commissioner's designee 161.18 except for the assessments established in paragraph (a). The 161.19 amount of personal care services authorized must be based on the 161.20 recipient's home care rating. A child may not be found to be 161.21 dependent in an activity of daily living if because of the 161.22 child's age an adult would either perform the activity for the 161.23 child or assist the child with the activity and the amount of 161.24 assistance needed is similar to the assistance appropriate for a 161.25 typical child of the same age. Based on medical necessity, the 161.26 commissioner may authorize: 161.27 (A) up to two times the average number of direct care hours 161.28 provided in nursing facilities for the recipient's comparable 161.29 case mix level; or 161.30 (B) up to three times the average number of direct care 161.31 hours provided in nursing facilities for recipients who have 161.32 complex medical needs or are dependent in at least seven 161.33 activities of daily living and need physical assistance with 161.34 eating or have a neurological diagnosis; or 161.35 (C) up to 60 percent of the average reimbursement rate, as 161.36 of July 1, 1991, for care provided in a regional treatment 162.1 center for recipients who have Level I behavior, plus any 162.2 inflation adjustment as provided by the legislature for personal 162.3 care service; or 162.4 (D) up to the amount the commissioner would pay, as of July 162.5 1, 1991, plus any inflation adjustment provided for home care 162.6 services, for care provided in a regional treatment center for 162.7 recipients referred to the commissioner by a regional treatment 162.8 center preadmission evaluation team. For purposes of this 162.9 clause, home care services means all services provided in the 162.10 home or community that would be included in the payment to a 162.11 regional treatment center; or 162.12 (E) up to the amount medical assistance would reimburse for 162.13 facility care for recipients referred to the commissioner by a 162.14 preadmission screening team established under section 256B.0911 162.15 or 256B.092; and 162.16 (F) a reasonable amount of time for the provision of 162.17 nursing supervision of personal care services. 162.18 (ii) The number of direct care hours shall be determined 162.19 according to the annual cost report submitted to the department 162.20 by nursing facilities. The average number of direct care hours, 162.21 as established by May 1, 1992, shall be calculated and 162.22 incorporated into the home care limits on July 1, 1992. These 162.23 limits shall be calculated to the nearest quarter hour. 162.24 (iii) The home care rating shall be determined by the 162.25 commissioner or the commissioner's designee based on information 162.26 submitted to the commissioner by the county public health nurse 162.27 on forms specified by the commissioner. The home care rating 162.28 shall be a combination of current assessment tools developed 162.29 under sections 256B.0911 and 256B.501 with an addition for 162.30 seizure activity that will assess the frequency and severity of 162.31 seizure activity and with adjustments, additions, and 162.32 clarifications that are necessary to reflect the needs and 162.33 conditions of recipients who need home care including children 162.34 and adults under 65 years of age. The commissioner shall 162.35 establish these forms and protocols under this section and shall 162.36 use an advisory group, including representatives of recipients, 163.1 providers, and counties, for consultation in establishing and 163.2 revising the forms and protocols. 163.3 (iv) A recipient shall qualify as having complex medical 163.4 needs if the care required is difficult to perform and because 163.5 of recipient's medical condition requires more time than 163.6 community-based standards allow or requires more skill than 163.7 would ordinarily be required and the recipient needs or has one 163.8 or more of the following: 163.9 (A) daily tube feedings; 163.10 (B) daily parenteral therapy; 163.11 (C) wound or decubiti care; 163.12 (D) postural drainage, percussion, nebulizer treatments, 163.13 suctioning, tracheotomy care, oxygen, mechanical ventilation; 163.14 (E) catheterization; 163.15 (F) ostomy care; 163.16 (G) quadriplegia; or 163.17 (H) other comparable medical conditions or treatments the 163.18 commissioner determines would otherwise require institutional 163.19 care. 163.20 (v) A recipient shall qualify as having Level I behavior if 163.21 there is reasonable supporting evidence that the recipient 163.22 exhibits, or that without supervision, observation, or 163.23 redirection would exhibit, one or more of the following 163.24 behaviors that cause, or have the potential to cause: 163.25 (A) injury to the recipient's own body; 163.26 (B) physical injury to other people; or 163.27 (C) destruction of property. 163.28 (vi) Time authorized for personal care relating to Level I 163.29 behavior in subclause (v), items (A) to (C), shall be based on 163.30 the predictability, frequency, and amount of intervention 163.31 required. 163.32 (vii) A recipient shall qualify as having Level II behavior 163.33 if the recipient exhibits on a daily basis one or more of the 163.34 following behaviors that interfere with the completion of 163.35 personal care services under subdivision 4, paragraph (a): 163.36 (A) unusual or repetitive habits; 164.1 (B) withdrawn behavior; or 164.2 (C) offensive behavior. 164.3 (viii) A recipient with a home care rating of Level II 164.4 behavior in subclause (vii), items (A) to (C), shall be rated as 164.5 comparable to a recipient with complex medical needs under 164.6 subclause (iv). If a recipient has both complex medical needs 164.7 and Level II behavior, the home care rating shall be the next 164.8 complex category up to the maximum rating under subclause (i), 164.9 item (B). 164.10 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 164.11 nursing services shall be prior authorized by the commissioner 164.12 or the commissioner's designee. Prior authorization for private 164.13 duty nursing services shall be based on medical necessity and 164.14 cost-effectiveness when compared with alternative care options. 164.15 The commissioner may authorize medically necessary private duty 164.16 nursing services in quarter-hour units when: 164.17 (i) the recipient requires more individual and continuous 164.18 care than can be provided during a nurse visit; or 164.19 (ii) the cares are outside of the scope of services that 164.20 can be provided by a home health aide or personal care assistant. 164.21 The commissioner may authorize: 164.22 (A) up to two times the average amount of direct care hours 164.23 provided in nursing facilities statewide for case mix 164.24 classification "K" as established by the annual cost report 164.25 submitted to the department by nursing facilities in May 1992; 164.26 (B) private duty nursing in combination with other home 164.27 care services up to the total cost allowed under clause (2); 164.28 (C) up to 16 hours per day if the recipient requires more 164.29 nursing than the maximum number of direct care hours as 164.30 established in item (A) and the recipient meets the hospital 164.31 admission criteria established under Minnesota Rules, parts 164.32 9505.0500 to 9505.0540. 164.33 The commissioner may authorize up to 16 hours per day of 164.34 medically necessary private duty nursing services or up to 24 164.35 hours per day of medically necessary private duty nursing 164.36 services until such time as the commissioner is able to make a 165.1 determination of eligibility for recipients who are 165.2 cooperatively applying for home care services under the 165.3 community alternative care program developed under section 165.4 256B.49, or until it is determined by the appropriate regulatory 165.5 agency that a health benefit plan is or is not required to pay 165.6 for appropriate medically necessary health care services. 165.7 Recipients or their representatives must cooperatively assist 165.8 the commissioner in obtaining this determination. Recipients 165.9 who are eligible for the community alternative care program may 165.10 not receive more hours of nursing under this section than would 165.11 otherwise be authorized under section 256B.49. 165.12 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 165.13 ventilator-dependent, the monthly medical assistance 165.14 authorization for home care services shall not exceed what the 165.15 commissioner would pay for care at the highest cost hospital 165.16 designated as a long-term hospital under the Medicare program. 165.17 For purposes of this clause, home care services means all 165.18 services provided in the home that would be included in the 165.19 payment for care at the long-term hospital. 165.20 "Ventilator-dependent" means an individual who receives 165.21 mechanical ventilation for life support at least six hours per 165.22 day and is expected to be or has been dependent for at least 30 165.23 consecutive days. 165.24 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 165.25 or the commissioner's designee shall determine the time period 165.26 for which a prior authorization shall be effective. If the 165.27 recipient continues to require home care services beyond the 165.28 duration of the prior authorization, the home care provider must 165.29 request a new prior authorization. Under no circumstances, 165.30 other than the exceptions in paragraph (b), shall a prior 165.31 authorization be valid prior to the date the commissioner 165.32 receives the request or for more than 12 months. A recipient 165.33 who appeals a reduction in previously authorized home care 165.34 services may continue previously authorized services, other than 165.35 temporary services under paragraph (h), pending an appeal under 165.36 section 256.045. The commissioner must provide a detailed 166.1 explanation of why the authorized services are reduced in amount 166.2 from those requested by the home care provider. 166.3 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 166.4 the commissioner's designee shall determine the medical 166.5 necessity of home care services, the level of caregiver 166.6 according to subdivision 2, and the institutional comparison 166.7 according to this subdivision, the cost-effectiveness of 166.8 services, and the amount, scope, and duration of home care 166.9 services reimbursable by medical assistance, based on the 166.10 assessment, primary payer coverage determination information as 166.11 required, the service plan, the recipient's age, the cost of 166.12 services, the recipient's medical condition, and diagnosis or 166.13 disability. The commissioner may publish additional criteria 166.14 for determining medical necessity according to section 256B.04. 166.15 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 166.16 The agency nurse, the independently enrolled private duty nurse, 166.17 or county public health nurse may request a temporary 166.18 authorization for home care services by telephone. The 166.19 commissioner may approve a temporary level of home care services 166.20 based on the assessment, and service or care plan information, 166.21 and primary payer coverage determination information as required. 166.22 Authorization for a temporary level of home care services 166.23 including nurse supervision is limited to the time specified by 166.24 the commissioner, but shall not exceed 45 days, unless extended 166.25 because the county public health nurse has not completed the 166.26 required assessment and service plan, or the commissioner's 166.27 determination has not been made. The level of services 166.28 authorized under this provision shall have no bearing on a 166.29 future prior authorization. 166.30 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 166.31 Home care services provided in an adult or child foster care 166.32 setting must receive prior authorization by the department 166.33 according to the limits established in paragraph (a). 166.34 The commissioner may not authorize: 166.35 (1) home care services that are the responsibility of the 166.36 foster care provider under the terms of the foster care 167.1 placement agreement and administrative rules. Requests for home 167.2 care services for recipients residing in a foster care setting 167.3 must include the foster care placement agreement and 167.4 determination of difficulty of care; 167.5 (2) personal care services when the foster care license 167.6 holder is also the personal care provider or personal care 167.7 assistant unless the recipient can direct the recipient's own 167.8 care, or case management is provided as required in section 167.9 256B.0625, subdivision 19a; 167.10 (3) personal care services when the responsible party is an 167.11 employee of, or under contract with, or has any direct or 167.12 indirect financial relationship with the personal care provider 167.13 or personal care assistant, unless case management is provided 167.14 as required in section 256B.0625, subdivision 19a; 167.15 (4) home care services when the number of foster care 167.16 residents is greater than four unless the county responsible for 167.17 the recipient's foster placement made the placement prior to 167.18 April 1, 1992, requests that home care services be provided, and 167.19 case management is provided as required in section 256B.0625, 167.20 subdivision 19a; or 167.21 (5) home care services when combined with foster care 167.22 payments, other than room and board payments that exceed the 167.23 total amount that public funds would pay for the recipient's 167.24 care in a medical institution. 167.25 Sec. 26. Minnesota Statutes 1997 Supplement, section 167.26 256B.0627, subdivision 8, is amended to read: 167.27 Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.] 167.28 (a) Medical assistance payments for personal care assistance 167.29 shared care shall be limited according to this subdivision. 167.30 (b) Recipients of personal care assistant services may 167.31 share staff and the commissioner shall provide a rate system for 167.32 shared personal care assistant services. For two persons 167.33 sharing care, the ratesystemshall not exceed 1-1/2 times the 167.34 amount paid forproviding services toone person, andshall167.35increase incrementally by one-half the cost of serving a single167.36person, for each person served. A personal care assistant may168.1not serve more than three children in a single setting.for 168.2 three persons, the rate shall not exceed twice the rate for 168.3 serving a single individual. No more than three persons may 168.4 receive shared care from a personal care assistant in a single 168.5 setting. 168.6 (c) Shared care is the provision of personal care services 168.7 by a personal care assistant to two or three recipients at the 168.8 same time and in the same setting. For the purposes of this 168.9 subdivision, "setting" means: 168.10 (1) the home or foster care home of one of the individual 168.11 recipients; or 168.12 (2) a child care program in which all recipients served by 168.13 one personal care assistant are participating, which is licensed 168.14 under chapter 245A or operated by a local school district or 168.15 private school. 168.16 The provisions of this subdivision do not apply when a 168.17 personal care assistant is caring for multiple recipients in 168.18 more than one setting. 168.19 (d) The recipient or the recipient's responsible party, in 168.20 conjunction with the county public health nurse, shall determine: 168.21 (1) whether shared care is an appropriate option based on 168.22 the individual needs and preferences of the recipient; and 168.23 (2) the amount of shared care allocated as part of the 168.24 overall authorization of personal care services. 168.25 The recipient or the responsible party, in conjunction with 168.26 the supervising registered nurse, shall approve the setting, 168.27 grouping, and arrangement of shared care based on the individual 168.28 needs and preferences of the recipients. Decisions on the 168.29 selection of recipients to share care must be based on the ages 168.30 of the recipients, compatibility, and coordination of their care 168.31 needs. 168.32 (e) The following items must be considered by the recipient 168.33 or the responsible party and the supervising nurse, and 168.34 documented in the recipient's care plan: 168.35 (1) the additional qualifications needed by the personal 168.36 care assistant to provide care to several recipients in the same 169.1 setting; 169.2 (2) the additional training and supervision needed by the 169.3 personal care assistant to ensure that the needs of the 169.4 recipient are met appropriately and safely. The provider must 169.5 provide on-site supervision by a registered nurse within the 169.6 first 14 days of shared care, and monthly thereafter; 169.7 (3) the setting in which the shared care will be provided; 169.8 (4) the ongoing monitoring and evaluation of the 169.9 effectiveness and appropriateness of the service and process 169.10 used to make changes in service or setting; and 169.11 (5) a contingency plan which accounts for absence of the 169.12 recipient in a shared care setting due to illness or other 169.13 circumstances and staffing contingencies. 169.14 (f) The provider must offer the recipient or the 169.15 responsible party the option of shared or individual personal 169.16 care assistant care. The recipient or the responsible party can 169.17 withdraw from participating in a shared care arrangement at any 169.18 time. 169.19 (g) Notwithstanding provisions to the contrary, all other 169.20 statutory and regulatory provisions relating to personal care 169.21 services continue to be in effect. 169.22 Nothing in this subdivision shall be construed to reduce 169.23 the total number of hours authorized for an individual recipient. 169.24 Sec. 27. Minnesota Statutes 1997 Supplement, section 169.25 256B.0645, is amended to read: 169.26 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 169.27 ELIGIBILITY.] 169.28 Payment to a provider for a health care service provided to 169.29 a general assistance medical care recipient who is later 169.30 determined eligible for medical assistance or MinnesotaCare 169.31 according to section 256L.14 for the period in which the health 169.32 care service was provided,shall be considered payment in full,169.33and shall notmay be adjusted due to the change in eligibility. 169.34 This sectionappliesdoes not apply toboth fee-for-service169.35payments andpayments made to health plans on a prepaid 169.36 capitated basis. 170.1 Sec. 28. Minnesota Statutes 1997 Supplement, section 170.2 256B.0911, subdivision 2, is amended to read: 170.3 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 170.4 All applicants to Medicaid certified nursing facilities must be 170.5 screened prior to admission, regardless of income, assets, or 170.6 funding sources, except the following: 170.7 (1) patients who, having entered acute care facilities from 170.8 certified nursing facilities, are returning to a certified 170.9 nursing facility; 170.10 (2) residents transferred from other certified nursing 170.11 facilities located within the state of Minnesota; 170.12 (3) individuals who have a contractual right to have their 170.13 nursing facility care paid for indefinitely by the veteran's 170.14 administration; 170.15 (4) individuals who are enrolled in the Ebenezer/Group 170.16 Health social health maintenance organization project, or 170.17 enrolled in a demonstration project under section 256B.69, 170.18 subdivision188, at the time of application to a nursing home; 170.19 (5) individuals previously screened and currently being 170.20 served under the alternative care program or under a home and 170.21 community-based services waiver authorized under section 1915(c) 170.22 of the Social Security Act; or 170.23 (6) individuals who are admitted to a certified nursing 170.24 facility for a short-term stay, which, based upon a physician's 170.25 certification, is expected to be 14 days or less in duration, 170.26 and who have been screened and approved for nursing facility 170.27 admission within the previous six months. This exemption 170.28 applies only if the screener determines at the time of the 170.29 initial screening of the six-month period that it is appropriate 170.30 to use the nursing facility for short-term stays and that there 170.31 is an adequate plan of care for return to the home or 170.32 community-based setting. If a stay exceeds 14 days, the 170.33 individual must be referred no later than the first county 170.34 working day following the 14th resident day for a screening, 170.35 which must be completed within five working days of the 170.36 referral. Payment limitations in subdivision 7 will apply to an 171.1 individual found at screening to not meet the level of care 171.2 criteria for admission to a certified nursing facility. 171.3 Regardless of the exemptions in clauses (2) to (6), persons 171.4 who have a diagnosis or possible diagnosis of mental illness, 171.5 mental retardation, or a related condition must receive a 171.6 preadmission screening before admission unless the admission 171.7 prior to screening is authorized by the local mental health 171.8 authority or the local developmental disabilities case manager, 171.9 or unless authorized by the county agency according to Public 171.10 Law Number 101-508. 171.11 Before admission to a Medicaid certified nursing home or 171.12 boarding care home, all persons must be screened and approved 171.13 for admission through an assessment process. The nursing 171.14 facility is authorized to conduct case mix assessments which are 171.15 not conducted by the county public health nurse under Minnesota 171.16 Rules, part 9549.0059. The designated county agency is 171.17 responsible for distributing the quality assurance and review 171.18 form for all new applicants to nursing homes. 171.19 Other persons who are not applicants to nursing facilities 171.20 must be screened if a request is made for a screening. 171.21 Sec. 29. Minnesota Statutes 1996, section 256B.0911, 171.22 subdivision 4, is amended to read: 171.23 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 171.24 TEAM.] (a) The county shall: 171.25 (1) provide information and education to the general public 171.26 regarding availability of the preadmission screening program; 171.27 (2) accept referrals from individuals, families, human 171.28 service and health professionals, and hospital and nursing 171.29 facility personnel; 171.30 (3) assess the health, psychological, and social needs of 171.31 referred individuals and identify services needed to maintain 171.32 these persons in the least restrictive environments; 171.33 (4) determine if the individual screened needs nursing 171.34 facility level of care; 171.35 (5) assess specialized service needs based upon an 171.36 evaluation by: 172.1 (i) a qualified independent mental health professional for 172.2 persons with a primary or secondary diagnosis of a serious 172.3 mental illness; and 172.4 (ii) a qualified mental retardation professional for 172.5 persons with a primary or secondary diagnosis of mental 172.6 retardation or related conditions. For purposes of this clause, 172.7 a qualified mental retardation professional must meet the 172.8 standards for a qualified mental retardation professional in 172.9 Code of Federal Regulations, title 42, section 483.430; 172.10 (6) make recommendations for individuals screened regarding 172.11 cost-effective community services which are available to the 172.12 individual; 172.13 (7) make recommendations for individuals screened regarding 172.14 nursing home placement when there are no cost-effective 172.15 community services available; 172.16 (8) develop an individual's community care plan and provide 172.17 follow-up services as needed; and 172.18 (9) prepare and submit reports that may be required by the 172.19 commissioner of human services. 172.20 (b) The screener shall document that the most 172.21 cost-effective alternatives available were offered to the 172.22 individual or the individual's legal representative. For 172.23 purposes of this section, "cost-effective alternatives" means 172.24 community services and living arrangements that cost the same or 172.25 less than nursing facility care. 172.26 (c)Screeners shall adhere to the level of care criteria172.27for admission to a certified nursing facility established under172.28section 144.0721.172.29(d)For persons who are eligible for medical assistance or 172.30 who would be eligible within 180 days of admission to a nursing 172.31 facility and who are admitted to a nursing facility, the nursing 172.32 facility must include a screener or the case manager in the 172.33 discharge planning process for those individuals who the team 172.34 has determined have discharge potential. The screener or the 172.35 case manager must ensure a smooth transition and follow-up for 172.36 the individual's return to the community. 173.1 Screeners shall cooperate with other public and private 173.2 agencies in the community, in order to offer a variety of 173.3 cost-effective services to the disabled and elderly. The 173.4 screeners shall encourage the use of volunteers from families, 173.5 religious organizations, social clubs, and similar civic and 173.6 service organizations to provide services. 173.7 Sec. 30. Minnesota Statutes 1997 Supplement, section 173.8 256B.0911, subdivision 7, is amended to read: 173.9 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 173.10 (a) Medical assistance reimbursement for nursing facilities 173.11 shall be authorized for a medical assistance recipient only if a 173.12 preadmission screening has been conducted prior to admission or 173.13 the local county agency has authorized an exemption. Medical 173.14 assistance reimbursement for nursing facilities shall not be 173.15 provided for any recipient who the local screener has determined 173.16 does not meet the level of care criteria for nursing facility 173.17 placement or, if indicated, has not had a level II PASARR 173.18 evaluation completed unless an admission for a recipient with 173.19 mental illness is approved by the local mental health authority 173.20 or an admission for a recipient with mental retardation or 173.21 related condition is approved by the state mental retardation 173.22 authority.The county preadmission screening team may deny173.23certified nursing facility admission using the level of care173.24criteria established under section 144.0721 and deny medical173.25assistance reimbursement for certified nursing facility care.173.26Persons receiving care in a certified nursing facility or173.27certified boarding care home who are reassessed by the173.28commissioner of health according to section 144.0722 and173.29determined to no longer meet the level of care criteria for a173.30certified nursing facility or certified boarding care home may173.31no longer remain a resident in the certified nursing facility or173.32certified boarding care home and must be relocated to the173.33community if the persons were admitted on or after July 1, 1998.173.34 (b)Persons receiving services under section 256B.0913,173.35subdivisions 1 to 14, or 256B.0915 who are reassessed and found173.36to not meet the level of care criteria for admission to a174.1certified nursing facility or certified boarding care home may174.2no longer receive these services if persons were admitted to the174.3program on or after July 1, 1998.The commissioner shall make a 174.4 request to the health care financing administration for a waiver 174.5 allowing screening team approval of Medicaid payments for 174.6 certified nursing facility care. An individual has a choice and 174.7 makes the final decision between nursing facility placement and 174.8 community placement after the screening team's recommendation, 174.9 except as provided in paragraphs (b) and (c). 174.10 (c) The local county mental health authority or the state 174.11 mental retardation authority under Public Law Numbers 100-203 174.12 and 101-508 may prohibit admission to a nursing facility, if the 174.13 individual does not meet the nursing facility level of care 174.14 criteria or needs specialized services as defined in Public Law 174.15 Numbers 100-203 and 101-508. For purposes of this section, 174.16 "specialized services" for a person with mental retardation or a 174.17 related condition means "active treatment" as that term is 174.18 defined in Code of Federal Regulations, title 42, section 174.19 483.440(a)(1). 174.20 (d) Upon the receipt by the commissioner of approval by the 174.21 Secretary of Health and Human Services of the waiver requested 174.22 under paragraph (a), the local screener shall deny medical 174.23 assistance reimbursement for nursing facility care for an 174.24 individual whose long-term care needs can be met in a 174.25 community-based setting and whose cost of community-based home 174.26 care services is less than 75 percent of the average payment for 174.27 nursing facility care for that individual's case mix 174.28 classification, and who is either: 174.29 (i) a current medical assistance recipient being screened 174.30 for admission to a nursing facility; or 174.31 (ii) an individual who would be eligible for medical 174.32 assistance within 180 days of entering a nursing facility and 174.33 who meets a nursing facility level of care. 174.34 (e) Appeals from the screening team's recommendation or the 174.35 county agency's final decision shall be made according to 174.36 section 256.045, subdivision 3. 175.1 Sec. 31. Minnesota Statutes 1997 Supplement, section 175.2 256B.0915, subdivision 1d, is amended to read: 175.3 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 175.4 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 175.5 provisions of section 256B.056, the commissioner shall make the 175.6 following amendment to the medical assistance elderly waiver 175.7 program effective July 1,19971999, or upon federal approval, 175.8 whichever is later. 175.9 A recipient's maintenance needs will be an amount equal to 175.10 the Minnesota supplemental aid equivalent rate as defined in 175.11 section 256I.03, subdivision 5, plus the medical assistance 175.12 personal needs allowance as defined in section 256B.35, 175.13 subdivision 1, paragraph (a), when applying posteligibility 175.14 treatment of income rules to the gross income of elderly waiver 175.15 recipients, except for individuals whose income is in excess of 175.16 the special income standard according to Code of Federal 175.17 Regulations, title 42, section 435.236. Recipient maintenance 175.18 needs shall be adjusted under this provision each July 1. 175.19 (b) The commissioner of human services shall secure 175.20 approval of additional elderly waiver slots sufficient to serve 175.21 persons who will qualify under the revised income standard 175.22 described in paragraph (a) before implementing section 175.23 256B.0913, subdivision 16. 175.24 Sec. 32. Minnesota Statutes 1996, section 256B.41, 175.25 subdivision 1, is amended to read: 175.26 Subdivision 1. [AUTHORITY.] The commissioner shall 175.27 establish, by rule, procedures for determining rates for care of 175.28 residents of nursing facilities which qualify as vendors of 175.29 medical assistance, and for implementing the provisions of this 175.30 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 175.31 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 175.32be based on methods and standards that the commissioner finds175.33are adequate to provide for the costs that must be incurred for175.34the care of residents in efficiently and economically operated175.35nursing facilities and shallspecify the costs that are 175.36 allowable for establishing payment rates through medical 176.1 assistance. 176.2 Sec. 33. Minnesota Statutes 1996, section 256B.431, 176.3 subdivision 2b, is amended to read: 176.4 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 176.5 rate years beginning on or after July 1, 1985, the commissioner 176.6 shall establish procedures for determining per diem 176.7 reimbursement for operating costs. 176.8 (b) The commissioner shall contract with an econometric 176.9 firm with recognized expertise in and access to national 176.10 economic change indices that can be applied to the appropriate 176.11 cost categories when determining the operating cost payment rate. 176.12 (c) The commissioner shall analyze and evaluate each 176.13 nursing facility's cost report of allowable operating costs 176.14 incurred by the nursing facility during the reporting year 176.15 immediately preceding the rate year for which the payment rate 176.16 becomes effective. 176.17 (d) The commissioner shall establish limits on actual 176.18 allowable historical operating cost per diems based on cost 176.19 reports of allowable operating costs for the reporting year that 176.20 begins October 1, 1983, taking into consideration relevant 176.21 factors including resident needs, geographic location, and size 176.22 of the nursing facility, and the costs that must be incurred for176.23the care of residents in an efficiently and economically176.24operated nursing facility. In developing the geographic groups 176.25 for purposes of reimbursement under this section, the 176.26 commissioner shall ensure that nursing facilities in any county 176.27 contiguous to the Minneapolis-St. Paul seven-county metropolitan 176.28 area are included in the same geographic group. The limits 176.29 established by the commissioner shall not be less, in the 176.30 aggregate, than the 60th percentile of total actual allowable 176.31 historical operating cost per diems for each group of nursing 176.32 facilities established under subdivision 1 based on cost reports 176.33 of allowable operating costs in the previous reporting year. 176.34 For rate years beginning on or after July 1, 1989, facilities 176.35 located in geographic group I as described in Minnesota Rules, 176.36 part 9549.0052, on January 1, 1989, may choose to have the 177.1 commissioner apply either the care related limits or the other 177.2 operating cost limits calculated for facilities located in 177.3 geographic group II, or both, if either of the limits calculated 177.4 for the group II facilities is higher. The efficiency incentive 177.5 for geographic group I nursing facilities must be calculated 177.6 based on geographic group I limits. The phase-in must be 177.7 established utilizing the chosen limits. For purposes of these 177.8 exceptions to the geographic grouping requirements, the 177.9 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 177.10 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 177.11 established under this paragraph remain in effect until the 177.12 commissioner establishes a new base period. Until the new base 177.13 period is established, the commissioner shall adjust the limits 177.14 annually using the appropriate economic change indices 177.15 established in paragraph (e). In determining allowable 177.16 historical operating cost per diems for purposes of setting 177.17 limits and nursing facility payment rates, the commissioner 177.18 shall divide the allowable historical operating costs by the 177.19 actual number of resident days, except that where a nursing 177.20 facility is occupied at less than 90 percent of licensed 177.21 capacity days, the commissioner may establish procedures to 177.22 adjust the computation of the per diem to an imputed occupancy 177.23 level at or below 90 percent. The commissioner shall establish 177.24 efficiency incentives as appropriate. The commissioner may 177.25 establish efficiency incentives for different operating cost 177.26 categories. The commissioner shall consider establishing 177.27 efficiency incentives in care related cost categories. The 177.28 commissioner may combine one or more operating cost categories 177.29 and may use different methods for calculating payment rates for 177.30 each operating cost category or combination of operating cost 177.31 categories. For the rate year beginning on July 1, 1985, the 177.32 commissioner shall: 177.33 (1) allow nursing facilities that have an average length of 177.34 stay of 180 days or less in their skilled nursing level of care, 177.35 125 percent of the care related limit and 105 percent of the 177.36 other operating cost limit established by rule; and 178.1 (2) exempt nursing facilities licensed on July 1, 1983, by 178.2 the commissioner to provide residential services for the 178.3 physically handicapped under Minnesota Rules, parts 9570.2000 to 178.4 9570.3600, from the care related limits and allow 105 percent of 178.5 the other operating cost limit established by rule. 178.6 For the purpose of calculating the other operating cost 178.7 efficiency incentive for nursing facilities referred to in 178.8 clause (1) or (2), the commissioner shall use the other 178.9 operating cost limit established by rule before application of 178.10 the 105 percent. 178.11 (e) The commissioner shall establish a composite index or 178.12 indices by determining the appropriate economic change 178.13 indicators to be applied to specific operating cost categories 178.14 or combination of operating cost categories. 178.15 (f) Each nursing facility shall receive an operating cost 178.16 payment rate equal to the sum of the nursing facility's 178.17 operating cost payment rates for each operating cost category. 178.18 The operating cost payment rate for an operating cost category 178.19 shall be the lesser of the nursing facility's historical 178.20 operating cost in the category increased by the appropriate 178.21 index established in paragraph (e) for the operating cost 178.22 category plus an efficiency incentive established pursuant to 178.23 paragraph (d) or the limit for the operating cost category 178.24 increased by the same index. If a nursing facility's actual 178.25 historic operating costs are greater than the prospective 178.26 payment rate for that rate year, there shall be no retroactive 178.27 cost settle-up. In establishing payment rates for one or more 178.28 operating cost categories, the commissioner may establish 178.29 separate rates for different classes of residents based on their 178.30 relative care needs. 178.31 (g) The commissioner shall include the reported actual real 178.32 estate tax liability or payments in lieu of real estate tax of 178.33 each nursing facility as an operating cost of that nursing 178.34 facility. Allowable costs under this subdivision for payments 178.35 made by a nonprofit nursing facility that are in lieu of real 178.36 estate taxes shall not exceed the amount which the nursing 179.1 facility would have paid to a city or township and county for 179.2 fire, police, sanitation services, and road maintenance costs 179.3 had real estate taxes been levied on that property for those 179.4 purposes. For rate years beginning on or after July 1, 1987, 179.5 the reported actual real estate tax liability or payments in 179.6 lieu of real estate tax of nursing facilities shall be adjusted 179.7 to include an amount equal to one-half of the dollar change in 179.8 real estate taxes from the prior year. The commissioner shall 179.9 include a reported actual special assessment, and reported 179.10 actual license fees required by the Minnesota department of 179.11 health, for each nursing facility as an operating cost of that 179.12 nursing facility. For rate years beginning on or after July 1, 179.13 1989, the commissioner shall include a nursing facility's 179.14 reported public employee retirement act contribution for the 179.15 reporting year as apportioned to the care-related operating cost 179.16 categories and other operating cost categories multiplied by the 179.17 appropriate composite index or indices established pursuant to 179.18 paragraph (e) as costs under this paragraph. Total adjusted 179.19 real estate tax liability, payments in lieu of real estate tax, 179.20 actual special assessments paid, the indexed public employee 179.21 retirement act contribution, and license fees paid as required 179.22 by the Minnesota department of health, for each nursing facility 179.23 (1) shall be divided by actual resident days in order to compute 179.24 the operating cost payment rate for this operating cost 179.25 category, (2) shall not be used to compute the care-related 179.26 operating cost limits or other operating cost limits established 179.27 by the commissioner, and (3) shall not be increased by the 179.28 composite index or indices established pursuant to paragraph 179.29 (e), unless otherwise indicated in this paragraph. 179.30 (h) For rate years beginning on or after July 1, 1987, the 179.31 commissioner shall adjust the rates of a nursing facility that 179.32 meets the criteria for the special dietary needs of its 179.33 residents and the requirements in section 31.651. The 179.34 adjustment for raw food cost shall be the difference between the 179.35 nursing facility's allowable historical raw food cost per diem 179.36 and 115 percent of the median historical allowable raw food cost 180.1 per diem of the corresponding geographic group. 180.2 The rate adjustment shall be reduced by the applicable 180.3 phase-in percentage as provided under subdivision 2h. 180.4(i) For the cost report year ending September 30, 1996, and180.5for all subsequent reporting years, certified nursing facilities180.6must identify, differentiate, and record resident day statistics180.7for residents in case mix classification A who, on or after July180.81, 1996, meet the modified level of care criteria in section180.9144.0721. The resident day statistics shall be separated into180.10case mix classification A-1 for any resident day meeting the180.11high-function class A level of care criteria and case mix180.12classification A-2 for other case mix class A resident days.180.13 Sec. 34. Minnesota Statutes 1996, section 256B.431, is 180.14 amended by adding a subdivision to read: 180.15 Subd. 27. [SPEND-UP AND HIGH COST LIMITS INDEXED; NOT 180.16 REBASED.] (a) For rate years beginning on or after July 1, 1998, 180.17 the commissioner shall modify the determination of the spend-up 180.18 limits referred to in subdivision 26, paragraph (a), by indexing 180.19 each group's previous year's median value by the factor in 180.20 subdivision 26, paragraph (d), clause (2), plus one percentage 180.21 point. 180.22 (b) For rate years beginning on or after July 1, 1998, the 180.23 commissioner shall modify the determination of the high cost 180.24 limits referred to in subdivision 26, paragraph (b), by indexing 180.25 each group's previous year's high cost per diem limits at .5 and 180.26 one standard deviations above the median by the factor in 180.27 subdivision 26, paragraph (d), clause (2), plus one percentage 180.28 point. 180.29 Sec. 35. Minnesota Statutes 1996, section 256B.501, 180.30 subdivision 2, is amended to read: 180.31 Subd. 2. [AUTHORITY.] The commissioner shall establish 180.32 procedures and rules for determining rates for care of residents 180.33 of intermediate care facilities for persons with mental 180.34 retardation or related conditions which qualify as providers of 180.35 medical assistance and waivered services.Approved rates shall180.36be established on the basis of methods and standards that the181.1commissioner finds adequate to provide for the costs that must181.2be incurred for the quality care of residents in efficiently and181.3economically operated facilities and services.The procedures 181.4 shall specify the costs that are allowable for payment through 181.5 medical assistance. The commissioner may use experts from 181.6 outside the department in the establishment of the procedures. 181.7 Sec. 36. Minnesota Statutes 1997 Supplement, section 181.8 256B.69, subdivision 2, is amended to read: 181.9 Subd. 2. [DEFINITIONS.] For the purposes of this section, 181.10 the following terms have the meanings given. 181.11 (a) "Commissioner" means the commissioner of human services. 181.12 For the remainder of this section, the commissioner's 181.13 responsibilities for methods and policies for implementing the 181.14 project will be proposed by the project advisory committees and 181.15 approved by the commissioner. 181.16 (b) "Demonstration provider" means a health maintenance 181.17 organizationor, community integrated service network, or 181.18 accountable provider network authorized and operating under 181.19 chapter 62Dor, 62N, or 62T that participates in the 181.20 demonstration project according to criteria, standards, methods, 181.21 and other requirements established for the project and approved 181.22 by the commissioner. Notwithstanding the above, Itasca county 181.23 may continue to participate as a demonstration provider until 181.24 July 1, 2000. 181.25 (c) "Eligible individuals" means those persons eligible for 181.26 medical assistance benefits as defined in sections 256B.055, 181.27 256B.056, and 256B.06. 181.28 (d) "Limitation of choice" means suspending freedom of 181.29 choice while allowing eligible individuals to choose among the 181.30 demonstration providers. 181.31 (e) This paragraph supersedes paragraph (c) as long as the 181.32 Minnesota health care reform waiver remains in effect. When the 181.33 waiver expires, this paragraph expires and the commissioner of 181.34 human services shall publish a notice in the State Register and 181.35 notify the revisor of statutes. "Eligible individuals" means 181.36 those persons eligible for medical assistance benefits as 182.1 defined in sections 256B.055, 256B.056, and 256B.06. 182.2 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 182.3 individual who becomes ineligible for the program because of 182.4 failure to submit income reports or recertification forms in a 182.5 timely manner, shall remain enrolled in the prepaid health plan 182.6 and shall remain eligible to receive medical assistance coverage 182.7 through the last day of the month following the month in which 182.8 the enrollee became ineligible for the medical assistance 182.9 program. 182.10 Sec. 37. Minnesota Statutes 1997 Supplement, section 182.11 256B.69, subdivision 3a, is amended to read: 182.12 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 182.13 implementing the general assistance medical care, or medical 182.14 assistance prepayment program within a county, must include the 182.15 county board in the process of development, approval, and 182.16 issuance of the request for proposals to provide services to 182.17 eligible individuals within the proposed county. County boards 182.18 must be given reasonable opportunity to make recommendations 182.19 regarding the development, issuance, review of responses, and 182.20 changes needed in the request for proposals. The commissioner 182.21 must provide county boards the opportunity to review each 182.22 proposal based on the identification of community needs under 182.23 chapters 145A and 256E and county advocacy activities. If a 182.24 county board finds that a proposal does not address certain 182.25 community needs, the county board and commissioner shall 182.26 continue efforts for improving the proposal and network prior to 182.27 the approval of the contract. The county board shall make 182.28 recommendations regarding the approval of local networks and 182.29 their operations to ensure adequate availability and access to 182.30 covered services. The provider or health plan must respond 182.31 directly to county advocates and the state prepaid medical 182.32 assistance ombudsperson regarding service delivery and must be 182.33 accountable to the state regarding contracts with medical 182.34 assistance and general assistance medical care funds. The 182.35 county board may recommend a maximum number of participating 182.36 health plans after considering the size of the enrolling 183.1 population; ensuring adequate access and capacity; considering 183.2 the client and county administrative complexity; and considering 183.3 the need to promote the viability of locally developed health 183.4 plans. The county board or a single entity representing a group 183.5 of county boards and the commissioner shall mutually select 183.6 health plans for participation at the time of initial 183.7 implementation of the prepaid medical assistance program in that 183.8 county or group of counties and at the time of contract renewal. 183.9 The commissioner shall also seek input for contract requirements 183.10 from the county or single entity representing a group of county 183.11 boards at each contract renewal and incorporate those 183.12 recommendations into the contract negotiation process. The 183.13 commissioner, in conjunction with the county board, shall 183.14 actively seek to develop a mutually agreeable timetable prior to 183.15 the development of the request for proposal, but counties must 183.16 agree to initial enrollment beginning on or before January 1, 183.17 1999, in either the prepaid medical assistance and general 183.18 assistance medical care programs or county-based purchasing 183.19 under section 256B.692. At least 90 days before enrollment in 183.20 the medical assistance and general assistance medical care 183.21 prepaid programs begins in a county in which the prepaid 183.22 programs have not been established, the commissioner shall 183.23 provide a report to the chairs of senate and house committees 183.24 having jurisdiction over state health care programs which 183.25 verifies that the commissioner complied with the requirements 183.26 for county involvement that are specified in this subdivision. 183.27 (b) The commissioner shall seek a federal waiver to allow a 183.28 fee-for-service plan option to MinnesotaCare enrollees. The 183.29 commissioner shall develop an increase of the premium fees 183.30 required under section 256L.06 up to 20 percent of the premium 183.31 fees for the enrollees who elect the fee-for-service option. 183.32 Prior to implementation, the commissioner shall submit this fee 183.33 schedule to the chair and ranking minority member of the senate 183.34 health care committee, the senate health care and family 183.35 services funding division, the house of representatives health 183.36 and human services committee, and the house of representatives 184.1 health and human services finance division. 184.2 (c) At the option of the county board, the board may 184.3 develop contract requirements related to the achievement of 184.4 local public health goals to meet the health needs of medical 184.5 assistance and general assistance medical care enrollees. These 184.6 requirements must be reasonably related to the performance of 184.7 health plan functions and within the scope of the medical 184.8 assistance and general assistance medical care benefit sets. If 184.9 the county board and the commissioner mutually agree to such 184.10 requirements, the department shall include such requirements in 184.11 all health plan contracts governing the prepaid medical 184.12 assistance and general assistance medical care programs in that 184.13 county at initial implementation of the program in that county 184.14 and at the time of contract renewal. The county board may 184.15 participate in the enforcement of the contract provisions 184.16 related to local public health goals. 184.17 (d) For counties in which prepaid medical assistance and 184.18 general assistance medical care programs have not been 184.19 established, the commissioner shall not implement those programs 184.20 if a county board submits acceptable and timely preliminary and 184.21 final proposals under section 256B.692, until county-based 184.22 purchasing is no longer operational in that county. For 184.23 counties in which prepaid medical assistance and general 184.24 assistance medical care programs are in existence on or after 184.25 September 1, 1997, the commissioner must terminate contracts 184.26 with health plans according to section 256B.692, subdivision 5, 184.27 if the county board submits and the commissioner accepts 184.28 preliminary and final proposals according to that subdivision. 184.29 The commissioner is not required to terminate contracts that 184.30 begin on or after September 1, 1997, according to section 184.31 256B.692 until two years have elapsed from the date of initial 184.32 enrollment. 184.33 (e) In the event that a county board or a single entity 184.34 representing a group of county boards and the commissioner 184.35 cannot reach agreement regarding: (i) the selection of 184.36 participating health plans in that county; (ii) contract 185.1 requirements; or (iii) implementation and enforcement of county 185.2 requirements including provisions regarding local public health 185.3 goals, the commissioner shall resolve all disputes after taking 185.4 into account the recommendations of a three-person mediation 185.5 panel. The panel shall be composed of one designee of the 185.6 president of the association of Minnesota counties, one designee 185.7 of the commissioner of human services, and one designee of the 185.8 commissioner of health. 185.9 (f) If a county which elects to implement county-based 185.10 purchasing ceases to implement county-based purchasing, it is 185.11 prohibited from assuming the responsibility of county-based 185.12 purchasing for a period of five years from the date it 185.13 discontinues purchasing. 185.14 (g) Notwithstanding the requirement in paragraph (a) that a 185.15 county must agree to initial enrollment on or before January 1, 185.16 1999, the commissioner shall grant a delay of up to 12 months in 185.17 the implementation of the county-based purchasing authorized in 185.18 section 256B.692 if the county or group of counties has 185.19 submitted a preliminary proposal for county-based purchasing by 185.20 September 1, 1997, has not already implemented the prepaid 185.21 medical assistance program before January 1, 1998, and has 185.22 submitted a written request for the delay to the commissioner by 185.23 July 1, 1998. In order for the delay to be continued, the 185.24 county or group of counties must also submit to the commissioner 185.25 the following information by December 1, 1998: 185.26 (1) identify the proposed date of implementation, not later 185.27 than January 1, 2000; 185.28 (2) include copies of the county board resolutions which 185.29 demonstrate the continued commitment to the implementation of 185.30 county-based purchasing by the proposed date of implementation. 185.31 County board authorization may remain contingent on the 185.32 submission of a final proposal which meets the requirements of 185.33 section 256B.692, subdivision 5, paragraph (b); 185.34 (3) if more than one county is involved in the proposal, 185.35 demonstrate actions taken for the establishment of a governance 185.36 structure between the participating counties and describe how 186.1 the fiduciary responsibilities of county-based purchasing will 186.2 be allocated between the counties; 186.3 (4) describe actions taken to identify how the risk of a 186.4 deficit will be managed in the event expenditures are greater 186.5 than total capitation payments. This description must identify 186.6 how any of the following strategies will be assessed: 186.7 (i) risk contracts with licensed health plans; 186.8 (ii) risk arrangements with providers who are not licensed 186.9 health plans; 186.10 (iii) risk arrangements with other licensed insurance 186.11 entities; and 186.12 (iv) funding from other county resources; 186.13 (5) include, if county-based purchasing will not contract 186.14 with licensed health plans or provider networks, letters of 186.15 interest from local providers in at least the categories of 186.16 hospital, physician, mental health, and pharmacy which express 186.17 interest in contracting for services; and 186.18 (6) describe the options being considered to obtain the 186.19 administrative services required in section 256B.692, 186.20 subdivision 3, clauses (3) and (5). 186.21 For counties which receive a delay under this subdivision, 186.22 the final proposals required under section 256B.692, subdivision 186.23 5, paragraph (b), must be submitted at least six months prior to 186.24 the requested implementation date. Authority to implement 186.25 county-based purchasing remains contingent on approval of the 186.26 final proposal as required under section 256B.692. 186.27 Sec. 38. Minnesota Statutes 1996, section 256B.69, is 186.28 amended by adding a subdivision to read: 186.29 Subd. 25. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 186.30 or after January 1, 1999, for American Indian recipients of 186.31 medical assistance who are required to enroll with a 186.32 demonstration provider under subdivision 4 or in a county-based 186.33 purchasing entity, if applicable, under section 256B.692, 186.34 medical assistance shall cover health care services provided at 186.35 Indian health services facilities and facilities operated by a 186.36 tribe or tribal organization under funding authorized by United 187.1 States Code, title 25, sections 450f to 450n, or title III of 187.2 the Indian Self-Determination and Education Assistance Act, 187.3 Public Law Number 93-638, if those services would otherwise be 187.4 covered under section 256B.0625. Payments for services provided 187.5 under this subdivision shall be made on a fee-for-service basis, 187.6 and may, at the option of the tribe or tribal organization, be 187.7 made in accordance with rates authorized under sections 256.969, 187.8 subdivision 16, and 256B.0625, subdivision 34. Implementation 187.9 of this subdivision is contingent on federal approval. 187.10 (b) The commissioner of human services, in consultation 187.11 with the tribal governments, shall develop a plan for tribes to 187.12 assist in the enrollment process for American Indian recipients 187.13 enrolled in the prepaid medical assistance program under this 187.14 section or the prepaid general assistance medical care program 187.15 under section 256D.03, subdivision 4, paragraph (d). This plan 187.16 also shall address how tribes will be included in ensuring the 187.17 coordination of care for American Indian recipients between 187.18 Indian health service or tribal providers and other providers. 187.19 (c) For purposes of this subdivision, "American Indian" has 187.20 the meaning given to persons to whom services will be provided 187.21 for in Code of Federal Regulations, title 42, section 36.12. 187.22 (d) This subdivision also applies to American Indian 187.23 recipients of general assistance medical care and to the prepaid 187.24 general assistance medical care program under section 256D.03, 187.25 subdivision 4, paragraph (d). 187.26 Sec. 39. Minnesota Statutes 1997 Supplement, section 187.27 256B.692, subdivision 2, is amended to read: 187.28 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 187.29 Notwithstanding chapters 62D and 62N, a county that elects to 187.30 purchase medical assistance and general assistance medical care 187.31 in return for a fixed sum without regard to the frequency or 187.32 extent of services furnished to any particular enrollee is not 187.33 required to obtain a certificate of authority under chapter 62D 187.34 or 62N. A county that elects to purchase medical assistance and 187.35 general assistance medical care services under this section must 187.36 satisfy the commissioner of health that the requirements of 188.1 chapter 62D, applicable to health maintenance organizations, or 188.2 chapter 62N, applicable to community integrated service 188.3 networks, will be met. A county must also assure the 188.4 commissioner of health that the requirements ofsectionsections 188.5 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 188.6 applicable provisions of chapter 62Q, including sections 62Q.07; 188.7 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 188.8 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 188.9 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 188.10 will be met. All enforcement and rulemaking powers available 188.11 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 188.12 granted to the commissioner of health with respect to counties 188.13 that purchase medical assistance and general assistance medical 188.14 care services under this section. 188.15 Sec. 40. Minnesota Statutes 1997 Supplement, section 188.16 256B.692, subdivision 5, is amended to read: 188.17 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 188.18 1997, a county board that wishes to purchase or provide health 188.19 care under this section must submit a preliminary proposal that 188.20 substantially demonstrates the county's ability to meet all the 188.21 requirements of this section in response to criteria for 188.22 proposals issued by the department on or before July 1, 1997. 188.23 Counties submitting preliminary proposals must establish a local 188.24 planning process that involves input from medical assistance and 188.25 general assistance medical care recipients, recipient advocates, 188.26 providers and representatives of local school districts, labor, 188.27 and tribal government to advise on the development of a final 188.28 proposal and its implementation. 188.29 (b) The county board must submit a final proposal on or 188.30 before July 1, 1998, that demonstrates the ability to meet all 188.31 the requirements of this section, including beginning enrollment 188.32 on January 1, 1999, unless a delay has been granted under 188.33 section 256B.69, subdivision 3a, paragraph (g). 188.34 (c) After January 1, 1999, for a county in which the 188.35 prepaid medical assistance program is in existence, the county 188.36 board must submit a preliminary proposal at least 15 months 189.1 prior to termination of health plan contracts in that county and 189.2 a final proposal six months prior to the health plan contract 189.3 termination date in order to begin enrollment after the 189.4 termination. Nothing in this section shall impede or delay 189.5 implementation or continuation of the prepaid medical assistance 189.6 and general assistance medical care programs in counties for 189.7 which the board does not submit a proposal, or submits a 189.8 proposal that is not in compliance with this section. 189.9 (d) The commissioner is not required to terminate contracts 189.10 for the prepaid medical assistance and prepaid general 189.11 assistance medical care programs that begin on or after 189.12 September 1, 1997, in a county for which a county board has 189.13 submitted a proposal under this paragraph, until two years have 189.14 elapsed from the date of initial enrollment in the prepaid 189.15 medical assistance and prepaid general assistance medical care 189.16 programs. 189.17 Sec. 41. Minnesota Statutes 1997 Supplement, section 189.18 256B.77, subdivision 3, is amended to read: 189.19 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 189.20 county authority that elects to participate in a demonstration 189.21 project for people with disabilities under this section is not 189.22 required to obtain a certificate of authority under chapter 62D 189.23 or 62N. A county authority that elects to participate in a 189.24 demonstration project for people with disabilities under this 189.25 section must assure the commissioner of health that the 189.26 requirements of chapters 62Dand, 62N, and section 256B.692, 189.27 subdivision 2, are met. All enforcement and rulemaking powers 189.28 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 189.29 granted to the commissioner of health with respect to the county 189.30 authorities that contract with the commissioner to purchase 189.31 services in a demonstration project for people with disabilities 189.32 under this section. 189.33 Sec. 42. Minnesota Statutes 1997 Supplement, section 189.34 256B.77, subdivision 7a, is amended to read: 189.35 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 189.36 for the demonstration project as provided in this subdivision. 190.1 (b) "Eligible individuals" means those persons living in 190.2 the demonstration site who are eligible for medical assistance 190.3 and are disabled based on a disability determination under 190.4 section 256B.055, subdivisions 7 and 12, or who are eligible for 190.5 medical assistance and have been diagnosed as having: 190.6 (1) serious and persistent mental illness as defined in 190.7 section 245.462, subdivision 20; 190.8 (2) severe emotional disturbance as defined in section 190.9 245.487, subdivision 6; or 190.10 (3) mental retardation, or being a mentally retarded person 190.11 as defined in section 252A.02, or a related condition as defined 190.12 in section 252.27, subdivision 1a. 190.13 Other individuals may be included at the option of the county 190.14 authority based on agreement with the commissioner. 190.15 (c) Eligible individuals residing on a federally recognized 190.16 Indian reservation may be excluded from participation in the 190.17 demonstration project at the discretion of the tribal government 190.18 based on agreement with the commissioner, in consultation with 190.19 the county authority. 190.20 (d) Eligible individuals include individuals in excluded 190.21 time status, as defined in chapter 256G. Enrollees in excluded 190.22 time at the time of enrollment shall remain in excluded time 190.23 status as long as they live in the demonstration site and shall 190.24 be eligible for 90 days after placement outside the 190.25 demonstration site if they move to excluded time status in a 190.26 county within Minnesota other than their county of financial 190.27 responsibility. 190.28 (e) A person who is a sexual psychopathic personality as 190.29 defined in section 253B.02, subdivision 18a, or a sexually 190.30 dangerous person as defined in section 253B.02, subdivision 18b, 190.31 is excluded from enrollment in the demonstration project. 190.32 Sec. 43. Minnesota Statutes 1997 Supplement, section 190.33 256B.77, subdivision 10, is amended to read: 190.34 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 190.35 pay a capitation payment to the county authority and, when 190.36 applicable under subdivision 6, paragraph (a), to the service 191.1 delivery organization for each medical assistance eligible 191.2 enrollee. The commissioner shall develop capitation payment 191.3 rates for the initial contract period for each demonstration 191.4 site in consultation with an independent actuary, to ensure that 191.5 the cost of services under the demonstration project does not 191.6 exceed the estimated cost for medical assistance services for 191.7 the covered population under the fee-for-service system for the 191.8 demonstration period. For each year of the demonstration 191.9 project, the capitation payment rate shall be based on 96 191.10 percent of the projected per person costs that would otherwise 191.11 have been paid under medical assistance fee-for-service during 191.12 each of those years. Rates shall be adjusted within the limits 191.13 of the available risk adjustment technology, as mandated by 191.14 section 62Q.03. In addition, the commissioner shall implement 191.15 appropriate risk and savings sharing provisions with county 191.16 administrative entities and, when applicable under subdivision 191.17 6, paragraph (a), service delivery organizations within the 191.18 projected budget limits. Capitation rates shall be adjusted at 191.19 least annually to include any rate increases and payments for 191.20 expanded or newly covered services for eligible individuals. 191.21 The initial demonstration project rate shall include an amount 191.22 in addition to the fee for service payments to adjust for 191.23 underutilization of dental services. Any savings beyond those 191.24 allowed for the county authority, county administrative entity, 191.25 or service delivery organization shall be first used to meet the 191.26 unmet needs of eligible individuals. Payments to providers 191.27 participating in the project are exempt from the requirements of 191.28 sections 256.966 and 256B.03, subdivision 2. 191.29 (b) The commissioner shall monitor and evaluate annually 191.30 the effect of the discount on consumers, the county authority, 191.31 and providers of disability services. Findings shall be 191.32 reported and recommendations made, as appropriate, to ensure 191.33 that the discount effect does not adversely affect the ability 191.34 of the county administrative entity or providers of services to 191.35 provide appropriate services to eligible individuals, and does 191.36 not result in cost shifting of eligible individuals to the 192.1 county authority. 192.2 Sec. 44. Minnesota Statutes 1997 Supplement, section 192.3 256B.77, subdivision 12, is amended to read: 192.4 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 192.5 section, "service coordinator" means an individual selected by 192.6 the enrollee or the enrollee's legal representative and 192.7 authorized by the county administrative entity or service 192.8 delivery organization to work in partnership with the enrollee 192.9 to develop, coordinate, and in some instances, provide supports 192.10 and services identified in the personal support plan. Service 192.11 coordinators may only provide services and supports if the 192.12 enrollee is informed of potential conflicts of interest, is 192.13 given alternatives, and gives informed consent. Eligible 192.14 service coordinators are individuals age 18 or older who meet 192.15 the qualifications as described in paragraph (b). Enrollees, 192.16 their legal representatives, or their advocates are eligible to 192.17 be service coordinators if they have the capabilities to perform 192.18 the activities and functions outlined in paragraph (b). 192.19 Providers licensed under chapter 245A to provide residential 192.20 services, or providers who are providing residential services 192.21 covered under the group residential housing program may not act 192.22 as service coordinator for enrollees for whom they provide 192.23 residential services. This does not apply to providers of 192.24 short-term detoxification services. Each county administrative 192.25 entity or service delivery organization may develop further 192.26 criteria for eligible vendors of service coordination during the 192.27 demonstration period and shall determine whom it contracts with 192.28 or employs to provide service coordination. County 192.29 administrative entities and service delivery organizations may 192.30 pay enrollees or their advocates or legal representatives for 192.31 service coordination activities. 192.32 (b) The service coordinator shall act as a facilitator, 192.33 working in partnership with the enrollee to ensure that their 192.34 needs are identified and addressed. The level of involvement of 192.35 the service coordinator shall depend on the needs and desires of 192.36 the enrollee. The service coordinator shall have the knowledge, 193.1 skills, and abilities to, and is responsible for: 193.2 (1) arranging for an initial assessment, and periodic 193.3 reassessment as necessary, of supports and services based on the 193.4 enrollee's strengths, needs, choices, and preferences in life 193.5 domain areas; 193.6 (2) developing and updating the personal support plan based 193.7 on relevant ongoing assessment; 193.8 (3) arranging for and coordinating the provisions of 193.9 supports and services, including knowledgeable and skilled 193.10 specialty services and prevention and early intervention 193.11 services, within the limitations negotiated with the county 193.12 administrative entity or service delivery organization; 193.13 (4) assisting the enrollee and the enrollee's legal 193.14 representative, if any, to maximize informed choice of and 193.15 control over services and supports and to exercise the 193.16 enrollee's rights and advocate on behalf of the enrollee; 193.17 (5) monitoring the progress toward achieving the enrollee's 193.18 outcomes in order to evaluate and adjust the timeliness and 193.19 adequacy of the implementation of the personal support plan; 193.20 (6) facilitating meetings and effectively collaborating 193.21 with a variety of agencies and persons, including attending 193.22 individual family service plan and individual education plan 193.23 meetings when requested by the enrollee or the enrollee's legal 193.24 representative; 193.25 (7) soliciting and analyzing relevant information; 193.26 (8) communicating effectively with the enrollee and with 193.27 other individuals participating in the enrollee's plan; 193.28 (9) educating and communicating effectively with the 193.29 enrollee about good health care practices and risk to the 193.30 enrollee's health with certain behaviors; 193.31 (10) having knowledge of basic enrollee protection 193.32 requirements, including data privacy; 193.33 (11) informing, educating, and assisting the enrollee in 193.34 identifying available service providers and accessing needed 193.35 resources and services beyond the limitations of the medical 193.36 assistance benefit set covered services; and 194.1 (12) providing other services as identified in the personal 194.2 support plan. 194.3 (c) For the demonstration project, the qualifications and 194.4 standards for service coordination in this section shall replace 194.5 comparable existing provisions of existing statutes and rules 194.6 governing case management for eligible individuals. 194.7 (d) The provisions of this subdivision apply only to the 194.8 demonstration sitesthat begin implementation on July 1, 1998194.9 designated by the commissioner under subdivision 5. 194.10 All other demonstration sites must comply with laws and 194.11 rules governing case management services for eligible 194.12 individuals in effect when the site begins the demonstration 194.13 project. 194.14 Sec. 45. Minnesota Statutes 1997 Supplement, section 194.15 256D.03, subdivision 3, is amended to read: 194.16 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 194.17 (a) General assistance medical care may be paid for any person 194.18 who is not eligible for medical assistance under chapter 256B, 194.19 including eligibility for medical assistance based on a 194.20 spenddown of excess income according to section 256B.056, 194.21 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 194.22 except as provided in paragraph (b); and: 194.23 (1) who is receiving assistance under section 256D.05, 194.24 except for families with children who are eligible under 194.25 Minnesota family investment program-statewide (MFIP-S), who is 194.26 having a payment made on the person's behalf under sections 194.27 256I.01 to 256I.06, or who resides in group residential housing 194.28 as defined in chapter 256I and can meet a spenddown using the 194.29 cost of remedial services received through group residential 194.30 housing; or 194.31 (2)(i) who is a resident of Minnesota; and whose equity in 194.32 assets is not in excess of $1,000 per assistance unit. Exempt 194.33 assets, the reduction of excess assets, and the waiver of excess 194.34 assets must conform to the medical assistance program in chapter 194.35 256B, with the following exception: the maximum amount of 194.36 undistributed funds in a trust that could be distributed to or 195.1 on behalf of the beneficiary by the trustee, assuming the full 195.2 exercise of the trustee's discretion under the terms of the 195.3 trust, must be applied toward the asset maximum; and 195.4 (ii) who has countable income not in excess of the 195.5 assistance standards established in section 256B.056, 195.6 subdivision 4, or whose excess income is spent down according to 195.7 section 256B.056, subdivision 5, using a six-month budget 195.8 period. The method for calculating earned income disregards and 195.9 deductions for a person who resides with a dependent child under 195.10 age 21 shall follow section 256B.056, subdivision 1a. However, 195.11 if a disregard of $30 and one-third of the remainder has been 195.12 applied to the wage earner's income, the disregard shall not be 195.13 applied again until the wage earner's income has not been 195.14 considered in an eligibility determination for general 195.15 assistance, general assistance medical care, medical assistance, 195.16 or MFIP-S for 12 consecutive months. The earned income and work 195.17 expense deductions for a person who does not reside with a 195.18 dependent child under age 21 shall be the same as the method 195.19 used to determine eligibility for a person under section 195.20 256D.06, subdivision 1, except the disregard of the first $50 of 195.21 earned income is not allowed;or195.22 (3) who would be eligible for medical assistance except 195.23 that the person resides in a facility that is determined by the 195.24 commissioner or the federal Health Care Financing Administration 195.25 to be an institution for mental diseases; or 195.26 (4) who is receiving care and rehabilitation services from 195.27 a nonprofit center established to serve victims of torture. 195.28 These individuals are eligible for general assistance medical 195.29 care only for the period during which they are receiving 195.30 services from the center. During this period of eligibility, 195.31 individuals eligible under this clause shall not be required to 195.32 participate in prepaid general assistance medical care. 195.33(4)(5) Beginning July 1, 1998, applicants or recipients 195.34 who meet all eligibility requirements of MinnesotaCare as 195.35 defined in sections 256L.01 to 256L.16, and are: 195.36 (i) adults with dependent children under 21 whose gross 196.1 family income is equal to or less than 275 percent of the 196.2 federal poverty guidelines; or 196.3 (ii) adults without children with earned income and whose 196.4 family gross income is between 75 percent of the federal poverty 196.5 guidelines and the amount set by section 256L.04, subdivision 7, 196.6 shall be terminated from general assistance medical care upon 196.7 enrollment in MinnesotaCare. 196.8 (b) For services rendered on or after July 1, 1997, 196.9 eligibility is limited to one month prior to application if the 196.10 person is determined eligible in the prior month. A 196.11 redetermination of eligibility must occur every 12 months. 196.12 Beginning July 1, 1998, Minnesota health care program 196.13 applications completed by recipients and applicants who are 196.14 persons described in paragraph (a), clause(4)(5), may be 196.15 returned to the county agency to be forwarded to the department 196.16 of human services or sent directly to the department of human 196.17 services for enrollment in MinnesotaCare. If all other 196.18 eligibility requirements of this subdivision are met, 196.19 eligibility for general assistance medical care shall be 196.20 available in any month during which a MinnesotaCare eligibility 196.21 determination and enrollment are pending. Upon notification of 196.22 eligibility for MinnesotaCare, notice of termination for 196.23 eligibility for general assistance medical care shall be sent to 196.24 an applicant or recipient. If all other eligibility 196.25 requirements of this subdivision are met, eligibility for 196.26 general assistance medical care shall be available until 196.27 enrollment in MinnesotaCare subject to the provisions of 196.28 paragraph (d). 196.29 (c) The date of an initial Minnesota health care program 196.30 application necessary to begin a determination of eligibility 196.31 shall be the date the applicant has provided a name, address, 196.32 and social security number, signed and dated, to the county 196.33 agency or the department of human services. If the applicant is 196.34 unable to provide an initial application when health care is 196.35 delivered due to a medical condition or disability, a health 196.36 care provider may act on the person's behalf to complete the 197.1 initial application. The applicant must complete the remainder 197.2 of the application and provide necessary verification before 197.3 eligibility can be determined. The county agency must assist 197.4 the applicant in obtaining verification if necessary. 197.5 (d) County agencies are authorized to use all automated 197.6 databases containing information regarding recipients' or 197.7 applicants' income in order to determine eligibility for general 197.8 assistance medical care or MinnesotaCare. Such use shall be 197.9 considered sufficient in order to determine eligibility and 197.10 premium payments by the county agency. 197.11 (e) General assistance medical care is not available for a 197.12 person in a correctional facility unless the person is detained 197.13 by law for less than one year in a county correctional or 197.14 detention facility as a person accused or convicted of a crime, 197.15 or admitted as an inpatient to a hospital on a criminal hold 197.16 order, and the person is a recipient of general assistance 197.17 medical care at the time the person is detained by law or 197.18 admitted on a criminal hold order and as long as the person 197.19 continues to meet other eligibility requirements of this 197.20 subdivision. 197.21 (f) General assistance medical care is not available for 197.22 applicants or recipients who do not cooperate with the county 197.23 agency to meet the requirements of medical assistance. General 197.24 assistance medical care is limited to payment of emergency 197.25 services only for applicants or recipients as described in 197.26 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 197.27 denied or terminated for nonpayment of premiums as required by 197.28 sections 256L.06 to 256L.08. 197.29 (g) In determining the amount of assets of an individual, 197.30 there shall be included any asset or interest in an asset, 197.31 including an asset excluded under paragraph (a), that was given 197.32 away, sold, or disposed of for less than fair market value 197.33 within the 60 months preceding application for general 197.34 assistance medical care or during the period of eligibility. 197.35 Any transfer described in this paragraph shall be presumed to 197.36 have been for the purpose of establishing eligibility for 198.1 general assistance medical care, unless the individual furnishes 198.2 convincing evidence to establish that the transaction was 198.3 exclusively for another purpose. For purposes of this 198.4 paragraph, the value of the asset or interest shall be the fair 198.5 market value at the time it was given away, sold, or disposed 198.6 of, less the amount of compensation received. For any 198.7 uncompensated transfer, the number of months of ineligibility, 198.8 including partial months, shall be calculated by dividing the 198.9 uncompensated transfer amount by the average monthly per person 198.10 payment made by the medical assistance program to skilled 198.11 nursing facilities for the previous calendar year. The 198.12 individual shall remain ineligible until this fixed period has 198.13 expired. The period of ineligibility may exceed 30 months, and 198.14 a reapplication for benefits after 30 months from the date of 198.15 the transfer shall not result in eligibility unless and until 198.16 the period of ineligibility has expired. The period of 198.17 ineligibility begins in the month the transfer was reported to 198.18 the county agency, or if the transfer was not reported, the 198.19 month in which the county agency discovered the transfer, 198.20 whichever comes first. For applicants, the period of 198.21 ineligibility begins on the date of the first approved 198.22 application. 198.23 (h) When determining eligibility for any state benefits 198.24 under this subdivision, the income and resources of all 198.25 noncitizens shall be deemed to include their sponsor's income 198.26 and resources as defined in the Personal Responsibility and Work 198.27 Opportunity Reconciliation Act of 1996, title IV, Public Law 198.28 Number 104-193, sections 421 and 422, and subsequently set out 198.29 in federal rules. 198.30 (i)(1) An undocumented noncitizen or a nonimmigrant is 198.31 ineligible for general assistance medical care other than 198.32 emergency services. For purposes of this subdivision, a 198.33 nonimmigrant is an individual in one or more of the classes 198.34 listed in United States Code, title 8, section 1101(a)(15), and 198.35 an undocumented noncitizen is an individual who resides in the 198.36 United States without the approval or acquiescence of the 199.1 Immigration and Naturalization Service. 199.2(j)(2) This paragraph does not apply to a child under age 199.3 18, to a Cuban or Haitian entrant as defined in Public Law 199.4 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 199.5 who is aged, blind, or disabled as defined in Code of Federal 199.6 Regulations, title 42, sections 435.520, 435.530, 435.531, 199.7 435.540, and 435.541, or to an individual eligible for general 199.8 assistance medical care under paragraph (a), clause (4), who 199.9 cooperates with the Immigration and Naturalization Service to 199.10 pursue any applicable immigration status, including citizenship, 199.11 that would qualify the individual for medical assistance with 199.12 federal financial participation. 199.13(k)(3) For purposes ofparagraphs (f) and (i)this 199.14 paragraph, "emergency services" has the meaning given in Code of 199.15 Federal Regulations, title 42, section 440.255(b)(1), except 199.16 that it also means services rendered because of suspected or 199.17 actual pesticide poisoning. 199.18(l)(j) Notwithstanding any other provision of law, a 199.19 noncitizen who is ineligible for medical assistance due to the 199.20 deeming of a sponsor's income and resources, is ineligible for 199.21 general assistance medical care. 199.22 Sec. 46. Minnesota Statutes 1996, section 256D.03, 199.23 subdivision 4, is amended to read: 199.24 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 199.25 For a person who is eligible under subdivision 3, paragraph (a), 199.26 clause (3), general assistance medical care covers, except as 199.27 provided in paragraph (c): 199.28 (1) inpatient hospital services; 199.29 (2) outpatient hospital services; 199.30 (3) services provided by Medicare certified rehabilitation 199.31 agencies; 199.32 (4) prescription drugs and other products recommended 199.33 through the process established in section 256B.0625, 199.34 subdivision 13; 199.35 (5) equipment necessary to administer insulin and 199.36 diagnostic supplies and equipment for diabetics to monitor blood 200.1 sugar level; 200.2 (6) eyeglasses and eye examinations provided by a physician 200.3 or optometrist; 200.4 (7) hearing aids; 200.5 (8) prosthetic devices; 200.6 (9) laboratory and X-ray services; 200.7 (10) physician's services; 200.8 (11) medical transportation; 200.9 (12) chiropractic services as covered under the medical 200.10 assistance program; 200.11 (13) podiatric services; 200.12 (14) dental services; 200.13 (15) outpatient services provided by a mental health center 200.14 or clinic that is under contract with the county board and is 200.15 established under section 245.62; 200.16 (16) day treatment services for mental illness provided 200.17 under contract with the county board; 200.18 (17) prescribed medications for persons who have been 200.19 diagnosed as mentally ill as necessary to prevent more 200.20 restrictive institutionalization; 200.21 (18)case management services for a person with serious and200.22persistent mental illness who would be eligible for medical200.23assistance except that the person resides in an institution for200.24mental diseases;200.25(19)psychological services, medical supplies and 200.26 equipment, and Medicare premiums, coinsurance and deductible 200.27 payments; 200.28(20)(19) medical equipment not specifically listed in this 200.29 paragraph when the use of the equipment will prevent the need 200.30 for costlier services that are reimbursable under this 200.31 subdivision; 200.32(21)(20) services performed by a certified pediatric nurse 200.33 practitioner, a certified family nurse practitioner, a certified 200.34 adult nurse practitioner, a certified obstetric/gynecological 200.35 nurse practitioner, or a certified geriatric nurse practitioner 200.36 in independent practice, if the services are otherwise covered 201.1 under this chapter as a physician service, and if the service is 201.2 within the scope of practice of the nurse practitioner's license 201.3 as a registered nurse, as defined in section 148.171; and 201.4(22)(21) services of a certified public health nurse or a 201.5 registered nurse practicing in a public health nursing clinic 201.6 that is a department of, or that operates under the direct 201.7 authority of, a unit of government, if the service is within the 201.8 scope of practice of the public health nurse's license as a 201.9 registered nurse, as defined in section 148.171. 201.10 (b) Except as provided in paragraph (c), for a recipient 201.11 who is eligible under subdivision 3, paragraph (a), clause (1) 201.12 or (2), general assistance medical care covers the services 201.13 listed in paragraph (a) with the exception of special 201.14 transportation services. 201.15 (c) Gender reassignment surgery and related services are 201.16 not covered services under this subdivision unless the 201.17 individual began receiving gender reassignment services prior to 201.18 July 1, 1995. 201.19 (d) In order to contain costs, the commissioner of human 201.20 services shall select vendors of medical care who can provide 201.21 the most economical care consistent with high medical standards 201.22 and shall where possible contract with organizations on a 201.23 prepaid capitation basis to provide these services. The 201.24 commissioner shall consider proposals by counties and vendors 201.25 for prepaid health plans, competitive bidding programs, block 201.26 grants, or other vendor payment mechanisms designed to provide 201.27 services in an economical manner or to control utilization, with 201.28 safeguards to ensure that necessary services are provided. 201.29 Before implementing prepaid programs in counties with a county 201.30 operated or affiliated public teaching hospital or a hospital or 201.31 clinic operated by the University of Minnesota, the commissioner 201.32 shall consider the risks the prepaid program creates for the 201.33 hospital and allow the county or hospital the opportunity to 201.34 participate in the program in a manner that reflects the risk of 201.35 adverse selection and the nature of the patients served by the 201.36 hospital, provided the terms of participation in the program are 202.1 competitive with the terms of other participants considering the 202.2 nature of the population served. Payment for services provided 202.3 pursuant to this subdivision shall be as provided to medical 202.4 assistance vendors of these services under sections 256B.02, 202.5 subdivision 8, and 256B.0625. For payments made during fiscal 202.6 year 1990 and later years, the commissioner shall consult with 202.7 an independent actuary in establishing prepayment rates, but 202.8 shall retain final control over the rate methodology. 202.9 Notwithstanding the provisions of subdivision 3, an individual 202.10 who becomes ineligible for general assistance medical care 202.11 because of failure to submit income reports or recertification 202.12 forms in a timely manner, shall remain enrolled in the prepaid 202.13 health plan and shall remain eligible for general assistance 202.14 medical care coverage through the last day of the month in which 202.15 the enrollee became ineligible for general assistance medical 202.16 care. 202.17 (e) The commissioner of human services may reduce payments 202.18 provided under sections 256D.01 to 256D.21 and 261.23 in order 202.19 to remain within the amount appropriated for general assistance 202.20 medical care, within the following restrictions.: 202.21 (i) For the period July 1, 1985 to December 31, 1985, 202.22 reductions below the cost per service unit allowable under 202.23 section 256.966, are permitted only as follows: payments for 202.24 inpatient and outpatient hospital care provided in response to a 202.25 primary diagnosis of chemical dependency or mental illness may 202.26 be reduced no more than 30 percent; payments for all other 202.27 inpatient hospital care may be reduced no more than 20 percent. 202.28 Reductions below the payments allowable under general assistance 202.29 medical care for the remaining general assistance medical care 202.30 services allowable under this subdivision may be reduced no more 202.31 than ten percent. 202.32 (ii) For the period January 1, 1986 to December 31, 1986, 202.33 reductions below the cost per service unit allowable under 202.34 section 256.966 are permitted only as follows: payments for 202.35 inpatient and outpatient hospital care provided in response to a 202.36 primary diagnosis of chemical dependency or mental illness may 203.1 be reduced no more than 20 percent; payments for all other 203.2 inpatient hospital care may be reduced no more than 15 percent. 203.3 Reductions below the payments allowable under general assistance 203.4 medical care for the remaining general assistance medical care 203.5 services allowable under this subdivision may be reduced no more 203.6 than five percent. 203.7 (iii) For the period January 1, 1987 to June 30, 1987, 203.8 reductions below the cost per service unit allowable under 203.9 section 256.966 are permitted only as follows: payments for 203.10 inpatient and outpatient hospital care provided in response to a 203.11 primary diagnosis of chemical dependency or mental illness may 203.12 be reduced no more than 15 percent; payments for all other 203.13 inpatient hospital care may be reduced no more than ten 203.14 percent. Reductions below the payments allowable under medical 203.15 assistance for the remaining general assistance medical care 203.16 services allowable under this subdivision may be reduced no more 203.17 than five percent. 203.18 (iv) For the period July 1, 1987 to June 30, 1988, 203.19 reductions below the cost per service unit allowable under 203.20 section 256.966 are permitted only as follows: payments for 203.21 inpatient and outpatient hospital care provided in response to a 203.22 primary diagnosis of chemical dependency or mental illness may 203.23 be reduced no more than 15 percent; payments for all other 203.24 inpatient hospital care may be reduced no more than five percent. 203.25 Reductions below the payments allowable under medical assistance 203.26 for the remaining general assistance medical care services 203.27 allowable under this subdivision may be reduced no more than 203.28 five percent. 203.29 (v) For the period July 1, 1988 to June 30, 1989, 203.30 reductions below the cost per service unit allowable under 203.31 section 256.966 are permitted only as follows: payments for 203.32 inpatient and outpatient hospital care provided in response to a 203.33 primary diagnosis of chemical dependency or mental illness may 203.34 be reduced no more than 15 percent; payments for all other 203.35 inpatient hospital care may not be reduced. Reductions below 203.36 the payments allowable under medical assistance for the 204.1 remaining general assistance medical care services allowable 204.2 under this subdivision may be reduced no more than five percent. 204.3 (f) There shall be no copayment required of any recipient 204.4 of benefits for any services provided under this subdivision. A 204.5 hospital receiving a reduced payment as a result of this section 204.6 may apply the unpaid balance toward satisfaction of the 204.7 hospital's bad debts. 204.8(f)(g) Any county may, from its own resources, provide 204.9 medical payments for which state payments are not made. 204.10(g)(h) Chemical dependency services that are reimbursed 204.11 under chapter 254B must not be reimbursed under general 204.12 assistance medical care. 204.13(h)(i) The maximum payment for new vendors enrolled in the 204.14 general assistance medical care program after the base year 204.15 shall be determined from the average usual and customary charge 204.16 of the same vendor type enrolled in the base year. 204.17(i)(j) The conditions of payment for services under this 204.18 subdivision are the same as the conditions specified in rules 204.19 adopted under chapter 256B governing the medical assistance 204.20 program, unless otherwise provided by statute or rule. 204.21 Sec. 47. Minnesota Statutes 1996, section 256D.03, is 204.22 amended by adding a subdivision to read: 204.23 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective July 204.24 1, 1999, general assistance medical care payments for ambulance 204.25 services shall be increased by ten percent. 204.26 Sec. 48. Minnesota Statutes 1997 Supplement, section 204.27 256L.07, subdivision 2, is amended to read: 204.28 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 204.29 COVERAGE.] (a) To be eligible for subsidized premium payments 204.30 based on a sliding scale, a family or individual must not have 204.31 access to subsidized health coverage through an employer, and 204.32 must not have had access to subsidized health coverage through 204.33 an employer for the 18 months prior to application for 204.34 subsidized coverage under the MinnesotaCare program. The 204.35 requirement that the family or individual must not have had 204.36 access to employer-subsidized coverage during the previous 18 205.1 months does not apply if: (1) employer-subsidized coverage was 205.2 lost due to the death of an employee or divorce; (2) 205.3 employer-subsidized coverage was lost because an individual 205.4 became ineligible for coverage as a child or dependent; or (3) 205.5 employer-subsidized coverage was lost for reasons that would not 205.6 disqualify the individual for unemployment benefits under 205.7 section 268.09 and the family or individual has not had access 205.8 to employer-subsidized coverage since the loss of coverage. If 205.9 employer-subsidized coverage was lost for reasons that 205.10 disqualify an individual for unemployment benefits under section 205.11 268.09, children of that individual are exempt from the 205.12 requirement of no access to employer subsidized coverage for the 205.13 18 months prior to application, as long as the children have not 205.14 had access to employer subsidized coverage since the 205.15 disqualifying event. The requirement that the family or 205.16 individual must not have had access to employer-subsidized 205.17 coverage during the previous 18 months does apply if 205.18 employer-subsidized coverage is lost due to an employer 205.19 terminating health care coverage as an employee benefit, unless 205.20 that coverage was provided under section 256M.03. 205.21 (b) For purposes of this requirement, subsidized health 205.22 coverage means health coverage for which the employer pays at 205.23 least 50 percent of the cost of coverage for the employee, 205.24 excluding dependent coverage, or a higher percentage as 205.25 specified by the commissioner. Children are eligible for 205.26 employer-subsidized coverage through either parent, including 205.27 the noncustodial parent. The commissioner must treat employer 205.28 contributions to Internal Revenue Code Section 125 plans as 205.29 qualified employer subsidies toward the cost of health coverage 205.30 for employees for purposes of this subdivision. 205.31 Sec. 49. Minnesota Statutes 1997 Supplement, section 205.32 256L.07, subdivision 3, is amended to read: 205.33 Subd. 3. [PERIOD UNINSURED.] To be eligible for subsidized 205.34 premium payments based on a sliding scale, families and 205.35 individuals initially enrolled in the MinnesotaCare program 205.36 under section 256L.04, subdivisions 5 and 7, must have had no 206.1 health coverage for at least four months prior to application. 206.2 The commissioner may change this eligibility criterion for 206.3 sliding scale premiums in order to remain within the limits of 206.4 available appropriations. The requirement of at least four 206.5 months of no health coverage prior to application for the 206.6 MinnesotaCare program does not apply to: 206.7 (1) families, children, and individuals who apply for the 206.8 MinnesotaCare program upon termination from or as required by 206.9 the medical assistance program, general assistance medical care 206.10 program, or coverage under a regional demonstration project for 206.11 the uninsured funded under section 256B.73, the Hennepin county 206.12 assured care program, or the Group Health, Inc., community 206.13 health plan; 206.14 (2) families and individuals initially enrolled under 206.15 section 256L.04, subdivisions 1, paragraph (a), and 3; 206.16 (3) children enrolled pursuant to Laws 1992, chapter 549, 206.17 article 4, section 17;or206.18 (4) individuals currently serving or who have served in the 206.19 military reserves, and dependents of these individuals, if these 206.20 individuals: (i) reapply for MinnesotaCare coverage after a 206.21 period of active military service during which they had been 206.22 covered by the Civilian Health and Medical Program of the 206.23 Uniformed Services (CHAMPUS); (ii) were covered under 206.24 MinnesotaCare immediately prior to obtaining coverage under 206.25 CHAMPUS; and (iii) have maintained continuous coverage; or 206.26 (5) children who lose coverage under section 256M.03 due to 206.27 an employer terminating health coverage as an employee benefit 206.28 or due to an employee layoff. 206.29 Sec. 50. [256M.01] [DEFINITIONS.] 206.30 Subdivision 1. [APPLICABILITY.] For purposes of this 206.31 chapter, the terms defined in this section have the meanings 206.32 given. 206.33 Subd. 2. [COMMISSIONER.] "Commissioner" means the 206.34 commissioner of human services. 206.35 Subd. 3. [EMPLOYER-SUBSIDIZED 206.36 INSURANCE.] "Employer-subsidized insurance" has the meaning 207.1 provided in section 256L.07, subdivision 2. 207.2 Sec. 51. [256M.03] [COVERAGE OF CHILDREN INELIGIBLE FOR 207.3 MINNESOTACARE.] 207.4 Subdivision 1. [PAYMENTS FOR EMPLOYER-SUBSIDIZED 207.5 COVERAGE.] A child who would otherwise be eligible for coverage 207.6 under MinnesotaCare, except for the availability of 207.7 employer-subsidized coverage, is eligible for payment of the 207.8 employee share of employer-subsidized coverage for the child 207.9 under the state children's health insurance program established 207.10 in title 21 of the Social Security Act, according to the sliding 207.11 scale in subdivision 2. In order to be eligible under this 207.12 subdivision, a child must not have employer-subsidized coverage 207.13 at the time of application for payment, and the 207.14 employer-subsidized coverage must qualify as benchmark coverage 207.15 or benchmark equivalent coverage under title 21 of the Social 207.16 Security Act, section 2103. Payments shall be made directly to 207.17 the employer providing employer-subsidized insurance. 207.18 Subd. 2. [SLIDING SCALE PAYMENTS.] Upon federal approval 207.19 of the plan, the commissioner shall pay the difference of the 207.20 MinnesotaCare sliding premium scale as specified in Minnesota 207.21 Statutes, section 256L.08, up to a maximum of five percent of 207.22 the qualifying family's income and the employee share of the 207.23 coverage. 207.24 Subd. 3. [LIMITATION.] The availability of payments under 207.25 this section is subject to the limits of available 207.26 appropriations. The commissioner may set limits on the number 207.27 of children receiving payments under this section, or modify 207.28 payment levels, in order to remain within the limits of 207.29 appropriations. 207.30 Subd. 4. [ADVISORY TASK FORCE.] The commissioner shall 207.31 convene an advisory task force comprised of representatives of 207.32 small businesses, health plan companies, and insurance agents in 207.33 order to develop a plan to implement this section. 207.34 Sec. 52. [256M.05] [MAINTENANCE OF EMPLOYER SUBSIDY.] 207.35 Employers providing employer-subsidized coverage to 207.36 employees who receive payments on behalf of an employee eligible 208.1 under section 256M.03, subdivision 1, shall maintain at least 208.2 the same percentage level of subsidy for employee and family 208.3 coverage that was in place on July 1, 1998, for a period of one 208.4 year following receipt of the initial payment for an eligible 208.5 employee. After the initial year, an employer may not decrease 208.6 the percentage level of subsidy to employee and family coverage 208.7 by more than five percentage points. 208.8 Sec. 53. Laws 1997, chapter 195, section 5, is amended to 208.9 read: 208.10 Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.] 208.11 The commissioner of health shall create a unique category 208.12 of licensure as appropriate for providers offering, providing, 208.13 or arranging personal care assistant services to more than one 208.14 individual. The commissioner shall work with the department of 208.15 human services, providers, consumers, and advocates in 208.16 developing the licensure standards. The licensure standards 208.17 must include requirements for providers to provide consumers 208.18 advance written notice of service termination, a service 208.19 transition plan, and an appeal process. If the commissioner 208.20 determines there are costs related to rulemaking under this 208.21 section, the commissioner shall include a budget request for 208.22 this item in the 2000-2001 biennial budget. Prior to 208.23 promulgating the rule, the commissioner shall submit the 208.24 proposed rule to the legislature by January 15, 1999. 208.25 Sec. 54. Laws 1997, chapter 203, article 4, section 64, is 208.26 amended to read: 208.27 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 208.28 The commissioner of human services shall appoint a task 208.29 force that includes representatives of counties, health plans, 208.30 consumers, and legislators to study the impact of the expansion 208.31 of the elderly waiver program under section 4 and to make 208.32 recommendations for any changes in law necessary to facilitate 208.33 an efficient and equitable relationship between the elderly 208.34 waiver program and the Minnesota senior health options project. 208.35 Based on the results of the task force study, the commissioner 208.36 may seek any federal waivers needed to improve the relationship 209.1 between the elderly waiver and the Minnesota senior health 209.2 options project. The commissioner shall report the results of 209.3 the task force study to the legislature byJanuary 15, 1998July 209.4 1, 2000. 209.5 Sec. 55. Laws 1997, chapter 225, article 2, section 64, is 209.6 amended to read: 209.7 Sec. 64. [EFFECTIVE DATE.] 209.8 Section 8 is effective for payments made for MinnesotaCare 209.9 services on or after July 1, 1996. Section 23 is effective the 209.10 day following final enactment. Section 46 is effective January 209.11 1, 1998, and applies to high deductible health plans issued or 209.12 renewed on or after that date. 209.13 Sec. 56. [SUBMITTAL OF PLAN TO ACCESS STATE CHILDREN'S 209.14 HEALTH INSURANCE FUNDING.] 209.15 The commissioner of human services shall submit a plan to 209.16 implement Minnesota Statutes, sections 256M.01 to 256M.05, to 209.17 the secretary of health and human services, in order to obtain 209.18 funding through the state children's health insurance program 209.19 established in title 21 of the Social Security Act. 209.20 Sec. 57. [OFFSET OF HMO SURCHARGE.] 209.21 Beginning October 1, 1998, and ending December 31, 1998, 209.22 the commissioner of human services shall offset monthly charges 209.23 for the health maintenance organization surcharge by the monthly 209.24 amount the health maintenance organization overpaid from August 209.25 1, 1997, to September 30, 1998, due to taxation of Medicare 209.26 revenues prohibited by section 256.9657, subdivision 3. 209.27 Sec. 58. [MR/RC WAIVER PROPOSAL.] 209.28 By November 15, 1998, the commissioner of human services 209.29 shall provide to the chairs of the house health and human 209.30 services finance division and the senate health and family 209.31 security finance division a detailed budget proposal for 209.32 providing services under the home and community-based waiver for 209.33 persons with mental retardation or related conditions to those 209.34 individuals who are screened and waiting for services. 209.35 Sec. 59. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC 209.36 SERVICES.] 210.1 (a) The threshold limits for fee-for-service medical 210.2 assistance rehabilitative and therapeutic services for January 210.3 1, 1998 through June 30, 1999, shall be the limits prescribed in 210.4 the department of human services health care programs provider 210.5 manual for calendar year 1997. Rehabilitative and therapeutic 210.6 services are: occupational therapy services provided to medical 210.7 assistance recipients pursuant to Minnesota Statutes, section 210.8 256B.0625, subdivision 8; physical therapy services provided to 210.9 medical assistance recipients pursuant to Minnesota Statutes, 210.10 section 256B.0625, subdivision 8a; and speech language pathology 210.11 services provided to medical assistance recipients pursuant to 210.12 Minnesota Rules, part 9505.0390. 210.13 (b) The commissioner of human services, in consultation 210.14 with the department of human services rehabilitative work group, 210.15 shall report to the chair of the senate health and family 210.16 security committee and the chair of the house health and human 210.17 services committee by January 15, 1999, recommendations and 210.18 proposed legislation for the appropriate level of rehabilitative 210.19 services delivered to medical assistance recipients before prior 210.20 authorization. The recommendations shall also include proposed 210.21 legislation to clarify the rehabilitative and therapeutic 210.22 benefit set for medical assistance, as well as the appropriate 210.23 response time for requests for prior authorization. 210.24 Sec. 60. [DISPROPORTIONATE SHARE ADJUSTMENT FOR DENTAL 210.25 SERVICES.] 210.26 The commissioner of human services shall develop a 210.27 disproportionate share adjustment for dental services provided 210.28 under the medical assistance, general assistance medical care, 210.29 and MinnesotaCare programs. The adjustment must provide 210.30 progressive increases above current fee-for-service rates for 210.31 dental providers whose medical assistance, general assistance 210.32 medical care, and MinnesotaCare caseloads in total comprise more 210.33 than specified percentages of their total caseloads. The 210.34 disproportionate share adjustment must also apply to managed 210.35 care capitation rates. 210.36 The commissioner shall present recommendations and proposed 211.1 legislation for a disproportionate share adjustment to the 211.2 legislature by December 15, 1998. 211.3 Sec. 61. [DENTAL FORMS.] 211.4 Dentists who provide services to medical assistance 211.5 patients may submit charges for dental reimbursement on American 211.6 Dental Association standardized provider payment forms to assist 211.7 in the collection of dental fees. 211.8 Sec. 62. [REPORT ON COUNTY ALLOCATIONS.] 211.9 Beginning August 1, 1998, the commissioner of human 211.10 services shall issue an annual report on the home and 211.11 community-based waiver for persons with mental retardation or a 211.12 related condition, which includes a list of the counties in 211.13 which less than 95 percent of the allocation provided, excluding 211.14 the county waivered services reserve, has been committed for two 211.15 or more quarters during the previous state fiscal year. For 211.16 each listed county, the report shall include the amount of funds 211.17 allocated but not used, the number and ages of individuals 211.18 screened and waiting for services, the services needed, a 211.19 description of the technical assistance provided by the 211.20 commissioner to assist the county in jointly planning with other 211.21 counties in order to serve more persons, and additional actions 211.22 which will be taken to serve those screened and waiting for 211.23 services. 211.24 Sec. 63. [DENTAL ACCESS.] 211.25 The commissioner of human services shall make 211.26 recommendations to the legislature by February 1, 1999, on how 211.27 access to dental services for medical assistance, general 211.28 assistance medical care, and MinnesotaCare enrollees could be 211.29 expanded. In preparing the recommendations, the commissioner 211.30 shall consult with consumers, the board of dentistry, dental 211.31 providers, the dental hygiene association, consumer advocates, 211.32 legislators, and other affected parties. 211.33 Sec. 64. [REPORT BY UNIVERSITY OF MINNESOTA ACADEMIC 211.34 HEALTH CENTER.] 211.35 The University of Minnesota academic health center, after 211.36 consultation with the health care community and the medical 212.1 education and research cost (MERC) advisory committee, is 212.2 requested to report to the commissioner of health and the 212.3 legislative commission on health care access by January 15, 212.4 1999, on plans for the strategic direction and vision of the 212.5 academic health center. The report shall address plans for the 212.6 ongoing assessment of health provider workforce needs; plans for 212.7 the ongoing assessment of the educational needs of health 212.8 professionals and the implications for their education and 212.9 training programs; and plans for ongoing, meaningful input from 212.10 the health care community on health-related research and 212.11 education programs administered by the academic health center. 212.12 Sec. 65. [COUNTY BILLING BY CLINICS.] 212.13 Clinics that (1) serve the primary health care needs of 212.14 low-income population groups; (2) use a sliding fee scale based 212.15 on ability to pay and do not limit access to care because of 212.16 financial limitations of the client; and (3) are nonprofit under 212.17 Minnesota Statutes, chapter 317, or are federally qualified 212.18 health centers, shall be eligible for a special payment for 212.19 uncompensated care. The clinics may bill a county of residence 212.20 for services provided to a resident of that county provided: 212.21 (1) the patient is from a county other than that in which 212.22 the clinic resides; and 212.23 (2) the clinic has made a preliminary determination at the 212.24 delivery of service that the patient was indigent based on 212.25 current medical assistance guidelines. 212.26 Counties that are billed under this program shall pay 212.27 eligible clinics at the rates established under the medical 212.28 assistance program. If the county can establish eligibility for 212.29 medical assistance after the service has been delivered, the 212.30 state shall reimburse the county for any funds paid to the 212.31 eligible clinic. 212.32 Sec. 66. [RECOMMENDATIONS FOR RECYCLING PROGRAM.] 212.33 The commissioner of human services shall develop 212.34 recommendations for a recycling program for used augmentative 212.35 and alternative communications systems that would allow these 212.36 systems to be reissued and used for trials and short-term use, 213.1 when appropriate. The commissioner shall present 213.2 recommendations to the legislature by December 15, 1998. 213.3 Sec. 67. [REPEALER.] 213.4 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 213.5 and Minnesota Statutes 1997 Supplement, sections 144.0721, 213.6 subdivision 3; and 256B.0913, subdivision 15, are repealed. 213.7 Sec. 68. [EFFECTIVE DATES.] 213.8 (a) Section 8 (256.9657, subdivision 3) is effective 213.9 retroactive to August 1, 1997. 213.10 (b) Sections 14 (256B.055, subdivision 7a) and 18 (256B.06, 213.11 subdivision 4) are effective retroactive to July 1, 1997. 213.12 (c) Sections 12 (256.969, subdivision 17), 21 (256B.0625, 213.13 subdivision 20), and 46 (256D.03, subdivision 4) are effective 213.14 January 1, 1999. 213.15 (d) Section 27 (256B.0645) is effective for changes in 213.16 eligibility that occur on or after July 1, 1998. 213.17 (e) Sections 5 (245.462, subdivision 8) and 36 (256B.69, 213.18 subdivision 25) are effective 30 days after final enactment. 213.19 (f) Section 26 (256B.0627, subdivision 8), related to 213.20 shared care, and section 59 (coverage of rehab.) are effective 213.21 the day following final enactment. 213.22 (g) Sections 20 and 47 (256B.0625, subdivision 17a, and 213.23 256D.03, subdivision 9) are effective July 1, 1999. 213.24 (h) Sections 48 to 52 (256L.07, subdivision 2; 256L.07, 213.25 subdivision 3; 256M.01; 256M.03; 256M.05) are effective only if 213.26 federal funding under the state children's health insurance 213.27 program is made available to the state and legislative approval 213.28 has been obtained. If the funding is made available and 213.29 legislative approval has been obtained, sections 48 to 52 are 213.30 effective on the date specified in the state plan. The 213.31 commissioner of human services shall publish a notice in the 213.32 State Register if federal funding is made available to implement 213.33 sections 48 to 52 and shall notify the revisor of statutes. 213.34 Section 56 (Submittal of plan) is effective the day following 213.35 final enactment. 213.36 (i) Sections 10 (256.969, subdivision 9c) and 65 (county 214.1 billing by clinics) are effective July 1, 2000. 214.2 ARTICLE 5 214.3 MINNESOTACARE 214.4 Section 1. Minnesota Statutes 1997 Supplement, section 214.5 256B.04, subdivision 18, is amended to read: 214.6 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 214.7 agency may take applications for medical assistance and conduct 214.8 eligibility determinations for MinnesotaCare enrolleeswho are214.9required to apply for medical assistance according to section214.10256L.03, subdivision 3, paragraph (b). 214.11 Sec. 2. Minnesota Statutes 1996, section 256B.057, is 214.12 amended by adding a subdivision to read: 214.13 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT REQUIREMENT.] 214.14 Unless a federal waiver of the maintenance of effort requirement 214.15 of section 2105(d) of title XXI of the Balanced Budget Act of 214.16 1997, Public Law Number 105-33, Statutes at Large, volume 111, 214.17 page 251, is granted by the federal Department of Health and 214.18 Human Services by September 30, 1998, eligibility for children 214.19 under age 21 must be determined without regard to asset 214.20 standards established in section 256B.056, subdivision 3. The 214.21 commissioner of human services shall publish a notice in the 214.22 State Register upon receipt of a federal waiver. 214.23 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 214.24 amended by adding a subdivision to read: 214.25 Subd. 8. [CHILDREN UNDER AGE TWO.] Medical assistance may 214.26 be paid for a child under two years of age whose countable 214.27 family income is above 275 percent of the federal poverty 214.28 guidelines for the same size family but less than or equal to 214.29 280 percent of the federal poverty guidelines for the same size 214.30 family. 214.31 Sec. 4. Minnesota Statutes 1997 Supplement, section 214.32 256D.03, subdivision 3, is amended to read: 214.33 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 214.34 (a) General assistance medical care may be paid for any person 214.35 who is not eligible for medical assistance under chapter 256B, 214.36 including eligibility for medical assistance based on a 215.1 spenddown of excess income according to section 256B.056, 215.2 subdivision 5, or MinnesotaCare as defined in clause (4), except 215.3 as provided in paragraph (b); and: 215.4 (1) who is receiving assistance under section 256D.05, 215.5 except for families with children who are eligible under 215.6 Minnesota family investment program-statewide (MFIP-S), who is 215.7 having a payment made on the person's behalf under sections 215.8 256I.01 to 256I.06, or who resides in group residential housing 215.9 as defined in chapter 256I and can meet a spenddown using the 215.10 cost of remedial services received through group residential 215.11 housing; or 215.12 (2)(i) who is a resident of Minnesota; and whose equity in 215.13 assets is not in excess of $1,000 per assistance unit. Exempt 215.14 assets, the reduction of excess assets, and the waiver of excess 215.15 assets must conform to the medical assistance program in chapter 215.16 256B, with the following exception: the maximum amount of 215.17 undistributed funds in a trust that could be distributed to or 215.18 on behalf of the beneficiary by the trustee, assuming the full 215.19 exercise of the trustee's discretion under the terms of the 215.20 trust, must be applied toward the asset maximum; and 215.21 (ii) who has countable income not in excess of the 215.22 assistance standards established in section 256B.056, 215.23 subdivision 4, or whose excess income is spent down according to 215.24 section 256B.056, subdivision 5, using a six-month budget 215.25 period. The method for calculating earned income disregards and 215.26 deductions for a person who resides with a dependent child under 215.27 age 21 shall follow section 256B.056, subdivision 1a. However, 215.28 if a disregard of $30 and one-third of the remainder has been 215.29 applied to the wage earner's income, the disregard shall not be 215.30 applied again until the wage earner's income has not been 215.31 considered in an eligibility determination for general 215.32 assistance, general assistance medical care, medical assistance, 215.33 or MFIP-S for 12 consecutive months. The earned income and work 215.34 expense deductions for a person who does not reside with a 215.35 dependent child under age 21 shall be the same as the method 215.36 used to determine eligibility for a person under section 216.1 256D.06, subdivision 1, except the disregard of the first $50 of 216.2 earned income is not allowed; or 216.3 (3) who would be eligible for medical assistance except 216.4 that the person resides in a facility that is determined by the 216.5 commissioner or the federal Health Care Financing Administration 216.6 to be an institution for mental diseases. 216.7 (4) BeginningJuly 1, 1998January 1, 2000, applicants or 216.8 recipients who meet all eligibility requirements of 216.9 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 216.10 (i) adults with dependent children under 21 whose gross 216.11 family income is equal to or less than 275 percent of the 216.12 federal poverty guidelines; or 216.13 (ii) adults without children with earned income and whose 216.14 family gross income is between 75 percent of the federal poverty 216.15 guidelines and the amount set by section 256L.04, subdivision 7, 216.16 shall be terminated from general assistance medical care upon 216.17 enrollment in MinnesotaCare. 216.18 (b) For services rendered on or after July 1, 1997, 216.19 eligibility is limited to one month prior to application if the 216.20 person is determined eligible in the prior month. A 216.21 redetermination of eligibility must occur every 12 months. 216.22 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 216.23 program applications completed by recipients and applicants who 216.24 are persons described in paragraph (a), clause (4), may be 216.25 returned to the county agency to be forwarded to the department 216.26 of human services or sent directly to the department of human 216.27 services for enrollment in MinnesotaCare. If all other 216.28 eligibility requirements of this subdivision are met, 216.29 eligibility for general assistance medical care shall be 216.30 available in any month during which a MinnesotaCare eligibility 216.31 determination and enrollment are pending. Upon notification of 216.32 eligibility for MinnesotaCare, notice of termination for 216.33 eligibility for general assistance medical care shall be sent to 216.34 an applicant or recipient. If all other eligibility 216.35 requirements of this subdivision are met, eligibility for 216.36 general assistance medical care shall be available until 217.1 enrollment in MinnesotaCare subject to the provisions of 217.2 paragraph (d). 217.3 (c) The date of an initial Minnesota health care program 217.4 application necessary to begin a determination of eligibility 217.5 shall be the date the applicant has provided a name, address, 217.6 and social security number, signed and dated, to the county 217.7 agency or the department of human services. If the applicant is 217.8 unable to provide an initial application when health care is 217.9 delivered due to a medical condition or disability, a health 217.10 care provider may act on the person's behalf to complete the 217.11 initial application. The applicant must complete the remainder 217.12 of the application and provide necessary verification before 217.13 eligibility can be determined. The county agency must assist 217.14 the applicant in obtaining verification if necessary. 217.15 (d) County agencies are authorized to use all automated 217.16 databases containing information regarding recipients' or 217.17 applicants' income in order to determine eligibility for general 217.18 assistance medical care or MinnesotaCare. Such use shall be 217.19 considered sufficient in order to determine eligibility and 217.20 premium payments by the county agency. 217.21 (e) General assistance medical care is not available for a 217.22 person in a correctional facility unless the person is detained 217.23 by law for less than one year in a county correctional or 217.24 detention facility as a person accused or convicted of a crime, 217.25 or admitted as an inpatient to a hospital on a criminal hold 217.26 order, and the person is a recipient of general assistance 217.27 medical care at the time the person is detained by law or 217.28 admitted on a criminal hold order and as long as the person 217.29 continues to meet other eligibility requirements of this 217.30 subdivision. 217.31 (f) General assistance medical care is not available for 217.32 applicants or recipients who do not cooperate with the county 217.33 agency to meet the requirements of medical assistance. General 217.34 assistance medical care is limited to payment of emergency 217.35 services only for applicants or recipients as described in 217.36 paragraph (a), clause (4), whose MinnesotaCare coverage is 218.1 denied or terminated for nonpayment of premiums as required by 218.2 sections 256L.06to 256L.08and 256L.07. 218.3 (g) In determining the amount of assets of an individual, 218.4 there shall be included any asset or interest in an asset, 218.5 including an asset excluded under paragraph (a), that was given 218.6 away, sold, or disposed of for less than fair market value 218.7 within the 60 months preceding application for general 218.8 assistance medical care or during the period of eligibility. 218.9 Any transfer described in this paragraph shall be presumed to 218.10 have been for the purpose of establishing eligibility for 218.11 general assistance medical care, unless the individual furnishes 218.12 convincing evidence to establish that the transaction was 218.13 exclusively for another purpose. For purposes of this 218.14 paragraph, the value of the asset or interest shall be the fair 218.15 market value at the time it was given away, sold, or disposed 218.16 of, less the amount of compensation received. For any 218.17 uncompensated transfer, the number of months of ineligibility, 218.18 including partial months, shall be calculated by dividing the 218.19 uncompensated transfer amount by the average monthly per person 218.20 payment made by the medical assistance program to skilled 218.21 nursing facilities for the previous calendar year. The 218.22 individual shall remain ineligible until this fixed period has 218.23 expired. The period of ineligibility may exceed 30 months, and 218.24 a reapplication for benefits after 30 months from the date of 218.25 the transfer shall not result in eligibility unless and until 218.26 the period of ineligibility has expired. The period of 218.27 ineligibility begins in the month the transfer was reported to 218.28 the county agency, or if the transfer was not reported, the 218.29 month in which the county agency discovered the transfer, 218.30 whichever comes first. For applicants, the period of 218.31 ineligibility begins on the date of the first approved 218.32 application. 218.33 (h) When determining eligibility for any state benefits 218.34 under this subdivision, the income and resources of all 218.35 noncitizens shall be deemed to include their sponsor's income 218.36 and resources as defined in the Personal Responsibility and Work 219.1 Opportunity Reconciliation Act of 1996, title IV, Public Law 219.2 Number 104-193, sections 421 and 422, and subsequently set out 219.3 in federal rules. 219.4 (i) An undocumented noncitizen or a nonimmigrant is 219.5 ineligible for general assistance medical care other than 219.6 emergency services. For purposes of this subdivision, a 219.7 nonimmigrant is an individual in one or more of the classes 219.8 listed in United States Code, title 8, section 1101(a)(15), and 219.9 an undocumented noncitizen is an individual who resides in the 219.10 United States without the approval or acquiescence of the 219.11 Immigration and Naturalization Service. 219.12 (j) This paragraph does not apply to a child under age 18, 219.13 to a Cuban or Haitian entrant as defined in Public Law Number 219.14 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 219.15 aged, blind, or disabled as defined in Code of Federal 219.16 Regulations, title 42, sections 435.520, 435.530, 435.531, 219.17 435.540, and 435.541, who cooperates with the Immigration and 219.18 Naturalization Service to pursue any applicable immigration 219.19 status, including citizenship, that would qualify the individual 219.20 for medical assistance with federal financial participation. 219.21 (k) For purposes of paragraphs (f) and (i), "emergency 219.22 services" has the meaning given in Code of Federal Regulations, 219.23 title 42, section 440.255(b)(1), except that it also means 219.24 services rendered because of suspected or actual pesticide 219.25 poisoning. 219.26 (l) Notwithstanding any other provision of law, a 219.27 noncitizen who is ineligible for medical assistance due to the 219.28 deeming of a sponsor's income and resources, is ineligible for 219.29 general assistance medical care. 219.30 Sec. 5. Minnesota Statutes 1997 Supplement, section 219.31 256L.01, is amended to read: 219.32 256L.01 [DEFINITIONS.] 219.33 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 219.34 to256L.10256L.18, the following terms shall have the meanings 219.35 given them. 219.36 Subd. 1a. [CHILD.] "Child" means an individual under 21 220.1 years of age, including the unborn child of a pregnant woman, an 220.2 emancipated minor, and an emancipated minor's spouse. 220.3 Subd. 2. [COMMISSIONER.] "Commissioner" means the 220.4 commissioner of human services. 220.5 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 220.6 those health care providers who provide covered health services 220.7 to medical assistance recipients under rules established by the 220.8 commissioner for that program. 220.9 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 220.10 children" means: 220.11 (1) parents, their children, and dependent siblings 220.12 residing in the same household; or 220.13 (2) grandparents, foster parents, relative caretakers as 220.14 defined in the medical assistance program, or legal guardians; 220.15 their wards who are children; and dependent siblings residing in 220.16 the same household. 220.17 (b) The term includes children and dependent siblings who 220.18 are temporarily absent from the household in settings such as 220.19 schools, camps, or visitation with noncustodial parents. 220.20 (c) For purposes of this subdivision, a dependent sibling 220.21 means an unmarried child who is a full-time student under the 220.22 age of 25 years who is financially dependent upon a parent, 220.23 grandparent, foster parent, relative caretaker, or legal 220.24 guardian. Proof of school enrollment is required. 220.25 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 220.26 individual or gross family income" for farm and nonfarm 220.27 self-employed means income calculated using as the baseline the 220.28 adjusted gross income reported on the applicant's federal income 220.29 tax form for the previous year and adding back in reported 220.30 depreciation, carryover loss, and net operating loss amounts 220.31 that apply to the business in which the family is currently 220.32 engaged. Applicants shall report the most recent financial 220.33 situation of the family if it has changed from the period of 220.34 time covered by the federal income tax form. The report may be 220.35 in the form of percentage increase or decrease. 220.36 Subd. 5. [INCOME.] "Income" has the meaning given for 221.1 earned and unearned income for families and children in the 221.2 medical assistance program, according to the state's aid to 221.3 families with dependent children plan in effect as of July 16, 221.4 1996. The definition does not include medical assistance income 221.5 methodologies and deeming requirements. The earned income of 221.6 full-time and part-time students under age 19 is not counted as 221.7 income. Public assistance payments and supplemental security 221.8 income are not excluded income. 221.9 Sec. 6. Minnesota Statutes 1997 Supplement, section 221.10 256L.02, subdivision 3, is amended to read: 221.11 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 221.12 shall manage spending for the MinnesotaCare program in a manner 221.13 that maintains a minimum reserve in accordance with section 221.14 16A.76. As part of each state revenue and expenditure forecast, 221.15 the commissioner must makea quarterlyan assessment of the 221.16 expected expenditures for the covered services for the remainder 221.17 of the current biennium and for the following biennium. The 221.18 estimated expenditure, including the reserve requirements 221.19 described in section 16A.76, shall be compared to an estimate of 221.20 the revenues that will bedepositedavailable in the health care 221.21 access fund. Based on this comparison, and after consulting 221.22 with the chairs of the house ways and means committee and the 221.23 senate finance committee, and the legislative commission on 221.24 health care access, the commissioner shall, as necessary, make 221.25 the adjustments specified in paragraph (b) to ensure that 221.26 expenditures remain within the limits of available revenues for 221.27 the remainder of the current biennium and for the following 221.28 biennium. The commissioner shall not hire additional staff 221.29 using appropriations from the health care access fund until the 221.30 commissioner of finance makes a determination that the 221.31 adjustments implemented under paragraph (b) are sufficient to 221.32 allow MinnesotaCare expenditures to remain within the limits of 221.33 available revenues for the remainder of the current biennium and 221.34 for the following biennium. 221.35 (b) The adjustments the commissioner shall use must be 221.36 implemented in this order: first, stop enrollment of single 222.1 adults and households without children; second, upon 45 days' 222.2 notice, stop coverage of single adults and households without 222.3 children already enrolled in the MinnesotaCare program; third, 222.4 upon 90 days' notice, decrease the premium subsidy amounts by 222.5 ten percent for families with gross annual income above 200 222.6 percent of the federal poverty guidelines; fourth, upon 90 days' 222.7 notice, decrease the premium subsidy amounts by ten percent for 222.8 families with gross annual income at or below 200 percent; and 222.9 fifth, require applicants to be uninsured for at least six 222.10 months prior to eligibility in the MinnesotaCare program. If 222.11 these measures are insufficient to limit the expenditures to the 222.12 estimated amount of revenue, the commissioner shall further 222.13 limit enrollment or decrease premium subsidies. 222.14 Sec. 7. Minnesota Statutes 1997 Supplement, section 222.15 256L.02, is amended by adding a subdivision to read: 222.16 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER 222.17 AGE TWO.] For fiscal years beginning on or after July 1, 1999, 222.18 the state cost of health care services provided to MinnesotaCare 222.19 enrollees who are pregnant women or children under age two shall 222.20 be paid out of the general fund rather than the health care 222.21 access fund. If the commissioner of finance decides to pay for 222.22 these costs using a source other than the general fund, the 222.23 commissioner shall include the change as a budget initiative in 222.24 the biennial or supplemental budget, and shall not change the 222.25 funding source through a forecast modification. 222.26 Sec. 8. Minnesota Statutes 1997 Supplement, section 222.27 256L.03, subdivision 1, is amended to read: 222.28 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 222.29 services" means the health services reimbursed under chapter 222.30 256B, with the exception of inpatient hospital services, special 222.31 education services, private duty nursing services, adult dental 222.32 care services other than preventive services, orthodontic 222.33 services, nonemergency medical transportation services, personal 222.34 care assistant and case management services, nursing home or 222.35 intermediate care facilities services, inpatient mental health 222.36 services, and chemical dependency services. Effective July 1, 223.1 1998, adult dental care for nonpreventive services with the 223.2 exception of orthodontic services is available to persons who 223.3 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,223.4 with family gross income equal to or less than 175 percent of 223.5 the federal poverty guidelines. Outpatient mental health 223.6 services covered under the MinnesotaCare program are limited to 223.7 diagnostic assessments, psychological testing, explanation of 223.8 findings, medication management by a physician, day treatment, 223.9 partial hospitalization, and individual, family, and group 223.10 psychotherapy. 223.11 No public funds shall be used for coverage of abortion 223.12 under MinnesotaCare except where the life of the female would be 223.13 endangered or substantial and irreversible impairment of a major 223.14 bodily function would result if the fetus were carried to term; 223.15 or where the pregnancy is the result of rape or incest. 223.16 Covered health services shall be expanded as provided in 223.17 this section. 223.18 Sec. 9. Minnesota Statutes 1997 Supplement, section 223.19 256L.03, is amended by adding a subdivision to read: 223.20 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 223.21 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.] 223.22 Children and pregnant women are eligible for coverage of all 223.23 services that are eligible for reimbursement under the medical 223.24 assistance program according to chapter 256B, except that 223.25 abortion services under MinnesotaCare shall be limited as 223.26 provided under section 256L.03, subdivision 1. Pregnant women 223.27 and children are exempt from the provisions of subdivision 5, 223.28 regarding copayments. Pregnant women and children who are 223.29 lawfully residing in the United States but who are not 223.30 "qualified noncitizens" under title IV of the Personal 223.31 Responsibility and Work Opportunity Reconciliation Act of 1996, 223.32 Public Law Number 104-193, Statutes at Large, volume 110, page 223.33 2105, are eligible for coverage of all services provided under 223.34 the medical assistance program according to chapter 256B. 223.35 Sec. 10. Minnesota Statutes 1997 Supplement, section 223.36 256L.03, is amended by adding a subdivision to read: 224.1 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 224.2 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 224.3 when her pregnancy is diagnosed is eligible for coverage of all 224.4 services provided under the medical assistance program according 224.5 to chapter 256B retroactive to the date the pregnancy is 224.6 medically diagnosed. Copayments totaling $30 or more, paid 224.7 after the date the pregnancy is diagnosed, shall be refunded. 224.8 Sec. 11. Minnesota Statutes 1997 Supplement, section 224.9 256L.03, subdivision 3, is amended to read: 224.10 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July224.111, 1993,Covered health services shall include inpatient 224.12 hospital services, including inpatient hospital mental health 224.13 services and inpatient hospital and residential chemical 224.14 dependency treatment, subject to those limitations necessary to 224.15 coordinate the provision of these services with eligibility 224.16 under the medical assistance spenddown. Prior to July 1, 1997, 224.17 the inpatient hospital benefit for adult enrollees is subject to 224.18 an annual benefit limit of $10,000.Effective July 1, 1997,The 224.19 inpatient hospital benefit for adult enrollees who qualify under 224.20 section 256L.04, subdivision 7, or who qualify under section 224.21 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 224.22 income that exceeds 175 percent of the federal poverty 224.23 guidelines and who are not pregnant, is subject to an annual 224.24 limit of $10,000. 224.25 (b)Enrollees who qualify under section 256L.04,224.26subdivision 7, or who qualify under section 256L.04,224.27subdivisions 1 to 6, or 256L.13 with family gross income that224.28exceeds 175 percent of the federal poverty guidelines and who224.29are not pregnant, and are determined by the commissioner to have224.30a basis of eligibility for medical assistance shall apply for224.31and cooperate with the requirements of medical assistance by the224.32last day of the third month following admission to an inpatient224.33hospital. If an enrollee fails to apply for medical assistance224.34within this time period, the enrollee and the enrollee's family224.35shall be disenrolled from the plan and they may not reenroll224.36until 12 calendar months have elapsed. Enrollees and enrollees'225.1families disenrolled for not applying for or not cooperating225.2with medical assistance may not reenroll.225.3(c)Admissions for inpatient hospital services paid for 225.4 under section 256L.11, subdivision 3, must be certified as 225.5 medically necessary in accordance with Minnesota Rules, parts 225.6 9505.0500 to 9505.0540, except as provided in clauses (1) and 225.7 (2): 225.8 (1) all admissions must be certified, except those 225.9 authorized under rules established under section 254A.03, 225.10 subdivision 3, or approved under Medicare; and 225.11 (2) payment under section 256L.11, subdivision 3, shall be 225.12 reduced by five percent for admissions for which certification 225.13 is requested more than 30 days after the day of admission. The 225.14 hospital may not seek payment from the enrollee for the amount 225.15 of the payment reduction under this clause. 225.16(d) Any enrollee or family member of an enrollee who has225.17previously been permanently disenrolled from MinnesotaCare for225.18not applying for and cooperating with medical assistance shall225.19be eligible to reenroll if 12 calendar months have elapsed since225.20the date of disenrollment.225.21 Sec. 12. Minnesota Statutes 1997 Supplement, section 225.22 256L.03, subdivision 4, is amended to read: 225.23 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 225.24 commissioner shall coordinate the provision of hospital 225.25 inpatient services under the MinnesotaCare program with enrollee 225.26 eligibility under the medical assistance spenddown, and shall225.27apply to the secretary of health and human services for any225.28necessary federal waivers or approvals. 225.29 Sec. 13. Minnesota Statutes 1997 Supplement, section 225.30 256L.03, subdivision 5, is amended to read: 225.31 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 225.32 benefit plan shall include the following copayments and 225.33 coinsurance requirements: 225.34 (1) ten percent of the paid charges for inpatient hospital 225.35 services for adult enrolleesnot eligible for medical225.36assistance, subject to an annual inpatient out-of-pocket maximum 226.1 of $1,000 per individual and $3,000 per family; 226.2 (2) $3 per prescription for adult enrollees; 226.3 (3) $25 for eyeglasses for adult enrollees; and 226.4 (4) effective July 1, 1998, 50 percent of the 226.5 fee-for-service rate for adult dental care services other than 226.6 preventive care services for persons eligible under section 226.7 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 226.8 or less than 175 percent of the federal poverty guidelines. 226.9Prior to July 1, 1997, enrollees who are not eligible for226.10medical assistance with or without a spenddown shall be226.11financially responsible for the coinsurance amount and amounts226.12which exceed the $10,000 benefit limit.Effective July 1, 1997, 226.13 adult enrolleeswho qualify under section 256L.04, subdivision226.147, or who qualify under section 256L.04, subdivisions 1 to 6, or226.15256L.13with family gross income that exceeds 175 percent of the 226.16 federal poverty guidelines and who are not pregnant, and who are226.17not eligible for medical assistance with or without a spenddown,226.18 shall be financially responsible for the coinsurance amount and 226.19 amounts which exceed the $10,000 inpatient hospital benefit 226.20 limit. 226.21 When a MinnesotaCare enrollee becomes a member of a prepaid 226.22 health plan, or changes from one prepaid health plan to another 226.23 during a calendar year, any charges submitted towards the 226.24 $10,000 annual inpatient benefit limit, and any out-of-pocket 226.25 expenses incurred by the enrollee for inpatient services, that 226.26 were submitted or incurred prior to enrollment, or prior to the 226.27 change in health plans, shall be disregarded. 226.28 Sec. 14. Minnesota Statutes 1997 Supplement, section 226.29 256L.04, subdivision 1, is amended to read: 226.30 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF226.31ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to226.32October 1, 1992, "eligible persons" means children who are one226.33year of age or older but less than 18 years of age who have226.34gross family incomes that are equal to or less than 185 percent226.35of the federal poverty guidelines and who are not eligible for226.36medical assistance without a spenddown under chapter 256B and227.1who are not otherwise insured for the covered services. The227.2period of eligibility extends from the first day of the month in227.3which the child's first birthday occurs to the last day of the227.4month in which the child becomes 18 years old.Families with 227.5 children with family income equal to or less than 275 percent of 227.6 the federal poverty guidelines for the applicable family size 227.7 shall be eligible for MinnesotaCare according to this section. 227.8 All other provisions of sections 256L.01 to 256L.18, including 227.9 the insurance-related barriers to enrollment under section 227.10 256L.07, shall apply unless otherwise specified. 227.11 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for227.12MinnesotaCare shall be expanded as provided in subdivisions 3 to227.137, except children who meet the criteria in this subdivision227.14shall continue to be enrolled pursuant to this subdivision. The227.15enrollment requirements in this paragraph apply to enrollment227.16under subdivisions 1 to 7.Parents who enroll in the 227.17 MinnesotaCare program must also enroll their children and 227.18 dependent siblings, if the children and their dependent siblings 227.19 are eligible. Children and dependent siblings may be enrolled 227.20 separately without enrollment by parents. However, if one 227.21 parent in the household enrolls, both parents must enroll, 227.22 unless other insurance is available. If one child from a family 227.23 is enrolled, all children must be enrolled, unless other 227.24 insurance is available. If one spouse in a household enrolls, 227.25 the other spouse in the household must also enroll, unless other 227.26 insurance is available. Families cannot choose to enroll only 227.27 certain uninsured members.For purposes of this section, a227.28"dependent sibling" means an unmarried child who is a full-time227.29student under the age of 25 years who is financially dependent227.30upon a parent. Proof of school enrollment will be required.227.31(c) [CONTINUATION OF ELIGIBILITY.] Individuals who227.32initially enroll in the MinnesotaCare program under the227.33eligibility criteria in subdivisions 3 to 7 remain eligible for227.34the MinnesotaCare program, regardless of age, place of227.35residence, or the presence or absence of children in the same227.36household, as long as all other eligibility criteria are met and228.1residence in Minnesota and continuous enrollment in the228.2MinnesotaCare program or medical assistance are maintained. In228.3order for either parent or either spouse in a household to228.4remain enrolled, both must remain enrolled, unless other228.5insurance is available.228.6 Sec. 15. Minnesota Statutes 1997 Supplement, section 228.7 256L.04, subdivision 2, is amended to read: 228.8 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 228.9 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 228.10 eligible for MinnesotaCare, individuals and families must 228.11 cooperate with the state agency to identify potentially liable 228.12 third party payers and assist the state in obtaining third party 228.13 payments. "Cooperation" includes, but is not limited to, 228.14 identifying any third party who may be liable for care and 228.15 services provided under MinnesotaCare to the enrollee, providing 228.16 relevant information to assist the state in pursuing a 228.17 potentially liable third party, and completing forms necessary 228.18 to recover third party payments. 228.19 (b) A parent, guardian, or child enrolled in the 228.20 MinnesotaCare program must cooperate with the department of 228.21 human services and the local agency in establishing the 228.22 paternity of an enrolled child and in obtaining medical care 228.23 support and payments for the child and any other person for whom 228.24 the person can legally assign rights, in accordance with 228.25 applicable laws and rules governing the medical assistance 228.26 program. A child shall not be ineligible for or disenrolled 228.27 from the MinnesotaCare program solely because the child's parent 228.28 or guardian fails to cooperate in establishing paternity or 228.29 obtaining medical support. 228.30 Sec. 16. Minnesota Statutes 1997 Supplement, section 228.31 256L.04, subdivision 7, is amended to read: 228.32 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 228.33 CHILDREN.](a) Beginning October 1, 1994, the definition of228.34"eligible persons" is expanded to include all individuals and228.35households with no children who have gross family incomes that228.36are equal to or less than 125 percent of the federal poverty229.1guidelines and who are not eligible for medical assistance229.2without a spenddown under chapter 256B.229.3(b) Beginning July 1, 1997,The definition of eligible 229.4 personsis expanded to includeincludes all individuals and 229.5 households with no children who have gross family incomes that 229.6 are equal to or less than 175 percent of the federal poverty 229.7 guidelinesand who are not eligible for medical assistance229.8without a spenddown under chapter 256B. 229.9(c) All eligible persons under paragraphs (a) and (b) are229.10eligible for coverage through the MinnesotaCare program but must229.11pay a premium as determined under sections 256L.07 and 256L.08.229.12Individuals and families whose income is greater than the limits229.13established under section 256L.08 may not enroll in the229.14MinnesotaCare program.229.15 Sec. 17. Minnesota Statutes 1997 Supplement, section 229.16 256L.04, is amended by adding a subdivision to read: 229.17 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 229.18 greater than the limits established under this section may not 229.19 enroll in the MinnesotaCare program. 229.20 Sec. 18. Minnesota Statutes 1997 Supplement, section 229.21 256L.04, subdivision 8, is amended to read: 229.22 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 229.23 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 229.24 supplemental security income or retirement, survivors, or 229.25 disability benefits due to a disability, or other 229.26 disability-based pension, who qualify under section 256L.04, 229.27 subdivision 7, but who are potentially eligible for medical 229.28 assistance without a spenddown shall be allowed to enroll in 229.29 MinnesotaCare for a period of 60 days, so long as the applicant 229.30 meets all other conditions of eligibility. The commissioner 229.31 shall identify and refer the applications of such individuals to 229.32 their county social service agency. The county and the 229.33 commissioner shall cooperate to ensure that the individuals 229.34 obtain medical assistance coverage for any months for which they 229.35 are eligible. 229.36 (b) The enrollee must cooperate with the county social 230.1 service agency in determining medical assistance eligibility 230.2 within the 60-day enrollment period. Enrollees who do notapply230.3for andcooperate with medical assistance within the 60-day 230.4 enrollment period, and their other family members,shall be 230.5 disenrolled from the plan within one calendar month. Persons 230.6 disenrolled for nonapplication for medical assistance may not 230.7 reenroll until they have obtained a medical assistance 230.8 eligibility determinationfor the family member or members who230.9were referred to the county agency. Persons disenrolled for 230.10 noncooperation with medical assistance may not reenroll until 230.11 they have cooperated with the county agency and have obtained a 230.12 medical assistance eligibility determination. 230.13 (c) Beginning January 1, 2000, counties that choose to 230.14 become MinnesotaCare enrollment sites shall consider 230.15 MinnesotaCare applications of individuals described in paragraph 230.16 (a) to also be applications for medical assistance and shall 230.17 first determine whether medical assistance eligibility exists. 230.18 Adults with children with family income under 175 percent of the 230.19 federal poverty guidelines for the applicable family size, 230.20 pregnant women, and children who qualify under subdivision 1 who 230.21 are potentially eligible for medical assistance without a 230.22 spenddown may choose to enroll in either MinnesotaCare or 230.23 medical assistance. 230.24 (d) The commissioner shall redetermine provider payments 230.25 made under MinnesotaCare to the appropriate medical assistance 230.26 payments for those enrollees who subsequently become eligible 230.27 for medical assistance. 230.28 Sec. 19. Minnesota Statutes 1997 Supplement, section 230.29 256L.04, subdivision 9, is amended to read: 230.30 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 230.31 cannot have coverage under both MinnesotaCare and general 230.32 assistance medical care in the same month. Eligibility for 230.33 MinnesotaCare cannot be replaced by eligibility for general 230.34 assistance medical care, and eligibility for general assistance 230.35 medical care cannot be replaced by eligibility for MinnesotaCare. 230.36 Sec. 20. Minnesota Statutes 1997 Supplement, section 231.1 256L.04, subdivision 10, is amended to read: 231.2 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 231.3 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 231.4 federal or state benefits under sections 256L.01 to256L.16231.5 256L.18, the income and resources of all noncitizens whose 231.6 sponsor signed an affidavit of support as defined under United 231.7 States Code, title 8, section 1183a, shall be deemed to include 231.8 their sponsors' income and resources as defined in the Personal 231.9 Responsibility and Work Opportunity Reconciliation Act of 1996, 231.10 title IV, Public Law Number 104-193, sections 421 and 422, and 231.11 subsequently set out in federal rules. To be eligible for the 231.12 program, noncitizens must provide documentation of their 231.13 immigration status. 231.14 Sec. 21. Minnesota Statutes 1997 Supplement, section 231.15 256L.04, is amended by adding a subdivision to read: 231.16 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 231.17 a correctional or detention facility is not eligible for 231.18 MinnesotaCare. An enrollee residing in a correctional or 231.19 detention facility is not eligible at renewal of eligibility 231.20 under section 256L.05, subdivision 3b. 231.21 Sec. 22. Minnesota Statutes 1997 Supplement, section 231.22 256L.04, is amended by adding a subdivision to read: 231.23 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 231.24 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 231.25 that include a grandparent, relative caretaker as defined in the 231.26 medical assistance program, foster parent, or legal guardian, 231.27 the grandparent, relative caretaker, foster parent, or legal 231.28 guardian may apply as a family or may apply separately for the 231.29 child. If the grandparent, relative caretaker, foster parent, 231.30 or legal guardian applies with the family, their income is 231.31 included in the gross family income for determining eligibility 231.32 and premium amount. 231.33 Sec. 23. Minnesota Statutes 1997 Supplement, section 231.34 256L.05, is amended by adding a subdivision to read: 231.35 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 231.36 BEHALF.] A family member who is age 18 or over or who is an 232.1 authorized representative, as defined in the medical assistance 232.2 program, may apply on an applicant's behalf. 232.3 Sec. 24. Minnesota Statutes 1997 Supplement, section 232.4 256L.05, subdivision 2, is amended to read: 232.5 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 232.6 use individuals' social security numbers as identifiers for 232.7 purposes of administering the plan and conduct data matches to 232.8 verify income. Applicants shall submit evidence of individual 232.9 and family income, earned and unearned,includingsuch as the 232.10 most recent income tax return, wage slips, or other 232.11 documentation that is determined by the commissioner as 232.12 necessary to verify income eligibility. The commissioner shall 232.13 perform random audits to verify reported income and 232.14 eligibility. The commissioner may execute data sharing 232.15 arrangements with the department of revenue and any other 232.16 governmental agency in order to perform income verification 232.17 related to eligibility and premium payment under the 232.18 MinnesotaCare program. 232.19 Sec. 25. Minnesota Statutes 1997 Supplement, section 232.20 256L.05, subdivision 3, is amended to read: 232.21 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 232.22 of coverage is the first day of the month following the month in 232.23 which eligibility is approved and the first premium payment has 232.24 been received. As provided in section 256B.057, coverage for 232.25 newborns is automatic from the date of birth and must be 232.26 coordinated with other health coverage. The effective date of 232.27 coverage foreligible newborns oreligible newly adoptive 232.28 children added to a family receiving covered health services is 232.29 the date of entry into the family. The effective date of 232.30 coverage for other new recipients added to the family receiving 232.31 covered health services is the first day of the month following 232.32 the month in which eligibility is approvedand the first premium232.33payment has been receivedor at renewal, whichever the family 232.34 receiving covered health services prefers. All eligibility 232.35 criteria must be met by the family at the time the new family 232.36 member is added. The income of the new family member is 233.1 included with the family's gross income and the adjusted premium 233.2 begins in the month the new family member is added. The premium 233.3 must be received eight working days prior to the end of the 233.4 month for coverage to begin the following month. Benefits are 233.5 not available until the day following discharge if an enrollee 233.6 is hospitalized on the first day of coverage. Notwithstanding 233.7 any other law to the contrary, benefits under sections 256L.01 233.8 to256L.10256L.18 are secondary to a plan of insurance or 233.9 benefit program under which an eligible person may have coverage 233.10 and the commissioner shall use cost avoidance techniques to 233.11 ensure coordination of any other health coverage for eligible 233.12 persons. The commissioner shall identify eligible persons who 233.13 may have coverage or benefits under other plans of insurance or 233.14 who become eligible for medical assistance. 233.15 Sec. 26. Minnesota Statutes 1997 Supplement, section 233.16 256L.05, is amended by adding a subdivision to read: 233.17 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 233.18 eligibility must be renewed every 12 months. The 12-month 233.19 period begins in the month after the month the application is 233.20 approved. An enrollee must meet all applicable eligibility 233.21 criteria at the time of renewal. An enrollee whose income 233.22 exceeds the income limits specified in section 256L.04, 233.23 subdivision 1 or 7 is subject to section 256L.07, subdivision 1. 233.24 Sec. 27. Minnesota Statutes 1997 Supplement, section 233.25 256L.05, is amended by adding a subdivision to read: 233.26 Subd. 3b. [REAPPLICATION.] Families and individuals must 233.27 reapply after a lapse in coverage of one calendar month or more 233.28 and must meet all eligibility criteria. 233.29 Sec. 28. Minnesota Statutes 1997 Supplement, section 233.30 256L.05, subdivision 4, is amended to read: 233.31 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 233.32 human services shall determine an applicant's eligibility for 233.33 MinnesotaCare no more than 30 days from the date that the 233.34 application is received by the department of human services. 233.35 Beginning January 1, 2000, this requirement also applies to 233.36 local county human services agencies that determine eligibility 234.1 for MinnesotaCare. To prevent processing delays, applicants who 234.2 appear to meet eligibility requirements shall be enrolled. The 234.3 enrollee must provide all required verifications within 30 days 234.4 of enrollment or coverage from the program shall be terminated. 234.5 Enrollees who are determined to be ineligible when verifications 234.6 are provided shall be terminated. 234.7 Sec. 29. Minnesota Statutes 1997 Supplement, section 234.8 256L.06, subdivision 3, is amended to read: 234.9 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 234.10 Premiums are dedicated to the commissioner for MinnesotaCare. 234.11The commissioner shall make an annual redetermination of234.12continued eligibility and identify people who may become234.13eligible for medical assistance.234.14 (b) The commissioner shall develop and implement procedures 234.15 to: (1) require enrollees to report changes in income; (2) 234.16 adjust sliding scale premium payments, based upon changes in 234.17 enrollee income; and (3) disenroll enrollees from MinnesotaCare 234.18 for failure to pay required premiums. Failure to pay includes 234.19 payment with a dishonored check. The commissioner may demand a 234.20 guaranteed form of payment as the only means to replace a 234.21 dishonored check. 234.22 (c) Premiums are calculated on a calendar month basis and 234.23 may be paid on a monthly, quarterly, or annual basis, with the 234.24 first payment due upon notice from the commissioner of the 234.25 premium amount required. The commissioner shall inform 234.26 applicants and enrollees of these premium payment options. 234.27 Premium payment is required before enrollment is complete and to 234.28 maintain eligibility in MinnesotaCare. 234.29 (d) Nonpayment of the premium will result in disenrollment 234.30 from the plan within one calendar month after the due date. 234.31 Persons disenrolled for nonpayment or who voluntarily terminate 234.32 coverage from the program may not reenroll until four calendar 234.33 months have elapsed. Persons disenrolled for nonpayment or who 234.34 voluntarily terminate coverage from the program may not reenroll 234.35 for four calendar months unless the person demonstrates good 234.36 cause for nonpayment. Good cause does not exist if a person 235.1 chooses to pay other family expenses instead of the premium. 235.2 The commissioner shall define good cause in rule. 235.3 Sec. 30. Minnesota Statutes 1997 Supplement, section 235.4 256L.07, is amended to read: 235.5 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 235.6 SLIDING SCALE.] 235.7 Subdivision 1. [GENERAL REQUIREMENTS.]Families and235.8individuals who enroll on or after October 1, 1992, are eligible235.9for subsidized premium payments based on a sliding scale under235.10section 256L.08 only if the family or individual meets the235.11requirements in subdivisions 2 and 3. Children already enrolled235.12in the children's health plan as of September 30, 1992, eligible235.13under section 256L.04, subdivision 1, paragraph (a), children235.14who enroll in the MinnesotaCare program after September 30,235.151992, pursuant to Laws 1992, chapter 549, article 4, section 17,235.16and children who enroll under section 256L.04, subdivision 6,235.17are eligible for subsidized premium payments without meeting235.18these requirements, as long as they maintain continuous coverage235.19in the MinnesotaCare plan or medical assistance.235.20Families and individuals who initially enrolled in235.21MinnesotaCare under section 256L.04, and whose income increases235.22above the limits established in section 256L.08, may continue235.23enrollment and pay the full cost of coverage.Families enrolled 235.24 in MinnesotaCare under section 256L.04, subdivision 1, whose 235.25 income increases above 275 percent of the federal poverty 235.26 guidelines, are no longer eligible for the program and shall be 235.27 disenrolled by the commissioner. Individuals enrolled in 235.28 MinnesotaCare under section 256L.04, subdivision 7, whose income 235.29 increases above 175 percent of the federal poverty guidelines 235.30 are no longer eligible for the program and shall be disenrolled 235.31 by the commissioner. For persons disenrolled under this 235.32 subdivision, MinnesotaCare coverage terminates the last day of 235.33 the calendar month following the month in which the commissioner 235.34 determines that the income of a family or individual, determined 235.35 over a four-month period as required by section 256L.08, exceeds 235.36 program income limits. 236.1 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 236.2 COVERAGE.] (a) To be eligible for subsidized premium payments 236.3 based on a sliding scale, a family or individual must not have 236.4 access to subsidized health coverage through an employer, and236.5must not have had access to subsidized health coverage through236.6an employer for the 18 months prior to application for236.7subsidized coverage under the MinnesotaCare program.The236.8requirement that the family or individual must not have had236.9access to employer-subsidized coverage during the previous 18236.10months does not apply if: (1) employer-subsidized coverage was236.11lost due to the death of an employee or divorce; (2)236.12employer-subsidized coverage was lost because an individual236.13became ineligible for coverage as a child or dependent; or (3)236.14employer-subsidized coverage was lost for reasons that would not236.15disqualify the individual for unemployment benefits under236.16section 268.09 and the family or individual has not had access236.17to employer-subsidized coverage since the loss of coverage. If236.18employer-subsidized coverage was lost for reasons that236.19disqualify an individual for unemployment benefits under section236.20268.09, children of that individual are exempt from the236.21requirement of no access to employer subsidized coverage for the236.2218 months prior to application, as long as the children have not236.23had access to employer subsidized coverage since the236.24disqualifying event. The requirement that the. A family or 236.25 individualmust not have had access to employer-subsidized236.26coverage during the previous 18 months does apply ifwhose 236.27 employer-subsidized coverage is lost due to an employer 236.28 terminating health care coverage as an employee benefit during 236.29 the previous 18 months is not eligible. 236.30 (b) For purposes of this requirement, subsidized health 236.31 coverage means health coverage for which the employer pays at 236.32 least 50 percent of the cost of coverage for the employee,236.33excluding dependent coverageor dependent, or a higher 236.34 percentage as specified by the commissioner. Children are 236.35 eligible for employer-subsidized coverage through either parent, 236.36 including the noncustodial parent. The commissioner must treat 237.1 employer contributions to Internal Revenue Code Section 125 237.2 plans and any other employer benefits intended to pay health 237.3 care costs as qualified employer subsidies toward the cost of 237.4 health coverage for employees for purposes of this subdivision. 237.5 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be237.6eligible for subsidized premium payments based on a sliding237.7scale,(a) Families and individualsinitiallyenrolled in the 237.8 MinnesotaCare programunder section 256L.04, subdivisions 5 and237.97,must havehadno health coverage while enrolled or for at 237.10 least four months prior to application and renewal. A child in 237.11 a family with income equal to or less than 150 percent of the 237.12 federal poverty guidelines, who has other health coverage, is 237.13 eligible if the other health coverage meets the requirements of 237.14 Minnesota Rules, part 9506.0020, subpart 3, item B. The 237.15 commissioner may change this eligibility criterion for sliding 237.16 scale premiums in order to remain within the limits of available 237.17 appropriations. The requirement ofat least four months ofno 237.18 health coverageprior to application for the MinnesotaCare237.19programdoes not apply to:newborns. 237.20(1) families, children, and individuals who apply for the237.21MinnesotaCare program upon termination from or as required by237.22the medical assistance program, general assistance medical care237.23program, or coverage under a regional demonstration project for237.24the uninsured funded under section 256B.73, the Hennepin county237.25assured care program, or the Group Health, Inc., community237.26health plan;237.27(2) families and individuals initially enrolled under237.28section 256L.04, subdivisions 1, paragraph (a), and 3;237.29(3) children enrolled pursuant to Laws 1992, chapter 549,237.30article 4, section 17; or237.31(4) individuals currently serving or who have served in the237.32military reserves, and dependents of these individuals, if these237.33individuals: (i) reapply for MinnesotaCare coverage after a237.34period of active military service during which they had been237.35covered by the Civilian Health and Medical Program of the237.36Uniformed Services (CHAMPUS); (ii) were covered under238.1MinnesotaCare immediately prior to obtaining coverage under238.2CHAMPUS; and (iii) have maintained continuous coverage.238.3 (b) For purposes of this section, medical assistance, 238.4 general assistance medical care, and civilian health and medical 238.5 program of the uniformed service (CHAMPUS) are not considered 238.6 insurance or health coverage. 238.7 (c) For purposes of this section, Medicare part A or B 238.8 coverage under title XVIII of the Social Security Act, United 238.9 States Code, title 42, sections 1395c to 1395w-4, is considered 238.10 health coverage. An applicant or enrollee may not refuse 238.11 Medicare coverage to establish eligibility for MinnesotaCare. 238.12 Subd. 4. [EXEMPTION FOR PERSONS WITH CONTINUATION 238.13 COVERAGE.] (a) Families, children, and individuals who want to 238.14 apply for the MinnesotaCare program upon termination from 238.15 continuation coverage required under federal or state law are 238.16 exempt from the requirements of subdivisions 2 and 3. 238.17 (b) For purposes of paragraph (a), "termination from 238.18 continuation coverage" means involuntary termination for any 238.19 reason, other than nonpayment of premium by the family, child, 238.20 or individual. Involuntary termination includes termination of 238.21 coverage due to reaching the end of the maximum period for 238.22 continuation coverage required under federal or state law. 238.23 Sec. 31. Minnesota Statutes 1997 Supplement, section 238.24 256L.09, subdivision 2, is amended to read: 238.25 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,238.261997, to be eligible for health coverage under the MinnesotaCare238.27program, families and individuals must be permanent residents of238.28Minnesota.238.29(b) Effective July 1, 1997,To be eligible for health 238.30 coverage under the MinnesotaCare program, adults without 238.31 children must be permanent residents of Minnesota. 238.32(c) Effective July 1, 1997,(b) To be eligible for health 238.33 coverage under the MinnesotaCare program, pregnant women, 238.34 families, and children must meet the residency requirements as 238.35 provided by Code of Federal Regulations, title 42, section 238.36 435.403, except that the provisions of section 256B.056, 239.1 subdivision 1, shall apply upon receipt of federal approval. 239.2 Sec. 32. Minnesota Statutes 1997 Supplement, section 239.3 256L.09, subdivision 4, is amended to read: 239.4 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 239.5 purposes of this section, a permanent Minnesota resident is a 239.6 person who has demonstrated, through persuasive and objective 239.7 evidence, that the person is domiciled in the state and intends 239.8 to live in the state permanently. 239.9 (b) To be eligible as a permanent resident,all applicants239.10 an applicant must demonstrate the requisite intent to live in 239.11 the state permanently by: 239.12 (1) showing that the applicant maintains a residence at a 239.13 verified address other than a place of public accommodation, 239.14 through the use of evidence of residence described in section 239.15 256D.02, subdivision 12a, clause (1); 239.16 (2) demonstrating that the applicant has been continuously 239.17 domiciled in the state for no less than 180 days immediately 239.18 before the application; and 239.19 (3) signing an affidavit declaring that (A) the applicant 239.20 currently resides in the state and intends to reside in the 239.21 state permanently; and (B) the applicant did not come to the 239.22 state for the primary purpose of obtaining medical coverage or 239.23 treatment. 239.24 (c) A person who is temporarily absent from the state does 239.25 not lose eligibility for MinnesotaCare. "Temporarily absent 239.26 from the state" means the person is out of the state for a 239.27 temporary purpose and intends to return when the purpose of the 239.28 absence has been accomplished. A person is not temporarily 239.29 absent from the state if another state has determined that the 239.30 person is a resident for any purpose. If temporarily absent 239.31 from the state, the person must follow the requirements of the 239.32 health plan in which he or she is enrolled to receive services. 239.33 Sec. 33. Minnesota Statutes 1997 Supplement, section 239.34 256L.09, subdivision 6, is amended to read: 239.35 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 239.36 requirement in subdivision 4, paragraph (b), clause (2), is 240.1 determined by a court to be unconstitutional, the commissioner 240.2 of human services shall impose a 12-month preexisting condition 240.3 exclusion on coverage for persons who have been domiciled in the 240.4 state for less than 180 days. 240.5 Sec. 34. Minnesota Statutes 1997 Supplement, section 240.6 256L.11, subdivision 6, is amended to read: 240.7 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 240.8 MinnesotaCare program for inpatient hospital services provided 240.9 to MinnesotaCare enrollees eligible under section 256L.04, 240.10 subdivision 7, or who qualify under section 256L.04, 240.11 subdivisions 1to 6and 2,or 256L.13with family gross income 240.12 that exceeds 175 percent of the federal poverty guidelines and 240.13 who are not pregnant, who are 18 years old or older on the date 240.14 of admission to the inpatient hospital must be in accordance 240.15 with paragraphs (a) and (b). Payment for adults who are not 240.16 pregnant and are eligible under section 256L.04, subdivisions 240.17 1to 6and 2,or 256L.13,and whose incomes are equal to or less 240.18 than 175 percent of the federal poverty guidelines, shall be as 240.19 provided for under paragraph (c). 240.20 (a) If the medical assistance rate minus any copayment 240.21 required under section 256L.03, subdivision 4, is less than or 240.22 equal to the amount remaining in the enrollee's benefit limit 240.23 under section 256L.03, subdivision 3, payment must be the 240.24 medical assistance rate minus any copayment required under 240.25 section 256L.03, subdivision 4. The hospital must not seek 240.26 payment from the enrollee in addition to the copayment. The 240.27 MinnesotaCare payment plus the copayment must be treated as 240.28 payment in full. 240.29 (b) If the medical assistance rate minus any copayment 240.30 required under section 256L.03, subdivision 4, is greater than 240.31 the amount remaining in the enrollee's benefit limit under 240.32 section 256L.03, subdivision 3, payment must be the lesser of: 240.33 (1) the amount remaining in the enrollee's benefit limit; 240.34 or 240.35 (2) charges submitted for the inpatient hospital services 240.36 less any copayment established under section 256L.03, 241.1 subdivision 4. 241.2 The hospital may seek payment from the enrollee for the 241.3 amount by which usual and customary charges exceed the payment 241.4 under this paragraph. If payment is reduced under section 241.5 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 241.6 seek payment from the enrollee for the amount of the reduction. 241.7 (c) For admissions occurring during the period of July 1, 241.8 1997, through June 30, 1998, for adults who are not pregnant and 241.9 are eligible under section 256L.04, subdivisions 1to 6and 241.10 2,or 256L.13,and whose incomes are equal to or less than 175 241.11 percent of the federal poverty guidelines, the commissioner 241.12 shall pay hospitals directly, up to the medical assistance 241.13 payment rate, for inpatient hospital benefits in excess of the 241.14 $10,000 annual inpatient benefit limit. 241.15 Sec. 35. Minnesota Statutes 1997 Supplement, section 241.16 256L.12, subdivision 5, is amended to read: 241.17 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 241.18 MinnesotaCare enrollees who become eligible for medical 241.19 assistance or general assistance medical care will remain in the 241.20 same managed care plan if the managed care plan has a contract 241.21 for that population. Effective January 1, 1998, MinnesotaCare 241.22 enrollees who were formerly eligible for general assistance 241.23 medical care pursuant to section 256D.03, subdivision 3, within 241.24 six months of MinnesotaCare enrollment and were enrolled in a 241.25 prepaid health plan pursuant to section 256D.03, subdivision 4, 241.26 paragraph (d), must remain in the same managed care plan if the 241.27 managed care plan has a contract for that population.Contracts241.28between the department of human services and managed care plans241.29must include MinnesotaCare, and medical assistance and may, at241.30the option of the commissioner of human services, also include241.31general assistance medical care.Managed care plans must 241.32 participate in the MinnesotaCare and general assistance medical 241.33 care programs under a contract with the department of human 241.34 services in service areas where they participate in the medical 241.35 assistance program. 241.36 Sec. 36. Minnesota Statutes 1997 Supplement, section 242.1 256L.15, is amended to read: 242.2 256L.15 [PREMIUMS.] 242.3 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 242.4 childrenenrolled according to sections 256L.13 to 256L.16and 242.5 individuals shall pay an enrollment fee or a premium determined 242.6 according to a sliding fee based on the cost of coverage as a 242.7 percentage of the family's gross family income. Pregnant women 242.8 and children under age two are exempt from the provisions of 242.9 section 256L.06, subdivision 3, paragraph (b), clause (3), 242.10 requiring disenrollment for failure to pay premiums. For 242.11 pregnant women, this exemption continues until the first day of 242.12 the month following the 60th day postpartum. Women who remain 242.13 enrolled during pregnancy or the postpartum period, despite 242.14 nonpayment of premiums, shall be disenrolled on the first of the 242.15 month following the 60th day postpartum for the penalty period 242.16 that otherwise applies under section 256L.06, unless they begin 242.17 paying premiums. 242.18 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 242.19 the following payment options to an enrollee: 242.20 (1) payment by check; 242.21 (2) payment by credit card; 242.22 (3) payment by recurring automatic checking withdrawal; 242.23 (4) payment by one-time electronic transfer of funds; or 242.24 (5) payment by wage withholding with the consent of the 242.25 employer and the employee. 242.26 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 242.27 and enrollment fees are not refundable. 242.28 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 242.29 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 242.30 sliding fee scale to determine the percentage of 242.31 gross individual or family income that households at different 242.32 income levels must pay to obtain coverage through the 242.33 MinnesotaCare program. The sliding fee scale must be based on 242.34 the enrollee's gross individual or family income during the 242.35 previous four months. The sliding fee scale begins with a 242.36 premium of 1.5 percent of gross individual or family income for 243.1 individuals or families with incomes below the limits for the 243.2 medical assistance program for families and children and 243.3 proceeds through the following evenly spaced steps: 1.8, 2.3, 243.4 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 243.5 matched to evenly spaced income steps ranging from the medical 243.6 assistance income limit for families and children to 275 percent 243.7 of the federal poverty guidelines for the applicable family 243.8 size. The sliding fee scale and percentages are not subject to 243.9 the provisions of chapter 14. If a family or individual reports 243.10 increased income after enrollment, premiums shall not be 243.11 adjusted until eligibility renewal. 243.12Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium243.13of $48 is required for all children who are eligible according243.14to section 256L.13, subdivision 4.243.15 Subd. 4. [CHILDREN IN FAMILIES WITH INCOME AT OR LESS THAN 243.16 150 PERCENT OF FEDERAL POVERTY GUIDELINES.] Children in families 243.17 with income at or below 150 percent of the federal poverty 243.18 guidelines, when only the children are enrolled, may pay an 243.19 annual enrollment fee of $48 per child. Payment of the $48 243.20 annual enrollment fee in families with only the children 243.21 enrolled guarantees eligibility for 12 months regardless of 243.22 changes in circumstances. If the entire family is enrolled, the 243.23 children are required to pay a monthly premium of $4. 243.24 Sec. 37. Minnesota Statutes 1997 Supplement, section 243.25 256L.17, is amended by adding a subdivision to read: 243.26 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 243.27 REQUIREMENT.] Unless a federal waiver of the maintenance of 243.28 effort requirements of section 2105(d) of title XXI of the 243.29 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 243.30 at Large, volume 111, page 251, is granted by the federal 243.31 Department of Health and Human Services by September 30, 1998, 243.32 this section does not apply to children. The commissioner shall 243.33 publish a notice in the State Register upon receipt of a federal 243.34 waiver. 243.35 Sec. 38. [256L.19] [STATE CHILDREN'S HEALTH INSURANCE 243.36 PROGRAM.] 244.1 Subdivision 1. [AUTHORITY.] The commissioner is authorized 244.2 to claim enhanced federal matching funds under sections 244.3 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 244.4 Law Number 105-33, for any and all state or local expenditures 244.5 eligible as child health assistance for targeted low income 244.6 children and health service initiatives for low income 244.7 children. If required by federal law or regulations, the 244.8 commissioner is authorized to establish accounts, make 244.9 appropriate payments, and receive reimbursement from state and 244.10 local entities providing child health assistance or health 244.11 services for low income children, in order to obtain enhanced 244.12 federal matching funds. Enhanced federal matching funds 244.13 received as a result of authority exercised under this section 244.14 shall be deposited in the general fund. 244.15 Subd. 2. [ENHANCED MATCHING FUNDS FOR CHILDREN'S HEALTH 244.16 CARE INITIATIVES.] The commissioner shall submit to the health 244.17 care financing administration all plans and waiver requests 244.18 necessary to obtain enhanced matching funds under the state 244.19 children's health insurance program established as Title 21 of 244.20 the Balanced Budget Act of 1997, Public Law Number 105-33, for: 244.21 (1) expenditures made under section 256B.057, subdivision 8; and 244.22 (2) expenditures made under the MinnesotaCare program. The 244.23 commissioner shall submit to the legislature, by January 15, 244.24 1999, all statutory changes to the MinnesotaCare program 244.25 necessary to receive enhanced federal matching funds. 244.26 Sec. 39. Minnesota Statutes 1997 Supplement, section 244.27 295.50, subdivision 4, is amended to read: 244.28 Subd. 4. [HEALTH CARE PROVIDER.] (a) "Health care 244.29 provider" means: 244.30 (1) a person whose health care occupation is regulated or 244.31 required to be regulated by the state of Minnesota furnishing 244.32 any or all of the following goods or services directly to a 244.33 patient or consumer: medical, surgical, optical, visual, 244.34dental,hearing, nursing services, drugs, laboratory, diagnostic 244.35 or therapeutic services; 244.36 (2) a person who provides goods and services not listed in 245.1 clause (1) that qualify for reimbursement under the medical 245.2 assistance program provided under chapter 256B; 245.3 (3) a staff model health plan company; 245.4 (4) an ambulance service required to be licensed; or 245.5 (5) a person who sells or repairs hearing aids and related 245.6 equipment or prescription eyewear. 245.7 (b) Health care provider does not include hospitals; 245.8 medical supplies distributors, except as specified under 245.9 paragraph (a), clause (5); providers of dental services; nursing 245.10 homes licensed under chapter 144A or licensed in any other 245.11 jurisdiction; pharmacies; surgical centers; bus and taxicab 245.12 transportation, or any other providers of transportation 245.13 services other than ambulance services required to be licensed; 245.14 supervised living facilities for persons with mental retardation 245.15 or related conditions, licensed under Minnesota Rules, parts 245.16 4665.0100 to 4665.9900; residential care homes licensed under 245.17 chapter 144B; board and lodging establishments providing only 245.18 custodial services that are licensed under chapter 157 and 245.19 registered under section 157.17 to provide supportive services 245.20 or health supervision services; adult foster homes as defined in 245.21 Minnesota Rules, part 9555.5105; day training and habilitation 245.22 services for adults with mental retardation and related 245.23 conditions as defined in section 252.41, subdivision 3; and 245.24 boarding care homes, as defined in Minnesota Rules, part 245.25 4655.0100. 245.26 (c) For purposes of this subdivision, "directly to a 245.27 patient or consumer" includes goods and services provided in 245.28 connection with independent medical examinations under section 245.29 65B.56 or other examinations for purposes of litigation or 245.30 insurance claims. 245.31 Sec. 40. [UNCOMPENSATED CARE STUDY.] 245.32 The commissioner of health, in consultation with the 245.33 commissioner of human services, shall present to the legislative 245.34 commission on health care access, by January 15, 1999, a report 245.35 and recommendations on the provision and financing of 245.36 uncompensated care in Minnesota. The report must: 246.1 (1) document the extent of uncompensated care provided in 246.2 Minnesota; 246.3 (2) discuss options for financing uncompensated care; 246.4 (3) describe other state approaches to monitoring and 246.5 financing uncompensated care; and 246.6 (4) describe alternative approaches to encourage health 246.7 care coverage. 246.8 Sec. 41. [REVISOR'S INSTRUCTION.] 246.9 In each section of Minnesota Statutes referred to in column 246.10 A, the revisor of statutes shall delete the reference in column 246.11 B and insert the reference in column C. 246.12 Column A Column B Column C 246.13 256B.057, subd. 1a 256L.08 256L.15 246.14 256B.0645 256L.14 256L.03, subd. 1a 246.15 256L.16 256L.14 256L.03, subd. 1a 246.16 Sec. 42. [REPEALER.] 246.17 Minnesota Statutes 1997 Supplement, sections 256B.057, 246.18 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 246.19 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 246.20 256L.14; and 256L.15, subdivision 3, are repealed. 246.21 Sec. 43. [EFFECTIVE DATE.] 246.22 (a) Sections 1 (256B.04, subdivision 18), 4 to 6, 8 to 36, 246.23 41 (Revisor Instruction), and 42 (Repealer) are effective 246.24 January 1, 1999. 246.25 (b) Sections 2 (256B.057, subdivision 7), 3 (256B.057, 246.26 subdivision 8), 37 (256L.17, subdivision 6), and 38 (256L.19) 246.27 are effective September 30, 1998. 246.28 ARTICLE 6 246.29 WELFARE REFORM; WORK FIRST; ASSISTANCE PROGRAM 246.30 AND CHILD SUPPORT CHANGES; AND LICENSING 246.31 Section 1. Minnesota Statutes 1997 Supplement, section 246.32 119B.01, subdivision 16, is amended to read: 246.33 Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year 246.34 families" means families who have received AFDC, or who were 246.35 eligible to receive AFDC after choosing to discontinue receipt 246.36 of the cash portion of MFIP-S assistance under section 256J.31, 247.1 subdivision 12, for at least three of the last six months before 247.2 losing eligibility for AFDC due to increased hours of 247.3 employment, increased income from employment or child or spousal 247.4 support, or the loss of income disregards due to time 247.5 limitations. 247.6 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 247.7 amended by adding a subdivision to read: 247.8 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 247.9 clause (2), does not apply to: 247.10 (1) a child care provider who as an applicant for licensure 247.11 or as a licenseholder has received a license denial under 247.12 section 245A.05, a fine under section 245A.06, or a sanction 247.13 under 245A.07 from the commissioner that has not been reversed 247.14 on appeal; or 247.15 (2) a child care provider, or a child care provider who has 247.16 a household member who, as a result of a licensing process, has 247.17 a disqualification under chapter 245A that has not been set 247.18 aside by the commissioner. 247.19 Sec. 3. Minnesota Statutes 1996, section 245A.03, is 247.20 amended by adding a subdivision to read: 247.21 Subd. 4. [EXCLUDED CHILD CARE PROGRAMS; RIGHT TO SEEK 247.22 LICENSURE.] Nothing in this section shall prohibit a child care 247.23 program that is excluded from licensure under subdivision 2, 247.24 clause (2), or under Laws 1997, chapter 248, section 46, as 247.25 amended by Laws 1997, First Special Session chapter 5, section 247.26 10, from seeking a license under this chapter. The commissioner 247.27 shall ensure that any application received from such an excluded 247.28 provider is processed in the same manner as all other 247.29 applications for licensed family day care. 247.30 Sec. 4. Minnesota Statutes 1996, section 245A.14, 247.31 subdivision 4, is amended to read: 247.32 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential 247.33 child care programs serving 14 or fewer children that are 247.34 conducted at a location other than the license holder's own 247.35 residence shall be licensed under this section and the rules 247.36 governing family day care or group family day care if: 248.1 (a) the license holder is the primary provider of care;248.2(b)and the nonresidential child care program is conducted 248.3 in a dwelling that is located on a residential lot;andor 248.4(c) the license holder complies with all other requirements248.5of sections 245A.01 to 245A.15 and the rules governing family248.6day care or group family day care.248.7 (b) the license holder is an employer who may or may not be 248.8 the primary provider of care, and the purpose for the child care 248.9 program is to provide child care services to children of the 248.10 license holder's employees. 248.11 Sec. 5. Minnesota Statutes 1997 Supplement, section 248.12 256.01, subdivision 2, is amended to read: 248.13 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 248.14 section 241.021, subdivision 2, the commissioner of human 248.15 services shall: 248.16 (1) Administer and supervise all forms of public assistance 248.17 provided for by state law and other welfare activities or 248.18 services as are vested in the commissioner. Administration and 248.19 supervision of human services activities or services includes, 248.20 but is not limited to, assuring timely and accurate distribution 248.21 of benefits, completeness of service, and quality program 248.22 management. In addition to administering and supervising human 248.23 services activities vested by law in the department, the 248.24 commissioner shall have the authority to: 248.25 (a) require county agency participation in training and 248.26 technical assistance programs to promote compliance with 248.27 statutes, rules, federal laws, regulations, and policies 248.28 governing human services; 248.29 (b) monitor, on an ongoing basis, the performance of county 248.30 agencies in the operation and administration of human services, 248.31 enforce compliance with statutes, rules, federal laws, 248.32 regulations, and policies governing welfare services and promote 248.33 excellence of administration and program operation; 248.34 (c) develop a quality control program or other monitoring 248.35 program to review county performance and accuracy of benefit 248.36 determinations; 249.1 (d) require county agencies to make an adjustment to the 249.2 public assistance benefits issued to any individual consistent 249.3 with federal law and regulation and state law and rule and to 249.4 issue or recover benefits as appropriate; 249.5 (e) delay or deny payment of all or part of the state and 249.6 federal share of benefits and administrative reimbursement 249.7 according to the procedures set forth in section 256.017;and249.8 (f) make contracts with and grants to public and private 249.9 agencies and organizations, both profit and nonprofit, and 249.10 individuals, using appropriated funds; and 249.11 (g) enter into contractual agreements with federally 249.12 recognized Indian tribes with a reservation in Minnesota to the 249.13 extent necessary for the tribe to operate a federally approved 249.14 family assistance program or any other program under the 249.15 supervision of the commissioner. The commissioner may establish 249.16 necessary accounts for the purposes of receiving and disbursing 249.17 funds as necessary for the operation of the programs. 249.18 (2) Inform county agencies, on a timely basis, of changes 249.19 in statute, rule, federal law, regulation, and policy necessary 249.20 to county agency administration of the programs. 249.21 (3) Administer and supervise all child welfare activities; 249.22 promote the enforcement of laws protecting handicapped, 249.23 dependent, neglected and delinquent children, and children born 249.24 to mothers who were not married to the children's fathers at the 249.25 times of the conception nor at the births of the children; 249.26 license and supervise child-caring and child-placing agencies 249.27 and institutions; supervise the care of children in boarding and 249.28 foster homes or in private institutions; and generally perform 249.29 all functions relating to the field of child welfare now vested 249.30 in the state board of control. 249.31 (4) Administer and supervise all noninstitutional service 249.32 to handicapped persons, including those who are visually 249.33 impaired, hearing impaired, or physically impaired or otherwise 249.34 handicapped. The commissioner may provide and contract for the 249.35 care and treatment of qualified indigent children in facilities 249.36 other than those located and available at state hospitals when 250.1 it is not feasible to provide the service in state hospitals. 250.2 (5) Assist and actively cooperate with other departments, 250.3 agencies and institutions, local, state, and federal, by 250.4 performing services in conformity with the purposes of Laws 250.5 1939, chapter 431. 250.6 (6) Act as the agent of and cooperate with the federal 250.7 government in matters of mutual concern relative to and in 250.8 conformity with the provisions of Laws 1939, chapter 431, 250.9 including the administration of any federal funds granted to the 250.10 state to aid in the performance of any functions of the 250.11 commissioner as specified in Laws 1939, chapter 431, and 250.12 including the promulgation of rules making uniformly available 250.13 medical care benefits to all recipients of public assistance, at 250.14 such times as the federal government increases its participation 250.15 in assistance expenditures for medical care to recipients of 250.16 public assistance, the cost thereof to be borne in the same 250.17 proportion as are grants of aid to said recipients. 250.18 (7) Establish and maintain any administrative units 250.19 reasonably necessary for the performance of administrative 250.20 functions common to all divisions of the department. 250.21 (8) Act as designated guardian of both the estate and the 250.22 person of all the wards of the state of Minnesota, whether by 250.23 operation of law or by an order of court, without any further 250.24 act or proceeding whatever, except as to persons committed as 250.25 mentally retarded. For children under the guardianship of the 250.26 commissioner whose interests would be best served by adoptive 250.27 placement, the commissioner may contract with a licensed 250.28 child-placing agency to provide adoption services. A contract 250.29 with a licensed child-placing agency must be designed to 250.30 supplement existing county efforts and may not replace existing 250.31 county programs, unless the replacement is agreed to by the 250.32 county board and the appropriate exclusive bargaining 250.33 representative or the commissioner has evidence that child 250.34 placements of the county continue to be substantially below that 250.35 of other counties. 250.36 (9) Act as coordinating referral and informational center 251.1 on requests for service for newly arrived immigrants coming to 251.2 Minnesota. 251.3 (10) The specific enumeration of powers and duties as 251.4 hereinabove set forth shall in no way be construed to be a 251.5 limitation upon the general transfer of powers herein contained. 251.6 (11) Establish county, regional, or statewide schedules of 251.7 maximum fees and charges which may be paid by county agencies 251.8 for medical, dental, surgical, hospital, nursing and nursing 251.9 home care and medicine and medical supplies under all programs 251.10 of medical care provided by the state and for congregate living 251.11 care under the income maintenance programs. 251.12 (12) Have the authority to conduct and administer 251.13 experimental projects to test methods and procedures of 251.14 administering assistance and services to recipients or potential 251.15 recipients of public welfare. To carry out such experimental 251.16 projects, it is further provided that the commissioner of human 251.17 services is authorized to waive the enforcement of existing 251.18 specific statutory program requirements, rules, and standards in 251.19 one or more counties. The order establishing the waiver shall 251.20 provide alternative methods and procedures of administration, 251.21 shall not be in conflict with the basic purposes, coverage, or 251.22 benefits provided by law, and in no event shall the duration of 251.23 a project exceed four years. It is further provided that no 251.24 order establishing an experimental project as authorized by the 251.25 provisions of this section shall become effective until the 251.26 following conditions have been met: 251.27 (a) The secretary of health, education, and welfare of the 251.28 United States has agreed, for the same project, to waive state 251.29 plan requirements relative to statewide uniformity. 251.30 (b) A comprehensive plan, including estimated project 251.31 costs, shall be approved by the legislative advisory commission 251.32 and filed with the commissioner of administration. 251.33 (13) According to federal requirements, establish 251.34 procedures to be followed by local welfare boards in creating 251.35 citizen advisory committees, including procedures for selection 251.36 of committee members. 252.1 (14) Allocate federal fiscal disallowances or sanctions 252.2 which are based on quality control error rates for the aid to 252.3 families with dependent children, Minnesota family investment 252.4 program-statewide, medical assistance, or food stamp program in 252.5 the following manner: 252.6 (a) One-half of the total amount of the disallowance shall 252.7 be borne by the county boards responsible for administering the 252.8 programs. For the medical assistance, MFIP-S, and AFDC 252.9 programs, disallowances shall be shared by each county board in 252.10 the same proportion as that county's expenditures for the 252.11 sanctioned program are to the total of all counties' 252.12 expenditures for the AFDC, MFIP-S, and medical assistance 252.13 programs. For the food stamp program, sanctions shall be shared 252.14 by each county board, with 50 percent of the sanction being 252.15 distributed to each county in the same proportion as that 252.16 county's administrative costs for food stamps are to the total 252.17 of all food stamp administrative costs for all counties, and 50 252.18 percent of the sanctions being distributed to each county in the 252.19 same proportion as that county's value of food stamp benefits 252.20 issued are to the total of all benefits issued for all 252.21 counties. Each county shall pay its share of the disallowance 252.22 to the state of Minnesota. When a county fails to pay the 252.23 amount due hereunder, the commissioner may deduct the amount 252.24 from reimbursement otherwise due the county, or the attorney 252.25 general, upon the request of the commissioner, may institute 252.26 civil action to recover the amount due. 252.27 (b) Notwithstanding the provisions of paragraph (a), if the 252.28 disallowance results from knowing noncompliance by one or more 252.29 counties with a specific program instruction, and that knowing 252.30 noncompliance is a matter of official county board record, the 252.31 commissioner may require payment or recover from the county or 252.32 counties, in the manner prescribed in paragraph (a), an amount 252.33 equal to the portion of the total disallowance which resulted 252.34 from the noncompliance, and may distribute the balance of the 252.35 disallowance according to paragraph (a). 252.36 (15) Develop and implement special projects that maximize 253.1 reimbursements and result in the recovery of money to the 253.2 state. For the purpose of recovering state money, the 253.3 commissioner may enter into contracts with third parties. Any 253.4 recoveries that result from projects or contracts entered into 253.5 under this paragraph shall be deposited in the state treasury 253.6 and credited to a special account until the balance in the 253.7 account reaches $1,000,000. When the balance in the account 253.8 exceeds $1,000,000, the excess shall be transferred and credited 253.9 to the general fund. All money in the account is appropriated 253.10 to the commissioner for the purposes of this paragraph. 253.11 (16) Have the authority to make direct payments to 253.12 facilities providing shelter to women and their children 253.13 according to section 256D.05, subdivision 3. Upon the written 253.14 request of a shelter facility that has been denied payments 253.15 under section 256D.05, subdivision 3, the commissioner shall 253.16 review all relevant evidence and make a determination within 30 253.17 days of the request for review regarding issuance of direct 253.18 payments to the shelter facility. Failure to act within 30 days 253.19 shall be considered a determination not to issue direct payments. 253.20 (17) Have the authority to establish and enforce the 253.21 following county reporting requirements: 253.22 (a) The commissioner shall establish fiscal and statistical 253.23 reporting requirements necessary to account for the expenditure 253.24 of funds allocated to counties for human services programs. 253.25 When establishing financial and statistical reporting 253.26 requirements, the commissioner shall evaluate all reports, in 253.27 consultation with the counties, to determine if the reports can 253.28 be simplified or the number of reports can be reduced. 253.29 (b) The county board shall submit monthly or quarterly 253.30 reports to the department as required by the commissioner. 253.31 Monthly reports are due no later than 15 working days after the 253.32 end of the month. Quarterly reports are due no later than 30 253.33 calendar days after the end of the quarter, unless the 253.34 commissioner determines that the deadline must be shortened to 253.35 20 calendar days to avoid jeopardizing compliance with federal 253.36 deadlines or risking a loss of federal funding. Only reports 254.1 that are complete, legible, and in the required format shall be 254.2 accepted by the commissioner. 254.3 (c) If the required reports are not received by the 254.4 deadlines established in clause (b), the commissioner may delay 254.5 payments and withhold funds from the county board until the next 254.6 reporting period. When the report is needed to account for the 254.7 use of federal funds and the late report results in a reduction 254.8 in federal funding, the commissioner shall withhold from the 254.9 county boards with late reports an amount equal to the reduction 254.10 in federal funding until full federal funding is received. 254.11 (d) A county board that submits reports that are late, 254.12 illegible, incomplete, or not in the required format for two out 254.13 of three consecutive reporting periods is considered 254.14 noncompliant. When a county board is found to be noncompliant, 254.15 the commissioner shall notify the county board of the reason the 254.16 county board is considered noncompliant and request that the 254.17 county board develop a corrective action plan stating how the 254.18 county board plans to correct the problem. The corrective 254.19 action plan must be submitted to the commissioner within 45 days 254.20 after the date the county board received notice of noncompliance. 254.21 (e) The final deadline for fiscal reports or amendments to 254.22 fiscal reports is one year after the date the report was 254.23 originally due. If the commissioner does not receive a report 254.24 by the final deadline, the county board forfeits the funding 254.25 associated with the report for that reporting period and the 254.26 county board must repay any funds associated with the report 254.27 received for that reporting period. 254.28 (f) The commissioner may not delay payments, withhold 254.29 funds, or require repayment under paragraph (c) or (e) if the 254.30 county demonstrates that the commissioner failed to provide 254.31 appropriate forms, guidelines, and technical assistance to 254.32 enable the county to comply with the requirements. If the 254.33 county board disagrees with an action taken by the commissioner 254.34 under paragraph (c) or (e), the county board may appeal the 254.35 action according to sections 14.57 to 14.69. 254.36 (g) Counties subject to withholding of funds under 255.1 paragraph (c) or forfeiture or repayment of funds under 255.2 paragraph (e) shall not reduce or withhold benefits or services 255.3 to clients to cover costs incurred due to actions taken by the 255.4 commissioner under paragraph (c) or (e). 255.5 (18) Allocate federal fiscal disallowances or sanctions for 255.6 audit exceptions when federal fiscal disallowances or sanctions 255.7 are based on a statewide random sample for the foster care 255.8 program under title IV-E of the Social Security Act, United 255.9 States Code, title 42, in direct proportion to each county's 255.10 title IV-E foster care maintenance claim for that period. 255.11 (19) Be responsible for ensuring the detection, prevention, 255.12 investigation, and resolution of fraudulent activities or 255.13 behavior by applicants, recipients, and other participants in 255.14 the human services programs administered by the department. 255.15 (20) Require county agencies to identify overpayments, 255.16 establish claims, and utilize all available and cost-beneficial 255.17 methodologies to collect and recover these overpayments in the 255.18 human services programs administered by the department. 255.19 (21) Have the authority to administer a drug rebate program 255.20 for drugs purchased pursuant to the senior citizen drug program 255.21 established under section 256.955 after the beneficiary's 255.22 satisfaction of any deductible established in the program. The 255.23 commissioner shall require a rebate agreement from all 255.24 manufacturers of covered drugs as defined in section 256B.0625, 255.25 subdivision 13. For each drug, the amount of the rebate shall 255.26 be equal to the basic rebate as defined for purposes of the 255.27 federal rebate program in United States Code, title 42, section 255.28 1396r-8(c)(1). This basic rebate shall be applied to 255.29 single-source and multiple-source drugs. The manufacturers must 255.30 provide full payment within 30 days of receipt of the state 255.31 invoice for the rebate within the terms and conditions used for 255.32 the federal rebate program established pursuant to section 1927 255.33 of title XIX of the Social Security Act. The manufacturers must 255.34 provide the commissioner with any information necessary to 255.35 verify the rebate determined per drug. The rebate program shall 255.36 utilize the terms and conditions used for the federal rebate 256.1 program established pursuant to section 1927 of title XIX of the 256.2 Social Security Act. 256.3 Sec. 6. Minnesota Statutes 1996, section 256.014, 256.4 subdivision 1, is amended to read: 256.5 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 256.6 commissioner of human services shall establish and enhance 256.7 computer systems necessary for the efficient operation of the 256.8 programs the commissioner supervises, including: 256.9 (1) management and administration of the food stamp and 256.10 income maintenance programs, including the electronic 256.11 distribution of benefits; 256.12 (2) management and administration of the child support 256.13 enforcement program; and 256.14 (3) administration of medical assistance and general 256.15 assistance medical care. 256.16 The commissioner shall distribute the nonfederal share of 256.17 the costs of operating and maintaining the systems to the 256.18 commissioner and to the counties participating in the system in 256.19 a manner that reflects actual system usage, except that the 256.20 nonfederal share of the costs of the MAXIS computer system and 256.21 child support enforcement systems shall be borne entirely by the 256.22 commissioner. Development costs must not be assessed against 256.23 county agencies. 256.24 The commissioner may enter into contractual agreements with 256.25 federally recognized Indian tribes with a reservation in 256.26 Minnesota to participate in state-operated computer systems 256.27 related to the management and administration of the food stamp, 256.28 income maintenance, child support enforcement, medical 256.29 assistance, and general assistance medical care programs to the 256.30 extent necessary for the tribe to operate a federally approved 256.31 family assistance program or any other program under the 256.32 supervision of the commissioner. 256.33 Sec. 7. Minnesota Statutes 1997 Supplement, section 256.34 256.031, subdivision 6, is amended to read: 256.35 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 256.36 the federal government, the field trials of the Minnesota family 257.1 investment plan will end June 30, 1998. 257.2 (b) Families in the comparison group under subdivision 3, 257.3 paragraph (d), clause (i), receiving aid to families with 257.4 dependent children under sections 256.72 to 256.87, and STRIDE 257.5 services under section 256.736 will continue in those programs 257.6 until June 30, 1998. After June 30, 1998, families who cease 257.7 receiving assistance under the Minnesota family investment plan 257.8 and comparison group families who cease receiving assistance 257.9 under AFDC and STRIDE who are eligible for the Minnesota family 257.10 investment program-statewide (MFIP-S), medical assistance, 257.11 general assistance medical care, or the food stamp program shall 257.12 be placed with their consent on the programs for which they are 257.13 eligible. 257.14 (c) Families who cease receiving assistance under the MFIP 257.15 and comparison families who cease receiving assistance under 257.16 AFDC and STRIDE who are ineligible for MFIP-S due to increased 257.17 income from employment, or increased child or spousal support or 257.18 a combination of employment income and child or spousal support, 257.19 shall be eligible for extended medical assistance under section 257.20 256B.0635. For the purpose of determining receipt of extended 257.21 medical assistance, receipt of AFDC and MFIP shall be considered 257.22 to be the same as receipt of MFIP-S. 257.23 Sec. 8. Minnesota Statutes 1997 Supplement, section 257.24 256.741, is amended by adding a subdivision to read: 257.25 Subd. 2a. [FAMILIES-FIRST DISTRIBUTION OF CHILD SUPPORT 257.26 ARREARAGES.] Child support collected on behalf of a family that 257.27 formerly received assistance under AFDC, MFIP, MFIP-R, MFIP-S, 257.28 or Work First must be distributed as follows: 257.29 (1) to the extent that the amount collected does not exceed 257.30 the amount required to be paid to the family for the month in 257.31 which collected, the state shall distribute the amount to the 257.32 family; and 257.33 (2) to the extent that the amount collected exceeds the 257.34 amount required to be paid to the family for the month in which 257.35 collected, the state shall distribute the amount as follows: 257.36 (i) the state shall first distribute the amount collected 258.1 to the family to the extent necessary to satisfy any support 258.2 arrearages accrued after the family ceased to receive assistance 258.3 from the state; and 258.4 (ii) the state shall then distribute the amount collected 258.5 to the family to the extent necessary to satisfy any support 258.6 arrearages with respect to the family that accrued before the 258.7 family received assistance from the state. 258.8 Sec. 9. Minnesota Statutes 1997 Supplement, section 258.9 256.9864, is amended to read: 258.10 256.9864 [REPORTS BY RECIPIENT.] 258.11 (a) An assistance unit with a recent work history or with 258.12 earned income shall report monthly to the county agency on 258.13 income received and other circumstances affecting eligibility or 258.14 assistance amounts. All other assistance units shall report on 258.15 income and other circumstances affecting eligibility and 258.16 assistance amounts, as specified by the state agency. 258.17 (b) An assistance unit required to submit a report on the 258.18 form designated by the commissioner and within ten days of the 258.19 due date or the date of the significant change, whichever is 258.20 later, or otherwise report significant changes which would 258.21 affect eligibility or assistance amounts, is considered to have 258.22 continued its application for assistance effective the date the 258.23 required report is received by the county agency, if a complete 258.24 report is received within a calendar month in which assistance 258.25 was received, except that no assistance shall be paid for the258.26period beginning with the end of the month in which the report258.27was due and ending with the date the report was received by the258.28county agency. 258.29 Sec. 10. Minnesota Statutes 1997 Supplement, section 258.30 256B.062, is amended to read: 258.31 256B.062 [CONTINUED ELIGIBILITY.] 258.32 Medical assistance may be paid for persons who received aid 258.33 to families with dependent children in at least three of the six 258.34 months preceding the month in which the person became ineligible 258.35 for aid to families with dependent children, if the 258.36 ineligibility was due to an increase in hours of employment or 259.1 employment income or due to the loss of an earned income 259.2 disregard. A person who is eligible for extended medical 259.3 assistance is entitled to six months of assistance without 259.4 reapplication, unless the assistance unit ceases to include a 259.5 dependent child. For a person under 21 years of age, medical 259.6 assistance may not be discontinued within the six-month period 259.7 of extended eligibility until it has been determined that the 259.8 person is not otherwise eligible for medical assistance. 259.9 Medical assistance may be continued for an additional six months 259.10 if the person meets all requirements for the additional six 259.11 months, according to Title XIX of the Social Security Act, as 259.12 amended by section 303 of the Family Support Act of 1988, Public 259.13 Law Number 100-485. This section is repealed effectiveMarch 31259.14 July 1, 1998. 259.15 Sec. 11. Minnesota Statutes 1997 Supplement, section 259.16 256B.0635, is amended by adding a subdivision to read: 259.17 Subd. 3. [EXTENDED MEDICAL ASSISTANCE FOR MFIP-S 259.18 PARTICIPANTS WHO OPT TO DISCONTINUE MONTHLY CASH 259.19 ASSISTANCE.] Upon federal approval, medical assistance is 259.20 available to persons who received MFIP-S in at least three of 259.21 the six months preceding the month in which the person opted to 259.22 discontinue receiving MFIP-S cash assistance under section 259.23 256J.31, subdivision 12. A person who is eligible for medical 259.24 assistance under this section may receive medical assistance 259.25 without reapplication as long as the person meets MFIP-S 259.26 eligibility requirements, unless the assistance unit does not 259.27 include a dependent child. Medical assistance may be paid 259.28 pursuant to subdivisions 1 and 2 for persons who are no longer 259.29 eligible for MFIP-S due to increased employment or child support. 259.30 Sec. 12. Minnesota Statutes 1997 Supplement, section 259.31 256D.05, subdivision 8, is amended to read: 259.32 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 259.33 citizenship requirements for applicants and recipients under 259.34 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 259.35 256D.21 shall be determined the same as under section 256J.11, 259.36 except that legal noncitizens who are applicants or recipients 260.1 must have been residents of Minnesota on March 1, 1997. Legal 260.2 noncitizens who arrive in Minnesota after March 1, 1997, and 260.3 become elderly or disabled after that date, or are refugees as 260.4 that term is used in United States Code, title 8, section 260.5 1101(a)(42), and are otherwise eligible for general assistance 260.6 can receive benefits under this section. The income and assets 260.7 of sponsors of noncitizens shall be deemed available to general 260.8 assistance applicants and recipients according to the Personal 260.9 Responsibility and Work Opportunity Reconciliation Act of 1996, 260.10 Public Law Number 104-193, title IV, sections 421 and 422, and 260.11 subsequently set out in federal rules. 260.12 (b) As a condition of eligibility, each legal adult 260.13 noncitizen in the assistance unit who has resided in the country 260.14 for four years or more and who is under 70 years of age must: 260.15 (1) be enrolled in a literacy class, English as a second 260.16 language class, or a citizen class; 260.17 (2) be applying for admission to a literacy class, English 260.18 as a second language class, and is on a waiting list; 260.19 (3) be in the process of applying for a waiver from the 260.20 Immigration and Naturalization Service of the English language 260.21 or civics requirements of the citizenship test; 260.22 (4) have submitted an application for citizenship to the 260.23 Immigration and Naturalization Service and is waiting for a 260.24 testing date or a subsequent swearing in ceremony; or 260.25 (5) have been denied citizenship due to a failure to pass 260.26 the test after two attempts or because of an inability to 260.27 understand the rights and responsibilities of becoming a United 260.28 States citizen, as documented by the Immigration and 260.29 Naturalization Service or the county. 260.30 If the county social service agency determines that a legal 260.31 noncitizen subject to the requirements of this subdivision will 260.32 require more than one year of English language training, then 260.33 the requirements of clause (1) or (2) shall be imposed after the 260.34 legal noncitizen has resided in the country for three years. 260.35 Individuals who reside in a facility licensed under chapter 260.36 144A, 144D, 245A, or 256I are exempt from the requirements of 261.1 this section. 261.2 Sec. 13. Minnesota Statutes 1996, section 256D.051, is 261.3 amended by adding a subdivision to read: 261.4 Subd. 18. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 261.5 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] 261.6 (a) To the extent of available resources, the commissioner 261.7 may waive the $400 service cost limit specified in subdivision 6 261.8 for county agencies who propose to provide enhanced services 261.9 under the food stamp employment and training program to 261.10 hard-to-employ individuals. A "hard-to-employ individual" is 261.11 defined as: 261.12 (1) a recipient of general assistance under chapter 256D; 261.13 or 261.14 (2) an individual with at least one of the following three 261.15 barriers to employment: 261.16 (i) the individual has not completed secondary school or 261.17 obtained a general equivalency development diploma or an adult 261.18 diploma, and has low skills in reading or mathematics; 261.19 (ii) the individual requires substance abuse treatment for 261.20 employment; and 261.21 (iii) the individual has a poor work history. 261.22 (b) To obtain a waiver, the county agency must submit a 261.23 waiver request to the commissioner. The request must specify: 261.24 (1) the number of hard-to-employ individuals the agency 261.25 plans to serve; 261.26 (2) the nature of the enhanced employment and training 261.27 services the agency will provide; and 261.28 (3) the agency's plan for providing referrals for substance 261.29 abuse assessment and treatment for hard-to-employ individuals 261.30 who require substance abuse treatment for employment. 261.31 Sec. 14. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 261.32 Subdivision 1. [PROGRAM ESTABLISHED.] For the period from 261.33 July 1, 1998, to June 30, 1999, the Minnesota food assistance 261.34 program is established to provide food assistance to legal 261.35 noncitizens residing in this state who are ineligible to 261.36 participate in the federal food stamp program solely due to the 262.1 provisions of section 402 or 403 of Public Law Number 104-193, 262.2 as authorized by Title VII of the 1997 Emergency Supplemental 262.3 Appropriations Act, Public Law Number 105-18. 262.4 Subd. 2. [ELIGIBILITY REQUIREMENTS.] (a) To be eligible 262.5 for the Minnesota food assistance program, all of the following 262.6 conditions must be met: 262.7 (1) the applicant must meet the initial and ongoing 262.8 eligibility requirements for the federal food stamp program, 262.9 except for the applicant's ineligible immigration status; 262.10 (2) the applicant must be either a qualified noncitizen as 262.11 defined in section 256J.08, subdivision 73, or a noncitizen 262.12 otherwise residing lawfully in the United States; 262.13 (3) the applicant must have been a resident of the state on 262.14 March 1, 1998; and 262.15 (4) the applicant must not be receiving assistance under 262.16 the Minnesota family investment program-statewide or the work 262.17 first program. 262.18 (b) Notwithstanding paragraph (a), clause (3), an applicant 262.19 who is a refugee, as that term is used in United States Code, 262.20 title 8, section 1101(a)(42), but who was not a resident of the 262.21 state on March 1, 1998, and who is otherwise eligible for this 262.22 program can receive benefits under this section. 262.23 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 262.24 Minnesota food assistance program shall follow exactly the 262.25 regulations for the federal food stamp program, except for the 262.26 provisions pertaining to immigration status under section 402 or 262.27 403 of Public Law Number 104-193. 262.28 (b) The county agency shall use the income, budgeting, and 262.29 benefit allotment regulations of the federal food stamp program 262.30 to calculate an eligible recipient's monthly Minnesota food 262.31 assistance program benefit. Until September 30, 1998, eligible 262.32 recipients under this subdivision shall receive the average per 262.33 person food stamp issuance in Minnesota in the fiscal year 262.34 ending June 30, 1997. Beginning October 1, 1998, eligible 262.35 recipients shall receive the same level of benefits as those 262.36 provided by the federal food stamp program to similarly situated 263.1 citizen recipients. The monthly Minnesota food assistance 263.2 program benefits, alone or in combination with any benefits 263.3 received through the Minnesota grown supplemental food program 263.4 under Laws 1997, chapter 216, section 7, subdivision 4, shall 263.5 not exceed an amount equal to the amount of federal food stamp 263.6 benefits the household would receive if all members of the 263.7 household were eligible for the federal food stamp program. 263.8 (c) Minnesota food assistance program benefits must be 263.9 disregarded as income in all programs that do not count food 263.10 stamps as income. 263.11 (d) The county agency must redetermine a Minnesota food 263.12 assistance program recipient's eligibility for the federal food 263.13 stamp program when the agency receives information that the 263.14 recipient's legal immigration status has changed in such a way 263.15 that would make the recipient potentially eligible for the 263.16 federal food stamp program. 263.17 (e) Until October 1, 1998, the commissioner shall issue 263.18 benefits under this section in state-purchased food coupons. 263.19 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 263.20 submit a state plan to the secretary of agriculture to allow the 263.21 commissioner to purchase federal food stamp benefits for each 263.22 Minnesota food assistance program recipient who is ineligible to 263.23 participate in the federal food stamp program solely due to the 263.24 provisions of section 402 or 403 of Public Law Number 104-193, 263.25 as authorized by Title VII of the 1997 Emergency Supplemental 263.26 Appropriations Act, Public Law Number 105-18. The commissioner 263.27 shall enter into a contract as necessary with the secretary to 263.28 use the existing federal food stamp benefit delivery system for 263.29 the purposes of administering the Minnesota food assistance 263.30 program under this section. 263.31 Sec. 15. Minnesota Statutes 1996, section 256D.46, 263.32 subdivision 2, is amended to read: 263.33 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 263.34 resources available to the recipient must be considered in 263.35 determining the recipient's ability to meet the emergency need. 263.36 Property that can be liquidated in time to resolve the emergency 264.1 and income,(excludingMinnesota supplemental aid issued for264.2current month's need)an amount equal to the Minnesota 264.3 supplemental aid standard of assistance, that is normally 264.4 disregarded or excluded under the Minnesota supplemental aid 264.5 program must be considered available to meet the emergency need. 264.6 Sec. 16. Minnesota Statutes 1997 Supplement, section 264.7 256J.02, subdivision 4, is amended to read: 264.8 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 264.9 of title I of Public Law Number 104-193, the Personal 264.10 Responsibility and Work Opportunity Reconciliation Act of 264.11 1996, as amended, the legislature may transfer money from the 264.12 TANF block grant to the child care fund under chapter 119B, or 264.13 the Title XX block grant under section 256E.07. 264.14 Sec. 17. Minnesota Statutes 1997 Supplement, section 264.15 256J.03, is amended to read: 264.16 256J.03 [TANF RESERVE ACCOUNT.] 264.17 Subdivision 1. TheMinnesota family investment264.18program-statewide/TANFTANF reserve account is created in the 264.19 state treasury. Funds retained or deposited in the TANF reserve 264.20 shall include: (1) funds designated by the legislatureand; (2) 264.21 unexpended state funds resulting from the acceleration of TANF 264.22 expenditures under subdivision 2; (3) earnings available from 264.23 the federal TANF block grant appropriated to the commissioner 264.24 but not expended in the biennium beginning July 1, 1997, shall264.25be retained; and (4) TANF funds available in fiscal years 1998, 264.26 1999, 2000, and 2001 that are not spent or not budgeted to be 264.27 spent in those years. 264.28 Funds deposited in the reserve accounttomust be expended 264.29 for the Minnesota family investment program-statewidein fiscal264.30year 2000 and subsequent fiscal yearsand directly related state 264.31 programs for the purposes in subdivision 3. 264.32 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 264.33 FUNDS.] The commissioner may expend federal Temporary Assistance 264.34 to Needy Families block grant funds in excess of appropriated 264.35 levels for the purpose of accelerating federal funding of the 264.36 MFIP program. By the end of the fiscal year in which the 265.1 additional federal expenditures are made, the commissioner must 265.2 deposit into the reserve account an amount of unexpended state 265.3 funds appropriated for assistance to families grants, aid to 265.4 families with dependent children, and Minnesota family 265.5 investment plan equal to the additional federal expenditures. 265.6 Reserve funds may be spent as TANF appropriations if 265.7 insufficient TANF funds are available because of acceleration. 265.8 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 265.9 reserve account may be used for the following purposes: 265.10 (1) unanticipated Temporary Assistance to Needy Families 265.11 block grant maintenance of effort shortfalls; 265.12 (2) MFIP cost increases due to reduced federal revenues and 265.13 federal law changes; 265.14 (3) one-half of the MFIP general fund cost increase in 265.15 fiscal year 2000 and subsequent fiscal years due to caseload 265.16 increases over fiscal year 1999; and 265.17 (4) transfers allowed under section 256J.02, subdivision 4. 265.18 Sec. 18. Minnesota Statutes 1997 Supplement, section 265.19 256J.08, subdivision 11, is amended to read: 265.20 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 265.21 natural or adoptive parent or parents and stepparent who live in 265.22 the home with the minor child. For purposes of determining 265.23 eligibility for this program, caregiver also means any of the 265.24 following individuals, if adults, who live with and provide care 265.25 and support to a minor child when the minor child's natural or 265.26 adoptive parent or parents or stepparent do not reside in the 265.27 same home: legalcustodianscustodian or guardian, grandfather, 265.28 grandmother, brother, sister,stepfather, stepmother,265.29 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 265.30 niece, person of preceding generation as denoted by prefixes of 265.31 "great," "great-great," or "great-great-great," or a spouse of 265.32 any person named in the above groups even after the marriage 265.33 ends by death or divorce. 265.34 Sec. 19. Minnesota Statutes 1997 Supplement, section 265.35 256J.08, is amended by adding a subdivision to read: 265.36 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 266.1 ineligible to receive MFIP-S due to noncooperation with program 266.2 requirements. Except for persons whose disqualification is 266.3 based on fraud, a disqualified person can take action to correct 266.4 the reason for ineligibility. 266.5 Sec. 20. Minnesota Statutes 1997 Supplement, section 266.6 256J.08, subdivision 26, is amended to read: 266.7 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 266.8 in-kind income earned through the receipt of wages, salary, 266.9 commissions, profit from employment activities, net profit from 266.10 self-employment activities, payments made by an employer for 266.11 regularly accrued vacation or sick leave, and any other profit 266.12 from activity earned through effort or labor. The income must 266.13 be in return for, or as a result of, legal activity. 266.14 Sec. 21. Minnesota Statutes 1997 Supplement, section 266.15 256J.08, subdivision 28, is amended to read: 266.16 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 266.17 set of circumstances that causes or threatens to cause 266.18 destitution to aminor childfamily with a child under age 21. 266.19 Sec. 22. Minnesota Statutes 1997 Supplement, section 266.20 256J.08, subdivision 40, is amended to read: 266.21 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 266.22 means earned income from employment before mandatory and 266.23 voluntary payroll deductions. Gross earned income includes 266.24 salaries, wages, tips, gratuities, commissions, incentive 266.25 payments from work or training programs, payments made by an 266.26 employer for regularly accrued vacation or sick leave, and 266.27 profits from other activity earned by an individual's effort or 266.28 labor. Gross earned income includes uniform and meal allowances 266.29 if federal income tax is deducted from the allowance. Gross 266.30 earned income includes flexible work benefits received from an 266.31 employer if the employee has the option of receiving the benefit 266.32 or benefits in cash. For self-employment, gross earned income 266.33 is the nonexcluded income minus expenses for the business. 266.34 Sec. 23. Minnesota Statutes 1997 Supplement, section 266.35 256J.08, is amended by adding a subdivision to read: 266.36 Subd. 46a. [SHELTER COSTS.] "Shelter costs" means rent, 267.1 manufactured home lot rental costs, or monthly principal, 267.2 interest, insurance premiums, and property taxes due for 267.3 mortgages or contracts for deed. 267.4 Sec. 24. Minnesota Statutes 1997 Supplement, section 267.5 256J.08, is amended by adding a subdivision to read: 267.6 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 267.7 transitional standard" means a combination of the cash 267.8 assistance a family with no other income would have received in 267.9 the state of previous residence and the Minnesota food portion 267.10 for the appropriate size family. 267.11 Sec. 25. Minnesota Statutes 1997 Supplement, section 267.12 256J.08, is amended by adding a subdivision to read: 267.13 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 267.14 person who is under a legal obligation to provide care and 267.15 support for a minor and who is in fact providing care and 267.16 support for a minor. For an Indian child, custodian means any 267.17 Indian person who has legal custody of an Indian child under 267.18 tribal law or custom or under state law or to whom temporary 267.19 physical care, custody, and control has been transferred by the 267.20 parent of the child, as provided in section 257.351, subdivision 267.21 8. 267.22 Sec. 26. Minnesota Statutes 1997 Supplement, section 267.23 256J.08, subdivision 60, is amended to read: 267.24 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 267.25 is living in the same home of a parent or other caregiver, is 267.26 not the parent of a child in the home, and is either less than 267.27 18 years of age or is under the age of 19 years and isregularly267.28attending asa full-time studentand is expected to complete a267.29high school orin a secondary school or pursuing a full-time 267.30 secondary level course of vocational or technical training 267.31 designed to fit students for gainful employmentbefore reaching267.32age 19. 267.33 Sec. 27. Minnesota Statutes 1997 Supplement, section 267.34 256J.08, is amended by adding a subdivision to read: 267.35 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 267.36 means a minor child's parent who does not live in the same home 268.1 as the child. 268.2 Sec. 28. Minnesota Statutes 1997 Supplement, section 268.3 256J.08, subdivision 68, is amended to read: 268.4 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 268.5 an item of value that is not real property, including the value 268.6 of a contract for deed held by a seller, assets held in trust on 268.7 behalf of members of an assistance unit,cash surrender value of268.8life insurance,value of a prepaid burial, savings account, 268.9 value of stocks and bonds, and value of retirement accounts. 268.10 Sec. 29. Minnesota Statutes 1997 Supplement, section 268.11 256J.08, subdivision 73, is amended to read: 268.12 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 268.13 means a person: 268.14 (1) who was lawfully admitted for permanent residence 268.15 pursuant to United States Code, title 8; 268.16 (2) who was admitted to the United States as a refugee 268.17 pursuant to United States Code, title 8; section 1157; 268.18 (3) whose deportation is being withheld pursuant to United 268.19 States Code, title 8, section 1253(h); 268.20 (4) who was paroled for a period of at least one year 268.21 pursuant to United States Code, title 8, section 1182(d)(5); 268.22 (5) who was granted conditional entry pursuant to United 268.23 State Code, title 8, section 1153(a)(7); 268.24 (6) who was granted asylum pursuant to United States Code, 268.25 title 8, section 1158;or268.26 (7) determined to be a battered noncitizen by the United 268.27 States Attorney General according to the Illegal Immigration 268.28 Reform and Immigrant Responsibility Act of 1996, Title V of the 268.29 Omnibus Consolidated Appropriations Bill, Public Law Number 268.30 104-208; or 268.31 (8) who was admitted as a Cuban or Haitian entrant. 268.32 Sec. 30. Minnesota Statutes 1997 Supplement, section 268.33 256J.08, is amended by adding a subdivision to read: 268.34 Subd. 82a. [SHARED HOUSEHOLD STANDARD.] "Shared household 268.35 standard" means the basic standard used when the household 268.36 includes an unrelated member. The cash portion of the shared 269.1 household standard is equal to 90 percent of the cash portion of 269.2 the transitional standard. The cash portion of the shared 269.3 household standard plus the food portion equals the full shared 269.4 household standard. 269.5 Sec. 31. Minnesota Statutes 1997 Supplement, section 269.6 256J.08, subdivision 83, is amended to read: 269.7 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 269.8 a decline in gross income of3536 percent or more from the 269.9 income used to determine the grant for the current month. 269.10 Sec. 32. Minnesota Statutes 1997 Supplement, section 269.11 256J.08, is amended by adding a subdivision to read: 269.12 Subd. 86a. [UNRELATED MEMBER.] "Unrelated member" means an 269.13 individual in the household who does not meet the definition of 269.14 an eligible caregiver. 269.15 Sec. 33. Minnesota Statutes 1997 Supplement, section 269.16 256J.09, subdivision 6, is amended to read: 269.17 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 269.18 not delay a decision on eligibility or delay issuing the 269.19 assistance payment except to establish state residence as 269.20 provided in section 256J.12 by: 269.21 (1) treating the 30-day processing period as a waiting 269.22 period; 269.23 (2) delaying approval or issuance of the assistance payment 269.24 pending the decision of the county board; or 269.25 (3) awaiting the result of a referral to a county agency in 269.26 another county when the county receiving the application does 269.27 not believe it is the county of financial responsibility. 269.28 Sec. 34. Minnesota Statutes 1997 Supplement, section 269.29 256J.09, subdivision 9, is amended to read: 269.30 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 269.31 addendum to an existing application must be used to add persons 269.32 to an assistance unit regardless of whether the persons being 269.33 added are required to be in the assistance unit. When a person 269.34 is added by addendum to an assistance unit, eligibility for that 269.35 person begins on the first of the month the addendum was filed 269.36 except as provided in section 256J.74, subdivision 2, clause (1). 270.1 (b) An overpayment must be determined when a change in 270.2 household composition is not reported within the deadlines in 270.3 section 256J.30, subdivision 9. Any overpayment must be 270.4 calculated from the month of the change including the needs, 270.5 income, and assets of any individual who is required to be 270.6 included in the assistance unit under section 256J.24, 270.7 subdivision 2. Individuals not included in the assistance unit 270.8 who are identified in section 256J.37, subdivisions 1 to 2, must 270.9 have their income and assets considered when determining the 270.10 amount of the overpayment. 270.11 Sec. 35. Minnesota Statutes 1997 Supplement, section 270.12 256J.11, subdivision 2, as amended by Laws 1997, Third Special 270.13 Session chapter 1, section 1, is amended to read: 270.14 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 270.15 September 1, 1997, to October 31, 1997, noncitizens who do not 270.16 meet one of the exemptions in section 412 of the Personal 270.17 Responsibility and Work Opportunity Reconciliation Act of 1996, 270.18 but were residing in this state as of July 1, 1997, are eligible 270.19 for the 6/10 of the average value of food stamps for the same 270.20 family size and composition until MFIP-S is operative in the 270.21 noncitizen's county of financial responsibility and thereafter, 270.22 the 6/10 of the food portion of MFIP-S. However, federal food 270.23 stamp dollars cannot be used to fund the food portion of MFIP-S 270.24 benefits for an individual under this subdivision. 270.25 (b) For the period November 1, 1997, to June 30,19981999, 270.26 noncitizens who do not meet one of the exemptions in section 412 270.27 of the Personal Responsibility and Work Opportunity 270.28 Reconciliation Act of 1996, but were residing in this state as 270.29 of July 1, 1997, or who were not residing in this state as of 270.30 July 1, 1997 but who are refugees as that term is used in United 270.31 States Code, title 8, section 1101(a)(42), and are receiving 270.32 cash assistance under the AFDC, family general assistance, MFIP 270.33 or MFIP-S programs are eligible for the average value of food 270.34 stamps for the same family size and composition until MFIP-S is 270.35 operative in the noncitizen's county of financial responsibility 270.36 and thereafter, the food portion of MFIP-S. However, federal 271.1 food stamp dollars cannot be used to fund the food portion of 271.2 MFIP-S benefits for an individual under this subdivision. The 271.3 assistance provided under this subdivision, which is designated 271.4 as a supplement to replace lost benefits under the federal food 271.5 stamp program, must be disregarded as income in all programs 271.6 that do not count food stamps as income where the commissioner 271.7 has the authority to make the income disregard determination for 271.8 the program. 271.9 (c) The commissioner shall submit a state plan to the 271.10 secretary of agriculture to allow the commissioner to purchase 271.11 federal food stamp benefits in an amount equal to the MFIP-S 271.12 food portion for each legal noncitizen receiving MFIP-S 271.13 assistance who is ineligible to participate in the federal food 271.14 stamp program solely due to the provisions of section 402 or 403 271.15 of Public Law Number 104-193, as authorized by Title VII of the 271.16 1997 Emergency Supplemental Appropriations Act, Public Law 271.17 Number 105-18. The commissioner shall enter into a contract as 271.18 necessary with the secretary to use the existing federal food 271.19 stamp benefit delivery system for the purposes of administering 271.20 the food portion of MFIP-S under this subdivision. 271.21 Sec. 36. Minnesota Statutes 1997 Supplement, section 271.22 256J.12, is amended to read: 271.23 256J.12 [MINNESOTA RESIDENCE.] 271.24 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 271.25 or MFIP-S, whichever is in effect,a familyan assistance unit 271.26 must have established residency in this state which means 271.27 thefamilyassistance unit is present in the state and intends 271.28 to remain here. 271.29 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 271.30 assistance unit is considered to have established residency in 271.31 this state only when a child or caregiver has resided in this 271.32 state for at least 30 days with the intention of making the 271.33 person's home here and not for any temporary purpose. The birth 271.34 of a child in Minnesota to a member of the assistance unit does 271.35 not automatically establish the residency in this state under 271.36 this subdivision of the other members of the assistance unit. 272.1 Time spent in a shelter for battered women shall count toward 272.2 satisfying the 30-day residency requirement. 272.3 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 272.4 residency requirement where unusual hardship would result from 272.5 denial of assistance. 272.6 (b) For purposes of this section, unusual hardship meansa272.7familyan assistance unit: 272.8 (1) is without alternative shelter; or 272.9 (2) is without available resources for food. 272.10 (c) For purposes of this subdivision, the following 272.11 definitions apply (1) "metropolitan statistical area" is as 272.12 defined by the U.S. Census Bureau; (2) "alternative shelter" 272.13 includes any shelter that is located within the metropolitan 272.14 statistical area containing the county and for which the family 272.15 is eligible, provided thefamilyassistance unit does not have 272.16 to travel more than 20 miles to reach the shelter and has access 272.17 to transportation to the shelter. Clause (2) does not apply to 272.18 counties in the Minneapolis-St. Paul metropolitan statistical 272.19 area. 272.20 (d) Applicants are considered to meet the residency 272.21 requirement under subdivision 1a if they once resided in 272.22 Minnesota and: 272.23 (1) joined the United States armed services, returned to 272.24 Minnesota within 30 days of leaving the armed services, and 272.25 intend to remain in Minnesota; or 272.26 (2) left to attend school in another state, paid 272.27 nonresident tuition or Minnesota tuition rates under a 272.28 reciprocity agreement, and returned to Minnesota within 30 days 272.29 of graduation with the intent to remain in Minnesota. 272.30 (e) The 30-day residence requirement is met when: 272.31 (1) a minor child or a minor caregiver moves from another 272.32 state to the residence of a relative caregiver; 272.33 (2) the minor caregiver applies for and receives family 272.34 cash assistance; 272.35 (3) the relative caregiver chooses not to be part of the 272.36 MFIP-S assistance unit; and 273.1 (4) the relative caregiver has resided in Minnesota for at 273.2 least 30 days prior to the date the assistance unit applies for 273.3 cash assistance. 273.4 (f) Ineligible mandatory unit members who have resided in 273.5 Minnesota for 12 months immediately before the unit's date of 273.6 application establish the other assistance unit members' 273.7 eligibility for the MFIP-S transitional standard. 273.8 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 273.9 in section 256J.08, and their immediate families are exempt from 273.10 the requirements of subdivisions 1 and 1a, provided the migrant 273.11 worker provides verification that the migrant family worked in 273.12 this state within the last 12 months and earned at least $1,000 273.13 in gross wages during the time the migrant worker worked in this 273.14 state. 273.15 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 273.16 to an eligiblefamilyassistance unit in which all members have 273.17 resided in this state for fewer than 12 consecutive calendar 273.18 months immediately preceding the date of application shall be at 273.19 the standard and in the form specified in section 256J.43. 273.20 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 273.21 section is enjoined from implementation or found 273.22 unconstitutional by any court of competent jurisdiction, the 273.23 remaining subdivisions shall remain valid and shall be given 273.24 full effect. 273.25 Sec. 37. Minnesota Statutes 1997 Supplement, section 273.26 256J.14, is amended to read: 273.27 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 273.28 (a) The definitions in this paragraph only apply to this 273.29 subdivision. 273.30 (1) "Household of a parent, legal guardian, or other adult 273.31 relative" means the place of residence of: 273.32 (i) a natural or adoptive parent; 273.33 (ii) a legal guardian according to appointment or 273.34 acceptance under section 260.242, 525.615, or 525.6165, and 273.35 related laws;or273.36 (iii) a caregiver as defined in section 256J.08, 274.1 subdivision 11; or 274.2 (iv) an appropriate adult relative designated by a county 274.3 agency. 274.4 (2) "Adult-supervised supportive living arrangement" means 274.5 a private family setting which assumes responsibility for the 274.6 care and control of the minor parent and minor child, or other 274.7 living arrangement, not including a public institution, licensed 274.8 by the commissioner of human services which ensures that the 274.9 minor parent receives adult supervision and supportive services, 274.10 such as counseling, guidance, independent living skills 274.11 training, or supervision. 274.12 (b) A minor parent and the minor child who is in the care 274.13 of the minor parent must reside in the household of a parent, 274.14 legal guardian, otherappropriateadult relative,or other274.15caregiver,or in an adult-supervised supportive living 274.16 arrangement in order to receive MFIP-S unless: 274.17 (1) the minor parent has no living parent, other 274.18appropriateadult relative, or legal guardian whose whereabouts 274.19 is known; 274.20 (2) no living parent, otherappropriateadult relative, or 274.21 legal guardian of the minor parent allows the minor parent to 274.22 live in the parent's,appropriateother adult relative's, or 274.23 legal guardian's home; 274.24 (3) the minor parent lived apart from the minor parent's 274.25 own parent or legal guardian for a period of at least one year 274.26 before either the birth of the minor child or the minor parent's 274.27 application for MFIP-S; 274.28 (4) the physical or emotional health or safety of the minor 274.29 parent or minor child would be jeopardized if the minor parent 274.30 and the minor child resided in the same residence with the minor 274.31 parent's parent, otherappropriateadult relative, or legal 274.32 guardian; or 274.33 (5) an adult supervised supportive living arrangement is 274.34 not available for the minor parent andthe dependentchild in 274.35 the county in which the minor parent and child currentlyresides274.36 reside. If an adult supervised supportive living arrangement 275.1 becomes available within the county, the minor parent and child 275.2 must reside in that arrangement. 275.3 (c) Minor applicants must be informed orally and in writing 275.4 about the eligibility requirements and their rights and 275.5 obligations under the MFIP-S program. The county must advise 275.6 the minor of the possible exemptions and specifically ask 275.7 whether one or more of these exemptions is applicable. If the 275.8 minor alleges one or more of these exemptions, then the county 275.9 must assist the minor in obtaining the necessary verifications 275.10 to determine whether or not these exemptions apply. 275.11 (d) If the county worker has reason to suspect that the 275.12 physical or emotional health or safety of the minor parent or 275.13 minor child would be jeopardized if they resided with the minor 275.14 parent's parent, other adult relative, or legal guardian, then 275.15 the county worker must make a referral to child protective 275.16 services to determine if paragraph (b), clause (4), applies. A 275.17 new determination by the county worker is not necessary if one 275.18 has been made within the last six months, unless there has been 275.19 a significant change in circumstances which justifies a new 275.20 referral and determination. 275.21 (e) If a minor parent is not living with a parentor, legal 275.22 guardian, or other adult relative due to paragraph (b), clause 275.23 (1), (2), or (4), the minor parent must reside, when possible, 275.24 in a living arrangement that meets the standards of paragraph 275.25 (a), clause (2). 275.26 (f) When a minor parent and minor childlivelives with 275.27anothera parent, other adult relative, legal guardian, or in an 275.28 adult-supervised supportive living arrangement, MFIP-S must be 275.29 paid, when possible, in the form of a protective payment on 275.30 behalf of the minor parent and minor childin accordance with275.31 according to section 256J.39, subdivisions 2 to 4. 275.32 Sec. 38. Minnesota Statutes 1997 Supplement, section 275.33 256J.15, subdivision 2, is amended to read: 275.34 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.] To receive 275.35 assistanceunder MFIP-S,when a member of an assistance unitwho275.36 is on strike, or when an individual identified under section 276.1 256J.37, subdivisions 1 to 2, whose income and assets must be 276.2 considered when determining the unit's eligibility is on strike, 276.3 the assistance unit must have beenanreceiving MFIP-S 276.4participant on the day before the strike,or have been eligible 276.5 for MFIP-S on the day before the strike. 276.6 The county agency must count the striker's prestrike 276.7 earnings as current earnings.WhenA significant change cannot 276.8 be invoked when a member of an assistance unit, or an individual 276.9 identified under section 256J.37, subdivisions 1 to 2, is on 276.10 strike. A member of an assistance unitwho, or an individual 276.11 identified under section 256J.37, subdivisions 1 to 2, is not 276.12 considered a striker when that person is not in the bargaining 276.13 unit that voted for the strike and does not cross the picket 276.14 line for fear of personal injury, the assistance unit member is276.15not a striker. Except for a member of an assistance unit who is276.16not in the bargaining unit that voted for the strike and who276.17does not cross the picket line for fear of personal injury, a276.18significant change cannot be invoked as a result of a labor276.19dispute. 276.20 Sec. 39. Minnesota Statutes 1997 Supplement, section 276.21 256J.20, subdivision 2, is amended to read: 276.22 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 276.23 property by an applicant or participant is subject to the 276.24 limitations in paragraphs (a) and (b). 276.25 (a) A county agency shall exclude the homestead of an 276.26 applicant or participant according to clauses (1) to(4)(5): 276.27 (1) an applicant or participant who is purchasing real 276.28 property through a contract for deed and using that property as 276.29 a home is considered the owner of real property; 276.30 (2) the total amount of land that can be excluded under 276.31 this subdivision is limited to surrounding property which is not 276.32 separated from the home by intervening property owned by 276.33 others. Additional property must be assessed as to its legal 276.34 and actual availability according to subdivision 1; 276.35 (3) when real property that has been used as a home by a 276.36 participant is sold, the county agency must treat the cash 277.1 proceeds from the sale as excluded property for six months when 277.2 the participant intends to reinvest the proceeds in another home 277.3 and maintains those proceeds, unused for other purposes, in a 277.4 separate account;and277.5 (4) when the homestead is jointly owned, but the client 277.6 does not reside in it because of legal separation, pending 277.7 divorce, or battering or abuse by the spouse or partner, the 277.8 homestead is excluded.; and 277.9 (5) the homestead shall continue to be excluded if it is 277.10 temporarily unoccupied due to employment, illness, or as the 277.11 result of compliance with a county-approved employability plan. 277.12 The education, training, or job search must be within the state, 277.13 but can be outside the immediate geographic area. A homestead 277.14 temporarily unoccupied because it is not habitable due to a 277.15 casualty or natural disaster is excluded. The homestead is 277.16 excluded during periods only if the client intends to return to 277.17 it. 277.18 (b) The equity value of real property that is not excluded 277.19 under paragraph (a) and which is legally available must be 277.20 applied against the limits in subdivision 3. When the equity 277.21 value of the real property exceeds the limits under subdivision 277.22 3, the applicant or participant may qualify to receive 277.23 assistance when the applicant or participant continues to make a 277.24 good faith effort to sell the property and signs a legally 277.25 binding agreement to repay the amount of assistance, less child 277.26 support collected by the agency. Repayment must be made within 277.27 five working days after the property is sold. Repayment to the 277.28 county agency must be in the amount of assistance received or 277.29 the proceeds of the sale, whichever is less. 277.30 Sec. 40. Minnesota Statutes 1997 Supplement, section 277.31 256J.20, subdivision 3, is amended to read: 277.32 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 277.33 MFIP-S, the equity value of all nonexcluded real and personal 277.34 property of the assistance unit must not exceed $2,000 for 277.35 applicants and $5,000 for ongoingrecipientsparticipants. The 277.36 value of assets in clauses (1) to(18)(20) must be excluded 278.1 when determining the equity value of real and personal property: 278.2 (1) a licensedvehiclesvehicle up to atotal marketloan 278.3 value of less than or equal to $7,500. The county agency shall 278.4 apply any excessmarketloan value as if it were equity value to 278.5 the asset limit described in this section. If the assistance 278.6 unit owns more than one licensed vehicle, the county agency 278.7 shall determine the vehicle with the highestmarketloan value 278.8 and count only themarketloan value over $7,500. The county 278.9 agency shall count themarketloan value of all other vehicles 278.10 and apply this amount as if it were equity value to the asset 278.11 limit described in this section. The value of special equipment 278.12 for a handicapped member of the assistance unit is excluded. To 278.13 establish themarketloan value of vehicles, a county agency 278.14 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 278.15 for newer model cars.The N.A.D.A. Official Used Car Guide,278.16Midwest Edition, is incorporated by reference.When a vehicle 278.17 is not listed in the guidebook, or when the applicant or 278.18 participant disputes the loan value listed in the guidebook as 278.19 unreasonable given the condition of the particular vehicle, the 278.20 county agency may require the applicant or participantto278.21 document the loan value by securing a written statement from a 278.22 motor vehicle dealer licensed under section 168.27, stating the 278.23 amount that the dealer would pay to purchase the vehicle. The 278.24 county agency shall reimburse the applicant or participant for 278.25 the cost of a written statement that documents a lower loan 278.26 value; 278.27 (2) the value of life insurance policies for members of the 278.28 assistance unit; 278.29 (3) one burial plot per member of an assistance unit; 278.30 (4) the value of personal property needed to produce earned 278.31 income, including tools, implements, farm animals, inventory, 278.32 business loans, business checking and savings accounts used at 278.33 least annually and used exclusively for the operation of a 278.34 self-employment business, and any motor vehicles if the vehicles 278.35 are essential for the self-employment business; 278.36 (5) the value of personal property not otherwise specified 279.1 which is commonly used by household members in day-to-day living 279.2 such as clothing, necessary household furniture, equipment, and 279.3 other basic maintenance items essential for daily living; 279.4 (6) the value of real and personal property owned by a 279.5 recipient of Supplemental Security Income or Minnesota 279.6 supplemental aid; 279.7 (7) the value of corrective payments, but only for the 279.8 month in which the payment is received and for the following 279.9 month; 279.10 (8) a mobile home used by an applicant or participant as 279.11 the applicant's or participant's home; 279.12 (9) money in a separate escrow account that is needed to 279.13 pay real estate taxes or insurance and that is used for this 279.14 purpose; 279.15 (10) money held in escrow to cover employee FICA, employee 279.16 tax withholding, sales tax withholding, employee worker 279.17 compensation, business insurance, property rental, property 279.18 taxes, and other costs that are paid at least annually, but less 279.19 often than monthly; 279.20 (11) monthly assistanceand, emergency assistance, and 279.21 diversionary payments for the current month's needs; 279.22 (12) the value of school loans, grants, or scholarships for 279.23 the period they are intended to cover; 279.24 (13) payments listed in section 256J.21, subdivision 2, 279.25 clause (9), which are held in escrow for a period not to exceed 279.26 three months to replace or repair personal or real property; 279.27 (14) income received in a budget month through the end of 279.28 thebudgetpayment month; 279.29 (15) savings from earned income of a minor child or a minor 279.30 parent that are set aside in a separate account designated 279.31 specifically for future education or employment costs; 279.32 (16) the federal earned incometaxcreditand, Minnesota 279.33 working family credit, state and federal income tax refunds, 279.34 state homeowners and renters credits under chapter 290A, 279.35 property tax rebates under Laws 1997, chapter 231, article 1, 279.36 section 16, and other federal or state tax rebates in the month 280.1 received and the following month; 280.2 (17) payments excluded under federal law as long as those 280.3 payments are held in a separate account from any nonexcluded 280.4 funds;and280.5 (18) money received by a participant of the corps to career 280.6 program under section 84.0887, subdivision 2, paragraph (b), as 280.7 a postservice benefit under the federal Americorps Act; 280.8 (19) the assets of children ineligible to receive MFIP-S 280.9 benefits because foster care or adoption assistance payments are 280.10 made on their behalf; and 280.11 (20) the assets of persons whose income is excluded under 280.12 section 256J.21, subdivision 2, clause 43. 280.13 Sec. 41. Minnesota Statutes 1997 Supplement, section 280.14 256J.21, is amended to read: 280.15 256J.21 [INCOME LIMITATIONS.] 280.16 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 280.17 eligibility, the county agency must evaluate income received by 280.18 members of an assistance unit, or by other persons whose income 280.19 is considered available to the assistance unit, and only count 280.20 income that is available to the member of the assistance unit. 280.21 Income is available if the individual has legal access to the 280.22 income. All payments, unless specifically excluded in 280.23 subdivision 2, must be counted as income. 280.24 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 280.25 excluded in determining a family's available income: 280.26 (1) payments for basic care, difficulty of care, and 280.27 clothing allowances received for providing family foster care to 280.28 children or adults under Minnesota Rules, parts 9545.0010 to 280.29 9545.0260 and 9555.5050 to 9555.6265, and payments received and 280.30 used for care and maintenance of a third-party beneficiary who 280.31 is not a household member; 280.32 (2) reimbursements for employment training received through 280.33 the Job Training Partnership Act, United States Code, title 29, 280.34 chapter 19, sections 1501 to 1792b; 280.35 (3) reimbursement for out-of-pocket expenses incurred while 280.36 performing volunteer services, jury duty, or employment; 281.1 (4) all educational assistance, except the county agency 281.2 must count graduate student teaching assistantships, 281.3 fellowships, and other similar paid work as earned income and, 281.4 after allowing deductions for any unmet and necessary 281.5 educational expenses, shall count scholarships or grants awarded 281.6 to graduate students that do not require teaching or research as 281.7 unearned income; 281.8 (5) loans, regardless of purpose, from public or private 281.9 lending institutions, governmental lending institutions, or 281.10 governmental agencies; 281.11 (6) loans from private individuals, regardless of purpose, 281.12 provided an applicant or participant documents that the lender 281.13 expects repayment; 281.14 (7)(i) stateand federalincome tax refunds; 281.15 (ii) federal income tax refunds; 281.16 (8)(i)state andfederal earned income credits; 281.17 (ii) Minnesota working family credits; 281.18 (iii) state homeowners and renters credits under chapter 281.19 290A; 281.20 (iv) property tax rebates under Laws 1997, chapter 231, 281.21 article 1, section 16; and 281.22 (v) other federal or state tax rebates; 281.23 (9) funds received for reimbursement, replacement, or 281.24 rebate of personal or real property when these payments are made 281.25 by public agencies, awarded by a court, solicited through public 281.26 appeal, or made as a grant by a federal agency, state or local 281.27 government, or disaster assistance organizations, subsequent to 281.28 a presidential declaration of disaster; 281.29 (10) the portion of an insurance settlement that is used to 281.30 pay medical, funeral, and burial expenses, or to repair or 281.31 replace insured property; 281.32 (11) reimbursements for medical expenses that cannot be 281.33 paid by medical assistance; 281.34 (12) payments by a vocational rehabilitation program 281.35 administered by the state under chapter 268A, except those 281.36 payments that are for current living expenses; 282.1 (13) in-kind income, including any payments directly made 282.2 by a third party to a provider of goods and services; 282.3 (14) assistance payments to correct underpayments, but only 282.4 for the month in which the payment is received; 282.5 (15) emergency assistance payments; 282.6 (16) funeral and cemetery payments as provided by section 282.7 256.935; 282.8 (17) nonrecurring cash gifts of $30 or less, not exceeding 282.9 $30 per participant in a calendar month; 282.10 (18) any form of energy assistance payment made through 282.11 Public Law Number 97-35, Low-Income Home Energy Assistance Act 282.12 of 1981, payments made directly to energy providers by other 282.13 public and private agencies, and any form of credit or rebate 282.14 payment issued by energy providers; 282.15 (19) Supplemental Security Income, including retroactive 282.16 payments; 282.17 (20) Minnesota supplemental aid, including retroactive 282.18 payments; 282.19 (21) proceeds from the sale of real or personal property; 282.20 (22) adoption assistance payments under section 259.67; 282.21 (23) state-funded family subsidy program payments made 282.22 under section 252.32 to help families care for children with 282.23 mental retardation or related conditions; 282.24 (24) interest payments and dividends from property that is 282.25 not excluded from and that does not exceed the asset limit; 282.26 (25) rent rebates; 282.27 (26) income earned by a minor caregiver or minor child who 282.28 is at least a half-time student in an approved secondary 282.29 education program; 282.30 (27) income earned by a caregiver under age 20 who is at 282.31 least a half-time student in an approved secondary education 282.32 program; 282.33 (28) MFIP-S child care payments under section 119B.05; 282.34 (29) all other payments made through MFIP-S to support a 282.35 caregiver's pursuit of greater self-support; 282.36 (30) income a participant receives related to shared living 283.1 expenses; 283.2 (31) reverse mortgages; 283.3 (32) benefits provided by the Child Nutrition Act of 1966, 283.4 United States Code, title 42, chapter 13A, sections 1771 to 283.5 1790; 283.6 (33) benefits provided by the women, infants, and children 283.7 (WIC) nutrition program, United States Code, title 42, chapter 283.8 13A, section 1786; 283.9 (34) benefits from the National School Lunch Act, United 283.10 States Code, title 42, chapter 13, sections 1751 to 1769e; 283.11 (35) relocation assistance for displaced persons under the 283.12 Uniform Relocation Assistance and Real Property Acquisition 283.13 Policies Act of 1970, United States Code, title 42, chapter 61, 283.14 subchapter II, section 4636, or the National Housing Act, United 283.15 States Code, title 12, chapter 13, sections 1701 to 1750jj; 283.16 (36) benefits from the Trade Act of 1974, United States 283.17 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 283.18 (37) war reparations payments to Japanese Americans and 283.19 Aleuts under United States Code, title 50, sections 1989 to 283.20 1989d; 283.21 (38) payments to veterans or their dependents as a result 283.22 of legal settlements regarding Agent Orange or other chemical 283.23 exposure under Public Law Number 101-239, section 10405, 283.24 paragraph (a)(2)(E); 283.25 (39) income that is otherwise specifically excluded from 283.26 the MFIP-S program consideration in federal law, state law, or 283.27 federal regulation; 283.28 (40) security and utility deposit refunds; 283.29 (41) American Indian tribal land settlements excluded under 283.30 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 283.31 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 283.32 reservations and payments to members of the White Earth Band, 283.33 under United States Code, title 25, chapter 9, section 331, and 283.34 chapter 16, section 1407; 283.35 (42) all income of the minor parent's parent and stepparent 283.36 when determining the grant for the minor parent in households 284.1 that include a minor parent living with a parent or stepparent 284.2 on MFIP-S with otherdependentchildren; and 284.3 (43) income of the minor parent's parent and stepparent 284.4 equal to 200 percent of the federal poverty guideline for a 284.5 family size not including the minor parent and the minor 284.6 parent's child in households that include a minor parent living 284.7 with a parent or stepparent not on MFIP-S when determining the 284.8 grant for the minor parent. The remainder of income is deemed 284.9 as specified in section 256J.37, subdivision11b; 284.10 (44) payments made to children eligible for relative 284.11 custody assistance under section 257.85; 284.12 (45) vendor payments for goods and services made on behalf 284.13 of a client unless the client has the option of receiving the 284.14 payment in cash; and 284.15 (46) the principal portion of a contract for deed payment. 284.16 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 284.17 determine initial eligibility by considering all earned and 284.18 unearned income that is not excluded under subdivision 2. To be 284.19 eligible for MFIP-S, the assistance unit's countable income 284.20 minus the disregards in paragraphs (a) and (b) must be below the 284.21 transitional standard of assistance according to section 256J.24 284.22 for that size assistance unit. 284.23 (a) The initial eligibility determination must disregard 284.24 the following items: 284.25 (1) the employment disregard is 18 percent of the gross 284.26 earned income whether or not the member is working full time or 284.27 part time; 284.28 (2) dependent care costs must be deducted from gross earned 284.29 income for the actual amount paid for dependent care up tothea 284.30 maximumdisregard allowedof $200 per month for each child less 284.31 than two years of age, and $175 per month for each child two 284.32 years of age and older under this chapter and chapter 119B;and284.33 (3) all payments made according to a court order 284.34 for spousal support or the support of children not living in the 284.35 assistance unit's household shall be disregarded from the income 284.36 of the person with the legal obligation to pay support, provided 285.1 that, if there has been a change in the financial circumstances 285.2 of the person with the legal obligation to pay support since the 285.3 support order was entered, the person with the legal obligation 285.4 to pay support has petitioned for a modification of the support 285.5 order; and 285.6 (4) an allocation for the unmet need of an ineligible 285.7 spouse or an ineligible child under the age of 21 for whom the 285.8 caregiver is financially responsible and who lives with the 285.9 caregiver according to section 256J.36. 285.10 (b) Notwithstanding paragraph (a), when determining initial 285.11 eligibility forapplicants who haveapplicant units when at 285.12 least one member has received AFDC, family general assistance, 285.13 MFIP, MFIP-R, work first, or MFIP-S in this state within four 285.14 months of the most recent application for MFIP-S, the employment 285.15 disregard for all unit members is 36 percent of the gross earned 285.16 income. 285.17 After initial eligibility is established, the assistance 285.18 payment calculation is based on the monthly income test. 285.19 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 285.20 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 285.21 eligibility and the assistance payment amount according to the 285.22 monthly income test. To be eligible for MFIP-S, the result of 285.23 the computations in paragraphs (a) to (e) must be at least $1. 285.24 (a) Apply a 36 percent income disregard to gross earnings 285.25 and subtract this amount from the family wage level. If the 285.26 difference is equal to or greater than the transitional 285.27 standard, the assistance payment is equal to the transitional 285.28 standard. If the difference is less than the transitional 285.29 standard, the assistance payment is equal to the difference. 285.30 The employment disregard in this paragraph must be deducted 285.31 every month there is earned income. 285.32 (b) All payments made according to a court order 285.33 for spousal support or the support of children not living in the 285.34 assistance unit's household must be disregarded from the income 285.35 of the person with the legal obligation to pay support, provided 285.36 that, if there has been a change in the financial circumstances 286.1 of the person with the legal obligation to pay support since the 286.2 support order was entered, the person with the legal obligation 286.3 to pay support has petitioned for a modification of the court 286.4 order. 286.5 (c) An allocation for the unmet need of an ineligible 286.6 spouse or an ineligible child under the age of 21 for whom the 286.7 caregiver is financially responsible and who lives with the 286.8 caregiver must be made according to section 256J.36. 286.9 (d) Subtract unearned income dollar for dollar from the 286.10 transitional standard to determine the assistance payment amount. 286.11(d)(e) When income is both earned and unearned, the amount 286.12 of the assistance payment must be determined by first treating 286.13 gross earned income as specified in paragraph (a). After 286.14 determining the amount of the assistance payment under paragraph 286.15 (a), unearned income must be subtracted from that amount dollar 286.16 for dollar to determine the assistance payment amount. 286.17(e)(f) When the monthly income is greater than the 286.18 transitional or family wage level standard after applicable 286.19 deductions and the income will only exceed the standard for one 286.20 month, the county agency must suspend the assistance payment for 286.21 the payment month. 286.22 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 286.23 members of the assistance unit must be counted. Income may also 286.24 be deemed from ineligible persons to the assistance unit. 286.25 Income must be attributed to the person who earns it or to the 286.26 assistance unit according to paragraphs (a) to (c). 286.27 (a) Funds distributed from a trust, whether from the 286.28 principal holdings or sale of trust property or from the 286.29 interest and other earnings of the trust holdings, must be 286.30 considered income when the income is legally available to an 286.31 applicant or participant. Trusts are presumed legally available 286.32 unless an applicant or participant can document that the trust 286.33 is not legally available. 286.34 (b) Income from jointly owned property must be divided 286.35 equally among property owners unless the terms of ownership 286.36 provide for a different distribution. 287.1 (c) Deductions are not allowed from the gross income of a 287.2 financially responsible household member or by the members of an 287.3 assistance unit to meet a current or prior debt. 287.4 Sec. 42. Minnesota Statutes 1997 Supplement, section 287.5 256J.24, subdivision 1, is amended to read: 287.6 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 287.7 assistance unit is either a group of individuals with at least 287.8 one minor child who live together whose needs, assets, and 287.9 income are considered together and who receive MFIP-S 287.10 assistance, or a pregnant woman and her spouse whoreceives287.11 receive MFIP-S assistance. 287.12 Individuals identified in subdivision 2 must be included in 287.13 the MFIP-S assistance unit. Individuals identified in 287.14 subdivision 3must be excluded from the assistance unitare 287.15 ineligible to receive MFIP-S. Individuals identified in 287.16 subdivision 4 may be included in the assistance unit at their 287.17 option. Individuals not included in the assistance unit who are 287.18 identified in section 256J.37,subdivisionsubdivisions 1orto 287.19 2, must have their income and assets considered when determining 287.20 eligibility and benefits for an MFIP-S assistance unit. All 287.21 assistance unit members, whether mandatory or elective, who live 287.22 together and for whom one caregiver or two caregivers apply must 287.23 be included in a single assistance unit. 287.24 Sec. 43. Minnesota Statutes 1997 Supplement, section 287.25 256J.24, subdivision 2, is amended to read: 287.26 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 287.27 for minor caregivers and their children whoaremust be in a 287.28 separate assistance unit from the other persons in the 287.29 household, when the following individuals live together, they 287.30 must be included in the assistance unit: 287.31 (1) a minor child, including a pregnant minor; 287.32 (2) the minor child's siblings, half-siblings, and 287.33 step-siblings;and287.34 (3) the minor child's natural, adoptive parents, and 287.35 stepparents; and 287.36 (4) the spouse of a pregnant woman. 288.1 Sec. 44. Minnesota Statutes 1997 Supplement, section 288.2 256J.24, subdivision 3, is amended to read: 288.3 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 288.4 ASSISTANCE UNIT.] (a) The following individualsmust be excluded288.5from an assistance unitwho are part of the assistance unit 288.6 determined under subdivision 2 are ineligible to receive MFIP-S: 288.7 (1) individuals receiving Supplemental Security Income or 288.8 Minnesota supplemental aid; 288.9 (2) individuals living at home while performing 288.10 court-imposed, unpaid community service work due to a criminal 288.11 conviction; 288.12 (3) individuals disqualified from the food stamp program or 288.13 MFIP-S, until the disqualification ends; 288.14 (4) children on whose behalf federal, state or local foster 288.15 care paymentsunder title IV-E of the Social Security Actare 288.16 made, except as provided insectionsections 256J.13, 288.17 subdivision 2, and 256J.74, subdivision 2; and 288.18 (5) children receiving ongoing monthly adoption assistance 288.19 payments under section 269.67. 288.20 (b) The exclusion of a person under this subdivision does 288.21 not alter the mandatory assistance unit composition. 288.22 Sec. 45. Minnesota Statutes 1997 Supplement, section 288.23 256J.24, subdivision 4, is amended to read: 288.24 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 288.25 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 288.26 choose to be in the assistance unit, if the caregiver is not 288.27 required to be in the assistance unit under subdivision 2. If 288.28 therelativeeligible caregiver chooses to be in the assistance 288.29 unit, that person's spouse must also be in the unit. 288.30 (b) Any minor child not related as a sibling, stepsibling, 288.31 or adopted sibling to the minor child in the unit, but for whom 288.32 there is an eligible caregiver may elect to be in the unit. 288.33 (c) A foster care provider of a minor child who is 288.34 receiving federal, state, or local foster care maintenance 288.35 payments may elect to receive MFIP-S if the provider meets the 288.36 definition of caregiver under section 256J.08, subdivision 11. 289.1 If the provider chooses to receive MFIP-S, the spouse of the 289.2 provider must also be included in the assistance unit with the 289.3 provider. The provider and spouse are eligible for assistance 289.4 even if the only minor child living in the provider's home is 289.5 receiving foster care maintenance payments. 289.6 (d) The adult caregiver or caregivers of a minor parent are 289.7 eligible to be a separate assistance unit from the minor parent 289.8 and the minor parent's child when: 289.9 (1) the adult caregiver or caregivers have no other minor 289.10 children in the household; 289.11 (2) the minor parent and the minor parent's child are 289.12 living together with the adult caregiver or caregivers; and 289.13 (3) the minor parent and the minor parent's child receive 289.14 MFIP-S, or would be eligible to receive MFIP-S, if they were not 289.15 receiving SSI benefits. 289.16 Sec. 46. Minnesota Statutes 1997 Supplement, section 289.17 256J.24, is amended by adding a subdivision to read: 289.18 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 289.19 STANDARD.] The commissioner shall adjust the food portion of the 289.20 MFIP-S transitional standard by October 1 each year beginning 289.21 October 1998 to reflect the cost-of-living adjustments to the 289.22 Food Stamp Program. The commissioner shall annually publish in 289.23 the State Register the transitional standard for an assistance 289.24 unit of sizes 1 to 10. 289.25 Sec. 47. Minnesota Statutes 1997 Supplement, section 289.26 256J.24, subdivision 7, is amended to read: 289.27 Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage 289.28 level standard is 110 percent of the transitional standard under 289.29 subdivision 5 and is the standard used when there is earned 289.30 income in the assistance unit. As specified in section 256J.21, 289.31 earned income is subtracted from the family wage level to 289.32 determine the amount of the assistance payment. Assistance 289.33 payments may not exceed the shared household standard or the 289.34 transitional standard for the assistance unit, whichever is less. 289.35 Sec. 48. Minnesota Statutes 1997 Supplement, section 289.36 256J.24, is amended by adding a subdivision to read: 290.1 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 290.2 UNITS.] For all applicants who are eligible for MFIP-S 290.3 assistance, payments for shelter and utilities up to the amount 290.4 of MFIP-S benefits for which the assistance unit is eligible 290.5 may, upon county option, be vendor paid for as many months as 290.6 the assistance unit is eligible or six months, whichever comes 290.7 first. The residual amount of the grant after vendor payment, 290.8 if any, must be paid to the MFIP-S caregiver. A county that 290.9 chooses this method of payment must use it for all eligible 290.10 applicants. 290.11 Sec. 49. Minnesota Statutes 1997 Supplement, section 290.12 256J.24, is amended by adding a subdivision to read: 290.13 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP-S.] (a) Except 290.14 as prohibited in paragraph (b), the county agency must use the 290.15 shared household standard when the household includes one or 290.16 more unrelated members, as that term is defined in section 290.17 256J.08, subdivision 86a. The county agency must use the shared 290.18 household standard, unless a member of the assistance unit is a 290.19 victim of domestic violence and has an approved safety plan, 290.20 regardless of the number of unrelated members in the household. 290.21 (b) The county agency must not use the shared household 290.22 standard when all unrelated members are one of the following: 290.23 (1) a recipient of public assistance benefits, including 290.24 food stamps, Supplemental Security Income, adoption assistance, 290.25 relative custody assistance, or foster care payments; 290.26 (2) a roomer or boarder, or a person to whom the assistance 290.27 unit is paying room or board; 290.28 (3) a minor; 290.29 (4) a minor caregiver living with the minor caregiver's 290.30 parents or in an approved supervised living arrangement; or 290.31 (5) a caregiver who is not the parent of the minor child in 290.32 the assistance unit. 290.33 Sec. 50. Minnesota Statutes 1997 Supplement, section 290.34 256J.26, subdivision 1, is amended to read: 290.35 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 290.36 Applicants orrecipientsparticipants who have been convicted of 291.1 a drug offense after July 1, 1997, may, if otherwise eligible, 291.2 receive AFDC or MFIP-S benefits subject to the following 291.3 conditions: 291.4 (1) Benefits for the entire assistance unit must be paid in 291.5 vendor form for shelter and utilities during any time the 291.6 applicant is part of the assistance unit;. 291.7 (2) The convicted applicant orrecipientparticipant shall 291.8 be subject to random drug testing as a condition of continued 291.9 eligibility andis subject to sanctions under section 256J.46291.10 following any positive test for an illegal controlled substance,291.11except that the grant must continue to be vendor paid under291.12clause (1).291.13For purposes of this subdivision, section 256J.46 is291.14effective July 1, 1997.291.15This subdivision also applies to persons who receive food291.16stamps under section 115 of the Personal Responsibility and Work291.17Opportunity Reconciliation Act of 1996.is subject to the 291.18 following sanctions: 291.19 (i) for failing a drug test the first time, the 291.20 participant's grant shall be reduced by ten percent of the 291.21 MFIP-S transitional standard or the interstate transitional 291.22 standard, whichever is applicable prior to making vendor 291.23 payments for shelter and utility costs; or 291.24 (ii) for failing a drug test two or more times, the 291.25 residual amount of the participant's grant after making vendor 291.26 payments for shelter and utility costs, if any, must be reduced 291.27 by an amount equal to 30 percent of the MFIP-S transitional 291.28 standard or the interstate transitional standard, whichever is 291.29 applicable. 291.30 (b) Applicants or participants who have been convicted of a 291.31 drug offense after July 1, 1997, may, if otherwise eligible, 291.32 receive food stamps if the convicted applicant or participant is 291.33 subject to random drug testing as a condition of continued 291.34 eligibility. Following a positive test for an illegal 291.35 controlled substance, the applicant is subject to the following 291.36 sanctions: 292.1 (1) for failing a drug test the first time, food stamps 292.2 shall be reduced by ten percent of the applicable food stamp 292.3 allotment; and 292.4 (2) for failing a drug test two or more times, food stamps 292.5 shall be reduced by an amount equal to 30 percent of the 292.6 applicable food stamp allotment. 292.7(b)(c) For the purposes of this subdivision, "drug offense" 292.8 means a conviction that occurred after July 1, 1997, of sections 292.9 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 292.10 means a conviction in another jurisdiction of the possession, 292.11 use, or distribution of a controlled substance, or conspiracy to 292.12 commit any of these offenses, if the offense occurred after July 292.13 1, 1997, and the conviction is a felony offense in that 292.14 jurisdiction, or in the case of New Jersey, a high misdemeanor. 292.15 Sec. 51. Minnesota Statutes 1997 Supplement, section 292.16 256J.26, subdivision 2, is amended to read: 292.17 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 292.18 condition of probation or parole or supervised release imposed 292.19 under federal law or the law of any state isineligible to292.20receivedisqualified from receiving AFDC or MFIP-S. 292.21 Sec. 52. Minnesota Statutes 1997 Supplement, section 292.22 256J.26, subdivision 3, is amended to read: 292.23 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 292.24 avoid prosecution, or custody, or confinement after conviction 292.25 for a crime that is a felony under the laws of the jurisdiction 292.26 from which the individual flees, or in the case of New Jersey, 292.27 is a high misdemeanor, isineligible to receivedisqualified 292.28 from receiving AFDC or MFIP-S. 292.29 Sec. 53. Minnesota Statutes 1997 Supplement, section 292.30 256J.26, subdivision 4, is amended to read: 292.31 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 292.32 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 292.33 individual who is convicted in federal or state court of having 292.34 made a fraudulent statement or representation with respect to 292.35 the place of residence of the individual in order to receive 292.36 assistance simultaneously from two or more states isineligible293.1to receivedisqualified from receiving AFDC or MFIP-S for ten 293.2 years beginning on the date of the conviction. 293.3 Sec. 54. Minnesota Statutes 1997 Supplement, section 293.4 256J.28, subdivision 1, is amended to read: 293.5 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 293.6 ASSISTANCE.] The following households are entitled to expedited 293.7 issuance of food stamp assistance: 293.8 (1) households with less than $150 in monthly gross income 293.9 provided their liquid assets do not exceed $100; 293.10 (2) migrant or seasonal farm worker households who are 293.11 destitute as defined in Code of Federal Regulations, title 7, 293.12 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 293.13 paragraph (e)(3), provided their liquid assets do not exceed 293.14 $100; and 293.15 (3) eligible households whose combined monthly gross income 293.16 and liquid resources are less than the household's monthly rent 293.17 or mortgage and utilities. 293.18The benefits issued through expedited issuance of food293.19stamp assistance must be deducted from the amount of the full293.20monthly MFIP-S assistance payment and a supplemental payment for293.21the difference must be issued.For any month an individual 293.22 receives expedited food stamp benefits, the individual is not 293.23 eligible for the MFIP-S food portion of assistance. 293.24 Sec. 55. Minnesota Statutes 1997 Supplement, section 293.25 256J.28, subdivision 2, is amended to read: 293.26 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 293.27 ASSISTANCE UNIT.] (a) For household members who purchase and 293.28 prepare food with the MFIP-S assistance unit but are not part of 293.29 the assistance unit, the county agency must determine a separate 293.30 food stamp benefit based on regulations agreed upon with the 293.31 United States Department of Agriculture. 293.32(b) This subdivision does not apply to optional members who293.33have chosen not to be in the assistance unit.293.34(c)(b) Fair hearing requirements for persons who receive 293.35 food stamps under this subdivision are governed by section 293.36 256.045, and Code of Federal Regulations, title 7, subtitle B, 294.1 chapter II, part 273, section 273.15. 294.2 Sec. 56. Minnesota Statutes 1997 Supplement, section 294.3 256J.28, is amended by adding a subdivision to read: 294.4 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 294.5 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 294.6 in a battered woman's shelter may receive food stamps or the 294.7 food portion twice in a month if the unit that initially 294.8 received the food stamps or food portion included the alleged 294.9 abuser. 294.10 Sec. 57. Minnesota Statutes 1997 Supplement, section 294.11 256J.30, subdivision 10, is amended to read: 294.12 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 294.13 caregiver of a minor child must cooperate with the county agency 294.14 to identify and provide information to assist the county agency 294.15 in pursuing third-party liability for medical services. 294.16 (b) A caregiver must assign to the department any rights to 294.17 health insurance policy benefits the caregiver has during the 294.18 period of MFIP-S eligibility. 294.19 (c) A caregiver must identify any third party who may be 294.20 liable for care and services available under the medical 294.21 assistance program on behalf of the applicant or participant and 294.22 all other assistance unit members. 294.23 (d) When a participant refuses to identify any third party 294.24 who may be liable for care and services, the recipient must be 294.25 sanctioned as provided in section 256J.46, subdivision 1. The 294.26 recipient is also ineligible for medical assistancefor a294.27minimum of one month anduntil the recipient cooperates with the 294.28 requirements of this subdivision. 294.29 Sec. 58. Minnesota Statutes 1997 Supplement, section 294.30 256J.30, subdivision 11, is amended to read: 294.31 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 294.32 RIGHTS.]To be eligibleAn assistance unit is ineligible for 294.33 MFIP-S,unless the caregivermust assignassigns all rights to 294.34 child support and spousal maintenance benefits according 294.35 tosections 256.74, subdivision 5, andsection 256.741, if294.36enacted. 295.1 Sec. 59. Minnesota Statutes 1997 Supplement, section 295.2 256J.31, subdivision 5, is amended to read: 295.3 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 295.4 shall be issued according to paragraphs (a) to (c). 295.5 (a) A county agency shall mail a notice of adverse action 295.6 at least ten days before the effective date of the adverse 295.7 action, except as provided in paragraphs (b) and (c). 295.8 (b) A county agency must mail a notice of adverse action at 295.9 least five days before the effective date of the adverse action 295.10 when the county agency has factual information that requires an 295.11 action to reduce, suspend, or terminate assistance based on 295.12 probable fraud. 295.13 (c) A county agency shall mail a notice of adverse action 295.14 before or on the effective date of the adverse action when the 295.15 county agency: 295.16 (1) receives the caregiver's signed monthly MFIP-S 295.17 household report form that includes information that requires 295.18 payment reduction, suspension, or termination; 295.19 (2) is informed of the death of a participant or the payee; 295.20 (3) receives a signed statement from the caregiver that 295.21 assistance is no longer wanted; 295.22 (4) receives a signed statement from the caregiver that 295.23 provides information that requires the termination or reduction 295.24 of assistance; 295.25 (5) verifies that a member of the assistance unit is absent 295.26 from the home and does not meet temporary absence provisions in 295.27 section 256J.13; 295.28 (6) verifies that a member of the assistance unit has 295.29 entered a regional treatment center or a licensed residential 295.30 facility for medical or psychological treatment or 295.31 rehabilitation; 295.32 (7) verifies that a member of an assistance unit has been 295.33 placed in foster care, and the provisions of section 256J.13, 295.34 subdivision 2, paragraph(b)(c), clause (2), do not apply; 295.35 (8) verifies that a member of an assistance unit has been 295.36 approved to receive assistance by another state; or 296.1 (9) cannot locate a caregiver. 296.2 Sec. 60. Minnesota Statutes 1997 Supplement, section 296.3 256J.31, subdivision 10, is amended to read: 296.4 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grantsor296.5earningsof a caregiver while participating in full or part-time 296.6 employment or training shall be protected from garnishment. 296.7This protection for earnings shall extend for a period of six296.8months from the date of termination from MFIP-S.296.9 Sec. 61. Minnesota Statutes 1997 Supplement, section 296.10 256J.31, is amended by adding a subdivision to read: 296.11 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 296.12 participant may discontinue receipt of the cash assistance 296.13 portion of MFIP-S assistance and retain eligibility for child 296.14 care assistance under section 119B.05 and for medical assistance 296.15 under sections 256B.055, subdivision 3a, and 256B.0635. 296.16 Sec. 62. [256J.311] [PROCEDURES TO IDENTIFY DOMESTIC 296.17 VIOLENCE VICTIMS.] The commissioner shall develop procedures for 296.18 county agencies and their contractors under this chapter and 296.19 chapter 256K to identify victims of domestic violence from among 296.20 applicants and recipients of assistance. The procedures must 296.21 provide, at a minimum, universal notification to all applicants 296.22 and recipients of MFIP-S that: 296.23 (1) referrals to counseling and supportive services are 296.24 available for victims of domestic violence; 296.25 (2) nonpermanent resident battered individuals married to 296.26 United States citizens or permanent residents may be eligible to 296.27 petition for permanent residency under the federal Violence 296.28 Against Women Act, and referrals to appropriate legal services 296.29 are available; 296.30 (3) victims of domestic violence are exempt from the 296.31 60-month limit on assistance while the individual is complying 296.32 with an approved safety plan, as defined in section 256J.49, 296.33 subdivision 11; and 296.34 (4) victims of domestic violence may choose to be exempt or 296.35 deferred from MFIP-S work requirements for up to 12 months while 296.36 the individual is complying with an approved safety plan as 297.1 defined in section 256J.49, subdivision 11. 297.2 The procedures must require that the notification must be 297.3 given in writing and orally at the time of application and 297.4 recertification, when the individual is referred to the title 297.5 IV-D child support enforcement agency, and at the beginning of 297.6 any employment and training services program. 297.7 Sec. 63. Minnesota Statutes 1997 Supplement, section 297.8 256J.32, subdivision 4, is amended to read: 297.9 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 297.10 verify the following at application: 297.11 (1) identity of adults; 297.12 (2) presence of the minor child in the home, if 297.13 questionable; 297.14 (3) relationship of a minor child to caregivers in the 297.15 assistance unit; 297.16 (4) age, if necessary to determine MFIP-S eligibility; 297.17 (5) immigration status; 297.18 (6) social security numberin accordance withaccording to 297.19 the requirements of section 256J.30, subdivision 12; 297.20 (7) income; 297.21 (8) self-employment expenses used as a deduction; 297.22 (9) source and purpose of deposits and withdrawals from 297.23 business accounts; 297.24 (10) spousal support and child support payments made to 297.25 persons outside the household; 297.26 (11) real property; 297.27 (12) vehicles; 297.28 (13) checking and savings accounts; 297.29 (14) savings certificates, savings bonds, stocks, and 297.30 individual retirement accounts; 297.31 (15) pregnancy, if related to eligibility; 297.32 (16) inconsistent information, if related to eligibility; 297.33 (17) medical insurance; 297.34 (18) anticipated graduation date of an 18-year-old; 297.35 (19) burial accounts; 297.36 (20) school attendance, if related to eligibility;and298.1 (21) residence; 298.2 (22) a claim of domestic violence if used as a basis for a 298.3 deferral or exemption from the 60-month time limit in section 298.4 256J.42 or employment and training services requirements in 298.5 section 256J.56; and 298.6 (23) disability if used as an exemption from employment and 298.7 training services requirements under section 256J.56. 298.8 Sec. 64. Minnesota Statutes 1997 Supplement, section 298.9 256J.32, subdivision 6, is amended to read: 298.10 Subd. 6. [RECERTIFICATION.] (a) The county agency shall 298.11 recertify eligibility in an annual face-to-face interview with 298.12 the participant and verify the following: 298.13 (1) presence of the minor child in the home, if 298.14 questionable; 298.15 (2) income, unless excluded, including self-employment 298.16 expenses used as a deduction or deposits or withdrawals from 298.17 business accounts; 298.18 (3) assets when the value is within $200 of the asset 298.19 limit; and 298.20 (4) inconsistent information, if related to eligibility. 298.21 (b) As part of the recertification process, each recipient 298.22 must be asked if the applicant has symptoms of a drug or alcohol 298.23 dependency or substance abuse problems. 298.24 Sec. 65. Minnesota Statutes 1997 Supplement, section 298.25 256J.32, is amended by adding a subdivision to read: 298.26 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 298.27 PRIVATE DATA.] County agencies in consultation with the 298.28 commissioner of human services shall provide notification to 298.29 undocumented persons regarding the release of personal data to 298.30 the immigration and naturalization service and develop protocol 298.31 regarding the release or sharing of data about undocumented 298.32 persons with the Immigration and Naturalization Service as 298.33 required under sections 404, 434, and 411A of the Personal 298.34 Responsibility and Work Opportunity Reconciliation Act of 1996. 298.35 Sec. 66. Minnesota Statutes 1997 Supplement, section 298.36 256J.33, subdivision 1, is amended to read: 299.1 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 299.2 agency must determine MFIP-S eligibility prospectively for a 299.3 payment month based on retrospectively assessing income and the 299.4 county agency's best estimate of the circumstances that will 299.5 exist in the payment month. 299.6 Except as described in section 256J.34, subdivision 1, when 299.7 prospective eligibility exists, a county agency must calculate 299.8 the amount of the assistance payment using retrospective 299.9 budgeting. To determine MFIP-S eligibility and the assistance 299.10 payment amount, a county agency must apply countable income, 299.11 described in section 256J.37, subdivisions 3 to 10, received by 299.12 members of an assistance unit or by other persons whose income 299.13 is counted for the assistance unit, described under sections 299.14 256J.21 and 256J.37, subdivisions 1andto 2. 299.15 This income must be applied to the transitional standard or 299.16 family wage standard subject to this section and sections 299.17 256J.34 to 256J.36. Income received in a calendar month and not 299.18 otherwise excluded under section 256J.21, subdivision 2, must be 299.19 applied to the needs of an assistance unit. 299.20 Sec. 67. Minnesota Statutes 1997 Supplement, section 299.21 256J.33, subdivision 4, is amended to read: 299.22 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 299.23 the monthly income test retrospectively for each month of MFIP-S 299.24 eligibility. An assistance unit is not eligible when the 299.25 countable income equals or exceeds the transitional standard or 299.26 the family wage level for the assistance unit. The income 299.27 applied against the monthly income test must include: 299.28 (1) gross earned income from employment, prior to mandatory 299.29 payroll deductions, voluntary payroll deductions, wage 299.30 authorizations, and after the disregards in section 256J.21, 299.31 subdivision34, and the allocations in section 256J.36, unless 299.32 the employment income is specifically excluded under section 299.33 256J.21, subdivision 2; 299.34 (2) gross earned income from self-employment less 299.35 deductions for self-employment expenses in section 256J.37, 299.36 subdivision 5, but prior to any reductions for personal or 300.1 business state and federal income taxes, personal FICA, personal 300.2 health and life insurance, and after the disregards in section 300.3 256J.21, subdivision34, and the allocations in section 300.4 256J.36; 300.5 (3) unearned income after deductions for allowable expenses 300.6 in section 256J.37, subdivision 9, and allocations in section 300.7 256J.36, unless the income has been specifically excluded in 300.8 section 256J.21, subdivision 2; 300.9 (4) gross earned income from employment as determined under 300.10 clause (1) which is received by a member of an assistance unit 300.11 who is a minor child or minor caregiver and less than a 300.12 half-time student; 300.13 (5) child support and spousal support received or 300.14 anticipated to be received by an assistance unit; 300.15 (6) the income of a parent when that parent is not included 300.16 in the assistance unit; 300.17 (7) the income of an eligible relative and spouse who seek 300.18 to be included in the assistance unit; and 300.19 (8) the unearned income of a minor child included in the 300.20 assistance unit. 300.21 Sec. 68. Minnesota Statutes 1997 Supplement, section 300.22 256J.35, is amended to read: 300.23 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 300.24 Except as provided in paragraphs (a) to(c)(d), the amount 300.25 of an assistance payment is equal to the difference between the 300.26 transitional standard or the Minnesota family wage level in 300.27 section 256J.24, whichever is less, and countable income. 300.28 (a) When MFIP-S eligibility exists for the month of 300.29 application, the amount of the assistance payment for the month 300.30 of application must be prorated from the date of application or 300.31 the date all other eligibility factors are met for that 300.32 applicant, whichever is later. This provision applies when an 300.33 applicant loses at least one day of MFIP-S eligibility. 300.34 (b) MFIP-S overpayments to an assistance unit must be 300.35 recouped according to section 256J.38, subdivision 4. 300.36 (c) An initial assistance payment must not be made to an 301.1 applicant who is not eligible on the date payment is made. 301.2 (d) An individual whose needs have been otherwise provided 301.3 for in another state, in whole or in part by county, state, or 301.4 federal dollars during a month, is ineligible to receive MFIP-S 301.5 for the month. 301.6 Sec. 69. Minnesota Statutes 1997 Supplement, section 301.7 256J.36, is amended to read: 301.8 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 301.9 MEMBERS.] 301.10 Except as prohibited in paragraphs (a) and (b), an 301.11 allocation of income is allowed from the caregiver's income to 301.12 meet the unmet need of an ineligible spouse or an ineligible 301.13 child under the age of 21 for whom the caregiver is financially 301.14 responsible who also lives with the caregiver.An allocation is301.15allowed from the caregiver's income to meet the need of an301.16ineligible or excluded person.That allocation is allowed in an 301.17 amount up to the difference between the MFIP-Sfamily allowance301.18 transitional standard for the assistance unit when thatexcluded301.19orineligible person is included in the assistance unit and the 301.20 MFIP-S family allowance for the assistance unit when 301.21 theexcluded orineligible person is not included in the 301.22 assistance unit. These allocations must be deducted from the 301.23 caregiver's counted earnings and from unearned income subject to 301.24 paragraphs (a) and (b). 301.25 (a) Income of a minor child in the assistance unit must not 301.26 be allocated to meet the need ofaan ineligible personwho is301.27not a member of the assistance unit, including the child's 301.28 parent, even when that parent is the payee of the child's income. 301.29 (b) Income ofan assistance unita caregiver must not be 301.30 allocated to meet the needs of a disqualified personineligible301.31for failure to cooperate with program requirements including301.32child support requirements, a person ineligible due to fraud, or301.33a relative caregiver and the caregiver's spouse who opt out of301.34the assistance unit. 301.35 Sec. 70. Minnesota Statutes 1997 Supplement, section 301.36 256J.37, subdivision 1, is amended to read: 302.1 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 302.2 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 302.3 the income of ineligible household members must be deemed after 302.4 allowing the following disregards: 302.5 (1) the first 18 percent of theexcludedineligible family 302.6 member's gross earned income; 302.7 (2) amounts the ineligible person actually paid to 302.8 individuals not living in the same household but whom the 302.9 ineligible person claims or could claim as dependents for 302.10 determining federal personal income tax liability; 302.11 (3)child or spousal support paid to a person who lives302.12outside of the householdall payments made by the ineligible 302.13 person according to a court order for spousal support or the 302.14 support of children not living in the assistance unit's 302.15 household, provided that, if there has been a change in the 302.16 financial circumstances of the ineligible person since the 302.17 support order was entered, the ineligible person has petitioned 302.18 for a modification of the support order; and 302.19 (4) an amount for the needs of the ineligible person and 302.20 other persons who live in the household but are not included in 302.21 the assistance unit and are or could be claimed by an ineligible 302.22 person as dependents for determining federal personal income tax 302.23 liability. This amount is equal to the difference between the 302.24 MFIP-Sneedtransitional standard when theexcludedineligible 302.25 person is included in the assistance unit and the MFIP-Sneed302.26 transitional standard when theexcludedineligible person is not 302.27 included in the assistance unit. 302.28 Sec. 71. Minnesota Statutes 1997 Supplement, section 302.29 256J.37, is amended by adding a subdivision to read: 302.30 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 302.31 income of disqualified members must be deemed after allowing the 302.32 following disregards: 302.33 (1) the first 18 percent of the disqualified member's gross 302.34 earned income; 302.35 (2) amounts the disqualified member actually paid to 302.36 individuals not living in the same household but whom the 303.1 disqualified member claims or could claim as dependents for 303.2 determining federal personal income tax liability; 303.3 (3) all payments made by the disqualified member according 303.4 to a court order for spousal support or the support of children 303.5 not living in the assistance unit's household, provided that, if 303.6 there has been a change in the financial circumstances of the 303.7 disqualified member's legal obligation to pay support since the 303.8 support order was entered, the disqualified member has 303.9 petitioned for a modification of the support order; and 303.10 (4) an amount for the needs of other persons who live in 303.11 the household but are not included in the assistance unit and 303.12 are or could be claimed by the disqualified member as dependents 303.13 for determining federal personal income tax liability. This 303.14 amount is equal to the difference between the MFIP-S 303.15 transitional standard when the ineligible person is included in 303.16 the assistance unit and the MFIP-S transitional standard when 303.17 the ineligible person is not included in the assistance unit. 303.18 An amount shall not be allowed for the needs of a disqualified 303.19 member. 303.20 Sec. 72. Minnesota Statutes 1997 Supplement, section 303.21 256J.37, is amended by adding a subdivision to read: 303.22 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 303.23 CAREGIVERS.] In households where minor caregivers live with a 303.24 parent or parents who do not receive MFIP-S, the income of the 303.25 parents must be deemed after allowing the following disregards: 303.26 (1) income of the parents equal to 200 percent of the 303.27 federal poverty guideline for a family size not including the 303.28 minor parent and the minor parent's child in the household 303.29 according to section 256J.21, subdivision 2, clause (43); 303.30 (2) 18 percent of the parents' gross earned income; 303.31 (3) amounts the parents actually paid to individuals not 303.32 living in the same household but whom the parents claim or could 303.33 claim as dependents for determining federal personal income tax 303.34 liability; and 303.35 (4) all payments made by parents according to a court order 303.36 for spousal support or the support of children not living in the 304.1 parent's household, provided that, if there has been a change in 304.2 the financial circumstances of the parent's legal obligation to 304.3 pay support since the support order was entered, the parents 304.4 have petitioned for a modification of the support order. 304.5 Sec. 73. Minnesota Statutes 1997 Supplement, section 304.6 256J.37, subdivision 2, is amended to read: 304.7 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 304.8 NONCITIZENS.]All income and assets of a sponsor, or sponsor's304.9spouse, who executed an affidavit of support for a noncitizen304.10must be deemed to be unearned income of the noncitizen as304.11specified in the Personal Responsibility and Work Opportunity304.12Reconciliation Act of 1996, title IV, Public Law Number 104-193,304.13sections 421 and 422, and subsequently set out in federal304.14rules.If a noncitizen applies for or receives MFIP-S, the 304.15 county must deem the income and assets of the noncitizen's 304.16 sponsor and the sponsor's spouse who have signed an affidavit of 304.17 support for the noncitizen as specified in sections 421 and 422 304.18 of the Personal Responsibility and Work Opportunity 304.19 Reconciliation Act of 1996, title IV, Public Law Number 304.20 104-193. The income of a sponsor and the sponsor's spouse is 304.21 considered unearned income of the noncitizen. The assets of a 304.22 sponsor and the sponsor's spouse are considered available assets 304.23 of the noncitizen. 304.24 Sec. 74. Minnesota Statutes 1997 Supplement, section 304.25 256J.37, subdivision 9, is amended to read: 304.26 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 304.27 apply unearned income, including housing subsidies as in304.28paragraph (b),to the transitional standard. When determining 304.29 the amount of unearned income, the county agency must deduct the 304.30 costs necessary to secure payments of unearned income. These 304.31 costs include legal fees, medical fees, and mandatory deductions 304.32 such as federal and state income taxes. 304.33 (b) Effective July 1, 1998, the county agency shall count 304.34 $100 of the value of public and assisted rental subsidies 304.35 provided through the Department of Housing and Urban Development 304.36 (HUD) as unearned income. The full amount of the subsidy must 305.1 be counted as unearned income when the subsidy is less than $100. 305.2 (c) For the period from July 1, 1998, to June 30, 1999, the 305.3 provisions of paragraph (b) shall not apply to MFIP-S 305.4 participants who are exempt from the employment and training 305.5 services component because they are: 305.6 (i) individuals who are age 60 or older; 305.7 (ii) individuals who are suffering from a professionally 305.8 certified permanent or temporary illness, injury, or incapacity 305.9 which is expected to continue for more than 30 days and which 305.10 prevents the person from obtaining or retaining employment; or 305.11 (iii) caregivers whose presence in the home is required 305.12 because of the professionally certified illness or incapacity of 305.13 another member in the household which is expected to last for 305.14 more than 30 days and the caregiver's presence replaces other 305.15 specialized care arrangements. 305.16 Sec. 75. Minnesota Statutes 1997 Supplement, section 305.17 256J.38, subdivision 1, is amended to read: 305.18 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 305.19 or former participant receives an overpayment due to agency, 305.20 client, or ATM error, or due to assistance received while an 305.21 appeal is pending and the participant or former participant is 305.22 determined ineligible for assistance or for less assistance than 305.23 was received, the county agency must recoup or recover the 305.24 overpaymentunderusing theconditions of this305.25section.following methods: 305.26 (1) reconstruct each affected budget month and 305.27 corresponding payment month; 305.28 (2) use the policies and procedures that were in effect for 305.29 the payment month; and 305.30 (3) do not allow employment disregards in section 256J.21, 305.31 subdivision 3 or 4, in the calculation of the overpayment when 305.32 the unit has not reported within two calendar months following 305.33 the end of the month in which the income was received. 305.34 Sec. 76. Minnesota Statutes 1997 Supplement, section 305.35 256J.39, subdivision 2, is amended to read: 305.36 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 306.1 paying assistance directly to a participant may be used when: 306.2 (1) a county agency determines that a vendor payment is the 306.3 most effective way to resolve an emergency situation pertaining 306.4 to basic needs; 306.5 (2) a caregiver makes a written request to the county 306.6 agency asking that part or all of the assistance payment be 306.7 issued by protective or vendor payments for shelter and utility 306.8 service only. The caregiver may withdraw this request in 306.9 writing at any time; 306.10 (3)a caregiver has exhibited a continuing pattern of306.11mismanaging funds as determined by the county agency;306.12(4)the vendor payment is part of a sanction under section 306.13 256J.46, subdivision 2;or306.14(5)(4) the vendor payment is required under section 306.15 256J.24, subdivision 8, 256J.26, 256J.80, or 256J.43; 306.16 (5) a protective payment is required for a minor parent 306.17 under section 256J.14; or 306.18 (6) a caregiver has exhibited a continuing pattern of 306.19 mismanaging funds as determined by the county agency. 306.20 The director of a county agency must approve a proposal for 306.21 protective or vendor payment for money mismanagement when there 306.22 is a pattern of mismanagement under clause (6). During the time 306.23 a protective or vendor payment is being made, the county agency 306.24 must provide services designed to alleviate the causes of the 306.25 mismanagement. 306.26 The continuing need for and method of payment must be 306.27 documented and reviewed every 12 months. The director of a 306.28 county agency must approve the continuation of protective or 306.29 vendor payments. When it appears that the need for protective 306.30 or vendor payments will continue or is likely to continue beyond 306.31 two years because the county agency's efforts have not resulted 306.32 in sufficiently improved use of assistance on behalf of the 306.33 minor child, judicial appointment of a legal guardian or other 306.34 legal representative must be sought by the county agency. 306.35 Sec. 77. Minnesota Statutes 1997 Supplement, section 306.36 256J.395, is amended to read: 307.1 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 307.2 UTILITIES.] 307.3 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 307.4 1997, when a county is required to provide assistance to 307.5 arecipientparticipant in vendor form forrentshelter costs 307.6 and utilities under this chapter, or chapter 256, 256D, or 256K, 307.7 the cost of utilities for a given family may be assumed to be: 307.8 (1) the average of the actual monthly cost of utilities for 307.9 that family for the prior 12 months at the family's current 307.10 residence, if applicable; 307.11 (2) the monthly plan amount, if any, set by the local 307.12 utilities for that family at the family's current residence; or 307.13 (3) the estimated monthly utility costs for the dwelling in 307.14 which the family currently resides. 307.15 (b) For purposes of this section, "utility" means any of 307.16 the following: municipal water and sewer service; electric, 307.17 gas, or heating fuel service; or wood, if that is the heating 307.18 source. 307.19 (c) In any instance where a vendor payment for rent is 307.20 directed to a landlord not legally entitled to the payment, the 307.21 county social services agency shall immediately institute 307.22 proceedings to collect the amount of the vendored rent payment, 307.23 which shall be considered a debt under section 270A.03, 307.24 subdivision 5. 307.25 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 307.26 agency is required to provide assistance to a participant in 307.27 vendor payment form for shelter costs or utilities under 307.28 subdivision 1, and the participant does not give the agency the 307.29 information needed to pay the vendor, the county agency shall 307.30 notify the participant of the intent to terminate assistance by 307.31 mail at least ten days before the effective date of the adverse 307.32 action. 307.33 (b) The notice of action shall include a request for 307.34 information about: 307.35 (1) the amount of the participant's shelter costs or 307.36 utilities; 308.1 (2) the due date of the shelter costs or utilities; and 308.2 (3) the name and address of the landlord, contract for deed 308.3 holder, mortgage company, and utility vendor. 308.4 (c) If the participant fails to provide the requested 308.5 information by the effective date of the adverse action, the 308.6 county must terminate the MFIP-S grant. If the applicant or 308.7 participant verifies they do not have shelter costs or utility 308.8 obligations, the county shall not terminate assistance if the 308.9 assistance unit is otherwise eligible. 308.10 Sec. 78. Minnesota Statutes 1997 Supplement, section 308.11 256J.42, is amended to read: 308.12 256J.42 [60-MONTH TIME LIMIT.] 308.13 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 308.14 in this section and in section 256J.11, subdivision 2, An 308.15 assistance unit in which any adult caregiver has received 60 308.16 months of cash assistance funded in whole or in part by the TANF 308.17 block grant in this or any other state or United States 308.18 territory, MFIP-S, AFDC, or family general assistance, funded in 308.19 whole or in part by state appropriations, is ineligible to 308.20 receive MFIP-S. Any cash assistance funded with TANF dollars in 308.21 this or any other state or United States territory, or MFIP-S 308.22 assistance funded in whole or in part by state appropriations, 308.23 that was received by the unit on or after the date TANF was 308.24 implemented, including any assistance received in states or 308.25 United States territories of prior residence, counts toward the 308.26 60-month limitation. The 60-month limit applies to a minor who 308.27 is the head of a household or who is married to the head of a 308.28 household except under subdivision 5. The 60-month time period 308.29 does not need to be consecutive months for this provision to 308.30 apply. 308.31 (b) Months before July 1998 in which individuals receive 308.32 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 308.33 comparison group family under sections 256.031 to 256.0361 or 308.34 sections 256.047 to 256.048 are not included in the 60-month 308.35 time limit. 308.36Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual309.1whose needs have been otherwise provided for in another state,309.2in whole or in part by the TANF block grant during a month, is309.3ineligible to receive MFIP-S for the month.309.4 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 309.5 determining the number of months for which an adult has received 309.6 assistance under MFIP-S, the county agency must disregard any 309.7 month during which the adult lived on an Indian reservation if,309.8 during the month:309.9(1) at least 1,000 individuals were living on the309.10reservation; and309.11(2)at least 50 percent of the adults living on the 309.12 reservation wereunemployednot employed. 309.13 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 309.14 assistance received by an assistance unit in a month when a 309.15 caregiver is complying with a safety plan under the MFIP-S 309.16 employment and training component does not count toward the 309.17 60-month limitation on assistance. 309.18 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 309.19 assistance received by an assistance unit does not count toward 309.20 the 60-month limit on assistance during a month in which 309.21 theparentalcaregiver is in the category in section 256J.56, 309.22 clause (1). The exemption applies for the period of time the 309.23 caregiver belongs to one of the categories specified in this 309.24 subdivision. 309.25 (b) From July 1, 1997, until the date MFIP-S is operative 309.26 in the caregiver's county of financial responsibility, any cash 309.27 assistance received by a caregiver who is complying with 309.28 sections 256.73, subdivision 5a, and 256.736, if applicable, 309.29 does not count toward the 60-month limit on assistance. 309.30 Thereafter, any cash assistance received by a minor caregiver 309.31 who is complying with the requirements of sections 256J.14 and 309.32 256J.54, if applicable, does not count towards the 60-month 309.33 limit on assistance. 309.34 (c) Any diversionary assistance or emergency assistance 309.35 received does not count toward the 60-month limit. 309.36 (d) Any cash assistance received by an 18 or 19 year old 310.1 caregiver during a month when the caregiver is complying with 310.2 the requirements of section 256J.54 does not count toward the 310.3 60-month limit. 310.4 Sec. 79. Minnesota Statutes 1997 Supplement, section 310.5 256J.43, is amended to read: 310.6 256J.43 [INTERSTATE PAYMENT STANDARDS.] 310.7 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 310.8 amount of assistance paid to an eligiblefamilyunit in which 310.9 all members have resided in this state for fewer than 12 310.10 consecutive calendar months immediately preceding the date of 310.11 application shall be the lesser of either thepaymentinterstate 310.12 transitional standard that would have been received by 310.13 thefamilyassistance unit from the state of immediate prior 310.14 residence, or the amount calculated in accordance with AFDC or 310.15 MFIP-S standards. The lesser payment must continue until 310.16 thefamilyassistance unit meets the 12-month requirement. An 310.17 assistance unit that has not resided in Minnesota for 12 months 310.18 from the date of application is not exempt from the interstate 310.19 payment provisions solely because a child is born in Minnesota 310.20 to a member of the assistance unit. Payment must be calculated 310.21 by applying this state's budgeting policies, and the unit's net 310.22 income must be deducted from the payment standard in the other 310.23 state or in this state, whichever is lower. Payment shall be 310.24 made in vendor form for rent and utilities, up to the limit of 310.25 the grant amount, and residual amounts, if any, shall be paid 310.26 directly to the assistance unit. 310.27 (b) During the first 12 monthsa familyan assistance unit 310.28 resides in this state, the number of months that afamilyunit 310.29 is eligible to receive AFDC or MFIP-S benefits is limited to the 310.30 number of months thefamilyassistance unit would have been 310.31 eligible to receive similar benefits in the state of immediate 310.32 prior residence. 310.33 (c) This policy applies whether or not thefamily310.34 assistance unit received similar benefits while residing in the 310.35 state of previous residence. 310.36 (d) Whena familyan assistance unit moves to this state 311.1 from another state where thefamilyassistance unit has 311.2 exhausted that state's time limit for receiving benefits under 311.3 that state's TANF program, thefamilyunit will not be eligible 311.4 to receive any AFDC or MFIP-S benefits in this state for 12 311.5 months from the date thefamilyassistance unit moves here. 311.6 (e) For the purposes of this section, "state of immediate 311.7 prior residence" means: 311.8 (1) the state in which the applicant declares the applicant 311.9 spent the most time in the 30 days prior to moving to this 311.10 state; or 311.11 (2) the state in which an applicant who is a migrant worker 311.12 maintains a home. 311.13 (f) The commissioner shall annually verify and update all 311.14 other states' payment standards as they are to be in effect in 311.15 July of each year. 311.16 (g) Applicants must provide verification of their state of 311.17 immediate prior residence, in the form of tax statements, a 311.18 driver's license, automobile registration, rent receipts, or 311.19 other forms of verification approved by the commissioner. 311.20 (h) Migrant workers, as defined in section 256J.08, and 311.21 their immediate families are exempt from this section, provided 311.22 the migrant worker provides verification that the migrant family 311.23 worked in this state within the last 12 months and earned at 311.24 least $1,000 in gross wages during the time the migrant worker 311.25 worked in this state. 311.26 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 311.27 assistance unit that has met the requirements of section 311.28 256J.12, the number of months that the assistance unit receives 311.29 benefits under the interstate payment standards in this section 311.30 is not affected by an absence from Minnesota for fewer than 30 311.31 consecutive days. 311.32 (b) For an assistance unit that has met the requirements of 311.33 section 256J.12, the number of months that the assistance unit 311.34 receives benefits under the interstate payment standards in this 311.35 section is not affected by an absence from Minnesota for more 311.36 than 30 consecutive days but fewer than 90 consecutive days, 312.1 provided the assistance unit continues to maintain a residence 312.2 in Minnesota during the period of absence. 312.3 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 312.4 POLICY.] Applicants who lived in another state in the 12 months 312.5 prior to applying for assistance are exempt from the interstate 312.6 payment policy for the months that a member of the unit: 312.7 (1) served in the United States armed services, provided 312.8 the person returned to Minnesota within 30 days of leaving the 312.9 armed forces, and intends to remain in Minnesota; 312.10 (2) attended school in another state, paid nonresident 312.11 tuition or Minnesota tuition rates under a reciprocity 312.12 agreement, provided the person left Minnesota specifically to 312.13 attend school and returned to Minnesota within 30 days of 312.14 graduation with the intent to remain in Minnesota; or 312.15 (3) meets the following criteria: 312.16 (i) a minor child or a minor caregiver moves from another 312.17 state to the residence of a relative caregiver; 312.18 (ii) the minor caregiver applies for and receives family 312.19 cash assistance; 312.20 (iii) the relative caregiver chooses not to be part of the 312.21 MFIP-S assistance unit; and 312.22 (iv) the relative caregiver has resided in Minnesota for at 312.23 least 12 months from the date the assistance unit applies for 312.24 cash assistance. 312.25 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 312.26 mandatory unit members who have resided in Minnesota for 12 312.27 months immediately before the unit's date of application 312.28 establish the other assistance unit members' eligibility for the 312.29 MFIP-S transitional standard. 312.30 Sec. 80. Minnesota Statutes 1997 Supplement, section 312.31 256J.44, is amended by adding a subdivision to read: 312.32 Subd. 3. [INTERVIEW TO IDENTIFY APPLICANTS WITH DRUG OR 312.33 ALCOHOL DEPENDENCIES.] As part of the initial screening under 312.34 this section, each applicant must also be asked if the applicant 312.35 has symptoms of a drug or alcohol dependency or substance abuse 312.36 problems. If this interview indicates that the applicant may 313.1 have a drug or alcohol dependency, the applicant must be 313.2 referred for further assessment. If the further assessment 313.3 indicates that the applicant or recipient has a drug or alcohol 313.4 dependency or substance abuse problem that requires treatment, 313.5 and that the individual's dependency is amenable to treatment, 313.6 the county must offer the individual a referral to an 313.7 appropriate treatment option. 313.8 Sec. 81. Minnesota Statutes 1997 Supplement, section 313.9 256J.45, subdivision 1, is amended to read: 313.10 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 313.11 county agency must provide each MFIP-S caregiver with a 313.12 face-to-face orientation. The caregiver must attend the 313.13 orientation. The county agency must inform the caregiver that 313.14 failure to attend the orientation is considereda firstan 313.15 occurrence of noncompliance with program requirements, and will 313.16 result in the imposition of a sanction under section 313.17 256J.46. If the client complies with the orientation 313.18 requirement prior to the effective date of the sanction, the 313.19 orientation sanction shall be lifted. 313.20 Sec. 82. Minnesota Statutes 1997 Supplement, section 313.21 256J.45, subdivision 2, is amended to read: 313.22 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 313.23 must consist of a presentation that informs caregivers of: 313.24 (1) the necessity to obtain immediate employment; 313.25 (2) the work incentives under MFIP-S; 313.26 (3) the requirement to comply with the employment plan and 313.27 other requirements of the employment and training services 313.28 component of MFIP-S; 313.29 (4) the consequences for failing to comply with the 313.30 employment plan and other program requirements; 313.31 (5) the rights, responsibilities, and obligations of 313.32 participants; 313.33 (6) the types and locations of child care services 313.34 available through the county agency; 313.35 (7) the availability and the benefits of the early 313.36 childhood health and developmental screening under sections 314.1 123.701 to 123.74; 314.2 (8) the caregiver's eligibility for transition year child 314.3 care assistance under section 119B.05; 314.4 (9) the caregiver's eligibility for extended medical 314.5 assistance when the caregiver loses eligibility for MFIP-S due 314.6 to increased earnings or increased child or spousal support;and314.7 (10) the caregiver's option to choose an employment and 314.8 training provider and information about each provider, including 314.9 but not limited to, whether the provider meets certification 314.10 standards under section 268.871 related to experience, staff 314.11 capabilities and qualifications, demonstrated effectiveness and 314.12 demonstrated administrative capabilities, services offered, 314.13 program components, job placement rates, job placement wages, 314.14 and job retention rates; and 314.15 (11) the caregiver's option to request approval of an 314.16 education and training plan according to section 256J.52. 314.17 Sec. 83. Minnesota Statutes 1997 Supplement, section 314.18 256J.45, is amended by adding a subdivision to read: 314.19 Subd. 3. [GOOD CAUSE FOR NOT ATTENDING ORIENTATION.] (a) 314.20 The county agency shall not impose the sanction under section 314.21 256J.46 if it determines that the participant has good cause for 314.22 failing to attend orientation. Good cause exists when: 314.23 (1) appropriate child care is not available; 314.24 (2) the participant is ill or injured; 314.25 (3) a family member is ill and needs care by the 314.26 participant that prevents the participant from attending 314.27 orientation; 314.28 (4) the caregiver is unable to secure necessary 314.29 transportation; 314.30 (5) the caregiver is in an emergency situation that 314.31 prevents orientation attendance; 314.32 (6) the orientation conflicts with the caregiver's work, 314.33 training, or school schedule; or 314.34 (7) the caregiver documents other verifiable impediments to 314.35 orientation attendance beyond the caregiver's control. 314.36 (b) Counties must work with clients to provide child care 315.1 and transportation necessary to ensure a caregiver has every 315.2 opportunity to attend orientation. 315.3 Sec. 84. Minnesota Statutes 1997 Supplement, section 315.4 256J.46, subdivision 1, is amended to read: 315.5 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 315.6 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 315.7 subject to a sanction under this subdivision: 315.8 (1) a participant who fails without good cause to comply 315.9 with the requirements of this chapter, and who is not subject to 315.10 a sanction under subdivision 2, shall be subject to a sanction315.11as provided in this subdivision; and 315.12 (2) a participant who has not complied with the orientation 315.13 requirement before the effective date of the sanction. 315.14 A sanction under this subdivision becomes effective ten 315.15 days after the required notice is given. For purposes of this 315.16 subdivision, each month that a participant fails to comply with 315.17 a requirement of this chapter shall be considered a separate 315.18 occurrence of noncompliance. A participant who has had one or 315.19 more sanctions imposed must remain in compliance with the 315.20 provisions of this chapter for six months in order for a 315.21 subsequent occurrence of noncompliance to be considered a first 315.22 occurrence. 315.23 (b) Sanctions for noncompliance shall be imposed as follows: 315.24 (1) For the first occurrence of noncompliance by a 315.25 participant in a single-parent household or by one participant 315.26 in a two-parent household, theparticipant'sassistance unit's 315.27 grant shall be reduced by ten percent of theapplicableMFIP-S 315.28 transitional standard or the interstate transitional standard 315.29 for an assistance unit of the same size, whichever is 315.30 applicable, with the residual paid to the participant. The 315.31 reduction in the grant amount must be in effect for a minimum of 315.32 one month and shall be removed in the month following the month 315.33 that the participant returns to compliance or in the month 315.34 following the minimum one-month sanction, whichever is later. 315.35 (2) For a second or subsequent occurrence of noncompliance, 315.36 or when both participants in a two-parent household are out of 316.1 compliance at the same time, theparticipant's rentassistance 316.2 unit's shelter costs shall be vendor paid up to the amount of 316.3 the cash portion of the MFIP-S grant for which the participant's 316.4 assistance unit is eligible. At county option, 316.5 theparticipant'sassistance unit's utilities may also be vendor 316.6 paid up to the amount of the cash portion of the MFIP-S grant 316.7 remaining after vendor payment of theparticipant's rent316.8 assistance unit's shelter costs.The vendor payment of rent316.9and, if in effect, utilities, must be in effect for six months316.10from the date that a sanction is imposed under this clause.The 316.11 residual amount of the grant after vendor payment, if any, must 316.12 be reduced by an amount equal to 30 percent of theapplicable316.13 MFIP-S transitional standard, or the interstate transitional 316.14 standard for an assistance unit of the same size, whichever is 316.15 applicable, before the residual is paid to theparticipant316.16 assistance unit. The reduction in the grant amount must be in 316.17 effect for a minimum of one month and shall be removed in the 316.18 month following the month thatthea participant in a one-parent 316.19 household returns to compliance or in the month following the 316.20 minimum one-month sanction, whichever is later. In a two-parent 316.21 household, the grant reduction shall be removed in the month 316.22 following the month both participants return to compliance or in 316.23 the month following the minimum one-month sanction, whichever is 316.24 later. The vendor payment ofrentshelter costs and, if 316.25 applicable, utilities shall be removed six months after the 316.26 month in which the participantreturnsor participants return to 316.27 compliance. 316.28 (c) No later than during the second month that a sanction 316.29 under paragraph (b), clause (2), is in effect due to 316.30 noncompliance with employment services, the participant's case 316.31 file must be reviewed to determine if: 316.32 (i) the continued noncompliance can be explained and 316.33 mitigated by providing a needed preemployment activity, as 316.34 defined in section 256J.49, subdivision 13, clause (16); 316.35 (ii) the participant qualifies for a good cause exception 316.36 under section 256J.57; or 317.1 (iii) the participant qualifies for an exemption under 317.2 section 256J.56. 317.3 If the lack of an identified activity can explain the 317.4 noncompliance, the county must work with the participant to 317.5 provide the identified activity, and the county must restore the 317.6 participant's grant amount to the full amount for which the 317.7 assistance unit is eligible. The grant must be restored 317.8 retroactively to the first day of the month in which the 317.9 participant was found to lack preemployment activities or to 317.10 qualify for an exemption or good cause exception. 317.11 If the participant is found to qualify for a good cause 317.12 exception or an exemption, the county must restore the 317.13 participant's grant to the full amount for which the assistance 317.14 unit is eligible.If the participant's grant is restored under317.15this paragraph, the vendor payment of rent and if applicable,317.16utilities, shall be removed six months after the month in which317.17the sanction was imposed and the county must consider a317.18subsequent occurrence of noncompliance to be a first occurrence.317.19 Sec. 85. Minnesota Statutes 1997 Supplement, section 317.20 256J.46, subdivision 2, is amended to read: 317.21 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 317.22 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 317.23 cooperate, as determined by the child support enforcement 317.24 agency, with support requirements under section 256.741, if 317.25 enacted, shall be subject to sanction as specified in this 317.26 subdivision. The assistance unit's grant must be reduced by 25 317.27 percent of the applicable transitional standard. The residual 317.28 amount of the grant, if any, must be paid to the caregiver. A 317.29 sanction under this subdivision becomes effective ten days after 317.30 the required notice is given. The sanction must be in effect 317.31 for a minimum of one month and shall be removed only when the 317.32 caregiver cooperates with the support requirements or in the 317.33 month following the minimum one-month sanction, whichever is 317.34 later. Each month that an MFIP-S caregiver fails to comply with 317.35 the requirements of section 256.741 must be considered a 317.36 separate occurrence of noncompliance. An MFIP-S caregiver who 318.1 has had one or more sanctions imposed must remain in compliance 318.2 with the requirements of section 256.741 for six months in order 318.3 for a subsequent sanction to be considered a first occurrence. 318.4 Sec. 86. Minnesota Statutes 1997 Supplement, section 318.5 256J.47, subdivision 4, is amended to read: 318.6 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 318.7 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 318.8 assistance, the family is ineligible for MFIP-S, emergency 318.9 assistance, and emergency general assistance for a period of 318.10 time. To determine the period of ineligibility, the county 318.11 shall use the following formula: regardless of household 318.12 changes, the county agency must calculate the number of days of 318.13 ineligibility by dividing the diversionary assistance issued by 318.14 the transitional standard a family of the same size and 318.15 composition would have received under MFIP-S, or if applicable 318.16 the interstate transitional standard, multiplied by 30, 318.17 truncating the result. The ineligibility period begins the date 318.18 the diversionary assistance is issued. 318.19 Sec. 87. Minnesota Statutes 1997 Supplement, section 318.20 256J.48, subdivision 2, is amended to read: 318.21 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 318.22 provisions of this chapter, any family without resources 318.23 immediately available to meet emergency needs identified in 318.24 subdivision 3 shall be eligible for an emergency grant under the 318.25 following conditions: 318.26 (1) a family member has resided in this state for at least 318.27 30 days; 318.28 (2) the family is without resources immediately available 318.29 to meet emergency needs; 318.30 (3) assistance is necessary to avoid destitution or provide 318.31 emergency shelter arrangements;and318.32 (4) the family's destitution or need for shelter or 318.33 utilities did not arise because the child or relative caregiver 318.34 refused without good cause under section 256J.57 to accept 318.35 employment or training for employment in this state or another 318.36 state; and 319.1 (5) at least one child or pregnant woman in the emergency 319.2 assistance unit meets MFIP-S citizenship requirements in section 319.3 256J.11. 319.4 Sec. 88. Minnesota Statutes 1997 Supplement, section 319.5 256J.48, subdivision 3, is amended to read: 319.6 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 319.7 the following: 319.8 (a) [RENT.] A county agency may deny assistance to prevent 319.9 eviction from rented or leased shelter of an otherwise eligible 319.10 applicant when the county agency determines that an applicant's 319.11 anticipated income will not cover continued payment for shelter, 319.12 subject to conditions in clauses (1) to (3): 319.13 (1) a county agency must not deny assistance when an 319.14 applicant can document that the applicant is unable to locate 319.15 habitable shelter, unless the county agency can document that 319.16 one or more habitable shelters are available in the community 319.17 that will result in at least a 20 percent reduction in monthly 319.18 expense for shelter and that this shelter will be cost-effective 319.19 for the applicant; 319.20 (2) when no alternative shelter can be identified by either 319.21 the applicant or the county agency, the county agency shall not 319.22 deny assistance because anticipated income will not cover rental 319.23 obligation; and 319.24 (3) when cost-effective alternative shelter is identified, 319.25 the county agency shall issue assistance for moving expenses as 319.26 provided in paragraph(d)(e). 319.27 (b) [DEFINITIONS.] For purposes of paragraph (a), the 319.28 following definitions apply (1) "metropolitan statistical area" 319.29 is as defined by the United States Census Bureau; (2) 319.30 "alternative shelter" includes any shelter that is located 319.31 within the metropolitan statistical area containing the county 319.32 and for which the applicant is eligible, provided the applicant 319.33 does not have to travel more than 20 miles to reach the shelter 319.34 and has access to transportation to the shelter. Clause (2) 319.35 does not apply to counties in the Minneapolis-St. Paul 319.36 metropolitan statistical area. 320.1 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 320.2 agency shall issue assistance for mortgage or contract for deed 320.3 arrearages on behalf of an otherwise eligible applicant 320.4 according to clauses (1) to (4): 320.5 (1) assistance for arrearages must be issued only when a 320.6 home is owned, occupied, and maintained by the applicant; 320.7 (2) assistance for arrearages must be issued only when no 320.8 subsequent foreclosure action is expected within the 12 months 320.9 following the issuance; 320.10 (3) assistance for arrearages must be issued only when an 320.11 applicant has been refused refinancing through a bank or other 320.12 lending institution and the amount payable, when combined with 320.13 any payments made by the applicant, will be accepted by the 320.14 creditor as full payment of the arrearage; 320.15 (4) costs paid by a family which are counted toward the 320.16 payment requirements in this clause are:principleprincipal 320.17 and interest payments on mortgages or contracts for deed, 320.18 balloon payments, homeowner's insurance payments, manufactured 320.19 home lot rental payments, and tax or special assessment payments 320.20 related to the homestead. Costs which are not counted include 320.21 closing costs related to the sale or purchase of real property. 320.22 To be eligible for assistance for costs specified in clause 320.23 (4) which are outstanding at the time of foreclosure, an 320.24 applicant must have paid at least 40 percent of the family's 320.25 gross income toward these costs in the month of application and 320.26 the 11-month period immediately preceding the month of 320.27 application. 320.28 When an applicant is eligible under clause (4), a county 320.29 agency shall issue assistance up to a maximum of four times the 320.30 MFIP-S transitional standard for a comparable assistance unit. 320.31 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 320.32 issue assistance for damage or utility deposits when necessary 320.33 to alleviate the emergency. The county may require that 320.34 assistance paid in the form of a damage depositor a utility320.35deposit, less any amount retained by the landlord to remedy a 320.36 tenant's default in payment of rent or other funds due to the 321.1 landlord under a rental agreement, or to restore the premises to 321.2 the condition at the commencement of the tenancy, ordinary wear 321.3 and tear excepted, be returned to the county when the individual 321.4 vacates the premises or be paid to the recipient's new landlord 321.5 as a vendor payment. The county may require that assistance 321.6 paid in the form of a utility deposit less any amount retained 321.7 to satisfy outstanding utility costs be returned to the county 321.8 when the person vacates the premises, or be paid for the 321.9 person's new housing unit as a vendor payment. The vendor 321.10 payment of returned funds shall not be considered a new use of 321.11 emergency assistance. 321.12 (e) [MOVING EXPENSES.] A county agency shall issue 321.13 assistance for expenses incurred when a family must move to a 321.14 different shelter according to clauses (1) to (4): 321.15 (1) moving expenses include the cost to transport personal 321.16 property belonging to a family, the cost for utility connection, 321.17 and the cost for securing different shelter; 321.18 (2) moving expenses must be paid only when the county 321.19 agency determines that a move is cost-effective; 321.20 (3) moving expenses must be paid at the request of an 321.21 applicant, but only when destitution or threatened destitution 321.22 exists; and 321.23 (4) moving expenses must be paid when a county agency 321.24 denies assistance to prevent an eviction because the county 321.25 agency has determined that an applicant's anticipated income 321.26 will not cover continued shelter obligation in paragraph (a). 321.27 (f) [HOME REPAIRS.] A county agency shall pay for repairs 321.28 to the roof, foundation, wiring, heating system, chimney, and 321.29 water and sewer system of a home that is owned and lived in by 321.30 an applicant. 321.31 The applicant shall document, and the county agency shall 321.32 verify the need for and method of repair. 321.33 The payment must be cost-effective in relation to the 321.34 overall condition of the home and in relation to the cost and 321.35 availability of alternative housing. 321.36 (g) [UTILITY COSTS.] Assistance for utility costs must be 322.1 made when an otherwise eligible family has had a termination or 322.2 is threatened with a termination of municipal water and sewer 322.3 service, electric, gas or heating fuel service, or lacks wood 322.4 when that is the heating source, subject to the conditions in 322.5 clauses (1) and (2): 322.6 (1) a county agency must not issue assistance unless the 322.7 county agency receives confirmation from the utility provider 322.8 that assistance combined with payment by the applicant will 322.9 continue or restore the utility; and 322.10 (2) a county agency shall not issue assistance for utility 322.11 costs unless a family paid at least eight percent of the 322.12 family's gross income toward utility costs due during the 322.13 preceding 12 months. 322.14 Clauses (1) and (2) must not be construed to prevent the 322.15 issuance of assistance when a county agency must take immediate 322.16 and temporary action necessary to protect the life or health of 322.17 a child. 322.18 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 322.19 shall pay for special diets or dietary items for MFIP-S 322.20 participants. Persons receiving emergency assistance funds for 322.21 special diets or dietary items are also eligible to receive 322.22 emergency assistance for shelter and utility emergencies, if 322.23 otherwise eligible. The need for special diets or dietary items 322.24 must be prescribed by a licensed physician. Costs for special 322.25 diets shall be determined as percentages of the allotment for a 322.26 one-person household under the Thrifty Food Plan as defined by 322.27 the United States Department of Agriculture. The types of diets 322.28 and the percentages of the Thrifty Food Plan that are covered 322.29 are as follows: 322.30 (1) high protein diet, at least 80 grams daily, 25 percent 322.31 of Thrifty Food Plan; 322.32 (2) controlled protein diet, 40 to 60 grams and requires 322.33 special products, 100 percent of Thrifty Food Plan; 322.34 (3) controlled protein diet, less than 40 grams and 322.35 requires special products, 125 percent of Thrifty Food Plan; 322.36 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 323.1 (5) high residue diet, 20 percent of Thrifty Food Plan; 323.2 (6) pregnancy and lactation diet, 35 percent of Thrifty 323.3 Food Plan; 323.4 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 323.5 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 323.6 (9) antidumping diet, 15 percent of Thrifty Food Plan; 323.7 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 323.8 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 323.9 Sec. 89. Minnesota Statutes 1997 Supplement, section 323.10 256J.49, subdivision 4, is amended to read: 323.11 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 323.12 "Employment and training service provider" means: 323.13 (1) a public, private, or nonprofit employment and training 323.14 agency certified by the commissioner of economic security under 323.15 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 323.16 is approved under section 256J.51 and is included in the county 323.17 plan submitted under section 256J.50, subdivision 7;or323.18 (2) a public, private, or nonprofit agency that is not 323.19 certified by the commissioner under clause (1), but with which a 323.20 county has contracted to provide employment and training 323.21 services and which is included in the county's plan submitted 323.22 under section 256J.50, subdivision 7; or 323.23 (3) a county agency, if the countyis certified under323.24clause (1)has opted to provide employment and training services 323.25 and the county has indicated that fact in the plan submitted 323.26 under section 256J.50, subdivision 7. 323.27 Notwithstanding section 268.871, an employment and training 323.28 services provider meeting this definition may deliver employment 323.29 and training services under this chapter. 323.30 Sec. 90. Minnesota Statutes 1997 Supplement, section 323.31 256J.50, subdivision 5, is amended to read: 323.32 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 323.33 TWO-PARENT CASES.] (a) A county must establish a uniform 323.34 schedule for requiring participation by single parents. 323.35 Mandatory participation must be required within six months of 323.36 eligibility for cash assistance. For two-parent cases, 324.1 participation is required concurrent with the receipt of MFIP-S 324.2 cash assistance. 324.3 (b) Beginning January 1, 1998, with the exception of 324.4 caregivers required to attend high school under the provisions 324.5 of section 256J.54, subdivision 5, MFIP caregivers, upon 324.6 completion of the secondary assessment, must develop an 324.7 employment plan and participate in work activities. 324.8 (c) Upon completion of the secondary assessment: 324.9 (1) In single-parent families with no children under six 324.10 years of age, the job counselor and the caregiver must develop 324.11 an employment plan that includes 20 to 35 hours per week of work 324.12 activities for the period January 1, 1998, to September 30, 324.13 1998; 25 to 35 hours of work activities per week in federal 324.14 fiscal year 1999; and 30 to 35 hours per week of work activities 324.15 in federal fiscal year 2000 and thereafter. 324.16 (2) In single-parent families with a child under six years 324.17 of age, the job counselor and the caregiver must develop an 324.18 employment plan that includes 20 to 35 hours per week of work 324.19 activities. 324.20 (3) In two-parent families, the job counselor and the 324.21 caregivers must develop employment plans which result in a 324.22 combined total of at least 55 hours per week of work activities. 324.23 Sec. 91. Minnesota Statutes 1997 Supplement, section 324.24 256J.50, subdivision 8, is amended to read: 324.25 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 324.26 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 324.27 working cooperatively, shall make available to participants the 324.28 choice of at least two employment and training service providers 324.29 as defined under section 256J.49, subdivision 4, except in 324.30 counties utilizing workforce centers that use multiple 324.31 employment and training services, offer multiple services 324.32 options under a collaborative effort and can document that 324.33 participants have choice among employment and training services 324.34 designed to meet specialized needs. Each county must make 324.35 available to participants at least one employment and training 324.36 service provider that is certified under section 268.871, 325.1 subdivision 1. 325.2 Sec. 92. Minnesota Statutes 1997 Supplement, section 325.3 256J.50, is amended by adding a subdivision to read: 325.4 Subd. 10. [COORDINATION.] The county agency and the county 325.5 agency's employment and training providers must consult and 325.6 coordinate with other providers of employment and training 325.7 services to identify existing resources, in order to prevent 325.8 duplication of services, to assure that other programs' services 325.9 are available to enable participants to achieve 325.10 self-sufficiency, and to assure that costs for these other 325.11 services for which participants are eligible are not incurred by 325.12 MFIP-S. At a minimum, the county agency and its providers must 325.13 coordinate with Jobs Training and Partnership Act providers and 325.14 with any other relevant employment, training, and education 325.15 programs in the county. 325.16 Sec. 93. Minnesota Statutes 1997 Supplement, section 325.17 256J.515, is amended to read: 325.18 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 325.19 During the first meeting with participants, job counselors 325.20 must ensure that an overview of employment and training services 325.21 is provided that: (1) stresses the necessity and opportunity of 325.22 immediate employment,; (2) outlines the job search resources 325.23 offered,; (3) outlines education or training opportunities 325.24 available; (4) describes the range of work activities that are 325.25 allowable under MFIP-S to meet the individual needs of 325.26 participants; (5) explains the requirements to comply with an 325.27 employment planand; (6) explains the consequences for failing 325.28 to comply,; and (7) explains the services that are available to 325.29 support job search and work and education. 325.30 Sec. 94. Minnesota Statutes 1997 Supplement, section 325.31 256J.52, subdivision 2, is amended to read: 325.32 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 325.33 with the cooperation of the participant, assess the 325.34 participant's ability to obtain and retain employment. This 325.35 initial assessment must include a review of the participant's 325.36 education level, prior employment or work experience, 326.1 transferable work skills, and existing job markets. The job 326.2 counselor must assess each participant's literacy and math 326.3 skills as part of an initial assessment. If a participant lacks 326.4 basic math or literacy skills at or below an eighth grade level, 326.5 the participant must be allowed to enroll in adult basic 326.6 education activities as part of the participant's job search 326.7 support plan or employment plan. A participant with low-level 326.8 math and literacy skills should not be categorically assumed to 326.9 be unemployable. 326.10 (b) In assessing the participant, the job counselor must 326.11 determine if the participant needs refresher courses for 326.12 professional certification or licensure, in which case, the job 326.13 search plan under subdivision 3 must include the courses 326.14 necessary to obtain the certification or licensure, in addition 326.15 to other work activities, provided the combination of the 326.16 courses and other work activities are at least for 40 hours per 326.17 week. 326.18 (c)If a participant can demonstrate to the satisfaction of326.19the county agency thatIf the job counselor determines that a 326.20 lack of proficiency in English is a barrier to obtaining 326.21 suitable employment, the job counselor must include 326.22 participation in an intensive English as a second language 326.23 program if available or otherwise a regular English as a second 326.24 language program in the individual's employment plan under 326.25 subdivision 5 for as long as the participant is making 326.26 satisfactory progress and the individual's lack of proficiency 326.27 in English remains a barrier to obtaining suitable employment. 326.28 Lack of proficiency in English is not necessarily a barrier to 326.29 employment. 326.30 (d) Understanding that education may provide the best 326.31 opportunity for unsubsidized employment, the job counselor may, 326.32 to the extent that funds are available, approve an education or 326.33 training plan as a first option, and postpone the job search 326.34 requirement, if the participant has a proposal for an education 326.35 program, including those that may lead to a certificate, 326.36 diploma, or degree and which: 327.1 (1) can be completed within 12 months or within 18 months 327.2 if remedial education courses are necessary; 327.3 (2) meets the criteria of section 256J.53, subdivisions 2, 327.4 3, and 5; and 327.5 (3) is likely, without additional training, to lead to 327.6 monthly employment earnings which, after subtraction of the 327.7 earnings disregard under section 256J.21, equal or exceed the 327.8 family wage level for the participant's assistance unit. 327.9 (e) A participant who, at the time of the initial 327.10 assessment, presents a plan that includes farming as a 327.11 self-employed work activity must have an employment plan 327.12 developed under subdivision 5 that includes the farming as an 327.13 approved work activity. 327.14 Sec. 95. Minnesota Statutes 1997 Supplement, section 327.15 256J.52, subdivision 3, is amended to read: 327.16 Subd. 3. [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 327.17 after the initial assessment, the job counselor determines that 327.18 the participant possesses sufficient skills that the participant 327.19 is likely to succeed in obtaining suitable employment, the 327.20 participant must conduct job search for a period of up to eight 327.21 weeks, for at least 30 hours per week. The participant must 327.22 accept any offer of suitable employment. The job counselor and 327.23 participant must develop a job search support plan which 327.24 specifies, at a minimum: whether the job search is to be 327.25 supervised or unsupervised; the number of hours of job search 327.26 that will be required; support services that will be provided 327.27 while the participant conducts job search activities; the 327.28 courses necessary to obtain certification or licensure, if 327.29 applicable, and after obtaining the license or certificate, the 327.30 client must comply with subdivision 5; and how frequently the 327.31 participant must report to the job counselor on the status of 327.32 the participant's job search activities. The job counselor may 327.33 approve other work activities listed in section 256J.49, 327.34 subdivision 13, to be included in a job search support plan. 327.35 (b) During the eight-week job search period, either the job 327.36 counselor or the participant may request a review of the 328.1 participant's job search plan and progress towards obtaining 328.2 suitable employment. If a review is requested by the 328.3 participant, the job counselor must concur that the review is 328.4 appropriate for the participant at that time. If a review is 328.5 conducted, the job counselor may make a determination to conduct 328.6 a secondary assessment prior to the conclusion of the job search. 328.7 (c) Failure to conduct the required job search, to accept 328.8 any offer of suitable employment, to develop or comply with a 328.9 job search support plan, or voluntarily quitting suitable 328.10 employment without good cause results in the imposition of a 328.11 sanction under section 256J.46. If at the end of eight weeks 328.12 the participant has not obtained suitable employment, the job 328.13 counselor must conduct a secondary assessment of the participant 328.14 under subdivision 3. 328.15 Sec. 96. Minnesota Statutes 1997 Supplement, section 328.16 256J.52, subdivision 4, is amended to read: 328.17 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 328.18 must conduct a secondary assessment for those participants who: 328.19 (1) in the judgment of the job counselor, have barriers to 328.20 obtaining employment that will not be overcome with a job search 328.21 support plan under subdivision 3; 328.22 (2) have completed eight weeks of job search under 328.23 subdivision 3 without obtaining suitable employment;or328.24 (3) have not received a secondary assessment, are working 328.25 at least 20 hours per week, and the participant, job counselor, 328.26 or county agency requests a secondary assessment; or 328.27 (4) have an existing plan or are already involved in 328.28 training or education activities under section 256J.55, 328.29 subdivision 5. 328.30 (b) In the secondary assessment the job counselor must 328.31 evaluate the participant's skills and prior work experience, 328.32 family circumstances, interests and abilities, need for 328.33 preemployment activities, supportive or educational services, 328.34 and the extent of any barriers to employment. The job counselor 328.35 must use the information gathered through the secondary 328.36 assessment to develop an employment plan under subdivision 5. 329.1 (c) The provider shall make available to participants 329.2 information regarding additional vendors or resources which 329.3 provide employment and training services that may be available 329.4 to the participant under a plan developed under this section. 329.5 The information must include a brief summary of services 329.6 provided and related performance indicators. Performance 329.7 indicators must include, but are not limited to, the average 329.8 time to complete program offerings, placement rates, entry and 329.9 average wages, and retention rates. To be included in the 329.10 information given to participants, a vendor or resource must 329.11 provide counties with relevant information in the format 329.12 required by the county. 329.13 Sec. 97. Minnesota Statutes 1997 Supplement, section 329.14 256J.52, is amended by adding a subdivision to read: 329.15 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 329.16 EDUCATION AND TRAINING.] After a caregiver has been employed for 329.17 six consecutive months, or after the first month in which the 329.18 caregiver works on average more than 20 hours per week, the 329.19 caregiver's job counselor shall inform the caregiver that the 329.20 caregiver may request a secondary assessment and shall provide 329.21 information about: 329.22 (1) part-time education and training options available to 329.23 the caregiver; and 329.24 (2) child care and transportation resources available to 329.25 support postemployment education and training. 329.26 Sec. 98. Minnesota Statutes 1997 Supplement, section 329.27 256J.52, is amended by adding a subdivision to read: 329.28 Subd. 9. [TRAINING CONCURRENT WITH EMPLOYMENT.] An MFIP 329.29 caregiver who is meeting the minimum hourly work participation 329.30 requirements under the Personal Responsibility and Work 329.31 Opportunity Reconciliation Act of 1996 through employment must 329.32 be allowed to meet any additional MFIP-S hourly work 329.33 participation requirements through training or education that 329.34 meets the requirements of section 256J.53. 329.35 Sec. 99. Minnesota Statutes 1997 Supplement, section 329.36 256J.54, subdivision 2, is amended to read: 330.1 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 330.2 PLAN.] For caregivers who are under age 18 without a high school 330.3 diploma or its equivalent, the assessment under subdivision 1 330.4 and the employment plan under subdivision 3 must be completed by 330.5 the social services agency under section 257.33. For caregivers 330.6 who are age 18 or 19 without a high school diploma or its 330.7 equivalent, the assessment under subdivision 1 and the 330.8 employment plan under subdivision 3 must be completed by the job 330.9 counselor. The social services agency or the job counselor 330.10 shall consult with representatives of educational agencies that 330.11 are required to assist in developing educational plans under 330.12 section 126.235. 330.13 Sec. 100. Minnesota Statutes 1997 Supplement, section 330.14 256J.54, subdivision 3, is amended to read: 330.15 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 330.16 counselor or county social services agency identifies an 330.17 appropriate educational option for a caregiver under the age of 330.18 20 without a high school diploma or its equivalent,itthe 330.19 counselor or agency must develop an employment plan which 330.20 reflects the identified option. The plan must specify that 330.21 participation in an educational activity is required, what 330.22 school or educational program is most appropriate, the services 330.23 that will be provided, the activities the caregiver will take 330.24 part in, including child care and supportive services, the 330.25 consequences to the caregiver for failing to participate or 330.26 comply with the specified requirements, and the right to appeal 330.27 any adverse action. The employment plan must, to the extent 330.28 possible, reflect the preferences of the caregiver. 330.29 Sec. 101. Minnesota Statutes 1997 Supplement, section 330.30 256J.54, subdivision 4, is amended to read: 330.31 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 330.32 counselor determines that there is no appropriate educational 330.33 option for a caregiver who is age 18 or 19 without a high school 330.34 diploma or its equivalent, the job counselor must develop an 330.35 employment plan, as defined in section 256J.49, subdivision 5, 330.36 for the caregiver. If the county social services agency 331.1 determines that school attendance is not appropriate for a 331.2 caregiver under age 18 without a high school diploma or its 331.3 equivalent, the county agency shall refer the caregiver to 331.4 social services for services as provided in section 257.33. 331.5 Sec. 102. Minnesota Statutes 1997 Supplement, section 331.6 256J.54, subdivision 5, is amended to read: 331.7 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 331.8 the provisions of section 256J.56, minor parents, or 18- or 331.9 19-year-old parents without a high school diploma or its 331.10 equivalent must attend school unless: 331.11 (1) transportation services needed to enable the caregiver 331.12 to attend school are not available; 331.13 (2) appropriate child care services needed to enable the 331.14 caregiver to attend school are not available; 331.15 (3) the caregiver is ill or incapacitated seriously enough 331.16 to prevent attendance at school; or 331.17 (4) the caregiver is needed in the home because of the 331.18 illness or incapacity of another member of the household. This 331.19 includes a caregiver of a child who is younger than six weeks of 331.20 age. 331.21 (b) The caregiver must be enrolled in a secondary school 331.22 and meeting the school's attendance requirements. The county, 331.23 social service agency, or job counselor must verify at least 331.24 once per quarter that the caregiver is meeting the school's 331.25 attendance requirements. An enrolled caregiver is considered to 331.26 be meeting the attendance requirements when the school is not in 331.27 regular session, including during holiday and summer breaks. 331.28 Sec. 103. Minnesota Statutes 1997 Supplement, section 331.29 256J.55, subdivision 5, is amended to read: 331.30 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 331.31 counselor approval, if a participant is already complying with a 331.32 job search support or employment plan that was developed for a 331.33 different program or is already involved in education or 331.34 training activities, the participant mayutilizecontinue that 331.35 planand that program's services, subject to the requirements of331.36subdivision 3,or activity to be in compliance with sections 332.1 256J.52 to 256J.57 so long as the plan meets, or is modified to 332.2 meet, the requirements of those sections. 332.3 Sec. 104. Minnesota Statutes 1997 Supplement, section 332.4 256J.56, is amended to read: 332.5 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 332.6 EXEMPTIONS.] 332.7 (a) An MFIP-S caregiver is exempt from the requirements of 332.8 sections 256J.52 to 256J.55 if the caregiver belongs to any of 332.9 the following groups: 332.10 (1) individuals who are age 60 or older; 332.11 (2) individuals who are suffering from a professionally 332.12 certified permanent or temporary illness, injury, or incapacity 332.13 which is expected to continue for more than 30 days and which 332.14 prevents the person from obtaining or retaining employment. 332.15 Persons in this category with a temporary illness, injury, or 332.16 incapacity must be reevaluated at least quarterly; 332.17 (3) caregivers whose presence in the home is required 332.18 because of the professionally certified illness or incapacity of 332.19 another member in the assistance unit, a relative in the 332.20 household, or a foster child in the household; 332.21 (4) women who are pregnant, if the pregnancy has resulted 332.22 in a professionally certified incapacity that prevents the woman 332.23 from obtaining or retaining employment; 332.24 (5) caregivers of a child under the age of one year who 332.25 personally provide full-time care for the child. This exemption 332.26 may be used for only 12 months in a lifetime. In two-parent 332.27 households, only one parent or other relative may qualify for 332.28 this exemption; 332.29 (6)individualssingle parents, or one parent in a 332.30 two-parent family, employed at least40 hours per week or at332.31least 30 hours per week and engaged in job search for at least332.32an additional ten35 hours per week; 332.33 (7) individuals experiencing a personal or family crisis 332.34 that makes them incapable of participating in the program, as 332.35 determined by the county agency. If the participant does not 332.36 agree with the county agency's determination, the participant 333.1 may seek professional certification, as defined in section 333.2 256J.08, that the participant is incapable of participating in 333.3 the program. 333.4 Persons in this exemption category must be reevaluated 333.5 every 60 days; or 333.6 (8) second parents in two-parent families, provided the333.7second parent isemployed for 20 or more hours per week, 333.8 provided the first parent is employed at least 35 hours per week. 333.9 A caregiver who is exempt under clause (5) must enroll in 333.10 and attend an early childhood and family education class, a 333.11 parenting class, or some similar activity, if available, during 333.12 the period of time the caregiver is exempt under this section. 333.13 Notwithstanding section 256J.46, failure to attend the required 333.14 activity shall not result in the imposition of a sanction. 333.15 (b) The county agency must provide employment and training 333.16 services to MFIP-S caregivers who are exempt under this section, 333.17 but who volunteer to participate. Exempt volunteers may request 333.18 approval for any work activity under section 256J.49, 333.19 subdivision 13. The hourly participation requirements for 333.20 nonexempt caregivers under section 256J.50, subdivision 5, do 333.21 not apply to exempt caregivers who volunteer to participate. 333.22 Sec. 105. Minnesota Statutes 1997 Supplement, section 333.23 256J.57, subdivision 1, is amended to read: 333.24 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 333.25 county agency shall not impose the sanction under section 333.26 256J.46 if it determines that the participant has good cause for 333.27 failing to comply with the requirements ofsection 256J.45 or333.28 sections 256J.52 to 256J.55. Good cause exists when: 333.29 (1) appropriate child care is not available; 333.30 (2) the job does not meet the definition of suitable 333.31 employment; 333.32 (3) the participant is ill or injured; 333.33 (4) afamilymember of the assistance unit, a relative in 333.34 the household, or a foster child in the household is ill and 333.35 needs care by the participant that prevents the participant from 333.36 complying with the job search support plan or employment plan; 334.1 (5) the parental caregiver is unable to secure necessary 334.2 transportation; 334.3 (6) the parental caregiver is in an emergency situation 334.4 that prevents compliance with the job search support plan or 334.5 employment plan; 334.6 (7) the schedule of compliance with the job search support 334.7 plan or employment plan conflicts with judicial proceedings; 334.8 (8) the parental caregiver is already participating in 334.9 acceptable work activities; 334.10 (9) the employment plan requires an educational program for 334.11 a caregiver under age 20, but the educational program is not 334.12 available; 334.13 (10) activities identified in the job search support plan 334.14 or employment plan are not available; 334.15 (11) the parental caregiver is willing to accept suitable 334.16 employment, but suitable employment is not available; or 334.17 (12) the parental caregiver documents other verifiable 334.18 impediments to compliance with the job search support plan or 334.19 employment plan beyond the parental caregiver's control. 334.20 Sec. 106. Minnesota Statutes 1997 Supplement, section 334.21 256J.74, subdivision 2, is amended to read: 334.22 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 334.23 agency must not count an applicant or participant as a member of 334.24 more than one assistance unit in a given payment month, except 334.25 as provided in clauses (1) and (2). 334.26 (1) A participant who is a member of an assistance unit in 334.27 this state is eligible to be included in a second assistance 334.28 unitinthe first full monththatafter the month the 334.29 participantleaves the first assistance unit and lives with334.30ajoins the secondassistanceunit. 334.31 (2) An applicant whose needs are met through foster care 334.32 that is reimbursed under title IV-E of the Social Security Act 334.33 for the first part of an application month is eligible to 334.34 receive assistance for the remaining part of the month in which 334.35 the applicant returns home. Title IV-E payments and adoption 334.36 assistance payments must be considered prorated payments rather 335.1 than a duplication of MFIP-S need. 335.2 Sec. 107. Minnesota Statutes 1997 Supplement, section 335.3 256J.74, is amended by adding a subdivision to read: 335.4 Subd. 5. [FOOD STAMPS.] For any month an individual 335.5 receives food stamp benefits, the individual is not eligible for 335.6 the MFIP-S food portion of assistance, except as provided under 335.7 section 256J.28, subdivision 5. 335.8 Sec. 108. [256J.77] [AGING OF CASH BENEFITS.] 335.9 Cash benefits under chapters 256D, 256J, and 256K by 335.10 warrants or electronic benefit transfer that have not been 335.11 accessed within 90 days of issuance, shall be canceled. Cash 335.12 benefits may be replaced after they are canceled, for up to one 335.13 year after the date of issuance, if failure to do so would place 335.14 the client or family at risk. For the purposes of this section, 335.15 "accessed" means cashing a warrant or making at least one 335.16 withdrawal from benefits deposited in an electronic benefit 335.17 account. 335.18 Sec. 109. [256J.80] [TRUANCY PREVENTION PROGRAM.] 335.19 Subdivision 1. [PILOT PROJECTS.] The commissioner of human 335.20 services, in consultation with the commissioner of the 335.21 department of children, families, and learning, shall develop a 335.22 truancy prevention pilot program to prevent tardiness and ensure 335.23 school attendance of children receiving assistance under this 335.24 chapter. The pilot program shall be developed in at least two 335.25 school districts, one rural and one urban. The pilots shall be 335.26 developed in collaboration with local school districts and 335.27 county social service agencies and shall serve families on 335.28 MFIP-S whose children are under the age of 13 and are subject to 335.29 the compulsory attendance requirements of section 120.101, and 335.30 are frequently tardy or are not attending school regularly, as 335.31 defined by the local school district. The program shall require 335.32 the local schools to refer such families to county social 335.33 service agencies for an assessment and development of a 335.34 corrective action plan to ensure punctual and regular school 335.35 attendance by the children in the family. The corrective action 335.36 plan must require that the children demonstrate satisfactory 336.1 attendance as defined by the local school district. Families 336.2 that fail to follow the corrective action plan shall be reported 336.3 to the county agency and shall be subject to sanction under 336.4 section 256J.46, subdivision 1, paragraphs (a) and (b). The 336.5 commissioner of human services may at its discretion expand the 336.6 program to other districts with the districts' agreement and 336.7 shall present a report to the legislature by November 30, 1999, 336.8 on the success of the implementation of the pilot projects 336.9 authorized by this section. 336.10 Subd. 2. [TRANSFER OF ATTENDANCE DATA.] Notwithstanding 336.11 the requirements of section 13.32, the commissioners of 336.12 children, families, and learning and human services shall 336.13 develop procedures to implement the transmittal of data on 336.14 student attendance to county social services agencies to 336.15 implement the program authorized by this section. 336.16 Sec. 110. Minnesota Statutes 1997 Supplement, section 336.17 256K.03, subdivision 5, is amended to read: 336.18 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 336.19 exempt from the job search requirements and development of a job 336.20 search plan and an employability development plan under 336.21 subdivisions 3, 4, and 8 if the applicant belongs to any of the 336.22 following groups: 336.23 (1)caregivers under age 20 who have not completed a high336.24school education and are attending high school on a full-time336.25basis;336.26(2)individuals who are age 60 or older; 336.27(3)(2) individuals who are suffering from a professionally 336.28 certified permanent or temporary illness, injury, or incapacity 336.29 which is expected to continue for more than 30 days and which 336.30 prevents the person from obtaining or retaining employment. 336.31 Persons in this category with a temporary illness, injury, or 336.32 incapacity must be reevaluated at least quarterly; 336.33(4)(3) caregivers whose presence in the home is needed 336.34 because of the professionally certified illness or incapacity of 336.35 another member in the assistance unit, a relative in the 336.36 household, or a foster child in the household; 337.1(5)(4) women who are pregnant, ifitthe pregnancy has 337.2been medically verifiedresulted in a professionally certified 337.3 incapacity thatthe child is expected to be born within the next337.4six monthsprevents the woman from obtaining and retaining 337.5 employment; 337.6(6)(5) caregiversor other caregiver relativesof a child 337.7 under the age ofthreeone year who personally provide full-time 337.8 care for the child. This exemption may be used for only 12 337.9 months in a lifetime. In two-parent households, only one parent 337.10 or other relative may qualify for this exemption; 337.11(7) individuals(6) single parents, or one parent in a 337.12 two-parent family, employed at least3035 hours per week; 337.13(8) individuals for whom participation would require a337.14round trip commuting time by available transportation of more337.15than two hours, excluding transporting of children for child337.16care;337.17(9) individuals for whom lack of proficiency in English is337.18a barrier to employment, provided such individuals are337.19participating in an intensive program which lasts no longer than337.20six months and is designed to remedy their language deficiency;337.21(10) individuals who, because of advanced age or lack of337.22ability, are incapable of gaining proficiency in English, as337.23determined by the county social worker, shall continue to be337.24exempt under this subdivision and are not subject to the337.25requirement that they be participating in a language program;337.26(11)(7) individualsunder such duress that they are337.27incapable of participating in the program, as determined by the337.28county social workerexperiencing a personal or family crisis 337.29 that makes them incapable of participating in the program, as 337.30 determined by the county agency. If the participant does not 337.31 agree with the county agency's determination, the participant 337.32 may seek professional certification, as defined in section 337.33 256J.08, that the participant is incapable of participating in 337.34 the program. Persons in this exemption category must be 337.35 reevaluated every 60 days; or 337.36(12) individuals in need of refresher courses for purposes338.1of obtaining professional certification or licensure.338.2(b) In a two-parent family, only one caregiver may be338.3exempted under paragraph (a), clauses (4) and (6).338.4 (8) second parents in two-parent families employed for 20 338.5 or more hours per week, provided the first parent is employed at 338.6 least 35 hours per week. 338.7 (b) A caregiver who is exempt under clause (5) must enroll 338.8 in and attend an early childhood and family education class, a 338.9 parenting class, or some similar activity, if available, during 338.10 the period of time the caregiver is exempt under this section. 338.11 Notwithstanding section 256J.46, failure to attend the required 338.12 activity shall not result in the imposition of a sanction. 338.13 Sec. 111. Minnesota Statutes 1996, section 268.88, is 338.14 amended to read: 338.15 268.88 [LOCAL SERVICE UNIT PLANS.] 338.16 (a) By April 15,19911999, and by April 15 of each second 338.17 year thereafter, local service units shall prepare and submit to 338.18 the commissioner a plan that covers the next two state fiscal 338.19 years. At least 30 days prior to submission of the plan, the 338.20 local service unit shall solicit comments from the public on the 338.21 contents of the proposed plan. The commissioner shall notify 338.22 each local service unit within 60 days of receipt of its plan 338.23 that the plan has been approved or disapproved. The plan must 338.24 include: 338.25 (1) a statement of objectives for the employment and 338.26 training services the local service unit administers; 338.27 (2) the establishment of job placement and job retention 338.28 goals, the establishment of public assistance caseload reduction 338.29 goals, and the strategies and programs that will be used to 338.30 achieve these goals; 338.31 (3) a statement of whether the goals from the preceding 338.32 year were met and an explanation if the local service unit 338.33 failed to meet the goals; 338.34 (4) the amount proposed to be allocated to each employment 338.35 and training service; 338.36 (5) the proposed types of employment and training services 339.1 the local service unit plans to utilize; 339.2 (6) a description of how the local service unit will use 339.3 funds provided undersection 256.736 to meet the requirements of339.4that section. The description must include the two work339.5programs required by section 256.736, subdivision 10, paragraph339.6(a), clause (13), what services will be provided, number of339.7clients served, per service expenditures, type of clients339.8served, and projected outcomeschapter 256J to meet the 339.9 requirements of that chapter. The description must include what 339.10 services will be provided, per service expenditures, how many 339.11 employment and training slots the local service unit will 339.12 provide, how slots will be allocated between providers, how many 339.13 dollars the local service unit will provide per slot per 339.14 provider, how many participants per slot, the ratio of 339.15 participants per job counselor, and an accounting of proposed 339.16 uses for any residual funds not included in slot allocations to 339.17 providers; 339.18 (7) a report on the use of wage subsidies, grant 339.19 diversions, community investment programs, and other services 339.20 administered under this chapter; 339.21 (8) a performance review of the employment and training 339.22 service providers delivering employment and training services 339.23 for the local service unit; 339.24 (9) a copy of any contract between the local service unit 339.25 and an employment and training service provider including 339.26 expected outcomes and service levels for public assistance 339.27 clients;and339.28 (10) a copy of any other agreements between educational 339.29 institutions, family support services, and child care providers; 339.30 and 339.31 (11) a description of how the local service unit ensures 339.32 compliance with section 256J.06, requiring community involvement 339.33 in the administration of MFIP-S. 339.34 (b) In counties with a city of the first class, the county 339.35 and the city shall develop and submit a joint plan. The plan 339.36 may not be submitted until agreed to by both the city and the 340.1 county. The plan must provide for the direct allocation of 340.2 employment and training money to the city and the county unless 340.3 waived by either. If the county and the city cannot concur on a 340.4 plan, the commissioner shall resolve their dispute. In counties 340.5 in which a federally recognized Indian tribe is operating an 340.6 employment and training program under an agreement with the 340.7 commissioner of human services, the plan must provide that the 340.8 county will coordinate its employment and training programs, 340.9 including developing a system for referrals, sanctions, and the 340.10 provision of supporting services such as access to child care 340.11 funds and transportation with programs operated by the Indian 340.12 tribe. The plan may not be given final approval by the 340.13 commissioner until the tribal unit and county have submitted 340.14 written agreement on these provisions in the plan. If the 340.15 county and Indian tribe cannot agree on these provisions, the 340.16 local service unit shall notify the commissioner of economic 340.17 security and the commissioners of economic security and human 340.18 services shall resolve the dispute. 340.19 (c) The commissioner may withhold the distribution of 340.20 employment and training money from a local service unit that 340.21 does not submit a plan to the commissioner by the date set by 340.22 this section, and shall withhold the distribution of employment 340.23 and training money from a local service unit whose plan has been 340.24 disapproved by the commissioner until an acceptable amended plan 340.25 has been submitted. 340.26 (d) Beginning April 15, 1992, and by April 15 of each 340.27 second year thereafter, local service units must prepare and 340.28 submit to the commissioner an interim year plan update that 340.29 deals with performance in that state fiscal year and changes 340.30 anticipated for the second year of the biennium. The update 340.31 must include information about employment and training programs 340.32 addressed in the local service unit's two-year plan and shall be 340.33 completed in accordance with criteria established by the 340.34 commissioner. 340.35 Sec. 112. [REPORT REQUIRED.] 340.36 Beginning January 1, 1999, the commissioner shall report 341.1 annually to the legislature on the percent, for each of the four 341.2 quarters of the immediate preceding year, of the MFIP-S caseload 341.3 participants who are exempt from work under the provisions of 341.4 Minnesota Statutes, section 256J.56, clause (2) or (3). 341.5 Sec. 113. [REPORT; NONCERTIFIED PROVIDERS.] 341.6 Beginning January 1, 1999, the commissioner of economic 341.7 security, in conjunction with the commissioner of human 341.8 services, shall report annually on the use in MFIP-S of 341.9 employment and training providers under Minnesota Statutes, 341.10 section 268.871. The report shall include information on the 341.11 number and types of noncertified providers and the performance 341.12 of noncertified providers compared to certified providers. 341.13 Sec. 114. [DEVELOPMENT OF REQUIRED ROUTINE INTERVIEW 341.14 TOOLS.] 341.15 The commissioner of human services shall develop a list of 341.16 no more than six questions to be used by county agencies and 341.17 their contractors under Minnesota Statutes, section 256J.44, 341.18 subdivision 3, to identify MFIP-S applicants and recipients who 341.19 have drug or alcohol dependencies or substance abuse problems. 341.20 Sec. 115. Laws 1997, chapter 248, section 46, as amended 341.21 by Laws 1997, First Special Session chapter 5, section 10, is 341.22 amended to read: 341.23 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 341.24 EXPANSION.] 341.25 (a) Notwithstanding Minnesota Statutes, section 245A.03, 341.26 subdivision 2, clause (2), until June 30, 1999, nonresidential 341.27 child care programs or services that are provided by an 341.28 unrelated individual to persons from two or three other 341.29 unrelated families are excluded from the licensure provisions of 341.30 Minnesota Statutes, chapter 245A, provided that: 341.31 (1) the individual provides services at any one time to no 341.32 more than four children who are unrelated to the individual; 341.33 (2) no more than two of the children are under two years of 341.34 age; and 341.35 (3) the total number of children being cared for at any one 341.36 time does not exceed five. 342.1 (b) Paragraph (a), clauses (1) to (3), do not apply to: 342.2 (1) nonresidential programs that are provided by an 342.3 unrelated individual to persons from a single related family; 342.4 (2) a child care provider whose child care services meet 342.5 the criteria in paragraph (a), clauses (1) to (3), but who 342.6 chooses to apply for licensure; 342.7 (3) a child care provider who, as an applicant for 342.8 licensure or as a licenseholder, has received a license denial 342.9 under Minnesota Statutes, section 245A.05, a fine under section 342.10 245A.06, or a sanction under section 245A.07 from the 342.11 commissioner that has not been reversed on appeal; or 342.12 (4) a child care provider, or a child care provider who has 342.13 a household member who, as a result of a licensing process, has 342.14 a disqualification under Minnesota Statutes, chapter 245A, that 342.15 has not been set aside by the commissioner. 342.16 Sec. 116. [COORDINATION OF MINNESOTA GROWN AND MINNESOTA 342.17 FOOD ASSISTANCE PROGRAM BENEFITS REQUIRED.] 342.18 The commissioner of agriculture must include with each set 342.19 of vouchers mailed under the Minnesota grown supplemental food 342.20 program established in Laws 1997, chapter 216, section 7, 342.21 subdivision 4, a notice to the recipient that acceptance of the 342.22 vouchers will reduce any benefits received through the Minnesota 342.23 food assistance program under Minnesota Statutes, section 342.24 256D.053, by an amount equal to the value of the vouchers 342.25 accepted by the recipient. The notice must also provide a 342.26 method for the recipient to decline the vouchers. The 342.27 commissioner must provide sufficient information each month on 342.28 any recipients who decline to accept Minnesota grown vouchers to 342.29 the commissioner of human services to enable the commissioner of 342.30 human services to comply with the requirements of Minnesota 342.31 Statutes, section 256D.053, subdivision 3, paragraph (b). 342.32 Sec. 117. [REPEALER.] 342.33 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 342.34 subdivision 4, is repealed effective January 1, 1998. 342.35 (b) Minnesota Statutes 1997 Supplement, section 256B.062, 342.36 is repealed effective July 1, 1998. 343.1 (c) Minnesota Statutes 1997 Supplement, section 256J.25, is 343.2 repealed. 343.3 (d) Minnesota Statutes 1996, sections 256.031, as amended 343.4 by Laws 1997, chapter 85, article 3, section 1; article 4, 343.5 section 11; 256.032; 256.033, as amended by Laws 1997, chapter 343.6 85, article 3, sections 2 and 3; 256.034; 256.035; 256.036; 343.7 256.0361; 256.047; 256.0475; 256.048; and 256.049; Minnesota 343.8 Statutes 1997 Supplement, sections 256J.32, subdivision 5; and 343.9 256J.34, subdivision 5, are repealed effective July 1, 1998. 343.10 (e) Minnesota Rules (exempt), parts 9500.9100 to 9500.9220, 343.11 are repealed effective July 1, 1998. 343.12 (f) Laws 1997, chapter 85, article 1, sections 61 and 71, 343.13 and article 3, section 55, are repealed. 343.14 Sec. 118. [EFFECTIVE DATE.] 343.15 (a) Section 48 (256J.24, subdivision 8) is effective 343.16 October 1, 1998. 343.17 (b) Sections 2, 3, and 115 (245A.03, subdivision 2b; 343.18 245A.03, subdivision 4; Laws 1997, chapter 248, section 46) are 343.19 effective the day following final enactment. 343.20 (c) Sections 5, 6, and 17 (256.01, subdivision 2; 256.014, 343.21 subdivision 1; 256J.03, subdivision 1) are effective the day 343.22 following final enactment. 343.23 (d) Section 12 (256D.05, subdivision 8) is effective the 343.24 day following final enactment. 343.25 (e) Section 49 (household standard) is effective for MFIP-S 343.26 applications received on or after January 1, 1999, and for all 343.27 MFIP-S recertifications occurring on or after January 1, 1999. 343.28 (f) Section 89 (256J.49, subdivision 4) is effective the 343.29 day following final enactment. 343.30 ARTICLE 7 343.31 TRIBAL CHILD CARE ASSISTANCE 343.32 Section 1. Minnesota Statutes 1997 Supplement, section 343.33 119B.02, is amended to read: 343.34 119B.02 [DUTIES OF COMMISSIONER.] 343.35 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 343.36 shall develop standards for county and human services boards to 344.1 provide child care services to enable eligible families to 344.3 participate in employment, training, or education programs. 344.4 Within the limits of available appropriations, the commissioner 344.5 shall distribute money to counties to reduce the costs of child 344.6 care for eligible families. The commissioner shall adopt rules 344.7 to govern the program in accordance with this section. The 344.8 rules must establish a sliding schedule of fees for parents 344.9 receiving child care services. The rules shall provide that 344.10 funds received as a lump sum payment of child support arrearages 344.11 shall not be counted as income to a family in the month received 344.12 but shall be prorated over the 12 months following receipt and 344.13 added to the family income during those months. In the rules 344.14 adopted under this section, county and human services boards 344.15 shall be authorized to establish policies for payment of child 344.16 care spaces for absent children, when the payment is required by 344.17 the child's regular provider. The rules shall not set a maximum 344.18 number of days for which absence payments can be made, but 344.19 instead shall direct the county agency to set limits and pay for 344.20 absences according to the prevailing market practice in the 344.21 county. County policies for payment of absences shall be 344.22 subject to the approval of the commissioner. The commissioner 344.23 shall maximize the use of federal money in section 256.736 and 344.24 other programs that provide federal or state reimbursement for 344.25 child care services for low-income families who are in 344.26 education, training, job search, or other activities allowed 344.27 under those programs. Money appropriated under this section 344.28 must be coordinated with the programs that provide federal 344.29 reimbursement for child care services to accomplish this 344.30 purpose. Federal reimbursement obtained must be allocated to 344.31 the county that spent money for child care that is federally 344.32 reimbursable under programs that provide federal reimbursement 344.33 for child care services. The counties shall use the federal 344.34 money to expand child care services. The commissioner may adopt 344.35 rules under chapter 14 to implement and coordinate federal 344.36 program requirements. 344.37 Subd. 2. [CONTRACTUAL AGREEMENTS WITH TRIBES.] The 345.1 commissioner may enter into contractual agreements with a 345.2 federally recognized Indian tribe with a reservation in 345.3 Minnesota to carry out the responsibilities of county human 345.4 service agencies to the extent necessary for the tribe to 345.5 operate child care assistance programs under the supervision of 345.6 the commissioner. Funding to support services under sections 345.7 119B.03 and 119B.05 may be transferred to the federally 345.8 recognized Indian tribe with a reservation in Minnesota from 345.9 allocations available to counties in which reservation 345.10 boundaries lie. When funding is transferred under section 345.11 119B.03, the amount shall be commensurate to estimates of the 345.12 proportion of reservation residents with characteristics 345.13 identified in section 119B.03, subdivision 6, to the total 345.14 population of county residents with those same characteristics. 345.15 Sec. 2. [EFFECTIVE DATE.] 345.16 Section 1 (119B.02, subdivision 1) is effective the day 345.17 following final enactment. 345.18 ARTICLE 8 345.19 MISCELLANEOUS 345.20 Section 1. Minnesota Statutes 1996, section 62A.65, 345.21 subdivision 5, is amended to read: 345.22 Subd. 5. [PORTABILITY OF COVERAGE.] (a) No individual 345.23 health plan may be offered, sold, issued, or with respect to 345.24 children age 18 or under renewed, to a Minnesota resident that 345.25 contains a preexisting condition limitation, preexisting 345.26 condition exclusion, or exclusionary rider, unless the 345.27 limitation or exclusion is permitted under this subdivision, 345.28 provided that, except for children age 18 or under, underwriting 345.29 restrictions may be retained on individual contracts that are 345.30 issued without evidence of insurability as a replacement for 345.31 prior individual coverage that was sold before May 17, 1993. 345.32 The individual may be subjected to an 18-month preexisting 345.33 condition limitation, unless the individual has maintained 345.34 continuous coverage as defined in section 62L.02. The 345.35 individual must not be subjected to an exclusionary rider. An 345.36 individual who has maintained continuous coverage may be 346.1 subjected to a one-time preexisting condition limitation of up 346.2 to 12 months, with credit for time covered under qualifying 346.3 coverage as defined in section 62L.02, at the time that the 346.4 individual first is covered under an individual health plan by 346.5 any health carrier. Credit must be given for all qualifying 346.6 coverage with respect to all preexisting conditions, regardless 346.7 of whether the conditions were preexisting with respect to any 346.8 previous qualifying coverage. The individual must not be 346.9 subjected to an exclusionary rider. Thereafter, the individual 346.10 must not be subject to any preexisting condition limitation, 346.11 preexisting condition exclusion, or exclusionary rider under an 346.12 individual health plan by any health carrier, except an 346.13 unexpired portion of a limitation under prior coverage, so long 346.14 as the individual maintains continuous coverage as defined in 346.15 section 62L.02. 346.16 (b) A health carrier must offer an individual health plan 346.17 to any individual previously covered under a group health plan 346.18 issued by that health carrier, regardless of the size of the 346.19 group, so long as the individual maintained continuous coverage 346.20 as defined in section 62L.02. If the individual has available 346.21 any continuation coverage provided under sections 62A.146; 346.22 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 346.23 62D.101; or 62D.105, or continuation coverage provided under 346.24 federal law, the health carrier need not offer coverage under 346.25 this paragraph until the individual has exhausted the 346.26 continuation coverage. The offer must not be subject to 346.27 underwriting, except as permitted under this paragraph. A 346.28 health plan issued under this paragraph must be a qualified plan 346.29 as defined in section 62E.02 and must not contain any 346.30 preexisting condition limitation, preexisting condition 346.31 exclusion, or exclusionary rider, except for any unexpired 346.32 limitation or exclusion under the previous coverage. The 346.33 individual health plan must cover pregnancy on the same basis as 346.34 any other covered illness under the individual health plan. The 346.35 initial premium rate for the individual health plan must comply 346.36 with subdivision 3. The premium rate upon renewal must comply 347.1 with subdivision 2. In no event shall the premium rate exceed 347.2 90 percent of the premium charged for comparable individual 347.3 coverage by the Minnesota comprehensive health association, and 347.4 the premium rate must be less than that amount if necessary to 347.5 otherwise comply with this section. An individual health plan 347.6 offered under this paragraph to a person satisfies the health 347.7 carrier's obligation to offer conversion coverage under section 347.8 62E.16, with respect to that person. Coverage issued under this 347.9 paragraph must provide that it cannot be canceled or nonrenewed 347.10 as a result of the health carrier's subsequent decision to leave 347.11 the individual, small employer, or other group market. Section 347.12 72A.20, subdivision 28, applies to this paragraph. 347.13 Sec. 2. Minnesota Statutes 1996, section 62D.042, 347.14 subdivision 2, is amended to read: 347.15 Subd. 2. [BEGINNING ORGANIZATIONSNET WORTH REQUIREMENTS.] 347.16 (a) Beginning organizations shall maintain net worth of at least 347.17 8-1/3 percent of the sum of all expenses expected to be incurred 347.18 in the 12 months following the date the certificate of authority 347.19 is granted, or $1,500,000, whichever is greater. 347.20 (b) After the first full calendar year of operation, 347.21 organizations shall maintain net worth of at least 8-1/3 percent 347.22 and at most16-2/325 percent of the sum of all expenses 347.23 incurred during the most recent calendar year, but in no case 347.24 shall net worth fall below $1,000,000. 347.25 (c) Notwithstanding paragraphs (a) and (b), any health 347.26 maintenance organization owned by a political subdivision of 347.27 this state, which has a higher than average percentage of 347.28 enrollees who are enrolled in medical assistance or general 347.29 assistance medical care, may exceed the maximum net worth limits 347.30 provided in paragraphs (a) and (b), with the advance approval of 347.31 the commissioner. 347.32 Sec. 3. Minnesota Statutes 1996, section 62E.16, is 347.33 amended to read: 347.34 62E.16 [POLICY CONVERSION RIGHTS.] 347.35 Every program of self-insurance, policy of group accident 347.36 and health insurance or contract of coverage by a health 348.1 maintenance organization written or renewed in this state, shall 348.2 include, in addition to the provisions required by section 348.3 62A.17, the right to convert to an individual coverage qualified 348.4 plan without the addition of underwriting restrictionsifafter 348.5 the individual insured has exhausted any continuation coverage 348.6 provided under section 62A.146; 62A.148; 62A.17, subdivisions 1 348.7 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or 348.8 continuation coverage provided under federal law, if any 348.9 continuation coverage is available to the individual, and then 348.10 leaves the group regardless of the reason for leaving the group 348.11 or if an employer member of a group ceases to remit payment so 348.12 as to terminate coverage for its employees, or upon cancellation 348.13 or termination of the coverage for the group except where 348.14 uninterrupted and continuous group coverage is otherwise 348.15 provided to the group. If the health maintenance organization 348.16 has canceled coverage for the group because of a loss of 348.17 providers in a service area, the health maintenance organization 348.18 shall arrange for other health maintenance or indemnity 348.19 conversion options that shall be offered to enrollees without 348.20 the addition of underwriting restrictions. The required 348.21 conversion contract must treat pregnancy the same as any other 348.22 covered illness under the conversion contract. The person may 348.23 exercise this right to conversion within 30 days of exhausting 348.24 any continuation coverage provided under section 62A.146; 348.25 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; or 62A.21, or 348.26 continuation coverage provided under federal law, and then 348.27 leaving the group or within 30 days following receipt of due 348.28 notice of cancellation or termination of coverage of the group 348.29 or of the employer member of the group and upon payment of 348.30 premiums from the date of termination or cancellation. Due 348.31 notice of cancellation or termination of coverage for a group or 348.32 of the employer member of the group shall be provided to each 348.33 employee having coverage in the group by the insurer, 348.34 self-insurer or health maintenance organization canceling or 348.35 terminating the coverage except where reasonable evidence 348.36 indicates that uninterrupted and continuous group coverage is 349.1 otherwise provided to the group. Every employer having a policy 349.2 of group accident and health insurance, group subscriber or 349.3 contract of coverage by a health maintenance organization shall, 349.4 upon request, provide the insurer or health maintenance 349.5 organization a list of the names and addresses of covered 349.6 employees. Plans of health coverage shall also include a 349.7 provision which, upon the death of the individual in whose name 349.8 the contract was issued, permits every other individual then 349.9 covered under the contract to elect, within the period specified 349.10 in the contract, to continue coverage under the same or a 349.11 different contract without the addition of underwriting 349.12 restrictions until the individual would have ceased to have been 349.13 entitled to coverage had the individual in whose name the 349.14 contract was issued lived. An individual conversion contract 349.15 issued by a health maintenance organization shall not be deemed 349.16 to be an individual enrollment contract for the purposes of 349.17 section 62D.10. An individual health plan offered under section 349.18 62A.65, subdivision 5, paragraph (b), to a person satisfies the 349.19 health carrier's obligation to offer conversion coverage under 349.20 this section with respect to that person. 349.21 Sec. 4. [62Q.091] [ANY WILLING PROVIDER.] 349.22 Subdivision 1. [DENIAL OF COVERAGE PROHIBITED.] No health 349.23 plan company shall deny or limit coverage under a health plan 349.24 for any health care service provided by a health care provider 349.25 on the basis that the health care provider is not in the health 349.26 plan company's network, if the health care provider: 349.27 (1) satisfies the health plan company's reasonable 349.28 credentialing standards; 349.29 (2) is willing to accept the relevant terms of the 349.30 contract, including the schedule of fees, that the health plan 349.31 company enters into with in-network providers; and 349.32 (3) agrees to follow the health plan company's utilization 349.33 regulations. 349.34 Subd. 2. [MEASURES TO MAINTAIN QUALITY AND CONTROL 349.35 COST.] (a) This section does not prevent a health plan company 349.36 from implementing and maintaining measures that promote quality 350.1 and control costs, including the requirement of coordination of 350.2 care by a primary care provider, so long as the measures apply 350.3 equally to all health care providers of the same type and do not 350.4 discriminate against out-of-network providers who satisfy 350.5 subdivision 1. 350.6 (b) This section shall not be interpreted as requiring 350.7 coverage of any specific health care service. 350.8 Subd. 3. [DEFINITIONS.] (a) For purposes of this section, 350.9 the terms defined in this subdivision have the meanings given. 350.10 (b) "Health care provider" means an independently enrolled 350.11 audiologist, chemical dependency treatment facility, 350.12 chiropractor, community clinic, community mental health center, 350.13 dentist, dietitian, home health care provider, hospital, 350.14 licensed marriage and family therapist, nurse practitioner or 350.15 advanced practice nurse, nursing facility, occupational 350.16 therapist, optometrist, optician, outpatient chemical dependency 350.17 counselor, outpatient surgical center, pharmacist, osteopath, 350.18 physical therapist, physician, podiatrist, licensed 350.19 psychologist, psychological practitioner, licensed social 350.20 worker, rural health clinic, or speech therapist. For purposes 350.21 of this paragraph, "independently enrolled" means that the 350.22 health care provider has authority under state law to bill, and 350.23 receive payment directly from, a patient or health plan company. 350.24 (c) "Health care services" means goods and services 350.25 provided by a health care provider within the scope of the 350.26 health care provider's license. 350.27 (d) "Health plan" has the meaning given in section 62Q.01, 350.28 subdivision 3, but includes the coverages that are excluded 350.29 under section 62A.011, subdivision 3, clauses (6), (7), (8), 350.30 (10), and (12). 350.31 Subd. 4. [APPLICABILITY.] Section 62Q.095 does not apply 350.32 to a health plan as of the date that this section applies to it. 350.33 Subd. 5. [PROHIBITION.] No health plan company shall 350.34 offer, sell, issue, or renew a health plan that does not comply 350.35 with this section. 350.36 Sec. 5. [62Q.096] [CREDENTIALING OF PROVIDERS.] 351.1 If a health plan company has initially credentialed, as 351.2 providers in its provider network, individual providers employed 351.3 by or under contract with an entity that: (1) is authorized to 351.4 bill under section 256B.0625, subdivision 5; (2) meets the 351.5 requirements of Minnesota Rules, parts 9520.0750 to 9520.0870; 351.6 (3) is designated an essential community provider under section 351.7 62Q.19; and (4) is under contract with the health plan company 351.8 to provide mental health services, the health plan company must 351.9 continue to credential at least the same number of providers 351.10 from that entity, as long as those providers meet the health 351.11 plan company's credentialing standards. A health plan company 351.12 shall not refuse to credential these providers on the grounds 351.13 that their provider network has a sufficient number of providers 351.14 of that type. 351.15 Sec. 6. Minnesota Statutes 1997 Supplement, section 351.16 171.29, subdivision 2, is amended to read: 351.17 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 351.18 license has been revoked as provided in subdivision 1, except 351.19 under section 169.121 or 169.123, shall pay a $30 fee before the 351.20 driver's license is reinstated. 351.21 (b) A person whose driver's license has been revoked as 351.22 provided in subdivision 1 under section 169.121 or 169.123 shall 351.23 pay a $250 fee plus a $10 surcharge before the driver's license 351.24 is reinstated. The $250 fee is to be credited as follows: 351.25 (1) Twenty percent shall be credited to the trunk highway 351.26 fund. 351.27 (2) Fifty-five percent shall be credited to the general 351.28 fund. 351.29 (3) Eight percent shall be credited to a separate account 351.30 to be known as the bureau of criminal apprehension account. 351.31 Money in this account may be appropriated to the commissioner of 351.32 public safety and the appropriated amount shall be apportioned 351.33 80 percent for laboratory costs and 20 percent for carrying out 351.34 the provisions of section 299C.065. 351.35 (4) Twelve percent shall be credited to a separate account 351.36 to be known as the alcohol-impaired driver education account. 352.1 Money in the account is appropriated as follows: 352.2 (i) The first $200,000 in a fiscal year is to the 352.3 commissioner of children, families, and learning for programs in 352.4 elementary and secondary schools. 352.5 (ii) The remainder credited in a fiscal year is 352.6 appropriated to the commissioner of transportation to be spent 352.7 as grants to the Minnesota highway safety center at St. Cloud 352.8 State University for programs relating to alcohol and highway 352.9 safety education in elementary and secondary schools. 352.10 (5) Five percent shall be credited to a separate account to 352.11 be known as the traumatic brain injury and spinal cord injury 352.12 account.$100,000 is annually appropriated from the account to352.13the commissioner of human services for traumatic brain injury352.14case management services.Theremainingmoney in the account is 352.15 annually appropriated to the commissioner of health to be used 352.16 as follows: 35 percent for a contract with a qualified 352.17 community-based organization to provide information, resources, 352.18 and support to assist persons with traumatic brain injury and 352.19 their families to access services, and 65 percent toestablish352.20andmaintain the traumatic brain injury and spinal cord injury 352.21 registry created in section 144.662 and to reimburse the 352.22 commissioner of economic security for the reasonable cost of 352.23 services provided under section 268A.03, clause (o). For the 352.24 purposes of this clause, a "qualified community-based 352.25 organization" is a private, not-for-profit organization of 352.26 consumers of traumatic brain injury services and their family 352.27 members. The organization must be registered with the United 352.28 States Internal Revenue Service under the provisions of section 352.29 501(c)(3) as a tax exempt organization and must have as its 352.30 purposes: 352.31 (i) the promotion of public, family, survivor, and 352.32 professional awareness of the incidence and consequences of 352.33 traumatic brain injury; 352.34 (ii) the provision of a network of support for persons with 352.35 traumatic brain injury, their families, and friends; 352.36 (iii) the development and support of programs and services 353.1 to prevent traumatic brain injury; 353.2 (iv) the establishment of education programs for persons 353.3 with traumatic brain injury; and 353.4 (v) the empowerment of persons with traumatic brain injury 353.5 through participation in its governance. 353.6 No patient's name, identifying information or identifiable 353.7 medical data will be disclosed to the organization without the 353.8 informed voluntary written consent of the patient or patient's 353.9 guardian, or if the patient is a minor, of the parent or 353.10 guardian of the patient. 353.11 (c) The $10 surcharge shall be credited to a separate 353.12 account to be known as the remote electronic alcohol monitoring 353.13 pilot program account. The commissioner shall transfer the 353.14 balance of this account to the commissioner of finance on a 353.15 monthly basis for deposit in the general fund. 353.16 Sec. 7. Minnesota Statutes 1997 Supplement, section 353.17 256F.05, subdivision 8, is amended to read: 353.18 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 353.19 county which has not demonstrated that year that its family 353.20 preservation core services are developed as provided in 353.21 subdivision 1a, must use its family preservation fund grant 353.22 exclusively for family preservation services defined in section 353.23 256F.03, subdivision 5, paragraphs (a), (b), (c), and (e). 353.24 (b) A county which has demonstrated that year that its 353.25 family preservation core services are developed becomes eligible 353.26 either to continue using its family preservation fund grant as 353.27 provided in paragraph (a), or to exercise the expanded service 353.28 option under paragraph (c). 353.29 (c) The expanded service option permits an eligible county 353.30 to use its family preservation fund grant for child welfare 353.31 preventive services. For purposes of this section, child 353.32 welfare preventive services are those services directed toward a 353.33 specific child or family that further the goals of section 353.34 256F.01 and include assessments, family preservation services, 353.35 service coordination, community-based treatment, crisis nursery 353.36 services when the parents retain custody and there is no 354.1 voluntary placement agreement with a child-placing agency, 354.2 respite care except when it is provided under a medical 354.3 assistance waiver, home-based services, and other related 354.4 services. For purposes of this section, child welfare 354.5 preventive services shall not include shelter care or other 354.6 placement services under the authority of the court or public 354.7 agency to address an emergency. To exercise this option, an 354.8 eligible county must notify the commissioner in writing of its 354.9 intention to do so no later than 30 days into the quarter during 354.10 which it intends to begin or in its county plan, as provided in 354.11 section 256F.04, subdivision 2. Effective with the first day of 354.12 that quarter, the county must maintain its base level of 354.13 expenditures for child welfare preventive services and use the 354.14 family preservation fund to expand them. The base level of 354.15 expenditures for a county shall be that established under 354.16 section 256F.10, subdivision 7. For counties which have no such 354.17 base established, a comparable base shall be established with 354.18 the base year being the calendar year ending at least two 354.19 calendar quarters before the first calendar quarter in which the 354.20 county exercises its expanded service option. The commissioner 354.21 shall, at the request of the counties, reduce, suspend, or 354.22 eliminate either or both of a county's obligations to continue 354.23 the base level of expenditures and to expand child welfare 354.24 preventive services under extraordinary circumstances. 354.25 (d) Notwithstanding paragraph (a), a county that is 354.26 participating in the child protection assessments or 354.27 investigations community collaboration pilot program under 354.28 section 626.5560, or in the concurrent permanency planning pilot 354.29 program under section 257.0711, may use its family preservation 354.30 fund grant for those programs. 354.31 Sec. 8. Laws 1997, chapter 207, section 7, is amended to 354.32 read: 354.33 Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 354.34 COUNTY.] 354.35 (a) Notwithstanding Minnesota Statutes, sections 92.45 and 354.36 282.018, subdivision 1, and the public sale provisions of 355.1 Minnesota Statutes, chapter 282, Carlton county may sell by 355.2 private sale the tax-forfeited land described in paragraph (d) 355.3 under the remaining provisions of Minnesota Statutes, chapter 355.4 282. 355.5 (b) The land described in paragraph (d) may be sold by 355.6 private sale. The considerationfor the conveyance must include355.7the taxes due on the property and any penalties, interest, and355.8costsshall be the appraised value of the land. If the lands 355.9 are sold, the conveyance must reserve to the state a 355.10 conservation easement, in a form prescribed by the commissioner 355.11 of natural resources, for the land within 100 feet of the 355.12 ordinary high water level of Slaughterhouse creek for public 355.13 angler access and stream habitat protection and enhancement. 355.14 (c) The conveyance must be in a form approved by the 355.15 attorney general. 355.16 (d) The land to be conveyed is located in Carlton county 355.17 and is described as: 355.18 North 6.66 acres of the West Half of the Northeast Quarter 355.19 of the Southwest Quarter, subject to pipeline easement, Section 355.20 6, Township 48 North, Range 16 West, City of Carlton. 355.21 (e) Carlton county has determined that this sale best 355.22 serves the land management interests of Carlton county. 355.23 Sec. 9. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 355.24 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 355.25 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 355.26 subdivision 3, or any other law to the contrary, the 355.27 commissioner of administration may convey all, or any part of, 355.28 the land and associated buildings described in subdivision 3 to 355.29 Anoka county after the commissioner of human services declares 355.30 said property surplus to its needs. 355.31 Subd. 2. [FORM.] (a) The conveyance shall be in a form 355.32 approved by the attorney general. 355.33 (b) The conveyance is subject to a scenic easement, as 355.34 defined in Minnesota Statutes, section 103F.311, subdivision 6, 355.35 to be under the custodial control of the commissioner of natural 355.36 resources, on that portion of the conveyed land that is 356.1 designated for inclusion in the wild and scenic river system 356.2 under Minnesota Statutes, section 103F.325. The scenic easement 356.3 shall allow for continued use of the structures located within 356.4 the easement and for development of a walking path within the 356.5 easement. 356.6 (c) The conveyance shall restrict use of the land to 356.7 governmental, including recreational, purposes and shall provide 356.8 that ownership of any portion of the land that ceases to be used 356.9 for such purposes shall revert to the state of Minnesota. 356.10 (d) The commissioner of administration may convey any part 356.11 of the property described in subdivision 3 any time after the 356.12 land is declared surplus by the commissioner of human services 356.13 and the execution and recording of the scenic easement under 356.14 paragraph (b) has been completed. 356.15 (e) Notwithstanding any law, regulation, or ordinance to 356.16 the contrary, the instrument of conveyance to Anoka county may 356.17 be recorded in the office of the Anoka county recorder without 356.18 compliance with any subdivision requirement. 356.19 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 356.20 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 356.21 State Trunk Highway No. 288, also known as 4th Avenue, the land 356.22 to be conveyed may include all, or part of, that which is 356.23 described as follows: 356.24 (1) all that part of Government Lots 3 and 4 and that part 356.25 of the Southeast Quarter of the Southwest Quarter, all in 356.26 Section 31, Township 32 North, Range 24 West, Anoka county, 356.27 Minnesota, described as follows: 356.28 Beginning at the southwest corner of said Southeast Quarter 356.29 of the Southwest Quarter of Section 31; thence North 13 356.30 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 356.31 feet; thence North 07 degrees 54 minutes 43 seconds East 356.32 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 356.33 West 154.77 feet; thence North 62 degrees 46 minutes 44 356.34 seconds West 526.92 feet; thence North 25 degrees 45 356.35 minutes 30 seconds East 74.43 feet; thence northerly 88.30 356.36 feet along a tangential curve concave to the west having a 357.1 radius of 186.15 feet and a central angle of 27 degrees 10 357.2 minutes 50 seconds; thence North 01 degrees 25 minutes 20 357.3 seconds West, tangent to said curve, 140.53 feet; thence 357.4 North 71 degrees 56 minutes 34 seconds West to the 357.5 southeasterly shoreline of the Rum river; thence 357.6 southwesterly along said shoreline to the south line of 357.7 said Government Lot 4; thence easterly along said south 357.8 line to the point of beginning. For the purpose of this 357.9 description the south line of said Southeast Quarter of the 357.10 Southwest Quarter of Section 31 has an assumed bearing of 357.11 North 89 degrees 08 minutes 19 seconds East; 357.12 (2) Government Lot 1, Section 6, Township 31 North, Range 357.13 24 West, Anoka county, Minnesota; EXCEPT that part platted as 357.14 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 357.15 lying southerly of the westerly extension of the south line of 357.16 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 357.17 Minnesota, and lying westerly of the west line of said plat of 357.18 Grant Properties, said line also being the centerline of 4th 357.19 Avenue; 357.20 (3) all that part of said Block 6, Woodbury's Addition to 357.21 the city of Anoka lying westerly of Northview 1st Addition, 357.22 Anoka county, Minnesota; 357.23 (4) all that part of said Northview 1st Addition lying 357.24 westerly of the east line of Lots 11 through 20, Block 1, 357.25 inclusive, thereof; and 357.26 (5) all that part of the Northeast Quarter of the Northwest 357.27 Quarter of said Section 6, Township 31 North, Range 24 West, 357.28 Anoka county, Minnesota, lying northerly of the centerline of 357.29 Grant Street as defined by said plat of Grant Properties and 357.30 lying westerly of said east line of Lots 11 through 20, Block 1, 357.31 inclusive, Northview 1st Addition and said line's extension 357.32 north and south. 357.33 Subd. 4. [DETERMINATION.] The commissioner of human 357.34 services has determined that the land described in subdivision 3 357.35 will no longer be needed for the Anoka metro regional treatment 357.36 center upon the completion of the state facilities currently 358.1 under construction, and the completion of renovation work to 358.2 state buildings that are not located on the land described in 358.3 subdivision 3. The state's land and building management 358.4 interests may best be served by conveying all, or part of, the 358.5 land and associated buildings located on the land described in 358.6 subdivision 3. 358.7 Sec. 10. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 358.8 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 358.9 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 358.10 subdivision 3, or any other law to the contrary, the 358.11 commissioner of administration may convey, all or any part of, 358.12 the land, and the state building located on said land, described 358.13 in subdivision 3 to Crow Wing county after the commissioner of 358.14 human services declares said property surplus to its needs. 358.15 Subd. 2. [FORM.] (a) The conveyance shall be in a form 358.16 approved by the attorney general. 358.17 (b) The conveyance shall restrict use of the land to county 358.18 governmental purposes, including community corrections programs, 358.19 and shall provide that ownership of any portion of the land or 358.20 building that ceases to be used for such purposes shall revert 358.21 to the state of Minnesota. 358.22 Subd. 3. [LAND DESCRIPTION.] The land to be conveyed is 358.23 that part of the Northeast Quarter of Section 30, Township 45 358.24 North, Range 30 West, Crow Wing county, Minnesota, described as 358.25 follows: 358.26 Commencing at the southeast corner of said Northeast 358.27 Quarter; thence North 00 degrees 46 minutes 05 seconds 358.28 West, bearing based on the Crow Wing county coordinate 358.29 database NAD 83/94, 1520.06 feet along the east line of 358.30 said Northeast Quarter to the point of beginning; thence 358.31 continue North 00 degrees 46 minutes 05 seconds West 634.14 358.32 feet along said east line of the Northeast Quarter; thence 358.33 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 358.34 thence South 18 degrees 57 minutes 23 seconds East 115.59 358.35 feet; thence South 42 degrees 44 minutes 39 seconds East 358.36 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 359.1 East 20.24 feet; thence North 89 degrees 13 minutes 55 359.2 seconds East 33.00 feet to the point of beginning. 359.3 Containing 4.69 acres, more or less. Subject to the 359.4 right-of-way of the township road along the east side 359.5 thereof, subject to other easements, reservations, and 359.6 restrictions of record, if any. 359.7 Subd. 4. [DETERMINATION.] The commissioner of human 359.8 services has determined that the land described in subdivision 3 359.9 and the building on the land will not be needed for future 359.10 operations of the Brainerd regional human services center. The 359.11 state's land management interests would best be served by 359.12 conveying the land to Crow Wing county for governmental use. 359.13 Sec. 11. [TOWN OF WHITE, ST. LOUIS COUNTY.] 359.14 Subdivision 1. [TRANSFER.] Notwithstanding any provision 359.15 of Minnesota Statutes to the contrary, the town of White is 359.16 hereby authorized to transfer the following property and any 359.17 buildings, equipment, and other improvements located thereon to 359.18 the White community hospital corporation, a nonprofit 359.19 corporation organized and existing under Minnesota Statutes, 359.20 chapter 317: 359.21 That part of the southeast quarter of southwest quarter (SE 359.22 1/4 of SW 1/4), section 10, township 58 north of range 15 west 359.23 of the fourth principal meridian, according to the United States 359.24 government survey thereof, St. Louis county, Minnesota, 359.25 described as follows: 359.26 Commencing at the southeast corner of said SE 1/4 of SW 359.27 1/4, section 10, township 58, range 15, thence proceeding north 359.28 along the east line thereof for a distance of 550 feet; thence 359.29 west and parallel to the south line thereof for a distance of 359.30 800 feet; thence south and parallel to the east line thereof, 359.31 for a distance of 550 feet to the south line; thence east along 359.32 said south line thereof, for a distance of 800 feet to the point 359.33 of beginning. 359.34 Subd. 2. [NO CONSIDERATION OR ELECTION REQUIRED.] The 359.35 transfer authorized by subdivision 1 shall be without 359.36 consideration and no vote of the electors of the town of White 360.1 or city of Aurora shall be required. 360.2 Subd. 3. [USE; PUBLIC PROPERTY.] The property legally 360.3 described in subdivision 1 shall be used for health care and 360.4 related purposes and shall be considered public property for 360.5 purposes of Minnesota Statutes, section 16A.695. The activities 360.6 conducted on the property described in subdivision 1 by the 360.7 White community hospital corporation, its successors and assigns 360.8 shall be considered a governmental program as authorized by 360.9 Minnesota Statutes, chapter 447. 360.10 Subd. 4. [NAME.] The public name of the buildings and 360.11 improvements located on the real property legally described in 360.12 subdivision 1 shall always include the words "White community." 360.13 Sec. 12. [LOAN GUARANTEE.] 360.14 The director of the division of emergency management of the 360.15 department of public safety shall, as the governor's authorized 360.16 representative and on behalf of the state, agree to provide 360.17 security for and guarantee a promissory note or similar document 360.18 for a loan from the Federal Emergency Management Agency under 360.19 its community disaster loan program to the city of Ada in the 360.20 amount of approximately $1,200,000. The loan is to cover 360.21 operating losses for a publicly owned health care facility that 360.22 was damaged in the spring floods of 1997. 360.23 Sec. 13. [LICENSING MORATORIUM; JUVENILE FACILITIES.] 360.24 Subdivision 1. [MORATORIUM; COMMISSIONER OF 360.25 CORRECTIONS.] Except as provided in subdivision 4, the 360.26 commissioner of corrections may not: 360.27 (1) issue any license under Minnesota Statutes, section 360.28 241.021, to operate a new correctional facility for the 360.29 detention or confinement of juvenile offenders that will include 360.30 more than 25 beds for juveniles; or 360.31 (2) renew a license under Minnesota Statutes, section 360.32 241.021, to operate a correctional facility licensed before the 360.33 effective date of this moratorium, for the detention or 360.34 confinement of juvenile offenders, if the number of beds in the 360.35 facility will increase by more than 25 beds since the time the 360.36 most recent license was issued. 361.1 Subd. 2. [MORATORIUM; COMMISSIONER OF HUMAN 361.2 SERVICES.] Except as provided in subdivision 4, the commissioner 361.3 of human services may not: 361.4 (1) issue any license under Minnesota Rules, parts 361.5 9545.0905 to 9545.1125, for the residential placement of 361.6 juveniles at a facility that will include more than 25 beds for 361.7 juveniles; or 361.8 (2) renew a license under Minnesota Rules, parts 9545.0905 361.9 to 9545.1125, for the residential placement of juveniles at a 361.10 facility licensed before the effective date of this moratorium, 361.11 if the number of beds in the facility will increase by more than 361.12 25 beds since the time the most recent license was issued. 361.13 Subd. 3. [MORATORIUM; OTHER BEDS.] Except as provided in 361.14 subdivision 4, no state agency may: 361.15 (1) issue a license for any new facility that will provide 361.16 an out-of-home placement for more than 25 juveniles at one time; 361.17 or 361.18 (2) renew a license for any existing facility licensed 361.19 before the effective date of this moratorium, if the number of 361.20 beds in the facility will increase by more than 25 beds since 361.21 the time the most recent license was issued. 361.22 For the purposes of this subdivision, "juvenile" means a 361.23 delinquent child, as defined in Minnesota Statutes, section 361.24 260.015, subdivision 5; a juvenile petty offender, as defined in 361.25 Minnesota Statutes, section 260.015, subdivision 21; or a child 361.26 in need of protection or services, as defined in Minnesota 361.27 Statutes, section 260.015, subdivision 2a. 361.28 Subd. 4. [EXEMPTIONS.] The moratorium in this section does 361.29 not apply to: 361.30 (1) any secure juvenile detention and treatment facility, 361.31 which is funded in part through a grant under Laws 1994, chapter 361.32 643, section 79; 361.33 (2) the department of corrections' facilities at Red Wing 361.34 and Sauk Centre; 361.35 (3) the proposed department of corrections' facility at 361.36 Camp Ripley; 362.1 (4) any facility that submitted a formal request for 362.2 licensure under Minnesota Statutes, section 241.021, before 362.3 December 31, 1997; and 362.4 (5) any residential academy receiving state funding for 362.5 fiscal year 1998 or 1999 for capital improvements. 362.6 Subd. 5. [MORATORIUM; LENGTH.] The moratorium in this 362.7 section stays in effect until June 30, 1999. 362.8 Sec. 14. [JUVENILE PLACEMENT STUDY.] 362.9 The legislative audit commission is requested to direct the 362.10 legislative auditor to conduct a study of juvenile out-of-home 362.11 placements. The study must include: 362.12 (1) an evaluation of existing placements for juveniles, 362.13 including, but not limited to, the number of beds at each 362.14 facility, the average number of beds occupied each day at each 362.15 facility, and the location of each facility, and an analysis of 362.16 the projected need for an increased number of beds for juvenile 362.17 out-of-home placements, including the geographic area where beds 362.18 will be needed; 362.19 (2) an evaluation of existing services and programming 362.20 provided in juvenile out-of-home placements and an assessment of 362.21 the types of services and programming that are needed in 362.22 juvenile out-of-home placements, by geographic area; 362.23 (3) an evaluation of the utilization of continuum of care; 362.24 (4) an assessment of the reasons why juveniles are placed 362.25 outside their homes; 362.26 (5) a summary of the demographics of juveniles placed 362.27 outside their homes, by county, including information on race, 362.28 gender, age, and other relevant factors; 362.29 (6) a summary of the geographic distance between the 362.30 juvenile's home and the location of the out-of-home placement, 362.31 including observations for the reasons a juvenile was placed at 362.32 a particular location; 362.33 (7) a determination of the average length of time that a 362.34 juvenile in Minnesota spends in an out-of-home placement and a 362.35 determination of the average length of time that a juvenile 362.36 spends in each type of out-of-home placement, including, but not 363.1 limited to, residential treatment centers, correctional 363.2 facilities, and group homes; 363.3 (8) a determination of the completion rates of juveniles 363.4 participating in programming in out-of-home placements and an 363.5 analysis of the reasons for noncompletion of programming; 363.6 (9) a determination of the percentage of juveniles whose 363.7 out-of-home placement ends due to the juvenile's failure to meet 363.8 the rules and conditions of the out-of-home placement and an 363.9 analysis of the reasons the juvenile failed; 363.10 (10) an analysis of the effectiveness of the juvenile 363.11 out-of-home placement, including information on recidivism, 363.12 where applicable, and the child's performance after returning to 363.13 the child's home; 363.14 (11) an estimate of the cost each county spends on juvenile 363.15 out-of-home placements; 363.16 (12) a description and examination of the per diem 363.17 components per offender at state, local, and private facilities 363.18 providing placements for juveniles; and 363.19 (13) other issues that may affect juvenile out-of-home 363.20 placements. 363.21 If the commission directs the auditor to conduct this 363.22 study, the auditor shall report its findings to the chairs of 363.23 the house and senate committees and divisions with jurisdiction 363.24 over criminal justice and health and human services policy and 363.25 funding by January 15, 1999. 363.26 Sec. 15. [CITY OF EVELETH; LOAN FORGIVENESS.] 363.27 Notwithstanding the provisions of any other law or charter, 363.28 the city of Eveleth may, by resolution of its city council, 363.29 forgive all or any portion of the principal and interest due or 363.30 to become due to the city, pursuant to any loan or loans made by 363.31 the city, in an amount not exceeding $100,000, prior to January 363.32 1, 1998, to any hospital, nursing home, other health care 363.33 facility or corporation, partnership, or limited liability 363.34 company operating such a facility within the city of Eveleth. 363.35 Sec. 16. [REPEALER.] 363.36 (a) Minnesota Rules, part 2740.1600, subpart 1, is repealed. 364.1 (b) Minnesota Statutes 1997 Supplement, section 62D.042, 364.2 subdivision 3, is repealed. 364.3 Sec. 17. [EFFECTIVE DATE.] 364.4 (a) Section 2 (62D.042, subdivision 2) is effective January 364.5 1, 1999. 364.6 (b) Section 16, paragraph (b) (repealing section 62D.042, 364.7 subdivision 3) is effective the day following final enactment. 364.8 (c) Section 8 (Laws 1997, chapter 207, section 7) is 364.9 effective the day following final enactment. 364.10 (d) Section 11 (TOWN OF WHITE, ST. LOUIS COUNTY) is 364.11 effective upon compliance with Minnesota Statutes, section 364.12 645.021, subdivision 2. 364.13 (e) Sections 13 and 14 (licensing and juvenile placement) 364.14 are effective the day following final enactment. 364.15 (f) Section 15 (loan forgiveness by the city of Eveleth) is 364.16 effective the day following final enactment without local 364.17 approval according to Minnesota Statutes, section 645.023, 364.18 subdivision 1, clause (a). 364.19 (g) Section 4 (62Q.091) is effective January 1, 1999, and 364.20 applies to health plans issued or renewed on or after that date.