Office of the Revisor of Statutes
Minnesota Session Laws - 1984, Regular Session
Key: (1) language to be deleted (2) new language
Laws of Minnesota 1984
CHAPTER 534-H.F.No. 1966
An act relating to public welfare; providing for the
collection of statistical data by the department of
health on dissolutions and annulments; restricting the
use of certain descriptive words to certain licensed
facilities; providing for collection of health care
cost information; limiting relative responsibility for
state hospital costs; providing appeal rights for
former recipients of public assistance; limiting
medical assistance and general assistance
reimbursements for chemical dependency treatment;
extending temporary rulemaking authority for
prospective payments for inpatient hospital services;
extending administrative aid to counties; expanding
medical assistance eligibility for certain persons;
eliminating the requirement that the commissioner seek
a co-payment waiver for HMO enrollees under medical
assistance; clarifying existing language relating to
asset transfers; increasing the personal needs
allowance; reimbursement for additional services under
general assistance medical care; providing for
recovery of supplemental aid; requiring county
investigations; requiring a cost-of-living adjustment
to the schedule of contribution of a
noninstitutionalized spouse; appropriating money;
amending Minnesota Statutes 1982, sections 144.224;
144.695; 144.696; 144.698; 144.699; 144.701; 144.702;
144.703; 246.50, subdivision 6; 256.045, subdivisions
2, 4, 5, and 7; 256B.17, as amended; 256B.19,
subdivision 1; 256B.35, subdivision 1; 261.035;
Minnesota Statutes 1983 Supplement, sections 256.045,
subdivision 3; 256.968; 256.969, subdivisions 2 and 6;
and 256B.06, subdivision 1; proposing new law coded in
Minnesota Statutes, chapters 144; 256D and 518;
repealing Minnesota Statutes 1982, sections 144.7021;
144.704; and 144.705.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1982, section 144.224, is
amended to read:
144.224 [REPORTS OF DISSOLUTION AND ANNULMENT OF MARRIAGE.]
Each month the clerk of court shall file a report with
forward to the state registrar, reporting commissioner of health
the dissolutions and annulments of marriage granted by the court
in statistical report forms collected pursuant to section 3
during the preceding month. The report form shall include only
the following information:
a. Name and, date of birth, birthplace, residence, race,
and educational attainment of the husband and wife;
b. County of decree;
c. Date and type of decree;
d. Signature of the clerk of court; and Place and date of
marriage;
e. Date signed of separation;
f. Number and ages of children of marriage;
g. Amount and status of maintenance and child support;
h. Custody of children;
i. Income of the parties;
j. Length of separation and length of marriage; and
k. Number of previous marriages and reasons for ending the
previous marriages (death, dissolution, or annulment).
The commissioner may publish data collected under this
section in summary form only. The statistical report form shall
contain a statement that neither the report form, nor
information contained in the form, shall be admissible in
evidence in this or any subsequent proceeding.
Sec. 2. [144.561] [RESTRICTION OF NAME AND DESCRIPTION OF
CERTAIN MEDICAL FACILITIES.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following words have the meanings given to them:
(a) "Person" means an individual, partnership, association,
corporation, state, county or local governmental unit or a
division, department, board or agency of a governmental unit.
(b) "Medical facility" means an institution, office,
clinic, or building, not attached to a licensed hospital, where
medical services for the diagnosis or treatment of illness or
injury or the maintenance of health are offered in an outpatient
or ambulatory setting.
Subd. 2. [PROHIBITION.] No person shall use the words
"emergency," "emergent," "trauma," "critical," or any form of
these words which suggest, offer, or imply the availability of
immediate care for any medical condition likely to cause death,
disability or serious illness in the name of any medical
facilities, or in advertising, publications or signs identifying
the medical facility unless the facility is licensed under the
provisions of section 144.50.
Sec. 3. Minnesota Statutes 1982, section 144.695, is
amended to read:
144.695 [CITATION.]
Sections 144.695 to 144.703 may be cited as the Minnesota
hospital administration act of 1976 Health Care Cost Information
Act of 1984.
Sec. 4. Minnesota Statutes 1982, section 144.696, is
amended to read:
144.696 [DEFINITIONS.]
Subdivision 1. Unless the context clearly indicates
otherwise, for the purposes of sections 144.695 to 144.703, the
terms defined in this section have the meanings given them.
Subd. 2. "Commissioner of health" means the state
commissioner of health.
Subd. 3. "Hospital" means any acute care institution
licensed pursuant to sections 144.50 to 144.58, but does not
include any health care institution conducted for those who rely
primarily upon treatment by prayer or spiritual means in
accordance with the creed or tenets of any church or
denomination.
Subd. 4. "Commissioner of insurance" means the
commissioner of insurance.
Subd. 5. "Insurer" means a person selling policies of
accident and health insurance pursuant to chapter 62A, or
nonprofit health service plan subscriber contracts pursuant to
chapter 62C "Outpatient surgical center" means a facility other
than a hospital offering elective outpatient surgery under a
license issued under sections 144.50 to 144.58.
Sec. 5. Minnesota Statutes 1982, section 144.698, is
amended to read:
144.698 [REPORTING REQUIREMENTS.]
Subdivision 1. Each hospital and each outpatient surgical
center, which has not filed the financial information required
by this section with a voluntary, nonprofit rate review
reporting organization pursuant to section 144.702, shall file
annually with the commissioner of health after the close of the
fiscal year:
(a) A balance sheet detailing the assets, liabilities, and
net worth of the hospital;
(b) A detailed statement of income and expenses; and
(c) A copy of its most recent cost report, if any, filed
pursuant to requirements of Title XVIII of the United States
Social Security Act; and
(d) A copy of all changes to articles of incorporation or
bylaws.
Subd. 2. If more than one licensed hospital or outpatient
surgical center is operated by the reporting organization, the
commissioner of health may require that the information be
reported separately for each hospital and each outpatient
surgical center.
Subd. 3. The commissioner of health may require
attestation by responsible officials of the hospital or
outpatient surgical center that the contents of the reports are
true.
Subd. 4. All reports, except privileged medical
information, filed pursuant to this section, section 144.701 or
section 144.702, subdivision 3 or 4 shall be open to public
inspection.
Subd. 5. The commissioner of health shall have the right
to inspect hospital and outpatient surgical center books,
audits, and records as reasonably necessary to verify hospital
and outpatient surgical center reports.
Sec. 6. Minnesota Statutes 1982, section 144.699, is
amended to read:
144.699 [CONTINUING ANALYSIS.]
Subdivision 1. [ACUTE CARE COSTS.] The commissioner of
health may:
(a) Undertake analyses and studies relating to hospital
acute care costs and to the financial status of any hospital or
outpatient surgical center subject to the provisions of sections
144.695 to 144.703; and
(b) Publish and disseminate the information relating to
hospital acute care costs.
Subd. 2. [FOSTERING PRICE COMPETITION.] The commissioner
of health shall:
(a) Encourage hospitals, outpatient surgical centers, and
professionals regulated by the health related licensing boards
as defined in section 214.01, subdivision 2, and by the
commissioner of health under section 214.13, to publish prices
for procedures and services that are representative of the
diagnoses and conditions for which citizens of this state seek
treatment.
(b) Analyze and disseminate available price information and
analyses so as to foster the development of price competition
among hospitals, outpatient surgical centers, and health
professionals.
Subd. 3. [COOPERATION WITH ATTORNEY GENERAL.] Upon request
of the attorney general, the commissioner of health shall make
available to the attorney general all requested information
provided under sections 144.695 to 144.703 in order to assist
the attorney general in discharging the responsibilities of
section 8.31.
Subd. 4. The commissioner of health shall prepare and file
summaries and compilations or other supplementary reports based
on the information filed with or made available to the
commissioner of health, which reports will advance the purposes
of sections 144.695 to 144.703.
Sec. 7. Minnesota Statutes 1982, section 144.701, is
amended to read:
144.701 [INVESTIGATIVE POWER RATE DISCLOSURE.]
Subdivision 1. The commissioner of health may initiate
reviews or investigations as necessary to assure all purchasers
of hospital health care services that the total costs of a
hospital are reasonably related to the total services offered,
that the hospital's aggregate revenues as expressed by rates are
reasonably related to the hospital's aggregate costs, and that
rates are set equitably. The commissioner of health shall
prohibit hospitals from discriminating among insurers in its
rates.
Subd. 2. In order to properly discharge these obligations,
the commissioner of health may review projected annual revenues
and expenses of hospitals and comment on them.
Subd. 3. In the interest of promoting the most efficient
and effective use of hospitals, the commissioner of health may
promote experimental alternative methods of budgeting, cost
control, rate determination and payment shall ensure that the
total costs, total revenues, and total services of each hospital
and each outpatient surgical center are reported to the public
in a form understandable to consumers.
Subd. 4 2. The commissioner of health shall begin to
compile relevant financial and accounting data concerning
hospitals and outpatient surgical centers in order to have
statistical information available for legislative policy making.
Subd. 5 3. The commissioner of health shall obtain from
each hospital and outpatient surgical center a current rate
schedule. Any subsequent amendments or modifications of that
schedule shall be filed with the commissioner of health at least
60 days in advance of their effective date. The commissioner of
health may, by rule, exempt from this requirement rate increases
which have a minimal impact on hospital costs. If the hospital
has not agreed to submit to a voluntary rate review in
accordance with section 144.702, the commissioner of health may
hold a public hearing pursuant to chapter 14, on any increase
which he determines is excessive and may publicly comment on any
increase.
Subd. 6 4. Each report which is required to be submitted
to the commissioner of health pursuant to subdivision 5 under
sections 144.695 to 144.703 and which is not submitted to be
reviewed by a voluntary, nonprofit rate review reporting
organization in accordance with section 144.702 shall be
accompanied by a filing fee in an amount prescribed by rule of
the commissioner of health. Filing fees shall be set at a level
sufficient to cover the costs of any reviews undertaken pursuant
to subdivision 5, and may take into consideration the length or
complexity of the report being filed. Fees received pursuant to
this subdivision shall be deposited in the general fund of the
state treasury.
Sec. 8. Minnesota Statutes 1982, section 144.702, is
amended to read:
144.702 [VOLUNTARY REPORTING AND RATE REVIEW OF HOSPITAL
AND OUTPATIENT SURGICAL CENTER COSTS.]
Subdivision 1. A hospital or outpatient surgical center
may agree to submit its financial reports to, and be subject to
a review of its rates by, a voluntary, nonprofit rate review
reporting organization whose reporting and review procedures
have been approved by the commissioner of health in accordance
with this section.
Subd. 2. The commissioner of health may approve voluntary
reporting and rate review procedures which are substantially
equivalent to reporting requirements and rate review procedures
adopted by the commissioner of health for reporting and rate
reviews conducted pursuant to procedures under sections 144.698
and 144.701 144.695 to 144.703. The commissioner of health
shall, by rule, prescribe standards for approval of voluntary
rate review reporting procedures, which standards shall provide
for:
(a) The filing of appropriate financial information with
the rate review reporting organization;
(b) Adequate analysis and verification of that financial
information; and
(c) Timely publication of the review organization's
findings and comments costs, revenues, and rates of individual
hospitals and outpatient surgical centers prior to the effective
date of any proposed rate increase. The commissioner of health
shall annually review the procedures approved pursuant to this
subdivision.
Subd. 3. Any voluntary, nonprofit rate review reporting
organization which conducts a review of the collects information
on costs, revenues, and rates of a hospital or outpatient
surgical center located in this state shall file a copy of its
findings and comments the information received for each hospital
and outpatient surgical center with the commissioner of health
within 30 days of completion of the review information
collection process, together with a summary of the financial
information acquired by the organization during the course of
its review.
Subd. 4. Any voluntary, nonprofit rate review reporting
organization which receives the financial information required
in section 144.698 by sections 144.695 to 144.703 shall make the
information and all summaries and analyses of the information
available to the commissioner of health in accordance with
procedures prescribed by the commissioner of health.
Subd. 5. If the reporting and rate review procedures of a
voluntary, nonprofit rate review reporting organization have
been approved by the commissioner of health those reporting and
rate reviewing activities of the organization shall be exempt
from the provisions of sections 325D.49 to 325D.66.
Subd. 6. For the purposes of this section "rate review
reporting organization" means an association or other
organization which has as one of its primary functions the peer
review of hospital rates collection and dissemination of acute
care cost information.
Sec. 9. Minnesota Statutes 1982, section 144.703, is
amended to read:
144.703 [ADDITIONAL POWERS.]
Subdivision 1. In addition to the other powers granted to
the commissioner of health and the commissioner of insurance by
law, the commissioner of health and the commissioner of
insurance may each:
(a) Adopt, amend, and repeal rules in accordance with
chapter 14;
(b) Hold public hearings, conduct investigations, and
administer oaths or affirmations in any hearing or investigation
Adopt in rule a schedule of fines, ranging from $100 to $1,000,
for failure of a hospital or an outpatient surgical center to
submit, or to make a timely submission of, information called
for by sections 144.695 to 144.703.
Subd. 2. Any person aggrieved by a final determination of
the commissioner of health or the commissioner of insurance as
to any rule or determination under sections 144.695 to 144.703;
or 62A.02, subdivision 3; or 62C.15, subdivision 2, shall be
entitled to an administrative hearing and judicial review in
accordance with the contested case provisions of chapter 14.
Sec. 10. [REPORT.]
By January 15, 1985, the commissioner of health shall, in
consultation with the state planning agency, conduct a study and
prepare a report to the legislature describing recommendations
for an integrated, comprehensive cost containment program for
acute care health services. At a minimum the commissioner shall
consider:
(a) a proposal for a mechanism that would constrain
expansion in the service capacity of the acute care health
system by means of specific and quantifiable prospectively
determined limits;
(b) a proposal for mechanisms that would prospectively
control increases in charges for acute care health services;
(c) a proposal detailing appropriate competitive
initiatives to achieve cost containment for acute care health
services;
(d) a proposal that would ensure appropriate financial and
geographic access to acute care health services; and
(e) any other related proposals and alternatives the
commissioner deems prudent.
Sec. 11. [SAVINGS CLAUSE.]
The following rules adopted by the commissioner of health
under sections 144.695 to 144.703 are repealed.
(a) Rules prescribing standards for the investigation,
analysis, and judging of the reasonableness of the use of
finances in a hospital.
(b) Rules prescribing standards for allowable increase
limits.
(c) Rules prescribing standards for acceptable increases in
gross acute care charges.
All other rules adopted by the commissioner under sections
144.695 to 144.703 remain in effect.
Notwithstanding the time limitation prescribed in 7 MCAR S
1.475 E.1., the experimental alternative reporting requirements
contained in 7 MCAR S 1.475 shall be in effect until amended or
repealed by the commissioner.
The rules not repealed by this section adopted under
sections 144.695 to 144.703 apply to hospitals and outpatient
surgical centers. The commissioner may grant outpatient
surgical centers a group variance from compliance with
provisions of the rules if uniform alternative requirements
substantially equivalent to those prescribed in the rules are
reasonably necessary to achieve the purposes of sections 144.695
to 144.703.
Promptly after enactment of sections 1 to 10, the
commissioner shall publish in the State Register rules adopted
under sections 144.695 to 144.703 that are not repealed by this
section.
Sec. 12. Minnesota Statutes 1982, section 246.50,
subdivision 6, is amended to read:
Subd. 6. "Relatives" means the spouse, and parents and, in
the case of the mentally ill or chemically dependent, children
of a patient, in that order of liability for cost of care.
Sec. 13. [ACTIONS DISCONTINUED.]
The commissioner of public welfare shall discontinue all
collection activities currently pending against persons who have
been determined to be
(1) responsible relatives because they are children of
current or former state hospital patients; and
(2) liable for relative contributions under sections 246.50
to 246.55.
Sec. 14. Minnesota Statutes 1982, section 256.045,
subdivision 2, is amended to read:
Subd. 2. [LOCAL WELFARE HEARINGS.] In counties in which
the commissioner of public welfare has appointed a local welfare
referee, any person applying for or, receiving, or having
received public assistance granted by a local agency pursuant to
Minnesota Statutes, Sections 256.72 to 256.87, Chapters 256B,
256D, 261, the Federal Food Stamp Act or a program of social
services whose application for assistance is denied, or not
acted upon with reasonable promptness, or whose assistance is
suspended, reduced, or terminated by a local agency, or claimed
to have been incorrectly paid, or any patient or relative
aggrieved by an order of the commissioner under section 252.27,
may contest that action or decision before the local welfare
referee by submitting a written request for a hearing to the
local agency within 30 days after receiving written notice of
the action or decision, or within 90 days of such written notice
if the applicant or recipient shows good cause why the request
was not submitted within the 30 day time limit. The local
welfare referee shall conduct a hearing on the matter and shall
issue a ruling affirming, reversing, or modifying the action or
decision of the local agency. The ruling of the local welfare
referee shall be binding upon the local agency and the aggrieved
party unless appeal is taken in the manner provided by
subdivision 3.
Sec. 15. Minnesota Statutes 1983 Supplement, section
256.045, subdivision 3, is amended to read:
Subd. 3. [STATE AGENCY HEARINGS.] In counties in which the
commissioner of welfare has not appointed a local welfare
referee, any person applying for or, receiving or having
received any of the forms of public assistance described in
subdivision 2 whose application for assistance is denied, not
acted upon with reasonable promptness, or whose assistance is
suspended, reduced, or terminated by a local agency, or claimed
to have been incorrectly paid, or any patient or relative
aggrieved by an order of the commissioner under section 252.27,
may contest that action or decision before the state agency by
submitting a written request for a hearing to the state agency
within 30 days after receiving written notice of the action or
decision, or within 90 days of such written notice if the
applicant, recipient, patient or relative shows good cause why
the request was not submitted within the 30 day time limit. A
local agency, applicant, recipient, patient or relative or party
aggrieved by a ruling of a local welfare referee may appeal the
ruling to the state agency by filing a notice of appeal with the
state agency within 30 days after receiving the ruling of the
local welfare referee. A state welfare referee shall conduct a
hearing on the matter and shall recommend an order to the
commissioner of public welfare. In appeals from rulings of
local welfare referees, the hearing may be limited, upon
stipulation of the parties, to a review of the record of the
local welfare referee.
Sec. 16. Minnesota Statutes 1982, section 256.045,
subdivision 4, is amended to read:
Subd. 4. [CONDUCT OF HEARINGS.] All hearings held pursuant
to subdivisions 2 or 3 shall be conducted according to the
provisions of the federal Social Security Act and the
regulations implemented in accordance with that act to enable
this state to qualify for federal grants-in-aid, and according
to the rules and written policies of the commissioner of public
welfare. The hearing shall not be held earlier than five days
after filing of the required notice with the local or state
agency. The local welfare referee or state welfare referee
shall notify all interested persons of the time, date and
location of the hearing at least five days before the date of
the hearing. Interested persons may be represented by legal
counsel or other spokesman of their choice at the hearing and
may appear personally, testify and offer evidence, and examine
and cross-examine witnesses. The applicant or, recipient, or
former recipient shall have the opportunity to examine the
contents of his case file and all documents and records to be
used by the local agency at the hearing at a reasonable time
before the date of the hearing and during the hearing. All
evidence, except that privileged by law, commonly accepted by
reasonable men in the conduct of their affairs as having
probative value with respect to the issues shall be submitted at
the hearing and such hearing shall not be "a contested case"
within the meaning of section 14.02, subdivision 3.
Sec. 17. Minnesota Statutes 1982, section 256.045,
subdivision 5, is amended to read:
Subd. 5. [ORDERS OF THE COMMISSIONER OF WELFARE.] The
commissioner of public welfare may accept the recommended order
of a state welfare referee and issue the order to the local
agency and the applicant or, recipient, or former recipient. If
the commissioner refuses to accept the recommended order of the
state welfare referee, he shall notify the local agency and the
applicant or, recipient, or former recipient of that fact and
shall state his reasons therefor and shall allow each party ten
days' time to submit additional written argument on the matter.
After the expiration of the ten day period, the commissioner
shall issue an order on the matter to the local agency and the
applicant or, recipient, or former recipient. Any order of the
commissioner issued in accordance with this subdivision shall be
conclusive upon the parties unless appeal is taken in the manner
provided by subdivision 7.
Sec. 18. Minnesota Statutes 1982, section 256.045,
subdivision 7, is amended to read:
Subd. 7. [JUDICIAL REVIEW.] An applicant or recipient or
local agency Any party who is aggrieved by an order of the
commissioner of welfare may appeal the order to the district
court of the county responsible for furnishing assistance by
serving a written copy of a notice of appeal upon the
commissioner and any adverse party of record within 30 days
after the date the commissioner issued the order, and by filing
the original notice and proof of service with the clerk of the
district court. Service may be made personally or by mail;
service by mail is complete upon mailing; no filing fee shall be
required by the clerk of court in appeals taken pursuant to this
subdivision. The commissioner may elect to become a party to
the proceedings in the district court. Any party may demand
that the commissioner furnish all parties to the proceedings
with a copy of his decision, and a transcript of any testimony,
evidence, or other supporting papers from the hearing held
before the state welfare referee, by serving a written demand
upon the commissioner within 30 days after service of the notice
of appeal.
Sec. 19. Minnesota Statutes 1983 Supplement, section
256.968, is amended to read:
256.968 [LIMITATION ON INPATIENT CHEMICAL DEPENDENCY
TREATMENT.]
The commissioner of public welfare shall limit medical
assistance and general assistance medical care reimbursement for
treatment of alcoholism, chemical dependency or drug addiction
which is rendered in a licensed inpatient hospital to one
treatment episode per calendar year per recipient if the
hospital is being reimbursed on a per episode basis or to 30
days per calendar year in a licensed hospital or certified
nursing home to 30 days reimbursed under other methodologies
unless need for extended care is certified by the attending
physician and has received prior approval from the commissioner.
Sec. 20. Minnesota Statutes 1983 Supplement, section
256.969, subdivision 2, is amended to read:
Subd. 2. [RATES FOR INPATIENT HOSPITALS.] Rates paid to
inpatient hospitals shall be based on a rate per admission until
the commissioner can begin to reimburse hospitals for services
under the medical assistance and general assistance medical care
programs based upon a diagnostic classification system
appropriate to the service populations. On July 1, 1984, the
commissioner shall begin to utilize to the extent possible
existing classification systems, including medicare. The
commissioner shall incorporate the grouping of hospitals with
similar characteristics for uniform rates upon the development
and implementation of the diagnostic classification system.
Prior to implementation of the diagnostic classification system,
the commissioner shall report the proposed grouping of hospitals
to the senate health and human services committee and the house
health and welfare committee. Medical assistance and general
assistance medical care reimbursement for treatment of mental
illness shall be reimbursed based upon diagnosis classifications.
Sec. 21. Minnesota Statutes 1983 Supplement, section
256.969, subdivision 6, is amended to read:
Subd. 6. [RULES.] The commissioner of public welfare shall
promulgate temporary and permanent rules to implement a system
of prospective payment for inpatient hospital services pursuant
to chapter 14, the Administrative Procedure Act.
Notwithstanding section 14.53, temporary rule authority
authorized by Laws 1983, chapter 312, Article 5, section 9,
subdivision 6, shall extend to August 1, 1985.
Sec. 22. Minnesota Statutes 1983 Supplement, section
256B.06, subdivision 1, is amended to read:
Subdivision 1. Medical assistance may be paid for any
person:
(1) Who is a child eligible for or receiving adoption
assistance payments under Title IV-E of the Social Security Act,
United States Code, title 42, sections 670 to 676 under
Minnesota Statutes, section 259.40; or
(2) Who is a child eligible for or receiving foster care
maintenance payments under Title IV-E of the Social Security
Act, United States Code, title 42, sections 670 to 676; or
(3) Who is eligible for or receiving public assistance, or
a woman who is pregnant, as medically verified, and who would be
eligible for assistance under the aid to families with dependent
children program if the child had been born and living with the
woman, the Minnesota supplemental aid program; or
(4) Who is a pregnant woman, as certified in writing by a
physician or nurse midwife, and who (a) meets the other
eligibility criteria of this section, and (b) would be
categorically eligible for assistance under the aid to families
with dependent children program if the child had been born and
was living with the woman; or
(5) Who meets the categorical eligibility requirements of
the supplemental security income program and the other
eligibility requirements of this section; or
(5) (6) Who, except for the amount of income or resources,
would qualify for supplemental security income for the aged,
blind and disabled, or aid to families with dependent children,
and is in need of medical assistance who meets the other
eligibility requirements of this section; or
(6) (7) Who is under 21 years of age and in need of medical
care that neither he nor his relatives responsible under
sections 256B.01 to 256B.26 are financially able to provide; or
(7) (8) Who is residing in a hospital for treatment of
mental disease or tuberculosis and is 65 years of age or older
and without means sufficient to pay the per capita hospital
charge; and
(8) (9) Who resides in Minnesota, or, if absent from the
state, is deemed to be a resident of Minnesota in accordance
with the regulations of the state agency; and
(9) (10) Who alone, or together with his spouse, does not
own real property other than the homestead. For the purposes of
this section, "homestead" means the house owned and occupied by
the applicant or recipient as his dwelling place primary place
of residence, together with the contiguous land upon which it is
situated and an area no greater than two contiguous lots in a
platted or laid out city or town or 80 contiguous acres in
unplatted land. Occupancy or exemption shall be determined as
provided in chapter 510 and applicable law, including continuing
exemption by filing notice under section 510.07. The homestead
shall continue to be excluded for persons residing in a
long-term care facility if it is used as a primary residence by
the spouse, minor child, or disabled child of any age; or the
applicant/recipient is expected to return to the home as a
principal residence within six calendar months of entry to the
long-term care facility. Certification of expected return to
the homestead shall be documented in writing by the attending
physician. Real estate not used as a home may not be retained
unless it produces net income applicable to the family's needs
or the family is making a continuing effort to sell it at a fair
and reasonable price or unless sale of the real estate would net
an insignificant amount of income applicable to the family's
needs, or unless the commissioner determines that sale of the
real estate would cause undue hardship; and
(10) (11) Who individually does not own more than $3,000 in
cash or liquid assets, or if a member of a household with two
family members (husband and wife, or parent and child), does not
own more than $6,000 in cash or liquid assets, plus $200 for
each additional legal dependent. Cash and liquid assets may
include a prepaid funeral contract and insurance policies with
cash surrender value. The value of the following shall not be
included:
(a) the homestead, and (b) one motor vehicle licensed
pursuant to chapter 168 and defined as: (1) passenger
automobile, (2) station wagon, (3) motorcycle, (4) motorized
bicycle or (5) truck of the weight found in categories A to E,
of section 168.013, subdivision 1e; and
(11) (12) Who has or anticipates receiving an annual income
not in excess of $2,600 for a single person, or $3,250 for two
family members (husband and wife, parent and child, or two
siblings), plus $625 for each additional legal dependent the
income standards by family size used in the aid to families with
dependent children program, or who has income in excess of these
maxima and in the month of application, or during the three
months prior to the month of application, incurs expenses for
medical care that total more than one-half of the annual excess
income in accordance with the regulations of the state agency.
In computing income to determine eligibility of persons who are
not residents of long term care facilities, the commissioner
shall disregard increases in income due solely to increases in
federal retiree, survivor's, and disability insurance benefits,
veterans administration benefits, and railroad retirement
benefits in the percentage amount established in the biennial
appropriations law unless prohibited by federal law or
regulation. If prohibited, the commissioner shall first seek a
waiver. In excess income cases, eligibility shall be limited to
a period of six months beginning with the first of the month in
which these medical obligations are first incurred; and
(12) (13) Who has continuing monthly expenses for medical
care that are more than the amount of his excess income,
computed on a monthly basis, in which case eligibility may be
established before the total income obligation referred to in
the preceding paragraph is incurred, and medical assistance
payments may be made to cover the monthly unmet medical need.
In licensed nursing home and state hospital cases, income over
and above that required for justified needs, determined pursuant
to a schedule of contributions established by the commissioner
of public welfare, is to be applied to the cost of institutional
care. The commissioner of public welfare may establish a
schedule of contributions to be made by the spouse of a nursing
home resident to the cost of care and shall seek a waiver from
federal regulations which establish the amount required to be
contributed by either spouse when one spouse is a nursing home
resident; and
(13) (14) Who has applied or agrees to apply all proceeds
received or receivable by him or his spouse from automobile
accident coverage and private health care coverage to the costs
of medical care for himself, his spouse, and children. The
state agency may require from any applicant or recipient of
medical assistance the assignment of any rights accruing under
private health care coverage. Any rights or amounts so assigned
shall be applied against the cost of medical care paid for under
this chapter. Any assignment shall not be effective as to
benefits paid or provided under automobile accident coverage and
private health care coverage prior to receipt of the assignment
by the person or organization providing the benefits.
Sec. 23. Minnesota Statutes 1982, section 256B.17, as
amended by Laws 1983, chapter 312, article 5, sections 20, 21,
22, 23, and 24, is amended to read:
256B.17 [TRANSFERS OF PROPERTY.]
Subdivision 1. [TRANSFERS FOR LESS THAN MARKET VALUE.] In
determining the resources of an individual and an eligible
spouse, there shall be included any resource or interest therein
which was given away or, sold, or disposed of for less than fair
market value within the 24 months preceding application for
medical assistance or during the period of eligibility.
Subd. 2. [PRESUMPTION OF PURPOSE.] Any transaction
described in subdivision 1 shall be presumed to have been for
the purpose of establishing eligibility for benefits or
assistance under this chapter unless the individual or eligible
spouse furnishes convincing evidence to establish that the
transaction was exclusively for another purpose.
Subd. 3. [RESOURCE VALUE.] For purposes of subdivision 1,
the value of the resource or interest shall be the fair market
value at the time it was given away, sold, or given away
disposed of, less the amount of compensation received.
Subd. 4. [PERIOD OF INELIGIBILITY.] For any uncompensated
transfer, the period of ineligibility shall be calculated by
dividing the uncompensated transferred amount by the statewide
average monthly skilled nursing facility per diem for the
previous calendar year to determine the number of months of
ineligibility. The individual shall remain ineligible until
this fixed ineligibility period has expired, subject to the
exclusions contained in section 256B.06, subdivision 1. The
period of ineligibility may exceed 24 months, and a
reapplication for benefits after 24 months from the date of the
transfer shall not result in eligibility unless and until the
period of ineligibility has expired.
Subd. 5. [EXCLUSIONS FOR HOMESTEAD TRANSFERS EXCLUDED
RESOURCES.] Notwithstanding subdivision 4, an individual shall
not be ineligible if the transferred property is a homestead as
defined by section 256B.06, subdivision 1, and one of the
following conditions applies: Except for the limitations
contained in subdivision 6, a resource which is transferred
while otherwise excluded under sections 256B.06 and 256B.07
shall not be considered an available resource for purposes of
medical assistance eligibility. This exception shall not apply
to applicants for or recipients of general assistance medical
care benefits under chapter 256D.
Subd. 6. [PROHIBITED TRANSFERS OF EXCLUDED RESOURCES.] Any
individual who is an inpatient in a skilled nursing facility or
an intermediate care facility who, at any time during or after
the 24-month period immediately prior to application for medical
assistance, disposed of a homestead for less than fair market
value shall be ineligible for medical assistance in accordance
with subdivisions 1 to 4. An individual shall not be ineligible
for medical assistance if one of the following conditions
applies to the homestead transfer:
(1) a satisfactory showing is made that the individual can
reasonably be expected to return to the homestead as a permanent
residence;
(2) title to the home homestead was transferred to the
individual's spouse, child who is under age 21, or blind or
permanently and totally disabled child as defined in the
supplemental security income program;
(3) a satisfactory showing is made that the individual
intended to dispose of the home homestead at fair market value
or for other valuable consideration; or
(4) the local agency determines that denial of eligibility
would cause undue hardship for the individual, based on imminent
threat to the individual's health and well-being.
Subd. 6 7. [EXCEPTION FOR ASSET TRANSFERS.]
Notwithstanding the provisions of subdivisions 1 to 5 6, an
institutionalized spouse who applies for medical assistance on
or after July 1, 1983, may transfer liquid assets to his or her
noninstitutionalized spouse without loss of eligibility if all
of the following conditions apply:
(a) The noninstitutionalized spouse is not applying for or
receiving assistance;
(b) The noninstitutionalized spouse has less than $10,000
in liquid assets, including assets singly owned and 50 percent
of assets owned jointly with the institutionalized spouse;
(c) The amount transferred, together with the
noninstitutionalized spouse's own assets, totals no more than
$10,000 in liquid assets; and
(d) The transfer may be effected only once, at the time of
initial medical assistance application.
Subd. 7 8. [CONFORMANCE WITH FEDERAL LAW.] Notwithstanding
the other provisions of this section, uncompensated property
transfers shall be treated no more restrictively than allowed by
federal law.
Subd. 8. [EFFECTIVE DATE.] Subdivisions 5, 6, and 7, and
the changes in subdivision 4 made by Laws 1983, chapter 312,
article 5, section 20 apply to transfers made on or after June
10, 1983, regardless of the individual's status in relation to
eligibility for medical assistance.
Sec. 24. Minnesota Statutes 1982, section 256B.19,
subdivision 1, is amended to read:
Subdivision 1. [DIVISION OF COST.] The cost of medical
assistance paid by each county of financial responsibility shall
be borne as follows: Payments shall be made by the state to the
county for that portion of medical assistance paid by the
federal government and the state on or before the 20th day of
each month for the succeeding month upon requisition from the
county showing the amount required for the succeeding month.
Ninety percent of the expense of assistance not paid by federal
funds available for that purpose shall be paid by the state and
ten percent shall be paid by the county of financial
responsibility.
For counties where health maintenance organizations are
under contract to the state to provide services to medical
assistance recipients, the division of the nonfederal share of
medical assistance expenses for payments made to health
maintenance organizations in the form of prepaid capitation
payments, this division of medical assistance expenses shall be
95 percent by the state and five percent by the county of
financial responsibility.
State contracts with health maintenance organizations shall
assure medical assistance recipients of at least the
comprehensive health maintenance services defined in section
62D.02, subdivision 7. The contracts shall require health
maintenance organizations to provide information to the
commissioner concerning the number of people receiving services,
the number of encounters, the type of services received,
evidence of an operational quality assurance program pursuant to
section 62D.04 and information about utilization. Persons who
become eligible for medical assistance after July 1, 1982 and
who choose to receive services from a health maintenance
organization under contract to the state pursuant to this
section shall be guaranteed six months medical assistance
eligibility.
The commissioner of public welfare shall seek a waiver to
charge a coinsurance fee to recipients of medical assistance who
become eligible for medical assistance benefits and who choose
not to receive the benefits of a health maintenance organization
contracted for by the state pursuant to this section. The
coinsurance fee shall be limited to the maximum monthly charge
allowed by 42 CFR, sections 447.50 to 447.59, as amended through
December 31, 1981. The local welfare agency may waive the
coinsurance fee when it determines that the medical needs of the
recipient would not be best served by enrollment in a health
maintenance organization. The coinsurance fee shall be charged
only to recipients who become eligible for medical assistance
after the commissioner has reported to the legislature regarding
the proposed method of implementing this paragraph Persons who
become eligible for medical assistance after July 1, 1984, who
are not participating in any medicaid demonstration project as
defined under sections 256B.70 and 256B.71, and who choose at
the time of application for assistance to receive services from
a health maintenance organization, shall be guaranteed six
months of coverage by a state contracted health maintenance
organization if the recipient remains in the health maintenance
organization from the time of initial enrollment. The continued
eligibility guarantee shall not be granted when ineligibility
for medical assistance is due to death, loss of state or county
residency, failure to respond to the county's efforts to contact
the recipient, failure to locate the recipient, or when the
recipient is eligible for continued eligibility as defined in
section 256B.062.
Sec. 25. Minnesota Statutes 1982, section 256B.35,
subdivision 1, is amended to read:
Subdivision 1. Notwithstanding any law to the contrary,
welfare allowances for clothing and personal needs for
individuals receiving medical assistance while residing in any
skilled nursing home or intermediate care facility, including
recipients of supplemental security income, in this state shall
not be less than $35 $40 per month from all sources.
Provided that this personal needs allowance may be paid as
part of the Minnesota supplemental aid program, notwithstanding
the provisions of section 256D.37, subdivision 2, and payments
to the recipients from Minnesota supplemental aid funds may be
made once each three months beginning in October, 1977 covering
liabilities that accrued during the preceding three months.
Sec. 26. [256D.43] [RECOVERIES OF SUPPLEMENTAL AID UNDER
INTERIM ASSISTANCE AGREEMENTS.]
Any applicant, otherwise eligible for supplemental aid and
possibly eligible for maintenance benefits from any other source
shall (a) make application for those benefits within 30 days of
the supplemental aid application; and (b) execute an interim
assistance authorization agreement on a form as directed by the
commissioner. If found eligible for benefits from other
sources, and a payment received from another source relates to
the period during which supplemental aid is also being received,
the recipient shall be required to reimburse the local agency
for the interim assistance paid. Reimbursement shall not exceed
the amount of supplemental aid paid during the time period to
which the other maintenance benefits apply and shall not exceed
the state standard applicable to that time period. Reimbursement
may be sought directly from the other source of maintenance
income but shall remain the primary obligation of the recipient
in those instances where an interim assistance agreement has
been executed. The commissioner shall adopt rules, and may
adopt temporary rules, in accordance with chapter 14,
authorizing local agencies to retain from the amount recovered
under an interim assistance agreement 25 percent plus actual
reasonable fees, costs, and disbursements of appeals and
litigation, of providing special assistance to the recipient in
processing the recipient's claim for maintenance benefits from
another source. The money retained under this section shall be
from the state share of the recovery. The local agency may
contract with qualified persons to provide the special
assistance. The rules adopted by the commissioner shall include
the methods by which local agencies shall identify, refer, and
assist recipients who may be eligible for benefits under federal
programs for the disabled. This subdivision does not require
repayment of per diem payments made to shelters for battered
women pursuant to section 256D.05, subdivision 3.
Sec. 27. [STATE ADMINISTRATIVE AIDS.]
Subdivision 1. [SUSPENSION.] Notwithstanding Laws 1983,
chapter 312, article 1, section 2, subdivision 3, the provisions
of section 256D.22 are suspended until December 31, 1984.
Subd. 2. [APPROPRIATIONS.] The sum of $2,000,000 is
appropriated from the general fund to the commissioner of public
welfare for purposes of section 256D.22.
Sec. 28. Minnesota Statutes 1982, section 261.035, is
amended to read:
When a person dies in any county, not leaving without
apparent means to provide for his own burial and without
relatives of sufficient ability to procure the burial, the
county board shall first investigate to determine whether the
person who has died has contracted for any prepaid burial
arrangements. If such arrangements have been made, the county
shall authorize burial in accord with the written instructions
of the deceased. If it is determined that the person did not
leave sufficient means to defray the necessary expenses of his
burial, nor any relatives therein of sufficient ability to
procure his burial, the county board shall cause a decent burial
of his remains to be made at the expense of the county.
Sec. 29. [518.147] [STATISTICAL REPORT FORM.]
On or before the time a final decree of dissolution or
annulment of marriage is entered, the petitioner or the moving
party, if other than the petitioner, shall complete and file
with the clerk of court a statistical report form provided by
the commissioner of health. After entry of the final decree,
the clerk shall forward the form to the commissioner of health
pursuant to section 144.224. The clerk of court shall not
refuse entry of a decree on the basis that the statistical
report form is incomplete. Neither the statistical report form,
nor information contained in the form, shall be admissible in
evidence in this or any subsequent proceeding.
Sec. 30. [CONTRIBUTION OF NONINSTITUTIONALIZED SPOUSE.]
The commissioner of public welfare shall adjust the
schedule for determining the contribution required from the
noninstitutionalized spouse of a resident or patient of a
nursing home or hospital to reflect an increase of at least 50
percent in the cost of living of the noninstitutionalized spouse
and shall provide for subsequent periodic adjustments to reflect
future increases using the RSD1 cost of living charge.
Sec. 31. [CITIZEN REVIEW BOARD PILOT PROJECT.]
Subdivision 1. [PURPOSE.] The purpose of a citizen review
board pilot project is to determine (1) the need for and
feasibility of establishing a statewide system of citizen review
boards for children placed in substitute care for more than six
months; (2) the optimal methods of achieving statewide
compliance with the requirements of Public Law 96-272, Sections
427 and 475; (3) a comparison of the citizen review board
concept with local social service agency administrative review
panels; (4) whether a citizen review facilitates the timely
return of children to their birth parents, placement for
adoption, or other permanency plans; and (5) whether the citizen
review process provides benefits to children that are comparable
to those provided by the juvenile court.
Subd. 2. [PILOT PROJECT; ESTABLISHMENT.] The commissioner
of public welfare, hereinafter the commissioner, shall establish
a citizen review board pilot project in at least one judicial
district to be determined by the commissioner. The citizen
review boards shall review one-half of the cases of children in
substitute care for more than six months in each project
district. The other one-half will be reviewed under existing
administrative review procedures.
Subd. 3. [CITIZEN REVIEW BOARD.] There shall be one
citizen review board for every 75 children eligible for review
by a citizen board in each project area. Each board shall
consist of five members who are residents of the judicial
district and have shown an interest in the welfare of children.
Each board shall, to the extent feasible, represent the various
socio-economic, racial, and ethnic groups of the district in
which it serves. At least one member shall be a foster parent.
No more than one person may be employed by the department of
public welfare, by a child welfare agency, or by the juvenile
court. Board members shall be appointed by the commissioner in
consultation with the administrator of the local social services
agency and the presiding judge of the juvenile court. Board
members shall be required to attend in-service training sessions
sponsored by the commissioner. Board members shall be appointed
to serve a term that expires June 30, 1987. Appointments to
fill vacancies on the board shall be made in the same manner and
subject to the same conditions as the initial appointments to
the board. Members shall continue to serve until a successor is
appointed. Members of the board shall not receive compensation
but shall be reimbursed for expenses.
Subd. 4. [REVIEW.] For purposes of determining what
efforts have been made by the supervising agency or child caring
institution to carry out the plan for permanent placement of
each child subject to review under the project, citizen review
boards shall, every six months from the date of the child's
initial placement, review the cases of participating children
who have resided in public or private foster care for a period
of more than six months and who are under the jurisdiction of
(1) the commissioner of corrections; (2) the designated social
service agency; (3) the commissioner of public welfare pursuant
to Minnesota Statutes, section 260.242; or (4) a child placing
agency, a facility licensed pursuant to Minnesota Statutes,
sections 245.781 to 245.812, a county home school, or a licensed
group foster home. All children in care who are subject to
citizen board review shall be reviewed within a year and every
six months thereafter until the project expires. The review
procedure established by this subdivision shall replace
administrative reviews required by Minnesota Statutes, section
257.071, subdivision 2, for children reviewed under the pilot
project.
Subd. 5. [RETURN OF CHILDREN TO PARENTS; ADOPTION.]
Citizen review boards shall encourage and facilitate the timely
return to their birth parents of foster children reviewed under
this program or, where appropriate, shall encourage the
appropriate agency to initiate procedures to make the child free
for adoption and to exert maximum effort to place the child for
adoption.
Subd. 6. [RECOMMENDATIONS TO JUVENILE COURT AND THE LOCAL
SOCIAL SERVICES AGENCY.] The citizen review board shall submit
to the juvenile court and the local social services agency,
within ten days following review of any placement, findings and
recommendations regarding the efforts and progress made by the
designated local social services agency to carry out the case
placement plan established pursuant to Minnesota Statutes,
section 257.071, together with any other recommendations
regarding the child. The findings and recommendations shall
include the date of the next review; the signature of all
persons attending the review; documentation of the procedural
safeguards as required in Public Law 96-272, Section 475; and
any comments the birth parents or the child wish to communicate
to the agency or the court.
Subd. 7. [UNNECESSARY CHANGES IN PLACEMENT.] Citizen
review boards shall promote and encourage the department of
public welfare and all agencies involved in placing children in
foster care to maximize stability and family continuity for
children in foster care by discouraging unnecessary changes in
the placement of foster children.
Subd. 8. [APPROPRIATENESS OF PLACEMENT.] Citizen review
boards shall review foster care placements and family
recruitment policies of agencies involved in placing children
for adoption to ensure that the best interests of minority
children are met by having due consideration given to their
racial and ethnic heritage.
Subd. 9. [INFORMATION ON RIGHTS.] Citizen review boards
shall assist the local social services agencies in informing
birth parents, foster parents, and other interested parties of
their rights and responsibilities with respect to any child in
foster care. Birth parents, foster parents, the child, and
other interested parties shall be allowed to participate in the
review process.
Subd. 10. [DEFICIENCY REPORTS.] Citizen review boards
shall report to the department of public welfare, the local
social services agency, and other adoptive or foster care
agencies deficiencies in the agencies' efforts to secure
permanent homes for children whose cases have been reviewed by
the board.
Subd. 11. [AGENCY COOPERATION; DATA PRIVACY REQUIREMENTS.]
All public and private agencies and institutions that provide or
arrange foster care services for children shall cooperate with
the citizen review boards by furnishing information required for
effective implementation of this section. Information in the
possession of a public agency or institution shall be provided
pursuant to Minnesota Statutes, section 13.05, subdivision 9,
and shall retain the same classification in the possession of a
citizen review board as it had in the possession of the public
agency or institution. Information supplied by a private agency
or institution that identifies an individual shall not be
disclosed or disseminated by a citizen review board for any
purpose except as required to implement this section.
Subd. 12. [LIMITATIONS.] This section shall not be
construed to limit or delay actions by agencies or institutions
to arrange for adoptions, foster care, termination of parental
rights, or other related matters on their own initiative; or to
alter or restrict the duties and authority of those agencies and
institutions in those matters.
Subd. 13. [REVIEW; REPORT.] The commissioner shall monitor
each pilot project. The commissioner, the local social services
agency, and the presiding judge of the juvenile court in each
project area shall review the quality, efficiency, and
effectiveness of the pilot project. The commissioner shall
evaluate the projects and report to the legislature by November
15, 1986. The report shall include: (1) a comparison of the
citizen review board process and the local social services
agency administrative review panels; (2) the cost-effectiveness
of the citizen review board; (3) the effect upon the numbers of
children in substitute care for longer than six months; (4) the
number of children served; (5) the extent of compliance with
federal requirements; (6) the quality and efficiency of the
citizen review board pilot projects; and (7) recommendations
regarding establishment of citizen review boards statewide in
order to maximize achievement of statewide compliance with
requirements of Public Law 96-272, Sections 427 and 475.
Sec. 32. [RULES OF THE DEPARTMENT.]
For purposes of the pilot projects the department of public
welfare shall promulgate permanent rules necessary to implement
section 1.
Sec. 33. [REPEALER.]
Minnesota Statutes 1982, sections 144.7021, 144.704, and
144.705 are repealed.
Sec. 34. [APPROPRIATIONS.]
Subdivision 1. There is appropriated to the commissioner
of public welfare from the general fund for the purposes of
sections 25 and 31, $776,000, for the fiscal year ending June
30, 1985. This appropriation is added to the appropriation for
medical assistance in Laws 1983, chapter 312, article 1, section
2, subdivisions 1 and 5.
Subd. 2. There is appropriated from the general fund to
the commissioner of health, $10,000 for the biennium ending June
30, 1985, for the purpose of processing the data received
pursuant to sections 1 and 30.
Sec. 35. [EFFECTIVE DATE.]
Sections 14 to 22, 24, 28, and 31 are effective July 1,
1984. Section 23 is effective for all transfers which occur on
or after the effective date of this act. Sections 12 and 13 of
this act are effective the day after final enactment and apply
to all claims which have not yet been reduced to judgment.
Section 25 is effective October 1, 1984.
Approved April 25, 1984
Official Publication of the State of Minnesota
Revisor of Statutes