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Minnesota Legislature

Office of the Revisor of Statutes

Key: (1) language to be deleted (2) new language

  

                         Laws of Minnesota 1985 

                         CHAPTER 21-H.F.No. 621 
           An act relating to mental health; revising the 
          language of statutes concerning persons with mental 
          illness and mental retardation and revising the 
          language of statutes concerning state treatment 
          facilities; amending Minnesota Statutes 1984, sections 
          147.021, subdivision 1; 243.55, subdivision 3; 
          245.072; 245.52; 245.821, subdivision 1; 245.825, 
          subdivision 1; 246.01; 246.013; 246.014; 246.13; 
          246.23; 246.234; 246.41; 246.50; 246.511; 246.52; 
          246.53; 246.54; 246.55; 246.56; 252.025; 252.05; 
          252.06; 252.07; 252.09; 252.10; 252.21; 252.22; 
          252.23; 252.24; 252.25; 252.27; 252.275, subdivisions 
          1 and 7; 252.28; 252.291; 252.30; 252.31; 252.32; 
          253.015; 253.10; 253.19; 253.20; 253.21; 253.25; 
          253.26; 256.01, subdivisions 2 and 5; 256.91; 256.93, 
          subdivision 1; 256B.02, subdivisions 2 and 8, and by 
          adding a subdivision; 256B.092; 256B.36; 256B.501; 
          256E.03, subdivision 2; 256E.06, subdivision 2a; 
          260.092; 260.36; 284.05; 299F.77; 447.42; 447.45; 
          501.27; and 517.03; proposing coding for new law in 
          Minnesota Statutes, chapter 252. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1984, section 147.021, 
subdivision 1, is amended to read:  
    Subdivision 1.  The board shall censure, shall refuse to 
grant a license to, shall order re-examination, or shall 
suspend, revoke, condition, limit, qualify or restrict the 
license, whether granted under this chapter or under Minnesota 
Statutes 1961, Sections 148.11 to 148.16, prior to May 1, 1963, 
of any person whom such board, after a hearing, adjudges 
unqualified or who the board determines after such a hearing is 
any one or more of the following: 
    (a) a person who fails to demonstrate the qualifications or 
satisfy the standards for a license contained in this chapter or 
rules of the board.  The burden of proof shall be upon the 
applicant to demonstrate such qualifications or satisfaction of 
such standards. 
    (b) a person who makes misleading, deceptive, untrue or 
fraudulent representations in the practice of medicine or who 
employs a trick or scheme in the practice of medicine or fraud 
or deceit in obtaining a license to practice medicine. 
    (c) a person who at any time during the previous five years 
was convicted of a felony reasonably related to his practice of 
medicine or osteopathy.  Conviction as used in this subdivision 
shall include a conviction of an offense which if committed in 
this state would be deemed a felony without regard to its 
designation elsewhere, or a criminal proceeding where a finding 
or verdict of guilt is made or returned but the adjudication of 
guilt is either withheld or not entered thereon.  
    (d) a person whose license to practice medicine has been 
revoked, suspended, annulled or with regard to whom disciplinary 
action has been taken or whose application for a license has 
been denied by the proper licensing authority of another state, 
territory or country.  
    In clauses (c) and (d) a copy of the judgment or proceeding 
under the seal of the clerk of the court or of the 
administrative agency which entered the same shall be admissible 
into evidence without further authentication and shall 
constitute prima facie evidence of the contents thereof.  
    (e) a person who advertises in any manner, either in his 
own name or under the name of another person or concern, actual 
or pretended, in any newspaper, pamphlet, circular, or other 
written or printed paper or document, professional superiority 
to or greater skill than that possessed by another doctor of 
medicine or another doctor of osteopathy licensed to practice 
medicine under this chapter, or the positive cure of any disease.
    (f) a person who violates a lawful rule promulgated by the 
board or violates a lawful order of the board, previously 
entered by the board in a disciplinary hearing. 
    (g) a person who engages in any unethical, deceptive or 
deleterious conduct or practice harmful to the public, or who 
demonstrates a willful or careless disregard for the health, 
welfare or safety of his patients, in any of which cases, proof 
of actual injury need not be established. 
    (h) a person who procures, aids, or abets in the procuring 
of a criminal abortion. 
    (i) a person who violates a statute or rule of this state 
or of any other state or of the United States which relates to 
the practice of medicine or in part regulates the practice of 
medicine. 
    (j) a person who has been adjudged mentally incompetent, 
mentally ill or mentally deficient retarded, or adjudged to be a 
drug chemically dependent person, an inebriate person, a person 
dangerous to the public, or a person who has a psychopathic 
personality by a court of competent jurisdiction, within or 
without this state. Such adjudication shall automatically 
suspend a license for the duration thereof unless the board 
orders otherwise. 
    (k) a person who is guilty of unprofessional conduct. 
Unprofessional conduct shall include any departure from or the 
failure to conform to the minimal standards of acceptable and 
prevailing medical practice in which proceeding actual injury to 
a patient need not be established. 
    (l) a person who is unable to practice medicine with 
reasonable skill and safety to patients by reason of illness, 
professional incompetence, senility, drunkenness, use of drugs, 
narcotics, chemicals or any other type of material or as a 
result of any mental or physical condition.  If the board has 
probable cause to believe that a physician comes within this 
clause, it shall direct the physician to submit to a mental or 
physical examination.  For the purpose of this clause, every 
physician licensed under this chapter shall be deemed to have 
given his consent to submit to a mental or physical examination 
when directed in writing by the board and further to have waived 
all objections to the admissibility of the examining physicians' 
testimony or examination reports on the ground that the same 
constitute a privileged communication.  Failure of a physician 
to submit to such examination when directed shall constitute an 
admission of the allegations against him, unless the failure was 
due to circumstances beyond his control, in which case a default 
and final order may be entered without the taking of testimony 
or presentation of evidence.  A physician affected under this 
clause shall at reasonable intervals be afforded an opportunity 
to demonstrate that he can resume the competent practice of 
medicine with reasonable skill and safety to patients. 
    In any proceeding under this clause, neither the record of 
proceedings nor the orders entered by the board shall be used 
against a physician in any other proceeding. 
    (m) a person who willfully betrays a professional secret. 
    (n) a doctor of osteopathy who fails to identify his school 
of healing in the professional use of his name by one of the 
following terms:  osteopathic physician and surgeon, doctor of 
osteopathy, or D.O. 
     Sec. 2.  Minnesota Statutes 1984, section 243.55, 
subdivision 3, is amended to read: 
    Subd. 3.  As used in this section, "state hospital" or 
"hospital" means any state operated facility or hospital under 
the authority of the commissioner of human services for (a) 
mentally ill, mentally deficient, or inebriate persons with 
mental illness, mental retardation, or chemical dependency, (b) 
sex offenders, or (c) persons with psychopathic personalities.  
    Sec. 3.  Minnesota Statutes 1984, section 245.072, is 
amended to read: 
    245.072 [MENTAL RETARDATION DIVISION.] 
    A mental retardation division is created in the department 
of human services which shall coordinate those laws administered 
and enforced by the commissioner of human services relating to 
mental retardation and mental deficiency related conditions, as 
defined in section 252.27, subdivision 1, which the commissioner 
may assign to the division.  The mental retardation division 
shall be under the supervision of a director whose 
responsibility it shall be to maximize the availability of 
federal or private moneys for programs to assist mentally 
retarded and mentally deficient persons with mental retardation 
or related conditions.  The commissioner shall appoint the 
director who shall serve in the classified service of the state 
civil service.  The commissioner may employ additional personnel 
with such qualifications and in such numbers as are reasonable 
and are necessary to carry out the provisions of this section. 
    Sec. 4.  Minnesota Statutes 1984, section 245.52, is 
amended to read: 
    245.52 [COMMISSIONER OF HUMAN SERVICES AS COMPACT 
ADMINISTRATOR.] 
    The commissioner of human services is hereby designated as 
"compact administrator."  He shall have the powers and duties 
specified in the compact, and he may, in the name of the state 
of Minnesota, subject to the approval of the attorney general as 
to form and legality, enter into such agreements authorized by 
the compact as he deems appropriate to effecting the purpose of 
the compact.  He shall, within the limits of the appropriations 
for the care of the mentally ill and mentally deficient 
available therefor persons with mental illness or mental 
retardation, authorize such payments as are necessary to 
discharge any financial obligations imposed upon this state by 
the compact or any agreement entered into under the compact.  
    If the patient has no established residence in a Minnesota 
county, the commissioner shall designate the county of financial 
responsibility for the purposes of carrying out the provisions 
of the Interstate Compact on Mental Health as it pertains to 
patients being transferred to Minnesota.  The commissioner shall 
designate the county which is the residence of the person in 
Minnesota who initiates the earliest written request for the 
patient's transfer.  
    Sec. 5.  Minnesota Statutes 1984, section 245.821, 
subdivision 1, is amended to read: 
    Subdivision 1.  Notwithstanding any law to the contrary, no 
private or public facility for the treatment, housing, or 
counseling of more than five mentally retarded, physically 
disabled, mentally ill, chemically or otherwise dependent 
persons with mental illness, physical disabilities, mental 
retardation or related conditions, as defined in section 252.27, 
subdivision 1, chemical dependency, or another form of 
dependency, nor any correctional facility for more than five 
persons, shall be established without 30 days written notice to 
the affected municipality or other political subdivision.  
    Sec. 6.  Minnesota Statutes 1984, section 245.825, 
subdivision 1, is amended to read: 
    Subdivision 1.  [RULES GOVERNING USE OF AVERSIVE AND 
DEPRIVATION PROCEDURES.] The commissioner of human services 
shall by October, 1983 promulgate rules governing the use of 
aversive and deprivation procedures in all licensed facilities 
serving mentally retarded persons with mental retardation or 
related conditions, as defined in section 252.27, subdivision 1. 
No provision of these rules shall encourage or require the use 
of aversive and deprivation procedures.  The rules shall 
prohibit:  (a) the application of certain aversive or 
deprivation procedures in facilities except as authorized and 
monitored by the designated regional review committees; and (b) 
the use of aversive or deprivation procedures that restrict the 
consumers' normal access to nutritious diet, drinking water, 
adequate ventilation, necessary medical care, ordinary hygiene 
facilities, normal sleeping conditions, and necessary clothing. 
The rule shall further specify that consumers may not be denied 
ordinary access to legal counsel and next of kin.  In addition, 
the rule may specify other prohibited practices and the specific 
conditions under which permitted practices are to be carried out.
    Sec. 7.  Minnesota Statutes 1984, section 246.01, is 
amended to read: 
    246.01 [POWERS AND DUTIES.] 
    The commissioner of human services is hereby specifically 
constituted the guardian of both the estate and person of all 
feeble-minded persons or persons having epilepsy with mental 
retardation, the guardianship of whom has heretofore been vested 
in the state board of control or in the director of social 
welfare whether by operation of law or by an order of court 
without any further act or proceeding, and all the powers and 
duties vested in or imposed upon the state board of control or 
the director of social welfare, with reference to mental testing 
of persons mentally deficient or persons having epilepsy with 
mental retardation, and with reference to the institutions of 
the state of Minnesota except correctional facilities 
administered and managed by the commissioner of corrections, are 
hereby transferred to, vested in, and imposed upon the 
commissioner of human services, and in relation thereto he is 
hereby charged with and shall have the exclusive power of 
administration and management of all of the following state 
institutions:  The schools and hospitals for the mentally 
retarded and persons having epilepsy, state hospitals for the 
mentally ill, and the state hospital for inebriates persons with 
mental retardation, mental illness, or chemical dependency.  He 
shall have power and authority to determine all matters relating 
to the unified and continuous development of all of the 
foregoing institutions and of such other institutions, the 
supervision of which may, from time to time, be vested in him.  
It is intended that there be vested in him all of the powers, 
functions, and authority heretofore vested in the state board of 
control relative to such state institutions.  He shall have the 
power and authority to accept, in behalf of the state, 
contributions and gifts of money and personal property for the 
use and benefit of the inmates residents of the public 
institutions under his control, and all moneys and securities so 
received shall be deposited in the state treasury subject to the 
order of the commissioner of human services.  If the gift or 
contribution is designated by the donor for a certain 
institution or purpose, the commissioner of human services shall 
expend or use the same as nearly as may be in accordance with 
the conditions of the gift or contribution, compatible with the 
best interests of the inmates and the state.  The commissioner 
of human services is hereby constituted the "state agency" as 
defined by the social security act of the United States and the 
laws of this state for all purposes relating to mental health 
and mental hygiene. 
    For the purpose of carrying out his duties, the 
commissioner of human services shall accept from mentally 
deficient wards with mental retardation for whom he is 
specifically appointed guardian a signed application for his 
consent to the marriage of said ward.  Upon receipt of such 
application he shall promptly conduct such investigation as he 
deems proper and determine if the contemplated marriage is for 
the best interest of the ward and the public.  A signed copy of 
the commissioner's determination shall be mailed to the ward and 
to the clerk of the district court of the county where the 
application for such marriage license was made. 
    There is hereby appropriated to such persons or 
institutions as are entitled to such sums as are provided for in 
this section, from the fund or account in the state treasury to 
which the money was credited, an amount sufficient to make such 
payment. 
    Sec. 8.  Minnesota Statutes 1984, section 246.013, is 
amended to read: 
    246.013 [MENTALLY ILL PERSONS WITH MENTAL ILLNESS; CARE, 
TREATMENT.] 
    Within the limits of the appropriations for the 
commissioner of human services, he is directed, in the 
performance of the duties imposed upon him by the laws of this 
state, to bring to the measure prescribed by section 246.012, 
the care and treatment of the mentally ill persons with mental 
illness as speedily as is possible, and to thereafter, subject 
to the paramount authority of the legislature with respect to 
appropriations, maintain said standards in the care and 
treatment of the mentally ill persons with mental illness.  
    Sec. 9.  Minnesota Statutes 1984, section 246.014, is 
amended to read: 
    246.014 [SERVICES.] 
    The measure of services established and prescribed by 
section 246.012, are: 
    (1) There shall be served in state hospitals a single 
standard of food for patients and employees alike, which is 
nutritious and palatable together with special diets as 
prescribed by the medical staff thereof.  There shall be a chief 
dietitian in the department of human services and at least one 
dietitian at each state hospital.  There shall be adequate staff 
and equipment for processing, preparation, distribution and 
serving of food. 
    (2) There shall be a staff of persons, professional and 
lay, sufficient in number, trained in the diagnosis, care and 
treatment of the mentally ill persons with mental illness, 
physical illness, and including religious and spiritual counsel 
through qualified chaplains (who shall be in the unclassified 
service) adequate to take advantage of and put into practice 
modern methods of psychiatry, medicine and related field. 
    (3) There shall be a staff and facilities to provide 
occupational and recreational therapy, entertainment and other 
creative activities as are consistent with modern methods of 
treatment and well being. 
    (4) There shall be in each state hospital for the care and 
treatment of the mentally ill persons with mental illness 
facilities for the segregation and treatment of patients and 
residents who have communicable disease. 
    (5) The commissioner of human services shall provide modern 
and adequate psychiatric social case work service. 
    (6) The commissioner of human services shall make every 
effort to improve the accommodations for patients and residents 
so that the same shall be comfortable and attractive with 
adequate furnishings, clothing, and supplies. 
    (7) The commissioner of human services shall establish 
training programs for the training of personnel and may require 
the participation of personnel in such programs.  Within the 
limits of the appropriations available he may establish 
professional training programs in the forms of educational 
stipends for positions for which there is a scarcity of 
applicants. 
    (8) The standards herein established shall be adapted and 
applied to the diagnosis, care and treatment of inebriate 
persons and mentally deficient persons with chemical dependency 
or mental retardation who come within those terms as defined in 
the laws relating to the hospitalization and commitment of such 
persons, and of persons who are psychopathic personalities 
within the definition thereof in Minnesota Statutes 1945, 
Section 526.09. 
    (9) The commissioner of human services shall establish a 
program of detection, diagnosis and treatment of mentally or 
nervously ill persons with mental illness and persons described 
in clause (8), and within the limits of appropriations may 
establish clinics and staff the same with persons specially 
trained in psychiatry and related fields. 
    (10) The commissioner of employee relations may reclassify 
employees of the mental institutions state hospitals from time 
to time, and assign classifications to such salary brackets as 
will adequately compensate personnel and reasonably assure a 
continuity of adequate staff. 
    (11) In addition to the chaplaincy services, provided in 
clause (2), the commissioner of human services shall open said 
institutions state hospitals to ministers members of the 
Gospel clergy and other spiritual leaders to the end that 
religious and spiritual counsel and services are made available 
to the patients and residents therein, and shall cooperate with 
all ministers members of the Gospel clergy and other spiritual 
leaders in making said patients and residents available for 
religious and spiritual counsel, and shall provide 
such ministers members of the Gospel clergy and other spiritual 
leaders with meals and accommodations. 
    (12) within the limits of the appropriations therefor, the 
commissioner of human services shall establish and provide 
facilities and equipment for research and study in the field of 
modern hospital management, the causes of mental and related 
illness and the treatment, diagnosis and care of the mentally 
ill persons with mental illness and funds provided therefor may 
be used to make available services, abilities and advice of 
leaders in these and related fields, and may provide them with 
meals and accommodations and compensate them for traveling 
expenses and services. 
    Sec. 10.  Minnesota Statutes 1984, section 246.13, is 
amended to read: 
    246.13 [RECORD OF PATIENTS AND RESIDENTS; DEPARTMENT OF 
HUMAN SERVICES.] 
    The commissioner of human services shall keep in his 
office, accessible only by his consent or on the order of a 
judge or court of record, a record showing the residence, sex, 
age, nativity, occupation, civil condition, and date of entrance 
or commitment of every person or patient, in the institutions 
state hospitals under his exclusive control, the date of 
discharge and whether such discharge was final, the condition of 
such person when he left the institution state hospital, and the 
date and cause of all deaths.  The record shall state every 
transfer from one institution state hospital to another, naming 
each.  This information shall be furnished to the commissioner 
of human services by each institution public and private agency, 
with such other obtainable facts as he may from time to time 
require.  The chief executive officer of each such institution 
state hospital, within ten days after the commitment or entrance 
thereto of a person or patient or resident, shall cause a true 
copy of his entrance record to be forwarded to the commissioner 
of human services.  When a patient or resident leaves, is 
discharged or transferred, or dies in any institution state 
hospital, the chief executive officer, or other person in charge 
shall inform the commissioner of human services within ten days 
thereafter on forms by him furnished.  
    The commissioner of human services may authorize the 
superintendent chief executive officer of any state institution 
hospital for the mentally ill, mentally retarded or persons 
having epilepsy with mental illness or mental retardation, to 
release to public or private medical personnel, hospitals, 
clinics, county welfare boards or other specifically designated 
interested persons or agencies any information regarding any 
patient or resident thereat, if, in the opinion of the 
commissioner, it will be for the benefit of the patient or 
resident.  
    Sec. 11.  Minnesota Statutes 1984, section 246.23, is 
amended to read: 
    246.23 [PERSONS ADMISSIBLE TO INSTITUTIONS STATE 
HOSPITALS.] 
    No person who has not a settlement in a county, as defined 
in section 256D.18, shall be admitted to a state hospital 
for the mentally ill, the school for the deaf, the Minnesota 
braille and sightsaving school, the schools and hospitals for 
the mentally retarded and persons having epilepsy, or the 
Owatonna state school persons with mental illness, mental 
retardation, or chemical dependency, except that the 
commissioner of human services may authorize admission thereto 
when the residence cannot be ascertained, or when the 
circumstances in his judgment make it advisable.  When 
application is made to a judge of probate for admission to any 
of the institutions state hospitals above named for admission 
thereto, if he finds that the person for whom application is 
made has not such residence, or that his residence cannot be 
ascertained, he shall so report to the commissioner; and he may 
recommend that such person be admitted notwithstanding, giving 
his reasons therefor.  The commissioner of human services shall 
thereupon investigate the question of residence and, if he finds 
that such person has not such residence and has a legal 
residence in another state or country, he may cause him to be 
returned thereto at the expense of this state.  When the 
overseer of a county poorhouse believes an inmate thereof not to 
have a residence in the state, but to have a residence 
elsewhere, he shall so notify the commissioner of human services 
who shall thereupon proceed in the manner above provided; except 
that, if deemed impracticable to return such person to the state 
of his residence, he may so certify and such person shall 
thereafter be a charge upon the county, town or city in which he 
has longest resided within the preceding year. 
    Sec. 12.  Minnesota Statutes 1984, section 246.234, is 
amended to read: 
    246.234 [RECIPROCAL EXCHANGE OF RELIEF PERSONS WITH MENTAL 
ILLNESS OR MENTAL RETARDATION.] 
    The commissioner of human services is hereby authorized and 
empowered with the approval of the governor to enter into 
reciprocal agreements with any other state or states, through 
the duly authorized authorities thereof, regarding the mutual 
exchange, return, and transportation of mentally ill persons, 
mentally deficient persons, or persons having epilepsy with 
mental illness or mental retardation who are within the confines 
of one state but have legal residence or legal settlement for 
the purposes of relief in another state.  Such agreements shall 
contain no provisions conflicting with any law of this state.  
    Sec. 13.  Minnesota Statutes 1984, section 246.41, is 
amended to read: 
    246.41 [CONTRIBUTIONS FOR BENEFIT OF MENTALLY DEFICIENT 
PERSONS AND PERSONS HAVING EPILEPSY WITH MENTAL RETARDATION.] 
    Subdivision 1.  [ACCEPTANCE.] The commissioner of human 
services is authorized to accept, for and in behalf of the 
state, contributions of money for the use and benefit of 
mentally deficient persons and persons having epilepsy with 
mental retardation.  
    Subd. 2.  [SPECIAL WELFARE FUND.] Any money so received by 
the commissioner shall be deposited with the state treasurer in 
a special welfare fund, which fund is to be used by the 
commissioner of human services for the benefit of mentally 
deficient persons and persons having epilepsy with mental 
retardation within the state, including those 
within institutions state hospitals.  And, without excluding 
other possible uses, research relating to mentally deficient 
persons and persons having epilepsy with mental retardation 
shall be considered an appropriate use of such funds; but such 
funds shall not be used for any structures or installations 
which by their nature would require state expenditures for their 
operation or maintenance without specific legislative enactment 
therefor.  
    Subd. 3.  [APPROPRIATION.] There is hereby appropriated 
from the special welfare fund in the state treasury to such 
persons as are entitled thereto to carry out the provisions 
stated in this section.  
    Sec. 14.  Minnesota Statutes 1984, section 246.50, is 
amended to read: 
    246.50 [CARE OF PATIENTS AND RESIDENTS AT STATE HOSPITALS; 
DEFINITIONS.] 
    Subdivision 1.  For the purposes of sections 246.50 to 
246.55, the terms set out in subdivisions 2 to 8 shall have the 
meanings ascribed to them.  
    Subd. 2.  "Commissioner" means the commissioner of human 
services of the state of Minnesota.  
    Subd. 3.  "State hospital" means a state hospital facility 
for the mentally ill or mentally deficient treating persons with 
mental illness, mental retardation, or chemical dependency now 
existing or hereafter established.  
    Subd. 4.  "Patient" means any person receiving care or 
treatment at a state hospital whether he entered such hospital 
voluntarily or under commitment with mental illness or chemical 
dependency.  
    Subd. 4a.  "Resident" means any mentally retarded person 
receiving care or treatment at a state hospital whether he 
entered such hospital voluntarily or under commitment.  
    Subd. 5.  "Cost of care" means the commissioner's 
determination of the anticipated average per capita cost of all 
maintenance, treatment and expense, including depreciation of 
buildings and equipment, interest paid on bonds issued for 
capital improvements to state hospitals, and indirect costs 
related to the operation other than that paid from the Minnesota 
state building fund, at all of the state hospitals for the 
mentally ill or mentally retarded or chemically dependent during 
the current year for which billing is being made.  The 
commissioner shall determine the anticipated average per capita 
cost.  The commissioner may establish one all inclusive rate or 
separate rates for each patient or resident disability group, 
and may establish separate charges for each hospital.  "Cost of 
care" for outpatient or day-care patients or residents shall be 
on a cost for service basis under a schedule the commissioner 
shall establish. 
    For purposes of this subdivision "resident patient" means a 
person who occupies a bed while housed in a hospital for 
observation, care, diagnosis, or treatment. 
    For purposes of this subdivision "outpatient" or "day-care" 
patient or resident means a person who makes use of diagnostic, 
therapeutic, counseling, or other service in a state hospital 
facility or through state hospital personnel but does not occupy 
a hospital bed overnight. 
    For the purposes of collecting from the federal government 
for the care of those patients eligible for medical care under 
the social security act "cost of care" shall be determined as 
set forth in the rules and regulations of the Department of 
Health and Human Services or its successor agency.  
    Subd. 6.  "Relatives" means the spouse, and parents of a 
patient or resident, in that order of liability for cost of care.
    Subd. 7.  "Patient's or resident's county" means the county 
of the patient's or resident's legal settlement for poor relief 
purposes at the time of commitment or voluntary admission to a 
state hospital, or if he has no such legal settlement in this 
state, it means the county of commitment, except that where a 
patient or resident with no such legal settlement is committed 
while serving a sentence at a penal institution, it means the 
county from which he was sentenced.  
    Subd. 8.  "County welfare board" means the welfare board of 
the patient's or resident's county as defined in subdivision 7 
and of the county of commitment, and any other county welfare 
board possessing information regarding, or requested by the 
commissioner to investigate, the financial circumstances of a 
patient or resident or his relatives.  
    Sec. 15.  Minnesota Statutes 1984, section 246.511, is 
amended to read: 
    246.511 [RELATIVE RESPONSIBILITY.] 
    In no case, shall a patient's or resident's relatives, 
pursuant to the commissioner's authority under section 246.51, 
be ordered to pay more than ten percent of the cost of care, 
unless they reside outside the state.  Parents of children in 
state hospitals shall have their responsibility to pay 
determined according to section 252.27, subdivision 2.  The 
commissioner may accept voluntary payments in excess of ten 
percent.  The commissioner may require full payment of the full 
per capita cost of care in state hospitals for patients or 
residents whose parent, parents, spouse, guardian or conservator 
do not reside in Minnesota.  
    Sec. 16.  Minnesota Statutes 1984, section 246.52, is 
amended to read: 
    246.52 [PAYMENT FOR CARE; ORDER; ACTION.] 
    The commissioner shall issue an order to the patient or 
resident or the guardian of his estate, if there be one, and 
relatives determined able to pay requiring them to pay monthly 
to the state of Minnesota the amounts so determined the total of 
which shall not exceed the full cost of care.  Such order shall 
specifically state the commissioner's determination and shall be 
conclusive unless appealed from as herein provided.  When a 
patient or resident or relative fails to pay the amount due 
hereunder the attorney general, upon request of the 
commissioner, may institute, or direct the appropriate county 
attorney to institute, civil action to recover such amount.  
    Sec. 17.  Minnesota Statutes 1984, section 246.53, is 
amended to read: 
    246.53 [CLAIM AGAINST ESTATE OF DECEASED PATIENT OR 
RESIDENT.] 
    Subdivision 1.  [PATIENT'S OR RESIDENT'S ESTATE.] Upon the 
death of a patient or resident, or a former patient or resident, 
the total cost of care given the patient or resident, less the 
amount actually paid toward the cost of care by the patient or 
resident and the patient's or resident's relatives, shall be 
filed by the commissioner as a claim against the estate of the 
patient or resident with the court having jurisdiction to 
probate the estate and all proceeds collected by the state in 
the case shall be divided between the state and county in 
proportion to the cost of care each has borne.  
    Subd. 2.  [PREFERRED STATUS.] An estate claim in 
subdivision 1 shall be considered an expense of the last illness 
for purposes of section 524.3-805.  
    If the commissioner of human services determines that the 
property or estate of any patient or resident is not more than 
needed to care for and maintain the spouse and minor or 
dependent children of a deceased patient or resident, the 
commissioner has the power to compromise the claim of the state 
in a manner deemed just and proper.  
    Subd. 3.  [EXCEPTION FROM STATUTE OF LIMITATIONS.] Any 
statute of limitations which limits the commissioner in 
recovering the cost of care obligation incurred by a patient or 
resident or former patient or resident shall not apply to any 
claim against an estate made hereunder to recover cost of care.  
    Sec. 18.  Minnesota Statutes 1984, section 246.54, is 
amended to read: 
    246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 
    The patient's or resident's county shall pay to the state 
of Minnesota a portion of the cost of care provided in a state 
hospital to a patient or resident legally settled in that 
county.  A county's payment shall be made from the county's own 
sources of revenue and payments shall be paid as follows:  
payments to the state from the county shall equal ten percent of 
the per capita rate, as determined by the commissioner, for each 
day, or the portion thereof, that the patient or resident spends 
at a state hospital.  If payments received by the state under 
sections 246.50 to 246.53 exceed 90 percent of the per capita 
rate, the county shall be responsible for paying the state only 
the remaining amount.  The county shall not be entitled to 
reimbursement from the patient or resident, the patient's or 
resident's estate, or from the patient's or resident's 
relatives, except as provided in section 246.53.  No such 
payments shall be made for any patient or resident who was last 
committed prior to July 1, 1947.  
    Sec. 19.  Minnesota Statutes 1984, section 246.55, is 
amended to read: 
    246.55 [APPEAL FROM ORDER OF COMMISSIONER.] 
    Any patient or resident or relative aggrieved by an order 
of the commissioner under sections 246.50 to 246.55 may appeal 
from the order to the district court of the county in which he 
resides by serving notice of the appeal on the commissioner and 
filing the notice, with proof of service, in the office of the 
clerk of the district court of the county within 30 days from 
the date the order was mailed, or a later date not exceeding one 
year from the date of mailing as permitted by order of the 
court.  The appeal may be brought on for hearing by the 
appellant or the commissioner upon ten days' written notice.  It 
shall be tried to the court which shall hear evidence it deems 
necessary and by order affirm or modify the order of the 
commissioner.  When any order or determination of the 
commissioner made under sections 246.50 to 246.55 is brought in 
question on appeal, the order or determination shall be 
determined de novo.  Appeal from the order of the district court 
may be taken as in other civil cases. 
    Sec. 20.  Minnesota Statutes 1984, section 246.56, is 
amended to read: 
    246.56 [PRE-VOCATIONAL TRAINING FOR MENTALLY ILL OR 
RETARDED PATIENTS WITH MENTAL ILLNESS OR RESIDENTS WITH MENTAL 
RETARDATION; ADMINISTRATION.] 
    Subdivision 1.  The commissioner of human services is 
hereby authorized to establish, subject to the approval of the 
commissioner of education economic security, within the 
state institutions hospitals for the mentally ill and mentally 
retarded patients with mental illness or residents with mental 
retardation, work activity programs for the manufacture, 
processing and repairing of goods, wares, and merchandise for 
the purpose of providing therapeutic work activities for 
patients and residents.  
    Subd. 2.  The work activity programs authorized herein 
shall be planned and designed exclusively to provide therapeutic 
activities for handicapped workers whose physical or mental 
impairment is so severe as to make productive capacity 
inconsequential.  The activities within this program shall 
conform to the rules and regulations relating to work activity 
centers promulgated by the United States Department of Labor.  
To accomplish the foregoing purpose the commissioner of human 
services shall have the power and authority to: 
    (a) use the diversified labor fund established by Laws 
1945, Chapter 575, Section 19, to purchase equipment and remodel 
facilities of the institutions state hospitals referred to in 
subdivision 1 to initiate the work activity program, 
    (b) formulate a system of records and accounts which shall 
at all times indicate the extent of purchases, sales, wages, and 
bidding practices and which shall be open to public inspection.  
    The commissioner of human services shall, subject to the 
approval of the commissioner of education, have the power and 
authority to: 
    (a) create a work activity center revolving fund for the 
purpose of receiving and expending moneys in the operation of 
the said programs, 
    (b) contract with public and private industries for the 
manufacture, repair, or assembling of work according to standard 
bidding practices, 
    (c) use the revenue from the operation of said programs to 
pay wages to patients and or residents according to their 
productivity, purchase equipment and supplies and pay other 
expenses necessary to the operation of the said programs, 
    (d) establish an advisory committee consisting of 
representatives from the departments of health, education 
economic security, and human services, labor and business 
groups, interested community agencies, including but not limited 
to the Minnesota Association of Rehabilitation Facilities, the 
Minnesota Association for Retarded Children, and the Minnesota 
Association for Mental Health, and the general public.  This 
committee will act in an advisory capacity with respect to the 
scope of work activity programs, the nature of the goods to be 
produced and services to be performed in such programs, 
    (e) utilize all available vocational rehabilitation 
services and encourage the integration of the work activity 
program into existing vocational rehabilitation and community 
based programs, so that the work activity program will neither 
duplicate nor unfairly compete with existing public or private 
community programs.  
    Sec. 21.  [252.021] [DEFINITION.] 
    For the purposes of this chapter, the words "related 
condition" have the meaning given them in section 252.27, 
subdivision 1. 
    Sec. 22.  Minnesota Statutes 1984, section 252.025, is 
amended to read: 
    252.025 [STATE HOSPITALS FOR MENTALLY RETARDED PERSONS AND 
PERSONS HAVING EPILEPSY PERSONS WITH MENTAL RETARDATION.] 
    Subdivision 1.  State hospitals for mentally retarded 
persons and persons having epilepsy with mental retardation 
shall be established and maintained at Faribault, Cambridge and 
Brainerd, and notwithstanding any provision to the contrary they 
shall be respectively known as the Faribault State Hospital, the 
Cambridge State Hospital, and the Brainerd State Hospital. Each 
of the foregoing state hospitals shall also be known by the name 
of regional center at the discretion of the commissioner of 
human services. 
    Subd. 2.  They shall be under the general management and 
control of the commissioner of human services. 
    Sec. 23.  Minnesota Statutes 1984, section 252.05, is 
amended to read: 
    252.05 [ABDUCTION OR ENTICING AWAY PROHIBITED; PENALTY.] 
    Every person who shall abduct, entice, or carry away from a 
state hospital for mentally retarded persons or persons having 
epilepsy with mental retardation any inmate resident thereof, 
who has not been legally discharged therefrom, shall be guilty 
of a felony and punished by a fine of not to exceed $3,000 or 
imprisonment in the Minnesota correctional facility-Stillwater 
or the Minnesota correctional facility-St. Cloud not to exceed 
three years, or both, in the discretion of the court; any and 
every person who shall abduct, entice, or carry away from any 
place other than a state hospital, a person duly committed 
as feebleminded or mentally deficient retarded to the 
guardianship of the commissioner of human services with the 
intention of wrongfully removing such person from the direct 
custody of the commissioner of human services, such person known 
by him to be under the supervision of the commissioner of human 
services or his agents, shall be guilty of a gross misdemeanor.  
    Sec. 24.  Minnesota Statutes 1984, section 252.06, is 
amended to read: 
    252.06 [SHERIFF TO TRANSPORT MENTALLY DEFICIENT PERSONS AND 
PERSONS HAVING EPILEPSY WITH MENTAL RETARDATION.] 
    It shall be the duty of the sheriff of any county, upon the 
request of the commissioner of human services, to take charge of 
and transport any mentally deficient person or any person having 
epilepsy persons with mental retardation who has been committed 
by the probate court of any county to the care and custody of 
the commissioner of human services to such institution state 
hospital as may be designated by the commissioner of human 
services and there deliver such person to the superintendent 
chief executive officer of the institution state hospital.  
    Sec. 25.  Minnesota Statutes 1984, section 252.07, is 
amended to read: 
    252.07 [SHERIFF, EXPENSES.] 
    In any county where the sheriff receives a salary in full 
compensation for official services performed for the county, he 
shall receive no additional compensation for services performed 
under the provisions of sections 252.06 to 252.08, but he shall 
be reimbursed by the county wherein such mentally deficient 
person or person having epilepsy person with mental retardation 
was committed for the necessary expenses incurred by him in 
taking charge of and transporting such person to such 
institution a state hospital and the subsistence of himself and 
such person while enroute.  
    In any county where the sheriff does not receive a salary 
he shall be paid $5 a day for the time necessarily employed in 
performance of the service, together with expenses incurred by 
him in taking charge of and transporting such person to such 
institution state hospital and the subsistence of himself and 
such person while enroute.  
    When the mentally deficient person or person having 
epilepsy with mental retardation is a female, the sheriff shall 
appoint some suitable woman to act in his stead.  Such woman 
shall exercise all the powers vested in the sheriff and shall be 
paid $5 per day for the time necessarily employed in the 
performance of such service, together with expenses incurred by 
her in taking charge of and transporting such person to 
such institution state hospital and the subsistence of herself 
and such person while enroute.  
    Sec. 26.  Minnesota Statutes 1984, section 252.09, is 
amended to read: 
    252.09 [COURSES OF INSTRUCTION FOR TEACHERS.] 
    The commissioner of human services may establish and 
maintain at the state hospital for mentally retarded persons and 
persons having epilepsy with mental retardation at Faribault 
courses of instruction for teachers and others interested in the 
care and training of mentally retarded or defective children 
persons with mental retardation and make all necessary rules and 
regulations for the organization and conduct of such courses.  
    Sec. 27.  Minnesota Statutes 1984, section 252.10, is 
amended to read: 
    252.10 [FEES AND EXPENSES.] 
    The commissioner of human services shall charge and collect 
from each person taking any such courses of instruction an 
amount for board and tuition not exceeding $10 per week and the 
moneys so collected shall be turned into the state treasury as 
are other miscellaneous receipts from the institution state 
hospital.  The expenses incident to the conduct of such courses 
of instruction and for the board of those taking the same shall 
be paid as are the other expenses for maintaining the state 
hospital for the mentally retarded persons and persons having 
epilepsy with mental retardation.  The courses of instruction 
herein referred to shall, within the limitation of charges as 
stated, be made as near self-sustaining as possible.  
    Sec. 28.  Minnesota Statutes 1984, section 252.21, is 
amended to read: 
    252.21 [COUNTY BOARDS MAY MAKE GRANTS FOR DEVELOPMENTAL 
ACHIEVEMENT CENTER SERVICES FOR THE MENTALLY RETARDED AND 
CEREBRAL PALSIED PERSONS WITH MENTAL RETARDATION OR RELATED 
CONDITIONS.] 
    In order to assist county boards in carrying out 
responsibilities for the provision of daytime developmental 
achievement center services for eligible persons, the county 
board or boards are hereby authorized to make grants, within the 
limits of the money appropriated, to developmental achievement 
centers for services to mentally retarded and cerebral palsied 
persons with mental retardation or related conditions.  In order 
to fulfill its responsibilities to the mentally retarded and 
cerebral palsied persons with mental retardation or related 
conditions as required by section 256E.08, subdivision 1, a 
county board may, beginning January 1, 1983, contract with 
developmental achievement centers or other providers.  
    Sec. 29.  Minnesota Statutes 1984, section 252.22, is 
amended to read: 
    252.22 [APPLICANTS FOR ASSISTANCE; TAX LEVY.] 
    Any city, town, or non-profit corporation or any 
combination thereof, may apply to the county board for 
assistance in establishing and operating a developmental 
achievement center and program for mentally retarded and 
cerebral palsied persons with mental retardation or related 
conditions.  Application for such assistance shall be on forms 
supplied by the board.  Each applicant shall annually submit to 
the board its plan and budget for the next fiscal year.  No 
applicant shall be eligible for a grant hereunder unless its 
plan and budget have been approved by the board. 
    Any city, town, or county is authorized, at the discretion 
of its governing body, to make grants from special tax revenues 
or from its general revenue fund to any nonprofit organization, 
governmental or corporate, within or outside its jurisdiction, 
that has established a developmental achievement center for the 
mentally retarded and cerebral palsied persons with mental 
retardation or related conditions.  Nothing contained herein 
shall in any way preclude the use of funds available for this 
purpose under any existing statute or charter provision relating 
to cities, towns and counties.  
    Sec. 30.  Minnesota Statutes 1984, section 252.23, is 
amended to read: 
    252.23 [ELIGIBILITY REQUIREMENTS.] 
    A developmental achievement center shall satisfy all of the 
following requirements to be eligible for assistance under 
sections 252.21 to 252.26: 
    (1) Provide daytime activities for any or all of the 
following classes of persons: 
    Mentally retarded and cerebral palsied children Children 
with mental retardation or related conditions who can benefit 
from the program of services, including those school age 
children who have been excused or excluded from school; 
    Mentally retarded and cerebral palsied children and adults 
Children and adults with mental retardation or related 
conditions who are unable to attend school because of their 
chronological age and are unable to independently engage in 
ordinary community activities; 
    (2) Provide counseling services to parents or guardians of 
mentally retarded and cerebral palsied persons with mental 
retardation or related conditions who may register at the center;
    (3) Comply with all rules duly promulgated by the 
commissioner of human services. 
    Sec. 31.  Minnesota Statutes 1984, section 252.24, is 
amended to read: 
    252.24 [DUTIES OF COUNTY BOARDS.] 
    Subdivision 1.  [SELECTION OF DEVELOPMENTAL ACHIEVEMENT 
CENTERS.] The county board shall administer developmental 
achievement services, including training and habilitation 
services provided by licensed developmental achievement centers 
to residents of intermediate care facilities for the mentally 
retarded.  The county board shall ensure that transportation is 
provided for persons who fulfill the eligibility requirements of 
section 252.23, clause (1), utilizing the most efficient and 
reasonable means available.  The county board may contract for 
developmental achievement services and transportation from a 
center which is licensed under the provisions of sections 
245.781 to 245.813, 252.28, and 257.175, and in the board's 
opinion, best provides daytime developmental achievement 
services for mentally retarded and cerebral palsied persons with 
mental retardation or related conditions within the 
appropriation and medical assistance resources made available 
for this purpose.  Daytime developmental achievement services 
administered by the county board shall comply with standards 
established by the commissioner pursuant to subdivision 2 and 
applicable federal regulations.  
    Subd. 2.  [SUPERVISION OF PROJECTS; PROMULGATION OF RULES.] 
The commissioner of human services shall closely supervise any 
developmental achievement center receiving a grant under 
sections 252.21 to 252.26.  He shall promulgate rules in the 
manner provided by law as necessary to carry out the purposes of 
sections 252.21 to 252.26, including but not limited to rules 
pertaining to facilities for housing developmental achievement 
centers, administration of centers, and eligibility requirements 
for admission and participation in activities of the center. 
    Subd. 3.  [PAYMENT PROCEDURE.] The board at the beginning 
of each year, shall allocate available money for developmental 
achievement services for disbursement during the year to those 
centers that have been selected to receive grants and whose 
plans and budgets have been approved.  The board shall, from 
time to time during the fiscal year, review the budgets, 
expenditures and programs of the various centers and if it 
determines that any amount of funds are not needed for any 
particular center to which they were allocated, it may, after 30 
days' notice, withdraw such funds as are unencumbered and 
reallocate them to other centers.  It may withdraw all funds 
from any center upon 90 days' notice whose program is not being 
administered in accordance with its approved plan and budget. 
    Subd. 4.  [FEES.] The county board may, with the approval 
of the commissioner, establish a schedule of fees for daytime 
developmental achievement services as provided in section 
256E.08, subdivision 6.  No mentally retarded or cerebral 
palsied person with mental retardation or related condition 
shall be denied daytime developmental achievement services 
because of an inability to pay such a fee. 
    Sec. 32.  Minnesota Statutes 1984, section 252.25, is 
amended to read: 
    252.25 [BOARD OF DIRECTORS.] 
    Every city, town, or non-profit corporation, or combination 
thereof, establishing a developmental achievement center for the 
mentally retarded and cerebral palsied persons with mental 
retardation or related conditions shall, before it comes under 
the terms of sections 252.21 to 252.26, appoint a board of 
directors for the center program.  When any city or town singly 
establishes such a center, such board shall be appointed by the 
chief executive officer of the city or the chairman of the 
governing board of the town.  When any combination of cities, 
towns, or non-profit corporations, establishes such a center, 
the chief executive officers of the cities or non-profit 
corporations and the chairman of the governing bodies of the 
towns shall appoint the board of directors.  If a non-profit 
corporation singly establishes such a center, its chief 
executive officer shall appoint the board of directors of the 
center.  Membership on a board of directors while not mandatory, 
should be representative of local health, education and welfare 
departments, medical societies, mental health centers, 
associations concerned with mental retardation and cerebral 
palsy related conditions, civic groups and the general public.  
Nothing in sections 252.21 to 252.26 shall be construed to 
preclude the appointment of elected or appointed public 
officials or members of the board of directors of the sponsoring 
non-profit corporation to such board of directors.  
    Sec. 33.  Minnesota Statutes 1984, section 252.27, is 
amended to read: 
    252.27 [COST OF BOARDING CARE OUTSIDE OF HOME OR 
INSTITUTION.] 
    Subdivision 1.  Whenever any child who has mental 
retardation, epilepsy or a related condition, or a physical or 
emotional handicap is in 24 hour care outside the home including 
respite care, in a facility licensed by the commissioner of 
human services, the cost of care shall be paid by the county of 
financial responsibility determined pursuant to section 256E.08, 
subdivision 7.  If the child's parents or guardians do not 
reside in this state, the cost shall be paid by the county in 
which the child is found.  For the purposes of this section an 
"emotionally handicapped child" means any child having A person 
has a "related condition" if that person has a severe, chronic 
disability that is (a) attributable to cerebral palsy, epilepsy, 
autism, or any other condition, other than mental illness, found 
to be closely related to mental retardation because the 
condition results in impairment of general intellectual 
functioning or adaptive behavior similar to that of persons with 
mental retardation or requires treatment or services similar to 
those required for persons with mental retardation; (b) is 
likely to continue indefinitely; and (c) results in substantial 
functional limitations in three or more of the following areas 
of major life activity:  self care, understanding and use of 
language, learning, mobility, self-direction, or capacity for 
independent living.  For the purposes of this section, a child 
has an "emotional handicap" if the child has a psychiatric or 
other emotional disorder which substantially impairs his mental 
health and who requires 24 hour treatment or supervision. 
    Subd. 2.  Responsibility of the parents for the cost of 
care shall be based upon ability to pay.  The state agency shall 
adopt rules to determine responsibility of the parents for the 
cost of care when:  
    (a) Insurance or other health care benefits pay some but 
not all of the cost of care; and 
    (b) No insurance or other health care benefits are 
available.  
    Parents who have more than one child in out-of-home care 
shall not be required to pay more than the amount for one child 
in out-of-home care.  In no event shall the parents be required 
to pay more than five percent of their income as defined in 
section 290A.03, subdivision 3.  There shall be no resource 
contribution from the parents.  
     Responsibility of the child for the cost of care shall be 
up to the maximum amount of the total income and resources 
attributed to the child except for the clothing and personal 
needs allowance as provided in section 256B.35, subdivision 1.  
Reimbursement by the parents and child shall be made to the 
county making any payments for care and treatment.  The county 
board may require payment of the full cost of caring for 
children whose parents or guardians do not reside in this state. 
     To the extent that a child described in subdivision 1 is 
eligible for benefits under chapters 62A, 62C, 62D, 62E, or 64A, 
the county is not liable for the cost of care.  A parent or 
legal guardian who discontinues payment of health insurance 
premiums, subscriber fees or enrollment fees for a child who is 
otherwise eligible for those benefits is ineligible for payment 
of the cost of care of that child under this section.  
     The commissioner's determination shall be conclusive in any 
action to enforce payment of the cost of care.  Any appeals from 
the commissioner's determination shall be made pursuant to 
section 256.045, subdivisions 2 and 3. 
    Subd. 3.  If the parent fails to make appropriate 
reimbursement as required in subdivision 2, the county attorney 
may initiate a civil action to collect any unpaid reimbursement. 
    Subd. 4.  In order to determine the effectiveness of the 
family unit in providing alternate living arrangements and 
providing or arranging for the training and developmental 
opportunities provided in a state hospital or a licensed 
community residential facility, the commissioner of human 
services may establish an experimental program to subsidize 
selected families who agree to carry out a planned program of 
home care and training for their minor dependents who are 
mentally retarded with mental retardation or related conditions. 
    This program shall be limited to children who otherwise 
would require and be eligible for placement in state hospitals 
or licensed community residential facilities. 
    Grants to families shall be determined by the commissioner 
of human services.  In determining the grants, the commissioner 
shall consider the cost of diagnostic assessments, homemaker 
services, training expenses including specialized equipment, 
visiting nurses' or other pertinent therapists' costs, preschool 
program costs, related transportation expenses, and parental 
relief or child care costs not to exceed $250 per month per 
family. 
    An individual care and training plan for the child shall be 
established and agreed upon by the parents receiving the subsidy 
and the appropriate local welfare agency.  Periods of parental 
relief, including vacations, may be included in the plan and do 
not require the approval of the local welfare agency.  The plan 
shall be periodically evaluated to determine the progress of the 
child. 
    Sec. 34.  Minnesota Statutes 1984, section 252.275, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PROGRAM.] The commissioner of human 
services shall establish a statewide program to assist counties 
in reducing the utilization of intermediate care services in 
state hospitals and in community residential facilities for 
persons who are mentally retarded with mental retardation or 
related conditions.  The commissioner shall make grants to 
county boards to establish, operate, or contract for the 
provision of semi-independent living services licensed by the 
commissioner pursuant to sections 245.781 to 245.812 and 252.28. 
    Sec. 35.  Minnesota Statutes 1984, section 252.275, 
subdivision 7, is amended to read:  
    Subd. 7.  [REPORTS.] The commissioner shall require 
collection of data and periodic reports necessary to demonstrate 
the effectiveness of semi-independent living services in helping 
mentally retarded persons with mental retardation or related 
conditions achieve self-sufficiency and independence.  The 
commissioner shall report to the legislature no later than 
January 15, 1984, on the effectiveness of the program, its 
effect on reducing the number of mentally retarded persons with 
mental retardation or related conditions in state hospitals and 
in intermediate care facilities, and his recommendations 
regarding making this program an integral part of the social 
services programs administered by the counties.  
    Sec. 36.  Minnesota Statutes 1984, section 252.28, is 
amended to read: 
    252.28 [COMMISSIONER OF HUMAN SERVICES; DUTIES.] 
    Subdivision 1.  [DETERMINATIONS; BIENNIAL 
REDETERMINATIONS.] The commissioner of human services shall 
determine, and shall redetermine biennially, the need, location, 
size, and program of public and private residential and day care 
facilities and services for mentally retarded children and 
adults with mental retardation or related conditions. 
    Subd. 2.  [RULES; PROGRAM STANDARDS; LICENSES.] The 
commissioner of human services shall: 
    (1) Establish uniform rules, regulations and program 
standards for each type of residential and day facility or 
service for mentally retarded persons with mental retardation or 
related conditions, including state institutions hospitals under 
control of the commissioner and serving mentally retarded 
persons with mental retardation or related conditions, and 
excluding mentally retarded persons with mental retardation or 
related conditions residing with their families. 
    (2) Grant licenses according to the provisions of Laws 
1976, chapter 243, sections 2 to 13. 
    Subd. 3.  [LICENSING DETERMINATIONS.] (1) No new license 
shall be granted pursuant to this section when the issuance of 
the license would substantially contribute to an excessive 
concentration of community residential facilities within any 
town, municipality or county of the state. 
    (2) In determining whether a license shall be issued 
pursuant to this subdivision, the commissioner of human services 
shall specifically consider the population, size, land use plan, 
availability of community services and the number and size of 
existing public and private community residential facilities in 
the town, municipality or county in which a licensee seeks to 
operate a residence.  Under no circumstances may the 
commissioner newly license any facility pursuant to this section 
except as provided in section 245.812.  The commissioner of 
human services shall establish uniform rules and regulations to 
implement the provisions of this subdivision. 
    (3) Licenses for community facilities and services shall be 
issued pursuant to section 245.821. 
    Subd. 4.  [RULES; DECERTIFICATION OF BEDS.] The 
commissioner shall promulgate in rule criteria for 
decertification of beds in intermediate care facilities for the 
mentally retarded persons with mental retardation or related 
conditions, and shall encourage providers in voluntary 
decertification efforts.  The commissioner shall not recommend 
to the commissioner of health the involuntary decertification of 
an intermediate care facility for beds for the mentally retarded 
persons with mental retardation or related conditions prior to 
the availability of appropriate services for those residents 
affected by the decertification.  The commissioner of health 
shall decertify those intermediate care beds determined to be 
not needed by the commissioner of human services.  
    Sec. 37.  Minnesota Statutes 1984, section 252.291, is 
amended to read: 
    252.291 [LIMITATION ON DETERMINATION OF NEED.] 
    Subdivision 1.  [MORATORIUM.] Notwithstanding section 
252.28, subdivision 1, or any other law or rule to the contrary, 
the commissioner of human services shall deny any request for a 
determination of need and refuse to grant a license pursuant to 
section 245.782 for any new intermediate care facility for 
mentally retarded persons with mental retardation or related 
conditions or for an increase in the licensed capacity of an 
existing facility except as provided in subdivision 2.  In no 
event shall the total of certified intermediate care beds 
for mentally retarded persons with mental retardation or related 
conditions in community facilities and state hospitals exceed 
7,500 beds as of July 1, 1983, and 7,000 beds as of July 1, 
1986.  "Certified bed" means an intermediate care bed for the 
mentally retarded persons with mental retardation or related 
conditions certified by the commissioner of health for the 
purposes of the medical assistance program under United States 
Code, title 42, sections 1396 to 1396p, as amended through 
December 31, 1982.  
    Subd. 2.  [EXCEPTIONS.] The commissioner of human services 
in coordination with the commissioner of health may approve a 
new intermediate care facility for mentally retarded 
persons with mental retardation or related conditions only in 
the following circumstances:  
    (a) when the facility is developed in accordance with a 
request for proposal system established pursuant to subdivision 
3, clause (b);  
    (b) when the facility is necessary to serve the needs of 
identifiable mentally retarded persons with mental retardation 
or related conditions who are seriously behaviorally disordered 
or who are physically or sensorily impaired; or 
    (c) to license beds in new facilities where need was 
determined by the commissioner prior to June 10, 1983.  
    Subd. 3.  [DUTIES OF COMMISSIONER OF HUMAN SERVICES.] The 
commissioner shall:  
    (a) establish standard admission criteria for state 
hospitals and county utilization targets to limit and reduce the 
number of intermediate care beds in state hospitals and 
community facilities in accordance with approved waivers under 
United States Code, title 42, sections 1396 to 1396p, as amended 
through December 31, 1982, to assure that appropriate services 
are provided in the least restrictive setting;  
    (b) provide technical assistance so that county boards may 
establish a request for proposal system for meeting individual 
service plan objectives through home and community-based 
services; alternative community services; or, if no other 
alternative will meet the needs of identifiable individuals for 
whom the county is financially responsible, a new intermediate 
care facility for mentally retarded persons with mental 
retardation or related conditions; and 
    (c) establish a client tracking and evaluation system as 
required under applicable federal waiver regulations, Code of 
Federal Regulations, title 42, sections 431, 435, 440, and 441, 
as amended through December 31, 1982.  
    (d) develop a state plan for the delivery and funding of 
residential day and support services to the mentally retarded 
persons with mental retardation or related conditions in 
Minnesota and submit that plan to the clerk of each house of the 
Minnesota legislature on or before the 15th of January of each 
biennium beginning January 15, 1985.  The biennial mental 
retardation plan shall include but not be limited to: 
    (1) county by county maximum intermediate care bed 
utilization quotas;  
    (2) plans for the development of the number and types of 
services alternative to intermediate care beds;  
    (3) procedures for the administration and management of the 
plan;  
    (4) procedures for the evaluation of the implementation of 
the plan; and 
    (5) the number, type, and location of intermediate care 
beds targeted for decertification. 
    The commissioner shall modify the plan to ensure 
conformance with the medical assistance home and community-based 
services waiver.  
    Subd. 4.  [MONITORING.] The commissioner of human services, 
in coordination with the commissioner of health, shall implement 
mechanisms to monitor and analyze the effect of the bed 
moratorium in the different geographic areas of the state.  The 
commissioner of human services shall submit to the legislature 
annually beginning January 15, 1984, an assessment of the impact 
of the moratorium by geographic areas.  
    Subd. 5.  [RULEMAKING.] The commissioner of human services 
shall promulgate emergency and permanent rules pursuant to 
chapter 14, the Administrative Procedure Act, to implement this 
section.  
    Sec. 38.  Minnesota Statutes 1984, section 252.30, is 
amended to read: 
    252.30 [AUTHORIZATION TO MAKE GRANTS FOR COMMUNITY 
RESIDENTIAL FACILITIES.] 
    The commissioner of human services may make grants to 
nonprofit organizations, municipalities or local units of 
government to provide up to 25 percent of the cost of 
constructing, purchasing or remodeling small community 
residential facilities for mentally retarded and cerebral 
palsied persons with mental retardation or related conditions 
allowing such persons to live in a homelike atmosphere near 
their families.  Operating capital grants may also be made for 
up to three months of reimbursable operating costs after the 
facility begins processing applications for admission and prior 
to reimbursement for services.  Repayment of the operating 
grants shall be made to the commissioner of human services at 
the end of the provider's first fiscal year, or at the 
conclusion of the interim rate period, whichever occurs first.  
No aid under this section shall be granted to a facility 
providing for more than 16 residents in a living unit and with 
more than two living units.  The advisory council established by 
section 252.31 shall recommend to the commissioner appropriate 
disbursement of the funds appropriated by Laws 1973, Chapter 
673, Section 3.  Prior to any disbursement of funds the 
commissioner shall review the plans and location of any proposed 
facility to determine whether such a facility is needed.  The 
commissioner shall promulgate such rules and regulations for the 
making of grants and for the administration of section 252.30 as 
he deems proper.  The remaining portion of the cost of 
constructing, purchasing, remodeling facilities, or of operating 
capital shall be borne by nonstate sources including federal 
grants, local government funds, funds from charitable sources, 
gifts and mortgages. 
    Sec. 39.  Minnesota Statutes 1984, section 252.31, is 
amended to read: 
    252.31 [ADVISORY TASK FORCE.] 
    The commissioner of human services may appoint an advisory 
task force for the mentally retarded and physically 
handicapped persons with mental retardation, related conditions, 
or physical handicaps.  The task force shall advise the 
commissioner relative to those laws for which the commissioner 
is responsible to administer and enforce relating to mental 
retardation or related conditions and physical disabilities.  
The task force shall consist of persons who are providers or 
consumers of service for the mentally retarded persons with 
mental retardation, related conditions, or physically 
handicapped physical handicaps, or who are interested citizens.  
The task force shall expire and the terms, compensation and 
removal of members shall be as provided in section 15.059. 
    Sec. 40.  Minnesota Statutes 1984, section 252.32, is 
amended to read: 
    252.32 [FAMILY SUBSIDY PROGRAM.] 
    Within the limits of appropriations, the commissioner of 
human services may provide subsidies to families with mentally 
retarded children with mental retardation or related conditions 
in order to enable those families to continue caring for the 
children in their own homes.  The commissioner may establish 
criteria for determining eligibility for a subsidy and subsidy 
amounts and conditions for use of subsidies.  
    Sec. 41.  Minnesota Statutes 1984, section 253.015, is 
amended to read: 
    253.015 [LOCATION; MANAGEMENT; COMMITMENT; SUPERINTENDENT 
CHIEF EXECUTIVE OFFICER.] 
    The state hospitals located at Anoka, Fergus Falls, 
Hastings, Moose Lake, Rochester, St. Peter, and Willmar shall 
constitute the state hospitals for mentally ill, and shall be 
maintained under the general management of the commissioner of 
human services.  The commissioner of human services shall 
determine to what state hospital mentally ill persons with 
mental illness shall be committed from each county and notify 
the probate judge thereof, and of changes made from time to time.
The chief executive officer of each hospital for the mentally 
ill persons with mental illness shall be known as the 
superintendent chief executive officer.  
    Sec. 42.  Minnesota Statutes 1984, section 253.10, is 
amended to read: 
    253.10 [DEATH OR ILLNESS; NOTICE GIVEN NEXT OF KIN.] 
    The superintendent chief executive officer of any state 
hospital shall give to the next of kin of any inmate resident 
thereof immediate notice of his death, serious illness, or 
special change in his condition and promptly and fully answer 
all letters of inquiry from relatives.  Immediately after the 
death of a patient or resident therein, he shall furnish for 
registration, to the proper clerk or health officer, and to the 
probate judge of the county from which he was committed, a 
certificate setting forth the name of the patient or resident, 
his age, the duration of his last sickness, and the cause and 
date of his death.  The expenses of all coroners' inquests upon 
persons dying in such institution hospital shall be paid from 
the appropriation for its current expenses.  
    Sec. 43.  Minnesota Statutes 1984, section 253.19, is 
amended to read: 
    253.19 [ANNUAL REPORT.] 
    On or before September 1 each year, the superintendent 
chief executive officer of each state hospital or asylum for the 
insane for persons with mental illness or mental retardation 
shall report to the commissioner of human services the number of 
insane persons with mental illness therein on July 31 preceding, 
giving the numbers of male and female and of the idiotic and 
number of persons having epilepsy with mental retardation 
separately, and a statistical exhibit of the admissions, 
discharges, and deaths, with causes of death, and such other 
facts and information as the commissioner may require.  Neglect 
to so report shall be a misdemeanor.  
    Sec. 44.  Minnesota Statutes 1984, section 253.20, is 
amended to read: 
    253.20 [MINNESOTA SECURITY HOSPITAL.] 
    The commissioner of human services is hereby authorized and 
directed to erect, equip, and maintain in connection with a 
state hospital at St. Peter a suitable building to be known as 
the Minnesota Security Hospital, for the purpose of holding in 
custody and caring for such insane persons, idiots, imbeciles, 
and persons having epilepsy persons with mental illness or 
mental retardation as may be committed thereto by courts of 
criminal jurisdiction, or otherwise, or transferred thereto by 
the commissioner of human services, and for such persons as may 
be declared insane while confined in any penal institution, or 
who may be found to be mentally infirm ill and dangerous, and he 
shall supervise and manage the same as in the case of other 
state hospitals or asylums. 
    Sec. 45.  Minnesota Statutes 1984, section 253.21, is 
amended to read: 
    253.21 [COMMITMENT; PROCEEDINGS; RESTORATION OF SANITY 
MENTAL HEALTH.] 
    When any person confined in the Minnesota correctional 
facility-Stillwater or the Minnesota correctional facility-St. 
Cloud is alleged to be insane mentally ill, the chief executive 
officer or other person in charge shall forthwith notify the 
commissioner of human services, who shall cause the prisoner to 
be examined by the probate court of the county where he is 
confined, as in the case of other insane mentally ill persons.  
In case he is found to be insane mentally ill, he shall be 
transferred by the order of the court to the Minnesota Security 
Hospital or to a state hospital for the insane mentally ill 
people in the discretion of the court, there to be kept and 
maintained as in the case of other insane mentally ill persons.  
If, in the judgment of the superintendent chief executive 
officer, his sanity mental health is restored before the period 
of his commitment to the penal institution has expired, he shall 
be removed by the commissioner, upon the certificate of 
the superintendent chief executive officer, to the institution 
whence he came, and there complete the period of his sentence.  
    Sec. 46.  Minnesota Statutes 1984, section 253.25, is 
amended to read: 
    253.25 [COMMITMENT BEFORE CONVICTION.] 
    When any person under indictment or information and before 
trial thereon shall be found to be insane, an idiot, or an 
imbecile incompetent to proceed and to have homicidal 
tendencies; or when during the trial of any person on an 
indictment or information such person shall be found to 
be insane, an idiot, or an imbecile incompetent to proceed and 
to have homicidal tendencies, the court in which such indictment 
or information is filed shall forthwith commit such person to 
the Minnesota Security Hospital for safekeeping and treatment 
and such person shall be received and cared for thereat until he 
shall recover when he shall be returned to the court from which 
he was received there to be dealt with according to law.  
    Sec. 47.  Minnesota Statutes 1984, section 253.26, is 
amended to read: 
    253.26 [TRANSFERS OF PATIENTS OR RESIDENTS.] 
    When any patient person of the state institution for the 
mentally ill, mentally defective or persons having 
epilepsy hospital for patients with mental illness or residents 
with mental retardation is found by the commissioner of human 
services to have homicidal tendencies or to be under sentence or 
indictment or information he may be transferred by the 
commissioner to the Minnesota Security Hospital for safekeeping 
and treatment.  
    Sec. 48.  Minnesota Statutes 1984, section 256.01, 
subdivision 2, is amended to read: 
    Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
section 241.021, subdivision 2, the commissioner of human 
services shall: 
    (1) Administer and supervise all forms of public assistance 
provided for by state law and other welfare activities or 
services as are vested in the commissioner. 
    (2) Administer and supervise all child welfare activities; 
promote the enforcement of laws protecting handicapped, 
dependent, neglected and delinquent children, and children born 
to mothers who were not married to the children's fathers at the 
times of the conception nor at the births of the children; 
license and supervise child-caring and child-placing agencies 
and institutions; supervise the care of children in boarding and 
foster homes or in private institutions; and generally perform 
all functions relating to the field of child welfare now vested 
in the state board of control. 
    (3) Administer and supervise all noninstitutional service 
to handicapped persons, including those who are visually 
impaired, hearing impaired, or physically impaired or otherwise 
handicapped.  The commissioner may provide and contract for the 
care and treatment of qualified indigent children in facilities 
other than those located and available at state hospitals when 
it is not feasible to provide the service in state hospitals. 
    (4) Assist and actively cooperate with other departments, 
agencies and institutions, local, state, and federal, by 
performing services in conformity with the purposes of Laws 
1939, chapter 431. 
    (5) Act as the agent of and cooperate with the federal 
government in matters of mutual concern relative to and in 
conformity with the provisions of Laws 1939, chapter 431, 
including the administration of any federal funds granted to the 
state to aid in the performance of any functions of the 
commissioner as specified in Laws 1939, chapter 431, and 
including the promulgation of rules making uniformly available 
medical care benefits to all recipients of public assistance, at 
such times as the federal government increases its participation 
in assistance expenditures for medical care to recipients of 
public assistance, the cost thereof to be borne in the same 
proportion as are grants of aid to said recipients. 
      (6) Establish and maintain any administrative units 
reasonably necessary for the performance of administrative 
functions common to all divisions of the department. 
      (7) Administer and supervise any additional welfare 
activities and services as are vested by law in the department. 
      (8) The commissioner is designated as guardian of both the 
estate and the person of all the wards of the state of 
Minnesota, whether by operation of law or by an order of court, 
without any further act or proceeding whatever, except as to 
persons committed as mentally retarded or having epilepsy.  
    (9) Act as coordinating referral and informational center 
on requests for service for newly arrived immigrants coming to 
Minnesota. 
    (10) The specific enumeration of powers and duties as 
hereinabove set forth shall in no way be construed to be a 
limitation upon the general transfer of powers herein contained. 
    (11) Establish county, regional, or statewide schedules of 
maximum fees and charges which may be paid by local agencies for 
medical, dental, surgical, hospital, nursing and nursing home 
care and medicine and medical supplies under all programs of 
medical care provided by the state and for congregate living 
care under the income maintenance programs. 
    (12) Have the authority to conduct and administer 
experimental projects to test methods and procedures of 
administering assistance and services to recipients or potential 
recipients of public welfare.  To carry out such experimental 
projects, it is further provided that the commissioner of human 
services is authorized to waive the enforcement of existing 
specific statutory program requirements, regulations, and 
standards in one or more counties.  The order establishing the 
waiver shall provide alternative methods and procedures of 
administration, shall not be in conflict with the basic 
purposes, coverage, or benefits provided by law, and in no event 
shall the duration of a project exceed two years.  It is further 
provided that no order establishing an experimental project as 
authorized by the provisions of this section shall become 
effective until the following conditions have been met: 
      (a) The proposed comprehensive plan including estimated 
project costs and the proposed order establishing the waiver 
shall be filed with the secretary of the senate and chief clerk 
of the house of representatives at least 60 days prior to its 
effective date. 
      (b) The secretary of health, education, and welfare of the 
United States has agreed, for the same project, to waive state 
plan requirements relative to statewide uniformity. 
      (c) A comprehensive plan, including estimated project 
costs, shall be approved by the legislative advisory commission 
and filed with the commissioner of administration.  
      (13) In accordance with federal requirements establish 
procedures to be followed by local welfare boards in creating 
citizen advisory committees, including procedures for selection 
of committee members. 
      (14) Allocate federal fiscal disallowances or sanctions 
which are based on quality control error rates for the aid to 
families with dependent children, medical assistance, or food 
stamp program in the following manner:  
     (a) One-half of the total amount of the disallowance shall 
be borne by the county boards responsible for administering the 
programs and shall be shared by each county board in the same 
proportion as that county's expenditures for the sanctioned 
program are to the total of all counties' expenditures for that 
program.  Each county shall pay its share of the disallowance to 
the state of Minnesota.  When a county fails to pay the amount 
due hereunder, the commissioner may deduct the amount from 
reimbursement otherwise due the county, or the attorney general, 
upon the request of the commissioner, may institute civil action 
to recover the amount due. 
     (b) Notwithstanding the provisions of paragraph (a), if the 
disallowance results from knowing noncompliance by one or more 
counties with a specific program instruction, and that knowing 
noncompliance is a matter of official county board record, the 
commissioner may require payment or recover from the county or 
counties, in the manner prescribed in paragraph (a), an amount 
equal to the portion of the total disallowance which resulted 
from the noncompliance, and may distribute the balance of the 
disallowance according to paragraph (a).  
     (15) Develop and implement special projects that maximize 
reimbursements and result in the recovery of money to the 
state.  For the purpose of recovering state money, the 
commissioner may enter into contracts with third parties.  Any 
recoveries that result from projects or contracts entered into 
under this paragraph shall be deposited in the state treasury 
and credited to a special account until the balance in the 
account reaches $400,000.  When the balance in the account 
exceeds $400,000, the excess shall be transferred and credited 
to the general fund.  All money in the account is appropriated 
to the commissioner for the purposes of this paragraph.  
    Sec. 49.  Minnesota Statutes 1984, section 256.01, 
subdivision 5, is amended to read: 
    Subd. 5.  [GIFTS, CONTRIBUTIONS, PENSIONS AND BENEFITS; 
ACCEPTANCE.] The commissioner shall have the power and authority 
to accept in behalf of the state contributions and gifts for the 
use and benefit of children under the guardianship or custody of 
the commissioner; he may also receive and accept on behalf of 
such children, and on behalf of patients and residents at the 
several state institutions for the mentally ill, the mentally 
retarded, or persons having epilepsy hospitals for persons with 
mental illness or mental retardation during the period of their 
hospitalization and while on provisional discharge therefrom, 
moneys due and payable to them as old age and survivors 
insurance benefits, veterans benefits, pensions or other such 
monetary benefits.  Such gifts, contributions, pensions and 
benefits shall be deposited in and disbursed from the social 
welfare fund provided for in sections 256.88 to 256.92. 
    Sec. 50.  Minnesota Statutes 1984, section 256.91, is 
amended to read: 
    256.91 [PURPOSES.] 
    From that part of the social welfare fund held in the state 
treasury subject to disbursement as provided in section 256.90 
the commissioner of human services at any time may pay out such 
amounts as he deems proper for the support, maintenance, or 
other legal benefit of any of the handicapped, dependent, 
neglected, and delinquent children, children born to mothers who 
were not married to the children's fathers at the times of the 
conception nor at the births of the children, persons found to 
be mentally retarded, chemically dependent or mentally ill with 
mental retardation, chemical dependency, or mental illness, or 
other wards or persons entitled thereto, not exceeding in the 
aggregate to or for any person the principal amount previously 
received for the benefit of the person, together with the 
increase in it from an equitable apportionment of interest 
realized from the social welfare fund. 
    When any such person dies or is finally discharged from the 
guardianship, care, custody, and control of the commissioner of 
human services, the amount then remaining subject to use for the 
benefit of the person shall be paid as soon as may be from the 
social welfare fund to the persons thereto entitled by law.  
    Sec. 51.  Minnesota Statutes 1984, section 256.93, 
subdivision 1, is amended to read: 
    Subdivision 1.  [LIMITATIONS.] In any case where the 
guardianship of the person of any mentally retarded, 
handicapped, dependent, neglected or delinquent child, or a 
child born to a mother who was not married to the child's father 
when the child was conceived nor when the child was born, has 
been committed to the commissioner of human services, and in any 
case where the guardianship or conservatorship of the person of 
any mentally retarded person or person having epilepsy person 
with mental retardation has been committed to the commissioner 
of human services, the probate court having jurisdiction of the 
estate may on such notice as the court may direct, authorize the 
commissioner to take possession of the personal property in the 
estate, liquidate it, and hold the proceeds in trust for the 
ward, to be invested, expended and accounted for as provided by 
sections 256.88 to 256.92.  
    Sec. 52.  Minnesota Statutes 1984, section 256B.02, 
subdivision 2, is amended to read: 
    Subd. 2.  "Excluded time" means any period of time an 
applicant spends in a hospital, sanatorium, nursing home, 
boarding home, shelter, halfway house, foster home, 
semi-independent living domicile, residential facility offering 
care, board and lodging facility offering 24-hour care or 
supervision of mentally ill, mentally retarded, or physically 
disabled persons, or other institution persons with mental 
illness, mental retardation, related conditions, or physical 
disabilities; or other treatment facility for the 
hospitalization or care of human beings, as defined in sections 
144.50, 144A.01, or 245.782, subdivision 6. 
    Sec. 53.  Minnesota Statutes 1984, section 256B.02, 
subdivision 8, is amended to read: 
    Subd. 8.  [MEDICAL ASSISTANCE; MEDICAL CARE.] "Medical 
assistance" or "medical care" means payment of part or all of 
the cost of the following care and services for eligible 
individuals whose income and resources are insufficient to meet 
all of this cost: 
    (1) Inpatient hospital services.  A second medical opinion 
is required prior to reimbursement for elective surgeries.  The 
commissioner shall publish in the State Register a proposed list 
of elective surgeries that require a second medical opinion 
prior to reimbursement.  The list is not subject to the 
requirements of sections 14.01 to 14.70.  The commissioner's 
decision whether a second medical opinion is required, made in 
accordance with rules governing that decision, is not subject to 
administrative appeal;  
    (2) Skilled nursing home services and services of 
intermediate care facilities, including training and 
habilitation services, as defined in section 256B.50, 
subdivision 1, for mentally retarded individuals persons with 
mental retardation or related conditions who are residing in 
intermediate care facilities for the mentally retarded persons 
with mental retardation or related conditions; 
    (3) Physicians' services; 
    (4) Outpatient hospital or nonprofit community health 
clinic services or physician-directed clinic services.  The 
physician-directed clinic staff shall include at least two 
physicians, one of whom is on the premises whenever the clinic 
is open, and all services shall be provided under the direct 
supervision of the physician who is on the premises.  Hospital 
outpatient departments are subject to the same limitations and 
reimbursements as other enrolled vendors for all services, 
except initial triage, emergency services, and services not 
provided or immediately available in clinics, physicians' 
offices, or by other enrolled providers.  "Emergency services" 
means those medical services required for the immediate 
diagnosis and treatment of medical conditions that, if not 
immediately diagnosed and treated, could lead to serious 
physical or mental disability or death or are necessary to 
alleviate severe pain.  Neither the hospital, its employees, nor 
any physician or dentist, shall be liable in any action arising 
out of a determination not to render emergency services or care 
if reasonable care is exercised in determining the condition of 
the person, or in determining the appropriateness of the 
facilities, or the qualifications and availability of personnel 
to render these services consistent with this section;  
     (5) Community mental health center services, as defined in 
rules adopted by the commissioner pursuant to section 256B.04, 
subdivision 2, and provided by a community mental health center 
as defined in section 245.62, subdivision 2;  
     (6) Home health care services; 
     (7) Private duty nursing services; 
     (8) Physical therapy and related services; 
     (9) Dental services, excluding cast metal restorations; 
     (10) Laboratory and xray services; 
         (11) The following if prescribed by a licensed 
practitioner:  drugs, eyeglasses, dentures, and prosthetic 
devices.  The commissioner shall designate a formulary committee 
which shall advise the commissioner on the names of drugs for 
which payment shall be made, recommend a system for reimbursing 
providers on a set fee or charge basis rather than the present 
system, and develop methods encouraging use of generic drugs 
when they are less expensive and equally effective as trademark 
drugs.  The commissioner shall appoint the formulary committee 
members no later than 30 days following July 1, 1981.  The 
formulary committee shall consist of nine members, four of whom 
shall be physicians who are not employed by the department of 
human services, and a majority of whose practice is for persons 
paying privately or through health insurance, three of whom 
shall be pharmacists who are not employed by the department of 
human services, and a majority of whose practice is for persons 
paying privately or through health insurance, a consumer 
representative, and a nursing home representative.  Committee 
members shall serve two year terms and shall serve without 
compensation.  The commissioner may establish a drug formulary.  
Its establishment and publication shall not be subject to the 
requirements of the Administrative Procedure Act, but the 
formulary committee shall review and comment on the formulary 
contents.  Prior authorization may be required by the 
commissioner, with the consent of the drug formulary committee, 
before certain formulary drugs are eligible for payment.  The 
formulary shall not include:  drugs or products for which there 
is no federal funding; over the counter drugs, except for 
antacids, acetaminophen, family planning products, aspirin, 
insulin, prenatal vitamins, and vitamins for children under the 
age of seven; or any other over the counter drug identified by 
the commissioner, in consultation with the appropriate 
professional consultants under contract with or employed by the 
state agency, as necessary, appropriate and cost effective for 
the treatment of certain specified chronic diseases, conditions 
or disorders, and this determination shall not be subject to the 
requirements of chapter 14, the Administrative Procedure Act; 
nutritional products, except for those products needed for 
treatment of phenylketonuria, hyperlysinemia, maple syrup urine 
disease, a combined allergy to human milk, cow milk, and soy 
formula, or any other childhood or adult diseases, conditions, 
or disorders identified by the commissioner as requiring a 
similarly necessary nutritional product; anorectics; and drugs 
for which medical value has not been established.  Separate 
payment shall not be made for nutritional products for residents 
of long-term care facilities; payment for dietary requirements 
is a component of the per diem rate paid to these facilities.  
Payment to drug vendors shall not be modified before the 
formulary is established except that the commissioner shall not 
permit payment for any drugs which may not by law be included in 
the formulary, and his determination shall not be subject to 
chapter 14, the Administrative Procedure Act.  The commissioner 
shall publish conditions for prohibiting payment for specific 
drugs after considering the formulary committee's 
recommendations.  
     The basis for determining the amount of payment shall be 
the actual acquisition costs of the drugs plus a fixed 
dispensing fee established by the commissioner.  Actual 
acquisition cost includes quantity and other special discounts 
except time and cash discounts.  Establishment of this fee shall 
not be subject to the requirements of the Administrative 
Procedure Act.  Whenever a generically equivalent product is 
available, payment shall be on the basis of the actual 
acquisition cost of the generic drug, unless the prescriber 
specifically indicates "dispense as written" on the prescription 
as required by section 151.21, subdivision 2.  
      Notwithstanding the above provisions, implementation of any 
change in the fixed dispensing fee which has not been subject to 
the Administrative Procedure Act shall be limited to not more 
than 180 days, unless, during that time, the commissioner shall 
have initiated rulemaking through the Administrative Procedure 
Act;  
     (12) Diagnostic, screening, and preventive services; 
     (13) Health care pre-payment plan premiums and insurance 
premiums if paid directly to a vendor and supplementary medical 
insurance benefits under Title XVIII of the Social Security Act; 
          (14) Abortion services, but only if one of the following 
conditions is met: 
      (a) The abortion is a medical necessity.  "Medical 
necessity" means (1) the signed written statement of two 
physicians indicating the abortion is medically necessary to 
prevent the death of the mother, and (2) the patient has given 
her consent to the abortion in writing unless the patient is 
physically or legally incapable of providing informed consent to 
the procedure, in which case consent will be given as otherwise 
provided by law; 
      (b) The pregnancy is the result of criminal sexual conduct 
as defined in section 609.342, clauses (c), (d), (e)(i), and 
(f), and the incident is reported within 48 hours after the 
incident occurs to a valid law enforcement agency for 
investigation, unless the victim is physically unable to report 
the criminal sexual conduct, in which case the report shall be 
made within 48 hours after the victim becomes physically able to 
report the criminal sexual conduct; or 
      (c) The pregnancy is the result of incest, but only if the 
incident and relative are reported to a valid law enforcement 
agency for investigation prior to the abortion; 
     (15) Transportation costs incurred solely for obtaining 
emergency medical care or transportation costs incurred by 
nonambulatory persons in obtaining emergency or nonemergency 
medical care when paid directly to an ambulance company, common 
carrier, or other recognized providers of transportation 
services.  For the purpose of this clause, a person who is 
incapable of transport by taxicab or bus shall be considered to 
be nonambulatory; 
     (16) To the extent authorized by rule of the state agency, 
costs of bus or taxicab transportation incurred by any 
ambulatory eligible person for obtaining nonemergency medical 
care; 
          (17) Personal care attendant services provided by an 
individual, not a relative, who is qualified to provide the 
services, where the services are prescribed by a physician in 
accordance with a plan of treatment and are supervised by a 
registered nurse.  Payments to personal care attendants shall be 
adjusted annually to reflect changes in the cost of living or of 
providing services by the average annual adjustment granted to 
vendors such as nursing homes and home health agencies; and 
          (18) Any other medical or remedial care licensed and 
recognized under state law unless otherwise prohibited by law. 
    Sec. 54.  Minnesota Statutes 1984, section 256B.02, is 
amended by adding a subdivision to read: 
    Subd. 11.  "Related condition" means that condition defined 
in section 252.27, subdivision 1. 
    Sec. 55.  Minnesota Statutes 1984, section 256B.092, is 
amended to read: 
    256B.092 [CASE MANAGEMENT OF MENTALLY RETARDED PERSONS WITH 
MENTAL RETARDATION OR RELATED CONDITIONS.] 
    Subdivision 1.  [COUNTY OF FINANCIAL RESPONSIBILITY; 
DUTIES.] Before any services shall be rendered to mentally 
retarded persons with mental retardation or related conditions 
who are in need of social service and medical assistance, the 
county of financial responsibility shall conduct a diagnostic 
evaluation in order to determine whether the person is or may be 
mentally retarded or has or may have a related condition.  If a 
client is diagnosed as mentally retarded or as having a related 
condition, that county must conduct a needs assessment, develop 
an individual service plan, and authorize placement for 
services.  If the county of financial responsibility places a 
client in another county for services, the placement shall be 
made in cooperation with the host county of service, and 
arrangements shall be made between the two counties for ongoing 
social service, including annual reviews of the client's 
individual service plan.  The host county may not make changes 
in the service plan without approval by the county of financial 
responsibility.  
    Subd. 2.  [MEDICAL ASSISTANCE.] To assure quality case 
management to those county clients who are eligible for medical 
assistance, the commissioner shall:  (a) provide consultation on 
the case management process; (b) assist county agencies in the 
screening and annual reviews of clients to assure that 
appropriate levels of service are provided; (c) provide 
consultation on service planning and development of services 
with appropriate options; (d) provide training and technical 
assistance to county case managers; and (e) authorize payment 
for medical assistance services.  
    Subd. 3.  [TERMINATION OF SERVICES.] County agency case 
managers, under rules of the commissioner, shall authorize and 
terminate services of community and state hospital providers in 
accordance with individual service plans.  Medical assistance 
services not needed shall not be authorized by county agencies 
nor funded by the commissioner.  
    Subd. 4.  [ALTERNATIVE HOME AND COMMUNITY-BASED SERVICES.] 
The commissioner shall make payments to county boards 
participating in the medical assistance program to pay costs of 
providing alternative home and community-based services to 
medical assistance eligible mentally retarded persons with 
mental retardation or related conditions who have been screened 
under subdivision 7.  Payment is available under this 
subdivision only for persons who, if not provided these 
services, would require the level of care provided in an 
intermediate care facility for mentally retarded persons with 
mental retardation or related conditions.  
    Subd. 5.  [FEDERAL WAIVERS.] The commissioner shall apply 
for any federal waivers necessary to secure, to the extent 
allowed by law, federal financial participation under United 
States Code, title 42, sections 1396 to 1396p, as amended 
through December 31, 1982, for the provision of services to 
persons who, in the absence of the services, would need the 
level of care provided in a state hospital or a community 
intermediate care facility for mentally retarded persons with 
mental retardation or related conditions.  The commissioner may 
seek amendments to the waivers or apply for additional waivers 
under United States Code, title 42, sections 1396 to 1396p, as 
amended through December 31, 1982, to contain costs.  The 
commissioner shall ensure that payment for the cost of providing 
home and community-based alternative services under the federal 
waiver plan shall not exceed the cost of intermediate care 
services that would have been provided without the waivered 
services.  
    Subd. 6.  [RULES.] The commissioner shall adopt emergency 
and permanent rules to establish required controls, 
documentation, and reporting of services provided in order to 
assure proper administration of the approved waiver plan.  
    Subd. 7.  [SCREENING TEAMS ESTABLISHED.] Each county agency 
shall establish a screening team which, under the direction of 
the county case manager, shall make an evaluation of need for 
home and community-based services of persons who are entitled to 
the level of care provided by an intermediate care facility 
for mentally retarded persons with mental retardation or related 
conditions or for whom there is a reasonable indication that 
they might need the services in the near future.  The screening 
team shall make an evaluation of need within 15 working days of 
the request for service and within five working days of an 
emergency admission of an individual to an intermediate care 
facility for mentally retarded persons with mental retardation 
or related conditions.  The screening team shall consist of the 
case manager, the client, a parent or guardian, a qualified 
mental retardation professional, as defined in the Code of 
Federal Regulations, title 42, section 442.401, as amended 
through December 31, 1982, assigned by the commissioner.  The 
case manager shall consult with the client's physician or other 
persons as necessary to make this evaluation.  Other persons may 
be invited to attend meetings of the screening team.  No member 
of the screening team shall have any direct or indirect service 
provider interest in the case.  
    Subd. 8.  [SCREENING TEAM DUTIES.] The screening team shall:
    (a) review diagnostic data;  
    (b) review health, social, and developmental assessment 
data using a uniform screening tool specified by the 
commissioner;  
    (c) identify the level of services needed to maintain the 
person in the most normal and least restrictive setting that is 
consistent with treatment needs;  
    (d) identify other noninstitutional public assistance or 
social service that may prevent or delay long-term residential 
placement;  
    (e) determine whether a client is in serious need of 
long-term residential care;  
    (f) make recommendations to the county agency regarding 
placement and payment for:  (1) social service or public 
assistance support to maintain a client in the client's own home 
or other place of residence; (2) training and habilitation 
service, vocational rehabilitation, and employment training 
activities; (3) community residential placement; (4) state 
hospital placement; or (5) a home and community-based 
alternative to community residential placement or state hospital 
placement;  
    (g) make recommendations to a court as may be needed to 
assist the court in making commitments of mentally retarded 
persons; and 
    (h) inform clients that appeal may be made to the 
commissioner pursuant to section 256.045.  
    Subd. 9.  [REIMBURSEMENT.] Payment shall not be provided to 
a service provider for any recipient placed in an intermediate 
care facility for the mentally retarded persons with mental 
retardation or related conditions prior to the recipient being 
screened by the screening team.  The commissioner shall not deny 
reimbursement for:  (a) an individual admitted to an 
intermediate care facility for mentally retarded persons with 
mental retardation or related conditions who is assessed to need 
long-term supportive services, if long-term supportive services 
other than intermediate care are not available in that 
community; (b) any individual admitted to an intermediate care 
facility for the mentally retarded persons with mental 
retardation or related conditions under emergency circumstances; 
(c) any eligible individual placed in the intermediate care 
facility for the mentally retarded persons with mental 
retardation or related conditions pending an appeal of the 
screening team's decision; or (d) any medical assistance 
recipient when, after full discussion of all appropriate 
alternatives including those that are expected to be less costly 
than intermediate care for mentally retarded persons with mental 
retardation or related conditions, the individual or the 
individual's legal representative insists on intermediate care 
placement.  The screening team shall provide documentation that 
the most cost effective alternatives available were offered to 
this individual or the individual's legal representative.  
    Sec. 56.  Minnesota Statutes 1984, section 256B.36, is 
amended to read: 
    256B.36 [PERSONAL ALLOWANCE, HANDICAPPED OR MENTALLY 
RETARDED FOR CERTAIN RECIPIENTS OF MEDICAL ASSISTANCE.] 
    In addition to the personal allowance established in 
section 256B.35, any handicapped or mentally retarded recipient 
of medical assistance with a handicap, mental retardation, or a 
related condition, confined in a skilled nursing home or 
intermediate care facility shall also be permitted a special 
personal allowance drawn solely from earnings from any 
productive employment under an individual plan of 
rehabilitation.  This special personal allowance shall not 
exceed (1) the limits set therefor by the commissioner, or (2) 
the amount of disregarded income the individual would have 
retained had he or she been a recipient of aid to the disabled 
benefits in December, 1973, whichever amount is lower.  
    Sec. 57.  Minnesota Statutes 1984, section 256B.501, is 
amended to read: 
    256B.501 [RATES FOR COMMUNITY-BASED SERVICES FOR THE 
MENTALLY RETARDED PERSONS WITH MENTAL RETARDATION OR RELATED 
CONDITIONS.] 
    Subdivision 1.  [DEFINITIONS.] For the purposes of this 
section, the following terms have the meaning given them.  
    (a) "Commissioner" means the commissioner of human services.
    (b) "Facility" means a facility licensed as a mental 
retardation residential facility under section 252.28, licensed 
as a supervised living facility under chapter 144, and certified 
as an intermediate care facility for the mentally retarded 
persons with mental retardation or related conditions.  
    (c) "Waivered service" means home or community-based 
service authorized under United States Code, title 42, section 
1396n(c), as amended through December 31, 1982, and defined in 
the Minnesota state plan for the provision of medical assistance 
services.  Waivered services include, at a minimum, case 
management, family training and support, developmental training 
homes, supervised living arrangements, semi-independent living 
services, respite care, and training and habilitation services.  
    (d) "Training and habilitation services" are those health 
and social services needed to ensure optimal functioning of 
persons who are mentally retarded or have with mental 
retardation or related conditions.  Training and habilitation 
services shall be provided to a client away from the residence 
unless medically contraindicated by an organization which does 
not have a direct or indirect financial interest in the 
organization which provides the person's residential services.  
This requirement shall not apply to any developmental 
achievement center which has applied for licensure prior to 
April 15, 1983.  
    Subd. 2.  [AUTHORITY.] The commissioner shall establish 
procedures and rules for determining rates for care of residents 
of intermediate care facilities for the mentally retarded 
persons with mental retardation or related conditions which 
qualify as vendors of medical assistance, waivered services, and 
for provision of training and habilitation services.  Approved 
rates shall be established on the basis of methods and standards 
that the commissioner finds adequate to provide for the costs 
that must be incurred for the quality care of residents in 
efficiently and economically operated facilities and services. 
The procedures shall specify the costs that are allowable for 
payment through medical assistance.  The commissioner may use 
experts from outside the department in the establishment of the 
procedures.  
    Subd. 3.  [RATES FOR INTERMEDIATE CARE FACILITIES FOR THE 
MENTALLY RETARDED PERSONS WITH MENTAL RETARDATION OR RELATED 
CONDITIONS.] The commissioner shall establish, by rule, 
procedures for determining rates for care of residents of 
intermediate care facilities for the mentally retarded persons 
with mental retardation or related conditions.  The procedures 
shall be based on methods and standards that the commissioner 
finds are adequate to provide for the costs that must be 
incurred for the care of residents in efficiently and 
economically operated facilities.  In developing the procedures, 
the commissioner shall include: 
    (a) cost containment measures that assure efficient and 
prudent management of capital assets and operating cost 
increases which do not exceed increases in other sections of the 
economy;  
    (b) limits on the amounts of reimbursement for property, 
general and administration, and new facilities;  
    (c) requirements to ensure that the accounting practices of 
the facilities conform to generally accepted accounting 
principles; and 
    (d) incentives to reward accumulation of equity.  
    In establishing rules and procedures for setting rates for 
care of residents in intermediate care facilities for mentally 
retarded persons with mental retardation or related conditions, 
the commissioner shall consider the recommendations contained in 
the February 11, 1983, Report of the Legislative Auditor on 
Community Residential Programs for the Mentally Retarded and the 
recommendations contained in the 1982 Report of the Department 
of Public Welfare Rule 52 Task Force.  Rates paid to supervised 
living facilities for rate years beginning during the fiscal 
biennium ending June 30, 1985, shall not exceed the final rate 
allowed the facility for the previous rate year by more than 
five percent.  
    Subd. 4.  [WAIVERED SERVICES.] In establishing rates for 
waivered services the commissioner shall consider the need for 
flexibility in the provision of those services to meet 
individual needs identified by the screening team.  
    Subd. 5.  [TRAINING AND HABILITATION SERVICES.] (a) Except 
as provided in subdivision 6, rates for reimbursement under 
medical assistance for training and habilitation services 
provided by a developmental achievement center either as a 
waivered service or to residents of an intermediate care 
facility for mentally retarded persons with mental retardation 
or related conditions shall be established and paid in 
accordance with this subdivision effective January 1, 1984.  
    (b) Prior to August 1, 1983, the county board shall submit 
to the commissioner its contractual per diem rate and its 
maximum per client annual payment limitations, if any, for each 
developmental achievement center it administers pursuant to 
section 252.24, subdivision 1, for the period from July 1, 1983, 
through December 31, 1983, which shall be the medical assistance 
reimbursement rate established for that developmental 
achievement center for 1983.  If the county rate is based on 
average daily attendance which is less than 93 percent of the 
developmental achievement center's average enrollment for the 
period from July 1, 1983, to December 31, 1983, the commissioner 
shall adjust that rate based on 93 percent average daily 
attendance.  
    (c) The base per diem reimbursement rate established for 
1983 may be increased by the commissioner in 1984 in an amount 
up to the projected percentage change in the average value of 
the consumer price index (all urban) for 1984 over 1983.  In 
subsequent years, the increase in the per diem rate shall not 
exceed the projected percentage change in the average annual 
value of the consumer price index (all urban) for the same time 
period.  
    (d) The county board in which an intermediate care facility 
for mentally retarded persons with mental retardation or related 
conditions is located shall contract annually with that facility 
and with the appropriate developmental achievement center or 
training and habilitation service provider for provision of 
training and habilitation services for each resident of the 
facility for whom the services are required by the resident's 
individual service plan.  This contract shall specify the county 
payment rate or the medical assistance reimbursement rate, as 
appropriate; the training and habilitation services to be 
provided; and the performance standards for program provision 
and evaluation.  A similar contract shall be entered into 
between the county and the developmental achievement center for 
persons receiving training and habilitation services from that 
center as a waivered service. 
    (e) The commissioner shall reimburse under medical 
assistance up to 210 days of training and habilitation services 
at developmental achievement centers for those centers which 
provided less than or equal to 210 days of training and 
habilitation services in calendar year 1982.  For developmental 
achievement centers providing more than 210 days of services in 
1982, the commissioner shall not reimburse under medical 
assistance in excess of the number of days provided by those 
programs in 1982.  
      (f) Medical assistance payments for training and 
habilitation services shall be made directly to the training and 
habilitation provider after submission of invoices to the 
medical assistance program following procedures established by 
the medical assistance program. 
      (g) Nothing in this subdivision shall prohibit county 
boards from contracting for rates for services not reimbursed 
under medical assistance.  
     Subd. 6.  [NEW DEVELOPMENTAL ACHIEVEMENT PROGRAMS; RATES.] 
The commissioner, upon the recommendation of the local county 
board, shall determine the medical assistance reimbursement rate 
for new developmental achievement programs.  The payment rate 
shall not exceed 125 percent of the average payment rate in the 
region.  
     Subd. 7.  [ALTERNATIVE RATES FOR TRAINING AND HABILITATION 
SERVICES.] Alternative methods may be proposed by the counties 
or the commissioner for provision of training and habilitation 
services during daytime hours apart from a residential facility 
to persons for whom needs identified in their individual service 
plan are not met by the training and habilitation services 
provided at a developmental achievement center.  The 
commissioner shall establish procedures for approval of the 
proposals and for medical assistance payment of rates which 
shall not exceed the average rate allowed in that county for 
training and habilitation services pursuant to subdivision 5. 
Nothing in this subdivision prohibits a county from contracting 
with a developmental achievement center for those purposes.  
    Subd. 8.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS.] The 
commissioner shall establish by December 31, 1983, procedures to 
be followed by the counties to seek authorization from the 
commissioner for medical assistance reimbursement for waivered 
services or training and habilitation services for very 
dependent persons with special needs in an amount in excess of 
the rates allowed pursuant to subdivisions 2, 4, 5, and 6, and 
procedures to be followed for rate limitation exemptions for 
intermediate care facilities for mentally retarded persons with 
mental retardation or related conditions.  No excess payment or 
limitation exemption shall be authorized unless the need for the 
service is documented in the individual service plan of the 
person or persons to be served, the type and duration of the 
services needed are stated, and there is a basis for estimated 
cost of the services.  
    The commissioner shall evaluate the services provided 
pursuant to this subdivision through program and fiscal audits.  
    Subd. 9.  [REPORTING REQUIREMENTS.] The developmental 
achievement center shall submit to the county and the 
commissioner no later than March 1 of each year an annual report 
which includes the actual program revenues and expenditures, 
client information, and program information.  The information 
shall be submitted on forms prescribed by the commissioner.  
    Subd. 10.  [RULES.] To implement this section, the 
commissioner shall promulgate emergency and permanent rules in 
accordance with chapter 14.  To implement subdivision 3, the 
commissioner shall promulgate emergency rules and permanent 
rules in accordance with sections 14.01 to 14.38.  
Notwithstanding the provisions of section 14.35, the emergency 
rule promulgated to implement subdivision 3 shall be effective 
for up to 720 days.  
    Sec. 58.  Minnesota Statutes 1984, section 256E.03, 
subdivision 2, is amended to read: 
    Subd. 2.  "Community social services" means services 
provided or arranged for by county boards to fulfill the 
responsibilities prescribed in section 256E.08, subdivision 1 to 
the following groups of persons: 
    (a) Families with children under age 18, who are 
experiencing child dependency, neglect or abuse, and also 
pregnant adolescents, adolescent parents under the age of 18, 
and their children; 
    (b) Persons who are under the guardianship of the 
commissioner of human services as dependent and neglected wards; 
    (c) Adults who are in need of protection and vulnerable as 
defined in section 626.557; 
    (d) Persons age 60 and over who are experiencing difficulty 
living independently and are unable to provide for their own 
needs; 
    (e) Emotionally disturbed children and adolescents, 
chronically and acutely mentally ill persons who are unable to 
provide for their own needs or to independently engage in 
ordinary community activities; 
    (f) Mentally retarded persons Persons with mental 
retardation as defined in section 252A.02, subdivision 2, or 
with related conditions as defined in section 252.27, 
subdivision 1, who are unable to provide for their own needs or 
to independently engage in ordinary community activities; 
    (g) Drug dependent and intoxicated persons as defined in 
section 254A.02, subdivisions 5 and 7, and persons at risk of 
harm to self or others due to the ingestion of alcohol or other 
drugs;  
    (h) Parents whose income is at or below 70 percent of the 
state median income and who are in need of child care services 
in order to secure or retain employment or to obtain the 
training or education necessary to secure employment; and 
    (i) Other groups of persons who, in the judgment of the 
county board, are in need of social services. 
    Community social services do not include public assistance 
programs known as aid to families with dependent children, 
Minnesota supplemental aid, medical assistance, general 
assistance, general assistance medical care, or community health 
services authorized by sections 145.911 to 145.922. 
    Sec. 59.  Minnesota Statutes 1984, section 256E.06, 
subdivision 2a, is amended to read: 
    Subd. 2a.  [STATE TRANSFER OF FUNDS.] Notwithstanding 
subdivisions 1 and 2, for the purpose of funding training and 
habilitation services provided to residents of intermediate care 
facilities for mentally retarded persons with mental retardation 
or related conditions as defined in section 252.27, subdivision 
1, as required under federal regulation, the commissioner is 
authorized to transfer on a quarterly basis to the medical 
assistance state account from each county's Community Social 
Services Act allocation an amount equal to the state share of 
medical assistance reimbursement for such services provided to 
clients for whom the county is financially responsible.  Upon 
federal approval and state implementation of the state medical 
assistance plan, county boards will not be responsible for the 
funding of training and habilitation services as a social 
service to residents of intermediate care facilities for the 
mentally retarded persons with mental retardation or related 
conditions.  County board responsibility for training and 
habilitation services shall be assumed under section 256B.20. 
County boards continue to be responsible for funding 
developmental achievement center services not covered under the 
medical assistance program established by United States Code, 
title 42, sections 1396 to 1396p, as amended through December 
31, 1982, and shall develop contractual agreements for these 
services under the authority of this chapter.  
    Sec. 60.  Minnesota Statutes 1984, section 260.092, is 
amended to read: 
    260.092 [EXPERT ASSISTANCE.] 
    In any county the court may provide for the physical and 
mental diagnosis of cases of minors who are believed to be 
physically or mentally diseased or defective handicapped, 
mentally ill, or mentally retarded, and for such purpose may 
appoint professionally qualified persons, whose compensation 
shall be fixed by the judge with the approval of the county 
board.  
    Sec. 61.  Minnesota Statutes 1984, section 260.36, is 
amended to read: 
    260.36 [SPECIAL PROVISIONS IN CERTAIN CASES.] 
    When the commissioner of human services shall find that a 
child transferred to his guardianship after parental rights to 
the child are terminated or that a child committed to his 
guardianship as a dependent or neglected child is handicapped 
physically or whose mentality has not been satisfactorily 
determined or who is affected by habits, ailments, or handicaps 
that produce erratic and unstable conduct, and is not suitable 
or desirable for placement in a home for permanent care or 
adoption, the commissioner of human services shall make special 
provision for his care and treatment designed to fit him, if 
possible, for such placement or to become self-supporting.  The 
facilities of the commissioner of human services and all state 
institutions treatment facilities, the Minnesota general 
hospital, and the child guidance clinic of its psychopathic 
department, as well as the facilities available through 
reputable clinics, private child-caring agencies, and foster 
boarding homes, accredited as provided by law, may be used as 
the particular needs of the child may demand.  When it appears 
that the child is suitable for permanent placement or adoption, 
the commissioner of human services shall cause him to be placed 
as provided in section 260.35.  If the commissioner of human 
services is satisfied that the child is feebleminded mentally 
retarded he may bring him before the probate court of the county 
where he is found or the county of his legal settlement for 
examination and commitment as provided by law.  
    Sec. 62.  Minnesota Statutes 1984, section 284.05, is 
amended to read: 
    284.05 [WHEN DEFENDANT A MINOR, WARD, OR INSANE MENTALLY 
ILL.] 
    If any defendant in any action mentioned in sections 284.01 
to 284.04 was the owner of record of any of the lands involved 
in any such action during the period of three years next after 
the sale thereof for nonpayment of taxes, and was a minor, an 
insane person, an idiot a person with mental illness or mental 
retardation, or person in captivity or in any country with which 
the United States was at war, and the period of redemption from 
such sale by such person has not expired, the court shall 
dismiss such action as to such person.  
    Sec. 63.  Minnesota Statutes 1984, section 299F.77, is 
amended to read: 
    299F.77 [ISSUANCE OF A LICENSE OR PERMIT TO CERTAIN PERSONS 
PROHIBITED.] 
    The following persons shall not be entitled to receive an 
explosives license or permit: 
    (a) Any person who within the past five years has been 
convicted of a felony or gross misdemeanor involving moral 
turpitude, is on parole or probation therefor, or is currently 
under indictment for any such crime; 
    (b) Any mentally ill person or any mentally deficient 
person with mental illness or mental retardation as defined in 
section 253A.02 who has been confined or committed in Minnesota 
or elsewhere for a mental disorder or defect illness or mental 
retardation to any hospital, mental institution or sanitarium, 
or who has been certified by a medical doctor as being mentally 
ill or mentally deficient retarded, unless he possesses a 
certificate of a medical doctor or psychiatrist licensed to 
practice in this state, or other satisfactory proof, that he is 
no longer suffering from has this disability; 
    (c) Any person who is or has been hospitalized or committed 
for treatment for the habitual use of a narcotic drug, as 
defined in section 152.01, subdivision 10 or a controlled 
substance, as defined in section 152.01, subdivision 4, or who 
has been certified by a medical doctor as being addicted to 
narcotic drugs or depressant or stimulant drugs, unless he 
possesses a certificate of a medical doctor or psychiatrist 
licensed to practice in this state, or other satisfactory proof, 
that he is no longer suffering from has this disability; 
    (d) Any person who by reason of the habitual and excessive 
use of intoxicating liquors is incapable of managing himself or 
his affairs and who has been confined or committed to any 
hospital, mental institution or sanitarium treatment facility in 
this state or elsewhere as an "inebriate chemically dependent 
person" as defined in section 253A.02 253B.02, or who has been 
certified by a medical doctor as being addicted to alcohol, 
unless he possesses a certificate of a medical doctor or 
psychiatrist licensed to practice in this state, or other 
satisfactory proof, that he is no longer suffering from has this 
disability; 
    (e) Any person under the age of 18 years. 
    Sec. 64.  Minnesota Statutes 1984, section 447.42, is 
amended to read: 
    447.42 [ESTABLISHMENT AND OPERATION OF COMMUNITY 
RESIDENTIAL FACILITIES FOR RETARDED AND CEREBRAL PALSIED PERSONS 
WITH MENTAL RETARDATION OR RELATED CONDITIONS.] 
    Subdivision 1.  Notwithstanding any provision of Minnesota 
Statutes to the contrary, any city, county, town, or any 
nonprofit corporation approved by the commissioner of human 
services, or any combination thereof may establish and operate a 
community residential facility for mentally retarded and 
cerebral palsied persons with mental retardation or related 
conditions, as defined in section 252.27, subdivision 1.  
    Subd. 2.  Community residential facilities established 
under this section may be administered by a nonprofit 
corporation, by the political subdivision establishing same or 
by a community mental health-mental retardation board organized 
under sections 245.66 and 245.67.  
    Subd. 3.  The premises and facilities for any community 
residential facility may be acquired by purchase, lease or gift 
and may be established and operated in connection with existing 
public and private facilities and institutions.  
    Subd. 4.  Any political subdivision, as described in 
subdivision 1, may use unexpended funds, accept gifts, grants 
and subsidies from any lawful source, or make application for 
federal funds and may use such moneys or grant or loan such 
moneys to any nonprofit corporation approved by the commissioner 
of human services for the establishment and operation of a 
community residential facility.  
    Subd. 5.  Any community residential facility established 
and operated pursuant to this section shall meet all applicable 
licensure standards established by the commissioners of health 
and human services.  
    Sec. 65.  Minnesota Statutes 1984, section 447.45, is 
amended to read: 
    447.45 [HOSPITALS AND NURSING HOMES, FACILITIES FOR 
MENTALLY RETARDED PERSONS WITH MENTAL RETARDATION OR RELATED 
CONDITIONS; FINANCING AND LEASING.] 
    Subdivision 1.  Any county, city, or hospital district, 
except cities of the first class and counties in which are 
located any cities of the first class, is authorized, in 
addition to and not in substitution for any other power granted 
to it by law, to issue revenue bonds by resolution or 
resolutions of its governing body to finance the acquisition and 
betterment of hospital, nursing home and related medical 
facilities, or any of them, including but without limitation the 
payment of interest during construction and for a reasonable 
period thereafter and the establishment of reserves for bond 
payment and for working capital, and, in connection with the 
acquisition of any existing hospital or nursing home facilities, 
to retire outstanding indebtedness incurred to finance the 
construction of the existing facilities.  
    Subd. 2.  Any county or city, including cities of the first 
class and counties in which are located any cities of the first 
class, is authorized to exercise with respect to facilities, 
including health care facilities, for the care, treatment and 
training of the mentally retarded and persons with cerebral 
palsy persons with mental retardation or related conditions, as 
defined in section 252.27, subdivision 1, all of the powers 
conferred by sections 447.45 to 447.50 with the same force and 
effect as if these facilities were hospital or nursing home 
facilities within the meaning of sections 447.45 to 447.50. 
    Sec. 66.  Minnesota Statutes 1984, section 501.27, is 
amended to read: 
    501.27 [INCOMPETENTS LEGAL INCOMPETENCE; NOTICE; SERVICE; 
GUARDIAN AD LITEM.] 
    In case any person, whose name is set out in such petition, 
is a minor, lunatic mentally ill, idiot mentally retarded, or 
person of unsound mind, or an habitual drunkard chemically 
dependent, or spendthrift a person who has difficulty managing 
money, such notice of hearing shall be served upon the duly 
appointed guardian, conservator, committee, or other legal 
representative, of such person, if any.  If there be none, then 
the court in which such proceedings are pending shall appoint a 
guardian ad litem to such person and may compel the person so 
appointed to act.  In such case, service of such notice of 
hearing shall be had by service on such guardian ad litem. 
    Sec. 67.  Minnesota Statutes 1984, section 517.03, is 
amended to read: 
    517.03 [PROHIBITED MARRIAGES.] 
    The following marriages are prohibited: 
    (a) A marriage entered into before the dissolution of an 
earlier marriage of one of the parties becomes final, as 
provided in section 518.145 or by the law of the jurisdiction 
where the dissolution was granted; 
    (b) A marriage between an ancestor and a descendant, or 
between a brother and a sister, whether the relationship is by 
the half or the whole blood or by adoption; 
    (c) A marriage between an uncle and a niece, between an 
aunt and a nephew, or between first cousins, whether the 
relationship is by the half or the whole blood, except as to 
marriages permitted by the established customs of aboriginal 
cultures; 
    provided, however, that mentally deficient retarded persons 
committed to the guardianship of the commissioner of human 
services and mentally deficient retarded persons committed to 
the conservatorship of the commissioner of human services in 
which the terms of the conservatorship limit the right to marry, 
may marry on receipt of written consent of the commissioner.  
The commissioner shall grant consent unless it appears from his 
investigation that the marriage is not in the best interest of 
the ward or conservatee and the public.  The clerk of the 
district court in the county where the application for a license 
is made by the ward or conservatee shall not issue the license 
unless he has received a signed copy of the consent of the 
commissioner of human services. 
    Approved April 16, 1985