Minnesota Session Laws - 1988, Regular Session

  

                         Laws of Minnesota 1988 

                        CHAPTER 532-S.F.No. 1620 
           An act relating to human services; regulating payments 
          for certain services for adults with mental 
          retardation and related conditions; providing 
          protection for the mentally retarded; providing for 
          therapeutic work activities; negotiating medical 
          assistance utilization review appeals; regulating 
          child support; amending Minnesota Statutes 1986, 
          section 246.56; Minnesota Statutes 1987 Supplement, 
          sections 252.41, subdivision 7; 252.46, subdivisions 
          1, 2, 3, 4, 5, and 12; 252.47; 252A.111, subdivision 
          6; 254B.05, subdivision 1; 254B.09, subdivision 5; 
          256B.04, subdivision 15; and 518.64, subdivision 2. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1986, section 246.56, is 
amended to read:  
    246.56 [PREVOCATIONAL TRAINING FOR 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 jobs and training, within the state hospitals 
for the patients with mental illness or residents with mental 
retardation, work activity programs for the purpose of providing 
therapeutic work activities for regional treatment center 
patients with mental illness and regional treatment center 
residents with mental retardation.  Work activity programs may 
be established for the provision of services and for the 
manufacture, processing and repairing of goods, wares, and 
merchandise for the purpose of providing therapeutic work 
activities for patients and residents.  Work activity programs 
may be located on the grounds of the regional treatment center 
or at work sites in the community.  In establishing services the 
commissioner shall cooperate with existing agencies to avoid 
duplication of available services to the extent feasible. 
    Subd. 2.  [POWERS OF COMMISSIONER.] 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.  Notwithstanding 
section 177.24, 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 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, 
    (c) contract with public or private entities for the 
provision of custodial, domestic, maintenance, and other 
services carried out by patients or residents.  To the extent 
that a qualified direct care employee of a regional treatment 
center is available, staff services required by the contract 
shall be provided by that direct care employee. 
    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 money 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 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, jobs and 
training, 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. 2.  Minnesota Statutes 1987 Supplement, section 
252.41, subdivision 7, is amended to read:  
    Subd. 7.  [REGIONAL CENTER.] "Regional center" means any 
one of the eight seven state-operated facilities under the 
direct administrative authority of the commissioner that serve 
persons with mental retardation and related conditions.  The 
following facilities are regional centers:  Anoka-Metro Regional 
Treatment Center; Brainerd Regional Human Services Center; 
Cambridge Regional Treatment Center; Faribault Regional Center; 
Fergus Falls Regional Treatment Center; Moose Lake Regional 
Treatment Center; St. Peter Regional Treatment Center; and 
Willmar Regional Treatment Center. 
    Sec. 3.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 1, is amended to read:  
    Subdivision 1.  [RATES ESTABLISHED THROUGH FOR CALENDAR 
YEARS 1988 AND 1989.] Payment rates to vendors, except regional 
centers, for county-funded day training and habilitation 
services and transportation provided to persons receiving day 
training and habilitation services established by a county board 
before January 1, for calendar years 1988 and 1989, are governed 
by subdivisions 2 to 10.  
    "Payment rate" as used in subdivisions 2 to 10 refers to 
three kinds of payment rates:  a full-day service rate for 
persons who receive at least six service hours a day, including 
the time it takes to transport the person to and from the 
service site; a partial-day service rate that must not exceed 75 
percent of the full-day service rate for persons who receive 
less than a full day of service; and a transportation rate for 
providing, or arranging and paying for, transportation of a 
person to and from the person's residence to the service site. 
    Sec. 4.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 2, is amended to read:  
    Subd. 2.  [1987 AND 1988 AND 1989 MINIMUM.] Unless a 
variance is granted under subdivision 6, the minimum payment 
rates set by a county board for each vendor for 1987 and 
calendar years 1988 and 1989 must be equal to the payment rates 
approved by the commissioner for that vendor in effect January 
1, 1986 1987, and January 1, 1987 1988, respectively. 
    Sec. 5.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 3, is amended to read:  
    Subd. 3.  [1987 AND 1988 AND 1989 MAXIMUM.] Unless a 
variance is granted under subdivision 6, the maximum payment 
rates for each vendor for 1987 and calendar years 1988 and 1989 
must be equal to the payment rates approved by the commissioner 
for that vendor in effect December 1, 1986 1987, and December 1, 
1987 1988, respectively, increased by no more than the projected 
percentage change in the urban consumer price index, all items, 
published by the United States Department of Labor, for the 
upcoming calendar year over the current calendar year. 
    Sec. 6.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 4, is amended to read:  
    Subd. 4.  [NEW VENDORS.] Payment rates established by a 
county before January 1, for calendar years 1988 and 1989, for a 
new vendor for which there were no previous rates must not 
exceed 125 percent of the average payment rates in the regional 
development commission district under sections 462.381 to 
462.396 in which the new vendor is located. 
    Sec. 7.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 5, is amended to read:  
    Subd. 5.  [SUBMITTING RECOMMENDED RATES.] The county board 
shall submit recommended payment rates to the commissioner on 
forms supplied by the commissioner by November 1, 1987, and at 
least 60 days before revised payment rates or payment rates for 
new vendors are to be effective.  The forms must require the 
county board's written verification of the individual 
documentation required under section 252.44, clause (a).  If the 
number of days of service provided by a licensed vendor are 
projected to increase, the county board must recommend payment 
rates based on the projected increased days of attendance and 
resulting lower per unit fixed costs.  If a vendor provides 
services at more than one licensed site, the county board may 
recommend the same payment rates for each site based on the 
average rate for all sites.  The county board may also recommend 
differing payment rates for each licensed site if it would 
result in a total annual payment to the vendor that is equal to 
or less than the total annual payment that would result if the 
average rates had been used for all sites.  For purposes of this 
subdivision, the average payment rate for all service sites used 
by a vendor must be computed by adding the amounts that result 
when the payment rates for each licensed site are multiplied by 
the projected annual number of service units to be provided at 
that site and dividing the sum of those amounts by the total 
units of service to be provided by the vendor at all sites. 
    Sec. 8.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 12, is amended to read:  
    Subd. 12.  [RATES ESTABLISHED AFTER 1988 1989.] Payment 
rates established by a county board to be paid to a vendor on or 
after January 1, 1989 1990, must be determined under permanent 
rules adopted by the commissioner.  No county shall pay a rate 
that is less than the minimum rate determined by the 
commissioner. 
    In developing procedures for setting minimum payment rates 
and procedures for establishing payment rates, the commissioner 
shall consider the following factors: 
    (1) a vendor's payment rate and historical cost in the 
previous year; 
    (2) current economic trends and conditions; 
    (3) costs that a vendor must incur to operate efficiently, 
effectively and economically and still provide training and 
habilitation services that comply with quality standards 
required by state and federal regulations; 
    (4) increased liability insurance costs; 
    (5) costs incurred for the development and continuation of 
supported employment services; 
    (6) cost variations in providing services to people with 
different needs; 
    (7) the adequacy of reimbursement rates that are more than 
15 percent below the statewide average; and 
    (8) other appropriate factors. 
    The commissioner may develop procedures to establish 
differing hourly rates that take into account variations in the 
number of clients per staff hour, to assess the need for day 
training and habilitation services, and to control the 
utilization of services. 
    In developing procedures for setting transportation rates, 
the commissioner may consider allowing the county board to set 
those rates or may consider developing a uniform standard. 
    Medical assistance rates for home and community-based 
services provided under section 256B.501 by licensed vendors of 
day training and habilitation services must not be greater than 
the rates for the same services established by counties under 
sections 252.40 to 252.47.  
    Sec. 9.  Minnesota Statutes 1987 Supplement, section 
252.47, is amended to read:  
    252.47 [RULES.] 
    To implement sections 252.40 to 252.47, the commissioner 
shall adopt permanent rules under sections 14.01 to 14.38.  The 
rules may include a plan for phasing in implementation of the 
procedures and rates established by the rules.  The phase-in may 
occur prior to calendar year 1990.  The commissioner shall 
establish an advisory task force to advise and make 
recommendations to the commissioner during the rulemaking 
process.  The advisory task force must include legislators, 
vendors, residential service providers, counties, consumers, 
department personnel, and others as determined by the 
commissioner. 
    Sec. 10.  Minnesota Statutes 1987 Supplement, section 
252A.111, subdivision 6, is amended to read:  
    Subd. 6.  [SPECIAL DUTIES.] In exercising powers and duties 
under this chapter, the commissioner shall: 
    (1) maintain close contact with the ward, visiting at least 
twice a year; 
    (2) prohibit filming a ward in any way that would reveal 
the identity of the ward unless the commissioner determines the 
filming to be in the best interests of the ward.  The 
commissioner may give written consent for filming of the ward 
after permitting and encouraging input by the nearest relative 
of the ward; 
    (3) take actions and make decisions on behalf of the ward 
that encourage and allow the maximum level of independent 
functioning in a manner least restrictive of the ward's personal 
freedom consistent with the need for supervision and protection; 
and 
    (4) permit and encourage maximum self-reliance on the part 
of the ward and permit and encourage input by the nearest 
relative of the ward in planning and decision making on behalf 
of the ward. 
    Sec. 11.  Minnesota Statutes 1987 Supplement, section 
254B.05, subdivision 1, is amended to read:  
    Subdivision 1.  [LICENSURE REQUIRED.] Programs licensed by 
the commissioner are eligible vendors.  Hospitals may apply for 
and receive licenses to be eligible vendors, notwithstanding the 
provisions of section 245.791.  American Indian programs that, 
if located outside of federally recognized tribal lands, would 
be required to be licensed to located on federally recognized 
tribal lands that provide chemical dependency primary treatment, 
extended care, transitional residence, or outpatient treatment 
services, and are licensed by tribal government are eligible 
vendors.  Detoxification programs are not eligible vendors.  
Programs that, if located outside of federally recognized tribal 
lands, would are not be licensed as a chemical dependency 
residential or nonresidential treatment program under sections 
245.781 to 245.812 by the commissioner or by tribal government 
are not eligible vendors.  To be eligible for payment under the 
Consolidated Chemical Dependency Treatment Fund, a vendor must 
participate in the Drug and Alcohol Abuse Normative Evaluation 
System or a comparable system approved by the commissioner.  
    Sec. 12.  Minnesota Statutes 1987 Supplement, section 
254B.09, subdivision 5, is amended to read:  
    Subd. 5.  [TRIBAL RESERVE ACCOUNT.] The commissioner shall 
reserve 7.5 percent of the American Indian chemical dependency 
account.  The reserve must be allocated to those tribal units 
that have used all money allocated under subdivision 4 according 
to agreements made under subdivision 2.  An American Indian 
tribal governing body may receive not more than 30 percent of 
the reserve account in a year.  Reserve payments shall be made 
only for persons entitled to services under section 254B.04, 
subdivision 1.  The commissioner may refuse to make reserve 
payments for persons not eligible under section 254B.04, 
subdivision 1, if the tribal governing body responsible for 
treatment placement has exhausted its allocation.  Money must be 
allocated as invoices are received. 
    Sec. 13.  Minnesota Statutes 1987 Supplement, section 
256B.04, subdivision 15, is amended to read:  
    Subd. 15.  [UTILIZATION REVIEW.] (1) Establish on a 
statewide basis a new program to safeguard against unnecessary 
or inappropriate use of medical assistance services, against 
excess payments, against unnecessary or inappropriate hospital 
admissions or lengths of stay, and against underutilization of 
services in prepaid health plans, long-term care facilities or 
any health care delivery system subject to fixed rate 
reimbursement.  In implementing the program, the state agency 
shall utilize both prepayment and postpayment review systems to 
determine if utilization is reasonable and necessary.  The 
determination of whether services are reasonable and necessary 
shall be made by the commissioner in consultation with a 
professional services advisory group appointed by the 
commissioner.  An aggrieved party may appeal the commissioner's 
determination pursuant to the contested case procedures of 
chapter 14.  
    (2) Contracts entered into for purposes of meeting the 
requirements of this subdivision shall not be subject to the 
set-aside provisions of chapter 16B. 
    (3) A recipient aggrieved by the commissioner's termination 
of services or denial of future services may appeal pursuant to 
section 256.045.  A vendor aggrieved by the commissioner's 
determination that services provided were not reasonable or 
necessary may appeal pursuant to the contested case procedures 
of chapter 14.  To appeal, the vendor shall notify the 
commissioner in writing within 30 days of receiving the 
commissioner's notice.  The appeal request shall specify each 
disputed item, the reason for the dispute, an estimate of the 
dollar amount involved for each disputed item, the computation 
that the vendor believes is correct, the authority in statute or 
rule upon which the vendor relies for each disputed item, the 
name and address of the person or firm with whom contacts may be 
made regarding the appeal, and other information required by the 
commissioner. 
    Sec. 14.  Minnesota Statutes 1987 Supplement, section 
518.64, subdivision 2, is amended to read:  
    Subd. 2.  [MODIFICATION.] The terms of a decree respecting 
maintenance or support may be modified upon a showing of one or 
more of the following:  (1) substantially increased or decreased 
earnings of a party; (2) substantially increased or decreased 
need of a party; (3) receipt of assistance under sections 256.72 
to 256.87; or (4) a change in the cost-of-living for either 
party as measured by the federal bureau of statistics, any of 
which makes the terms unreasonable and unfair.  On a motion for 
modification of maintenance, the court shall apply, in addition 
to all other relevant factors, the factors for an award of 
maintenance under section 518.552 that exist at the time of the 
motion.  On a motion for modification of support, the court 
shall take into consideration the needs of the children and 
shall not consider the financial circumstances of each party's 
spouse, if any.  A modification which decreases of support or 
maintenance may be made retroactive only with respect to any 
period during which the support obligor petitioning party has 
pending a motion for modification but only from the date that of 
service of notice of the motion has been given to on the obligee 
and to the court or other entity which issued each support 
order.  A modification which increases support or maintenance 
shall not be made retroactive if the obligor has substantially 
complied with the previous order responding party.  Except for 
an award of the right of occupancy of the homestead, provided in 
section 518.63, all divisions of real and personal property 
provided by section 518.58 shall be final, and may be revoked or 
modified only where the court finds the existence of conditions 
that justify reopening a judgment under the laws of this state.  
The court may impose a lien or charge on the divided property at 
any time while the property, or subsequently acquired property, 
is owned by the parties or either of them, for the payment of 
maintenance or support money, or may sequester the property as 
is provided by section 518.24. 
      Sec. 15.  [EFFECTIVE DATE.] 
     This act is effective the day after final enactment. 
    Approved April 14, 1988