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Office of the Revisor of Statutes

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

  

                         Laws of Minnesota 1988 

                        CHAPTER 689-H.F.No. 2126 
           An act relating to the organization and operation of 
          state government; appropriating money for human 
          services and health and other purposes with certain 
          conditions; amending Minnesota Statutes 1986, sections 
          3.9223, subdivision 3; 3.9225, subdivision 3; 3.9226, 
          subdivision 3; 62A.54; 62E.04, by adding subdivisions; 
          129A.02, subdivision 3; 129A.09; 129A.10; 144.053, by 
          adding a subdivision; 144.125; 144.50, by adding a 
          subdivision; 144A.04, by adding a subdivision; 
          144A.08, by adding a subdivision; 145.43, subdivisions 
          1 and 1a; 145.853, subdivision 2; 145.894; 245.771, by 
          adding a subdivision; 245.814, subdivisions 1, 2, and 
          3; 245.83; 245.84, subdivision 1; 246.023, subdivision 
          1; 252.291, subdivisions 1 and 2; 253B.03, by adding a 
          subdivision; 253B.17, subdivision 1; 256.73, 
          subdivisions 2 and 6, and by adding subdivisions; 
          256.736, by adding subdivisions; 256.76, subdivision 
          1; 256B.08; 256B.092, subdivisions 5 and 7; 256B.14, 
          subdivision 2; 256B.17, subdivision 7; 256B.431, by 
          adding subdivisions; 256B.50, subdivision 1, and by 
          adding subdivisions; 256B.501, subdivision 3, and by 
          adding subdivisions; 256B.69, subdivisions 3 and 4; 
          256D.02, subdivision 7, and by adding a subdivision; 
          256D.06, by adding a subdivision; 256D.07; 256D.35, by 
          adding a subdivision; 256D.37, subdivision 2, and by 
          adding subdivisions; 256E.12, subdivisions 1 and 2; 
          256F.03, subdivision 8; 256F.07, by adding a 
          subdivision; 257.071, subdivisions 2, 3, 6, and by 
          adding a subdivision; 257.072; 260.181, subdivision 3; 
          268.0111, by adding a subdivision; 268.86, by adding a 
          subdivision; 268.91, subdivision 7; 268.911, 
          subdivision 3; 326.371; 462.05, by adding a 
          subdivision; 462A.21, by adding a subdivision; 609.72, 
          subdivision 1; and 611A.32, by adding a subdivision; 
          Minnesota Statutes 1987 Supplement, sections 3.922, 
          subdivision 6; 16B.08, subdivision 7; 62A.152, 
          subdivision 2; 62A.48, subdivision 7; 62A.50, 
          subdivision 3; 62D.102; 129A.01, subdivision 5, 6, and 
          7; 129A.03; 129A.06, subdivision 1; 129A.07, 
          subdivision 1; 129A.08, subdivisions 1, 4, 5, and by 
          adding a subdivision; 144A.071, subdivision 3; 
          144A.073, subdivisions 1, 7, and 8; 145.43, 
          subdivision 4; 145A.06, by adding a subdivision; 
          148B.23, subdivision 1; 148B.42, subdivision 1; 
          245.462, subdivisions 3, 4, 6, 17, 18, 19, 20, 21, 23, 
          and 25; 245.465; 245.466, subdivisions 1, 2, and 5; 
          245.467, by adding subdivisions; 245.469, subdivision 
          2; 245.471, subdivisions 2 and 3; 245.472, subdivision 
          2; 245.475, subdivisions 1 and 2; 245.476, subdivision 
          1; 245.477; 245.478, subdivisions 1, 2, and 9; 245.479;
          245.482, subdivision 2; 245.696, subdivision 2; 
          245.697, subdivision 2, and by adding a subdivision; 
          252.291, subdivision 3; 252.46, subdivisions 5 and 6, 
          and by adding subdivisions; 253B.03, subdivision 6; 
          256.01, subdivision 4; 256.015, subdivision 2; 
          256.736, subdivisions 1b, 4, and 11; 256.936; 256.969, 
          subdivisions 2 and 3; 256B.02, subdivision 8; 
          256B.031, subdivision 5; 256B.042, subdivision 2; 
          256B.06, subdivisions 1 and 4; 256B.091, subdivision 
          4; 256B.35, subdivision 1; 256B.431, subdivisions 2b, 
          3, and 4; 256B.433, subdivision 1; 256B.50, 
          subdivision 2; 256B.501, subdivision 1; 256B.73, 
          subdivision 2; 256D.01, subdivision 1a; 256D.03, 
          subdivision 3; 256D.06, subdivisions 1 and 1b; 
          256D.37, subdivision 1; 256E.12, subdivision 3; 
          268.91, subdivisions 1, 3, 3b, 3c, 3e, 4, and 12; and 
          326.73; Laws 1984, chapter 654, article 5, section 57, 
          subdivision 1, as amended; Laws 1987, chapter 337, 
          section 131; Laws 1987, chapter 403, articles 1, 
          section 4, subdivision 4; 2, section 34; and 4, 
          section 13; proposing coding for new law in Minnesota 
          Statutes, chapters 62A; 62C; 62D; 144; 145; 153A; 157; 
          179A; 198; 245; 252; 256; 256B; 257; and 268; 
          proposing coding for new law as Minnesota Statutes, 
          chapter 152A; repealing Minnesota Statutes 1986, 
          sections 144.388; 153A.01; 153A.02; 153A.03; 153A.04; 
          153A.05; 153A.06; 153A.07; 153A.08; 153A.09; 153A.10; 
          153A.11; 153A.12; 245.84, subdivision 4; 245.86; 
          245.87; 246.023, subdivisions 2, 3, 4, and 5; 257.071, 
          subdivision 6; and 268.061; Minnesota Statutes 1987 
          Supplement, sections 129A.01, subdivision 8; 129A.07, 
          subdivision 2; 129A.08, subdivision 3; 148B.04, 
          subdivision 1; and 256B.73, subdivision 10. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 

                                ARTICLE 1

                             APPROPRIATIONS
    Section 1.  [HUMAN SERVICES; HEALTH; APPROPRIATIONS.] 
    The sums shown in the columns marked "APPROPRIATIONS" are 
appropriated from the general fund, or another fund named, to 
the agencies and for the purposes specified in this act, to be 
available for the fiscal years indicated for each purpose.  The 
figures "1988" and "1989," where used in this article, mean that 
the appropriation or appropriations listed under them are 
available for the year ending June 30, 1988, or June 30, 1989, 
respectively.  
                      SUMMARY BY FUND 
                           1988            1989          TOTAL 
General                 $(17,545,900)  $17,035,700   $(510,200) 
Special Revenue             -0-            320,300     320,300  
Public Health                175,200       200,800     376,000  
Trunk Highway                 74,400        85,500     159,900  
Metro Landfill                19,300        22,000      41,300 
TOTAL                   $(17,277,000)  $17,664,300   $ 387,300  
                                               APPROPRIATIONS
                                           Available for the Year
                                               Ending June 30
                                             1988          1989 
     Sec. 2.  HUMAN SERVICES 
     Subdivision 1.  Appropriation 
by Fund 
General Fund                            (17,553,800)  11,722,100
 This appropriation is added to the 
appropriation in Laws 1987, chapter 
403, article 1, section 2. 
     Subd. 2.  Human Services 
Management 
  $   -0-       $   -0-      
     Subd. 3.  Social Services 
  $   -0-       $1,220,200   
 Any balance remaining at the end of 
fiscal year 1988 in the appropriation 
for chemical dependency evaluation in 
Laws 1987, chapter 403, article 1, 
section 2, subdivision 8, does not 
cancel but is available for fiscal year 
1989 to complete the incidence and 
prevalence survey on the extent of drug 
and alcohol problems in Minnesota. 
 Of this appropriation, $200,000 is for 
semi-independent living services for 
those people determined eligible who 
have not received funding.  This 
appropriation may be used to fund 
services for individuals who are 
currently living in intermediate care 
facilities for the mentally retarded, 
who are receiving waivered services and 
are no longer eligible for those 
services, or who are living in their 
family home, a foster home, or their 
own home.  
 Of this appropriation, $50,000 is for a 
grant related to attention deficit 
disorder (ADD).  The commissioner shall 
award the grant to a nonprofit 
corporation whose only purpose is to 
educate people about ADD and to support 
children with ADD and their families.  
Grant money awarded under this 
provision must be used for the 
following purposes:  (1) in-service 
training for school personnel, 
including teachers at all levels from 
early childhood through college and 
vocational training, on the unique 
problems of children who suffer from 
ADD, and (2) support groups for 
children with ADD and their families.  
 Of this appropriation, $150,000 is for 
a demonstration grant under the 
community initiatives for children 
program, to be awarded to a project in 
the seven-county metropolitan area.  
The amount of the grant may not exceed 
the lesser of $150,000 or 50 percent of 
capital costs incurred within a 
two-year period. 
      Subd. 4.  Mental Health 
  $(1,330,000)  $1,395,000   
 Of the amount appropriated in Laws 
1987, chapter 403, article 1, section 
2, subdivision 5, for state mental 
health grants for fiscal year 1988, 
$720,000 does not cancel but is 
available for fiscal year 1989 for the 
same purposes and $1,330,000 is 
transferred to fiscal year 1989. 
 Of the amount appropriated in Laws 
1987, chapter 403, article 1, section 
2, subdivision 5, for mental health for 
fiscal year 1988, $250,000 for 
information systems is transferred in 
fiscal year 1988 to the state systems 
account established in Minnesota 
Statutes, section 256.014, subdivision 
2. 
 Money appropriated for the children's 
mental health plan is for fiscal year 
1989 only.  Money needed beyond June 
30, 1989, to develop or implement the 
plan must be requested as a change 
request in the 1989 to 1991 biennial 
budget.  
 Upon approval of the legislative audit 
commission, $25,000 of this 
appropriation is transferred to the 
legislative auditor for a program 
evaluation of the quality of treatment 
provided by community residential 
programs for people who are mentally 
ill or mentally ill and chemically 
dependent.  The evaluation should 
consider the extent to which facility 
size and ownership structure affect the 
quality of treatment; the 
appropriateness of the reimbursement 
and payment system, including methods 
of paying for buildings and land; and 
the impact of programs on residential 
areas.  
     Subd. 5.  Income Maintenance 
and Residential Programs 
General Fund  
  $(16,987,000) $5,884,300  
(a) Health Care and Residential 
Programs 
  $(11,933,200) $6,252,900  
 For services rendered on or after 
January 1, 1989, the maximum pharmacy 
dispensing fee under medical assistance 
and general assistance medical care is 
$4.20. 
 For medical assistance services 
rendered on or after October 1, 1988, 
payments to medical assistance vendors 
for physician services, dental care, 
vision care, podiatric services, 
chiropractic care, physical therapy, 
occupational therapy, speech 
pathologists, audiologists, mental 
health centers, psychologists, public 
health clinics, and independent 
laboratory and X-ray services must be 
based on payment rates in effect on 
June 30, 1987, except that the base 
rate for obstetrical care is increased 
by ten percent from the base rate in 
effect on June 30, 1987.  
 For medical assistance and general 
assistance medical care services 
rendered on or after July 1, 1989, 
payments to physicians and dentists 
must be calculated at the lower of (1) 
the submitted charges, or (2) the 50th 
percentile of prevailing charges in 
1982.  
 The increased payments to small 
hospitals in Minnesota Statutes, 
section 256.969, subdivision 3, are 
authorized for fiscal year 1989 only.  
 Notwithstanding Minnesota Statutes 
1986, section 256.969, subdivision 3, 
paragraph (b), the appropriation in 
Laws 1987, chapter 403, article 1, 
section 2, subdivision 6, paragraph 
(b), for supplemental grants to 
hospitals is allocated as follows:  
$51,900 to Hennepin county medical 
center and $48,100 to St. Paul-Ramsey 
medical center.  The commissioner shall 
distribute this money by June 30, 1988. 
 For the six-month period ending June 
30, 1989, persons with serious and 
persistent mental illness who, except 
for their residence in a facility 
licensed under Minnesota Rules, parts 
9520.0500 to 9520.0690, would be 
eligible for medical assistance 
services, are eligible under the 
general assistance medical care program 
for services covered under the general 
assistance medical care program plus 
case management.  The commissioner may, 
with the approval of the governor and 
after consulting with the legislative 
advisory commission, transfer $711,000 
of the medical assistance appropriation 
to the general assistance medical care 
appropriation for this purpose.  
 In the biennium ending on June 30, 
1989, the commissioner shall not 
authorize or approve more than 150 
newly constructed or newly established 
intermediate care beds for persons with 
mental retardation or related 
conditions under Minnesota Statutes, 
section 252.291, subdivision 2.  
One-half of the first 70 newly 
constructed or newly established 
intermediate care beds for persons with 
mental retardation or related 
conditions approved by the commissioner 
must be state-operated community-based 
intermediate care beds for persons with 
mental retardation or related 
conditions.  Money appropriated to 
operate and expand state-operated 
community-based program pilot projects 
pursuant to Laws 1987, chapter 403, 
article 1, section 2, subdivision 9, 
may be used to establish state-operated 
community-based intermediate care beds 
for persons with mental retardation or 
related conditions.  
 Of this appropriation, $200,000 is for 
a regional demonstration project under 
Minnesota Statutes, section 256B.73, to 
provide health coverage to low-income 
uninsured persons.  The appropriation 
is available when the planning for the 
project is complete, sufficient money 
has been committed from nonstate 
sources to allow the project to 
proceed, and the project is prepared to 
begin accepting and approving 
applications from uninsured 
individuals.  The commissioner shall 
contract with the coalition formed for 
the nine counties named in Minnesota 
Statutes, section 256B.73, subdivision 
2.  
 Of this appropriation, $752,500 in 
fiscal year 1988 and $5,117,000 in 
fiscal year 1989 are for additional 
positions required in the regional 
treatment centers as a result of health 
care financing administration surveys 
of mental illness program staffing.  
 Any unexpended balance remaining in the 
regional treatment center accounts for 
fiscal year 1988 is available to pay 
the billing for the state health 
insurance trust fund and the costs of 
implementing the Jarvis v. Levine court 
decision.  For fiscal year 1989, 
$420,000 is appropriated for the costs 
of implementing the decision.  
 $1,600,000 is appropriated in the 
public health fund for medical 
assistance to extend eligibility to 
include pregnant women and infants to 
age one with income at or below 185 
percent of the federal poverty level.  
 On or after October 1, 1988, the 
commissioner shall transfer $1,600,000 
to the public health fund for the 
children's health plan and $500,000 to 
the preadmission screening and 
alternative care grants program from 
the medical assistance and general 
assistance medical care programs after 
any transfers necessary because of 
projected deficits in the aid to 
families with dependent children, 
general assistance, or Minnesota 
supplemental aid programs.  The 
transfers may occur only to the extent 
possible using any surplus projected to 
exist at the end of the biennium within 
the appropriations for the medical 
assistance and general assistance 
medical care programs. 
(b) Family Support Programs 
  $(3,551,500)  $(1,376,600) 
(c) Other Income Maintenance Activities 
  $(1,502,300)  $1,008,000   
 Federal receipts for the alien 
verification entitlement system must be 
deposited in the state systems account. 
 Money appropriated for the medical 
assistance and general assistance 
medical care managed care project under 
Minnesota Statutes, section 256B.74, is 
available through June 30, 1989.  Money 
needed to implement or continue the 
recommendations of the task force must 
be included as a change request in the 
1989 to 1991 biennial budget. 
 Money appropriated to develop a plan to 
implement the healthspan program is 
available until June 30, 1989.  
 By January 1, 1989, the commissioner of 
the department of human services shall, 
in cooperation with the commissioner of 
employee relations, complete a job 
evaluation study to determine the 
comparable worth value of direct care 
staff positions in intermediate care 
facilities for the mentally retarded, 
waivered residential services, 
semi-independent living programs, and 
developmental achievement centers that 
are licensed by the department of human 
services or by a county.  The 
commissioner shall contract with the 
department of employee relations for 
completion of the study.  Results of 
the study shall be reported to the 
chair of the finance committee of the 
senate and to the chair of the 
appropriations committee of the house.  
 Notwithstanding Laws 1987, chapter 403, 
article 1, section 14, subdivision 1, 
the commissioner is authorized to 
transfer funds as necessary from 
nonsalary object of expenditure classes 
to salary object of expenditure classes 
in the medical assistance demonstration 
project in order to efficiently educate 
and enroll medical assistance 
recipients in the project. 
 $40,000 of this appropriation must be 
transferred to the commissioner of the 
state planning agency for the biennium 
ending June 30, 1989, to fund the local 
efforts of a multicounty area in 
southwest central Minnesota to plan, 
organize, and design a health insurance 
program demonstration project for low 
income adults and their dependents.  
The demonstration project shall be 
designed to best meet the health 
insurance needs of individuals and 
families who are not eligible for any 
other federally subsidized health 
benefits program and who do not have 
any health insurance or who do not have 
adequate health insurance.  The project 
shall be planned and organized to make 
the best use of existing community 
health providers and agencies.  By 
February 1, 1989, the commissioner 
shall report to the chairs of the 
health and human services committees of 
the senate and the house with a plan, 
organization, and design for 
implementation of the health insurance 
demonstration project.  The report must 
be based on recommendations from the 
multicounty area. 
 The developmental achievement center 
pilot payment rate system in Minnesota 
Statutes, section 252.46, subdivision 
14, may operate through June 30, 1990.  
 Of this appropriation, $150,000 is 
immediately available to contract with 
the commissioner of health to implement 
that part of Public Law No. 100-203 
specified in section 6, subdivision 3.  
 Federal receipts for the independent 
review of medical assistance prepaid 
plans under contract with the 
commissioner are appropriated to the 
commissioner for the review process. 
 $85,000 of this appropriation must be 
transferred to the commissioner of 
administration to complete by February 
1, 1989, (1) an operational cost 
analysis, (2) an impact analysis on 
other nursing homes in the area, (3) a 
demographic study of the number of 
veterans that would be served in the 
area, (4) staffing level requirements 
and the availability of staff, and (5) 
a site feasibility study for the 
following projects: (a) establishment 
of a facility in Fergus Falls for the 
housing and nursing care of veterans; 
and (b) establishment of a veterans 
home in southwestern Minnesota. 
 Money appropriated for the Faribault 
regional center planning study must be 
transferred to the commissioner of the 
state planning agency and is available 
until June 30, 1989. 
     Subd. 6.  Veterans Homes 
  $ 763,200     $3,222,600
 Funds appropriated for the Minnesota 
veterans homes shall be transferred to 
the board of directors of the homes 
immediately upon licensure of the board 
by the commissioner of health for the 
biennium ending June 30, 1989. 
 During the biennium, the board of 
directors of the veterans homes shall 
report the results of all health 
department and Veterans Administration 
inspections and surveys to the 
governor, the chair of the House of 
Representatives appropriation 
committee, the chair of the Senate 
finance committee, the chair of the 
House health and human services 
appropriation division and the chair of 
the Senate health and human services 
finance division, within ten days of 
receiving written notification of the 
results.  The report shall include 
plans for correcting deficiencies. 
 The board of directors of the veterans 
homes shall report to the legislature 
by January 1, 1989, regarding efforts 
to maximize use of federal Veterans 
Administration funds. 
 Of this appropriation, $410,000 is for 
the replacement of electrical 
transformers and for phase 1 of the 
steam retrofitting for the veterans 
home. 
 Money appropriated for repairs and 
replacement at the veterans homes is 
not included in the base funding 
level.  The commissioner shall request 
necessary funds for this purpose as a 
change request to the 1989 to 1991 
biennial budget. 
     Sec. 3.  OMBUDSMAN FOR MENTAL 
HEALTH AND MENTAL RETARDATION                 -0-        200,000
 This appropriation is added to the 
appropriation in Laws 1987, chapter 
352, section 13. 
 Any balance remaining at the end of 
fiscal year 1988 in the account of the 
ombudsman for mental health and mental 
retardation does not cancel but is 
available for fiscal year 1989. 
     Sec. 4.  JOBS AND TRAINING 
     Subdivision 1.  Appropriation by 
Fund 
General Fund                                   -0-     1,800,000 
 This appropriation is added to the 
appropriation in Laws 1987, chapter 
403, article 1, section 4. 
     Subd. 2.  Employment and Training 
General Fund 
  $  -0-    $  100,000 
 All money remaining in the emergency 
interest repayment fund established 
under Minnesota Statutes, section 
268.061, on June 29, 1988, is 
transferred to the unemployment 
compensation fund established under 
Minnesota Statutes, section 268.05. 
     Subd. 3.  Rehabilitation Services
  $  -0-    $  350,000
 Of this appropriation, $150,000 is for 
grants to certified rehabilitation 
facilities to provide needed services 
to eligible persons who are on a 
waiting list for community-based 
employment services. 
     Subd. 4.  Community Services 
  $   -0-       $1,350,000   
 Of this appropriation, $300,000 is for 
Minnesota economic opportunity grants, 
of which $200,000 is for the Olmsted 
and Freeborn county community action 
agencies.  Notwithstanding Laws 1987, 
chapter 403, article 1, section 4, 
subdivision 4, in the event the Olmsted 
and Freeborn county community action 
agencies become federal-eligible 
entities, the discretionary funds being 
held in reserve for the Olmsted and 
Freeborn county community action 
agencies must be distributed to all 
community action agencies. 
 Grants for development and 
administration of life skills and 
employment plans for homeless 
individuals are authorized for fiscal 
year 1989 only.  Money needed to 
continue this program must be included 
as a change request in the 1989 to 1991 
biennial budget document. 
     Sec. 5.  CORRECTIONS 
     Subdivision 1.  Total 
Appropriation                                 7,900      521,600 
 This appropriation is added to the 
appropriation in Laws 1987, chapter 
403, article 1, section 5. 
     Subd. 2.  Correctional Institutions 
  $   -0-       $  360,000      
 This appropriation is to replace boiler 
number three at the Red Wing 
correctional facility. 
 Of the appropriation in Laws 1987, 
chapter 403, article 1, section 5, 
subdivision 4, the commissioner may 
transfer $41,200 in 1988 and $69,100 in 
1989 from contractual services to 
salaries.  
 The commissioner may transfer 
unencumbered grant money during the 
biennium to pay the department's share 
of the employee insurance trust fund 
deficit and for the completion of the 
Lino Lakes expansion project. 
     Subd. 3.  Community Services 
  $  7,900      $161,600     
     Sec. 6.  HEALTH 
     Subdivision 1.  Appropriation by 
Fund 
General Fund                                  -0-     2,792,000 
Special Revenue Fund                          -0-       320,300 
Public Health Fund                         175,200      200,800 
Trunk Highway Fund                          74,400       85,500 
Metro Landfill Fund                         19,300       22,000 
 This appropriation is added to the 
appropriation in Laws 1987, chapter 
403, article 1, section 8. 
     Subd. 2.  Preventive and Protective 
Health Services 
General Fund 
  $   -0-       $2,002,000  
Special Revenue Fund 
  $   -0-       $  220,300  
 Of the appropriation from the general 
fund, $700,000 is to be used for AIDS 
prevention grants for certain high-risk 
populations:  $350,000 for communities 
of color; $250,000 for adolescents at 
highest risk; and $100,000 for 
intravenous drug abusers.  
 Of the appropriation from the general 
fund, $200,000 is to establish the 
Minnesota institute for addiction and 
stress research.  Of this total, 
$160,000 will be used for a grant to 
the institute and $40,000 will be 
retained by the department.  The 
approved complement of the department 
of health is increased by one position 
for purposes of developing and 
monitoring the institute.  
 Of the appropriation from the special 
revenue fund, $55,000 is for 
implementation of the environmental 
laboratories certification program and 
is available until June 30, 1992. 
 Of the appropriation in Laws 1987, 
chapter 403, article 1, section 8, 
subdivision 2, the commissioner may 
transfer $142,000 in fiscal year 1989 
from supplies and expense to salaries.  
 Of the appropriation in Laws 1987, 
chapter 403, article 1, section 8, 
subdivision 2, for the purchase of 
equipment, $190,000 is available until 
June 30, 1989. 
 Money appropriated for the safe 
drinking water program is available 
only for fiscal year 1989.  The 
commissioner shall study alternative 
structures for funding the program 
beyond fiscal year 1989 and shall 
recommend a funding structure to the 
legislature by January 1, 1989.  
 Money appropriated for a medical 
screening of past employees and family 
members of past employees of the Conwed 
Corporation plant in Cloquet is 
available until expended.  
     Subd. 3.  Health Delivery Systems  
General Fund
 $   -0-       $  790,000  
Special Revenue Fund 
 $   -0-       $  100,000 
 Of the appropriation from the general 
fund, $400,000 is for grants to poison 
information centers selected by the 
commissioner under criteria established 
in Minnesota Statutes, section 145.93.  
 The commissioner may develop a schedule 
of fees for diagnostic evaluations 
conducted at clinics held by the 
services for children with handicaps 
program. 
 Notwithstanding the provisions of 
Minnesota Rules, part 4690.4600, an 
emergency medical technician 
certificate issued to a firefighter 
employed by the city of Minneapolis 
which expires as of December 31, 1988, 
shall be effective until December 31, 
1989, provided that the firefighter 
does not serve as an ambulance 
attendant. 
 The commissioner of health, in 
consultation with the commissioner of 
human services, shall implement the 
provisions of Public Law Number 
100-203, the Omnibus Budget 
Reconciliation Act of 1987, that relate 
to training and competency evaluation 
programs and the establishment of a 
registry for nurse aides in nursing 
homes and boarding care homes certified 
for participation in the medical 
assistance or Medicare programs.  The 
board of nursing, at the request of the 
commissioner of health, may establish 
training and competency evaluation 
standards and may establish a registry 
of nurse aides who have completed the 
programs.  The board of nursing and the 
commissioner of health may adopt 
emergency rules that may be required 
for the implementation of Public Law 
Number 100-203.  Emergency rulemaking 
authority expires June 30, 1989.  The 
commissioner of human services shall 
amend the interagency contract with the 
commissioner of health to incorporate 
these requirements. 
 Money appropriated for a demonstration 
project relating to blood lead levels 
in pregnant women is available until 
June 30, 1990.  
 Money appropriated for a demonstration 
project relating to blood lead levels 
in children is available until expended.
     Subd. 4.  Health Support Services 
Public Health Fund 
  $  175,200     $  200,800  
Trunk Highway Fund 
  $   74,400     $   85,500  
Metro Landfill Fund 
  $   19,300     $   22,000  
      Sec. 7.  PROJECT LABOR
 For human services and corrections 
institutions, wages for project labor 
may be paid if the employee is to be 
engaged in a construction or repair 
project of short-term and nonrecurring 
nature.  Minnesota Statutes, section 
43A.25, does not prevent the payment of 
the prevailing wage rate, as defined in 
Minnesota Statutes, section 177.42, 
subdivision 6, to a person hired to 
work on a project, whether or not the 
person is working under a contract. 

                                ARTICLE 2
    Section 1.  Minnesota Statutes 1987 Supplement, section 
3.922, subdivision 6, is amended to read:  
    Subd. 6.  [DUTIES.] The primary duties of the council shall 
be to: 
    (1) clarify for the legislature and state agencies the 
nature of tribal governments, the relationship of tribal 
governments to the Indian people of Minnesota; 
    (2) assist the secretary of state in establishing an 
election of at large members of the council; 
    (3) make recommendations to members of the legislature on 
desired and needed legislation for the benefit of the statewide 
Indian community and communicate to the members of the 
legislature when legislation has or will have an adverse effect 
on the statewide Indian community; 
    (4) provide, through the elected apparatus of the council, 
an effective conduit for programs, proposals, and projects to 
the legislature submitted by tribal governments, organizations, 
committees, groups, or individuals; 
    (5) provide a continuing dialogue with members of the 
appropriate tribal governments in order to improve their 
knowledge of the legislative process, state agencies, and 
governmental due process; 
    (6) assist in establishing Indian advisory councils in 
cooperation with state agencies delivering services to the 
Indian community; 
    (7) assist state agencies in defining what groups, 
organizations, committees, councils, or individuals are eligible 
for delivery of their respective services; 
    (8) assist in providing resources, tribal and other, in the 
delivery of services to the statewide Indian community; 
    (9) act as a liaison between local, state, and national 
units of government in the delivery of services to the Indian 
population of Minnesota; 
    (10) assist state agencies in the implementation and 
updating of studies of services delivered to the Indian 
community; 
    (11) provide, for the benefit of all levels of state 
government, a continuing liaison between those governmental 
bodies and duly elected tribal governments and officials; 
    (12) interreact with private organizations involved with 
Indian concerns in the development and implementation of 
programs designed to assist Indian people, insofar as they 
affect state agencies and departments; 
    (13) act as an intermediary, when requested and if 
necessary between Indian interests and state agencies and 
departments when questions, problems, or conflicts exist or 
arise; 
    (14) provide information for and direction to a program 
designed to assist Indian citizens to assume all the rights, 
privileges, and duties of citizenship, and to coordinate and 
cooperate with local, state, and national private agencies 
providing services to the Indian people; 
    (15) develop educational programs, community organization 
programs, leadership development programs, motivational 
programs, and business development programs for the benefit of 
Indian persons who have been, are, or will be subject to 
prejudice and discrimination; and 
    (16) cooperate and consult with appropriate commissioners 
and agencies to develop plans and programs to most effectively 
serve the needs of Indians; and 
    (17) review data provided by the commissioner of human 
services under section 257.072, subdivision 5, and present 
recommendations on the out-of-home placement of Indian 
children.  Recommendations must be presented to the commissioner 
and the legislature by February 1, 1990; November 1, 1990; and 
November 1 of each year thereafter.  
    Sec. 2.  Minnesota Statutes 1986, section 3.9223, 
subdivision 3, is amended to read:  
    Subd. 3.  [DUTIES.] The council shall: 
    (a) Advise the governor and the legislature on the nature 
of the issues and disabilities confronting Spanish-speaking 
people in this state including the unique problems encountered 
by Spanish-speaking migrant agricultural workers; 
    (b) Advise the governor and the legislature on statutes or 
rules necessary to insure Spanish-speaking people access to 
benefits and services provided to people in this state; 
    (c) Recommend to the governor and the legislature 
legislation designed to improve the economic and social 
condition of Spanish-speaking people in this state; 
    (d) Serve as a conduit to state government for 
organizations of Spanish-speaking people in the state; 
    (e) Serve as a referral agency to assist Spanish-speaking 
people in securing access to state agencies and programs; 
    (f) Serve as a liaison with the federal government, local 
government units and private organizations on matters relating 
to the Spanish-speaking people of this state; 
    (g) Perform or contract for the performance of studies 
designed to suggest solutions to problems of Spanish-speaking 
people in the areas of education, employment, human rights, 
health, housing, social welfare and other related programs; 
    (h) Implement programs designed to solve problems of 
Spanish-speaking people when so authorized by other statute, 
rule or order; 
    (i) Review data provided by the commissioner of human 
services under section 257.072, subdivision 5, and present 
recommendations on the out-of-home placement of children of 
Hispanic people.  Recommendations must be presented to the 
commissioner and the legislature by February 1, 1990; November 
1, 1990; and November 1 of each year thereafter; and 
    (j) Publicize the accomplishments of Spanish-speaking 
people and the contributions made by them to this state. 
    Sec. 3.  Minnesota Statutes 1986, section 3.9225, 
subdivision 3, is amended to read:  
    Subd. 3.  [DUTIES.] The council shall:  
    (a) Advise the governor and the legislature on the nature 
of the issues confronting Black people in this state; 
    (b) Advise the governor and the legislature on statutes or 
rules necessary to insure Black people access to benefits and 
services provided to people in this state;  
    (c) Recommend to the governor and the legislature any 
revisions in the state's affirmative action program and any 
other steps that are necessary to eliminate underutilization of 
Blacks in the state's work force;  
    (d) Recommend to the governor and the legislature 
legislation designed to improve the economic and social 
condition of Black people in this state;  
    (e) Serve as a conduit to state government for 
organizations of Black people in the state;  
    (f) Serve as a referral agency to assist Black people in 
securing access to state agencies and programs;  
    (g) Serve as a liaison with the federal government, local 
government units and private organizations on matters relating 
to the Black people of this state;  
    (h) Perform or contract for the performance of studies 
designed to suggest solutions to problems of Black people in the 
areas of education, employment, human rights, health, housing, 
social welfare and other related areas;  
    (i) Implement programs designed to solve problems of Black 
people when so authorized by other statute, rule or order; and 
    (j) Review data provided by the commissioner of human 
services under section 257.072, subdivision 5, and present 
recommendations on the out-of-home placement of Black children.  
Recommendations must be presented to the commissioner and the 
legislature by February 1, 1990; November 1, 1990; and November 
1 of each year thereafter; and 
    (k) Publicize the accomplishments of Black people and the 
contributions made by them to this state.  
    Sec. 4.  Minnesota Statutes 1986, section 3.9226, 
subdivision 3, is amended to read:  
    Subd. 3.  [DUTIES.] The council shall: 
    (1) advise the governor and the legislature on issues 
confronting Asian-Pacific people in this state, including the 
unique problems of non-English-speaking immigrants and refugees; 
    (2) advise the governor and the legislature of 
administrative and legislative changes necessary to ensure 
Asian-Pacific people access to benefits and services provided to 
people in this state; 
    (3) recommend to the governor and the legislature any 
revisions in the state's affirmative action program and other 
steps that are necessary to eliminate underutilization of 
Asian-Pacific people in the state's work force; 
    (4) recommend to the governor and the legislature 
legislation designed to improve the economic and social 
condition of Asian-Pacific people in this state; 
    (5) serve as a conduit to state government for 
organizations of Asian-Pacific people in the state; 
    (6) serve as a referral agency to assist Asian-Pacific 
people in securing access to state agencies and programs; 
    (7) serve as a liaison with the federal government, local 
government units, and private organizations on matters relating 
to the Asian-Pacific people of this state; 
    (8) perform or contract for the performance of studies 
designed to suggest solutions to the problems of Asian-Pacific 
people in the areas of education, employment, human rights, 
health, housing, social welfare, and other related areas; 
    (9) implement programs designed to solve the problems of 
Asian-Pacific people when authorized by other law; 
    (10) publicize the accomplishments of Asian-Pacific people 
and their contributions to this state; 
    (11) work with other state and federal agencies and 
organizations to develop small business opportunities and 
promote economic development for Asian-Pacific Minnesotans;  
    (12) supervise development of an Asian-Pacific trade 
primer, outlining Asian and Pacific customs, cultural 
traditions, and business practices, including language usage, 
for use by Minnesota's export community; and 
    (13) cooperate with other state and federal agencies and 
organizations to develop improved state trade relations with 
Asian and Pacific countries; and 
    (14) review data provided by the commissioner of human 
services under section 257.072, subdivision 5, and present 
recommendations on the out-of-home placement of Asian-Pacific 
children.  Recommendations must be presented to the commissioner 
and the legislature by February 1, 1990; November 1, 1990; and 
November 1 of each year thereafter. 
     Sec. 5.  Minnesota Statutes 1987 Supplement, section 
16B.08, subdivision 7, is amended to read:  
    Subd. 7.  [SPECIFIC PURCHASES.] (a) The following may be 
purchased without regard to the competitive bidding requirements 
of this chapter:  
    (1) merchandise for resale at state park refectories or 
facility operations;  
    (2) farm and garden products, which may be sold at the 
prevailing market price on the date of the sale;  
    (3) meat for other state institutions from the vocational 
school maintained at Pipestone by independent school district 
No. 583; and 
    (4) furniture from the Minnesota correctional facilities.  
    (b) Supplies, materials, equipment, and utility services 
for use by a community-based residential facility operated by 
the commissioner of human services may be purchased or rented 
without regard to the competitive bidding requirements of this 
chapter. 
    (c) Supplies, materials, or equipment to be used in the 
operation of a hospital licensed under sections 144.50 to 144.56 
that are purchased under a shared service purchasing arrangement 
whereby more than one hospital purchases supplies, materials, or 
equipment with one or more other hospitals, either through one 
of the hospitals or through another entity, may be purchased 
without regard to the competitive bidding requirements of this 
chapter if the following conditions are met: 
    (1) the hospital's governing authority authorizes the 
arrangement; 
    (2) the shared services purchasing program purchases items 
available from more than one source on the basis of competitive 
bids or competitive quotations of prices; and 
    (3) the arrangement authorizes the hospital's governing 
authority or its representatives to review the purchasing 
procedures to determine compliance with these requirements. 
    Sec. 6.  [62A.048] [DEPENDENT COVERAGE.] 
    A policy of accident and sickness insurance that covers an 
employee who is a Minnesota resident must, if it provides 
dependent coverage, allow dependent children who do not reside 
with the covered employee to be covered on the same basis as if 
they reside with the covered employee.  Neither the amount of 
support provided by the employee to the dependent child nor the 
residency of the child may be used as an excluding or limiting 
factor for coverage or payment for health care. 
    Sec. 7.  Minnesota Statutes 1987 Supplement, section 
62A.152, subdivision 2, is amended to read:  
    Subd. 2.  [MINIMUM BENEFITS.] (a) All group policies and 
all group subscriber contracts providing benefits for mental or 
nervous disorder treatments in a hospital shall also provide 
coverage on the same basis as coverage for other benefits for at 
least 80 percent of the cost of the usual and customary charges 
of the first ten hours of treatment incurred over a 12-month 
benefit period, for mental or nervous disorder consultation, 
diagnosis and treatment services delivered while the insured 
person is not a bed patient in a hospital, and at least 75 
percent of the cost of the usual and customary charges for any 
additional hours of treatment during the same 12-month benefit 
period for serious and or persistent mental or nervous 
disorders, if the services are furnished by (1) a licensed or 
accredited hospital, (2) a community mental health center or 
mental health clinic approved or licensed by the commissioner of 
human services or other authorized state agency, or (3) a 
licensed consulting psychologist licensed under the provisions 
of sections 148.87 to 148.98, or a psychiatrist licensed under 
chapter 147.  Prior authorization from an accident and health 
insurance company, or a nonprofit health service corporation, 
shall be required for an extension of coverage beyond ten hours 
of treatment.  This prior authorization must be based upon the 
severity of the disorder, the patient's risk of deterioration 
without ongoing treatment and maintenance, degree of functional 
impairment, and a concise treatment plan.  Authorization for 
extended treatment may not exceed be limited to a maximum of 30 
visit hours during any 12-month benefit period. 
    (b) For purposes of this section, covered treatment for a 
minor shall include includes treatment for the family if family 
therapy is recommended by a provider listed above in paragraph 
(a), item (1), (2) or (3).  For purposes of determining benefits 
under this section, "hours of treatment" means treatment 
rendered on an individual or single-family basis.  If treatment 
is rendered on a group basis, the hours of covered group 
treatment must be provided at a ratio of no less than two group 
treatment sessions to one individual treatment hour.  
    Sec. 8.  Minnesota Statutes 1987 Supplement, section 
62A.48, subdivision 7, is amended to read:  
    Subd. 7.  [EXISTING POLICIES.] Nothing in sections 62A.46 
to 62A.56 62A.58 prohibits the renewal of the following 
long-term care policies: 
     (1) policies sold outside the state of Minnesota to persons 
who at the time of sale were not residents of the state of 
Minnesota; 
     (2) policies sold before August 1, 1986; and 
     (3) policies sold before July 1, 1988, by associations 
exempted from sections 62A.31 to 62A.44 under section 62A.31, 
subdivision 1a. 
    Sec. 9.  Minnesota Statutes 1987 Supplement, section 
62A.50, subdivision 3, is amended to read:  
    Subd. 3.  [DISCLOSURES.] No long-term care policy shall be 
offered or delivered in this state, whether or not the policy is 
issued in this state, and no certificate of coverage under a 
group long-term care policy shall be offered or delivered in 
this state, unless a statement containing at least the following 
information is delivered to the applicant at the time the 
application is made: 
    (1) a description of the benefits and coverage provided by 
the policy and the differences between this policy, a 
supplemental Medicare policy and the benefits to which an 
individual is entitled under parts A and B of Medicare and the 
differences between policy designations A and AA; 
    (2) a statement of the exceptions and limitations in the 
policy including the following language, as applicable, in bold 
print:  "THIS POLICY DOES NOT COVER ALL NURSING CARE FACILITIES 
OR NURSING HOME OR, HOME CARE, OR ADULT DAY CARE EXPENSES AND 
DOES NOT COVER RESIDENTIAL CARE.  READ YOUR POLICY CAREFULLY TO 
DETERMINE WHICH FACILITIES AND EXPENSES ARE COVERED BY YOUR 
POLICY."; 
    (3) a statement of the renewal provisions including any 
reservation by the insurer of the right to change premiums; 
    (4) a statement that the outline of coverage is a summary 
of the policy issued or applied for and that the policy should 
be consulted to determine governing contractual provisions; 
    (5) an explanation of the policy's loss ratio including at 
least the following language:  "This means that, on the average, 
policyholders may expect that $........ of every $100 in premium 
will be returned as benefits to policyholders over the life of 
the contract."; and 
    (6) a statement of the out-of-pocket expenses, including 
deductibles and copayments for which the insured is responsible, 
and an explanation of the specific out-of-pocket expenses that 
may be accumulated toward any out-of-pocket maximum as specified 
in the policy;  
    (7) the following language, in bold print:  "YOUR PREMIUMS 
CAN BE INCREASED IN THE FUTURE.  THE RATE SCHEDULE THAT LISTS 
YOUR PREMIUM NOW CAN CHANGE."; 
    (8) the following language, if applicable, in bold print:  
"IF YOU ARE NOT HOSPITALIZED PRIOR TO ENTERING A NURSING HOME OR 
NEEDING HOME CARE, YOU WILL NOT BE ABLE TO COLLECT ANY BENEFITS 
UNDER THIS PARTICULAR POLICY."; and 
    (9) a signed and completed copy of the application for 
insurance is left with the applicant at the time the application 
is made. 
    Sec. 10.  Minnesota Statutes 1986, section 62A.54, is 
amended to read:  
    62A.54 [PROHIBITED PRACTICES.] 
    Unless otherwise provided for in Laws 1986, chapter 397, 
sections 2 to 8, the solicitation or sale of long-term care 
policies is subject to the requirements and penalties applicable 
to the sale of medicare supplement insurance policies as set 
forth in sections 62A.31 to 62A.44. 
    It is misconduct for any agent or company to make any 
misstatements concerning eligibility or coverage under the 
medical assistance program, or about how long-term care costs 
will or will not be financed if a person does not have long-term 
care insurance.  Any agent or company providing information on 
the medical assistance program shall also provide information 
about how to contact the county human services department or the 
state department of human services. 
    Sec. 11.  [62C.143] [DEPENDENT COVERAGE.] 
    A subscriber contract of a nonprofit health service plan 
corporation that covers an employee who is a Minnesota resident 
must, if it provides dependent coverage, allow dependent 
children who do not reside with the covered employee to be 
covered on the same basis as if they reside with the covered 
employee.  Neither the amount of support provided by the 
employee to the dependent child nor the residency of the child 
may be used as an excluding or limiting factor for coverage or 
payment for health care. 
    Sec. 12.  Minnesota Statutes 1987 Supplement, section 
62D.102, is amended to read:  
    62D.102 [MINIMUM BENEFITS.] 
    (a) In addition to minimum requirements established in 
other sections, all group health maintenance contracts providing 
benefits for mental or nervous disorder treatments in a hospital 
shall also provide coverage for at least ten hours of treatment 
over a 12-month period with a copayment not to exceed the 
greater of $10 or 20 percent of the applicable usual and 
customary charge for mental or nervous disorder consultation, 
diagnosis and treatment services delivered while the enrollee is 
not a bed patient in a hospital and at least 75 percent of the 
cost of the usual and customary charges for any additional hours 
of ambulatory mental health treatment during the same 12-month 
benefit period for serious and or persistent mental or nervous 
disorders.  Prior authorization may be required for an extension 
of coverage beyond ten hours of treatment.  This prior 
authorization must be based upon the severity of the disorder, 
the patient's risk of deterioration without ongoing treatment 
and maintenance, degree of functional impairment, and a concise 
treatment plan.  Authorization for extended treatment may not 
exceed be limited to a maximum of 30 visit hours during any 
12-month benefit period. 
    (b) For purposes of this section, covered treatment for a 
minor shall include includes treatment for the family if family 
therapy is recommended by a health maintenance organization 
provider.  For purposes of determining benefits under this 
section, "hours of treatment" means treatment rendered on an 
individual or single-family basis.  If treatment is rendered on 
a group basis, the hours of covered group treatment must be 
provided at a ratio of no less than two group treatment sessions 
to one individual treatment hour.  For a health maintenance 
contract that is offered as a companion to a health insurance 
subscriber contract, the benefits for mental or nervous 
disorders must be calculated in aggregate for the health 
maintenance contract and the health insurance subscriber 
contract. 
    Sec. 13.  [62D.106] [DEPENDENT COVERAGE.] 
    A health maintenance organization subscriber contract must, 
if it provides dependent coverage, allow dependent children who 
do not reside with the covered employee to be covered on the 
same basis as if they reside with the covered employee.  Neither 
the amount of support provided by the employee to the dependent 
child nor the residency of the child can be used as an excluding 
or limiting factor for coverage or payment for any health care.  
Coverage under this section shall apply only if the dependent 
child resides within the service area of the health maintenance 
organization or if the dependent child is a birth or legally 
adopted child.  
    Sec. 14.  Minnesota Statutes 1986, section 62E.04, is 
amended by adding a subdivision to read: 
    Subd. 9.  [REDUCTION OF BENEFITS BECAUSE OF ERISA 
SERVICES.] No plan of health coverage including, but not limited 
to, any plan under the federal Employee Retirement Income 
Security Act of 1974 (ERISA), United States Code, title 29, 
sections 1001 to 1461, which covers a Minnesota resident shall 
deny or reduce benefits because services are rendered to a 
covered person or dependent who is eligible for or receiving 
benefits under chapter 256B.  
    Sec. 15.  Minnesota Statutes 1986, section 62E.04, is 
amended by adding a subdivision to read: 
    Subd. 10.  [DEPENDENT COVERAGE.] A plan of health coverage 
under the Federal Employee Retirement Income Security Act of 
1974 (ERISA), United State Code, title 29, sections 1001 to 
1461, which covers an employee who is a Minnesota resident must, 
if it provides dependent coverage, allow dependent children who 
are eligible for or receiving benefits under chapter 256B and 
who do not reside with the covered employee to be covered on the 
same basis as if they reside with the covered employee.  Neither 
the amount of support provided by the employee to the dependent 
child nor the residency of the child can be used as an excluding 
or limiting factor for coverage or payment for any health care. 
    Sec. 16.  Minnesota Statutes 1987 Supplement, section 
129A.01, subdivision 5, is amended to read:  
    Subd. 5.  [HANDICAPPED PERSON PERSON WITH A 
DISABILITY.] "Handicapped person" "Person with a disability" 
means a person who because of a substantial physical, mental, or 
emotional disability or dysfunction requires special services in 
order to enjoy the benefits of society. 
    Sec. 17.  Minnesota Statutes 1987 Supplement, section 
129A.01, subdivision 6, is amended to read:  
    Subd. 6.  [LONG-TERM SHELTERED WORKSHOP REHABILITATION 
FACILITY.] "Long-term sheltered workshop Rehabilitation 
facility" means a facility where any manufacture or handiwork is 
carried on and an entity which meets the definition of 
"rehabilitation facility" in the federal Rehabilitation Act of 
1973, as amended; however, for the purposes of sections 129A.03, 
paragraph (a), 129A.06, 129A.07, and 129A.08, "rehabilitation 
facility" means an entity which is operated for the primary 
purpose of providing remunerative employment to 
those handicapped persons with a disability who, as a result of 
physical or mental disability, are unable to participate in 
competitive employment.  A long-term sheltered workshop 
rehabilitation facility shall supply such employment (1) as a 
step in the rehabilitation process for those who cannot be 
readily absorbed in the competitive labor market, or (2) during 
such time as employment opportunities for them in the 
competitive labor market do not exist. 
    Sec. 18.  Minnesota Statutes 1987 Supplement, section 
129A.01, subdivision 7, is amended to read:  
    Subd. 7.  [WORK ACTIVITY PROGRAM.] "Work activity program" 
means a program which utilizes paid work and training services 
for the primary purpose of providing basic vocational skills 
development for the handicapped persons with a disability and 
which permits a level of production below that required for a 
long-term employment program.  
    Sec. 19.  Minnesota Statutes 1986, section 129A.02, 
subdivision 3, is amended to read:  
    Subd. 3.  [CONSUMER ADVISORY COUNCIL.] To assure that 
consumer concerns are integral parts of the considerations of a 
major consideration in the department department's programs, 
policies, and decision making process, the commissioner shall 
establish and appoint a consumer advisory council on vocational 
rehabilitation which shall be composed of nine no more than 13 
members.  No fewer than five A majority of the members of the 
council shall be handicapped persons, and there shall be with a 
disability who are current or former recipients of vocational 
rehabilitation services or who represent consumer/advocacy 
organizations that regularly serve vocational rehabilitation 
clients.  If a qualified person is available to so serve, one 
person shall be appointed to the council to represent each of 
the following:  business, labor, education, medicine and the 
private not-for-profit rehabilitation industry.  The remaining 
members shall be public members.  Under the direction of the 
commissioner, the council shall organize itself and elect a 
chair and other officers as it deems appropriate.  The council 
shall meet at the call of the chair or the commissioner as often 
as necessary.  The council shall expire and the terms, 
compensation, and removal of members of the council shall be as 
provided in section 15.059.  The council shall not expire as 
provided by section 15.059, subdivision 5. 
    Sec. 20.  Minnesota Statutes 1987 Supplement, section 
129A.03, is amended to read:  
    129A.03 [POWERS AND DUTIES.] 
    The commissioner shall: 
    (a) certify the long-term sheltered workshops 
rehabilitation facilities to offer extended employment programs, 
grant funds to the extended employment programs, and perform the 
duties as specified in section 129A.08; 
    (b) provide vocational rehabilitation services such as to 
persons with disabilities in accordance with the state plan for 
vocational rehabilitation.  These services include but are not 
limited to:  diagnostic and related services incidental to 
determination of eligibility for services to be provided, 
including medical diagnosis and vocational diagnosis; vocational 
counseling, training and instruction, including personal 
adjustment training; physical restoration, including corrective 
surgery, therapeutic treatment, hospitalization and 
prosthetic and orthotic devices, all of which shall be obtained 
from appropriate established agencies; transportation; 
occupational and business licenses or permits, customary tools 
and equipment,; maintenance,; books, supplies and training 
materials; initial stocks and supplies; placement; on-the-job 
skill training and time-limited postemployment services leading 
to supported employment; acquisition of vending stands or other 
equipment, initial stocks and supplies for small business 
enterprises; supervision and management of small business 
enterprises, merchandising programs or services rendered by 
severely disabled persons; establishment, improvement, 
maintenance or extension of public and other nonprofit 
rehabilitation facilities, centers, workshops, demonstration 
projects and research.  These services shall be provided for 
handicapped persons in the state whose capacity to earn a living 
has in any way been destroyed or impaired through industrial 
accident or otherwise; these Persons with a disability are 
entitled to free choice of vendor for any medical or, dental, 
prosthetic, or orthotic services provided under this paragraph; 
    (c) expend funds and provide technical assistance for the 
establishment, improvement, maintenance, or extension of public 
and other nonprofit rehabilitation facilities or centers; 
    (d) formulate plans of cooperation with the commissioner of 
labor and industry for providing services to workers covered 
under the workers' compensation act; 
    (d) (e) maintain a contractual or regulatory relationship 
with the United States as authorized by the act of Congress 
approved September 1, 1954, known as the "Social Security 
Amendments of 1954," Public Law Number 761, section 221, and the 
act approved October 30, 1972, known as the Social Security 
Amendments of 1972, Public Law Number 92-603, and subsequent 
amendments Social Security Act, as amended.  Under the contract 
this relationship, the state will undertake to make 
determinations referred to in those public laws with respect to 
all individuals in Minnesota, or with respect to a class or 
classes of individuals in this state that is designated in the 
agreement at the state's request.  It is the purpose of this 
relationship to permit the citizens of this state to obtain all 
benefits available under federal law; 
    (e) (f) provide an in-service training program for 
department division of rehabilitation services employees by 
paying for its direct costs with state and federal funds; 
    (f) (g) conduct research and demonstration projects; 
provide training and instruction, including establishment and 
maintenance of research fellowships and traineeships, along with 
all necessary stipends and allowances; disseminate information 
to the handicapped persons with a disability and the general 
public; and provide technical assistance relating to vocational 
rehabilitation and independent living; 
    (g) (h) receive and disburse pursuant to law money and 
gifts available from governmental and private sources including, 
but not limited to, the federal Department of Education and the 
Social Security Administration, for the purpose of vocational 
rehabilitation or independent living.  Money received from 
workers' compensation carriers for vocational rehabilitation 
services to injured workers must be deposited in the general 
fund; 
    (h) (i) design all state plans of for vocational 
rehabilitation or independent living services required as a 
condition to the receipt and disbursement of any money available 
from the federal government; 
    (i) (j) cooperate with other public or private agencies or 
organizations for the purpose of vocational rehabilitation or 
independent living.  Money received from school districts, 
governmental subdivisions, mental health centers or boards, and 
private nonprofit organizations is appropriated to the 
commissioner for conducting joint or cooperative vocational 
rehabilitation or independent living programs; 
    (j) (k) enter into contractual arrangements with 
instrumentalities of federal, state, or local government and 
with private individuals, organizations, agencies, or facilities 
with respect to providing vocational rehabilitation or 
independent living services; 
    (k) (l) take other actions required by state and federal 
legislation relating to vocational rehabilitation, independent 
living, and disability determination programs; 
    (l) (m) hire staff and arrange services and facilities 
necessary to perform the duties and powers specified in this 
section; and 
    (m) (n) adopt, amend, suspend, or repeal rules necessary to 
implement or make specific programs that the commissioner by 
sections 129A.01 to 129A.09 is empowered to administer. 
    Sec. 21.  Minnesota Statutes 1987 Supplement, section 
129A.06, subdivision 1, is amended to read:  
    Subdivision 1.  Any city, town, county, nonprofit 
corporation, state regional center, or any combination thereof, 
may apply to the commissioner for assistance in establishing or 
operating a community long-term sheltered workshop 
rehabilitation facility.  Application for assistance shall be on 
forms supplied by the commissioner.  Each applicant shall 
annually submit to the commissioner 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 
commissioner. 
    Sec. 22.  Minnesota Statutes 1987 Supplement, section 
129A.07, subdivision 1, is amended to read:  
    Subdivision 1.  Every city, town, county, nonprofit 
corporation, or combination thereof establishing a long-term 
sheltered workshop rehabilitation facility shall appoint a 
long-term sheltered workshop rehabilitation facility board of no 
fewer than nine members before becoming eligible for the 
assistance provided by sections 129A.06 to 129A.08.  When any 
city, town, or county singly establishes such a 
workshop rehabilitation facility, the board shall be appointed 
by the chief executive officer of the city or the chair of the 
governing board of the county or town.  When any combination of 
cities, towns, counties or nonprofit corporations establishes 
a workshop rehabilitation facility, the chief executive officers 
of the cities, nonprofit corporations and the chairs of the 
governing bodies of the counties or towns shall appoint the 
board.  If a nonprofit corporation singly establishes a workshop 
rehabilitation facility, the corporation shall appoint the board 
of directors.  Membership on a board shall be representative of 
the community served and shall include a handicapped person with 
a disability.  One-third to one-half of the board shall be 
representative of industry or business.  The remaining members 
should be representative of lay associations for the handicapped 
persons with a disability, labor, the general public, and 
education, welfare, medical, and health professions.  Nothing in 
sections 129A.06 to 129A.08 shall be construed to preclude the 
appointment of elected or appointed public officials or members 
of the board of directors of the sponsoring nonprofit 
corporation to the board, so long as representation described 
above is preserved.  If a state regional center establishes an 
extended employment program, the chief executive officer of the 
state regional center shall perform the functions of the 
rehabilitation facility board as prescribed in subdivision 3.  
The regional center is not required to establish a separate 
governing body as a board.  The state regional center shall 
establish an advisory committee following the membership 
representation requirements of this subdivision.  If a county 
establishes a workshop an extended employment program and 
manages the workshop program with county employees, the 
governing board shall be the county board of commissioners and 
other provisions of this chapter pertaining to membership on the 
governing board do not apply. 
    Sec. 23.  Minnesota Statutes 1987 Supplement, section 
129A.08, subdivision 1, is amended to read:  
    Subdivision 1.  [GRANTS.] The commissioner may make grants 
to assist cities, towns, counties, nonprofit corporations, state 
regional centers, or any combination thereof in the 
establishment, operation, and expansion of the extended 
employment programs offered by long-term sheltered workshops 
rehabilitation facilities.  The commissioner may accept federal 
grants or aids and shall cooperate with federal agencies in any 
reasonable manner necessary to qualify for federal grants or 
aids for long-term sheltered workshops rehabilitation facilities 
or their programs. 
    Sec. 24.  Minnesota Statutes 1987 Supplement, section 
129A.08, subdivision 4, is amended to read:  
    Subd. 4.  [EVALUATION OF PROGRAMS.] The program evaluation 
must include, but not be limited to, the following 
considerations:  
    (a) Wages and benefits paid to sheltered employees extended 
employment program participants and number of hours worked;  
    (b) Rate of placement in competitive employment;  
    (c) Opportunities for sheltered employees extended 
employment program participants to participate in decisions 
affecting their employment;  
    (d) Workshop Rehabilitation facility responsiveness to 
sheltered employees extended employment program participants' 
grievances;  
    (e) Increases in individual sheltered employee extended 
employment program participants' productivity; 
    (f) Implementing innovative ways to increase placement and 
retention of sheltered employees in competitive employment, or 
in sheltered positions with competitive employers, or innovative 
ways that increase sheltered employee wages;  
    (g) Efficiency of the workshops rehabilitation facilities; 
and 
    (h) (g) Types and levels of disability of the sheltered 
employees extended employment program participants and 
willingness of the workshop rehabilitation facility to accept 
and assist persons with serious behavioral, mental, sensory, or 
physical disabilities.  
    The evaluation must take into account the disability levels 
of the sheltered employees extended employment program 
participants, the geographic location and size of the workshop 
rehabilitation facility and the economic conditions of the 
surrounding community.  
    Sec. 25.  Minnesota Statutes 1987 Supplement, section 
129A.08, is amended by adding a subdivision to read: 
    Subd. 4a.  [FUND ALLOCATION.] Funds appropriated for the 
extended employment program shall be distributed to 
rehabilitation facilities in a manner prescribed in rule, 
provided that 15 percent shall be allocated based on economic 
conditions as defined in rule and that, for funding purposes, no 
credit can be given for full-time equivalents, as defined in 
rule, in excess of the number of persons in the program. 
    Sec. 26.  Minnesota Statutes 1987 Supplement, section 
129A.08, subdivision 5, is amended to read:  
    Subd. 5.  [RULE AUTHORITY.] In addition to the powers 
already conferred by law, the commissioner shall promulgate 
rules on: 
    (a) state certification of all long-term sheltered 
workshops rehabilitation facilities; 
    (b) allocation of state grant funds to extended employment 
programs; 
    (c) standards for qualification of personnel and quality of 
professional service and for in-service training and education 
leave programs for personnel; 
    (d) eligibility for service so that no person will be 
denied service on the basis of race, creed, or color; 
    (e) regulatory fees for consultation services;  
    (f) standards and criteria by which handicapped persons 
with a disability are to be judged eligible for the services;  
    (g) evaluation criteria for extended employment programs; 
and 
    (h) program evaluation criteria for work activity programs 
in order to determine the extent to which these programs meet 
the goals and objectives established in state and federal law 
relating to work activity programs.  
    The rules on evaluation criteria for long-term sheltered 
workshops rehabilitation facilities must be in effect by July 1, 
1986.  The rules must be used in making allocations for fiscal 
years beginning after June 30, 1987.  
    Sec. 27.  Minnesota Statutes 1986, section 129A.09, is 
amended to read:  
    129A.09 [EXPENDITURE OF FEDERAL FUNDS.] 
    Notwithstanding the provisions of Laws 1975, chapter 433, 
section 2, subdivision 9, Any additional federal funds which 
become available to the state of Minnesota for vocational 
rehabilitation or independent living purposes after March 1, 
1976 and April 1 of each fiscal year thereafter as a result of a 
reallocation of funds returned by other states or release of 
additional funds may be carried over and expended in the next 
fiscal year.  The state of Minnesota shall have earned these 
funds in the year they are received with state expenditures in 
accordance with the federal-state formula in effect for that 
year.  These funds shall be subject to the provisions of Laws 
1976, chapter 332, section 9, subdivision 8. 
    Sec. 28.  Minnesota Statutes 1986, section 129A.10, is 
amended to read:  
    129A.10 [INDEPENDENT LIVING SERVICES.] 
    Subdivision 1.  [SERVICES OFFERED.] Independent living 
services are those services designed to materially improve 
opportunities for persons with disabilities to live and function 
more independently in their home, family, and community, and the 
services include:  
    (1) intake counseling to determine the individual's needs 
for services; 
    (2) referral and counseling services with respect to 
attendant care;  
    (3) counseling and advocacy with respect to legal and 
economic rights and benefits; 
    (4) independent living skills, training, and counseling;  
    (5) housing and transportation referral and assistance;  
    (6) surveys, directories, and other activities to identify 
appropriate housing and accessible transportation and other 
support services;  
    (7) peer counseling;  
    (8) education and training necessary to living in the 
community and participating in community affairs;  
    (9) individual and group social and recreational activities;
    (10) attendant care and training of personnel to provide 
the care; and 
    (11) other necessary services which are not inconsistent 
with sections 62A.26 and 62E.06, subdivision 1. 
    Subd. 2.  [ADMINISTRATION.] This section shall be 
administered by the department of jobs and training through the 
division of vocational rehabilitation services.  The department 
may employ staff as reasonably required to administer this 
section and may accept and receive funds from nonstate sources 
for the purpose of effectuating this section.  
    Subd. 3.  [CERTIFICATION.] No applicant center for 
independent living may receive funding under this section unless 
it has received certification from the division of vocational 
rehabilitation services.  
    The division of vocational rehabilitation services shall 
involve disabled consumers persons with a disability and other 
interested persons to consider performance evaluation criteria 
in order to formulate rules by which centers will be certified 
by July 1, 1986.  
    The division of vocational rehabilitation services shall 
review the programs for centers of independent living receiving 
funds from this section to determine their adherence to 
standards adopted by rule and if the standards are substantially 
met, shall issue appropriate certifications.  
    Subd. 4.  [APPLICATION OF CENTERS FOR INDEPENDENT LIVING.] 
The division of vocational rehabilitation services shall require 
centers for independent living to complete application forms, 
expenditure reports, and proposed plans and budgets.  These 
reports must be in the manner and on the form prescribed by the 
division.  When applying, the center for independent living 
shall agree to provide reports and records, and make available 
records for audit as may be required by the division of 
vocational rehabilitation services. 
    The applicant center for independent living shall be 
notified in writing by the division concerning the approval of 
budgets and plans. 
    Sec. 29.  Minnesota Statutes 1986, section 144.053, is 
amended by adding a subdivision to read: 
    Subd. 5.  The commissioner of health or the commissioner's 
agent is not required to solicit information that personally 
identifies persons selected to participate in an epidemiologic 
study if the commissioner determines that: 
    (1) the study monitors incidence or prevalence of a serious 
disease to detect potential health problems and predict risks, 
provides specific information to develop public health 
strategies to prevent serious disease, enables the targeting of 
intervention resources for communities, patients, or groups at 
risk of the disease, and informs health professionals about 
risks, early detection, or treatment of the disease;  
    (2) the personally identifying information is not necessary 
to validate the quality, accuracy, or completeness of the study; 
or 
    (3) the collection of personally identifying information 
may seriously jeopardize the validity of study results, as 
demonstrated by an epidemiologic study. 
    Sec. 30.  [144.056] [PLAIN LANGUAGE IN WRITTEN MATERIALS.] 
    (a) To the extent reasonable and consistent with the goals 
of providing easily understandable and readable materials and 
complying with federal and state laws governing the program, all 
written materials relating to determinations of eligibility for 
or amounts of benefits that will be given to applicants for or 
recipients of assistance under a program administered or 
supervised by the commissioner of health must be understandable 
to a person who reads at the seventh-grade level, using the 
Flesch scale analysis readability score as determined under 
section 72C.09. 
    (b) All written materials relating to services and 
determinations of eligibility for or amounts of benefits that 
will be given to applicants for or recipients of assistance 
under programs administered or supervised by the commissioner of 
health must be developed to satisfy the plain language 
requirements of the plain language contract act under sections 
325G.29 to 325G.36.  Materials may be submitted to the attorney 
general for review and certification.  Notwithstanding section 
325G.35, subdivision 1, the attorney general shall review 
submitted materials to determine whether they comply with the 
requirements of section 325G.31.  The remedies available 
pursuant to sections 8.31 and 325G.33 to 325G.36 do not apply to 
these materials.  Failure to comply with this section does not 
provide a basis for suspending the implementation or operation 
of other laws governing programs administered by the 
commissioner. 
    (c) The requirements of this section apply to all materials 
modified or developed by the commissioner on or after July 1, 
1988.  The requirements of this section do not apply to 
materials that must be submitted to a federal agency for 
approval, to the extent that application of the requirements 
prevents federal approval. 
    (d) Nothing in this section may be construed to prohibit a 
lawsuit brought to require the commissioner to comply with this 
section or to affect individual appeal rights under the special 
supplemental food program for women, infants, and children 
granted pursuant to federal regulations under the Code of 
Federal Regulations, chapter 7, section 246. 
    (e) The commissioner shall report annually to the chairs of 
the health and human services divisions of the senate finance 
committee and the house of representatives appropriations 
committee on the number and outcome of cases that raise the 
issue of the commissioner's compliance with this section. 
    Sec. 31.  Minnesota Statutes 1986, section 144.125, is 
amended to read:  
    144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS 
CAUSING MENTAL RETARDATION.] 
    It is the duty of (1) the administrative officer or other 
person in charge of each institution caring for infants 28 days 
or less of age and (2) the person required in pursuance of the 
provisions of section 144.215, to register the birth of a child, 
to cause to have administered to every such infant or child in 
its care tests for hemoglobinopathy, phenylketonuria and other 
inborn errors of metabolism causing mental retardation in 
accordance with rules prescribed by the state commissioner of 
health.  In determining which tests must be administered, the 
commissioner shall take into consideration the adequacy of 
laboratory methods to detect the inborn metabolic error, the 
ability to treat or prevent medical conditions caused by the 
inborn metabolic error, and the severity of the medical 
conditions caused by the inborn metabolic error.  Testing and 
the recording and reporting of the results of such the tests 
shall be performed at such the times and in such the manner as 
may be prescribed by the state commissioner of health.  The 
provisions of This section shall does not apply to any an 
infant whose parents object thereto on the grounds that such the 
tests and treatment conflict with their religious tenets and 
practices.  The commissioner shall charge laboratory service 
fees for conducting the tests of infants for inborn metabolic 
errors so that the total of fees collected will approximate the 
costs of conducting the tests.  Costs associated with capital 
expenditures and the development of new procedures may be 
prorated over a three-year period when calculating the amount of 
the fees. 
    Sec. 32.  Minnesota Statutes 1986, section 144.50, is 
amended by adding a subdivision to read: 
    Subd. 6.  [SUPERVISED LIVING FACILITY LICENSES.] The 
commissioner may license as a supervised living facility a 
facility seeking medical assistance certification as an 
intermediate care facility for persons with mental retardation 
or related conditions for four or more persons as authorized 
under section 252.291. 
    Sec. 33.  [144.97] [DEFINITIONS.] 
    Subdivision 1.  [APPLICATION.] The definitions in this 
section apply to section 144.98. 
    Subd. 2.  [CERTIFICATION.] "Certification" means written 
acknowledgement of a laboratory's demonstrated capability to 
perform tests for a specific purpose. 
    Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
commissioner of health. 
    Subd. 4.  [CONTRACT LABORATORY.] "Contract laboratory" 
means a laboratory that performs tests on samples on a contract 
or fee-for-service basis. 
    Subd. 5.  [ENVIRONMENTAL SAMPLE.] "Environmental sample" 
means a substance derived from a nonhuman source and collected 
for the purpose of analysis. 
    Subd. 6.  [LABORATORY.] "Laboratory" means the state, a 
person, corporation, or other entity, including governmental, 
that examines, analyzes, or tests samples. 
    Subd. 7.  [SAMPLE.] "Sample" means a substance derived from 
a nonhuman source and collected for the purpose of analysis, or 
a tissue, blood, excretion, or other bodily fluid specimen 
obtained from a human for the detection of a chemical, etiologic 
agent, or histologic abnormality.  
    Sec. 34.  [144.98] [CERTIFICATION OF ENVIRONMENTAL 
LABORATORIES.] 
    Subdivision 1.  [AUTHORIZATION.] The commissioner of health 
may certify laboratories that test environmental samples. 
    Subd. 2.  [RULES.] The commissioner may adopt rules to 
implement this section, including: 
    (1) procedures, requirements, and fee adjustments for 
laboratory certification, including provisional status and 
recertification; 
    (2) standards and fees for certificate approval, 
suspension, and revocation; 
    (3) standards for environmental samples; 
    (4) analysis methods that assure reliable test results; 
    (5) laboratory quality assurance, including internal 
quality control, proficiency testing, and personnel training; 
and 
    (6) criteria for recognition of certification programs of 
other states and the federal government. 
    Subd. 3.  [FEES.] (a) An application for certification 
under subdivision 1 must be accompanied by the annual fee 
specified in this subdivision.  The fees are for: 
    (1) base certification fee, $250; and 
    (2) test category certification fees: 
Test Category                               Certification Fee
Bacteriology                                         $100
Inorganic chemistry, fewer than 4 constituents       $ 50
Inorganic chemistry, 4 or more constituents          $150
Chemistry metals, fewer than 4 constituents          $100
Chemistry metals, 4 or more constituents             $250
Volatile organic compounds                           $300
Other organic compounds                              $300
     (b) The total annual certification fee is the base fee plus 
the applicable test category fees.  The annual certification fee 
for a contract laboratory is 1.5 times the total certification 
fee. 
    (c) Laboratories located outside of this state that require 
an on-site survey will be assessed an additional $1,200 fee. 
    (d) The commissioner of health may adjust fees under 
section 16A.128, subdivision 2.  Fees must be set so that the 
total fees support the laboratory certification program.  Direct 
costs of the certification service include program 
administration, inspections, the agency's general support costs, 
and attorney general costs attributable to the fee function. 
    Subd. 4.  [FEES FOR LABORATORY PROFICIENCY TESTING AND 
TECHNICAL TRAINING.] The commissioner of health may set fees for 
proficiency testing and technical training services under 
section 16A.128.  Fees must be set so that the total fees cover 
the direct costs of the proficiency testing and technical 
training services, including salaries, supplies and equipment, 
travel expenses, and attorney general costs attributable to the 
fee function. 
    Subd. 5.  [LABORATORY CERTIFICATION ACCOUNT.] There is an 
account in the special revenue fund called the laboratory 
certification account.  Fees collected under this section and 
appropriations for the purposes of this section must be 
deposited in the laboratory certification account.  Money in the 
laboratory certification account is annually appropriated to the 
commissioner of health to administer this section. 
    Sec. 35.  Minnesota Statutes 1986, section 144A.04, is 
amended by adding a subdivision to read: 
    Subd. 7.  [MINIMUM NURSING STAFF REQUIREMENT.] 
Notwithstanding the provisions of Minnesota Rules, part 
4655.5600, the minimum staffing standard for nursing personnel 
in nursing homes is as follows: 
    (a) The minimum number of hours of nursing personnel to be 
provided in a nursing home is the greater of two hours per 
resident per 24 hours or 0.95 hours per standardized resident 
day. 
    (b) For purposes of this subdivision, "hours of nursing 
personnel" means the paid, on-duty, productive nursing hours of 
all nurses and nursing assistants, calculated on the basis of 
any given 24-hour period.  "Productive nursing hours" means all 
on-duty hours during which nurses and nursing assistants are 
engaged in nursing duties.  Examples of nursing duties may be 
found in Minnesota Rules, parts 4655.5900, 4655.6100, and 
4655.6400.  Not included are vacations, holidays, sick leave, 
in-service classroom training, or lunches.  Also not included 
are the nonproductive nursing hours of the in-service training 
director.  In homes with more than 60 licensed beds, the hours 
of the director of nursing are excluded.  "Standardized resident 
day" means the sum of the number of residents in each case mix 
class multiplied by the case mix weight for that resident class, 
as found in Minnesota Rules, part 9549.0059, subpart 2, 
calculated on the basis of a facility's census for any given day.
    (c) Calculation of nursing hours per standardized resident 
day is performed by dividing total hours of nursing personnel 
for a given period by the total of standardized resident days 
for that same period. 
    Sec. 36.  Minnesota Statutes 1987 Supplement, section 
144A.071, subdivision 3, is amended to read:  
    Subd. 3.  [EXCEPTIONS.] The commissioner of health, in 
coordination with the commissioner of human services, may 
approve the addition of a new certified bed or the addition of a 
new licensed nursing home bed, under the following conditions:  
    (a) to replace a bed decertified after May 23, 1983 or to 
address an extreme hardship situation, in a particular county 
that, together with all contiguous Minnesota counties, has fewer 
nursing home beds per 1,000 elderly than the number that is ten 
percent higher than the national average of nursing home beds 
per 1,000 elderly individuals.  For the purposes of this 
section, the national average of nursing home beds shall be the 
most recent figure that can be supplied by the federal health 
care financing administration and the number of elderly in the 
county or the nation shall be determined by the most recent 
federal census or the most recent estimate of the state 
demographer as of July 1, of each year of persons age 65 and 
older, whichever is the most recent at the time of the request 
for replacement.  In allowing replacement of a decertified bed, 
the commissioners shall ensure that the number of added or 
recertified beds does not exceed the total number of decertified 
beds in the state in that level of care.  An extreme hardship 
situation can only be found after the county documents the 
existence of unmet medical needs that cannot be addressed by any 
other alternatives; 
    (b) to certify a new bed in a facility that commenced 
construction before May 23, 1983.  For the purposes of this 
section, "commenced construction" means that all of the 
following conditions were met:  the final working drawings and 
specifications were approved by the commissioner of health; the 
construction contracts were let; a timely construction schedule 
was developed, stipulating dates for beginning, achieving 
various stages, and completing construction; and all zoning and 
building permits were secured; 
    (c) to certify beds in a new nursing home that is needed in 
order to meet the special dietary needs of its residents, if: 
the nursing home proves to the commissioner's satisfaction that 
the needs of its residents cannot otherwise be met; elements of 
the special diet are not available through most food 
distributors; and proper preparation of the special diet 
requires incurring various operating expenses, including extra 
food preparation or serving items, not incurred to a similar 
extent by most nursing homes; 
    (d) to license a new nursing home bed in a facility that 
meets one of the exceptions contained in clauses (a) to (c); 
    (e) to license nursing home beds in a facility that has 
submitted either a completed licensure application or a written 
request for licensure to the commissioner before March 1, 1985, 
and has either commenced any required construction as defined in 
clause (b) before May 1, 1985, or has, before May 1, 1985, 
received from the commissioner approval of plans for phased-in 
construction and written authorization to begin construction on 
a phased-in basis.  For the purpose of this clause, 
"construction" means any erection, building, alteration, 
reconstruction, modernization, or improvement necessary to 
comply with the nursing home licensure rules; 
    (f) to certify or license new beds in a new facility that 
is to be operated by the commissioner of veterans' affairs or 
when the costs of constructing and operating the new beds are to 
be reimbursed by the commissioner of veterans' affairs or the 
United States Veterans Administration; 
    (g) to license or certify beds in a new facility 
constructed to replace a facility that was destroyed after June 
30, 1987, by fire, lightning, or other hazard provided:  
    (1) destruction was not caused by the intentional act of or 
at the direction of a controlling person of the facility; 
    (2) at the time the facility was destroyed the controlling 
persons of the facility maintained insurance coverage for the 
type of hazard that occurred in an amount that a reasonable 
person would conclude was adequate; 
    (3) the net proceeds from an insurance settlement for the 
damages caused by the hazard are applied to the cost of the new 
facility; 
    (4) the new facility is constructed on the same site as the 
destroyed facility or on another site subject to the 
restrictions in section 144A.073, subdivision 5; and 
    (5) the number of licensed and certified beds in the new 
facility does not exceed the number of licensed and certified 
beds in the destroyed facility; 
    (h) to license or certify beds that are moved from one 
location to another within a nursing home facility, provided the 
total costs of remodeling performed in conjunction with the 
relocation of beds does not exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, or to 
license or certify beds in a facility for which the total costs 
of remodeling or renovation exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, if the 
facility makes a written commitment to the commissioner of human 
services that it will not seek to receive an increase in its 
property-related payment rate by reason of the remodeling or 
renovation; 
    (i) to license or certify beds in a facility that has been 
involuntarily delicensed or decertified for participation in the 
medical assistance program, provided that an application for 
relicensure or recertification is submitted to the commissioner 
within 120 days after delicensure or decertification; 
    (j) to license or certify beds in a project recommended for 
approval by the interagency board for quality assurance under 
section 144A.073; 
    (k) to license nursing home beds in a hospital facility 
that are relocated from a different hospital facility under 
common ownership or affiliation, provided: (1) the hospital in 
which the nursing home beds were originally located ceases to 
function as an acute care facility, or necessary support 
services for nursing homes as required for licensure under 
sections 144A.02 to 144A.10, such as dietary service, physical 
plant, housekeeping, physical therapy, occupational therapy, and 
administration, are no longer available from the original 
hospital site; and (2) the nursing home beds are not certified 
for participation in the medical assistance program; 
    (1) to license or certify beds that are moved from one 
location to another within an existing identifiable complex of 
hospital buildings, from a hospital-attached nursing home to the 
hospital building, or from a separate nursing home under common 
ownership with or control of a hospital to the hospital when a 
hospital-attached nursing home is moved simultaneously to the 
hospital to a building formerly used as a hospital, provided the 
original nursing home building will no longer be operated as a 
nursing home and the building to which the beds are moved will 
no longer be operated as a hospital.  As a condition of 
receiving a license or certification under this clause, the 
facility must make a written commitment to the commissioner of 
human services that it will not seek to receive an increase in 
its property-related payment rate as a result of the 
relocation.  At the time of the licensure and certification of 
the nursing home beds, the commissioner of health shall 
delicense the same number of acute care beds within the existing 
complex of hospital buildings or building.  When a separate 
nursing home and a hospital-attached nursing home under common 
ownership or control are simultaneously relocated to a hospital 
building, a combined cost report must be submitted for the cost 
reporting year ending September 30, 1987, and the freestanding 
nursing home limits apply.  Relocation of nursing home beds 
under this clause is subject to the limitations in section 
144A.073, subdivision 5; 
    (m) to license or certify beds that are moved from an 
existing state nursing home to a different state facility, 
provided there is no net increase in the number of state nursing 
home beds; 
    (n) to license new nursing home beds in a continuing care 
retirement community affiliated with a national referral center 
engaged in substantial programs of patient care, medical 
research, and medical education meeting state and national needs 
that receives more than 40 percent of its residents from outside 
the state for the purpose of meeting contractual obligations to 
residents of the retirement community, provided the facility 
makes a written commitment to the commissioner of human services 
that it will not seek medical assistance certification for the 
new beds; or 
    (o) to certify or license new beds in a new facility on the 
Red Lake Indian reservation for which payments will be made 
under the Indian Health Care Improvement Act, Public Law Number 
94-437, at the rates specified in United States Code, title 42, 
section 1396d(b); 
    (p) to certify and license as nursing home beds boarding 
care beds in a certified boarding care facility if the beds meet 
the standards for nursing home licensure and if the cost of any 
remodeling of the facility does not exceed ten percent of the 
appraised value of the facility or $200,000, whichever is less.  
If boarding care beds are licensed as nursing home beds, the 
number of boarding care beds in the facility must not increase 
in the future.  The provisions contained in section 144A.073 
regarding the upgrading of the facilities do not apply to 
facilities that satisfy these requirements; or 
    (q) to license and certify up to 40 beds transferred from 
an existing facility owned and operated by the Amherst H. Wilder 
Foundation in the city of Saint Paul to a new unit at the same 
location as the existing facility that will serve persons with 
Alzheimer's disease and other related disorders.  The transfer 
of beds may occur gradually or in stages, provided the total 
number of beds transferred does not exceed 40.  At the time of 
licensure and certification of a bed or beds in the new unit, 
the commissioner of health shall delicense and decertify the 
same number of beds in the existing facility.  As a condition of 
receiving a license or certification under this clause, the 
facility must make a written commitment to the commissioner of 
human services that it will not seek to receive an increase in 
its property-related payment rate as a result of the transfers 
allowed under this clause. 
    Sec. 37.  Minnesota Statutes 1987 Supplement, section 
144A.073, subdivision 1, is amended to read:  
    Subdivision 1.  [DEFINITIONS.] For purposes of this 
section, the following terms have the meanings given them: 
    (a) "Conversion" means the relocation of a nursing home bed 
from a nursing home to an attached hospital. 
    (b) "Renovation" means extensive remodeling of, or 
construction of an addition to, a facility on an existing site 
with a total cost exceeding ten percent of the appraised value 
of the facility or $200,000, whichever is less. 
    (c) "Replacement" means the demolition and reconstruction 
of all or part of an existing facility. 
    (d) "Upgrading" means a change in the level of licensure of 
a bed from a boarding care bed to a nursing home bed in a 
certified boarding care facility that is attached to a nursing 
home or a boarding care bed in a freestanding boarding care 
facility that currently meets all health department standards 
for a nursing home. 
    Sec. 38.  Minnesota Statutes 1987 Supplement, section 
144A.073, subdivision 7, is amended to read:  
    Subd. 7.  [UPGRADING RESTRICTIONS.] Proposals submitted or 
approved under this section involving upgrading must satisfy the 
following conditions: 
    (a) No proposal for upgrading may be approved after June 
30, 1989. 
    (b) No more than one proposal for upgrading may be approved 
for a facility. 
    (c) Upgrading is limited to a total of ten beds. 
    (d) The facility must meet minimum nursing home care 
standards. 
    (e) Upgrading must not result in an increase in per diem 
operating costs, except for the upgrading of those freestanding 
boarding care facilities which currently meet existing nursing 
home building and space standards. 
    (f) (b) If beds are upgraded to nursing home beds, the 
number of boarding care beds in a facility must not increase in 
the future. 
    (g) (c) The average occupancy rate in the existing nursing 
home beds in an attached facility must be greater than 96 
percent according to the most recent annual statistical report 
of the department of health. 
    (h) The cost of remodeling the facility to meet current 
nursing home construction standards must not exceed ten percent 
of the appraised value of the facility or $200,000, whichever is 
less. 
    Sec. 39.  Minnesota Statutes 1987 Supplement, section 
144A.073, subdivision 8, is amended to read:  
    Subd. 8.  [RULEMAKING.] The commissioner of health shall 
adopt emergency or permanent rules to implement this 
section.  The authority to adopt emergency rules continues until 
December 30, 1988.  
    Sec. 40.  Minnesota Statutes 1986, section 144A.08, is 
amended by adding a subdivision to read: 
    Subd. 1b.  [SUMMER TEMPERATURE AND HUMIDITY.] A nursing 
home, or part of a nursing home that includes resident-occupied 
space, constructed after June 30, 1988, must meet the interior 
summer design temperature and humidity recommendations in 
chapter 7 of the 1982 applications of the handbook published by 
the American Society of Heating, Refrigerating and 
Air-Conditioning Engineers, Inc., as amended. 
    Sec. 41.  Minnesota Statutes 1986, section 145.43, 
subdivision 1, is amended to read:  
    Subdivision 1.  [DEFINITION.] "Hearing aid" means any 
instrument or device designed for or represented as aiding 
defective human hearing, and its any parts, attachments, or 
accessories of the instrument or device, including but not 
limited to ear molds.  Batteries and cords shall not be 
considered parts, attachments, or accessories of a hearing aid.  
    Sec. 42.  Minnesota Statutes 1986, section 145.43, 
subdivision 1a, is amended to read:  
    Subdivision 1a.  [30-DAY GUARANTEE AND BUYER RIGHT TO 
CANCEL.] No person shall sell a hearing aid in this state unless:
    (a) The seller provides the buyer with a 30-day written 
money-back guarantee.  The guarantee must:  (1) permit the buyer 
to cancel the purchase for any reason within 30 days after 
receiving the hearing aid by giving or mailing written notice of 
cancellation to the seller; (2).  If the hearing aid must be 
repaired, remade, or adjusted during the 30-day money-back 
guarantee period, the running of the 30-day period is suspended 
one day for each 24-hour period that the hearing aid is not in 
the buyer's possession.  A repaired, remade, or adjusted hearing 
aid must be claimed by the buyer within three working days after 
notification of availability, after which time the running of 
the 30-day period resumes.  The guarantee must entitle the 
buyer, upon cancellation, to receive a full refund of payment 
within 30 days of return of the hearing aid to the seller; 
provided, however, that.  The seller may retain as a 
cancellation fee the actual cost of any custom ear molds made 
for the canceled hearing aid so long as this cancellation fee 
does not exceed ten percent of the buyer's total payment for the 
hearing aid;.  
    (b) The seller shall provide the buyer with a contract 
written receipt or contract to the buyer which includes, in 
plain English, that contains uniform language and provisions 
that meet the requirements and are certified by the attorney 
general under the Plain Language Contract Act, sections 325G.29 
to 325G.36.  The contract must include, but is not limited to, 
the following:  in immediate proximity to the space reserved for 
the signature of the buyer, or on the first page if there is no 
space reserved for the signature of the buyer, a clear and 
conspicuous disclosure of the following specific statement in 
all capital letters of no less than 12-point boldface 
type:  MINNESOTA STATE LAW GIVES THE BUYER HAS THE RIGHT TO 
CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO 
MIDNIGHT OF THE 30TH CALENDAR DAY AFTER RECEIPT OF THE HEARING 
AID(S).  IF THE BUYER DECIDES TO RETURN THE HEARING AID(S) 
WITHIN THIS 30-DAY PERIOD, THE BUYER WILL RECEIVE A REFUND OF 
$.......  (State the dollar amount of refund.) 
    Sec. 43.  Minnesota Statutes 1987 Supplement, section 
145.43, subdivision 4, is amended to read:  
    Subd. 4.  [ITEMIZED REPAIR BILL.] (a) Any person or company 
who agrees to repair a hearing aid must provide the customer 
owner of the hearing aid, or the owner's representative, with a 
billing bill that specifically itemizes all parts and labor 
charges for services rendered.  The bill must also include the 
person's or company's name, address, and phone number. 
    (b) This subdivision does not apply to: 
    (1) a person or company that repairs a hearing aid pursuant 
to an express warranty covering the entire hearing aid and the 
warranty covers the entire costs, both parts and labor, of the 
repair; and 
    (2) a person or company that repairs a hearing aid and the 
repair entire hearing aid, after being repaired, is expressly 
warranted for a period of at least one year six months, the 
warranty covers the entire costs, both parts and labor, of the 
repair, and a copy of the express warranty is given to the 
customer owner or the owner's representative.  The owner of the 
hearing aid or the owner's representative must be given a 
written express warranty that includes the name, address, and 
phone number of the repairing person or company; the make, 
model, and serial number of the hearing aid repaired; the exact 
date of the last day of the warranty period; and the terms of 
the warranty.  
     Sec. 44.  Minnesota Statutes 1986, section 145.853, 
subdivision 2, is amended to read:  
    Subd. 2.  In seeking to determine whether a disabled person 
suffers from an illness, a law enforcement officer shall make a 
reasonable search for an identifying device and an 
identification card of the type described in section 145.852, 
subdivision 2 and examine them for emergency information.  The 
law enforcement officer may not search for an identifying device 
or an identification card in a manner or to an extent that would 
appear to a reasonable person in the circumstances to cause an 
unreasonable risk of worsening the disabled person's condition.  
The law enforcement officer may not remove an identifying device 
or an identification card from the possession of a disabled 
person unless the removal is necessary for law enforcement 
purposes or to protect the safety of the disabled person. 
    Sec. 45.  Minnesota Statutes 1986, section 145.894, is 
amended to read:  
    145.894 [STATE COMMISSIONER OF HEALTH; DUTIES, 
RESPONSIBILITIES.] 
    The commissioner of health shall: 
    (a) Develop a comprehensive state plan for the delivery of 
nutritional supplements to pregnant and lactating women, 
infants, and children; 
    (b) Contract with existing local public or private 
nonprofit organizations for the administration of the 
nutritional supplement program; 
    (c) Develop and implement a public education program 
promoting the provisions of sections 145.891 to 145.897, and 
provide for the delivery of individual and family nutrition 
education and counseling at project sites; 
    (d) Develop in cooperation with other agencies and vendors 
a uniform state voucher system for the delivery of nutritional 
supplements; 
    (e) Authorize local health agencies to issue vouchers 
bimonthly to some or all eligible individuals served by the 
agency, provided the agency demonstrates that the federal 
minimum requirements for providing nutrition education will 
continue to be met and that the quality of nutrition education 
and health services provided by the agency will not be adversely 
impacted; 
    (f) Investigate and implement an infant formula cost 
reduction system that will reduce the cost of nutritional 
supplements so that by October 1, 1988, additional mothers and 
children will be served; 
    (g) Develop, analyze and evaluate the health aspects of the 
nutritional supplement program and establish nutritional 
guidelines for the program; 
    (f) (h) Apply for, administer, and annually expend at least 
99 percent of available federal or private funds; 
    (g) (i) Aggressively market services to eligible 
individuals by conducting ongoing outreach activities and by 
coordinating with and providing marketing materials and 
technical assistance to local human services and community 
service agencies and nonprofit service providers; 
    (h) (j) Determine, on July 1 of each year, the number of 
pregnant women participating in each special supplemental food 
program for women, infants, and children (W.I.C.) and, in 1986, 
1987, and 1988, at the commissioner's discretion, designate a 
different food program deliverer if the current deliverer fails 
to increase the participation of pregnant women in the program 
by at least ten percent over the previous year's participation 
rate; 
    (i) (k) Promulgate all rules necessary to carry out the 
provisions of sections 145.891 to 145.897; and 
    (j) (l) Report to the legislature by November 15 of every 
year on the expenditures and activities under sections 145.891 
to 145.897 of the state and local health agencies for the 
preceding fiscal year. 
    Sec. 46.  [145.924] [AIDS PREVENTION GRANTS.] 
    The commissioner may award grants to local boards of 
health, state agencies, state councils, or nonprofit 
corporations to provide evaluation and counseling services to 
populations at risk for acquiring human immunodeficiency virus 
infection, including, but not limited to, minorities, 
adolescents, intravenous drug users, and homosexual men. 
    Sec. 47.  Minnesota Statutes 1987 Supplement, section 
145A.06, is amended by adding a subdivision to read: 
    Subd. 5.  [DEADLY INFECTIOUS DISEASES.] The commissioner 
shall promote measures aimed at preventing businesses from 
facilitating sexual practices that transmit deadly infectious 
diseases by providing technical advice to boards of health to 
assist them in regulating these practices or closing 
establishments that constitute a public health nuisance. 
    Sec. 48.  Minnesota Statutes 1987 Supplement, section 
148B.23, subdivision 1, is amended to read:  
    Subdivision 1.  [EXEMPTION FROM EXAMINATION.] For two years 
from July 1, 1987, the board shall issue a license without 
examination to an applicant: 
    (1) for a licensed social worker, if the board determines 
that the applicant has received a baccalaureate degree from an 
accredited program of social work, or that the applicant has at 
least a baccalaureate degree from an accredited college or 
university and two years in full-time employment or 4,000 hours 
of experience in the supervised practice of social work within 
the five years before July 1, 1987 1989; 
    (2) for a licensed graduate social worker, if the board 
determines that the applicant has received a master's degree 
from an accredited program of social work or doctoral degree in 
social work; or a master's or doctoral degree from a graduate 
program in a human service discipline, as approved by the board; 
    (3) for a licensed independent social worker, if the board 
determines that the applicant has received a master's degree 
from an accredited program of social work or doctoral degree in 
social work; or a master's or doctoral degree from a graduate 
program in a human service discipline, as approved by the board; 
and, after receiving the degree, has practiced social work for 
at least two years in full-time employment or 4,000 hours under 
the supervision of a social worker meeting these requirements, 
or of another qualified professional; and 
    (4) for a licensed independent clinical social worker, if 
the board determines that the applicant has received a master's 
degree from an accredited program of social work or doctoral 
degree in social work; or a master's or doctoral degree from a 
graduate program in a human service discipline as approved by 
the board; and, after receiving the degree, has practiced 
clinical social work for at least two years in full-time 
employment or 4,000 hours under the supervision of a clinical 
social worker meeting these requirements, or of another 
qualified mental health professional. 
    Sec. 49.  Minnesota Statutes 1987 Supplement, section 
148B.42, subdivision 1, is amended to read:  
    Subdivision 1.  [FILING.] All mental health service 
providers shall file with the state, on a form provided by the 
board, their name; home and business address; telephone number; 
degrees held, if any, major field, and whether the degrees are 
from an accredited institution and how the institution is 
accredited; and any other relevant experience.  An applicant for 
filing who has practiced in another state shall authorize, in 
writing, the licensing or regulatory entity in the other state 
or states to release to the board any information on complaints 
or disciplinary actions pending against that individual, as well 
as any final disciplinary actions taken against that individual. 
The board shall provide a form for this purpose.  The board may 
reject a filing if there is evidence of a violation of or 
failure to comply with this chapter.  Filings under this 
subdivision are public data. 
    Sec. 50.  [152A.01] [INSTITUTE ESTABLISHED; STRUCTURE; 
BOARD OF DIRECTORS.] 
    Subdivision 1.  [INSTITUTE ESTABLISHED; NAME.] The 
Minnesota Institute for Addiction and Stress Research is 
established.  For purpose of sections 152A.01 to 152A.05, 
"institute" means the Minnesota Institute for Addiction and 
Stress Research.  All business of the institute must be 
conducted under the name "Minnesota Institute for Addiction and 
Stress Research."  The institute is funded by a grant from the 
commissioner of health.  
    Subd. 2.  [BOARD OF DIRECTORS.] The institute must be 
governed by a board of nine directors appointed by the governor. 
Terms are for three years.  Three of the initial directors must 
be appointed for three-year terms, three for two-year terms, and 
three for one-year terms. 
    Subd. 3.  [BOARD COMPOSITION; EXECUTIVE COMMITTEE.] (a) The 
board must include representatives from the Minnesota department 
of health, the medical and scientific teams of the institute, 
established health organizations, private citizens, and 
corporate representatives.  The vice president for finance and 
operations of the institute shall serve as an ex-officio member 
of the board. 
    (b) An executive committee of four members of the board and 
the vice president for finance and operations of the institute 
shall oversee the regular activities of the institute and keep 
the board informed of progress and new developments at the 
institute. 
    Subd. 4.  [OPERATING PROCEDURES.] The board shall adopt 
operating procedures necessary to conduct the business of the 
institute, consistent with sections 152A.01 to 152A.05.  
Adoption of operating procedures under this subdivision is not 
subject to the administrative procedure act under chapter 14. 
    Subd. 5.  [PLACES OF BUSINESS.] The board shall locate and 
maintain the institute's places of business within the state. 
    Subd. 6.  [MEETINGS AND ACTIONS OF THE BOARD.] The board 
shall hold meetings as determined necessary by the executive 
committee, upon giving notice as provided in the operating 
procedures adopted by the board. 
    Sec. 51.  [152A.02] [INSTITUTE PERSONNEL.] 
    Subdivision 1.  [PRESIDENT.] The board shall appoint and 
set the compensation for a president, who serves as chief 
executive officer of the institute.  Subject to the control of 
the board, the president may appoint subordinate employees and 
agents. 
    Subd. 2.  [STATUS OF EMPLOYEES.] The president serves in 
the unclassified state civil service and is excluded from 
collective bargaining.  All other employees of the board are 
subject to chapters 43A and 179A. 
    Sec. 52.  [152A.03] [POWERS OF THE INSTITUTE.] 
    In addition to other powers granted by sections 152A.01 to 
152A.05, the institute may:  
    (1) sue, and be sued; 
    (2) have a seal and alter it at will; 
    (3) acquire and dispose of personal property, including 
inchoate and intellectual property, royalties, stock, and stock 
warrants; 
    (4) enter into contracts or agreements with a federal or 
state agency, person, business, or other organization; 
    (5) acquire and dispose of real property or an interest in 
real property; 
    (6) purchase insurance; 
    (7) sell, at public or private sale, any note, mortgage, or 
other instrument or obligation; 
    (8) consent to the modification of a contract or agreement 
to which the institute is a party; 
    (9) borrow money to carry out its purposes and issue 
negotiable notes, which it may refund, guarantee, or insure in 
whole or in part with money from the fund, other assets of the 
institute, or an account created by the institute for that 
purpose; 
    (10) develop, buy, and possess financial and technical 
information, including credit reports and financial statements; 
    (11) accept gifts, grants, and bequests and use or dispose 
of them for its purposes; and 
    (12) receive payments in the form of royalties, dividends, 
or other proceeds in connection with the ownership, license, or 
lease of products or businesses. 
    Sec. 53.  [152A.04] [OPERATIONS PLAN; REPORTS.] 
    Subdivision 1.  [OPERATIONS PLAN.] The board shall submit a 
progress report and an operations plan to the governor and the 
legislature by January 1, 1989.  The plan must include the 
board's operating procedures, accounting procedures, personnel 
procedures, investment procedures, and rules of conduct and 
ethics. 
    Subd. 2.  [REPORTS.] The board shall report quarterly to 
the commissioner of finance, on forms provided by the 
commissioner of finance, information about fiscal performance 
and status.  The board shall also report quarterly to the 
commissioner of health, on forms provided by the commissioner of 
health, information about the institute's status, research and 
clinical projects and findings, and performance. 
    Sec. 54.  [152A.05] [MONITORING; TERMINATION.] 
    Subdivision 1.  [MONITORING.] All relevant records and the 
performance of the institute shall be monitored by the 
commissioner of health to assure that the institute continues to 
demonstrate the following: 
    (1) the ability to carry out task-oriented basic and 
clinical neurobiological research on addictive disorders and the 
commitment to develop an integrated, comprehensive program of 
basic and clinical research;  
    (2) the institute's involvement in basic and clinical 
research of stress especially as it relates to addictive 
disorders and chronic viral infections; 
    (3) the ability to work with other research and education 
programs; 
    (4) the ability to cooperate with interested health 
professionals throughout the state to implement the research 
findings; 
    (5) the ability to seek and receive outside funding; 
    (6) a significant ongoing treatment program based on a 
medical model capable of statewide application; 
    (7) the relatively close proximity to a major medical 
educational institution; and 
    (8) the commitment to develop a program to educate the 
public about addictive and stress-related medical disorders and 
also to train therapists in Minnesota. 
    Subd. 2.  [TERMINATION.] If the commissioner of health 
finds that the institute is not continuing to meet the 
requirements in subdivision 1, the commissioner of health may 
terminate the grant to the institute upon 90 days' notice to the 
board. 
    Sec. 55.  [153A.13] [DEFINITIONS.] 
    Subdivision 1.  [APPLICABILITY.] The definitions in this 
section apply to sections 153A.13 to 153A.18. 
    Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
commissioner of health. 
    Subd. 3.  [HEARING INSTRUMENT.] "Hearing instrument" means 
an instrument designed to or represented as being able to aid 
defective human hearing.  "Hearing instrument" includes the 
instrument's parts, attachments, and accessories, including, but 
not limited to, ear molds.  Batteries and cords are not parts, 
attachments, or accessories of a hearing instrument.  Surgically 
implanted hearing instruments, and assistive listening devices 
that do not require testing, fitting, or the use of ear molds 
and are not worn within the ear canal, are not hearing 
instruments. 
    Subd. 4.  [HEARING INSTRUMENT SELLING.] "Hearing instrument 
selling" means fitting and selling hearing instruments, 
assisting the consumer in instrument selection, selling hearing 
instruments at retail, and testing human hearing in connection 
with these activities. 
    Subd. 5.  [SELLER OF HEARING INSTRUMENTS.] "Seller of 
hearing instruments" means a natural person who engages in 
hearing instrument selling whether or not registered by the 
commissioner of health or licensed by an existing health-related 
board. 
    Sec. 56.  [153A.14] [REGULATION.] 
    Subdivision 1.  [APPLICATION FOR PERMIT.] A seller of 
hearing instruments shall apply to the commissioner for a permit 
to sell hearing instruments.  The commissioner shall provide 
applications for permits.  At a minimum, the information that an 
applicant must provide includes the seller's name, social 
security number, business address and phone number, employer, 
and information about the seller's education, training, and 
experience in testing human hearing and fitting hearing 
instruments.  The commissioner may reject an application for a 
permit if there is evidence of a violation or failure to comply 
with sections 153A.13 to 153A.16. 
    Subd. 2.  [ISSUANCE OF PERMIT.] The commissioner shall 
issue a permit to each seller of hearing instruments who applies 
under subdivision 1 if the commissioner determines that the 
applicant is in compliance with sections 153A.13 to 153A.16. 
    Subd. 3.  [NONTRANSFERABILITY OF PERMIT.] The permit cannot 
be transferred.  
    Subd. 4.  [SALE OF HEARING INSTRUMENTS WITHOUT PERMIT.] It 
is unlawful for any person not holding a valid permit to sell a 
hearing instrument as defined in section 153A.13, subdivision 
3.  A person who sells a hearing instrument without the permit 
required by this section is guilty of a gross misdemeanor. 
    Subd. 5.  [RULEMAKING AUTHORITY.] The commissioner shall 
adopt rules under chapter 14 to implement sections 153A.13 to 
153A.18. 
    Subd. 6.  [HEARING INSTRUMENTS TO COMPLY WITH FEDERAL AND 
STATE REQUIREMENTS.] The commissioner shall ensure that hearing 
instruments are sold in compliance with state requirements and 
the requirements of the United States Food and Drug 
Administration.  Failure to comply with state or federal 
regulations may be grounds for enforcement actions. 
    Subd. 7.  [CONTESTED CASES.] The commissioner shall comply 
with the contested case procedures in chapter 14 when 
suspending, revoking, or refusing to issue a permit under this 
section. 
    Sec. 57.  [153A.15] [PROHIBITED ACTS; ENFORCEMENT; AND 
PENALTY.] 
    Subdivision 1.  [PROHIBITED ACTS.] The commissioner may 
reject an application for a permit or may act under subdivision 
2 against a seller of hearing instruments for failure to comply 
with sections 153A.13 to 153A.16.  Failure to apply to the 
commissioner for a permit, or supplying false or misleading 
information on the application for a permit, is a ground for 
action under subdivision 2.  The following acts and conduct are 
also grounds for action under subdivision 2: 
    (1) prescribing or otherwise recommending to a consumer or 
potential consumer the use of a hearing instrument, unless the 
prescription from a physician or recommendation from a hearing 
instrument seller or audiologist is in writing, is delivered to 
the consumer or potential consumer, and bears the following 
information in all capital letters of 12-point or larger 
bold-face type:  "THIS PRESCRIPTION OR RECOMMENDATION MAY BE 
FILLED BY, AND HEARING INSTRUMENTS MAY BE PURCHASED FROM, THE 
DISPENSER, AUDIOLOGIST, OR PHYSICIAN OF YOUR CHOICE."  A 
prescription or written recommendation must include, upon the 
authorization of the consumer or potential consumer, the 
audiogram upon which the prescription or recommendation is based 
if there has been a charge for the audiogram; 
    (2) representing through any advertising or communication 
to a consumer or potential consumer, that a person's permit to 
sell hearing instruments indicates state approval, endorsement, 
or satisfaction of standards of training or skill; 
    (3) being disciplined through a revocation, suspension, 
restriction, or limitation, by another state for conduct subject 
to action under subdivision 2; 
    (4) presenting advertising that is false or misleading; 
    (5) providing the commissioner with false or misleading 
statements of credentials, training, or experience; 
    (6) engaging in conduct likely to deceive, defraud, or harm 
the public; or demonstrating a willful or careless disregard for 
the health, welfare, or safety of a consumer; 
    (7) splitting fees or promising to pay a portion of a fee 
to any other professional other than a fee for services rendered 
by the other professional to the client; 
    (8) engaging in abusive or fraudulent billing practices, 
including violations of federal Medicare and Medicaid laws, Food 
and Drug Administration regulations, or state medical assistance 
laws; 
    (9) obtaining money, property, or services from a consumer 
through the use of undue influence, high pressure sales tactics, 
harassment, duress, deception, or fraud; or 
    (10) failing to comply with restrictions on sales of 
hearing aids in section 145.43. 
    Subd. 2.  [ENFORCEMENT ACTIONS.] When the commissioner 
finds that a seller of hearing instruments has violated one or 
more provisions of sections 153A.13 to 153A.16, the commissioner 
may do one or more of the following: 
    (1) deny or reject the application for a permit; 
    (2) revoke the permit; 
    (3) suspend the permit; 
    (4) impose, for each violation, a civil penalty that 
deprives the seller of any economic advantage gained by the 
violation and that reimburses the department of health for costs 
of the investigation and proceeding; and 
    (5) censure or reprimand the dispenser. 
    Subd. 3.  [PROCEDURES.] The commissioner shall establish, 
in writing, internal operating procedures for receiving and 
investigating complaints and imposing enforcement actions.  
Establishment of the operating procedures are not subject to 
rulemaking procedures under chapter 14. 
    Subd. 4.  [PENALTY.] A person violating sections 153A.13 to 
153A.16 is guilty of a misdemeanor. 
    Sec. 58.  [153A.16] [BOND REQUIRED.] 
    A sole proprietor, partnership, association, or corporation 
engaged in hearing instrument sales shall provide a surety bond 
in favor of the state of Minnesota in the amount of $5,000 for 
every individual engaged in the practice of selling hearing 
instruments, up to a maximum of $25,000.  The bond required by 
this section must be in favor of the state for the benefit of 
any person who suffers loss of payments for the purchase or 
repair of a hearing instrument after July 1, 1988, due to 
insolvency or cessation of the business of the sole proprietor, 
partnership, association, or corporation engaged in hearing 
instrument sales.  A copy of the bond must be filed with the 
attorney general.  A person claiming against the bond may 
maintain an action at law against the surety and the sole 
proprietor, partnership, association, or corporation.  The 
aggregate liability of the surety to all persons for all 
breaches of the conditions of the bonds provided herein must not 
exceed the amount of the bond. 
    Sec. 59.  [153A.17] [EXPENSES.] 
    The expenses for administering the permit requirements for 
hearing aid sellers in section 153A.14 and the consumer 
information center under section 153A.18, must be paid from 
permit fees collected under the authority granted in section 
214.06, subdivision 1. 
    Sec. 60.  [153A.18] [CONSUMER INFORMATION CENTER.] 
    The commissioner shall establish a consumer information 
center to assist actual and potential purchasers of hearing aids 
by providing them with information regarding hearing instrument 
sales.  The consumer information center shall disseminate 
information about consumers' legal rights related to hearing 
instrument sales, provide information relating to complaints 
about sellers of hearing instruments, and provide information 
about outreach and advocacy services for consumers of hearing 
instruments.  In establishing the center and developing the 
information, the commissioner shall consult with representatives 
of hearing instrument sellers, audiologists, physicians, and 
consumers. 
    Sec. 61.  [157.081] [FINES.] 
    Subdivision 1.  [FINES FOR VIOLATIONS; LIMITS.] The 
commissioner shall impose a civil fine for repeated or egregious 
violation of rules relating to facilities licensed under chapter 
157 or 327.  The fine shall be assessed for each day the 
licensed facility fails to comply with the rules.  A fine for a 
specific violation shall not exceed $50 per day.  
    Subd. 2.  [SCHEDULE OF FINES; RULES.] The commissioner 
shall establish a schedule of fines by adopting rules. 
    Subd. 3.  [NOTICE OF FINE; APPEAL.] A licensed facility 
that is fined under subdivision 1 shall be notified of the fine 
by certified mail.  The notice must be mailed to the address 
shown on the application for the license or the last known 
address of the licensed facility.  The notice must state the 
reasons for the fine and must inform the licensed facility of 
the right to a contested case hearing under chapter 14.  
    Sec. 62.  [179A.30] [REGIONAL TREATMENT CENTER, NURSING 
HOME, AND COMMUNITY-BASED FACILITY EMPLOYEES.] 
    Subdivision 1.  [EXCLUSIVE REPRESENTATIVE.] The exclusive 
representative of employees may meet and negotiate with the 
commissioner of employee relations, in consultation with the 
commissioner of human services, concerning possible changes in 
hours or work schedules that could produce cost reductions in 
the regional treatment centers. 
    Subd. 2.  [COMMISSIONER OF EMPLOYEE RELATIONS.] The 
commissioner of employee relations shall meet and negotiate in 
accordance with chapter 179A with the appropriate exclusive 
representative of the regional treatment center employees 
concerning the terms and conditions of employment that result 
from state-operated, community-based residential programs 
established under section 252.035. 
    Sec. 63.  [198.35] [VETERANS HOME; SILVER BAY.] 
    Subdivision 1.  [ESTABLISHMENT.] The commissioner may 
establish a veterans home in Silver Bay by renovating an 
existing facility owned by the city of Silver Bay if the city 
donates the building to the commissioner at no cost.  Contracts 
made by the commissioner for the purposes of this subdivision 
are subject to chapter 16B.  Buildings used for the veterans 
home must comply with requirements established by federal 
agencies as conditions for the receipt of federal funds for the 
nursing and boarding care of veterans.  The city of Silver Bay 
shall secure the state match requirement from sources other than 
the state general fund.  Money from other sources must equal at 
least 35 percent of the total cost of the renovation with the 
remainder of the funds to be provided by the United States 
Veterans Administration. 
    Subd. 2.  [OPERATION.] The home must provide beds for 
nursing or boarding and nursing care in conformance with 
licensing rules of the department of health.  The home must be 
under the management of an administrator appointed by the 
commissioner in the unclassified service. 
    Sec. 64.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 3, is amended to read:  
    Subd. 3.  [CASE MANAGEMENT ACTIVITIES.] "Case management 
activities" means activities that are part of coordinated with 
the community support services program as defined in subdivision 
6 and are designed to help people with serious and persistent 
mental illness in gaining access to needed medical, social, 
educational, vocational, and other necessary services as they 
relate to the client's mental health needs.  Case management 
activities include obtaining a diagnostic assessment, developing 
an individual community support plan, referring the person to 
needed mental health and other services, coordinating ensuring 
coordination of services, and monitoring the delivery of 
services. 
    Sec. 65.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 4, is amended to read:  
    Subd. 4.  [CASE MANAGER.] "Case manager" means an 
individual employed by the county or other entity authorized by 
the county board to provide the case management activities as 
part of a community support services program specified in 
sections 245.462, subdivision 3; 245.471; and 245.475.  A case 
manager must be qualified at the mental health practitioner 
level, have a bachelor's degree in one of the behavioral 
sciences or related fields from an accredited college or 
university and have at least 2,000 hours of supervised 
experience in the delivery of services to persons with mental 
illness, must be skilled in the process of identifying and 
assessing a wide range of client needs, and must be 
knowledgeable about local community resources and how to use 
those resources for the benefit of the client.  The case manager 
shall meet in person with a mental health professional at least 
once each month to obtain clinical supervision of the case 
manager's activities.  Case managers with a bachelor's degree 
but without 2,000 hours of supervised experience in the delivery 
of services to persons with mental illness must complete 40 
hours of training approved by the commissioner of human services 
in case management skills and in the characteristics and needs 
of persons with serious and persistent mental illness and must 
receive clinical supervision regarding individual service 
delivery from a mental health professional at least once each 
week until the requirement of 2,000 hours of supervised 
experience is met.  Clinical supervision must be documented in 
the client record. 
    Sec. 66.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 6, is amended to read:  
    Subd. 6.  [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community 
support services program" means services, other than inpatient 
or residential treatment services, provided or coordinated by an 
identified program and staff under the clinical supervision of a 
mental health professional designed to help people with serious 
and persistent mental illness to function and remain in the 
community.  A community support services program includes case 
management activities provided to persons with serious and 
persistent mental illness,: 
    (1) client outreach, 
    (2) medication management, 
    (3) assistance in independent living skills, 
    (4) development of employability and supportive work 
opportunities, 
    (5) crisis assistance, 
    (6) psychosocial rehabilitation, 
    (7) help in applying for government benefits, and 
    (8) the development, identification, and monitoring of 
living arrangements.  
    The community support services program must be coordinated 
with the case management activities specified in sections 
245.462, subdivision 3; 245.471; and 245.475. 
    Sec. 67.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 17, is amended to read:  
    Subd. 17.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
practitioner" means a person providing services to persons with 
mental illness who is qualified in at least one of the following 
ways:  
    (1) holds a bachelor's degree in one of the behavioral 
sciences or related fields from an accredited college or 
university, and has at least 2,000 hours of supervised 
experience in the delivery of services to persons with mental 
illness; 
    (2) has at least 6,000 hours of supervised experience in 
the delivery of services to persons with mental illness; 
    (3) is a graduate student in one of the behavioral sciences 
or related fields and is formally assigned by an accredited 
college or university to an agency or facility for clinical 
training by an accredited college or university; or 
    (4) holds a master's or other graduate degree in one of the 
behavioral sciences or related fields from an accredited college 
or university with and has less than 4,000 hours post-master's 
experience in the treatment of mental illness. 
    Sec. 68.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 18, is amended to read:  
    Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
professional" means a person providing clinical services in the 
treatment of mental illness who is qualified in at least one of 
the following ways:  
    (1) in psychiatric nursing:  a registered nurse with a 
master's degree in one of the behavioral sciences or related 
fields from an accredited college or university or its 
equivalent, who is licensed under sections 148.171 to 148.285, 
with at least 4,000 hours of post-master's supervised experience 
in the delivery of clinical services in the treatment of mental 
illness;  
    (2) in clinical social work:  a person licensed as an 
independent clinical social worker under section 148B.21, 
subdivision 6, or a person with a master's degree in social work 
from an accredited college or university, with at least 4,000 
hours of post-master's supervised experience in the delivery of 
clinical services in the treatment of mental illness;  
    (3) in psychology:  a psychologist licensed under sections 
148.88 to 148.98 who has stated to the board of psychology 
competencies in the diagnosis and treatment of mental illness;  
    (4) in psychiatry:  a physician licensed under chapter 147 
and certified by the American board of psychiatry and neurology 
or eligible for board certification in psychiatry; or 
    (5) in allied fields:  a person with a master's degree from 
an accredited college or university in one of the behavioral 
sciences or related fields, with at least 4,000 hours of 
post-master's supervised experience in the delivery of clinical 
services in the treatment of mental illness.  
    Sec. 69.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 19, is amended to read:  
    Subd. 19.  [MENTAL HEALTH SERVICES.] "Mental health 
services" means at least all of the treatment services and case 
management activities that are provided to persons with mental 
illness and are described in sections 245.468 245.461 to 245.476 
245.486. 
    Sec. 70.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 20, is amended to read:  
    Subd. 20.  [MENTAL ILLNESS.] (a) "Mental illness" means an 
organic disorder of the brain or a clinically significant 
disorder of thought, mood, perception, orientation, memory, or 
behavior that is listed in the clinical manual of the 
International Classification of Diseases (ICD-9-CM), current 
edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 
corresponding code in the American Psychiatric Association's 
Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 
current edition, Axes I, II, or III, and that seriously limits a 
person's capacity to function in primary aspects of daily living 
such as personal relations, living arrangements, work, and 
recreation.  
    (b) A "person with acute mental illness" means a person who 
has a mental illness that is serious enough to require prompt 
intervention.  
    (c) For purposes of sections 245.461 to 245.486 case 
management and community support services, a "person with 
serious and persistent mental illness" means a person who has a 
mental illness and meets at least one of the following criteria: 
    (1) the person has undergone two or more episodes of 
inpatient care for a mental illness within the preceding 24 
months.; 
    (2) the person has experienced a continuous psychiatric 
hospitalization or residential treatment exceeding six months' 
duration within the preceding 12 months.; 
    (3) the person: 
    (i) has had a history of recurring inpatient or residential 
treatment episodes of a frequency described in clause (1) or 
(2), but not within the preceding 24 months.  There must also be 
a diagnosis of schizophrenia, bipolar disorder, major 
depression, or borderline personality disorder; 
    (ii) indicates a significant impairment in functioning; and 
    (iii) has a written opinion of from a mental health 
professional stating that the person is reasonably likely to 
have future episodes requiring inpatient or residential 
treatment, of a frequency described in clause (1) or (2), unless 
an ongoing community support services program is provided; or 
    (4) the person has been committed by a court as a mentally 
ill person under chapter 253B, or the person's commitment has 
been stayed or continued. 
    Sec. 71.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 21, is amended to read:  
    Subd. 21.  [OUTPATIENT SERVICES.] "Outpatient services" 
means mental health services, excluding day treatment and 
community support services programs, provided by or under the 
clinical supervision of a mental health professional to persons 
with a mental illness who live outside a hospital or residential 
treatment setting.  Outpatient services include clinical 
activities such as individual, group, and family therapy; 
individual treatment planning; diagnostic assessments; 
medication management; and psychological testing.  
    Sec. 72.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 23, is amended to read:  
    Subd. 23.  [RESIDENTIAL TREATMENT.] "Residential treatment" 
means a 24-hour-a-day residential program under the clinical 
supervision of a mental health professional, in a community 
residential setting other than an acute care hospital or 
regional treatment center, which that must be licensed as a 
residential treatment facility for mentally ill persons with 
mental illness under Minnesota Rules, parts 9520.0500 to 
9520.0690 for adults, 9545.0900 to 9545.1090 for children, or 
other rule adopted by the commissioner. 
    Sec. 73.  Minnesota Statutes 1987 Supplement, section 
245.462, subdivision 25, is amended to read:  
    Subd. 25.  [CLINICAL SUPERVISION.] "Clinical 
supervision," when referring to the responsibilities of a mental 
health professional, means the oversight responsibility of a 
mental health professional for individual treatment plans, and 
individual service delivery, and program activities including 
that provided by the case manager.  Clinical supervision may 
must be accomplished by full or part-time employment of or 
contracts with mental health professionals.  Clinical 
supervision must be documented by the mental health professional 
cosigning individual treatment plans and evidence of input into 
service delivery and program development by entries in the 
client's record regarding supervisory activities. 
    Sec. 74.  Minnesota Statutes 1987 Supplement, section 
245.465, is amended to read:  
    245.465 [DUTIES OF COUNTY BOARD.] 
    The county board in each county shall use its share of 
mental health and community social service act funds allocated 
by the commissioner according to a biennial local mental health 
service proposal approved by the commissioner.  The county board 
must: 
    (1) develop and coordinate a system of affordable and 
locally available mental health services in accordance with 
sections 245.466 245.461 to 245.474 245.486; 
    (2) provide for case management services to persons with 
serious and persistent mental illness in accordance with section 
245.475 sections 245.462, subdivisions 3 and 4; 245.471; 
245.475; and 245.486; 
    (3) provide for screening of persons specified in section 
245.476 upon admission to a residential treatment facility or 
acute care hospital inpatient, or informal admission to a 
regional treatment center; and 
    (4) prudently administer grants and purchase-of-service 
contracts that the county board determines are necessary to 
fulfill its responsibilities under sections 245.461 to 245.486. 
    Sec. 75.  Minnesota Statutes 1987 Supplement, section 
245.466, subdivision 1, is amended to read:  
    Subdivision 1.  [DEVELOPMENT OF SERVICES.] The county board 
in each county is responsible for using all available resources 
to develop and coordinate a system of locally available and 
affordable mental health services.  The county board may provide 
some or all of the mental health services and activities 
specified in subdivision 2 directly through a county agency or 
under contracts with other individuals or agencies.  A county or 
counties may enter into an agreement with a regional treatment 
center under section 246.57 to enable the county or counties to 
provide the treatment services in subdivision 2.  Services 
provided through an agreement between a county and a regional 
treatment center must meet the same requirements as services 
from other service providers.  County boards shall demonstrate 
their continuous progress toward full implementation of sections 
245.461 to 245.486 during the period July 1, 1987 to January 1, 
1990.  County boards must develop fully each of the treatment 
services and management activities prescribed by sections 
245.461 to 245.486 by January 1, 1990, according to the 
priorities established in section 245.464 and the local mental 
health services proposal approved by the commissioner under 
section 245.478. 
    Sec. 76.  Minnesota Statutes 1987 Supplement, section 
245.466, subdivision 2, is amended to read:  
    Subd. 2.  [MENTAL HEALTH SERVICES.] The mental health 
service system developed by each county board must include the 
following treatment services:  
    (1) education and prevention services in accordance with 
section 245.468;  
    (2) emergency services in accordance with section 245.469;  
    (3) outpatient services in accordance with section 245.470; 
    (4) community support program services in accordance with 
sections 245.471 and 245.475;  
    (5) residential treatment services in accordance with 
section 245.472;  
    (6) acute care hospital inpatient treatment services in 
accordance with section 245.473;  
    (7) regional treatment center inpatient services in 
accordance with section 245.474; and 
    (8) screening in accordance with section 245.476; and 
    (9) case management in accordance with sections 245.462, 
subdivision 3; 245.471; and 245.475. 
    Sec. 77.  Minnesota Statutes 1987 Supplement, section 
245.466, subdivision 5, is amended to read:  
    Subd. 5.  [LOCAL ADVISORY COUNCIL.] The county board, 
individually or in conjunction with other county boards, shall 
establish a local mental health advisory council or mental 
health subcommittee of an existing advisory council.  The 
council's members must reflect a broad range of community 
interests.  They must include at least one consumer, one family 
member of a person with mental illness, one mental health 
professional, and one community support services program 
representative.  The local mental health advisory council or 
mental health subcommittee of an existing advisory council shall 
meet at least quarterly to review, evaluate, and make 
recommendations regarding the local mental health system.  
Annually, the local advisory council or mental health 
subcommittee of an existing advisory council shall arrange for 
input from the regional treatment center review board center's 
mental illness program unit regarding coordination of care 
between the regional treatment center and community-based 
services.  The county board shall consider the advice of its 
local mental health advisory council or mental health 
subcommittee of an existing advisory council in carrying out its 
authorities and responsibilities.  
    Sec. 78.  Minnesota Statutes 1987 Supplement, section 
245.467, is amended by adding a subdivision to read: 
    Subd. 4.  [REFERRAL FOR CASE MANAGEMENT.] Each provider of 
emergency services, outpatient treatment, community support 
services, residential treatment, acute care hospital inpatient 
treatment, or regional treatment center inpatient treatment must 
inform each of its clients with serious and persistent mental 
illness of the availability and potential benefits to the client 
of case management.  If the client consents, the provider must 
refer the client by notifying the county employee designated by 
the county board to coordinate case management activities of the 
client's name and address and by informing the client of whom to 
contact to request case management.  The provider must document 
compliance with this subdivision in the client's record. 
    Sec. 79.  Minnesota Statutes 1987 Supplement, section 
245.467, is amended by adding a subdivision to read: 
    Subd. 5.  [INFORMATION FOR BILLING.] Each provider of 
outpatient treatment, community support services, emergency 
services, residential treatment, or acute care hospital 
inpatient treatment must include the name and home address of 
each client for whom services are included on a bill submitted 
to a county, if the client has consented to the release of that 
information and if the county requests the information.  Each 
provider shall attempt to obtain each client's consent and must 
explain to the client that the information can only be released 
with the client's consent and may be used only for purposes of 
payment and maintaining provider accountability.  The provider 
shall document the attempt in the client's record. 
    Sec. 80.  Minnesota Statutes 1987 Supplement, section 
245.467, is amended by adding a subdivision to read: 
    Subd. 6.  [RESTRICTED ACCESS TO DATA.] The county board 
shall establish procedures to ensure that the names and 
addresses of persons receiving mental health services are 
disclosed only to: 
    (1) county employees who are specifically responsible for 
determining county of financial responsibility or making 
payments to providers; and 
    (2) staff who provide treatment services or case management 
and their clinical supervisors. 
    Release of mental health data on individuals submitted 
under section 245.467, subdivisions 4 and 5, to persons other 
than those specified in this subdivision, or use of this data 
for purposes other than those stated in section 245.467, 
subdivisions 4 and 5, results in civil or criminal liability 
under the standards in sections 13.08 or 13.09. 
    Sec. 81.  Minnesota Statutes 1987 Supplement, section 
245.469, subdivision 2, is amended to read:  
    Subd. 2.  [SPECIFIC REQUIREMENTS.] The county board shall 
require that all service providers of emergency services provide 
immediate direct access to a mental health professionals 
professional during regular business hours.  For evenings, 
weekends, and holidays, the service may be by direct toll free 
telephone access to a mental health professional, a mental 
health practitioner, or a designated person with training in 
human services who is under the receives clinical supervision of 
from a mental health professional.  Whenever emergency service 
during nonbusiness hours is provided by anyone other than a 
mental health professional, a mental health professional must be 
available for at least telephone consultation within 30 minutes. 
    Sec. 82.  Minnesota Statutes 1987 Supplement, section 
245.471, subdivision 2, is amended to read:  
    Subd. 2.  [CASE MANAGEMENT ACTIVITIES.] (a) By January 1, 
1989, the county board shall develop case management activities 
must be developed as part of the community support program 
available to for all persons with serious and persistent mental 
illness residing in the county who request or consent to the 
services.  Staffing ratios must be sufficient to serve the needs 
of the clients.  The case manager must at a minimum qualify as a 
mental health practitioner meet the requirements in section 
245.462, subdivision 4.  
    (b) All providers of case management activities must 
develop an individual community support plan.  The individual 
community support plan must state for each of their clients:  
    (1) the goals of each service;  
    (2) the activities for accomplishing each goal;  
    (3) a schedule for each activity; and 
    (4) the frequency of face-to-face client contacts, as 
appropriate to client need and the implementation of the 
community support plan.  
    The case manager must develop an individual community 
support plan must incorporate for each client that incorporates 
the client's individual treatment plan.  The individual 
treatment plan may not be a substitute for the development of an 
individual community support plan.  The individual community 
support plan must be developed within 30 days of client intake 
and reviewed every 90 days after it is developed.  The case 
manager is responsible for developing the individual community 
support plan based on a diagnostic assessment and for 
implementing and monitoring the delivery of services according 
to the individual community support plan.  To the extent 
possible, the person with serious and persistent mental illness, 
the person's family, advocates, service providers, and 
significant others must be involved in all phases of development 
and implementation of the individual community support plan.  
     (c) The client's individual community support plan must 
state: 
     (1) the goals of each service; 
     (2) the activities for accomplishing each goal;  
     (3) a schedule for each activity; and 
    (4) the frequency of face-to-face contacts by the case 
manager, as appropriate to client need and the implementation of 
the community support plan. 
    (d) The county board must establish procedures that ensure 
ongoing contact and coordination between the case manager and 
the community support program as well as other mental health 
services. 
    Sec. 83.  Minnesota Statutes 1987 Supplement, section 
245.471, subdivision 3, is amended to read:  
    Subd. 3.  [DAY TREATMENT ACTIVITIES SERVICES PROVIDED.] (a) 
By July 1, 1989, day treatment activities services must be 
developed as a part of the community support program available 
to persons with serious and persistent mental illness residing 
in the county.  Day treatment services must be available to 
persons with serious and persistent mental illness residing in 
the county as part of the community support program of each 
county.  Clients may be required to pay a fee.  Day treatment 
services must be designed to:  
    (1) provide a structured environment for treatment;  
    (2) provide family and community support;  
    (3) prevent placement in settings that are more intensive, 
costly, or restrictive than necessary and appropriate to meet 
client need; and 
    (4) establish fee schedules approved by the county board 
that are based on a client's ability to pay. 
    (b) County boards may request a waiver from including day 
treatment services if they can document that:  
    (1) an alternative plan of care exists through the county's 
community support program for clients who would otherwise need 
day treatment services;  
    (2) that day treatment, if included, would be duplicative 
of other components of the community support program; and 
    (3) that county demographics and geography make the 
provision of day treatment services cost ineffective and 
unfeasible.  
     Sec. 84.  Minnesota Statutes 1987 Supplement, section 
245.472, subdivision 2, is amended to read:  
    Subd. 2.  [SPECIFIC REQUIREMENTS.] Providers of residential 
services must be licensed under applicable rules adopted by the 
commissioner and must be clinically supervised by a mental 
health professional.  Persons employed in facilities licensed 
under Minnesota Rules, parts 9520.0500 to 9520.0690, in the 
capacity of program director as of July 1, 1987, in accordance 
with Minnesota Rules, parts 9520.0500 to 9520.0690, may be 
allowed to continue providing clinical supervision within a 
facility until July 1, 1991, provided they continue to be 
employed as a program director in a facility licensed under 
Minnesota Rules, parts 9520.0500 to 9520.0690. 
    Sec. 85.  Minnesota Statutes 1987 Supplement, section 
245.475, subdivision 1, is amended to read:  
    Subdivision 1.  [CLIENT ELIGIBILITY CASE MANAGEMENT.] By 
January 1, 1989, the county board shall provide case management 
and other appropriate community support services to all persons 
each person with serious and persistent mental illness who 
requests services or is referred by a provider under section 
245.467, subdivision 4, and to each person for whom the court 
appoints a case manager.  Case management services provided to 
people with serious and persistent mental illness eligible for 
medical assistance must be billed to the medical assistance 
program under section 256B.02, subdivision 8. 
    Sec. 86.  Minnesota Statutes 1987 Supplement, section 
245.475, subdivision 2, is amended to read:  
    Subd. 2.  [DESIGNATION OF CASE MANAGER NOTIFICATION OF CASE 
MANAGEMENT ELIGIBILITY.] The county board shall designate a 
notify the client of the person's potential eligibility for case 
manager management services within five working days after 
receiving an application for community support services or 
immediately after authorizing payment for residential, acute 
care hospital inpatient, or regional treatment center services 
under section 245.476 a request from an individual or a referral 
from a provider under section 245.467, subdivision 4. 
    The county board shall send a written notice to the 
applicant client and the applicant's client's representative, if 
any, that identifies the designated case manager management 
providers. 
    Sec. 87.  Minnesota Statutes 1987 Supplement, section 
245.476, subdivision 1, is amended to read:  
    Subdivision 1.  [SCREENING REQUIRED.] By No later than 
January 1, 1989 1991, the county board shall screen all persons 
before they may be admitted for treatment of mental illness to a 
residential treatment facility, an acute care hospital, or 
informally admitted to a regional treatment center if public 
funds are used to pay for the services.  Screening prior to 
admission must occur within ten days.  If a person is admitted 
for treatment of mental illness on an emergency basis to a 
residential facility or acute care hospital or held for 
emergency care by a regional treatment center under section 
253B.05, subdivision 1, screening must occur within five days of 
the admission.  Persons must be screened within ten days before 
or within five days after admission to ensure that:  
    (1) an admission is necessary, 
    (2) the length of stay is as short as possible consistent 
with individual client need, and 
    (3) a the case manager, if assigned, is immediately 
assigned to individuals with serious and persistent mental 
illness and developing an individual community support plan is 
developed.  
    The screening process and placement decision must be 
documented in the client's record.  
    An alternate review process may be approved by the 
commissioner if the county board demonstrates that an alternate 
review process has been established by the county board and the 
times of review, persons responsible for the review, and review 
criteria are comparable to the standards specified in clauses 
(1) to (3). 
    Sec. 88.  Minnesota Statutes 1987 Supplement, section 
245.477, is amended to read:  
    245.477 [APPEALS.] 
    Any person who applies for requests mental health services 
under sections 245.461 to 245.486 must be advised of services 
available and the right to appeal at the time of application the 
request and each time the community service plan is reviewed.  
Any person whose application request for mental health services 
under sections 245.468 245.461 to 245.476 245.486 is denied, not 
acted upon with reasonable promptness, or whose services are 
suspended, reduced, or terminated may contest that action before 
the state agency as specified in section 256.045.  The 
commissioner shall monitor the nature and frequency of 
administrative appeals under this section. 
    Sec. 89.  Minnesota Statutes 1987 Supplement, section 
245.478, subdivision 1, is amended to read:  
    Subdivision 1.  [TIME PERIOD.] The first local mental 
health proposal period is from July 1, 1988, to December 31, 
1989.  The county board shall submit its first proposal to the 
commissioner by January 1, 1988.  Subsequent proposals must be 
on the same two-year cycle as community social service plans.  
If a proposal complies with sections 245.461 to 245.486, it 
satisfies the requirement of the community social service plan 
for the mental illness target population as required by section 
256E.09.  The proposal must be made available upon request to 
all residents of the county at the same time it is submitted to 
the commissioner. 
    Sec. 90.  Minnesota Statutes 1987 Supplement, section 
245.478, subdivision 2, is amended to read:  
    Subd. 2.  [PROPOSAL CONTENT.] The local mental health 
proposal must include: 
    (1) the local mental health advisory council's or mental 
health subcommittee of an existing advisory council's report on 
unmet needs and any other needs assessment used by the county 
board in preparing the local mental health proposal; 
    (2) a description of the local mental health advisory 
council's or the mental health subcommittee of an existing 
advisory council's involvement in preparing the local mental 
health proposal and methods used by the county board to obtain 
participation of citizens, mental health professionals, and 
providers in development of the local mental health proposal; 
    (3) information for the preceding year, including the 
actual number of clients who received each of the mental health 
services listed in sections 245.468 to 245.476, and actual 
expenditures and revenues for each mental health service; 
    (4) for the first proposal period only, information for the 
year during which the proposal is being prepared: 
    (i) a description of the current mental health system 
identifying each mental health service listed in sections 
245.468 to 245.476; 
    (ii) a description of each service provider, including a 
listing of the professional qualifications of the staff involved 
in service delivery, that is either the sole provider of one of 
the treatment mental health services or management activities 
described in sections 245.468 to 245.476 or that provides over 
$10,000 of mental health services per year for the county; 
    (iii) a description of how the mental health services in 
the county are unified and coordinated; 
    (iv) the estimated number of clients receiving each mental 
health service;  
    (v) estimated expenditures and revenues for each mental 
health service; and 
    (5) the following information describing how the county 
board intends to meet the requirements of sections 245.461 to 
245.486 during the proposal period: 
    (i) specific objectives and outcome goals for each mental 
health service listed in sections 245.468 to 245.476; 
    (ii) a description of each service provider, including 
county agencies, contractors, and subcontractors, that is 
expected to either be the sole provider of one of the treatment 
mental health services or management activities described in 
sections 245.468 to 245.476 or to provide over $10,000 of mental 
health services per year, including a listing of the 
professional qualifications of the staff involved in service 
delivery for the county; 
    (iii) a description of how the mental health services in 
the county will be unified and coordinated; 
    (iv) the estimated number of clients who will receive each 
mental health service; and 
    (v) estimated expenditures and revenues for each mental 
health service and revenues for the entire proposal. 
    Sec. 91.  Minnesota Statutes 1987 Supplement, section 
245.478, subdivision 9, is amended to read:  
    Subd. 9.  [PLAN AMENDMENT.] If the county board finds it 
necessary to make significant changes in the approved local 
proposal, it must present the proposed changes to the 
commissioner for approval at least 60 30 days before the changes 
take effect.  "Significant changes" means: 
    (1) the county board proposes to provide a mental health 
service through a provider other than the provider listed for 
that service in the approved local proposal; 
    (2) the county board expects the total annual expenditures 
for any single mental health service to vary more than ten 
percent or $5,000, whichever is greater, from the amount in the 
approved local proposal; 
    (3) the county board expects a combination of changes in 
expenditures per mental health service to exceed more than ten 
percent of the total mental health services expenditures; or 
    (4) the county board proposes a major change in the 
specific objectives and outcome goals listed in the approved 
local proposal. 
    Sec. 92.  Minnesota Statutes 1987 Supplement, section 
245.479, is amended to read:  
    245.479 [COUNTY OF FINANCIAL RESPONSIBILITY.] 
    For purposes of section 245.476 sections 245.461 to 
245.486, the county of financial responsibility is the same as 
that for community social services determined under 
section 256E.08, subdivision 7 256G.02, subdivision 4.  Disputes 
between counties regarding financial responsibility must be 
resolved by the commissioner in accordance with section 256D.18, 
subdivision 4 256G.09. 
    Sec. 93.  Minnesota Statutes 1987 Supplement, section 
245.482, subdivision 2, is amended to read:  
    Subd. 2.  [PROGRAM REPORTS.] The commissioner shall develop 
a unified format for a semiannual an annual program report that 
will include information that the commissioner determines 
necessary to carry out sections 245.461 to 245.486 and section 
256E.10.  The county board shall submit a completed program 
report in the required format no later than 75 days after each 
six-month period by March 15 of each year. 
     Sec. 94.  Minnesota Statutes 1987 Supplement, section 
245.696, subdivision 2, is amended to read: 
    Subd. 2.  [SPECIFIC DUTIES.] In addition to the powers and 
duties already conferred by law, the commissioner of human 
services shall: 
    (1) review and evaluate local programs and the performance 
of administrative and mental health personnel and make 
recommendations to county boards and program administrators; 
    (2) provide consultative staff service to communities and 
advocacy groups to assist in ascertaining local needs and in 
planning and establishing community mental health programs; 
    (3) employ qualified personnel to implement this chapter; 
    (4) as part of the biennial budget process, report to the 
legislature on staff use and staff performance, including in the 
report a description of duties performed by each person in the 
mental health division; 
    (5) adopt rules for minimum standards in community mental 
health services as directed by the legislature; 
    (6) cooperate with the commissioners of health and jobs and 
training to coordinate services and programs for people with 
mental illness;  
    (7) convene meetings with the commissioners of corrections, 
health, education, and commerce at least four times each year 
for the purpose of coordinating services and programs for 
children with mental illness and children with emotional or 
behavioral disorders; 
    (8) evaluate the needs of people with mental illness as 
they relate to assistance payments, medical benefits, nursing 
home care, and other state and federally funded services;  
    (8) (9) provide data and other information, as requested, 
to the advisory council on mental health; 
    (9) (10) develop and maintain a data collection system to 
provide information on the prevalence of mental illness, the 
need for specific mental health services and other services 
needed by people with mental illness, funding sources for those 
services, and the extent to which state and local areas are 
meeting the need for services;  
    (10) (11) apply for grants and develop pilot programs to 
test and demonstrate new methods of assessing mental health 
needs and delivering mental health services;  
    (11) (12) study alternative reimbursement systems and make 
waiver requests that are deemed necessary by the commissioner; 
    (12) (13) provide technical assistance to county boards to 
improve fiscal management and accountability and quality of 
mental health services, and consult regularly with county 
boards, public and private mental health agencies, and client 
advocacy organizations for purposes of implementing this chapter;
    (13) (14) promote coordination between the mental health 
system and other human service systems in the planning, funding, 
and delivery of services; entering into cooperative agreements 
with other state and local agencies for that purpose as deemed 
necessary by the commissioner; 
    (14) (15) conduct research regarding the relative 
effectiveness of mental health treatment methods as the 
commissioner deems appropriate, and for this purpose, enter 
treatment facilities, observe clients, and review records in a 
manner consistent with the Minnesota government data practices 
act, chapter 13; and 
    (15) (16) enter into contracts and promulgate rules the 
commissioner deems necessary to carry out the purposes of this 
chapter. 
     Sec. 95.  Minnesota Statutes 1987 Supplement, section 
245.697, subdivision 2, is amended to read: 
    Subd. 2.  [DUTIES.] The state advisory council on mental 
health shall:  
    (1) advise the governor, the legislature, and heads of 
state departments and agencies about policy, programs, and 
services affecting people with mental illness;  
    (2) advise the commissioner of human services on all phases 
of the development of mental health aspects of the biennial 
budget; 
    (3) advise the governor and the legislature about the 
development of innovative mechanisms for providing and financing 
services to people with mental illness;  
    (4) encourage state departments and other agencies to 
conduct needed research in the field of mental health; 
    (5) review recommendations of the subcommittee on 
children's mental health; 
    (6) educate the public about mental illness and the needs 
and potential of people with mental illness; and 
    (6) (7) review and comment on all grants dealing with 
mental health and on the development and implementation of state 
and local mental health plans. 
    Sec. 96.  Minnesota Statutes 1987 Supplement, section 
245.697, is amended by adding a subdivision to read: 
    Subd. 2a.  [SUBCOMMITTEE ON CHILDREN'S MENTAL HEALTH.] The 
state advisory council on mental health (the "advisory council") 
must have a subcommittee on children's mental health.  The 
subcommittee must make recommendations to the advisory council 
on policies, laws, regulations, and services relating to 
children's mental health.  Members of the subcommittee must 
include: 
    (1) the commissioners or designees of the commissioners of 
the departments of human services, health, education, and 
corrections; 
    (2) the commissioner of commerce or a designee of the 
commissioner who is knowledgeable about medical insurance issues;
    (3) at least one representative of an advocacy group for 
children with mental illness; 
    (4) providers of children's mental health services, 
including at least one provider of services to preadolescent 
children, one provider of services to adolescents, and one 
hospital-based provider; 
    (5) parents of children who have mental illness or 
emotional or behavioral disorders; 
    (6) a present or former consumer of adolescent mental 
health services; 
     (7) educators experienced in working with emotionally 
disturbed children; 
    (8) people knowledgeable about the needs of emotionally 
disturbed children of minority races and cultures; 
    (9) people experienced in working with emotionally 
disturbed children who have committed status offenses;  
    (10) members of the advisory council; and 
     (11) county commissioners and social services agency 
representatives. 
    The chair of the advisory council shall appoint 
subcommittee members described in clauses (3) through (11) 
through the process established in section 15.0597.  The chair 
shall appoint members to ensure a geographical balance on the 
subcommittee.  Terms, compensation, removal, and filling of 
vacancies are governed by subdivision 1, except that terms of 
subcommittee members who are also members of the advisory 
council are coterminous with their terms on the advisory 
council.  The subcommittee shall meet at the call of the 
subcommittee chair, who is elected by the subcommittee from 
among its members.  The subcommittee expires with the expiration 
of the advisory council. 
    Sec. 97.  [245.698] [CHILDREN'S MENTAL HEALTH SERVICE 
SYSTEM.] 
     The commissioner of human services shall create and ensure 
a unified, accountable, comprehensive children's mental health 
service system that: 
    (a) identifies children who are eligible for mental health 
services; 
     (b) makes preventive services available to a wide range of 
children, including those who are not eligible for more 
intensive services; 
     (c) assures access to a continuum of services that: 
    (1) educate the community about the mental health needs of 
children; 
    (2) address the unique physical, emotional, social, and 
educational needs of children; 
    (3) are coordinated with other social and human services 
provided to children and their families; 
     (4) are appropriate to the developmental needs of children; 
and 
    (5) are sensitive to cultural differences and special needs;
    (d) includes early screening and prompt intervention in 
order to: 
    (1) identify and treat the mental health needs of children 
in the least restrictive setting appropriate to their needs; and 
    (2) prevent further deterioration; 
    (e) provides services to children and their families in the 
context in which the children live and go to school; 
    (f) addresses the unique problems of paying for mental 
health services for children, including: 
     (1) access to private insurance coverage; and 
     (2) public funding; 
    (g) to every extent possible, includes children and their 
families in planning the child's program of mental health 
services; and 
    (h) when necessary, assures a smooth transition to the 
adult services system. 
    For purposes of this section, "child" means a person under 
age 18. 
    The commissioner shall begin implementing the goals and 
objectives of this section by February 15, 1990, and shall fully 
implement the goals and objectives by February 15, 1992.  By 
February 15, 1989, the commissioner shall present a report to 
the legislature outlining recommendations for full 
implementation.  The report must include a timetable for 
implementing the recommendations and identify additional 
resources needed for full implementation.  The report must be 
updated annually by February 15 of 1990, 1991, and 1992. 
    Sec. 98.  Minnesota Statutes 1986, section 245.771, is 
amended by adding a subdivision to read: 
    Subd. 3.  [EMPLOYMENT AND TRAINING PROGRAMS.] The 
commissioner of human services may contract with the 
commissioner of jobs and training to implement and supervise 
employment and training programs for food stamp recipients that 
are required by federal regulations.  
    Sec. 99.  Minnesota Statutes 1986, section 245.814, 
subdivision 1, is amended to read:  
    Subdivision 1.  [INSURANCE FOR FOSTER PARENTS HOME 
PROVIDERS.] The commissioner of human services shall within the 
appropriation provided purchase and provide insurance to 
individuals licensed as foster parents home providers to cover 
their liability for: 
    (1) injuries or property damage caused or sustained by 
foster children persons in foster care in their home; and 
    (2) actions arising out of alienation of affections 
sustained by the natural parents of a foster child or natural 
parents or children of a foster adult. 
    Sec. 100.  Minnesota Statutes 1986, section 245.814, 
subdivision 2, is amended to read:  
    Subd. 2.  [APPLICATION OF COVERAGE.] Coverage shall apply 
to all foster boarding homes licensed by the department of human 
services, licensed by a federally recognized tribal government, 
or established by the juvenile court and certified by the 
commissioner of corrections pursuant to section 260.185, 
subdivision 1, clause (c)(5), to the extent that the liability 
is not covered by the provisions of the standard homeowner's or 
automobile insurance policy.  The insurance shall not cover 
property owned by the individual foster parents home provider, 
damage caused intentionally by a child person over 12 years of 
age, or property damage arising out of business pursuits or the 
operation of any vehicle, machinery, or equipment. 
    Sec. 101.  Minnesota Statutes 1986, section 245.814, 
subdivision 3, is amended to read:  
    Subd. 3.  [COMPENSATION PROVISIONS.] If the commissioner of 
human services is unable to obtain insurance through ordinary 
methods for coverage of foster parents home providers, the 
appropriation shall be returned to the general fund and the 
state shall pay claims subject to the following limitations. 
    (a) Compensation shall be provided only for injuries, 
damage, or actions set forth in subdivision 1. 
    (b) Compensation shall be subject to the conditions and 
exclusions set forth in subdivision 2. 
    (c) The state shall provide compensation for bodily injury, 
property damage, or personal injury resulting from the foster 
parent's home providers activities as a foster parent home 
provider while the foster child or adult is in the care, 
custody, and control of the foster parent home provider in an 
amount not to exceed $250,000 for each occurrence. 
    (d) The state shall provide compensation for damage or 
destruction of property caused or sustained by a foster child or 
adult in an amount not to exceed $250 for each occurrence. 
    (e) The compensation in clauses (c) and (d) is the total 
obligation for all damages because of each occurrence regardless 
of the number of claims made in connection with the same 
occurrence, but compensation applies separately to each foster 
home.  The state shall have no other responsibility to provide 
compensation for any injury or loss caused or sustained by any 
foster parent home provider or foster child or foster adult. 
    This coverage is extended as a benefit to foster parents 
home providers to encourage care of children persons who need 
out-of-home care.  Nothing in this section shall be construed to 
mean that foster parents home providers are agents or employees 
of the state nor does the state accept any responsibility for 
the selection, monitoring, supervision, or control of 
foster parents home providers which is exclusively the 
responsibility of the counties which shall regulate 
foster parents home providers in the manner set forth in the 
rules of the commissioner of human services. 
    Sec. 102.  [245.827] [COMMUNITY INITIATIVES FOR CHILDREN.] 
    Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
human services shall establish a demonstration program of grants 
for community initiatives for children.  The goal of the program 
is to enlist the resources of a community to promote the healthy 
physical, educational, and emotional development of children who 
are living in poverty.  Community initiatives for children 
accomplish the goal by offering support services that enable a 
family to provide the child with a nurturing home environment.  
The commissioner shall award grants to nonprofit organizations 
based on the criteria in subdivision 3. 
    Subd. 2.  [DEFINITION.] "Community initiatives for children"
are programs that promote the healthy development of children by 
increasing the stability of their home environment.  They 
include support services such as child care, parenting 
education, respite activities for parents, counseling, 
recreation, and other services families may need to maintain a 
nurturing environment for their children.  Community initiatives 
for children must be planned by members of the community who are 
concerned about the future of children. 
    Subd. 3.  [CRITERIA.] In order to qualify for a community 
initiatives for children grant, a nonprofit organization must: 
    (1) involve members of the community and use community 
resources in planning and executing all aspects of the program; 
    (2) provide a central location that is accessible to 
low-income families and is available for informal as well as 
scheduled activities during the day and on evenings and weekends;
    (3) provide a wide range of services to families living at 
or below the poverty level, including but not limited to, 
quality affordable child care and training in parental skills; 
    (4) demonstrate that the organization is using and 
coordinating existing resources of the community;  
    (5) demonstrate that the organization has applied to 
private foundations for funding; 
    (6) ensure that services are focused on development of the 
whole child; and 
    (7) have a governing structure that includes consumer 
families and members of the community. 
    Subd. 4.  [COVERED EXPENSES.] Grants awarded under this 
section may be used for the capital costs of establishing or 
improving a program that meets the criteria listed in 
subdivision 3.  Capital costs include land and building 
acquisition, planning, site preparation, design fees, 
rehabilitation, construction, and equipment costs. 
    Sec. 103.  Minnesota Statutes 1986, section 245.83, is 
amended to read: 
    245.83 [CHILD CARE SERVICES; DEFINITIONS.] 
    Subdivision 1.  As used in sections 245.83 to 245.87 
245.858 the words defined in this section shall have the 
meanings given them. 
    Subd. 2.  [CHILD CARE SERVICES.] "Child care services" 
means child care provided in family day care homes, group day 
care centers homes, nursery schools, day nurseries, child day 
care centers, play groups, head start and parent cooperatives, 
as defined by rules of the commissioner, and in-home child care 
as defined in the Minnesota plan for social services to families 
and children. 
    Subd. 3.  [CHILD.] "Child" means any a person 14 12 years 
of age old or younger, or a person age 13 or 14 who is 
handicapped, as defined in section 120.03. 
    Subd. 3a.  [CHILD CARE.] "Child care" means the care of a 
child by someone other than a parent or legal guardian outside 
the child's own home for gain or otherwise, on a regular basis, 
for any part of a 24-hour day. 
    Subd. 3b.  [CHILD CARE WORKER.] "Child care worker" means a 
person who cares for children for compensation, including a 
licensed provider of child care services, an employee of a 
provider and a person who has applied for a license as a 
provider. 
    Subd. 4.  [COMMISSIONER.] "Commissioner" means the 
commissioner of human services. 
    Subd. 4a.  [FACILITY IMPROVEMENT EXPENSES.] "Facility 
improvement expenses" means building improvements, equipment, 
toys, and supplies needed to establish, expand, or improve a 
licensed child care facility. 
    Subd. 5.  [INTERIM FINANCING.] "Interim financing" means 
funds to carry out such activities as are necessary for family 
day care homes, group family day care homes and cooperative 
child care centers to receive and maintain state licensing, to 
expand an existing program or to improve program quality and to 
provide operating funds for a period of six consecutive months 
following receipt of state licensing by a family day care home, 
group family day care home, or cooperative child care 
center.  Interim financing may not exceed a period of 18 months. 
    Subd. 6.  [RESOURCE AND REFERRAL PROGRAM.] "Resource and 
referral program" means a program that provides information to 
parents, including referrals and coordination of community child 
care resources for parents and public or private providers of 
care.  Services may include parent education, technical 
assistance for providers, staff development programs, and 
referrals to social services. 
    Subd. 7.  [STAFF TRAINING OR DEVELOPMENT EXPENSES.] "Staff 
training or development expenses" include the cost to a child 
care worker of tuition, transportation, required materials and 
supplies, and wages for a substitute while the child care worker 
is engaged in a training program. 
    Subd. 8.  [TRAINING PROGRAM.] "Training program" means 
child development courses offered by an accredited 
post-secondary institution or similar training approved by a 
county board or the department of human services.  To qualify as 
a training program under this section, a course of study must 
teach specific skills that a child care worker needs to meet 
licensing requirements. 
    Sec. 104.  [245.871] [DUTIES OF COMMISSIONER.] 
    In addition to the powers and duties already conferred by 
law, the commissioner of human services shall: 
    (1) by September 1, 1990, and by September 1 of each 
subsequent even-numbered year, survey and report on all 
components of the child care system including, but not limited 
to, availability of licensed child care slots; numbers of 
children in various kinds of child care settings; staff wages, 
rate of staff turnover, and qualifications of child care 
workers; cost of child care by type of service and ages of 
children; and child care availability through school systems; 
    (2) by September 1, 1990, and September 1 of each 
subsequent even-numbered year, survey and report on the extent 
to which existing child care services fulfill the need for child 
care, giving particular attention to the need for part-time care 
and for care of infants, sick children, children with special 
needs, and low-income children; 
    (3) administer the child care fund, including the sliding 
fee program, authorized under section 268.91; 
    (4) monitor the child care resource and referral programs 
established under section 268.911; and 
    (5) encourage child care providers to participate in a 
nationally-recognized accreditation system for early childhood 
programs. 
    Sec. 105.  [245.872] [GRANTS FOR CHILD CARE SERVICES.] 
    Subdivision 1.  [GRANTS ESTABLISHED.] The commissioner 
shall award grants to develop child care services, including 
facility improvement expenses, interim financing, resource and 
referral programs, and staff training expenses.  The 
commissioner shall develop a grant application form, inform 
county social service agencies about the availability of child 
care services grants, and set a date by which applications must 
be received by the commissioner. 
    Subd. 2.  [DISTRIBUTION OF FUNDS.] The commissioner shall 
allocate grant money appropriated for child care services among 
the 12 development regions designated by the governor under 
section 462.385, in proportion to the ratio of the number of 
children to the number of licensed child care slots available in 
each region.  Out of the amount allocated for each development 
region the commissioner shall award grants based on the 
recommendation of the grant review advisory task force.  In 
addition, the commissioner shall: 
    (1) award no more than 75 percent of the money either to 
child care facilities for the purpose of facility improvement or 
interim financing or to child care workers for staff training 
expenses; and 
    (2) redistribute funds not awarded by January 1, 1989, 
without regard to the distribution formula in this subdivision. 
    Subd. 3.  [GRANT REVIEW ADVISORY TASK FORCE.] The 
commissioner shall appoint a child care grant review advisory 
task force.  Members appointed under this subdivision must be 
parents of children in child care, providers of child care, or 
citizens with a demonstrated interest in child care issues.  The 
grant review advisory task force shall review and make 
recommendations to the commissioner on applications for grants 
under this section.  Task force members do not receive a per 
diem but may be reimbursed for expenses in accordance with 
section 15.059, subdivision 6.  The advisory task force does not 
expire but is otherwise governed by section 15.059.  
    Subd. 4.  [FUNDING PRIORITIES; FACILITY IMPROVEMENT AND 
INTERIM FINANCING.] In evaluating applications for funding and 
making recommendations to the commissioner, the grant review 
advisory task force shall give priority to: 
    (1) new programs or projects, or the expansion or 
enrichment of existing programs or projects; 
    (2) programs or projects in areas where a demonstrated need 
for child care facilities has been shown, with special emphasis 
on programs or projects in areas where there is a shortage of 
licensed child care; 
    (3) programs and projects that serve sick children, 
infants, children with special needs, and children from 
low-income families; and 
    (4) unlicensed providers who wish to become licensed. 
    Subd. 5.  [FUNDING PRIORITIES; TRAINING GRANTS.] In 
evaluating applications for training grants and making 
recommendations to the commissioner, the grant review advisory 
task force shall give priority to: 
    (1) applicants who will work in facilities caring for sick 
children, infants, children with special needs, and children 
from low-income families; 
    (2) applicants who will work in geographic areas where 
there is a shortage of child care; 
    (3) unlicensed providers who wish to become licensed; 
    (4) child care providers seeking accreditation; and 
    (5) entities that will use grant money for scholarships for 
child care workers attending educational or training programs 
sponsored by the entity. 
    Sec. 106.  Minnesota Statutes 1986, section 245.84, 
subdivision 1, is amended to read:  
    Subdivision 1.  [AUTHORITY.] The county board is authorized 
to provide child care services, to make grants from the 
community social service fund, special tax revenue, or its 
general fund, or other sources to any municipality, corporation 
or combination thereof for the cost of providing technical 
assistance and child care services, or to contract for services 
with any licensed day care facility, as the board deems 
necessary or proper to carry out the purposes of sections 245.83 
to 245.87 245.856. 
    The board is further authorized to make grants to or 
contract with any municipality, incorporated licensed child care 
facility or resource and referral program, or corporation or 
combination thereof for any of the following purposes: 
    (a) For creating new licensed day care facilities and 
expanding existing facilities including, but not limited to, 
supplies, equipment, and facility renovation and remodeling; 
    (b) For improving licensed day care facility programs, 
including, but not limited to, staff specialists, staff 
training, supplies, equipment, and facility renovation and 
remodeling.  In awarding grants for training, counties must give 
priority to child care workers caring for infants, toddlers, 
sick children, children in low-income families, and children 
with special needs; 
    (c) For supportive child development services including, 
but not limited to, in-service training, curriculum development, 
consulting specialist, resource centers, and program and 
resource materials; 
    (d) For carrying out programs including, but not limited 
to, staff, supplies, equipment, facility renovation, and 
training; 
    (e) For interim financing; and 
    (f) For carrying out the resource and referral program 
services identified in section 268.911, subdivision 3.  
    Sec. 107.  [245.873] [INTERAGENCY ADVISORY COMMITTEE ON 
CHILD CARE.] 
    Subdivision 1.  [MEMBERSHIP.] By July 1, 1988, the 
commissioner of the state planning agency shall convene and 
chair an interagency advisory committee on child care.  In 
addition to the commissioner, members of the committee are the 
commissioners of each of the following agencies and 
departments:  health, human services, jobs and training, public 
safety, education, and the higher education coordinating board.  
The purpose of the committee is to improve the quality and 
quantity of child care and the coordination of child care 
related activities among state agencies.  
    Subd. 2.  [DUTIES.] The committee shall advise its member 
agencies on matters related to child care policy and planning.  
Specifically, the committee shall:  
    (1) develop a consistent policy on issues related to child 
care; 
    (2) advise the member agencies on implementing policies and 
developing rules that are consistent with the committee's policy 
on child care; 
    (3) advise the member agencies on state efforts to increase 
the supply and improve the quality of child care facilities and 
options; and 
    (4) perform other advisory tasks related to improving child 
care options throughout the state. 
    Subd. 3.  [MEETINGS.] The committee shall meet as often as 
necessary to perform its duties.  
    Sec. 108.  Minnesota Statutes 1986, section 246.023, 
subdivision 1, is amended to read:  
    Subdivision 1.  [LEGISLATIVE POLICY.] It is recognized that 
closure and consolidation of state hospitals regional treatment 
centers have negative economic effects upon public employees and 
communities.  It is the policy of the state that 
deinstitutionalization policies shall be carried out in a manner 
that ensures fair and equitable arrangements to protect the 
interests of employees and communities affected by 
deinstitutionalization of state hospitals.  
    Sec. 109.  [252.50] [STATE-OPERATED, COMMUNITY-BASED 
RESIDENTIAL PROGRAMS.] 
    Subdivision 1.  [RESIDENTIAL PROGRAMS ESTABLISHED.] The 
commissioner may establish a system of noninstitutional, 
state-operated, community-based residential services for persons 
with mental retardation or related conditions.  For purposes of 
this section, "state-operated, community-based residential 
facility" means a residential program administered by the state 
to provide treatment and habilitation in noninstitutional 
community settings to persons with mental retardation or related 
conditions.  Employees of the facilities must be state employees 
under chapters 43A and 179A.  The establishment of 
state-operated, community-based residential facilities must be 
within the context of a comprehensive definition of the role of 
state-operated services in the state.  The role of 
state-operated services must be defined within the context of a 
comprehensive system of services for persons with mental 
retardation or related conditions.  Services may include, but 
are not limited to, community group homes, foster care, 
supportive living arrangements, and respite care arrangements.  
The commissioner may operate the pilot projects established 
under Laws 1985, First Special Session chapter 9, article 1, 
section 2, subdivision 6, and may, within the limits of 
available appropriations, establish additional state-operated, 
community-based services for regional treatment center residents 
with mental retardation or related conditions.  Day program 
services for clients living in state-operated, community-based 
residential facilities must not be provided by a regional 
treatment center or a state-operated, community-based program. 
    Subd. 2.  [AUTHORIZATION TO BUILD OR PURCHASE.] Within the 
limits of available appropriations, the commissioner may build, 
purchase or lease suitable buildings for state-operated, 
community-based residential facilities.  Facilities must be 
homelike and adaptable to the needs of persons with mental 
retardation or related conditions. 
    Subd. 3.  [ALTERNATIVE FUNDING MECHANISMS.] To the extent 
possible, the commissioner may amend the medical assistance home 
and community-based waiver and, as appropriate, develop special 
waiver procedures for targeting services to persons currently in 
state regional centers.  
    Subd. 4.  [COUNTIES.] State-operated, community-based 
residential facilities may be developed in conjunction with 
existing county responsibilities and authorities for persons 
with mental retardation.  Assessment, placement, screening, case 
management responsibilities, and determination of need 
procedures must be consistent with county responsibilities 
established under law and rule.  Counties may enter into shared 
service agreements with state-operated programs. 
    Sec. 110.  [252.52] [REGIONAL CENTER AND COMMUNITY-BASED 
FACILITY EMPLOYEES.] 
    In accordance with section 43A.21, the commissioner shall 
develop procedures to assure that: 
    (1) there are workers employed at state regional centers 
and nursing homes who are skilled in the treatment of persons 
with severe and profound mental retardation or related 
conditions, behavioral problems, and medical needs, to 
facilitate adjustment to community living; 
    (2) suitable training programs exist for regional treatment 
center and state-operated, community-based residential facility 
staff; and 
    (3) state employees under the jurisdiction of the 
commissioner who are included in a position reduction plan have 
the option of transferring to a community-based program; to a 
similar, comparable classification in another regional center 
setting; or to a position in another state agency. 
    Sec. 111.  Minnesota Statutes 1986, section 252.291, 
subdivision 1, is amended to read:  
    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 
persons with mental retardation or related conditions or for an 
increase in the licensed capacity of an existing facility except 
as provided in this subdivision and subdivision 2.  In no event 
shall The total number of certified intermediate care beds for 
persons with mental retardation or related conditions in 
community facilities and state hospitals shall not exceed 7,500 
beds as of July 1, 1983, and 7,000 beds as of July 1, 1986 
except that, to the extent that federal authorities disapprove 
any applications of the commissioner for home and 
community-based waivers under United States Code, title 42, 
section 1396n, as amended through December 31, 1987, the 
commissioner may authorize new intermediate care beds, as 
necessary, to serve persons with mental retardation or related 
conditions who would otherwise have been served under a proposed 
waiver.  "Certified bed" means an intermediate care bed for 
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 1987.  
    Sec. 112.  Minnesota Statutes 1986, section 252.291, 
subdivision 2, is amended to read:  
    Subd. 2.  [EXCEPTIONS.] The commissioner of human services 
in coordination with the commissioner of health may approve 
a new newly constructed or newly established publicly or 
privately operated community intermediate care facility for six 
or fewer persons with mental retardation or related conditions 
only in when the following circumstances exist:  
    (a) when the facility is developed in accordance with a 
request for proposal system established pursuant to subdivision 
3, clause (b) approved by the commissioner of human services; 
    (b) when the facility is necessary to serve the needs of 
identifiable identified persons with mental retardation or 
related conditions who are seriously behaviorally disordered or 
who are seriously physically or sensorily impaired.  At least 50 
percent of the capacity of the facility must be used for persons 
coming from regional treatment centers; or and 
    (c) to license beds in new facilities where need was 
determined by the commissioner prior to June 10, 1983 when the 
commissioner determines that the need for increased service 
capacity cannot be met by the use of alternative resources or 
the modification of existing facilities.  
    Sec. 113.  Minnesota Statutes 1987 Supplement, section 
252.291, subdivision 3, is amended to read:  
    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 1987, to assure that appropriate 
services are provided in the least restrictive setting;  
    (b) define services, including respite care, that may be 
needed in meeting individual service plan objectives; 
    (c) 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 persons with mental retardation or related 
conditions; 
    (d) 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 1987; and 
    (e) develop a state plan for the delivery and funding of 
residential day and support services to 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. 
    Sec. 114.  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.  Recommended increases in 
payment rates for vendors whose approved payment rates are ten 
or more than ten percent below the statewide median payment 
rates must be equal to the maximum increases allowed for that 
vendor under subdivision 3.  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. 115.  Minnesota Statutes 1987 Supplement, section 
252.46, subdivision 6, is amended to read:  
    Subd. 6.  [VARIANCES.] A variance from the minimum or 
maximum payment rates in subdivisions 2 and 3 may be granted by 
the commissioner when the vendor requests and the county board 
submits to the commissioner a written variance request with the 
recommended payment rates.  A variance may be utilized for costs 
associated with compliance with state administrative rules, 
compliance with court orders, increased insurance costs, 
start-up and conversion costs for supported employment, direct 
service staff salaries, and transportation.  The county board 
shall review all vendors' payment rates that are 20 ten or more 
than ten percent lower than the average rates for the regional 
development commission district to which the county 
belongs statewide median payment rates.  If the county 
determines that the payment rates do not provide sufficient 
revenue to the vendor for authorized service delivery the county 
must recommend a variance under this section.  This review must 
occur prior to November 1, 1987.  When the county board 
contracts for increased services from any vendor for some or all 
individuals receiving services from the vendor, the county board 
shall review the vendor's payment rates to determine whether the 
increase requires that a variance to the minimum rates be 
recommended under this section to reflect the vendor's lower per 
unit fixed costs.  The written variance request must include 
documentation that all the following criteria have been met: 
    (1) The commissioner and the county board have both 
conducted a review and have identified a need for a change in 
the payment rates to change the number of direct service staff 
or the level of qualifications of the staff. 
    (2) The proposed changes are required for the vendor to 
deliver authorized individual services in an effective and 
efficient manner. 
    (3) The proposed changes are necessary to demonstrate 
compliance with minimum licensing standards governing minimum 
staffing ratios and staff qualifications. 
    (4) The vendor documents that the change in staff numbers 
or qualifications changes cannot be achieved by reallocating 
current staff or by reallocating financial resources to provide 
or purchase the necessary services. 
    (5) The county board submits evidence that the need for 
additional staff cannot be met by using temporary special needs 
rate exceptions under Minnesota Rules, parts 9510.1020 to 
9510.1140. 
    (6) The county board submits a description of the nature 
and cost of the proposed changes, and how the county will 
monitor the use of money by the vendor to make necessary changes 
in services.  Allowable costs are limited to salaries, related 
fringe benefits, and payroll taxes. 
    (7) The county board's recommended payment rates do not 
exceed 125 percent of the average current calendar year's 
statewide median payment rates in the regional development 
commission district in which the vendor is located. 
    Sec. 116.  Minnesota Statutes 1987 Supplement, section 
252.46, is amended by adding a subdivision to read: 
    Subd. 13.  [REVIEW AND REVISION OF PROCEDURES FOR RATE 
EXCEPTIONS FOR VERY DEPENDENT PERSONS WITH SPECIAL NEEDS.] The 
commissioner shall review the procedures established in 
Minnesota Rules, parts 9510.1020 to 9510.1140, that counties 
must follow to seek authorization for a medical assistance rate 
exception for services for very dependent persons with special 
needs.  The commissioner shall appoint an advisory task force to 
work with the commissioner.  Members of the task force must 
include vendors, providers, advocates, and consumers.  After 
considering the recommendations of the advisory task force and 
county rate setting procedures developed under this section, the 
commissioner shall: 
    (1) revise administrative procedures as necessary; 
    (2) implement new review procedures for county applications 
for medical assistance rate exceptions for services for very 
dependent persons with special needs in a manner that accounts 
for services available to the person within the approved payment 
rates of the vendor; 
    (3) provide training and technical assistance to vendors, 
providers, and counties in use of procedures governing medical 
assistance rate exceptions for very dependent persons with 
special needs and in county rate setting procedures established 
under this subdivision; and 
    (4) develop a strategy and implementation plan for uniform 
data collection for use in establishing equitable payment rates 
and medical assistance rate exceptions for services provided by 
vendors. 
    Sec. 117.  Minnesota Statutes 1987 Supplement, section 
252.46, is amended by adding a subdivision to read:  
    Subd. 14.  [PILOT STUDY.] The commissioner may initiate a 
pilot payment rate system under section 252.47.  The pilot 
project may establish training and demonstration sites.  The 
pilot payment rate system must include actual transfers of 
funds, not simulated transfers.  The pilot payment rate system 
may involve up to four counties and four vendors representing 
different geographic regions and rates of reimbursement.  
Participation in the pilot project is voluntary.  Selection of 
participants by the commissioner is based on the vendor's 
submission of a complete application form provided by the 
commissioner.  The application must include letters of agreement 
from the host county, counties of financial responsibility, and 
residential service providers.  Evaluation of the pilot project 
must include consideration of the effectiveness of procedures 
governing establishment of equitable payment rates.  
Implementation of the pilot payment rate system is contingent 
upon federal approval and systems feasibility.  The policies and 
procedures governing administration, participation, evaluation, 
service utilization, and payment for services under the pilot 
payment rate system are not subject to the rulemaking 
requirements of chapter 14.  
    Sec. 118.  Minnesota Statutes 1987 Supplement, section 
253B.03, subdivision 6, is amended to read:  
    Subd. 6.  [CONSENT FOR MEDICAL PROCEDURE.] A patient has 
the right to prior consent to any medical or surgical treatment, 
other than the treatment of mental illness or chemical 
dependency.  A patient with mental retardation or the patient's 
guardian or conservator has the right to give or withhold 
consent before:  
    (1) the implementation of any aversive or deprivation 
procedure except for emergency procedures permitted in rules of 
the commissioner adopted under section 245.825; or 
    (2) the administration of psychotropic medication.  
    The following procedures shall be used to obtain consent 
for any treatment necessary to preserve the life or health of 
any committed patient:  
    (a) The written, informed consent of a competent adult 
patient for the treatment is sufficient.  
    (b) If the patient is subject to guardianship or 
conservatorship which includes the provision of medical care, 
the written, informed consent of the guardian or conservator for 
the treatment is sufficient.  
    (c) If the head of the treatment facility determines that 
the patient is not competent to consent to the treatment and the 
patient has not been adjudicated incompetent, written, informed 
consent for the surgery or medical treatment shall be obtained 
from the nearest proper relative.  For this purpose, the 
following persons are proper relatives, in the order listed:  
the patient's spouse, parent, adult child, or adult sibling.  If 
the nearest proper relatives cannot be located or refuse to 
consent to the procedure, the head of the treatment facility or 
an interested person may petition the committing court for 
approval for the treatment or may petition an appropriate a 
court of competent jurisdiction for the appointment of a 
guardian or conservator.  The determination that the patient is 
not competent, and the reasons for the determination, shall be 
documented in the patient's clinical record.  
    (d) Consent to treatment of any minor patient shall be 
secured in accordance with sections 144.341 to 144.346, except 
that a minor 16 years of age or older may give valid consent for 
hospitalization, routine diagnostic evaluation, and emergency or 
short-term acute care.  
    (e) In the case of an emergency and when the persons 
ordinarily qualified to give consent cannot be located, the head 
of the treatment facility may give consent.  
    No person who consents to treatment pursuant to the 
provisions of this subdivision shall be civilly or criminally 
liable for the performance or the manner of performing the 
treatment.  No person shall be liable for performing treatment 
without consent if written, informed consent was given pursuant 
to this subdivision.  This provision shall not affect any other 
liability which may result from the manner in which the 
treatment is performed.  
    Sec. 119.  Minnesota Statutes 1986, section 253B.03, is 
amended by adding a subdivision to read: 
    Subd. 6a.  [ADMINISTRATION OF NEUROLEPTIC MEDICATIONS.] (a) 
Neuroleptic medications may be administered to persons committed 
as mentally ill or mentally ill and dangerous only as described 
in this subdivision. 
    (b) A neuroleptic medication may be administered to a 
patient who is competent to consent to neuroleptic medications 
only if the patient has given written, informed consent to 
administration of the neuroleptic medication. 
    (c) A neuroleptic medication may be administered to a 
patient who is not competent to consent to neuroleptic 
medications only if a court approves the administration of the 
neuroleptic medication or: 
    (1) the patient does not object to or refuse the medication;
    (2) a guardian ad litem appointed by the court with 
authority to consent to neuroleptic medications gives written, 
informed consent to the administration of the neuroleptic 
medication; and 
    (3) a multidisciplinary treatment review panel composed of 
persons who are not engaged in providing direct care to the 
patient gives written approval to administration of the 
neuroleptic medication. 
    (d) A person who consents to treatment pursuant to this 
subdivision is not civilly or criminally liable for the 
performance of or the manner of performing the treatment.  A 
person is not liable for performing treatment without consent if 
written, informed consent was given pursuant to this 
subdivision.  This provision does not affect any other liability 
that may result from the manner in which the treatment is 
performed. 
    Sec. 120.  Minnesota Statutes 1986, section 253B.17, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PETITION.] Any patient, except one 
committed as mentally ill and dangerous to the public, or any 
interested person may petition the committing court or the court 
to which venue has been transferred for an order that the 
patient is not in need of continued institutionalization or for 
an order that an individual is no longer mentally ill, mentally 
retarded, or chemically dependent, or for any other relief as 
the court deems just and equitable.  A patient committed as 
mentally ill or mentally ill and dangerous may petition the 
committing court or the court to which venue has been 
transferred for a hearing concerning the administration of 
neuroleptic medication.  A hearing may also be held pursuant to 
sections 253B.09 and 253B.12. 
    Sec. 121.  Minnesota Statutes 1987 Supplement, section 
256.01, subdivision 4, is amended to read:  
    Subd. 4.  [DUTIES AS STATE AGENCY.] The state agency shall: 
    (1) supervise the administration of assistance to dependent 
children under Laws 1937, chapter 438, by the county agencies in 
an integrated program with other service for dependent children 
maintained under the direction of the state agency; 
    (2) may subpoena witnesses and administer oaths, make 
rules, and take such action as may be necessary, or desirable 
for carrying out the provisions of Laws 1937, chapter 438.  All 
rules made by the state agency shall be binding on the counties 
and shall be complied with by the respective county agencies; 
    (3) establish adequate standards for personnel employed by 
the counties and the state agency in the administration of Laws 
1937, chapter 438, and make the necessary rules to maintain such 
standards; 
    (4) prescribe the form of and print and supply to the 
county agencies blanks for applications, reports, affidavits, 
and such other forms as it may deem necessary and advisable; 
    (5) cooperate with the federal government and its public 
welfare agencies in any reasonable manner as may be necessary to 
qualify for federal aid for aid to dependent children and in 
conformity with the provisions of Laws 1937, chapter 438, 
including the making of such reports and such forms and 
containing such information as the Federal Social Security Board 
may from time to time require, and comply with such provisions 
as such board may from time to time find necessary to assure the 
correctness and verification of such reports; and 
    (6) may cooperate with other state agencies in establishing 
reciprocal agreements in instances where a child receiving aid 
to dependent children moves or contemplates moving into or out 
of the state, in order that such child may continue to receive 
supervised aid from the state moved from until the child shall 
have resided for one year in the state moved to; and 
    (7) on or before October 1 in each even-numbered year make 
a biennial report to the governor concerning the activities of 
the agency; and 
    (8) design, develop, and administer an intake, referral, 
and inventory system that provides localized, single-point 
intake with a direct access to a statewide data base to match 
client needs with employment opportunities and public and 
private services.  The system must include information on all 
available public and private programs for employment and 
training services and income maintenance and support services as 
defined in section 268.0111.  The state agency shall cooperate 
with the department of jobs and training, counties and other 
local service units, service providers, and clients in the 
development and operation of the system.  The system is not 
subject to sections 16B.40 to 16B.45; 
    (9) enter into agreements with other departments of the 
state as necessary to meet all requirements of the federal 
government. 
    Sec. 122.  Minnesota Statutes 1987 Supplement, section 
256.015, subdivision 2, is amended to read:  
    Subd. 2.  [PERFECTION; ENFORCEMENT.] The state agency may 
perfect and enforce its lien under sections 514.69, 514.70, and 
514.71, and must file the verified lien statement with the 
appropriate court administrator in the county of financial 
responsibility.  The verified lien statement must contain the 
following:  the name and address of the person to whom medical 
care, subsistence, or other payment was furnished; the date of 
injury; the name and address of vendors furnishing medical care; 
the dates of the service or payment; the amount claimed to be 
due for the care or payment; and to the best of the state 
agency's knowledge, the names and addresses of all persons, 
firms, or corporations claimed to be liable for damages arising 
from the injuries.  
    This section does not affect the priority of any attorney's 
lien.  The state agency is not subject to any limitations period 
referred to in section 514.69 or 514.71 and has one year from 
the date notice is received by it under subdivision 4, paragraph 
(c), or one year from the date medical bills are first paid by 
the state agency, whichever is later, to file its verified lien 
statement.  The state agency may commence an action to enforce 
the lien within one year of (1) the date the notice required by 
subdivision 4, paragraph (c), is received, or (2) the date the 
person's cause of action is concluded by judgment, award, 
settlement, or otherwise, whichever is later. 
    Sec. 123.  [256.016] [PLAIN LANGUAGE IN WRITTEN MATERIALS.] 
    (a) To the extent reasonable and consistent with the goals 
of providing easily understandable and readable materials and 
complying with federal and state laws governing the programs, 
all written materials relating to services and determinations of 
eligibility for or amounts of benefits that will be given to 
applicants for or recipients of assistance under a program 
administered or supervised by the commissioner of human services 
must be understandable to a person who reads at the 
seventh-grade level, using the Flesch scale analysis readability 
score as determined under section 72C.09. 
    (b) All written materials relating to determinations of 
eligibility for or amounts of benefits that will be given to 
applicants for or recipients of assistance under programs 
administered or supervised by the commissioner of human services 
must be developed to satisfy the plain language requirements of 
the plain language contract act under sections 325G.29 to 
325G.36.  Materials may be submitted to the attorney general for 
review and certification.  Notwithstanding section 325G.35, 
subdivision 1, the attorney general shall review submitted 
materials to determine whether they comply with the requirements 
of section 325G.31.  The remedies available pursuant to sections 
8.31 and 325G.33 to 325G.36 do not apply to these materials.  
Failure to comply with this section does not provide a basis for 
suspending the implementation or operation of other laws 
governing programs administered by the commissioner. 
    (c) The requirements of this section apply to all materials 
modified or developed by the commissioner on or after July 1, 
1988.  The requirements of this section do not apply to 
materials that must be submitted to a federal agency for 
approval, to the extent that application of the requirements 
prevents federal approval. 
    (d) Nothing in this section may be construed to prohibit a 
lawsuit brought to require the commissioner to comply with this 
section or to affect individual appeal rights granted pursuant 
to section 256.045. 
    (e) The commissioner shall report annually to the chairs of 
the health and human services divisions of the senate finance 
committee and the house of representatives appropriations 
committee on the number and outcome of cases that raise the 
issue of the commissioner's compliance with this section. 
    Sec. 124.  Minnesota Statutes 1986, section 256.73, 
subdivision 2, is amended to read:  
    Subd. 2.  [ALLOWANCE BARRED BY OWNERSHIP OF PROPERTY.] 
Ownership by an assistance unit of property as follows is a bar 
to any allowance under sections 256.72 to 256.87: 
    (1) The value of real property other than the homestead, 
which when combined with other assets exceeds the limits of 
paragraph (2), unless the assistance unit is making a good faith 
effort to sell the nonexcludable real property.  The time period 
for disposal must not exceed nine months and the assistance unit 
shall execute an agreement to dispose of the property to repay 
assistance received during the nine months up to the amount of 
the net sale proceeds.  The payment must be made when the 
property is sold.  If the property is not sold within the 
required time or the assistance unit becomes ineligible for any 
reason the entire amount received during the nine months is an 
overpayment and subject to recovery.  For the purposes of this 
section "homestead" means the house home owned and occupied by 
the child, relative or other member of the assistance unit as a 
dwelling place, together with the land upon which it is situated 
in an area no greater than two contiguous lots in a platted or 
laid out city or town or all contiguous acres in rural 
areas surrounding property which is not separated from the home 
by intervening property owned by others.  Public rights-of-way, 
such as roads which run through the surrounding property and 
separate it from the home, will not affect the exemption of the 
property; or 
    (2) Personal property of an equity value in excess of 
$1,000 for the entire assistance unit, exclusive of personal 
property used as the home, one motor vehicle of an equity value 
not exceeding $1,500 or the entire equity value of a motor 
vehicle determined to be necessary for the operation of a 
self-employment business, one burial plot for each member of the 
assistance unit, one prepaid burial contract with an equity 
value of no more than $1,000 for each member of the assistance 
unit, clothing and necessary household furniture and equipment 
and other basic maintenance items essential for daily living, in 
accordance with rules promulgated by and standards established 
by the commissioner of human services. 
    Sec. 125.  Minnesota Statutes 1986, section 256.73, 
subdivision 6, is amended to read:  
    Subd. 6.  [REPORTS BY RECIPIENT.] (a) An assistance unit 
with a recent work history or with earned income shall report 
monthly to the local agency on income received and other 
circumstances affecting eligibility or assistance amounts.  All 
other assistance units shall report on income and other 
circumstances affecting eligibility and assistance amounts at 
less frequent intervals, as specified by the state agency.  All 
income not specifically disregarded by the Social Security Act, 
the Code of Federal Regulations, or state law and rules, shall 
be income applicable to the budgetary needs of the family.  If 
any amount of aid to families with dependent children assistance 
is paid to a recipient thereof in excess of the payment due it 
shall be recoverable by the local agency.  The agency shall give 
written notice to the recipient of its intention to recover the 
overpayment.  Overpayments to a current assistance unit shall be 
recovered either through repayment by the individual in part or 
in full or by reducing the amount of aid payable to the 
assistance unit of which the individual is a member.  For any 
month in which an overpayment must be recovered, recoupment may 
be made by reducing the grant but only if the reduced assistance 
payment, together with the assistance unit's liquid assets and 
total income after deducting actual work expenses equals at 
least 95 percent of the standard of need for the assistance 
unit, except that if the overpayment is due solely to agency 
error, this total after deducting actual work expenses shall 
equal at least 99 percent of the standard of need.  In cases 
when there is both an overpayment and underpayment the local 
agency shall offset one against the other in correcting the 
payment.  The local agency shall make reasonable efforts to 
recover overpayments made to persons no longer on assistance in 
accordance with standards established by the commissioner of 
human services.  The local agency need not attempt to recover 
overpayments of less than $35 paid to an individual no longer on 
assistance if the individual does not receive assistance again 
within three years, unless the individual has been convicted of 
fraud under section 256.98.  The recipient may appeal the 
agency's determination that an overpayment has occurred in 
accordance with section 256.045.  The county agency shall 
promptly repay the recipient for any underpayment and shall 
disregard that payment when determining the assistance unit's 
income and resources in the month when the payment is made and 
the following month.  
    (b) An assistance unit required to submit a report on the 
form designated by the commissioner is considered to have 
continued its application for assistance effective the date the 
required report is received by the local agency, if a complete 
report is received within a calendar month after the month in 
which assistance was received, except that no assistance shall 
be paid for the period beginning with the end of the month in 
which the report was due and ending with the date the report was 
received by the local agency. 
    Sec. 126.  Minnesota Statutes 1986, section 256.73, is 
amended by adding a subdivision to read: 
    Subd. 8.  [RECOVERY OF OVERPAYMENTS.] (a) If an amount of 
aid to families with dependent children assistance is paid to a 
recipient in excess of the payment due, it shall be recoverable 
by the local agency.  The agency shall give written notice to 
the recipient of its intention to recover the overpayment. 
     (b) When an overpayment occurs, the local agency shall 
recover the overpayment from a current recipient by reducing the 
amount of aid payable to the assistance unit of which the 
recipient is a member for one or more monthly assistance 
payments until the overpayment is repaid.  For any month in 
which an overpayment must be recovered, recoupment may be made 
by reducing the grant but only if the reduced assistance 
payment, together with the assistance unit's total income after 
deducting work expenses as allowed under section 256.74, 
subdivision 1, clauses (3) and (4), equals at least 95 percent 
of the standard of need for the assistance unit, except that if 
the overpayment is due solely to agency error, this total after 
deducting allowable work expenses must equal at least 99 percent 
of the standard of need.  Notwithstanding the preceding 
sentence, beginning on the date on which the commissioner 
implements a computerized client eligibility and information 
system in one or more counties, all local agencies in the state 
shall reduce the assistance payment by three percent of the 
assistance unit's standard of need or the amount of the monthly 
payment, whichever is less, for all overpayments whether or not 
the overpayment is due solely to agency error.  In cases when 
there is both an overpayment and underpayment, the local agency 
shall offset one against the other in correcting the payment. 
     (c) Overpayments may also be voluntarily repaid, in part or 
in full, by the individual, in addition to the above aid 
reductions, until the total amount of the overpayment is repaid. 
    (d) The local agency shall make reasonable efforts to 
recover overpayments to persons no longer on assistance in 
accordance with standards adopted in rule by the commissioner of 
human services.  The local agency need not attempt to recover 
overpayments of less than $35 paid to an individual no longer on 
assistance if the individual does not receive assistance again 
within three years, unless the individual has been convicted of 
fraud under section 256.98. 
    Sec. 127.  Minnesota Statutes 1986, section 256.73, is 
amended by adding a subdivision to read: 
    Subd. 9.  [APPEAL OF OVERPAYMENT DETERMINATIONS.] The 
recipient may appeal the agency's determination that an 
overpayment has occurred in accordance with section 256.045. 
    Sec. 128.  Minnesota Statutes 1986, section 256.73, is 
amended by adding a subdivision to read: 
    Subd. 10.  [UNDERPAYMENTS.] The local agency shall promptly 
repay the recipient for any underpayment.  The local agency 
shall disregard that payment when determining the assistance 
unit's income and resources in the month when the payment is 
made and the following month. 
    Sec. 129.  Minnesota Statutes 1986, section 256.73, is 
amended by adding a subdivision to read: 
    Subd. 11.  [COMPLIANCE WITH FEDERAL LAW AND REGULATION.] 
None of the provisions in this section shall be implemented to 
the extent that they violate federal law or regulation. 
     Sec. 130.  Minnesota Statutes 1987 Supplement, section 
256.736, subdivision 1b, is amended to read:  
    Subd. 1b.  [WORK INCENTIVE SUBSIDIZED HOUSING PROGRAM.] 
Within the limit of available appropriations, employed 
recipients of aid to families with dependent children who meet 
eligibility requirements established by the commissioner of 
human services are eligible for a state housing subsidy as an 
incentive to seek and retain employment.  The commissioner of 
human services shall adopt rules for the work incentive 
subsidized housing program using eligibility criteria, subsidy 
amounts, and an administrative system developed jointly by the 
commissioner of human services and the commissioner of jobs and 
training.  Unless superseded by permanent rules, emergency rules 
adopted to implement this section remain in effect until July 1, 
1989.  The rules must: 
    (1) target recipients who are or are likely to become 
long-term recipients or who experience substantial barriers to 
employment; 
    (2) establish a fixed or sliding scale subsidy amount that 
will create a significant work incentive yet enable the program 
to serve the greatest possible number of recipients; 
    (3) limit the subsidy to persons who become employed while 
receiving assistance; and 
    (4) provide for continued subsidy payments for up to one 
year after termination of assistance to ease the transition from 
assistance to self-sufficiency.  
    The program must be coordinated with existing work and 
training programs and must be designed to maximize savings in 
the aid to families with dependent children program.  The 
subsidy must be provided as in-kind assistance, and it is not 
available if it would be considered countable income under state 
and federal requirements. 
    Sec. 131.  Minnesota Statutes 1986, section 256.736, is 
amended by adding a subdivision to read:  
    Subd. 3b.  [MANDATORY SCHOOL ATTENDANCE FOR MINOR PARENTS.] 
(a)  [DEFINITIONS.] The definitions in this paragraph apply to 
this subdivision. 
    (1) "Minor parent" means a recipient of AFDC who is under 
age 18, and who is the natural or adoptive parent of a child 
living with the minor parent. 
    (2) "School" means: 
    (i) an educational program which leads to a high school 
diploma.  The program or coursework may be, but is not limited 
to, a program under the post-secondary enrollment options of 
section 123.3514, a regular or alternative program of an 
elementary or secondary school, a technical institute, or a 
college; 
    (ii) coursework for a general educational development (GED) 
diploma of not less than six hours of classroom instruction per 
week; or 
    (iii) any other post-secondary educational program that is 
approved by the public school or the local agency under 
subdivision 11. 
    (b)  [SCHOOL ATTENDANCE REQUIRED.] Notwithstanding section 
256.736, subdivision 3, a minor parent must attend school if all 
of the following apply: 
    (1) the minor parent has no child living with the parent 
who is younger than six weeks of age; 
    (2) transportation services needed to enable the minor 
parent to attend school are available; 
    (3) licensed or legal nonlicensed child care services 
needed to enable the minor parent to attend school are available;
    (4) the minor parent has not already graduated from high 
school and has not received a general educational development 
(GED) diploma; and 
    (5) the minor parent does not have good cause for failing 
to attend school, as provided in paragraph (d). 
    (c)  [ENROLLMENT AND ATTENDANCE.] The minor parent must be 
enrolled in school and meeting the school's attendance 
requirements.  The minor parent is considered to be attending 
when the minor parent is enrolled but the school is not in 
regular session, including during holiday and summer breaks. 
    (d)  [GOOD CAUSE FOR NOT ATTENDING SCHOOL.] The local 
agency shall determine whether good cause for not attending or 
not enrolling in school exists, according to this paragraph: 
    (1) Good cause exists when the minor parent is ill or 
injured seriously enough to prevent the minor parent from 
attending school. 
    (2) Good cause exists when the minor parent's child is ill 
or injured and the minor parent's presence in the home is 
required to care for the child. 
    (3) Good cause exists when the local agency has verified 
that the only available school program requires round trip 
commuting time from the minor parent's residence of more than 
two hours by available means of transportation, excluding the 
time necessary to transport children to and from child care. 
    (4) Good cause exists when there is an interruption in 
availability of child care services. 
    (5) Good cause exists when the minor parent has indicated a 
desire to attend school, but the public school system is not 
providing for the minor parent's education and alternative 
programs are not available. 
    (6) Good cause exists when the school does not cooperate 
with the local agency in providing verification of the minor 
parent's education or attendance. 
    (7) Good cause exists when the minor parent or the minor 
parent's child has a medical appointment or an appointment with 
the local welfare agency, is required to appear in court during 
the minor parent's normal school hours, or has any other 
obligation consistent with the case management contract. 
    (8) For the minor parent of a child between six and twelve 
weeks of age, good cause exists when child care is not available 
on the premises of the school, or a medical doctor certifies 
that it would be better for the health of either the parent or 
the child for the parent to remain at home with the child for a 
longer period of time. 
    (e)  [FAILURE TO COMPLY.] If the school notifies the local 
agency that the minor parent is not enrolled or is not meeting 
the school's attendance requirements, and the local agency 
determines that the minor parent does not have good cause, the 
local agency shall apply the sanctions listed in subdivision 4 
beginning with the first payment month after issuance of notice. 
    (f)  [NOTICE AND HEARING.] A right to notice and fair 
hearing shall be provided in accordance with section 256.045 and 
the Code of Federal Regulations, title 45, section 205.10. 
    (g)  [SOCIAL SERVICES.] When a minor parent has failed to 
attend school and does not have good cause, the local agency 
shall refer the minor parent to social services for services, as 
provided in section 257.33. 
    (h)  [VERIFICATION.] No less often than quarterly, the 
local agency must verify that the minor parent is meeting the 
requirements of this subdivision.  Notwithstanding section 
13.32, subdivision 3, when the local agency notifies the school 
that a minor parent is subject to this subdivision, the school 
must furnish verification of school enrollment and attendance to 
the local agency. 
    Sec. 132.  Minnesota Statutes 1986, section 256.736, is 
amended by adding a subdivision to read: 
    Subd. 3c.  [MINOR PARENTS NOT LIVING WITH RELATIVES.] (a) 
This subdivision applies to a minor parent who is not living 
with a parent or other adult relative and who is not living in a 
group or foster home licensed by the commissioner.  
    (b) For purposes of this subdivision, the following terms 
have the meanings given them: 
    (1) "Minor parent" means an applicant for or recipient of 
AFDC who is under age 18, and who is the natural or adoptive 
parent of a child living with the minor parent. 
    (2) "Other adult relative" means a person who qualifies to 
be an eligible relative caretaker for AFDC, as specified in 
federal regulations. 
    (c) The agency shall determine, for each minor parent who 
applies for or receives AFDC, whether this section applies.  For 
a minor parent to whom this section applies, the local agency 
shall refer the minor parent to its social services unit within 
30 days of the date the application for assistance is approved 
for development of a social service plan as required in section 
257.33.  The agency shall notify the minor parent of the 
referral to social services and that cooperation in developing 
and participating in a social service plan is required in order 
for AFDC eligibility to continue.  
    (d) In addition to meeting the requirements of section 
257.33, the social service plan may, based upon the social 
service unit's evaluation of the minor caretaker's needs and 
parenting abilities, and the health, safety, and parenting needs 
of the minor caretaker's child, require the minor caretaker to 
live in a group or foster home or participate in available 
programs which teach skills in parenting or independent living. 
    (e) If the minor parent fails to cooperate in developing or 
participating in the social service plan, the social services 
unit shall notify the income maintenance unit of the local 
agency, which shall then notify the minor parent of the 
determination and of the sanctions in subdivision 4 that will be 
applied. 
    Sec. 133.  Minnesota Statutes 1987 Supplement, section 
256.736, subdivision 4, is amended to read: 
    Subd. 4.  [CONDITIONS OF CERTIFICATION.] The commissioner 
of human services shall: 
    (1) Arrange for or provide any caretaker or child required 
to participate in employment and training services pursuant to 
this section with child-care services, transportation, and other 
necessary family services; 
    (2) Pay 10 percent of the cost of the work incentive 
program and any other costs that are required of that agency by 
federal regulation for employment and training services for 
recipients of aid to families with dependent children; 
    (3) Provide that in determining a recipient's needs any 
monthly incentive training payment made to the recipient by the 
department of jobs and training is disregarded and the 
additional expenses attributable to participation in a program 
are taken into account in grant determination to the extent 
permitted by federal regulation; and 
    (4) Provide that when it has been certified by the county 
board that a caretaker or child required to participate in an 
employment and training program has been found by the employment 
and training service provider to have refused without good cause 
to participate in appropriate employment and training services 
or to have refused without good cause to accept a bona fide 
offer of public or other employment, the county board shall 
provide that the county board shall impose the sanctions in 
clause (5) or (6) when the county board: 
    (a) is notified that a caretaker or child required to 
participate in employment and training services has been found 
by the employment and training service provider to have failed 
without good cause to participate in appropriate employment and 
training services or to have failed without good cause to accept 
a bona fide offer of public or other employment; 
    (b) determines that a minor parent who is required to 
attend school under subdivision 3b has, without good cause, 
failed to attend school; 
    (c) determines that subdivision 3c applies to a minor 
parent and the minor parent has, without good cause, failed to 
cooperate with development of a social service plan or to 
participate in execution of the plan, to live in a group or 
foster home, or to participate in a program that teaches skills 
in parenting and independent living; or 
    (d) determines that a caretaker has, without good cause, 
failed to attend orientation. 
    (5) To the extent permissible by federal law, the following 
sanctions must be imposed for a recipient's failure to 
participate in required employment and training services, 
education, orientation, or the requirements of subdivision 3c: 
    (a) For the first failure, 50 percent of the grant provided 
to the family for the month following the failure shall be made 
in the form of protective or vendor payments; 
    (b) For the second and subsequent failures, the entire 
grant provided to the family must be made in the form of 
protective or vendor payments.  Assistance provided to the 
family must be in the form of protective or vendor payments 
until the recipient complies with the requirement; and 
    (c) When protective payments are required, the local agency 
may continue payments to the caretaker if a protective payee 
cannot reasonably be found. 
    (6) When the sanctions provided by clause (5) are not 
permissible under federal law, the following sanctions shall be 
imposed for a recipient's failure to participate in required 
employment and training services, education, orientation, or the 
requirements of subdivision 3c: 
    (a) If the caretaker makes the refusal fails to 
participate, the caretaker's needs shall not be taken into 
account in making the grant determination, and aid for any 
dependent child in the family will be made in the form of 
protective or vendor payments, except that when protective 
payments are made, the local agency may continue payments to the 
caretaker if a protective payee cannot reasonably be found.  The 
standard of assistance for the remaining eligible members of the 
assistance unit is the standard that is used in other instances 
in which the caretaker is excluded from the assistance unit for 
noncompliance with a program requirement. 
    (b) Aid with respect to a dependent child will be denied if 
a child who makes the refusal fails to participate is the only 
child receiving aid in the family. 
    (c) If there is more than one child receiving aid in the 
family, aid for the child who makes the refusal fails to 
participate will be denied and the child's needs will not be 
taken into account in making the grant determination. 
    (d) If the assistance unit's eligibility is based on the 
nonexempt principal earner's unemployment and this principal 
earner fails or refuses without good cause to participate or to 
accept employment, the entire assistance unit is ineligible for 
benefits under sections 256.72 to 256.87. 
    Sec. 134.  Minnesota Statutes 1987 Supplement, section 
256.736, subdivision 11, is amended to read: 
    Subd. 11.  [CASE MANAGEMENT SERVICES.] (a) For clients 
described in subdivision 2a, the case manager shall: 
    (1) Assess the education, skills, and ability of the 
caretaker to secure and retain a job which, when added to child 
support, will support the caretaker's family.  The case manager 
must work with the caretaker in completing this task;  
    (2) Set goals and develop a timetable for completing 
education and employment goals.  The case manager must work with 
the caretaker in completing this task.  For caretakers who are 
not literate or who have not completed high school, the first 
goal for the caretaker must be to complete literacy training or 
a general education diploma.  Caretakers who are literate and 
have completed high school shall be counseled to set realistic 
attainable goals, taking into account the long-term needs of 
both the caretaker and the caretaker's family;  
    (3) Coordinate services such as child care, transportation, 
and education assistance necessary to enable the caretaker to 
work toward the goals developed in clause (2).  When a client 
needs child care services in order to attend a Minnesota public 
or nonprofit college, university or technical institute, the 
case manager shall contact the appropriate agency to reserve 
child care funds for the client.  A caretaker who needs child 
care services in order to complete high school or a general 
education diploma is eligible for child care under section 
268.91;  
    (4) Develop, execute, and monitor a contract between the 
local agency and the caretaker.  The contract must include:  (a) 
specific goals of the caretaker including stated measurements of 
progress toward each goal; (b) specific services provided by the 
county agency; and (c) conditions under which the county will 
withdraw the services provided; 
    The contract may include other terms as desired or needed 
by either party.  In all cases, however, the case manager must 
ensure that the caretaker has set forth in the contract 
realistic goals consistent with the ultimate goal of 
self-sufficiency for the caretaker's family; and 
    (5) Develop and refer caretakers to counseling or peer 
group networks for emotional support while participating in 
work, education, or training. 
    (b) In addition to the duties in paragraph (a), for minor 
parents and pregnant minors, the case manager shall: 
    (1) Ensure that the contract developed under paragraph 
(a)(4) considers all factors set forth in section 257.33, 
subdivision 2; and 
    (2) Assess the housing and support systems needed by the 
caretaker in order to provide the dependent children with 
adequate parenting.  The case manager shall encourage minor 
parents and pregnant minors who are not living with friends or 
relatives to live in a group home or foster care setting.  If 
minor parents and pregnant minors are unwilling to live in a 
group home or foster care setting or if no group home or foster 
care setting is available, the case manager shall assess the 
minor parent's their need for training in parenting and 
independent living skills and when appropriate shall refer 
appropriate minor parents them to available counseling programs 
designed to teach needed skills; and 
    (3) Inform minor parents or pregnant minors of, and assist 
them in evaluating the appropriateness of, the high school 
graduation incentives program under section 126.22, including 
post-secondary enrollment options, and the employment related 
and community based instruction programs.  
    (c) A caretaker may request a conciliation conference to 
attempt to resolve disputes regarding the contents of a contract 
developed under this section or a housing and support systems 
assessment conducted under this section.  The caretaker may 
request a hearing pursuant to section 256.045 to dispute the 
contents of a contract or assessment developed under this 
section.  The caretaker need not request a conciliation 
conference in order to request a hearing pursuant to section 
256.045. 
    Sec. 135.  Minnesota Statutes 1986, section 256.76, 
subdivision 1, is amended to read:  
    Subdivision 1.  Upon the completion of such the 
investigation the county agency shall decide whether the child 
is eligible for assistance under the provisions of sections 
256.72 to 256.87, and determine the amount of such the 
assistance, and the date on which such the assistance shall 
begin begins.  A decision on an application for assistance must 
be made as promptly as possible and no more than 30 days from 
the date of application.  Notwithstanding section 393.07, the 
county agency shall not delay approval or issuance of assistance 
pending formal action of the county board of commissioners.  The 
first month's grant shall be based upon that portion of the 
month from the date of application, or from the date that the 
applicant meets all eligibility factors, whichever occurs later, 
provided that on the date that assistance is first requested, 
the local agency shall inquire and determine whether the person 
requesting assistance is in immediate need of food, shelter, 
clothing, or other emergency assistance.  If an emergency need 
is found to exist, the applicant shall be granted assistance 
pursuant to section 256.871 within a reasonable period of time.  
It shall make a grant of assistance which shall be binding upon 
the county and be complied with by the county until such the 
grant is modified or vacated.  If the applicant is subsequently 
found to have been eligible for assistance under sections 256.72 
to 256.87, assistance rendered under section 256.871 must be 
considered as a regular AFDC payment and not a payment under 
section 256.871.  The county agency shall notify the applicant 
of its decision in writing.  Such The assistance shall be paid 
monthly to the applicant or to the vendor of medical care upon 
order of the county agency from funds appropriated to the county 
agency for this purpose.  The county agency shall, upon the 
granting of assistance under these sections, file an order on 
the form to be approved by the state agency with the auditor of 
the county and thereafter.  After the order is filed, warrants 
shall be drawn and payments made only in accordance with this 
order to or for recipients of this assistance or in accordance 
with any subsequent order. 
    Sec. 136.  [256.925] [OPTIONAL VOTER REGISTRATION FOR 
PUBLIC ASSISTANCE APPLICANTS AND RECIPIENTS.] 
    A county agency shall provide voter registration cards to 
every individual eligible to vote who applies for a public 
assistance program at the time application is made.  The agency 
shall also make voter registration cards available to a public 
assistance recipient upon the recipient's request or at the time 
of the recipient's eligibility redetermination.  The county 
agency shall assist applicants and recipients in completing the 
voter registration cards, as needed.  Applicants must be 
informed that completion of the cards is optional.  Completed 
forms shall be collected by agency employees and submitted to 
proper election officials. 
    Sec. 137.  Minnesota Statutes 1987 Supplement, section 
256.936, is amended to read:  
    256.936 [CHILDREN'S HEALTH PLAN.] 
    Subdivision 1.  [DEFINITIONS.] For purposes of this section 
the following terms shall have the meanings given them: 
    (a) "Eligible persons" means pregnant women and children 
under six years old who are one year of age or older but less 
than nine years of age who have gross family incomes that are 
equal to or less than 185 percent of the federal poverty 
guidelines and who are not eligible for medical assistance under 
chapter 256B or general assistance medical care under chapter 
256D and who are not otherwise insured for the covered services. 
Eligibility for pregnant women shall continue for 60 days 
postpartum to allow for follow-up visits.  The period of 
eligibility extends from the first day of the month in which the 
child's first birthday occurs to the last day of the month in 
which the child becomes nine years old. 
    (b) "Covered services" means prenatal care services and 
children's health services. 
    (c) "Prenatal care services" means the outpatient services 
provided to pregnant women which are medically necessary for the 
pregnancy.  Physician or certified nurse-midwife services for 
delivery are included but inpatient hospital services are not 
included. 
    (d) "Children's health services" means the health services 
reimbursed under chapter 256B, with the exception of inpatient 
hospital services, private duty nursing services, orthodontic 
services, medical transportation services, personal care 
assistant and case management services, hospice care services, 
nursing home or intermediate care facilities services, and 
mental health and chemical dependency services.  
    (e) (d) "Eligible providers" means those health care 
providers who provide prenatal care services and children's 
health services to medical assistance clients under rules 
established by the commissioner for that program.  Reimbursement 
under this section shall be at the same rates and conditions 
established for medical assistance.  A provider of prenatal care 
services shall assess whether the pregnant woman is at risk of 
delivering a low birth weight baby or has a health condition 
which may increase the probability of a problem birth. 
    (f) (e) "Commissioner" means the commissioner of human 
services. 
    Subd. 2.  [PLAN ADMINISTRATION.] The children's health plan 
is established to promote access to appropriate primary health 
care for pregnant women and to assure healthy babies and healthy 
children.  The commissioner shall establish an office for the 
state administration of this plan.  The plan shall be used to 
provide prenatal care and children's health services for 
eligible persons.  Payment for these services shall be made to 
all eligible providers.  The commissioner shall establish 
marketing efforts to encourage potentially eligible persons to 
receive information about the program and about other medical 
care programs administered or supervised by the department of 
human services.  A toll-free telephone number must be used to 
provide information about the plan medical programs and to 
promote access to the covered services.  The commissioner must 
make a quarterly assessment of the expected expenditures for the 
covered services and the appropriation.  Based on this 
assessment the commissioner may limit enrollments and target 
former aid to families with dependent children recipients.  If 
sufficient money is not available to cover all costs incurred in 
one quarter, the commissioner may seek an additional 
authorization for funding from the legislative advisory 
committee. 
    Subd. 3.  [APPLICATION PROCEDURES.] Applications and other 
information must be made available in to provider offices, local 
human services agencies, school districts, public and private 
elementary schools in which 25 percent or more of the students 
receive free or reduced price lunches, community health offices, 
and Women, Infants and Children (WIC) program sites.  These 
sites may accept applications, collect the enrollment fee, and 
forward the forms and fees to the commissioner.  Otherwise, 
applicants may apply directly to the commissioner.  The 
commissioner may use individuals' social security numbers as 
identifiers for purposes of administering the plan and conduct 
data matches to verify income.  Applicants shall submit evidence 
of family income, earned and unearned, that will be used to 
verify income eligibility.  Notwithstanding any other law to the 
contrary, benefits under this section are secondary to any a 
plan of insurance or benefit program under which an eligible 
person may have coverage.  The commissioner shall identify 
eligible persons who may have coverage or benefits under other 
plans of insurance or who become eligible for medical assistance.
    Subd. 4.  [ENROLLMENT FEE.] An enrollment fee of $35 is 
required from eligible persons for prenatal care services and an 
annual enrollment fee of $25, not to exceed $150 per family, is 
required from eligible persons for children's health 
services.  The fees may be paid together at the time of 
enrollment or as two payment installments.  Enrollment fees must 
be deposited in the public health fund and are appropriated to 
the commissioner for the children's health plan program.  The 
commissioner shall make an annual redetermination of continued 
eligibility and identify people who may become eligible for 
medical assistance.  
    Sec. 138.  [256.9655] [PAYMENTS TO MEDICAL PROVIDERS.] 
    The commissioner shall establish procedures to analyze and 
correct problems associated with medical care claims preparation 
and processing under the medical assistance, general assistance 
medical care, and children's health plan programs.  At a 
minimum, the commissioner shall: 
    (1) designate a full-time position as a liaison between the 
department of human services and providers; 
    (2) analyze impediments to timely processing of claims, 
provide information and consultation to providers, and develop 
methods to resolve or reduce problems; 
    (3) provide to each acute-care hospital a quarterly listing 
of claims received and identify claims that have been suspended 
and the reason the claims were suspended; 
    (4) provide education and information on reasons for 
rejecting and suspending claims and identify methods that would 
avoid multiple submissions of claims; and 
    (5) for each acute-care hospital, identify and prioritize 
claims that are in jeopardy of exceeding time factors that 
eliminate payment. 
    Sec. 139.  Minnesota Statutes 1987 Supplement, section 
256.969, subdivision 2, is amended to read: 
    Subd. 2.  [RATES FOR INPATIENT HOSPITALS.] On July 1, 1984, 
the commissioner shall begin to utilize to the extent possible 
existing classification systems, including Medicare.  The 
commissioner may incorporate the grouping of hospitals with 
similar characteristics for uniform rates upon the development 
and implementation of the diagnostic classification system.  
Prior to implementation of the diagnostic classification system, 
the commissioner shall report the proposed grouping of hospitals 
to the senate health and human services committee and the house 
health and welfare committee.  The computation of the base year 
cost per admission and the computation of the relative values of 
the diagnostic categories must include identified outlier cases 
and their weighted costs up to the point that they become 
outlier cases, but must exclude costs and days beyond that 
point.  Claims paid for care provided on or after August 1, 
1985, shall be adjusted to reflect a recomputation of rates, 
unless disapproved by the federal Health Care Financing 
Administration.  The state shall pay the state share of the 
adjustment for care provided on or after August 1, 1985, up to 
and including June 30, 1987, whether or not the adjustment is 
approved by the federal Health Care Financing Administration.  
The commissioner may reconstitute the diagnostic categories to 
reflect actual hospital practices, the specific character of 
specialty hospitals, or to reduce variances within the 
diagnostic categories after notice in the State Register and a 
30-day comment period.  After May 1, 1986, acute care hospital 
billings under the medical assistance and general assistance 
medical care programs must not be submitted until the recipient 
is discharged.  However, the commissioner shall establish 
monthly interim payments with inpatient hospitals that have 
individual patient lengths of stay in excess of 30 days 
regardless of diagnosis-related group.  For purposes of 
establishing interim rates, the commissioner is exempt from the 
requirements of chapter 14.  Medical assistance and general 
assistance medical care reimbursement for treatment of mental 
illness shall be reimbursed based upon diagnosis 
classifications.  The commissioner may selectively contract with 
hospitals for services within the diagnostic classifications 
relating to mental illness and chemical dependency under 
competitive bidding when reasonable geographic access by 
recipients can be assured.  No physician shall be denied the 
privilege of treating a recipient required to utilize a hospital 
under contract with the commissioner, as long as the physician 
meets credentialing standards of the individual hospital.  
Effective July 1, 1988, the commissioner shall limit the annual 
increase in pass-through cost payments for depreciation, rents 
and leases, and interest expense to the annual growth in the 
consumer price index for all urban consumers (CPI-U) hospital 
cost index described in section 256.969, subdivision 1.  When 
computing budgeted pass-through cost payments, the commissioner 
shall use the annual increase in the CPI-U hospital cost index 
forecasted by Data Resources, Inc. consistent with the quarter 
of the hospital's fiscal year end.  In final settlement of 
pass-through cost payments, the commissioner shall use the CPI-U 
hospital cost index for the month in which the hospital's fiscal 
year ends compared to the same month one year earlier. 
    Sec. 140.  Minnesota Statutes 1987 Supplement, section 
256.969, subdivision 3, is amended to read: 
    Subd. 3.  [SPECIAL CONSIDERATIONS.] (a) In determining the 
rate the commissioner of human services will take into 
consideration whether the following circumstances exist:  
    (1) minimal medical assistance and general assistance 
medical care utilization;  
    (2) unusual length of stay experience; and 
    (3) disproportionate numbers of low-income patients served. 
    (b) To the extent of available appropriations, the 
commissioner shall provide supplemental grants directly to a 
hospital described in section 256B.031, subdivision 10, 
paragraph (a), that receives medical assistance payments through 
a county-managed health plan that serves only residents of the 
county.  The payments must be designed to compensate for 
actuarially demonstrated higher health care costs within the 
county, for the population served by the plan, that are not 
reflected in the plan's rates under section 256B.031, 
subdivision 4. 
    (c) For inpatient hospital originally paid admissions, 
excluding medicare cross-overs, provided from July 1, 1988, 
through June 30, 1989, hospitals with 100 or fewer medical 
assistance annualized paid admissions, excluding medicare 
cross-overs, that were paid by March 1, 1988, for admissions 
paid during the period January 1, 1987, to June 30, 1987, shall 
have medical assistance inpatient payments increased 30 percent. 
Hospitals with more than 100 but fewer than 250 medical 
assistance annualized paid admissions, excluding medicare 
cross-overs, that were paid by March 1, 1988, for admissions 
paid during the period January 1, 1987, to June 30, 1987, shall 
have medical assistance inpatient payments increased 20 percent 
for inpatient hospital originally paid admissions, excluding 
medicare cross-overs, provided from July 1, 1988, through June 
30, 1989.  This provision applies only to hospitals that have 
100 or fewer licensed beds on March 1, 1988. 
    Sec. 141.  Minnesota Statutes 1987 Supplement, 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 identified in 
subdivisions 8a to 8y, for eligible individuals whose income and 
resources are insufficient to meet all of this cost:.  
    (1) Subd. 8a.  [INPATIENT HOSPITAL SERVICES.] Medical 
assistance covers inpatient hospital services.  A second medical 
opinion is required prior to reimbursement for elective 
surgeries requiring a second opinion.  The commissioner shall 
publish in the State Register a list of elective surgeries that 
require a second medical opinion prior to reimbursement, and the 
criteria and standards for deciding whether an elective surgery 
should require a second medical opinion.  The list and the 
criteria and standards are not subject to the requirements of 
sections 14.01 to 14.69.  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) Subd. 8b.  [SKILLED AND INTERMEDIATE NURSING 
CARE.] Medical assistance covers skilled nursing home services 
and services of intermediate care facilities, including training 
and habilitation services, as defined in section 252.41, 
subdivision 3, for persons with mental retardation or related 
conditions who are residing in intermediate care facilities for 
persons with mental retardation or related conditions.  Medical 
assistance must not be used to pay the costs of nursing care 
provided to a patient in a swing bed as defined in section 
144.562;, unless (a) the facility in which the swing bed is 
located is eligible as a sole community provider, as defined in 
Code of Federal Regulations, title 42, section 412.92, or the 
facility is a public hospital owned by a governmental entity 
with 15 or fewer licensed acute-care beds; (b) the health care 
financing administration approves the necessary state plan 
amendments; (c) the patient was screened as provided in section 
256B.091; (d) the patient no longer requires acute-care 
services; and (e) no nursing home beds are available within 25 
miles of the facility.  The daily medical assistance payment for 
nursing care for the patient in the swing bed is the statewide 
average medical assistance skilled nursing care per diem as 
computed annually by the commissioner on July 1 of each year. 
    (3) Subd. 8c.  [PHYSICIANS' SERVICES.] Medical assistance 
covers physicians' services;. 
    (4) Subd. 8d.  [OUTPATIENT AND CLINIC SERVICES.] Medical 
assistance covers 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.  A second medical 
opinion is required before reimbursement for elective surgeries 
requiring a second opinion.  The commissioner shall publish in 
the State Register a list of elective surgeries that require a 
second medical opinion before reimbursement and the criteria and 
standards for deciding whether an elective surgery should 
require a second surgical opinion.  The list and the criteria 
and standards are not subject to the requirements of sections 
14.01 to 14.69.  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.  "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) Subd. 8e.  [COMMUNITY HEALTH CENTER SERVICES.] Medical 
assistance covers 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) Subd. 8f.  [HOME HEALTH CARE.] Medical assistance 
covers home health care services;. 
    (7) Subd. 8g.  [PRIVATE DUTY NURSING.] Medical assistance 
covers private duty nursing services;. 
    (8) Subd. 8h.  [PHYSICAL THERAPY.] Medical assistance 
covers physical therapy and related services;. 
    (9)  Subd. 8i. [DENTAL SERVICES.] Medical assistance covers 
dental services, excluding cast metal restorations;. 
    (10) Subd. 8j.  [LABORATORY AND X-RAY SERVICES.] Medical 
assistance covers laboratory and X-ray services;. 
    (11) Subd. 8k.  [NURSE ANESTHETIST SERVICES.] Medical 
assistance covers nurse anesthetist services. 
    Subd. 8l.  [EYEGLASSES, DENTURES, AND PROSTHETIC 
DEVICES.] The following Medical assistance covers eyeglasses, 
dentures, and prosthetic devices if prescribed by a licensed 
practitioner: drugs, eyeglasses, dentures, and prosthetic 
devices.  
     Subd. 8m.  [DRUGS.] (a) Medical assistance covers drugs if 
prescribed by a licensed practitioner.  The commissioner shall 
designate a formulary committee which shall to advise the 
commissioner on the names of drugs for which payment shall be is 
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 the commissioner's 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.  
    (b) The basis for determining the amount of payment shall 
be the lower of the actual acquisition costs of the drugs plus a 
fixed dispensing fee established by the commissioner, the 
maximum allowable cost set by the federal government or by the 
commissioner plus the fixed dispensing fee or the usual and 
customary price charged to the public.  Actual acquisition cost 
includes quantity and other special discounts except time and 
cash discounts.  The actual acquisition cost of a drug may be 
estimated by the commissioner.  The maximum allowable cost of a 
multisource drug may be set by the commissioner and it shall be 
comparable to, but no higher than, the maximum amount paid by 
other third party payors in this state who have maximum 
allowable cost programs.  Establishment of the amount of payment 
for drugs shall not be subject to the requirements of the 
administrative procedure act.  An additional dispensing fee of 
$.30 may be added to the dispensing fee paid to pharmacists for 
prescriptions dispensed to residents of long-term care 
facilities when a unit dose blister card system, approved by the 
department, is used.  Under this type of dispensing system, the 
pharmacist must dispense a 30-day supply of drug.  The National 
Drug Code (NDC) from the drug container used to fill the blister 
card must be identified on the claim to the department.  The 
unit dose blister card containing the drug must meet the 
packaging standards set forth in Minnesota Rules, part 
6800.2700, that govern the return of unused drugs to the 
pharmacy for reuse.  The pharmacy provider will be required to 
credit the department for the actual acquisition cost of all 
unused drugs that are eligible for reuse.  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 
that has not been subject to the administrative procedure 
act shall be is limited to not more than 180 days, unless, 
during that time, the commissioner shall have 
initiated initiates rulemaking through the administrative 
procedure act;. 
    (12) Subd. 8n.  [DIAGNOSTIC, SCREENING, AND PREVENTIVE 
SERVICES.] Medical assistance covers diagnostic, screening, and 
preventive services.  "Preventive services" include services 
related to pregnancy, including services for those conditions 
which may complicate a pregnancy and which may be available to a 
pregnant woman determined to be at risk of poor pregnancy 
outcome.  Preventive services available to a woman at risk of 
poor pregnancy outcome may differ in an amount, duration, or 
scope from those available to other individuals eligible for 
medical assistance;. 
    (13) Subd. 8o.  [HEALTH PLAN PREMIUMS.] Medical assistance 
covers health care prepayment plan premiums and insurance 
premiums if paid directly to a vendor and supplementary medical 
insurance benefits under Title XVIII of the Social Security 
Act.  For purposes of obtaining Medicare part B, expenditures 
may be made even if federal funding is not available;. 
    (14) Subd. 8p.  [ABORTION SERVICES.] Medical assistance 
covers 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) Subd. 8q.  [TRANSPORTATION COSTS.] Medical assistance 
covers 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) Subd. 8r.  [BUS OR TAXICAB TRANSPORTATION.] To the 
extent authorized by rule of the state agency, medical 
assistance covers costs of bus or taxicab transportation 
incurred by any ambulatory eligible person for obtaining 
nonemergency medical care;. 
    (17) Subd. 8s.  [PERSONAL CARE ASSISTANTS.] Medical 
assistance covers personal care assistant 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 assistants 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;. 
    (18) Subd. 8t.  [MENTAL ILLNESS CASE MANAGEMENT.] To the 
extent authorized by rule of the state agency, medical 
assistance covers case management services to persons with 
serious and persistent mental illness;. 
    (19) Subd. 8u.  [CASE MANAGEMENT FOR BRAIN INJURED 
PERSONS.] To the extent authorized by rule of the state 
agency, medical assistance covers case management services to 
persons with brain injuries;. 
    (20) Subd. 8v.  [HOSPICE CARE.] Medical assistance covers 
hospice care services under Public Law Number 99-272, section 
9505, to the extent authorized by rule; and. 
    (21) Subd. 8w.  [DAY TREATMENT SERVICES.] Medical 
assistance covers day treatment services as specified in 
sections 245.462, subdivision 8, and 245.471, subdivision 3, 
that are provided under contract with the county board. 
    Subd. 8x.  [OTHER MEDICAL OR REMEDIAL CARE.] Medical 
assistance covers any other medical or remedial care licensed 
and recognized under state law unless otherwise prohibited by 
law, except licensed chemical dependency treatment programs or 
primary treatment or extended care treatment units in hospitals 
that are covered under Laws 1986, chapter 394, sections 8 to 
20.  The commissioner shall include chemical dependency services 
in the state medical assistance plan for federal reporting 
purposes, but payment must be made under Laws 1986, chapter 394, 
sections 8 to 20.  The commissioner shall publish in the State 
Register a list of elective surgeries that require a second 
medical opinion before medical assistance reimbursement, and the 
criteria and standards for deciding whether an elective surgery 
should require a second medical opinion.  The list and criteria 
and standards are not subject to the requirements of sections 
14.01 to 14.69.  
    Subd. 8y.  [SECOND OPINION OR PRIOR AUTHORIZATION 
REQUIRED.] The commissioner shall publish in the State Register 
a list of health services that require prior authorization, as 
well as the criteria and standards used to select health 
services on the list.  The list and the criteria and standards 
used to formulate it are not subject to the requirements of 
sections 14.01 to 14.69.  The commissioner's decision whether 
prior authorization is required for a health service or a second 
medical opinion is required for an elective surgery is not 
subject to administrative appeal. 
    Sec. 142.  Minnesota Statutes 1987 Supplement, section 
256B.031, subdivision 5, is amended to read:  
    Subd. 5.  [FREE CHOICE LIMITED.] (a) The commissioner may 
require recipients of aid to families with dependent children, 
except those recipients who are refugees and whose health 
services are reimbursed 100 percent by the federal government 
for the first 31 months after entry into the United States, to 
enroll in a prepaid health plan and receive services from or 
through the prepaid health plan, with the following exceptions: 
    (1) recipients who are refugees and whose health services 
are reimbursed 100 percent by the federal government for the 
first 24 months after entry into the United States; and 
    (2) recipients who are placed in a foster home or 
facility.  If placement occurs before the seventh day prior to 
the end of any month, the recipient will be disenrolled from the 
recipient's prepaid health plan effective the first day of the 
following month.  If placement occurs after the seventh day 
before the end of any month, that recipient will be disenrolled 
from the prepaid health plan on the first day of the second 
month following placement.  The prepaid health plan must provide 
all services set forth in subdivision 2 during the interim 
period. 
    Enrollment in a prepaid health plan is mandatory only when 
recipients have a choice of at least two prepaid health plans.  
    (b) Recipients who become eligible on or after December 1, 
1987, must choose a health plan within 30 days of the date 
eligibility is determined.  At the time of application, the 
local agency shall ask the recipient whether the recipient has a 
primary health care provider.  If the recipient has not chosen a 
health plan within 30 days but has provided the local agency 
with the name of a a primary health care provider, the local 
agency shall determine whether the provider participates in a 
prepaid health plan available to the recipient and, if so, the 
local agency shall select that plan on the recipient's behalf.  
If the recipient has not provided the name of a primary health 
care provider who participates in an available prepaid health 
plan, commissioner shall randomly assign the recipient to a 
health plan.  
    (c) Recipients who are eligible on November 30, 1987, must 
choose a prepaid health plan by January 15, 1988.  If possible, 
the local agency shall ask whether the recipient has a primary 
health care provider and the procedures under paragraph (b) 
shall apply.  If a recipient does not choose a prepaid health 
plan by this date, the commissioner shall randomly assign the 
recipient to a health plan.  
    (d) Each recipient must be enrolled in the health plan for 
a minimum of six months following the effective date of 
enrollment, except that the recipient may change health plans 
once within the first 60 days after initial enrollment.  The 
commissioner shall request a waiver from the federal Health Care 
Financing Administration to extend the minimum period to 12 
months to limit a recipient's ability to change health plans to 
once every six or 12 months.  If such a waiver is obtained, each 
recipient must be enrolled in the health plan for a minimum of 
six or 12 months.  A recipient may change health plans once 
within the first 60 days after initial enrollment. 
    (e) Women who are receiving medical assistance due to 
pregnancy and later become eligible for aid to families with 
dependent children are not required to choose a prepaid health 
plan until 60 days postpartum.  An infant born as a result of 
that pregnancy must be enrolled in a prepaid health plan at the 
same time as the mother. 
    (f) If third-party coverage is available to a recipient 
through enrollment in a prepaid health plan through employment, 
through coverage by the former spouse, or if a duty of support 
has been imposed by law, order, decree, or judgment of a court 
under section 518.551, the obligee or recipient shall 
participate in the prepaid health plan in which the obligee has 
enrolled provided that the commissioner has contracted with the 
plan. 
    Sec. 143.  Minnesota Statutes 1987 Supplement, section 
256B.042, subdivision 2, is amended to read:  
    Subd. 2.  [LIEN ENFORCEMENT.] The state agency may perfect 
and enforce its lien by following the procedures set forth in 
sections 514.69, 514.70 and 514.71, and its verified lien 
statement shall be filed with the appropriate court 
administrator in the county of financial responsibility.  The 
verified lien statement shall contain the following:  the name 
and address of the person to whom medical care was furnished, 
the date of injury, the name and address of the vendor or 
vendors furnishing medical care, the dates of the service, the 
amount claimed to be due for the care, and, to the best of the 
state agency's knowledge, the names and addresses of all 
persons, firms, or corporations claimed to be liable for damages 
arising from the injuries.  This section shall not affect the 
priority of any attorney's lien.  The state agency is not 
subject to any limitations period referred to in section 514.69 
or 514.71 and has one year from the date notice is received by 
it under subdivision 4, paragraph (c), or one year from the date 
medical bills are first paid by the state agency, whichever is 
later, to file its verified lien statement.  The state agency 
may commence an action to enforce the lien within one year of 
(1) the date the notice required by subdivision 4, paragraph 
(c), is received or (2) the date the recipient's cause of action 
is concluded by judgment, award, settlement, or otherwise, 
whichever is later. 
    Sec. 144.  Minnesota Statutes 1987 Supplement, section 
256B.06, subdivision 1, is amended to read:  
    Subdivision 1.  [CHILDREN ELIGIBLE FOR SUBSIDIZED ADOPTION 
ASSISTANCE.] Medical assistance may be paid for any person: (1) 
who is a child eligible for or receiving adoption assistance 
payments under Title IV-E of the Social Security Act, United 
States Code, title 42, sections 670 to 676 under Minnesota 
Statutes, section 259.40 or 259.431; or. 
    (2) who is Subd. 1a.  [SUBSIDIZED FOSTER CHILDREN.] Medical 
assistance may be paid for a child eligible for or receiving 
foster care maintenance payments under Title IV-E of the Social 
Security Act, United States Code, title 42, sections 670 to 676; 
or.  
    (3) Subd. 1b.  [AFDC FAMILIES.] Medical assistance may be 
paid for a person who is eligible for or receiving public 
assistance under the aid to families with dependent children 
program,.  
    Subd. 1c.  [RECIPIENTS OF MINNESOTA SUPPLEMENTAL 
AID.] Medical assistance may be paid for a person who is 
receiving public assistance under the Minnesota supplemental aid 
program, except for those persons eligible for Minnesota 
supplemental aid because the local agency waived excess assets 
under section 256D.37, subdivision 2; or. 
    (4) who is Subd. 1d.  [PREGNANT WOMEN; DEPENDENT UNBORN 
CHILD.] Medical assistance may be paid for a pregnant woman, as 
certified in writing by a physician or nurse midwife, and who 
(a) meets the other eligibility criteria of this section, and 
(b) who would be categorically eligible for assistance under the 
aid to families with dependent children program if the child had 
been born and was living with the woman.  For purposes of 
this section subdivision, a woman is considered pregnant for 60 
days postpartum; or. 
    (5) who is Subd. 1e.  [PREGNANT WOMEN; NEEDY UNBORN CHILD.] 
Medical assistance may be paid for a pregnant woman, as 
certified in writing by a physician or nurse midwife, who meets 
the other eligibility criteria of this section and whose unborn 
child would be eligible as a needy child under clause (8) if 
born and living with the woman.  For purposes of this section 
subdivision, a woman is considered pregnant for 60 days 
postpartum; or. 
    (6) Subd. 1f.  [AGED, BLIND, OR DISABLED PERSONS.] Medical 
assistance may be paid for a person who meets the categorical 
eligibility requirements of the supplemental security income 
program and the other eligibility requirements of this section; 
or.  The methodology for calculating disregards and deductions 
from income must be as specified in section 256D.37, 
subdivisions 6 to 14. 
    (7) Subd. 1g.  [MEDICALLY NEEDY PERSONS WITH EXCESS INCOME 
OR ASSETS.] Medical assistance may be paid for a person who, 
except for the amount of income or assets, would qualify for 
supplemental security income for the aged, blind and disabled, 
or aid to families with dependent children, and who meets the 
other eligibility requirements of this section.  However, in the 
case of families and children who meet the categorical 
eligibility requirements for aid to families with dependent 
children, the methodology for calculating assets shall be as 
specified in section 256.73, subdivision 2, except that the 
exclusion for an automobile shall be as in clause (13)(g) as 
long as acceptable to the health care financing administration, 
and the methodology for calculating deductions from earnings for 
child care and work expenses shall be as specified in section 
256.74, subdivision 1; or. 
    (8) Subd. 1h.  [CHILDREN.] Medical assistance may be paid 
for a person who is under 21 years of age and in need of medical 
care that neither the person nor the person's relatives 
responsible under sections 256B.01 to 256B.26 are financially 
able to provide; or. 
    (9) who is Subd. 1i.  [INFANTS.] Medical assistance may be 
paid for an infant less than one year of age born on or after 
October 1, 1984, whose mother was eligible at the time of birth 
and who remains in the mother's household.  Eligibility under 
this clause subdivision is concurrent with the mother's and does 
not depend on the father's income except as the income affects 
the mother's eligibility; or. 
    (10) Subd. 1j.  [ELDERLY HOSPITAL INPATIENTS.] Medical 
assistance may be paid for a person who is residing in a 
hospital for treatment of mental disease or tuberculosis and is 
65 years of age or older and without means sufficient to pay the 
per capita hospital charge; and.  
    (11) who resides Subd. 1k.  [RESIDENCY.] To be eligible for 
medical assistance, a person must reside in Minnesota, or, if 
absent from the state, is be deemed to be a resident of 
Minnesota in accordance with the rules of the state agency; and. 
    (12) who alone, Subd. 1l.  [HOMESTEAD.] To be eligible for 
medical assistance, a person must not own, individually or 
together with the person's spouse, does not own real property 
other than the homestead.  For the purposes of this section, 
"homestead" means the house owned and occupied by the applicant 
or recipient as a primary place of residence, together with the 
contiguous land upon which it is situated.  The homestead shall 
continue to be excluded for persons residing in a long-term care 
facility if it is used as a primary residence by the spouse, 
minor child, or disabled child of any age.  The homestead is 
also excluded for the first six calendar months of the person's 
stay in the long-term care facility.  The homestead must be 
reduced to an amount within limits or excluded on another basis 
if the person remains in the long-term care facility for a 
period longer than six months.  Real estate not used as a home 
may not be retained unless the property is not salable, the 
equity is $6,000 or less and the income produced by the property 
is at least six percent of the equity, or the excess real 
property is exempted for a period of nine months if there is a 
good faith effort to sell the property and a legally binding 
agreement is signed to repay the amount of assistance issued 
during that nine months; and.  
    (13) who Subd. 1m.  [ASSET LIMITATIONS.] To be eligible for 
medical assistance, a person must not individually does not own 
more than $3,000 in cash or liquid assets, or if a member of a 
household with two family members (husband and wife, or parent 
and child), does the household must not own more than $6,000 in 
cash or liquid assets, plus $200 for each additional legal 
dependent.  In addition to these maximum amounts, an eligible 
individual or family may accrue interest on these amounts, but 
they must be reduced to the maximum at the time of an 
eligibility redetermination.  For residents of long-term care 
facilities, the accumulation of the clothing and personal needs 
allowance pursuant to section 256B.35 must also be reduced to 
the maximum at the time of the eligibility redetermination.  
Cash and liquid assets may include a prepaid funeral contract 
and insurance policies with cash surrender value.  The value of 
the following shall not be included: 
    (a) the homestead, (b) household goods and furniture in use 
in the home personal effects with a total equity value of $2,000 
or less, (c) wearing apparel, (d) personal property used as a 
regular abode by the applicant or recipient, (e) (d) a lot in a 
burial plot for each member of the household, (f) personal 
jewelry acquired more than 24 months immediately prior to the 
period of medical assistance eligibility and personal jewelry 
acquired within 24 months immediately prior to the period of 
medical assistance eligibility and not purchased with assets of 
the applicant or recipient, (g) (e) capital and operating assets 
of a trade or business that the local agency determines are 
necessary to the person's ability to earn an income, (h) (f) for 
a period of six months, insurance settlements to repair or 
replace damaged, destroyed, or stolen property, (i) (g) one 
motor vehicle that is licensed pursuant to chapter 168 and 
defined as:  (1) passenger automobile, (2) station wagon, (3) 
motorcycle, (4) motorized bicycle or (5) truck of the weight 
found in categories A to E, of section 168.013, subdivision 1e, 
and that is used primarily for the person's benefit, and (j) (h) 
other items which may be required by federal law or statute.  To 
be excluded, the vehicle must have a market value of less than 
$4,500; be necessary to obtain medically necessary health 
services; be necessary for employment; be modified for operation 
by or transportation of a handicapped person; or be necessary to 
perform essential daily tasks because of climate, terrain, 
distance, or similar factors.  The equity value of other motor 
vehicles is counted against the cash or liquid asset limit; and. 
    (14) who has Subd. 1n.  [INCOME.] To be eligible for 
medical assistance, a person must not have, or anticipates 
anticipate receiving a, semiannual income not in excess of 115 
percent of the income standards by family size used in the aid 
to families with dependent children program, except that 
families and children may have an income up to 133-1/3 percent 
of the AFDC income standard.  Notwithstanding any laws or rules 
to the contrary, in computing income to determine eligibility of 
persons who are not residents of long-term care facilities, the 
commissioner shall disregard increases in income as required by 
Public Law Numbers 94-566, section 503; 99-272; and 99-509; and. 
    (15) Subd. 1o.  [EXCESS INCOME.] A person who has monthly 
excess income is eligible for medical assistance if the person 
has expenses for medical care that are more than the amount of 
the person's excess income, computed on a monthly basis, in 
which case eligibility may be established and medical assistance 
payments may be made to cover the monthly unmet medical need by 
deducting incurred medical expenses from the excess income to 
reduce the excess to the income standard specified in clause 
(14).  The person shall elect to have the medical expenses 
deducted monthly or at the beginning of the budget period; or 
who is a pregnant woman or infant up to one year of age who 
meets the requirements of clauses (1) to (8) except that her 
anticipated income is in excess of the income standards by 
family size used in the aid to families with dependent children 
program, but is equal to or less than 133-1/3 185 percent of 
that income standard the federal poverty guideline for the same 
family size.  Eligibility for a pregnant woman or infant up to 
one year of age with respect to this clause shall be without 
regard to the asset standards specified in clauses (12) and 
(13).  For persons who reside in licensed nursing homes, 
regional treatment centers, or medical institutions, the income 
over and above that required in section 256B.35 for personal 
needs allowance is to be applied to the cost of institutional 
care.  In addition, income may be retained by an 
institutionalized person (a) to support dependents in the amount 
that, together with the income of the spouse and child under age 
18, would provide net income equal to the medical assistance 
standard for the family size of the dependents excluding the 
person residing in the facility; or (b) for a period of up to 
three calendar months, in an amount equal to the medical 
assistance standard for a family size of one if the person was 
not living together with a spouse or child under age 21 at the 
time the person entered a long-term care facility, if the person 
has expenses of maintaining a residence in the community, and if 
a physician certifies that the person is expected to reside in 
the long-term care facility on a short-term basis.  For purposes 
of this section, persons are determined to be residing in 
licensed nursing homes, regional treatment centers, or medical 
institutions if the persons are expected to remain for a period 
expected to last longer than three months.  The commissioner of 
human services may establish a schedule of contributions to be 
made by the spouse of a nursing home resident to the cost of 
care; and.  
    (16) who Subd. 1p.  [ASSIGNMENT OF BENEFITS.] has To be 
eligible for medical assistance a person must have applied or 
agrees must agree to apply all proceeds received or receivable 
by the person or the person's spouse from any third person 
liable for the costs of medical care for the person, the spouse, 
and children.  The state agency shall require from any applicant 
or recipient of medical assistance the assignment of any rights 
to medical support and third party payments.  Persons must 
cooperate with the state in establishing paternity and obtaining 
third party payments.  By signing an application for medical 
assistance, a person assigns to the department of human services 
all rights the person may have to medical support or payments 
for medical expenses from any other person or entity on their 
own or their dependent's behalf and agrees to cooperate with the 
state in establishing paternity and obtaining third party 
payments.  Any rights or amounts so assigned shall be applied 
against the cost of medical care paid for under this chapter.  
Any assignment takes effect upon the determination that the 
applicant is eligible for medical assistance and up to three 
months prior to the date of application if the applicant is 
determined eligible for and receives medical assistance 
benefits.  The application must contain a statement explaining 
this assignment.  Any assignment shall not be effective as to 
benefits paid or provided under automobile accident coverage and 
private health care coverage prior to notification of the 
assignment by the person or organization providing the benefits; 
and.  
    (17) Subd. 1q.  [DISABLED CHILDREN.] A person is eligible 
for medical assistance if the person is under age 19 and 
qualifies as a disabled individual under United States Code, 
title 42, section 1382c(a), and would be eligible for medical 
assistance under the state plan if residing in a medical 
institution, and who requires a level of care provided in a 
hospital, skilled nursing facility, intermediate care facility, 
or intermediate care facility for persons with mental 
retardation or related conditions, for whom home care is 
appropriate, provided that the cost to medical assistance for 
home care services is not more than the amount that medical 
assistance would pay for appropriate institutional care.  
    Subd. 1r.  [PERIOD OF INELIGIBILITY.] Eligibility is 
available for the month of application and for three months 
prior to application if the person was eligible in those prior 
months.  A redetermination of eligibility must occur every 12 
months. 
    Sec. 145.  Minnesota Statutes 1987 Supplement, section 
256B.06, subdivision 4, is amended to read:  
    Subd. 4.  [CITIZENSHIP REQUIREMENTS.] Eligibility for 
medical assistance is limited to citizens of the United States 
and aliens lawfully admitted for permanent residence or 
otherwise permanently residing in the United States under the 
color of law.  Aliens who are seeking legalization under the 
Immigration Reform and Control Act of 1986, Public Law Number 
99-603, who are under age 18, over age 65, blind, disabled, or 
Cuban or Haitian, and who meet the eligibility requirements of 
medical assistance under subdivision 1 and section 256B.17 are 
eligible to receive medical assistance.  Pregnant women who are 
aliens seeking legalization under the Immigration Reform and 
Control Act of 1986, Public Law Number 99-603, and who meet the 
eligibility requirements of medical assistance under subdivision 
1 are eligible for payment of care and services through the 
period of pregnancy and six weeks postpartum.  Payment shall 
also be made for care and services that are furnished to an 
alien, regardless of immigration status, who otherwise meets the 
eligibility requirements of this section if such care and 
services are necessary for the treatment of an emergency medical 
condition.  For purposes of this subdivision, the term 
"emergency medical condition" means a medical condition, 
including labor and delivery, that if not immediately treated 
could cause a person physical or mental disability, continuation 
of severe pain, or death. 
    Sec. 146.  Minnesota Statutes 1986, section 256B.08, is 
amended to read: 
    256B.08 [APPLICATION.] 
    Subdivision 1.  [APPLICATION PROCESS.] An applicant for 
medical assistance hereunder, or a person acting in the 
applicant's behalf, shall file an application with a county 
local agency in such the manner and form as shall be prescribed 
by the state agency.  When a married applicant resides in a 
nursing home or applies for medical assistance for nursing home 
services, the county local agency shall consider an application 
on behalf of the applicant's spouse only upon specific request 
of the applicant or upon specific request of the spouse and 
separate filing of an application. 
    Subd. 2.  [EXPEDITED REVIEW FOR PREGNANT WOMEN.] A pregnant 
woman who may be eligible for assistance under section 256B.06, 
subdivision 1, must receive an appointment for eligibility 
determination no later than five working days from the date of 
her request for assistance from the local agency.  The local 
agency shall expedite processing her application for assistance 
and shall make a determination of eligibility on a completed 
application no later than ten working days following the 
applicant's initial appointment.  The local agency shall assist 
the applicant to provide all necessary information and 
documentation in order to process the application within the 
time period required under this subdivision.  The state agency 
shall provide for the placement of applications for medical 
assistance in eligible provider offices, community health 
offices, and Women, Infants and Children (WIC) program sites. 
    Sec. 147.  Minnesota Statutes 1987 Supplement, section 
256B.091, subdivision 4, is amended to read: 
    Subd. 4.  [SCREENING OF PERSONS.] Prior to nursing home or 
boarding care home admission, screening teams shall assess the 
needs of all applicants, except (1) patients transferred from 
other certified nursing homes or boarding care homes; (2) 
patients who, having entered acute care facilities from nursing 
homes or boarding care homes, are returning to a nursing home or 
boarding care home; (3) persons entering a facility described in 
section 256B.431, subdivision 4, paragraph (c); (4) individuals 
not eligible for medical assistance whose length of stay is 
expected to be 30 days or less based on a physician's 
certification, if the facility notifies the screening team upon 
admission and provides an update to the screening team on the 
30th day after admission; (5) individuals who have a contractual 
right to have their nursing home care paid for indefinitely by 
the veteran's administration; or (6) persons entering a facility 
conducted by and for the adherents of a recognized church or 
religious denomination for the purpose of providing care and 
services for those who depend upon spiritual means, through 
prayer alone, for healing.  The cost for screening applicants 
who are receiving medical assistance must be paid by the medical 
assistance program.  The total screening cost for each county 
for applicants who are not eligible for medical assistance and 
residents of nursing homes who request a screening must be paid 
monthly by nursing homes and boarding care homes participating 
in the medical assistance program in the county.  The monthly 
amount to be paid by each nursing home and boarding care home 
must be determined by dividing the county's estimate of the 
total annual cost of screenings allowed by the commissioner in 
the county for the following rate year by 12 to determine the 
monthly cost estimate and allocating the monthly cost estimate 
to each nursing home and boarding care home based on the number 
of licensed beds in the nursing home or boarding care home.  The 
monthly cost estimate for each nursing home or boarding care 
home must be submitted to the nursing home or boarding care home 
and the state by the county no later than February 15 of each 
year for inclusion in the nursing home's or boarding care home's 
payment rate on the following rate year.  The commissioner shall 
include the reported annual estimated cost of screenings for 
each nursing home or boarding care home as an operating cost of 
that nursing home in accordance with section 256B.431, 
subdivision 2b, clause (g).  For all individuals regardless of 
payment source, if delay-of-screening timelines are not met 
because a county is late in screening an individual who meets 
the delay-of-screening criteria, the county is solely 
responsible for paying the cost of the preadmission screening.  
Notwithstanding section 256B.0641, overpayments attributable to 
payment of the screening costs under the medical assistance 
program may not be recovered from a facility.  Any other 
interested person may be screened under this subdivision if the 
person pays a fee for the screening based upon a sliding fee 
scale determined by the commissioner. 
    Sec. 148.  Minnesota Statutes 1986, section 256B.092, 
subdivision 5, is amended to read:  
    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 1987, 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 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 1987, 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.  
    Sec. 149.  Minnesota Statutes 1986, section 256B.092, 
subdivision 7, is amended to read:  
    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 
persons with mental retardation or related conditions or for 
whom there is a reasonable indication that they might require 
the level of care provided by an intermediate care facility.  
The screening team shall make an evaluation of need within 15 
working days of the request for service date that the assessment 
is completed or within 60 working days of a request for service 
by a person with mental retardation or related conditions, 
whichever is the earlier, and within five working days of an 
emergency admission of an individual to an intermediate care 
facility for 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 1987.  For individuals determined to have 
overriding health care needs, a registered nurse must be 
designated as either the case manager or the qualified mental 
retardation professional.  The case manager shall consult with 
the client's physician, other health professionals or other 
persons as necessary to make this evaluation.  The case manager, 
with the concurrence of the client or the client's legal 
representative, may invite other persons 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.  
    Sec. 150.  Minnesota Statutes 1986, section 256B.14, 
subdivision 2, is amended to read:  
    Subd. 2.  [ACTIONS TO OBTAIN PAYMENT.] The state agency 
shall promulgate rules to determine the ability of responsible 
relatives to contribute partial or complete repayment of medical 
assistance furnished to recipients for whom they are 
responsible.  In determining the No resource contribution is 
required of a spouse at the time of the first approved medical 
assistance application, all medical assistance exclusions shall 
be allowed, and a resource limit of $10,000 for nonexcluded 
resources shall be implemented.  Above these limits, a 
contribution of one-third of the excess resources shall be 
required.  These rules shall not require repayment when payment 
would cause undue hardship to the responsible relative or that 
relative's immediate family.  These rules shall be consistent 
with the requirements of section 252.27, subdivision 2, for 
parents of children whose eligibility for medical assistance was 
determined without deeming of the parents' resources and 
income.  For parents of children receiving services under a 
federal medical assistance waiver or under section 134 of the 
Tax Equity and Fiscal Responsibility Act of 1982, United States 
Code, title 42, section 1396a(e)(3), while living in their 
natural home, including in-home family support services, respite 
care, homemaker services, and minor adaptations to the home, the 
state agency shall take into account the room, board, and 
services provided by the parents in determining the parental 
contribution to the cost of care.  The county agency shall give 
the responsible relative notice of the amount of the repayment.  
If the state agency or county agency finds that notice of the 
payment obligation was given to the responsible relative, but 
that the relative failed or refused to pay, a cause of action 
exists against the responsible relative for that portion of 
medical assistance granted after notice was given to the 
responsible relative, which the relative was determined to be 
able to pay.  
    The action may be brought by the state agency or the county 
agency in the county where assistance was granted, for the 
assistance, together with the costs of disbursements incurred 
due to the action.  
    In addition to granting the county or state agency a money 
judgment, the court may, upon a motion or order to show cause, 
order continuing contributions by a responsible relative found 
able to repay the county or state agency.  The order shall be 
effective only for the period of time during which the recipient 
receives medical assistance from the county or state agency. 
    Sec. 151.  Minnesota Statutes 1986, section 256B.17, 
subdivision 7, is amended to read:  
    Subd. 7.  [EXCEPTION FOR ASSET TRANSFERS.] Notwithstanding 
the provisions of subdivisions 1 to 6, an institutionalized 
spouse who applies for medical assistance on or after July 1, 
1983, may transfer liquid assets to a noninstitutionalized 
spouse without loss of eligibility if all of the following 
conditions apply:  
    (a) The noninstitutionalized spouse is not applying for or 
receiving assistance;  
    (b) Either (1) the noninstitutionalized spouse has less 
than $10,000 in liquid assets, including assets singly owned and 
50 percent of assets owned jointly with the institutionalized 
spouse; or (2) the noninstitutionalized spouse has less than 50 
percent of the total value of nonexempt assets owned by both 
parties, jointly or individually;  
    (c) The amount transferred, together with the 
noninstitutionalized spouse's own assets, totals no more 
than one-half of the total value of the liquid assets of the 
parties or $10,000 in liquid assets, whichever is greater; and 
    (d) The transfer may be effected only once, at the time of 
initial medical assistance application. 
    Sec. 152.  [256B.31] [CONTINUED HOSPITAL CARE FOR LONG-TERM 
POLIO PATIENT.] 
    A medical assistance recipient who has been a polio patient 
in an acute care hospital for a period of not less than 25 
consecutive years is eligible to continue receiving hospital 
care, whether or not the care is medically necessary for 
purposes of federal reimbursement.  The cost of continued 
hospital care not reimbursable by the federal government must be 
paid with state money allocated for the medical assistance 
program.  The rate paid to the hospital is the rate per day 
established using Medicare principles for the hospital's fiscal 
year ending December 31, 1981, adjusted each year by the annual 
hospital cost index established under section 256.969, 
subdivision 1, or by other limits in effect at the time of the 
adjustment.  This section does not prohibit a voluntary move to 
another living arrangement by a recipient whose care is 
reimbursed under this section. 
    Sec. 153.  Minnesota Statutes 1987 Supplement, section 
256B.35, subdivision 1, is amended to read:  
    Subdivision 1.  [PERSONAL NEEDS ALLOWANCE.] (a) 
Notwithstanding any law to the contrary, welfare allowances for 
clothing and personal needs for individuals receiving medical 
assistance while residing in any skilled nursing home, 
intermediate care facility, or medical institution including 
recipients of supplemental security income, in this state shall 
not be less than $40 $45 per month from all sources.  When 
benefit amounts for social security or supplemental security 
income recipients are increased pursuant to United States Code, 
title 42, sections 415(i) and 1382f, the commissioner shall, 
effective in the month in which the increase takes effect, 
increase by the same percentage to the nearest whole dollar the 
clothing and personal needs allowance for individuals receiving 
medical assistance while residing in any skilled nursing home, 
medical institution, or intermediate care facility.  The 
commissioner shall provide timely notice to local agencies, 
providers, and recipients of increases under this provision. 
    Provided that this (b) The personal needs allowance may be 
paid as part of the Minnesota supplemental aid program, 
notwithstanding the provisions of section 256D.37, subdivision 
2, and payments to the recipients from of Minnesota supplemental 
aid funds may be made once each three months beginning in 
October 1977, covering liabilities that accrued during the 
preceding three months. 
    Sec. 154.  Minnesota Statutes 1987 Supplement, section 
256B.431, subdivision 2b, is amended to read:  
    Subd. 2b.  [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 
rate years beginning on or after July 1, 1985, the commissioner 
shall establish procedures for determining per diem 
reimbursement for operating costs.  
    (b) The commissioner shall contract with an econometric 
firm with recognized expertise in and access to national 
economic change indices that can be applied to the appropriate 
cost categories when determining the operating cost payment rate.
    (c) The commissioner shall analyze and evaluate each 
nursing home's cost report of allowable operating costs incurred 
by the nursing home during the reporting year immediately 
preceding the rate year for which the payment rate becomes 
effective.  
    (d) The commissioner shall establish limits on actual 
allowable historical operating cost per diems based on cost 
reports of allowable operating costs for the reporting year that 
begins October 1, 1983, taking into consideration relevant 
factors including resident needs, geographic location, size of 
the nursing home, and the costs that must be incurred for the 
care of residents in an efficiently and economically operated 
nursing home.  In developing the geographic groups for purposes 
of reimbursement under this section, the commissioner shall 
ensure that nursing homes in any county contiguous to the 
Minneapolis-St. Paul seven-county metropolitan area are included 
in the same geographic group.  The limits established by the 
commissioner shall not be less, in the aggregate, than the 60th 
percentile of total actual allowable historical operating cost 
per diems for each group of nursing homes established under 
subdivision 1 based on cost reports of allowable operating costs 
in the previous reporting year.  For rate years beginning on or 
after July 1, 1987, or until the new base period is established, 
facilities located in geographic group I as described in 
Minnesota Rules, part 9549.0052 (Emergency), on January 1, 1987, 
may choose to have the commissioner apply either the care 
related limits or the other operating cost limits calculated for 
facilities located in geographic group II, or both, if either of 
the limits calculated for the group II facilities is higher.  
The efficiency incentive for geographic group I nursing homes 
must be calculated based on geographic group I limits.  The 
phase-in must be established utilizing the chosen limits.  For 
purposes of these exceptions to the geographic grouping 
requirements, the definitions in Minnesota Rules, parts 
9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080, 
apply.  The limits established under this paragraph remain in 
effect until the commissioner establishes a new base period.  
Until the new base period is established, the commissioner shall 
adjust the limits annually using the appropriate economic change 
indices established in paragraph (e).  In determining allowable 
historical operating cost per diems for purposes of setting 
limits and nursing home payment rates, the commissioner shall 
divide the allowable historical operating costs by the actual 
number of resident days, except that where a nursing home is 
occupied at less than 90 percent of licensed capacity days, the 
commissioner may establish procedures to adjust the computation 
of the per diem to an imputed occupancy level at or below 90 
percent.  The commissioner shall establish efficiency incentives 
as appropriate.  The commissioner may establish efficiency 
incentives for different operating cost categories.  The 
commissioner shall consider establishing efficiency incentives 
in care related cost categories.  The commissioner may combine 
one or more operating cost categories and may use different 
methods for calculating payment rates for each operating cost 
category or combination of operating cost categories.  For the 
rate year beginning on July 1, 1985, the commissioner shall: 
    (1) allow nursing homes that have an average length of stay 
of 180 days or less in their skilled nursing level of care, 125 
percent of the care related limit and 105 percent of the other 
operating cost limit established by rule; and 
    (2) exempt nursing homes licensed on July 1, 1983, by the 
commissioner to provide residential services for the physically 
handicapped under Minnesota Rules, parts 9570.2000 to 9570.3600, 
from the care related limits and allow 105 percent of the other 
operating cost limit established by rule. 
    For the purpose of calculating the other operating cost 
efficiency incentive for nursing homes referred to in clause (1) 
or (2), the commissioner shall use the other operating cost 
limit established by rule before application of the 105 percent. 
    (e) The commissioner shall establish a composite index or 
indices by determining the appropriate economic change 
indicators to be applied to specific operating cost categories 
or combination of operating cost categories.  
    (f) Each nursing home shall receive an operating cost 
payment rate equal to the sum of the nursing home's operating 
cost payment rates for each operating cost category.  The 
operating cost payment rate for an operating cost category shall 
be the lesser of the nursing home's historical operating cost in 
the category increased by the appropriate index established in 
paragraph (e) for the operating cost category plus an efficiency 
incentive established pursuant to paragraph (d) or the limit for 
the operating cost category increased by the same index.  If a 
nursing home's actual historic operating costs are greater than 
the prospective payment rate for that rate year, there shall be 
no retroactive cost settle-up.  In establishing payment rates 
for one or more operating cost categories, the commissioner may 
establish separate rates for different classes of residents 
based on their relative care needs.  
    (g) The commissioner shall include the reported actual real 
estate tax liability or payments in lieu of real estate tax of 
each nursing home as an operating cost of that nursing 
home.  Except as provided in Minnesota Rules, parts 9549.0010 to 
9549.0080, the commissioner shall allow an amount for payments 
in lieu of real estate tax assessed by a municipality, city, 
township, or county that does not exceed an amount equivalent to 
a similar assessment for fire, police, or sanitation services 
assessed to all other nonprofit or governmental entities located 
in the municipality, city, township, or county in which a 
nursing home to be assessed is located.  For rate years 
beginning on or after July 1, 1987, the reported actual real 
estate tax liability or payments in lieu of real estate tax of 
nursing homes shall be adjusted to include an amount equal to 
one-half of the dollar change in real estate taxes from the 
prior year.  The commissioner shall include a reported actual 
special assessment, and reported actual license fees required by 
the Minnesota department of health, for each nursing home as an 
operating cost of that nursing home.  Total adjusted real estate 
tax liability, payments in lieu of real estate tax, actual 
special assessments paid, and license fees paid as required by 
the Minnesota department of health, for each nursing home (1) 
shall be divided by actual resident days in order to compute the 
operating cost payment rate for this operating cost category, 
(2) shall not be used to compute the 60th percentile or other 
operating cost limits established by the commissioner, and (3) 
shall not be increased by the composite index or indices 
established pursuant to paragraph (e). 
    (h) For rate years beginning on or after July 1, 1987, the 
commissioner shall adjust the rates of a nursing home that meets 
the criteria for the special dietary needs of its residents as 
specified in section 144A.071, subdivision 3, clause (c), and 
the requirements in section 31.651.  The adjustment for raw food 
cost shall be the difference between the nursing home's 
allowable historical raw food cost per diem and 115 percent of 
the median historical allowable raw food cost per diem of the 
corresponding geographic group. 
    The rate adjustment shall be reduced by the applicable 
phase-in percentage as provided under subdivision 2h. 
    Sec. 155.  Minnesota Statutes 1986, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2i.  [OPERATING COSTS AFTER JULY 1, 1988.] (a) 
[OTHER-OPERATING-COST LIMITS.] For the rate year beginning July 
1, 1988, the commissioner shall increase the 
other-operating-cost limits established in Minnesota Rules, part 
9549.0055, subpart 2, item E, to 110 percent of the median of 
the array of allowable historical other-operating-cost per diems 
and index these limits as in Minnesota Rules, part 9549.0056, 
subparts 3 and 4.  The limits must be established in accordance 
with subdivision 2b, paragraph (d).  For rate years beginning on 
or after July 1, 1989, the adjusted other-operating-cost limits 
must be indexed as in Minnesota Rules, part 9549.0056, subparts 
3 and 4. 
    (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate year 
beginning July 1, 1988, the commissioner shall increase the 
care-related operating cost limits established in Minnesota 
Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 
of the median of the array of the allowable historical case mix 
operating cost standardized per diems and the allowable 
historical other-care-related operating cost per diems and index 
those limits as in Minnesota Rules, part 9549.0056, subparts 1 
and 2.  The limits must be established in accordance with 
subdivision 2b, paragraph (d).  For rate years beginning on or 
after July 1, 1989, the adjusted care-related limits must be 
indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 
    (c) [SALARY ADJUSTMENT PER DIEM.] For the rate period 
October 1, 1988, through June 30, 1990, the commissioner shall 
add the appropriate salary adjustment per diem calculated in 
clause (1) or (2) to the total operating cost payment rate of 
each nursing home.  The salary adjustment per diem for each 
nursing home must be determined as follows: 
    (1) for each nursing home that reports salaries for 
registered nurses, licensed practical nurses, and aides, 
orderlies and attendants separately, the commissioner shall 
determine the salary adjustment per diem by multiplying the 
total salaries, payroll taxes, and fringe benefits allowed in 
each operating cost category, except management fees and 
administrator and central office salaries and the related 
payroll taxes and fringe benefits, by 3.5 percent and then 
dividing the resulting amount by the nursing home's actual 
resident days; and 
    (2) for each nursing home that does not report salaries for 
registered nurses, licensed practical nurses, aides, orderlies, 
and attendants separately, the salary adjustment per diem is the 
weighted average salary adjustment per diem increase determined 
under clause (1). 
    Each nursing home that receives a salary adjustment per 
diem pursuant to this subdivision shall adjust nursing home 
employee salaries by a minimum of the amount determined in 
clause (1) or (2).  The commissioner shall review allowable 
salary costs, including payroll taxes and fringe benefits, for 
the reporting year ending September 30, 1989, to determine 
whether or not each nursing home complied with this 
requirement.  The commissioner shall report the extent to which 
each nursing home complied with the legislative commission on 
long-term care by August 1, 1990.  
    (d) [PENSION CONTRIBUTIONS.] For rate years beginning on or 
after July 1, 1989, the commissioner shall exempt allowable 
employee pension contributions separately reported by a nursing 
home on its annual cost report from the care-related operating 
cost limits and the other-operating-cost limits.  
Hospital-attached homes that provide allowable employee pension 
contributions may report the costs that are allocated to nursing 
home operations independently for verification by the 
commissioner.  For rate years beginning on or after July 1, 
1989, amounts verified as allowable employee pension 
contributions are exempt from care-related operating cost limits 
and other-operating-cost limits.  For purposes of this 
paragraph, "employee pension contributions" means contributions 
required under the Public Employee Retirement Act and 
contributions to other employee pension plans if the pension 
plan existed on March 1, 1988.  
    (e) [NEW BASE YEAR.] The commissioner shall establish the 
reporting year ending September 30, 1989, as a new base year. 
    Sec. 156.  Minnesota Statutes 1987 Supplement, section 
256B.431, subdivision 3, is amended to read:  
    Subd. 3.  [PROPERTY-RELATED COSTS, 1983-1985.] (a) For rate 
years beginning July 1, 1983 and July 1, 1984, property-related 
costs shall be reimbursed to each nursing home at the level 
recognized in the most recent cost report received by December 
31, 1982 and audited by March 1, 1983, and may be subsequently 
adjusted to reflect the costs recognized in the final rate for 
that cost report, adjusted for rate limitations in effect before 
the effective date of this section.  Effective for rate years 
beginning on or after July 1, 1988, a rate limitation ratio that 
is based on historical limitations resulting from the 
application of the regional maximum rate, private-pay rate, or 
ten percent cap on rate increases, must not be less than .90.  
Property-related costs include:  depreciation, interest, 
earnings or investment allowance, lease, or rental payments.  No 
adjustments shall be made as a result of sales or 
reorganizations of provider entities.  
    (b) Adjustments for the cost of repairs, replacements, 
renewals, betterments, or improvements to existing buildings, 
and building service equipment shall be allowed if:  
    (1) the cost incurred is reasonable, necessary, and 
ordinary;  
    (2) the net cost is greater than $5,000.  "Net cost" means 
the actual cost, minus proceeds from insurance, salvage, or 
disposal;  
    (3) the nursing home's property-related costs per diem is 
equal to or less than the average property-related costs per 
diem within its group; and 
    (4) the adjustment is shown in depreciation schedules 
submitted to and approved by the commissioner.  
    (c) Annual per diem shall be computed by dividing total 
property-related costs by 96 percent of the nursing home's 
licensed capacity days for nursing homes with more than 60 beds 
and 94 percent of the nursing home's licensed capacity days for 
nursing homes with 60 or fewer beds.  For a nursing home whose 
residents' average length of stay is 180 days or less, the 
commissioner may waive the 96 or 94 percent factor and divide 
the nursing home's property-related costs by the actual resident 
days to compute the nursing home's annual property-related per 
diem.  The commissioner shall promulgate emergency and permanent 
rules to recapture excess depreciation upon sale of a nursing 
home. 
    Sec. 157.  Minnesota Statutes 1986, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 3d.  [BETTERMENTS AND ADDITIONS.] Notwithstanding any 
contrary provision of chapter 256B, or a rule adopted under 
chapter 256B, a nursing home that commenced construction on a 
betterment and addition costing $700,000 or more prior to the 
expiration of Minnesota Rules, 12 MCAR 2.05001 to 2.05016 
(Temporary)(1983) shall have its property-related payment rate 
step-up as a result of the betterment and addition calculated as 
set forth in 12 MCAR 2.05011.B.3 in the case of betterments, and 
12 MCAR 2.05011.D in the case of additions.  For purposes of 
this subdivision, the terms "betterment" and "addition" have the 
meaning set forth in 12 MCAR 2.05002 and the term "commenced 
construction" has the meaning set forth in section 144A.071, 
subdivision 3. 
    Sec. 158.  Minnesota Statutes 1986, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 3e.  [HOSPITAL ATTACHED CONVALESCENT AND NURSING CARE 
FACILITIES.] If a community-operated hospital and attached 
convalescent and nursing care facility suspend operation of the 
hospital, the surviving nursing care facility must be allowed to 
continue its status as a hospital-attached convalescent and 
nursing care facility for reimbursement purposes in three 
subsequent rate years. 
    Sec. 159.  Minnesota Statutes 1986, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 3f.  [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 
[INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 
1988, the replacement-cost-new per bed limit must be $32,571 per 
licensed bed in multiple bedrooms and $48,857 per licensed bed 
in a single bedroom.  Beginning January 1, 1989, the 
replacement-cost-new per bed limits must be adjusted annually as 
specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 
subitem (1). 
    (b) [RENTAL FACTOR.] For the rate year beginning July 1, 
1988, the commissioner shall increase the rental factor as 
established in Minnesota Rules, part 9549.0060, subpart 8, item 
A, by 6.2 percent rounded to the nearest 100th percent for the 
purpose of reimbursing nursing homes for soft costs and 
entrepreneurial profits not included in the cost valuation 
services used by the state's contracted appraisers.  For rate 
years beginning on or after July 1, 1989, the rental factor is 
the amount determined under this paragraph for the rate year 
beginning July 1, 1988. 
    (c) [OCCUPANCY FACTOR.] For rate years beginning on or 
after July 1, 1988, in order to determine property-related 
payment rates under Minnesota Rules, part 9549.0060, for all 
nursing homes except those whose average length of stay in a 
skilled level of care within a nursing home is 180 days or less, 
the commissioner shall use 95 percent of capacity days.  For a 
nursing home whose average length of stay in a skilled level of 
care within a nursing home is 180 days or less, the commissioner 
shall use the greater of resident days or 80 percent of capacity 
days but in no event shall the divisor exceed 95 percent of 
capacity days. 
    (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on July 
1, 1988, and July 1, 1989, the commissioner shall add ten cents 
per resident per day to each nursing home's property-related 
payment rate.  The ten-cent property-related payment rate 
increase is not cumulative from rate year to rate year.  For the 
rate year beginning July 1, 1990, the commissioner shall 
increase each nursing home's equipment allowance as established 
in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per 
resident per day.  For rate years beginning on or after July 1, 
1991, the adjusted equipment allowance must be adjusted annually 
for inflation as in Minnesota Rules, part 9549.0060, subpart 10, 
item E.  
    (e) [REFINANCING.] If a nursing home is refinanced, the 
commissioner shall adjust the nursing home's property-related 
payment rate for the savings that result from refinancing.  The 
adjustment to the property-related payment rate must be as 
follows: 
    (1) The commissioner shall recalculate the nursing home's 
rental per diem by substituting the new allowable annual 
principle and interest payments for those of the refinanced debt.
    (2) The nursing home's property-related payment rate must 
be decreased by the difference between the nursing home's 
current rental per diem and the rental per diem determined under 
clause (1). 
    If a nursing home payment rate is adjusted according to 
this paragraph, the adjusted payment rate is effective the first 
of the month following the date of the refinancing for both 
medical assistance and private paying residents.  The nursing 
home's adjusted property-related payment rate is effective until 
June 30, 1990. 
    Sec. 160.  Minnesota Statutes 1986, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 3g.  [PROPERTY COSTS AFTER JULY 1, 1990, FOR CERTAIN 
FACILITIES.] For rate years beginning on or after July 1, 1990, 
non-hospital-attached nursing homes that, on or after January 1, 
1976, but prior to December 31, 1985, were newly licensed after 
new construction, or increased their licensed beds by a minimum 
of 35 percent through new construction, and whose building 
capital allowance is less than their allowable annual principal 
and interest on allowable debt prior to the application of the 
replacement-cost-new per bed limit and whose remaining weighted 
average debt amortization schedule as of January 1, 1988, 
exceeded 15 years, must receive a property-related payment rate 
equal to the greater of their rental per diem or their annual 
allowable principal and allowable interest without application 
of the replacement-cost-new per bed limit plus their equipment 
allowance.  A nursing home that is eligible for a 
property-related payment rate under this subdivision and whose 
property-related payment rate in a subsequent rate year is its 
rental per diem must continue to have its property-related 
payment rates established for all future rate years based on the 
rental reimbursement method in Minnesota Rules, part 9549.0060.  
The commissioner may require the nursing home to apply for 
refinancing as a condition of receiving special rate treatment 
under this subdivision. 
    Sec. 161.  Minnesota Statutes 1987 Supplement, section 
256B.431, subdivision 4, is amended to read: 
    Subd. 4.  [SPECIAL RATES.] (a) For the rate years beginning 
July 1, 1983, and July 1, 1984, a newly constructed nursing home 
or one with a capacity increase of 50 percent or more may, upon 
written application to the commissioner, receive an interim 
payment rate for reimbursement for property-related costs 
calculated pursuant to the statutes and rules in effect on May 
1, 1983, and for operating costs negotiated by the commissioner 
based upon the 60th percentile established for the appropriate 
group under subdivision 2a, to be effective from the first day a 
medical assistance recipient resides in the home or for the 
added beds.  For newly constructed nursing homes which are not 
included in the calculation of the 60th percentile for any 
group, subdivision 2f, the commissioner shall establish by rule 
procedures for determining interim operating cost payment rates 
and interim property-related cost payment rates.  The interim 
payment rate shall not be in effect for more than 17 months.  
The commissioner shall establish, by emergency and permanent 
rules, procedures for determining the interim rate and for 
making a retroactive cost settle-up after the first year of 
operation; the cost settled operating cost per diem shall not 
exceed 110 percent of the 60th percentile established for the 
appropriate group.  Until procedures determining operating cost 
payment rates according to mix of resident needs are 
established, the commissioner shall establish by rule procedures 
for determining payment rates for nursing homes which provide 
care under a lesser care level than the level for which the 
nursing home is certified.  
     (b) For the rate years beginning on or after July 1, 1985, 
a newly constructed nursing home or one with a capacity increase 
of 50 percent or more may, upon written application to the 
commissioner, receive an interim payment rate for reimbursement 
for property related costs, operating costs, and real estate 
taxes and special assessments calculated under rules promulgated 
by the commissioner. 
     (c) For rate years beginning on or after July 1, 1983, the 
commissioner may exclude from a provision of 12 MCAR S 2.050 any 
facility that is licensed by the commissioner of health only as 
a boarding care home, certified by the commissioner of health as 
an intermediate care facility, is licensed by the commissioner 
of human services under Minnesota Rules, parts 9520.0500 to 
9520.0690, and has less than five percent of its licensed 
boarding care capacity reimbursed by the medical assistance 
program.  Until a permanent rule to establish the payment rates 
for facilities meeting these criteria is promulgated, the 
commissioner shall establish the medical assistance payment rate 
as follows:  
    (1) The desk audited payment rate in effect on June 30, 
1983, remains in effect until the end of the facility's fiscal 
year.  The commissioner shall not allow any amendments to the 
cost report on which this desk audited payment rate is based.  
    (2) For each fiscal year beginning between July 1, 1983, 
and June 30, 1985, the facility's payment rate shall be 
established by increasing the desk audited operating cost 
payment rate determined in clause (1) at an annual rate of five 
percent.  
    (3) For fiscal years beginning on or after July 1, 1985, 
but before January 1, 1988, the facility's payment rate shall be 
established by increasing the facility's payment rate in the 
facility's prior fiscal year by the increase indicated by the 
consumer price index for Minneapolis and St. Paul.  
     (4) For the fiscal year beginning on January 1, 1988, the 
facility's payment rate must be established using the following 
method:  The commissioner shall divide the real estate taxes and 
special assessments payable as stated in the facility's current 
property tax statement by actual resident days to compute a real 
estate tax and special assessment per diem.  Next, the prior 
year's payment rate must be adjusted by the higher of (1) the 
percentage change in the consumer price index (CPI-U U.S. city 
average) as published by the Bureau of Labor Statistics between 
the previous two Septembers, new series index (1967-100), or (2) 
2.5 percent, to determine an adjusted payment rate.  The 
facility's payment rate is the adjusted prior year's payment 
rate plus the real estate tax and special assessment per diem. 
    (5) For fiscal years beginning on or after January 1, 1989, 
the facility's payment rate must be established using the 
following method:  The commissioner shall divide the real estate 
taxes and special assessments payable as stated in the 
facility's current property tax statement by actual resident 
days to compute a real estate tax and special assessment per 
diem.  Next, the prior year's payment rate less the real estate 
tax and special assessment per diem must be adjusted by the 
higher of (1) the percentage change in the consumer price index 
(CPI-U U.S. city average) as published by the Bureau of Labor 
Statistics between the previous two Septembers, new series index 
(1967-100), or (2) 2.5 percent, to determine an adjusted payment 
rate.  The facility's payment rate is the adjusted payment rate 
plus the real estate tax and special assessment per diem. 
     (6) For the purpose of establishing payment rates under 
this paragraph, the facility's rate and reporting years coincide 
with the facility's fiscal year.  
     A facility that meets the criteria of this paragraph shall 
submit annual cost reports on forms prescribed by the 
commissioner.  
     For the rate year beginning July 1, 1985, each nursing home 
total payment rate must be effective two calendar months from 
the first day of the month after the commissioner issues the 
rate notice to the nursing home.  From July 1, 1985, until the 
total payment rate becomes effective, the commissioner shall 
make payments to each nursing home at a temporary rate that is 
the prior rate year's operating cost payment rate increased by 
2.6 percent plus the prior rate year's property-related payment 
rate and the prior rate year's real estate taxes and special 
assessments payment rate.  The commissioner shall retroactively 
adjust the property-related payment rate and the real estate 
taxes and special assessments payment rate to July 1, 1985, but 
must not retroactively adjust the operating cost payment rate. 
     (d) For the purposes of Minnesota Rules, part 9549.0060, 
subpart 13, item F, the following types of transactions shall 
not be considered a sale or reorganization of a provider entity: 
     (1) the sale or transfer of a nursing home upon death of an 
owner; 
     (2) the sale or transfer of a nursing home due to serious 
illness or disability of an owner as defined under the social 
security act; 
     (3) the sale or transfer of the nursing home upon 
retirement of an owner at 62 years of age or older; 
     (4) any transaction in which a partner, owner, or 
shareholder acquires an interest or share of another partner, 
owner, or shareholder in a nursing home business provided the 
acquiring partner, owner, or shareholder has less than 50 
percent ownership after the acquisition; 
     (5) a sale and leaseback to the same licensee which does 
not constitute a change in facility license; 
     (6) a transfer of an interest to a trust; 
     (7) gifts or other transfers for no consideration; 
     (8) a merger of two or more related organizations; 
     (9) a transfer of interest in a facility held in 
receivership; 
     (10) a change in the legal form of doing business other 
than a publicly held organization which becomes privately held 
or vice versa; 
     (11) the addition of a new partner, owner, or shareholder 
who owns less than 20 percent of the nursing home or the 
issuance of stock; or 
     (12) an involuntary transfer including foreclosure, 
bankruptcy, or assignment for the benefit of creditors. 
     Any increase in allowable debt or allowable interest 
expense or other cost incurred as a result of the foregoing 
transactions shall be a nonallowable cost for purposes of 
reimbursement under Minnesota Rules, parts 9549.0010 to 
9549.0080. 
     (e) For rate years beginning on or after July 1, 1986, the 
commissioner may exclude from a provision of Minnesota Rules, 
parts 9549.0010 to 9549.0080, any facility that is certified by 
the commissioner of health as an intermediate care facility, 
licensed by the commissioner of human services as a chemical 
dependency treatment program, and enrolled in the medical 
assistance program as an institution for mental disease.  The 
commissioner of human services shall establish a medical 
assistance payment rate for these facilities.  Chapter 14 does 
not apply to the procedures and criteria used to establish the 
ratesetting structure.  The ratesetting method is not appealable.
    Sec. 162.  Minnesota Statutes 1987 Supplement, section 
256B.433, subdivision 1, is amended to read: 
    Subdivision 1.  [SETTING PAYMENT; MONITORING USE OF THERAPY 
SERVICES.] The commissioner shall promulgate rules pursuant to 
the administrative procedure act to set the amount and method of 
payment for ancillary materials and services provided to 
recipients residing in nursing homes.  Payment for materials and 
services may be made to either the nursing home in the operating 
cost per diem, to the vendor of ancillary services pursuant to 
Minnesota Rules, parts 9500.0750 to 9500.1080 or to a nursing 
home pursuant to Minnesota Rules, parts 9500.0750 to 9500.1080.  
Payment for the same or similar service to a recipient shall not 
be made to both the nursing home and the vendor.  The 
commissioner shall ensure the avoidance of double payments 
through audits and adjustments to the nursing home's annual cost 
report as required by section 256B.47, and that charges and 
arrangements for ancillary materials and services are cost 
effective and as would be incurred by a prudent and 
cost-conscious buyer.  Therapy services provided to a recipient 
must be medically necessary and appropriate to the medical 
condition of the recipient.  If the vendor, nursing home, or 
ordering physician cannot provide adequate medical necessity 
justification, as determined by the commissioner, in 
consultation with an advisory committee that meets the 
requirements of section 256B.064, subdivision 1a, the 
commissioner may recover or disallow the payment for the 
services and may require prior authorization for therapy 
services as a condition of payment or may impose administrative 
sanctions to limit the vendor, nursing home, or ordering 
physician's participation in the medical assistance program.  If 
the provider number of a nursing home is used to bill services 
provided by a vendor of therapy services that is not related to 
the nursing home by ownership, control, affiliation or 
employment status, no withholding of payment shall be imposed 
against the nursing home for services not medically necessary 
except for funds due the unrelated vendor of therapy services as 
provided in subdivision 3, paragraph (c).  For the purpose of 
this subdivision, no monetary recovery may be imposed against 
the nursing home for funds paid to the unrelated vendor of 
therapy services as provided in subdivision 3, paragraph (c), 
for services not medically necessary. 
    Sec. 163.  Minnesota Statutes 1986, section 256B.50, 
subdivision 1, is amended to read:  
    Subdivision 1.  [SCOPE.] A nursing home provider may appeal 
from a decision arising from the application of standards or 
methods determination of a payment rate established pursuant 
to sections 256B.41 and 256B.47 this chapter and reimbursement 
rules of the commissioner if the appeal, if successful, would 
result in a change to the nursing home's provider's payment 
rate, or appraised value.  The appeal procedures also apply to 
appeals of payment rates calculated under Minnesota Rules, parts 
9510.0010 to 9510.0480 filed with the commissioner on or after 
May 1, 1984.  Appeals must be filed in accordance with 
procedures in this section.  This section does not apply to a 
request from a resident or nursing home for reconsideration of 
the classification of a resident under section 144.0722.  
    Subd. 1a.  [DEFINITIONS.] For the purposes of this section, 
the following terms have the meanings given. 
    (a) "Determination of a payment rate" means the process by 
which the commissioner establishes the payment rate paid to a 
provider pursuant to this chapter, including determinations made 
in desk audit, field audit, or pursuant to an amendment filed by 
the provider.  
    (b) "Provider" means a nursing home as defined in section 
256B.421, subdivision 7, or a facility as defined in section 
256B.501, subdivision 1. 
    (c) "Reimbursement rules" means Minnesota Rules, parts 
9510.0010 to 9510.0480, 9510.0500 to 9510.0890, and rules 
adopted by the commissioner pursuant to sections 256B.41 and 
256B.501, subdivision 3. 
    Subd. 1b.  [FILING AN APPEAL.] To appeal, the nursing home 
provider shall notify file with the commissioner in writing of 
its intent to appeal within 30 days and submit a written notice 
of appeal; the appeal request must be received by the 
commissioner within 60 days of receiving notice of the date 
the payment rate determination or decision of the payment rate 
was mailed.  The notice of appeal request shall must specify 
each disputed item,; the reason for the dispute, an estimate of; 
the total dollar amount involved for each disputed item, and the 
dollar amount per bed in dispute for each separate disallowance, 
allocation, or adjustment of each cost item or part of a cost 
item; the computation that the nursing home provider believes is 
correct,; the authority in statute or rule upon which the 
nursing home provider 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. 
    Subd. 1c.  [CONTESTED CASE PROCEDURES.] Except as provided 
in subdivision 2, the appeal shall must be heard by an 
administrative law judge according to sections 14.48 to 14.56, 
or upon agreement by both parties according to a modified 
appeals procedure established by the commissioner and the 
administrative law judge.  In any proceeding under this section, 
the appealing party must demonstrate by a preponderance of the 
evidence that the commissioner's determination is incorrect.  
Regardless of any rate appeal, the rate established shall must 
be the rate paid and shall must remain in effect until final 
resolution of the appeal or subsequent desk or field audit 
adjustment, notwithstanding any provision of law or rule to the 
contrary.  To challenge the validity of rules established by the 
commissioner pursuant to this section and sections 256B.41, 
256B.421, 256B.431, 256B.47, 256B.48, 256B.501, and 256B.502, a 
nursing home provider shall comply with section 14.44. 
    Sec. 164.  Minnesota Statutes 1986, section 256B.50, is 
amended by adding a subdivision to read: 
    Subd. 1d.  [EXPEDITED APPEAL REVIEW PROCESS.] (a) Within 
120 days of the date an appeal is due according to subdivision 
1b, the department shall review an appealed adjustment equal to 
or less than $100 annually per licensed bed of the provider, 
make a determination concerning the adjustment, and notify the 
provider of the determination.  Except as allowed in paragraph 
(g), this review does not apply to an appeal of an adjustment 
made to, or proposed on, an amount already paid to the 
provider.  In this subdivision, an adjustment is each separate 
disallowance, allocation, or adjustment of a cost item or part 
of a cost item as submitted by a provider according to forms 
required by the commissioner. 
    (b) For an item on which the provider disagrees with the 
results of the determination of the department made under 
paragraph (a), the provider may, within 60 days of the date of 
the review notice, file with the office of administrative 
hearings and the department its written argument and documents, 
information, or affidavits in support of its appeal.  If the 
provider fails to make a submission in accordance with this 
paragraph, the department's determinations on the disputed items 
must be upheld. 
    (c) Within 60 days of the date the department received the 
provider's submission under paragraph (b), the department may 
file with the office of administrative hearings and serve upon 
the provider its written argument and documents, information, 
and affidavits in support of its determination.  If the 
department fails to make a submission in accordance with this 
paragraph, the administrative law judge shall proceed pursuant 
to paragraph (d) based on the provider's submission. 
    (d) Upon receipt by the office of administrative hearings 
of the department's submission made under paragraph (c) or upon 
the expiration of the 60-day filing period, whichever is 
earlier, the chief administrative law judge shall assign the 
matter to an administrative law judge.  The administrative law 
judge shall consider the submissions of the parties and all 
relevant rules, statutes, and case law.  The administrative law 
judge may request additional argument from the parties if it is 
deemed necessary to reach a final decision, but shall not allow 
witnesses to be presented or discovery to be made in the 
proceeding.  Within 60 days of receipt by the office of 
administrative hearings of the department's submission or the 
expiration of the 60-day filing period in paragraph (c), 
whichever is earlier, the administrative law judge shall make a 
final decision on the items in issue, and shall notify the 
provider and the department by first-class mail of the decision 
on each item.  The decision of the administrative law judge is 
the final administrative decision, is not appealable, and does 
not create legal precedent, except that the department may make 
an adjustment contrary to the decision of the administrative law 
judge based upon a subsequent cost report amendment or field 
audit that reveals information relating to the adjustment that 
was not known to the department at the time of the final 
decision. 
    (e) For a disputed item otherwise subject to the review set 
forth in this subdivision, the department and the provider may 
mutually agree to bypass the expedited review process and 
proceed to a contested case hearing at any time prior to the 
time for the department's submission under paragraph (c). 
    (f) When the department determines that the appeals of two 
or more providers otherwise subject to the review set forth in 
this subdivision present the same or substantially the same 
adjustment, the department may remove the disputed items from 
the review in this subdivision, and the disputed items shall 
proceed in accordance with subdivision 1c.  The department's 
decision to remove the appealed adjustments to contested case 
proceeding is final and is not reviewable. 
    (g) For a disputed item otherwise subject to the review in 
this subdivision, the department or a provider may petition the 
chief administrative law judge to issue an order allowing the 
petitioning party to bypass the expedited review process.  If 
the petition is granted, the disputed item must proceed in 
accordance with subdivision 1c.  In making the determination, 
the chief administrative law judge shall consider the potential 
impact and precedential and monetary value of the disputed 
item.  A petition for removal to contested case hearing must be 
filed with the chief administrative law judge and the opposing 
party on or before the date on which its submission is due under 
paragraph (b) or (c).  Within 20 days of receipt of the 
petition, the opposing party may submit its argument opposing 
the petition.  Within 20 days of receipt of the argument 
opposing the petition, or if no argument is received, within 20 
days of the date on which the argument was due, the chief 
administrative law judge shall issue a decision granting or 
denying the petition.  If the petition is denied, the 
petitioning party has 60 days from the date of the denial to 
make a submission under paragraph (b) or (c). 
    (h) The department and a provider may mutually agree to use 
the procedures set forth in this subdivision for any disputed 
item not otherwise subject to this subdivision. 
    (i) Nothing shall prevent either party from making its 
submissions and arguments under this subdivision through a 
person who is not an attorney. 
    (j) This subdivision applies to all appeals for rate years 
beginning after June 30, 1988. 
    Sec. 165.  Minnesota Statutes 1986, section 256B.50, is 
amended by adding a subdivision to read: 
    Subd. 1e.  [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 
section 3.762, paragraph (a), for an issue appealed under 
subdivision 1, the prevailing party in a contested case 
proceeding or, if appealed, in subsequent judicial review, must 
be awarded reasonable attorney's fees and costs incurred in 
litigating the appeal, if the prevailing party shows that the 
position of the opposing party was not substantially justified.  
The procedures for awarding fees and costs set forth in section 
3.764 must be followed in determining the prevailing party's 
fees and costs except as otherwise provided in this 
subdivision.  For purposes of this subdivision, "costs" means 
subpoena fees and mileage, transcript costs, court reporter 
fees, witness fees, postage and delivery costs, photocopying and 
printing costs, amounts charged the commissioner by the office 
of administrative hearings, and direct administrative costs of 
the department; and "substantially justified" means that a 
position had a reasonable basis in law and fact, based on the 
totality of the circumstances prior to and during the contested 
case proceeding and subsequent review. 
    (b) When an award is made to the department under this 
subdivision, attorney fees must be calculated at the cost to the 
department.  When an award is made to a provider under this 
subdivision, attorney fees must be calculated at the rate 
charged to the provider except that attorney fees awarded must 
be the lesser of the attorney's normal hourly fee or $100 per 
hour. 
    (c) In contested case proceedings involving more than one 
issue, the administrative law judge shall determine what portion 
of each party's attorney fees and costs is related to the issue 
or issues on which it prevailed and for which it is entitled to 
an award.  In making that determination, the administrative law 
judge shall consider the amount of time spent on each issue, the 
precedential value of the issue, the complexity of the issue, 
and other factors deemed appropriate by the administrative law 
judge.  
    (d) When the department prevails on an issue involving more 
than one provider, the administrative law judge shall allocate 
the total amount of any award for attorney fees and costs among 
the providers.  In determining the allocation, the 
administrative law judge shall consider each provider's monetary 
interest in the issue and other factors deemed appropriate by 
the administrative law judge.  
    (e) Attorney fees and costs awarded to the department for 
proceedings under this subdivision must not be reported or 
treated as allowable costs on the provider's cost report.  
    (f) Fees and costs awarded to a provider for proceedings 
under this subdivision must be reimbursed to them by reporting 
the amount of fees and costs awarded as allowable costs on the 
provider's cost report for the reporting year in which they were 
awarded.  Fees and costs reported pursuant to this subdivision 
must be included in the general and administrative cost category 
but are not subject to either the general and administrative or 
other-operating-cost limits. 
    (g) If the provider fails to pay the awarded attorney fees 
and costs within 120 days of the final decision on the award of 
attorney fees and costs, the department may collect the amount 
due through any method available to it for the collection of 
medical assistance overpayments to providers.  Interest charges 
must be assessed on balances outstanding after 120 days of the 
final decision on the award of attorney fees and costs.  The 
annual interest rate charged must be the rate charged by the 
commissioner of revenue for late payment of taxes that is in 
effect on the 121st day after the final decision on the award of 
attorney fees and costs.  
    (h) Amounts collected by the commissioner pursuant to this 
subdivision must be deemed to be recoveries pursuant to section 
256.01, subdivision 2, clause 15. 
    (i) This subdivision applies to all contested case 
proceedings set on for hearing by the commissioner on or after 
the effective date of this section, regardless of the date the 
appeal was filed.  
    Sec. 166.  Minnesota Statutes 1986, section 256B.50, is 
amended by adding a subdivision to read: 
     Subd. 1f.  [LEGAL AND RELATED EXPENSES.] Legal and related 
expenses for unresolved challenges to decisions by governmental 
agencies shall be separately identified and explained on the 
provider's cost report for each year in which the expenses are 
incurred.  When the challenge is resolved in favor of the 
governmental agency, the provider shall notify the department of 
the extent to which its challenge was unsuccessful or the cost 
report filed for the reporting year in which the challenge was 
resolved.  In addition, the provider shall inform the department 
of the years in which it claimed legal and related expenses and 
the amount of the expenses claimed in each year relating to the 
unsuccessful challenge.  The department shall reduce the 
provider's medical assistance rate in the subsequent rate year 
by the total amount claimed by the provider for legal and 
related expenses incurred in an unsuccessful challenge to a 
decision by a governmental agency. 
    Sec. 167.  Minnesota Statutes 1986, section 256B.50, is 
amended by adding a subdivision to read:  
    Subd. 1g.  [APPEAL SUPPLEMENT.] (a) For an appeal filed 
with the commissioner regarding payment rates calculated 
pursuant to Minnesota Rules, parts 9510.0010 to 9510.0480, or 
parts 9510.0500 to 9510.0890, or prior provisions of these 
rules, that was not subject to the provisions of this section or 
section 256B.501, subdivision 3, at the time it was filed, the 
appellant must file an appeal supplement.  The appeal supplement 
must be filed no later than December 31, 1988, and must specify 
each disputed item, the reason for the dispute, an estimate of 
the dollar amount involved for each disputed item, the 
computation that the provider believes is correct, the authority 
in statute or rule upon which the provider relies for each 
disputed item, the name and address of the person or firm with 
whom contacts may be made regarding the appeal, and any other 
information required by the commissioner.  Failure to file the 
appeal supplement is jurisdictional and the commissioner may 
accordingly dismiss the appeal, and the rate established by the 
commissioner shall take effect.  
    (b) Filing of an appeal supplement must not be construed to 
correct any legal defect in the original appeal.  
    (c) An appeal for which an appeal supplement is filed 
pursuant to this subdivision must be set on for a contested case 
hearing, made part of the expedited appeal process with the 
agreement of both the provider and the department, or otherwise 
resolved by December 31, 1989. 
    Sec. 168.  Minnesota Statutes 1987 Supplement, section 
256B.50, subdivision 2, is amended to read:  
    Subd. 2.  [APPRAISED VALUE.] (a) An A nursing home may 
appeal the determination of its appraised value, as determined 
by the commissioner pursuant to section 256B.431 and rules 
established thereunder.  A written notice of appeal request 
concerning the appraised value of a nursing home's real estate 
as established by an appraisal conducted after July 1, 1986, 
shall must be filed with the commissioner within 60 days of the 
date the determination was made and shall state the appraised 
value the nursing home believes is correct for the building, 
land improvements, and attached equipment and the name and 
address of the firm with whom contacts may be made regarding the 
appeal.  The appeal request shall include a separate appraisal 
report prepared by an independent appraiser of real estate which 
supports the total appraised value claimed by the nursing home.  
The appraisal report shall be based on an on-site inspection of 
the nursing home's real estate using the depreciated replacement 
cost method, must be in a form comparable to that used in the 
commissioner's appraisal, and must pertain to the same time 
period covered by the appealed appraisal.  The appraisal report 
shall include information related to the training, experience, 
and qualifications of the appraiser who conducted and prepared 
the appraisal report for the nursing home. 
    (b) A nursing home which has filed an appeal request prior 
to the effective date of Laws 1987, chapter 403, concerning the 
appraised value of its real estate as established by an 
appraisal conducted before July 1, 1986, must submit to the 
commissioner the information described under paragraph (a) 
within 60 days of the effective date of Laws 1987, chapter 403, 
in order to preserve the appeal. 
    (c) An appeal request which has been filed pursuant to the 
provisions of paragraph (a) or (b) shall be finally resolved 
through an agreement entered into by and between the 
commissioner and the nursing home or by the determination of an 
independent appraiser based upon an on-site inspection of the 
nursing home's real estate using the depreciated replacement 
cost method, in a form comparable to that used in the 
commissioner's appraisal, and pertaining to the same time period 
covered by the appealed appraisal.  The appraiser shall be 
selected by the commissioner and the nursing home by alternately 
striking names from a list of appraisers approved for state 
contracts by the commissioner of administration.  The appraiser 
shall make assurances to the satisfaction of the commissioner 
and the nursing home that the appraiser is experienced in the 
use of the depreciated cost method of appraisals and that the 
appraiser is free of any personal, political, or economic 
conflict of interest that may impair the ability to function in 
a fair and objective manner.  The commissioner shall pay costs 
of the appraiser through a negotiated rate for services of the 
appraiser. 
    (d) The decision of the appraiser is final and is not 
appealable.  Exclusive jurisdiction for appeals of the appraised 
value of nursing homes lies with the procedures set out in this 
subdivision.  No court of law shall possess subject matter 
jurisdiction to hear appeals of appraised value determinations 
of nursing homes. 
    Sec. 169.  Minnesota Statutes 1987 Supplement, section 
256B.501, subdivision 1, is amended to read:  
    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 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 1987, 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. 
     Sec. 170.  Minnesota Statutes 1986, section 256B.501, 
subdivision 3, is amended to read:  
    Subd. 3.  [RATES FOR INTERMEDIATE CARE FACILITIES FOR 
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 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; 
    (d) incentives to reward accumulation of equity; and 
    (e) a revaluation on sale for a facility that, for at least 
three years before its use as an intermediate care facility, has 
been used by the seller as a single family home and been claimed 
by the seller as a homestead, and was not revalued immediately 
prior to or upon entering the medical assistance program, 
provided that the facility revaluation not exceed the amount 
permitted by the Social Security Act, section 1902(a)(13); and 
    (f) appeals procedures that satisfy the requirements of 
section 256B.50 for appeals of decisions arising from the 
application of standards or methods pursuant to Minnesota Rules, 
parts 9510.0500 to 9510.0890, 9553.0010 to 9553.0080, and 12 
MCAR 2.05301 to 2.05315 (temporary).  
    In establishing rules and procedures for setting rates for 
care of residents in intermediate care facilities for 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. 
    Sec. 171.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3a.  [INTERIM RATES.] For rate years beginning 
October 1, 1988, and October 1, 1989, the commissioner shall 
establish an interim program operating cost payment rate for 
care of residents in intermediate care facilities for persons 
with mental retardation.  
    (a) For the rate year beginning October 1, 1988, the 
interim program operating cost payment rate is the greater of 
the facility's 1987 reporting year allowable program operating 
costs per resident day increased by the composite forecasted 
index in section 256B.501, subdivision 3c, or the facility's 
January 1, 1988, program operating cost payment rate increased 
by the composite forecasted index in section 256B.501, 
subdivision 3c, except that the composite forecasted index is 
established based on the midpoint of the period January 1, 1988, 
through September 30, 1988, to the midpoint of the following 
rate year.  
    (b) For the rate year beginning October 1, 1989, the 
interim program operating cost payment rate is the greater of 
the facility's 1988 reporting year allowable program operating 
costs per resident day increased by the composite forecasted 
index in section 256B.501, subdivision 3c, or the facility's 
October 1, 1988, program operating cost payment rate increased 
by the composite forecasted index in section 256B.501, 
subdivision 3c, except that the composite forecasted index is 
established based on the midpoint of the rate year beginning 
October 1, 1988, to the midpoint of the following rate year. 
    Sec. 172.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3b.  [SETTLE-UP OF COSTS.] The facility's program 
operating costs are subject to a retroactive settle-up for the 
1988 and 1989 reporting years, determined by the following 
method: 
    (a) If a facility's program operating costs, including 
one-time adjustment program operating costs for the facility's 
1988 or 1989 reporting year, are less than 98 percent of the 
facility's total program operating cost payments for facilities 
with 20 or fewer licensed beds, or less than 99 percent of the 
facility's total program operating cost payments for facilities 
with more than 20 licensed beds, then the facility must repay 
the difference to the state according to the desk audit 
adjustment procedures in Minnesota Rules, part 9553.0041, 
subpart 13, items B to E.  For the purpose of determining the 
retroactive settle-up amounts, the facility's total program 
operating cost payments must be computed by multiplying the 
facility's program operating cost payment rates, including 
one-time program operating cost adjustment rates for those 
reporting years, by the prorated resident days that correspond 
to those program operating cost payment rates paid during those 
reporting years. 
    (b) If a facility's program operating costs, including 
one-time adjustment program operating costs for the facility's 
1989 reporting year are between 102 and 105 percent of the 
amount computed by multiplying the facility's program operating 
cost payment rates, including one-time program operating cost 
adjustment rates for those reporting years, by the prorated 
resident days that correspond to those program operating cost 
payment rates paid during that reporting year, the state must 
repay the difference to the facility according to the desk audit 
adjustment procedures in Minnesota Rules, part 9553.0041, 
subpart 13, items B to E. 
    A facility's retroactive settle-up must be calculated by 
October 1, 1990. 
    Sec. 173.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3c.  [COMPOSITE FORECASTED INDEX.] For rate years 
beginning on or after October 1, 1988, the commissioner shall 
establish a statewide composite forecasted index to take into 
account economic trends and conditions between the midpoint of 
the facility's reporting year and the midpoint of the rate year 
following the reporting year.  The statewide composite index 
must incorporate the forecast by Data Resources, Inc. of 
increases in the average hourly earnings of nursing and personal 
care workers indexed in Standard Industrial Code 805 in 
"Employment and Earnings," published by the Bureau of Labor 
Statistics, United States Department of Labor.  This portion of 
the index must be weighted annually by the proportion of total 
allowable salaries and wages to the total allowable operating 
costs in the program, maintenance, and administrative operating 
cost categories for all facilities. 
    For adjustments to the other operating costs in the 
program, maintenance, and administrative operating cost 
categories, the statewide index must incorporate the Data 
Resources, Inc. forecast for increases in the national CPI-U.  
This portion of the index must be weighted annually by the 
proportion of total allowable other operating costs to the total 
allowable operating costs in the program, maintenance, and 
administrative operating cost categories for all facilities.  
The commissioner shall use the indices as forecasted by Data 
Resources, Inc., in the fourth quarter of the reporting year. 
    Sec. 174.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3d.  [LIMITS ON ADMINISTRATIVE OPERATING COSTS.] For 
the rate year beginning October 1, 1989, the administrative 
operating cost per bed limit shall be calculated according to 
paragraphs (a) to (d). 
    (a) The commissioner shall classify a facility into one of 
two groups based on the number of licensed beds reported on the 
facility's cost report.  Group one includes facilities with more 
than 20 licensed beds.  Group two includes facilities with 20 or 
fewer licensed beds. 
    (b) The commissioner shall determine the allowable 
administrative historical operating cost per licensed bed for 
each facility in the two groups by dividing the allowable 
administrative historical operating cost in each facility by the 
number of licensed beds in each facility. 
    (c) The commissioner shall establish the administrative 
cost per licensed bed limit by multiplying the median of the 
array of allowable administrative historical operating costs per 
licensed bed for each group by the percentage that establishes 
the limit at the 75th percentile of the array of each group. 
    (d) For the rate year beginning October 1, 1989, the 
maximum allowable administrative historical operating cost shall 
be the facility's allowable administrative historical operating 
cost or the amount in paragraph (c) multiplied by the facility's 
licensed beds, whichever is less. 
    Sec. 175.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3e.  [INCREASE IN LIMITS.] For rate years beginning 
on or after October 1, 1990, the commissioner shall increase the 
administrative cost per licensed bed limit in section 256B.501, 
subdivision 3d, paragraph (c), and the maintenance operating 
cost limit in Minnesota Rules, part 9553.0050, subpart 1, item 
A, subitem (2), by multiplying the administrative operating cost 
per bed limit and the maintenance operating cost limit by the 
composite forecasted index in section 256B.501, subdivision 3c 
except that the index shall be based on the 12 months between 
the midpoints of the two preceding reporting years. 
    Sec. 176.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3f.  [RATE ADJUSTMENTS.] For rate years beginning 
October 1, 1989, the commissioner may develop a method to adjust 
facility rates to meet new licensing or certification standards 
or regulations adopted by the state or federal government that 
result in significant cost increases.  The commissioner may also 
consider establishing separate administrative cost limits based 
on other factors including difficulty of care of residents and 
licensure classification. 
    Sec. 177.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3g.  [ASSESSMENT OF RESIDENTS.] For rate years 
beginning on or after October 1, 1990, the commissioner shall 
establish program operating cost rates for care of residents in 
facilities that take into consideration service characteristics 
of residents in those facilities.  To establish the service 
characteristics of residents, the quality assurance and review 
teams in the department of health shall assess all residents 
annually beginning January 1, 1989, using a uniform assessment 
instrument developed by the commissioner.  This instrument shall 
include assessment of the client's behavioral needs, integration 
into the community, ability to perform activities of daily 
living, medical and therapeutic needs, and other relevant 
factors determined by the commissioner.  The commissioner may 
establish procedures to adjust the program operating costs of 
facilities based on a comparison of client services 
characteristics, resource needs, and costs. 
    Sec. 178.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3h.  [WAIVING INTEREST CHARGES.] The commissioner may 
waive interest charges on overpayments incurred by intermediate 
care facilities for persons with mental retardation and related 
conditions for the period October 1, 1987, through February 29, 
1988, if the overpayments resulted from the continuation of the 
desk audit rate in effect on September 30, 1987, through the 
period. 
    Sec. 179.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3i.  [SCOPE.] Subdivisions 3a to 3h do not apply to 
facilities whose payment rates are governed by Minnesota Rules, 
part 9553.0075. 
    Sec. 180.  Minnesota Statutes 1986, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 3j.  [RULES.] The commissioner shall adopt rules to 
implement this section.  The commissioner shall consult with 
provider groups, advocates, and legislators to develop these 
rules. 
    Sec. 181.  [256B.64] [ATTENDANTS TO VENTILATOR-DEPENDENT 
RECIPIENTS.] 
    A ventilator-dependent recipient of medical assistance who 
has been receiving the services of a private duty nurse or 
personal care assistant in the recipient's home may continue to 
have a private duty nurse or personal care assistant present 
upon admission to a hospital licensed under chapter 144.  The 
personal care assistant or private duty nurse shall perform only 
the services of communicator or interpreter for the 
ventilator-dependent patient during a transition period of up to 
120 hours to assure adequate training of the hospital staff to 
communicate with the patient and to understand the unique 
comfort, safety, and personal care needs of the patient.  The 
personal care assistant or private duty nurse may offer 
nonbinding advice to the health care professionals in charge of 
the ventilator-dependent patient's care and treatment on matters 
pertaining to the comfort and safety of the patient.  After the 
120 hour transition period, an assessment may be made by the 
ventilator-dependent patient, the attending physician, and the 
patient's primary care nurse to determine whether continued 
services of communicator or interpreter for the patient by the 
private duty nurse or personal care assistant are necessary and 
appropriate for the patient's needs.  If continued service is 
necessary and appropriate, the physician must certify this need 
to the commissioner of human services in order for payments to 
continue.  The commissioner may adopt rules necessary to 
implement this section.  Reimbursement under this section must 
be at the payment rate and in a manner consistent with the 
payment rate and manner used in reimbursing these providers for 
home care services for the ventilator-dependent recipient under 
the medical assistance program.  
    Sec. 182.  Minnesota Statutes 1986, section 256B.69, 
subdivision 3, is amended to read: 
    Subd. 3.  [GEOGRAPHIC AREA.] The commissioner shall 
designate the geographic areas in which eligible individuals may 
be included in the demonstration project.  The geographic areas 
shall may include one urban, one suburban, and at least one 
rural county.  In order to encourage the participation of 
long-term care providers, the project area may be expanded 
beyond the designated counties for eligible individuals over age 
65.  
    Sec. 183.  Minnesota Statutes 1986, section 256B.69, 
subdivision 4, is amended to read: 
    Subd. 4.  [LIMITATION OF CHOICE.] The commissioner shall 
develop criteria to determine when limitation of choice may be 
implemented in the experimental counties.  The criteria shall 
ensure that all eligible individuals in the county have 
continuing access to the full range of medical assistance 
services as specified in subdivision 6.  The commissioner shall 
exempt the following persons from participation in the project, 
in addition to those who do not meet the criteria for limitation 
of choice:  (1) persons eligible for medical assistance 
according to section 256B.06, subdivision 1, clause (1) or who 
are in foster placement; and (2) persons eligible for medical 
assistance due to blindness or disability as determined by the 
social security administration or the state medical review team, 
unless they are 65 years of age or older.  Before limitation of 
choice is implemented, eligible individuals shall be notified 
and after notification, shall be allowed to choose only among 
demonstration providers.  After initially choosing a provider, 
the recipient is allowed to change that choice only at specified 
times as allowed by the commissioner.  
    Sec. 184.  Minnesota Statutes 1987 Supplement, section 
256B.73, subdivision 2, is amended to read:  
    Subd. 2.  [ESTABLISHMENT: GEOGRAPHIC AREA.] The 
commissioner of human services shall cooperate with a local 
coalition to establish a demonstration project to provide low 
cost medical insurance to uninsured low income persons in 
Cook, Crow Wing, Lake, St. Louis, Carlton, Aitkin, Pine, Itasca, 
and Koochiching counties except an individual county may be 
excluded as determined by the county board of commissioners.  
The coalition shall work with the commissioner and potential 
demonstration providers as well as other public and private 
organizations to determine program design, including enrollee 
eligibility requirements, benefits, and participation. 
    Sec. 185.  Minnesota Statutes 1987 Supplement, section 
256D.01, subdivision 1a, is amended to read:  
    Subd. 1a.  [STANDARDS.] (1) A principal objective in 
providing general assistance is to provide for persons 
ineligible for federal programs who are unable to provide for 
themselves.  The minimum standard of assistance determines the 
total amount of the general assistance grant without separate 
standards for shelter, utilities, or other needs. 
    (2) The commissioner shall set the standard of assistance 
for an assistance unit consisting of an adult recipient who is 
childless and unmarried or living apart from children and spouse 
and who does not live with a parent or parents or a legal 
custodian.  When the other standards specified in this 
subdivision increase, this standard shall also be increased by 
the same percentage. 
    (3) For an assistance unit consisting of an a single adult 
who is childless and unmarried or living apart from children and 
spouse, but who lives with a parent or parents, the general 
assistance standard of assistance shall be equal to the amount 
that the aid to families with dependent children standard of 
assistance would increase if the recipient were added as an 
additional minor child to an assistance unit consisting of the 
recipient's parent and all of that parent's family members, 
provided that the standard shall not exceed the standard for a 
general assistance recipient living alone.  Benefits received by 
a responsible relative of the assistance unit under the 
supplemental security income program, a workers' compensation 
program, the Minnesota supplemental aid program, or any other 
program based on the responsible relative's disability, and any 
benefits received by a responsible relative of the assistance 
unit under the social security retirement program, shall not be 
counted in the determination of eligibility or benefit level for 
the assistance unit.  An adult child shall be The assistance 
unit is ineligible for general assistance if the available 
resources or the countable income of the adult child assistance 
unit and the parent or parents with whom the adult child 
assistance unit lives are such that a family consisting of the 
adult child's assistance unit's parent or parents, the parent or 
parents' other family members and the adult child assistance 
unit as the only or additional minor child would be financially 
ineligible for general assistance.  For the purposes of 
calculating the countable income of the assistance unit's parent 
or parents, use the calculation methods, income deductions, 
exclusions, and disregards used when calculating the countable 
income for a single adult or childless couple. 
    (4) For an assistance unit consisting of a married 
childless couple who are childless or who live apart from any 
child or children of whom either of the married couple is a 
parent or legal custodian, the standards of assistance shall be 
equal to the first and second adult standards of the aid to 
families with dependent children program.  If one member of the 
couple is not included in the general assistance grant, then the 
standard of assistance for the other shall be equal to the 
second adult standard of the aid to families with dependent 
children program, except that, when one member of the couple is 
not included in the general assistance grant because that member 
is not categorically eligible for general assistance under 
section 256D.05, subdivision 1, and has exhausted work readiness 
eligibility under section 256D.051, subdivision 4 or 5, for the 
period of time covered by the general assistance grant, then the 
standard of assistance for the remaining member of the couple 
shall be equal to the first adult standard of the aid to 
families with dependent children program. 
    (5) For an assistance unit consisting of all members of a 
family, the standards of assistance shall be the same as the 
standards of assistance applicable to a family under the aid to 
families with dependent children program if that family had the 
same number of parents and children as the assistance unit under 
general assistance and if all members of that family were 
eligible for the aid to families with dependent children 
program.  If one or more members of the family are not included 
in the assistance unit for general assistance, the standards of 
assistance for the remaining members shall be equal to the 
standards of assistance applicable to an assistance unit 
composed of the entire family, less the standards of assistance 
applicable to a family of the same number of parents and 
children as those members of the family who are not in the 
assistance unit for general assistance.  Notwithstanding the 
foregoing, if an assistance unit consists solely of the minor 
children because their parent or parents have been sanctioned 
from receiving benefits from the aid to families with dependent 
children program, the standard for the assistance unit shall be 
equal to the special child standard of the aid to families with 
dependent children program.  A child shall not be excluded from 
the assistance unit unless income intended for its benefit is 
received from a federally aided categorical assistance 
program; or supplemental security income; retirement, survivors, 
and disability income; other assistance programs; or child 
support and maintenance payments.  The income of a child who is 
excluded from the assistance unit shall not be counted in the 
determination of eligibility or benefit level for the assistance 
unit. 
    Sec. 186.  Minnesota Statutes 1986, section 256D.02, 
subdivision 7, is amended to read:  
    Subd. 7.  "Childless couple" means two individuals who are 
related by marriage and who are living married to each other, 
live in a place of residence maintained by them as their own 
home, and are either childless or living apart from their 
children. 
    Sec. 187.  Minnesota Statutes 1986, section 256D.02, is 
amended by adding a subdivision to read:  
    Subd. 16.  "Single adult" means an individual 18 years or 
older who is childless and unmarried or living apart from the 
individual's children and spouse. 
    Sec. 188.  Minnesota Statutes 1987 Supplement, section 
256D.03, subdivision 3, is amended to read: 
    Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
(a) General assistance medical care may be paid for any person: 
    (1) who is eligible for assistance under section 256D.05 or 
256D.051 and is not eligible for medical assistance under 
chapter 256B; or 
    (2) who is a resident of Minnesota; whose income as 
calculated under chapter 256B is not in excess of the medical 
assistance standards or whose excess income is spent down 
pursuant to chapter 256B; and whose equity in resources is not 
in excess of $1,000 per assistance unit.  Exempt real and liquid 
assets, the reduction of excess assets, and the waiver of excess 
assets must conform to the medical assistance program in chapter 
256B.  
    (b) Eligibility is available for the month of application 
and for three months prior to application if the person was 
eligible in those prior months.  A redetermination of 
eligibility must occur every 12 months. 
    (c) General assistance medical care may be paid for a 
person, regardless of age, who is detained by law for less than 
one year in a county correctional or detention facility as a 
person accused or convicted of a crime, or admitted as an 
inpatient to a hospital on a criminal hold order, if the person 
is a recipient of general assistance medical care at the time 
the person is detained by law or admitted on a criminal hold 
order and as long as the person continues to meet other 
eligibility requirements of this subdivision.  
    (d) General assistance medical care is not available for 
applicants or recipients who do not cooperate with the local 
agency to meet the requirements of medical assistance. 
    Sec. 189.  Minnesota Statutes 1987 Supplement, section 
256D.06, subdivision 1, is amended to read:  
    Subdivision 1.  General assistance shall be granted in such 
an amount that when added to the nonexempt income actually 
available to the individual, married couple, or 
family assistance unit, the total amount equals the applicable 
standard of assistance for general assistance.  In determining 
eligibility for and the amount of assistance for an individual 
or married couple, the local agency shall disregard the first 
$50 of earned income per month.  
    Sec. 190.  Minnesota Statutes 1987 Supplement, section 
256D.06, subdivision 1b, is amended to read: 
    Subd. 1b.  [EARNED INCOME SAVINGS ACCOUNT.] In addition to 
the $50 disregard required under subdivision 1, the local agency 
shall disregard an additional earned income up to a maximum of 
$150 per month for persons residing in facilities licensed under 
Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 
9530.4000, and for whom discharge and work are part of a 
treatment plan and for persons living in supervised apartments 
with services funded under Minnesota Rules, parts 9535.0100 to 
9535.1600, and for whom discharge and work are part of a 
treatment plan.  The additional amount disregarded must be 
placed in a separate savings account by the eligible individual, 
to be used upon discharge from the residential facility into the 
community.  A maximum of $1,000, including interest, of the 
money in the savings account must be excluded from the resource 
limits established by section 256D.08, subdivision 1, clause (1).
Amounts in that account in excess of $1,000 must be applied to 
the resident's cost of care. If excluded money is removed from 
the savings account by the eligible individual at any time 
before the individual is discharged from the facility into the 
community, the money is income to the individual in the month of 
receipt and a resource in subsequent months.  If an eligible 
individual moves from a community facility to an inpatient 
hospital setting, the separate savings account is an excluded 
asset for up to 18 months.  During that time, amounts that 
accumulate in excess of the $1,000 savings limit must be applied 
to the patient's cost of care.  If the patient continues to be 
hospitalized at the conclusion of the 18-month period, the 
entire account must be applied to the patient's cost of care. 
    Sec. 191.  Minnesota Statutes 1986, section 256D.06, is 
amended by adding a subdivision to read:  
    Subd. 1c.  [ELIGIBILITY OF FAMILIES.] Notwithstanding any 
other provisions of sections 256D.01 to 256D.22, general 
assistance for an assistance unit consisting of members of a 
family must be granted in an amount that is equal to the amount 
of assistance which would be paid to an aid to families with 
dependent children assistance unit which has the same size, 
composition, income, and other circumstances relevant to the 
computation of an AFDC grant.  Income for an assistance unit 
consisting of members of a family applying for or receiving 
general assistance must be determined in the same manner as for 
persons applying for or receiving aid to families with dependent 
children, except that the first $50 per month of total child 
support paid on behalf of family members is excluded and the 
balance is counted as unearned income, and nonrecurring lump 
sums received by the family shall be considered income in the 
month received and a resource thereafter. 
    Sec. 192.  Minnesota Statutes 1986, section 256D.07, is 
amended to read:  
    256D.07 [TIME OF PAYMENT OF ASSISTANCE.] 
    An applicant for general assistance or general assistance 
medical care authorized by section 256D.03, subdivision 3 shall 
be deemed eligible if the application and the verification of 
the statement on that application demonstrate that the applicant 
is within the eligibility criteria established by sections 
256D.01 to 256D.21 and any applicable rules of the 
commissioner.  Any person requesting general assistance or 
general assistance medical care shall be permitted by the local 
agency to make an application for assistance as soon as 
administratively possible and in no event later than the fourth 
day following the date on which assistance is first requested, 
and no local agency shall require that a person requesting 
assistance appear at the offices of the local agency more than 
once prior to the date on which the person is permitted to make 
the application.  The application shall be in writing in the 
manner and upon the form prescribed by the commissioner and 
attested to by the oath of the applicant or in lieu thereof 
shall contain the following declaration which shall be signed by 
the applicant:  "I declare that this application has been 
examined by me and to the best of my knowledge and belief is a 
true and correct statement of every material point."  On the 
date that general assistance is first requested, the local 
agency shall inquire and determine whether the person requesting 
assistance is in immediate need of food, shelter, clothing, 
assistance for necessary transportation, or other emergency 
assistance pursuant to section 256D.06, subdivision 2.  A person 
in need of emergency assistance shall be granted emergency 
assistance immediately, and necessary emergency assistance shall 
continue until either the person is determined to be ineligible 
for general assistance or the first grant of general assistance 
is paid to the person.  A determination of an applicant's 
eligibility for general assistance shall be made by the local 
agency as soon as the required verifications are received by the 
local agency and in no event later than 30 days following the 
date that the application is made.  Any verifications required 
of the applicant shall be reasonable, and the commissioner shall 
by rule establish reasonable verifications.  General assistance 
shall be granted to an eligible applicant without the necessity 
of first securing action by the board of the local agency.  The 
amount of the first grant of general assistance awarded to an 
applicant shall be computed to cover the time period starting 
with the date that assistance is first requested or if the 
applicant is not eligible on that date, the date on which the 
applicant first becomes eligible, and the first grant may be 
reduced by the amount of emergency general assistance provided 
to the applicant.  The first month's grant must be computed to 
cover the time period starting with the date a signed 
application form is received by the local agency or from the 
date that the applicant meets all eligibility factors, whichever 
occurs later.  The first grant may be reduced by the amount of 
emergency general assistance provided to the applicant.  
    If upon verification and due investigation it appears that 
the applicant provided false information and the false 
information materially affected the applicant's eligibility for 
general assistance or general assistance medical care provided 
pursuant to section 256D.03, subdivision 3 or the amount of the 
applicant's general assistance grant, the local agency may refer 
the matter to the county attorney.  The county attorney may 
commence a criminal prosecution or a civil action for the 
recovery of any general assistance wrongfully received, or both. 
    Sec. 193.  Minnesota Statutes 1986, section 256D.35, is 
amended by adding a subdivision to read: 
    Subd. 9.  [HOMESTEAD.] "Homestead" means a shelter in which 
the individual or the spouse with whom the individual lives has 
an ownership interest, and that is the principal residence of 
the individual, spouse, or the individual's minor or disabled 
child.  The home may be either real or personal property, fixed 
or mobile, and located on land or water.  The home includes all 
the land that appertains to it and buildings located on that 
land. 
    Sec. 194.  Minnesota Statutes 1987 Supplement, section 
256D.37, subdivision 1, is amended to read:  
    Subdivision 1.  (a) For all individuals who apply to the 
appropriate local agency for supplemental aid, the local agency 
shall determine whether the individual meets the eligibility 
criteria prescribed in subdivision 2.  For each individual who 
meets the relevant eligibility criteria prescribed in 
subdivision 2, the local agency shall certify to the 
commissioner the amount of supplemental aid to which the 
individual is entitled in accordance with all of the standards 
in effect December 31, 1973, for the appropriate categorical aid 
program.  
    (b) When a recipient is an adult with mental illness in a 
facility licensed under Minnesota Rules, parts 9520.0500 to 
9520.0690, a resident of a state hospital or a dwelling with a 
negotiated rate, the recipient is not eligible for a shelter 
standard, a basic needs standard, or for special needs 
payments.  The state standard of assistance for those recipients 
is the clothing and personal needs allowance for medical 
assistance recipients under section 256B.35.  Minnesota 
supplemental aid may be paid to negotiated rate facilities at 
the rates in effect on March 1, 1985, for services provided 
under the supplemental aid program to residents of the facility, 
up to the maximum negotiated rate specified in this section.  
The rate for room and board for a licensed facility must not 
exceed $800.  The maximum negotiated rate does not apply to a 
facility that, on August 1, 1984, was licensed by the 
commissioner of health only as a boarding care home, certified 
by the commissioner of health as an intermediate care facility, 
and licensed by the commissioner of human services under 
Minnesota Rules, parts 9520.0500 to 9520.0690 or a facility 
that, on August 1, 1984, was licensed by the commissioner of 
human services under Minnesota Rules, parts 9525.0520 to 
9525.0660, but funded as a supplemental aid negotiated rate 
facility under this chapter.  The following facilities are 
exempt from the limit on negotiated rates and must be reimbursed 
for documented actual costs, until an alternative reimbursement 
system covering services excluding room and board maintenance 
services is developed by the commissioner:  
    (1) a facility that only provides services to persons with 
mental retardation; and 
    (2) a facility not certified to participate in the medical 
assistance program that is licensed as a boarding care facility 
as of March 1, 1985, and does not receive supplemental program 
funding under Minnesota Rules, parts 9535.2000 to 9535.3000 or 
parts 9553.0010 to 9553.0080.  Beginning July 1, 1987, the 
facilities under clause (1) are subject to applicable 
supplemental aid limits, and must meet all applicable licensing 
and reimbursement requirements for programs for persons with 
mental retardation.  The negotiated rates may be paid for 
persons who are placed by the local agency or who elect to 
reside in a room and board facility or a licensed facility for 
the purpose of receiving physical, mental health, or 
rehabilitative care, provided the local agency agrees that this 
care is needed by the person.  When Minnesota supplemental aid 
is used to pay a negotiated rate, the rate payable to the 
facility must not exceed the rate paid by an individual not 
receiving Minnesota supplemental aid.  To receive payment for a 
negotiated rate, the dwelling must comply with applicable laws 
and rules establishing standards necessary for health, safety, 
and licensure.  The negotiated rate must be adjusted by the 
annual percentage change in the consumer price index (CPI-U U.S. 
city average), as published by the Bureau of Labor Statistics 
between the previous two Septembers, new series index (1967-100) 
or 2.5 percent, whichever is less.  In computing the amount of 
supplemental aid under this section, the local agency shall 
deduct from the gross amount of the individual's determined 
needs all income, subject to the criteria for income disregards 
in effect December 31, 1973, for the appropriate categorical aid 
program, except that the earned income disregard for disabled 
persons who are not residents of long-term care facilities must 
be the same as the earned income disregard available to disabled 
persons in the supplemental security income program and all 
actual work expenses must be deducted when determining the 
amount of income for the individual.  From the first of the 
month in which an effective application is filed, the state and 
the county shall share responsibility for the payment of the 
supplemental aid to which the individual is entitled under this 
section as provided in section 256D.36. 
    Sec. 195.  Minnesota Statutes 1986, section 256D.37, 
subdivision 2, is amended to read:  
    Subd. 2.  [RESOURCE STANDARDS.] The resource standards and 
restrictions for supplemental aid under this section shall be 
those used to determine eligibility for disabled individuals in 
the supplemental security income program.  The local agency 
shall apply the relevant criteria to each application.  The 
local agency in its discretion may permit eligibility of an 
applicant having assets in excess of the amount prescribed in 
this section if liquidation of the assets would cause undue loss 
or hardship. 
    Sec. 196.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 6.  [TRANSFERS.] (a) In determining the resources of 
an individual and an eligible spouse, if any, a person shall 
include a resource or interest that exceeds the limits set out 
in subdivision 2 and that was given away or sold for less than 
fair market value within the 24 months preceding application for 
Minnesota supplemental aid or during the period of eligibility. 
    (b) A transaction described in this subdivision is presumed 
to have been made to establish eligibility for benefits or 
assistance under this chapter unless the individual or eligible 
spouse gives convincing evidence to establish that the 
transaction was made exclusively for another purpose. 
    (c) For purposes of this subdivision, the value of a 
resource or interest is the fair market value when it was sold 
or given away, less the amount of compensation received. 
    (d) For any uncompensated transfer, the period of 
ineligibility must be calculated by dividing the amount of the 
uncompensated transferred amount by the statewide average 
monthly skilled nursing facility payment for the previous 
calendar year to determine the number of months of 
ineligibility.  The individual is ineligible until the fixed 
period of ineligibility has expired.  The period of 
ineligibility may exceed 24 months, and a reapplication for 
benefits after 24 months from the date of the transfer does not 
result in eligibility unless and until the period of 
ineligibility has expired. 
    (e) The period of ineligibility must not be applied if the 
local agency determines that it would create an immediate threat 
to the health or safety of the assistance unit. 
    Sec. 197.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 7.  [EXCLUSIONS.] The following must not be included 
as income in determining eligibility: 
    (1) the value of food stamps; 
    (2) home-produced food used by the household; 
    (3) Indian claim payments made by the United States 
Congress to compensate members of Indian tribes for the taking 
of tribal lands by the federal government; 
    (4) cash payments to displaced persons who face relocation 
as a result of the Housing Act of 1965, the Housing and Urban 
Development Act of 1965, or the Uniform Relocation Assistance 
and Real Property Acquisition Policies Act of 1970; 
    (5) one-third of child support payments received by an 
eligible child from an absent parent; 
    (6) displaced homemaker payments; 
    (7) reimbursement received for maintenance costs of 
providing foster care to adults or children; 
    (8) benefits received under Title IV and Title VII of the 
Older Americans Act of 1965; 
    (9) Minnesota renter or homeowner property tax refunds; 
    (10) infrequent, irregular income that does not total more 
than $20 per person in a month; 
    (11) reimbursement payments received from the VISTA program;
    (12) in-kind income; 
    (13) payments received for providing volunteer services 
under Title I, Title II, and Title III of the Domestic Volunteer 
Service Act of 1973; 
    (14) loans that have to be repaid; 
    (15) federal low income heating assistance program 
payments; and 
    (16) any other type of funds excluded as income by state 
law. 
    The local agency shall exclude the first $20 of earned or 
unearned income. 
    Sec. 198.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 8.  [APPLICATION FOR FEDERALLY FUNDED BENEFITS.] 
Persons for whom the applicant or recipient has financial 
responsibility and who have unmet needs must apply for, and if 
eligible, accept aid to families with dependent children and 
other federally funded benefits before allocation of earned and 
unearned income from the applicant or recipient to meet the 
needs of those persons.  If the persons are determined 
potentially eligible for these benefits, the applicant or 
recipient may not allocate earned or unearned income to those 
persons. 
    Sec. 199.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 9.  [ALLOCATION OF INCOME.] The rate of allocation 
for the financially responsible relatives of applicants or 
recipients is one-half the individual supplemental security 
income standard of assistance, except as restricted in 
subdivision 8. 
    If the applicant or recipient shares a residence with 
another person who has financial responsibility for the 
applicant or recipient, the income of the responsible relative 
must be considered available to the applicant or recipient after 
allowing the deductions in subdivisions 11 and 12. 
    Sec. 200.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 10.  [EARNED INCOME DISREGARDS.] From the assistance 
unit's gross earned income, the local agency shall disregard $65 
plus one-half of the remaining income. 
    Sec. 201.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 11.  [EARNED INCOME DEDUCTIONS.] From the assistance 
unit's gross earned income, the local agency shall subtract work 
expenses allowed by the supplemental security income program. 
    Sec. 202.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 12.  [SELF-EMPLOYMENT EARNINGS.] A local agency must 
determine gross earned income from self-employment by 
subtracting business costs from gross receipts. 
    Sec. 203.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 13.  [RENTAL PROPERTY.] Income from rental property 
must be considered self-employment earnings for each month that 
an average of at least ten hours a week of labor is expended by 
the owner of the property.  When no labor is expended, income 
from rental property must be considered as unearned income and 
an additional deduction must be allowed for actual, reasonable, 
and necessary labor costs for upkeep and repair.  
    Sec. 204.  Minnesota Statutes 1986, section 256D.37, is 
amended by adding a subdivision to read: 
    Subd. 14.  [GROSS INCOME TEST.] The local agency shall 
apply a gross income test prospectively for each month of 
program eligibility.  An assistance unit is ineligible when 
nonexcluded income, before applying any disregards or 
deductions, exceeds 300 percent of the supplemental security 
income standard for the assistance unit. 
    Sec. 205.  Minnesota Statutes 1986, section 256E.12, 
subdivision 1, is amended to read:  
    Subdivision 1.  The commissioner shall establish an 
experimental a statewide program to assist counties in providing 
services to chronically mentally ill persons with serious and 
persistent mental illness as defined in section 245.462, 
subdivision 20.  The commissioner shall make grants to counties 
to establish, operate, or contract with private providers to 
provide services designed to help chronically mentally ill 
persons with serious and persistent mental illness remain and 
function in their own communities.  Grants received pursuant to 
this section may be used to fund innovative community support 
services programs, relating to physical fitness programs 
designed as part of a mental health treatment plan as specified 
in section 245.462, subdivision 6, and case management 
activities that cannot be billed to the medical assistance 
program under section 256B.02, subdivision 8. 
    Sec. 206.  Minnesota Statutes 1986, section 256E.12, 
subdivision 2, is amended to read:  
    Subd. 2.  To apply for a grant a county board shall submit 
an application and budget for the use of the money in the form 
specified by the commissioner.  The commissioner shall make 
grants only to counties whose applications and budgets are 
approved by the commissioner.  A county receiving a grant under 
this section shall finance at least ten percent of the cost of 
services for chronically mentally ill persons with serious and 
persistent mental illness from local resources, which may 
include private contributions and federal money.  
    Sec. 207.  Minnesota Statutes 1987 Supplement, section 
256E.12, subdivision 3, is amended to read:  
    Subd. 3.  The commissioner shall allocate grants under this 
section to finance up to 90 percent of each county's costs for 
services for chronically mentally ill to persons with serious 
and persistent mental illness.  The commissioner shall 
promulgate emergency and permanent rules to govern grant 
applications, approval of applications, allocation of grants, 
and maintenance of financial statements by grant recipients.  
The commissioner shall require collection of data and periodic 
reports as the commissioner deems necessary to demonstrate the 
effectiveness of the services in helping chronically mentally 
ill persons with serious and persistent mental illness remain 
and function in their own communities.  The experimental program 
shall expire no later than June 30, 1989. 
    Sec. 208.  Minnesota Statutes 1986, section 256F.03, 
subdivision 8, is amended to read:  
    Subd. 8.  [PLACEMENT PREVENTION AND FAMILY REUNIFICATION 
SERVICES.] "Placement prevention and family reunification 
services" means a continuum of services designed to help 
children remain with their families or to facilitate 
reunification of children with their parents.  Placement 
prevention and family reunification services available to a 
minority family must reflect and support family models that are 
accepted within the culture of the particular minority. 
    Sec. 209.  Minnesota Statutes 1986, section 256F.07, is 
amended by adding a subdivision to read:  
    Subd. 3a.  [MINORITY FAMILY SERVICES.] In addition to 
services listed in subdivision 3, placement prevention and 
family reunification services for minority children include: 
    (1) development of foster and adoptive placement resources, 
including recruitment, licensing, and support; 
    (2) advocacy in working with the county and private social 
service agencies, and activities to help provide access to 
agency services; 
    (3) family and community involvement strategies to combat 
child abuse and chronic neglect of children; 
    (4) coordinated child welfare and mental health services to 
minority families; and 
    (5) other activities and services approved by the 
commissioner that further the goals of the minority heritage 
preservation act. 
    Sec. 210.  [257.066] [RULES.] 
    By December 31, 1989, the commissioner of human services 
shall revise Minnesota Rules, parts 9545.0750 to 9545.0830, 
9560.0010 to 9560.0180, and 9560.0500 to 9560.0670 to ensure 
that, as conditions of licensure, social services and 
child-placing agencies meet the requirements of section 257.072, 
subdivisions 7 and 8, and keep records in compliance with 
sections 257.01 and 259.46. 
    Sec. 211.  Minnesota Statutes 1986, section 257.071, 
subdivision 2, is amended to read:  
    Subd. 2.  [SIX MONTH REVIEW OF PLACEMENTS.] There shall be 
an administrative review of the case plan of each child placed 
in a residential facility no later than 180 days after the 
initial placement of the child in a residential facility and at 
least every six months thereafter if the child is not returned 
to the home of the parent or parents within that time.  The case 
plan must be monitored and updated at each administrative 
review.  As an alternative to the administrative review, the 
social service agency responsible for the placement may bring a 
petition as provided in section 260.131, subdivision 1a, to the 
court for review of the foster care to determine if placement is 
in the best interests of the child.  This petition must be 
brought to the court within the applicable six months and is not 
in lieu of the requirements contained in subdivision 3 or 4.  
    Sec. 212.  Minnesota Statutes 1986, section 257.071, 
subdivision 3, is amended to read:  
    Subd. 3.  [REVIEW OF VOLUNTARY PLACEMENTS.] Subject to the 
provisions of subdivision 4, if the child has been placed in a 
residential facility pursuant to a voluntary release by the 
parent or parents, and is not returned home within 18 months 
after initial placement in the residential facility, the social 
service agency responsible for the placement shall: 
    (a) Return the child to the home of the parent or parents; 
or 
    (b) File an appropriate petition pursuant to section 
260.131, subdivision 1, or 260.231, and if the petition is 
dismissed, petition the court within two years, pursuant to 
section 260.131, subdivision 1a, to determine if the placement 
is in the best interests of the child.  
    The case plan must be updated when a petition is filed and 
must include a specific plan for permanency. 
    Sec. 213.  Minnesota Statutes 1986, section 257.071, 
subdivision 6, is amended to read: 
    Subd. 6.  [ANNUAL FOSTER CARE REPORT.] The commissioner of 
human services shall publish annually a report on children in 
residential facilities as defined in subdivision 1.  The report 
shall include, by county and statewide, information on legal 
status, living arrangement, age, sex, race, accumulated length 
of time in foster care, and other demographic information deemed 
appropriate on all children placed in residential facilities. 
The report shall also state the extent to which authorized child 
placing agencies comply with sections 257.072 and 259.455 and 
include descriptions of the methods used to comply with those 
sections.  The commissioner shall publish the report for each 
calendar year by June 1 of the following year. 
    Sec. 214.  Minnesota Statutes 1986, section 257.071, is 
amended by adding a subdivision to read: 
    Subd. 7.  [RULES.] By December 31, 1988, the commissioner 
shall revise Minnesota Rules, parts 9545.0010 to 9545.0269, the 
rules setting standards for family and group family foster care. 
The commissioner shall: 
    (1) require that, as a condition of licensure, foster care 
providers attend training on the importance of protecting 
cultural heritage within the meaning of Laws 1983, chapter 278, 
the Indian Child Welfare Act, Public Law Number 95-608, and the 
Minnesota Indian family preservation act, sections 257.35 to 
257.357; and 
    (2) review and, where necessary, revise foster care rules 
to reflect sensitivity to cultural diversity and differing 
lifestyles.  Specifically, the commissioner shall examine 
whether space and other requirements discriminate against 
single-parent, minority, or low-income families who may be able 
to provide quality foster care reflecting the values of their 
own respective cultures. 
    Sec. 215.  Minnesota Statutes 1986, section 257.072, is 
amended to read:  
    257.072 [RECRUITMENT OF FOSTER FAMILIES WELFARE OF MINORITY 
CHILDREN.] 
    Subdivision 1.  [RECRUITMENT OF FOSTER FAMILIES.] Each 
authorized child placing agency shall make special efforts to 
recruit a foster family from among the child's relatives, except 
as authorized in section 260.181, subdivision 3, and among 
families of the same minority racial or minority ethnic 
heritage.  Special efforts include contacting and working with 
community organizations and religious organizations, utilizing 
local media and other local resources, and conducting outreach 
activities, and increasing the number of minority recruitment 
staff employed by the agency.  The agency may accept any gifts, 
grants, offers of services, and other contributions to use in 
making special recruitment efforts.  
    Subd. 2.  [DUTIES OF COMMISSIONER.] The commissioner of 
human services shall: 
    (1) in cooperation with child-placing agencies, develop a 
cost-effective campaign using radio and television to recruit 
minority adoptive and foster families; 
    (2) require that agency staff people who work in the area 
of minority adoption and foster family recruitment attend 
cultural sensitivity training; and 
    (3) monitor the record keeping, licensing, placement 
preference, recruitment, review, and reporting requirements of 
the minority child heritage protection act, Laws 1983, chapter 
278. 
    Subd. 3.  [MINORITY RECRUITMENT SPECIALIST.] The 
commissioner shall designate a permanent professional staff 
position for a minority recruitment specialist.  The minority 
recruitment specialist shall provide services to child-placing 
agencies seeking to recruit minority adoptive and foster care 
families and qualified minority professional staff.  The 
minority recruitment specialist shall: 
    (1) develop materials for use by the agencies in training 
staff; 
    (2) conduct in-service workshops for agency personnel; 
    (3) provide consultation, technical assistance, and other 
appropriate services to agencies wishing to improve service 
delivery to minority populations; 
    (4) conduct workshops for foster care and adoption 
recruiters to evaluate the effectiveness of techniques for 
recruiting minority families; and 
    (5) perform other duties as assigned by the commissioner to 
implement the minority child heritage protection act and the 
Minnesota Indian family preservation act. 
    Upon recommendation of the minority recruitment specialist, 
the commissioner may contract for portions of these services. 
    Subd. 4.  [CONSULTATION WITH MINORITY REPRESENTATIVES.] The 
commissioner of human services shall, after seeking and 
considering advice from representatives from the councils 
established under sections 3.922, 3.9223, 3.9225, and 3.9226: 
    (1) review, and where necessary, revise the department of 
human services social service manual and practice guide to 
reflect the scope and intent of Laws 1983, chapter 278; 
    (2) develop criteria for determining whether a prospective 
adoptive or foster family is "knowledgeable and appreciative" as 
the term is used in section 260.181, subdivision 3; 
    (3) develop a standardized training curriculum for adoption 
and foster care workers, family-based providers and 
administrators who work with minority and special needs 
children.  Training must address the following subjects: 
    (a) developing and maintaining sensitivity to other 
cultures; 
    (b) assessing values and their cultural implications; and 
    (c) implementing the minority child heritage protection 
act, Laws 1983, chapter 278, and the Minnesota Indian family 
preservation act, sections 257.35 to 257.357; 
    (4) develop a training curriculum for family and extended 
family members of minority adoptive and foster children.  The 
curriculum must address issues relating to cross-cultural 
placements as well as issues that arise after a foster or 
adoptive placement is made; and 
    (5) develop and provide to agencies an assessment tool to 
be used in combination with group interviews and other 
preplacement activities to evaluate prospective adoptive and 
foster families of minority children.  The tool must assess 
problem-solving skills; identify parenting skills; and, when 
required by section 260.181, subdivision 3, evaluate the degree 
to which the prospective family is knowledgeable and 
appreciative of racial and ethnic differences. 
    Subd. 5.  [MINORITY PLACEMENTS.] Beginning December 1, 
1989, the commissioner shall provide to the Indian affairs 
council, the council on affairs of Spanish-Speaking people, the 
council on Black Minnesotans, and the council on Asian-Pacific 
Minnesotans the semiannual reports required under section 216. 
    Subd. 6.  [ADVISORY TASK FORCE.] The commissioner of human 
services may convene and meet periodically with an advisory task 
force on minority child welfare.  The task force may advise the 
commissioner on issues related to minority child welfare, 
including, but not limited to, adoption and foster care, the use 
of citizen review boards, infant mortality in minority 
communities, and placement prevention.  The task force should 
include minority adoption and foster care workers and minority 
adoptive and foster parents. 
    Subd. 7.  [DUTIES OF CHILD-PLACING AGENCIES.] Each 
authorized child-placing agency must: 
    (1) develop and follow procedures for implementing the 
order of preference prescribed by section 260.181, subdivision 3;
    (2) have a written plan for recruiting minority adoptive 
and foster families.  The plan must include (a) strategies for 
using existing resources in minority communities, (b) use of 
minority outreach staff wherever possible, (c) use of minority 
foster homes for placements after birth and before adoption, and 
(d) other techniques as appropriate; 
    (3) have a written plan for training adoptive and foster 
families of minority children; 
    (4) if located in an area with a significant minority 
population, have a written plan for employing minority social 
workers in adoption and foster care.  The plan must include 
staffing goals and objectives; and 
    (5) ensure that adoption and foster care workers attend 
training offered or approved by the department of human services 
regarding cultural diversity and the needs of special needs 
children. 
    Subd. 8.  [REPORTING REQUIREMENTS.] Each authorized 
child-placing agency shall provide to the commissioner of human 
services all data needed by the commissioner for the report 
required by section 216.  The agency shall provide the data 
within 60 days of the end of the six-month period for which the 
data is applicable. 
    Sec. 216.  [257.0725] [SEMIANNUAL REPORT.] 
    The commissioner of human services shall publish a 
semiannual report on children in out-of-home placement.  The 
report shall include, by county and statewide, information on 
legal status, living arrangement, age, sex, race, accumulated 
length of time in placement, reason for most recent placement, 
race of family with whom placed, number of families from the 
child's own culture in the placement pool during the period for 
which data is provided, and other demographic information deemed 
appropriate on all children in out-of-home placement.  The 
commissioner shall provide the required data for children who 
entered placement during the previous quarter and for children 
who are in placement at the end of the quarter.  Out-of-home 

placement includes placement in any facility by an authorized 
child-placing agency.  By December 1, 1989, and by December 1 of 
each successive year, the commissioner shall publish a report 
covering the first six months of the calendar year.  By June 1, 
1990, and by June 1 of each successive year, the commissioner 
shall publish a report covering the last six months of the 
calendar year. 
    Sec. 217.  [257.075] [GRANTS FOR SUPPORT SERVICES.] 
    The commissioner of human services may make grants to 
authorized child-placing agencies that provide services to 
minority children in out-of-home placements.  Support services 
may include, but are not limited to: 
    (1) development of foster and adoptive placement resources, 
including recruitment, licensing, and support; 
    (2) advocacy in working with the county and private social 
service agencies, and activities to help provide access to 
agency services; 
    (3) family and community involvement strategies to combat 
child abuse and chronic neglect of children; 
    (4) coordinated child welfare and mental health services to 
minority families; 
    (5) preadoption, postadoption, and foster care support 
groups for minority children and prospective adoptive and foster 
families; 
    (6) the use of minority foster parents as continuing 
support for children returned to birth homes; 
    (7) information, counseling, and support groups to assist 
minority children approaching age 18 in setting permanent goals 
for independent living; 
    (8) minority adolescent support groups for children in 
long-term foster care, new adoptive placements, and nonminority 
homes where identity issues threaten the adoptive relationship 
and adjustment; 
    (9) services listed at section 256F.07; and 
    (10) other activities and services approved by the 
commissioner that further the goals of the minority heritage 
preservation act. 
    Sec. 218.  Minnesota Statutes 1986, section 260.181, 
subdivision 3, is amended to read:  
    Subd. 3.  [PROTECTION OF RACIAL OR ETHNIC HERITAGE, OR 
RELIGIOUS AFFILIATION.] The policy of the state is to ensure 
that the best interests of children are met by requiring due 
consideration of the child's minority race or minority ethnic 
heritage in foster care placements.  
    The court, in transferring legal custody of any child or 
appointing a guardian for the child under the laws relating to 
juvenile courts, shall place the child, in the following order 
of preference, in the absence of good cause to the contrary, in 
the legal custody or guardianship of an individual who (a) is 
the child's relative, or if that would be detrimental to the 
child or a relative is not available, who (b) is of the same 
racial or ethnic heritage as the child, or if that is not 
possible, who (c) is knowledgeable and appreciative of the 
child's racial or ethnic heritage.  The court may require the 
county welfare agency to continue efforts to find a guardian of 
the child's minority racial or minority ethnic heritage when 
such a guardian is not immediately available.  For purposes of 
this subdivision, "relative" includes members of a child's 
extended family and important friends with whom the child has 
resided or had significant contact. 
    If the child's genetic parent or parents explicitly request 
that the preference described in clause (a) or in clauses (a) 
and (b) not be followed, the court shall honor that request 
consistent with the best interests of the child.  
    If the child's genetic parent or parents express a 
preference for placing the child in a foster or adoptive home of 
the same or a similar religious background to that of the 
genetic parent or parents, in following the preferences in 
clause (a) or (b), the court shall order placement of the child 
with an individual who meets the genetic parent's religious 
preference.  Only if no individual is available who is described 
in clause (a) or (b) may the court give preference to an 
individual described in clause (c) who meets the parent's 
religious preference.  
    Sec. 219.  Minnesota Statutes 1986, section 268.0111, is 
amended by adding a subdivision to read: 
    Subd. 4a.  [HOMELESS INDIVIDUAL.] "Homeless individual," or 
"homeless person" means: 
    (1) an individual who lacks a fixed, regular, and adequate 
nighttime residence; and 
    (2) an individual who has a primary nighttime residence 
that is:  
    (i) a supervised publicly or privately operated shelter or 
dwelling designed to provide temporary living accommodations, 
    (ii) an institution that provides a temporary residence for 
individuals intended to be institutionalized, or 
    (iii) a public or private place not designed for, or 
ordinarily used as, a regular sleeping accommodation for humans. 
    The term "homeless individual" does not include any 
individual imprisoned or otherwise detained pursuant to federal 
or state law. 
    Sec. 220.  [268.0124] [PLAIN LANGUAGE IN WRITTEN 
MATERIALS.] 
    (a) To the extent reasonable and consistent with the goals 
of providing easily understandable and readable materials and 
complying with federal and state laws governing the programs, 
all written materials relating to services and determinations of 
eligibility for or amounts of benefits that will be given to 
applicants for or recipients of assistance under a program 
administered or supervised by the commissioner of jobs and 
training must be understandable to a person who reads at the 
seventh-grade level, using the Flesch scale analysis readability 
score as determined under section 72C.09. 
    (b) All written materials relating to determinations of 
eligibility for or amounts of benefits that will be given to 
applicants for or recipients of assistance under programs 
administered or supervised by the commissioner of jobs and 
training must be developed to satisfy the plain language 
requirements of the plain language contract act under sections 
325G.29 to 325G.36.  Materials may be submitted to the attorney 
general for review and certification.  Notwithstanding section 
325G.35, subdivision 1, the attorney general shall review 
submitted materials to determine whether they comply with the 
requirements of section 325G.31.  The remedies available 
pursuant to sections 8.31 and 325G.33 to 325G.36 do not apply to 
these materials.  Failure to comply with this section does not 
provide a basis for suspending the implementation or operation 
of other laws governing programs administered by the 
commissioner. 
    (c) The requirements of this section apply to all materials 
modified or developed by the commissioner on or after July 1, 
1988.  The requirements of this section do not apply to 
materials that must be submitted to a federal agency for 
approval, to the extent that application of the requirements 
prevents federal approval. 
    (d) Nothing in this section may be construed to prohibit a 
lawsuit brought to require the commissioner to comply with this 
section or to affect individual appeal rights granted pursuant 
to section 268.10. 
    (e) The commissioner shall report annually to the chairs of 
the health and human services divisions of the senate finance 
committee and the house of representatives appropriations 
committee on the number and outcome of cases that raise the 
issue of the commissioner's compliance with this section. 
    Sec. 221.  [268.39] [LIFE SKILLS AND EMPLOYMENT GRANTS.] 
    The commissioner may provide grants to organizations for 
the development and administration of life skills and employment 
plans for homeless individuals that reside in residential units 
constructed or rehabilitated under section 462A.05, subdivision 
29.  Grants awarded under this section may also be used for the 
management of these residential units.  The organizations that 
receive grants under this section must coordinate their efforts 
with organizations that receive grants under section 462A.05, 
subdivision 29. 
    A life skills and employment plan must be developed for 
each tenant residing in a dwelling that receives funding under 
section 462A.05, subdivision 29.  The plan may include 
preapprentice and apprenticeship training in the area of housing 
rehabilitation.  If preapprentice and apprenticeship training is 
part of a plan, the organization must consult with labor 
organizations experienced in working with apprenticeship 
programs.  The completion or compliance with the individual life 
skills and employment plan must be required for a tenant to 
remain in a unit constructed or rehabilitated under section 
462A.05, subdivision 29. 
    The application for a grant under this section must include 
a plan that must provide for: 
   (1) training for tenants in areas such as cleaning and 
maintenance, payment of rent, and roommate skills, and 
    (2) tenant selection and rental policies that insure rental 
of units to people who are homeless if applicable. 
    The applicant must provide a proposed occupancy contract if 
applicable, the name and address of the rental agent if 
applicable, and other information the commissioner considers 
necessary with the application. 
    The commissioner may adopt permanent rules to administer 
this grant program. 
     Sec. 222.  Minnesota Statutes 1986, section 268.86, is 
amended by adding a subdivision to read:  
    Subd. 10.  [INVENTORY, REFERRAL, AND INTAKE SERVICES.] The 
commissioner of jobs and training, in cooperation with the 
commissioner of human services, shall develop an inventory, 
referral, and intake system.  The system must provide for 
coordinated delivery of employment and training and income 
maintenance support services, efficient client referral among 
programs and services, reduction of duplicate data collection, 
coordinated program intake by local agencies, and effective 
evaluation of employment and training services.  The system 
must, at a minimum, include the following: 
    (1) a listing of all available public and private 
employment and training services, income maintenance and support 
services, and vocationally directed education and training 
programs; 
    (2) the capability to assess client needs and match those 
needs with employment opportunities, education and training 
programs, and employment and training and income maintenance and 
support services, and to refer the client to the appropriate 
employer, educational institution, or service provider; 
    (3) a coordinated intake procedure for employment and 
training services, and income maintenance and support services; 
    (4) access to a statewide data base for client tracking and 
program evaluation; and 
    (5) internal security measures to protect private data from 
unauthorized access. 
    In developing the system, the commissioner shall consult 
with the public post-secondary educational systems, local 
agencies, employment and training service providers, and client 
and employer representatives.  The system must be available in 
each local agency or service provider delivering programs 
administered by the commissioner of jobs and training or the 
commissioner of human services.  Access by intake workers, state 
agency personnel, clients, and any other system users to 
information contained in the system must conform with all 
applicable federal and state data privacy requirements.  
     Sec. 223.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 1, is amended to read: 
    Subdivision 1.  [DEFINITIONS.] For the purposes of this 
section the following terms have the meanings given. 
    (a) "Child care services" means child care provided in 
family day care homes, group day care homes, nursery schools, 
day nurseries, child day care centers, play groups, head start, 
and parent cooperatives, or in the child's home. 
    (b) "Child" means a person 12 years old or younger, or a 
person age 13 or 14 who is handicapped, as defined in section 
120.03. 
    (c) "Commissioner" means the commissioner of human services.
    (d) "Child care" means the care of a child by someone other 
than a parent or legal guardian in or outside the child's own 
home for gain or otherwise, on a regular basis, for any part of 
a 24-hour day. 
    (e) "County board" means the board of county commissioners 
in each county. 
    (f) "Education program" means remedial or basic education 
or English as a second language instruction, high school 
education, a program leading to a general equivalency diploma, 
and post-secondary education excluding post-baccalaureate 
programs. 
    (g) "Employment program" means employment of recipients 
financially eligible for the child care sliding fee program, 
vocational assessment, and job readiness and job search 
activities. 
    (h) "Family" means parents, stepparents, guardians, or 
other caretaker relatives, and their blood related dependent 
children and adoptive siblings under the age of 18 years living 
in the same home including children temporarily absent from the 
household in settings such as schools, foster care, and 
residential treatment facilities.  When a minor parent or 
parents and his, her, or their child or children are living with 
other relatives, and the minor parent or parents apply for a 
child care subsidy, "family" means only the minor parent or 
parents and the child or children.  An adult may be considered a 
dependent member of the family unit if 50 percent of the adult's 
support is being provided by the parents, stepparents, 
guardians, or other caregiver relatives residing in the same 
household.  An adult age 18 who is a full-time high school 
student and can reasonably be expected to graduate before age 19 
may be considered a dependent member of the family unit. 
    (i) "Human services board" means a board established under 
section 402.02, Laws 1974, chapter 293, or Laws 1976, chapter 
340. 
    (j) "Income" means earned or unearned income received by 
all family members 16 years or older, including public 
assistance benefits, unless specifically excluded.  The 
following are excluded from income:  scholarships and grants 
that cover costs for tuition, fees, books, and educational 
supplies; student loans for tuition, fees, books, supplies, and 
living expenses; in-kind income such as food stamps, energy 
assistance, medical assistance, and housing subsidies; income 
from summer or part-time employment of 16-, 17-, and 18-year-old 
full-time secondary school students; grant awards under the 
family subsidy program; and nonrecurring lump sum income only to 
the extent that it is earmarked and used for the purpose for 
which it is paid. 
    (i) (k) "Provider" means the child care license holder or 
the legal nonlicensed caregiver who operates a family day care 
home, a group family day care home, a day care center, a nursery 
school, or a day nursery, or who functions in the child's home.  
    (j) (l) "Post-secondary educational systems" means the 
University of Minnesota board of regents, the state university 
board, the state board for community colleges, and the state 
board of vocational technical education.  
    (k) (m) "AFDC priority groups" means the recipients defined 
in section 256.736, subdivision 2a. 
    (l) (n) "AFDC" means aid to families with dependent 
children. 
    Sec. 224.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 3, is amended to read: 
    Subd. 3.  [ALLOCATION.] (a) By June 1 of each odd-numbered 
year, the commissioner shall notify all county and human 
services boards and post-secondary educational systems of their 
allocation.  If the appropriation is insufficient to meet the 
needs in all counties, the amount must be prorated among the 
counties.  Each county that receives funds under this section 
must keep a written record and report to the commissioner the 
number of eligible families who have applied for a child care 
subsidy.  Counties shall perform a cursory determination of 
eligibility when a family requests information about child care 
assistance.  A family that appears to be eligible must be put on 
a waiting list if funds are not immediately available. 
    (b) Except for set-aside money allocated under subdivisions 
3a, 3b, 3c, and 3d, the commissioner shall allocate money 
appropriated between the metropolitan area, comprising the 
counties of Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and 
Washington, and the area outside the metropolitan area so that 
no more than 55 percent of the total appropriation goes to 
either area after excluding allocations for statewide 
administrative costs.  The commissioner shall allocate 50 
percent of the money among counties on the basis of the number 
of families below the poverty level, as determined from the most 
recent special census, and 50 percent on the basis of caseloads 
of aid to families with dependent children for the preceding 
fiscal year, as determined by the commissioner of human services.
    (c) Once each quarter, the commissioner shall review the 
use of child care fund allocations by county.  In accordance 
with the formula found in paragraph (b), The commissioner may 
reallocate unexpended or unencumbered money among those counties 
who have expended their full portion.  Any unexpended money from 
the first year of the biennium may be carried forward to the 
second year of the biennium.  
    Sec. 225.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 3b, is amended to read:  
    Subd. 3b.  [SET-ASIDE MONEY FOR AFDC PRIORITY GROUPS.] (a) 
Set-aside money for AFDC priority groups must be allocated among 
the counties based on the average monthly number of caretakers 
receiving AFDC under the age of 21 and the average monthly 
number of AFDC cases open 24 or more consecutive months.  For 
each fiscal year the average monthly caseload shall be based on 
the 12-month period ending March 31 of the previous fiscal year. 
The commissioner may reallocate quarterly unexpended or 
unencumbered set-aside money to counties that expend their full 
allocation.  The county shall use the set-aside money for AFDC 
priority groups and for former AFDC recipients who (1) have had 
their child care subsidized under the set-aside for AFDC 
priority groups; (2) continue to require a child care subsidy in 
order to remain employed; and (3) are on a waiting list for the 
basic sliding fee program. 
    (b) The county shall develop cooperative agreements with 
the employment and training service provider for coordination of 
child care funding with employment, training, and education 
programs for aid to families with dependent children priority 
groups.  The cooperative agreement shall specify that 
individuals receiving employment, training, and education 
services under an employability plan from the employment and 
training service provider shall, as resources permit, be 
guaranteed set-aside money for child care assistance from the 
county of their residence.  
    (c) Counties may contract for administration of the program 
or may arrange for or contract for child care funds to be used 
by other appropriate programs, in accordance with this section 
and as permitted by federal law and regulations.  
    (d) If the commissioner finds, on or after January 1 of a 
fiscal year, that set-aside money for AFDC priority groups is 
not being fully utilized, the commissioner may permit counties 
to use set-aside money for other eligible applicants, as long as 
priority for use of the money will continue to be given to the 
AFDC priority groups.  
    (e) A county may claim federal reimbursement under the AFDC 
special needs program for money spent for persons listed in 
subdivision 3a, clause (1).  The commissioner shall allocate any 
federal earnings to the county.  The county shall use the money 
to expand services to AFDC recipients child care sliding fee 
services under the child care sliding fee program this 
subdivision. 
    Sec. 226.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 3c, is amended to read: 
    Subd. 3c.  [SET-ASIDE MONEY FOR AFDC POST-SECONDARY 
STUDENTS.] (a) For the fiscal year ending June 30, 1988, 
set-aside money for persons listed in subdivision 3a, clause 
(2), shall be allocated to the counties based on caseloads of 
aid to families with dependent children for the preceding fiscal 
year, as determined by the commissioner.  For succeeding fiscal 
years, the commissioner shall, in cooperation with the director 
of the higher education coordinating board, develop a formula 
for allocation of the funds to counties based on the number of 
AFDC caretakers in each county who are enrolled at 
post-secondary institutions. 
    (b) Money allocated in paragraph (a) must be used for child 
care expenses of AFDC recipients attending post-secondary 
educational programs, excluding post-baccalaureate programs, and 
making satisfactory progress towards completion of the program. 
    (c) Once each quarter the commissioner shall review the use 
of child care fund allocations under this subdivision by 
county.  The commissioner may reallocate unexpended or 
unencumbered money among those counties that have expended their 
full portion for the purposes of this subdivision. 
    (d) A county may claim federal reimbursement under the AFDC 
special needs program for money spent for persons listed in 
subdivision 3a, clause (2).  The commissioner shall allocate any 
federal earnings to the county.  The county shall use the money 
to expand child care sliding fee services to AFDC recipients 
under the child care sliding fee program under this subdivision. 
    (e) Recipients of AFDC who have completed their 
post-secondary education and had received child care funds 
during that education shall be assured, to the extent of 
available resources allocations, of sliding fee money for 
employment programs after graduation if they meet sliding fee 
program eligibility standards. 
    Sec. 227.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 3e, is amended to read: 
    Subd. 3e.  [USE OF MONEY.] Money for persons listed in 
subdivision 3a, clauses (2) and (3), shall be used to reduce the 
costs of child care for students, including the costs of child 
care for students while employed if enrolled in an eligible 
education program at the same time and making satisfactory 
progress towards completion of the program.  The county may plan 
for and provided child care assistance to persons listed in 
subdivision 3a, clauses (2) and (3), from the regular sliding 
fee fund to supplement the set-aside funds.  Financially 
eligible students provided who have received child care 
assistance for one academic year shall be provided child care 
assistance in the following academic year, providing they remain 
financially eligible if funds allocated under subdivision 3c or 
3d are available. 
    Sec. 228.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 4, is amended to read:  
    Subd. 4.  [FINANCIAL ELIGIBILITY.] (a) Child care services 
must be available to families who need child care to find or 
keep employment or to obtain the training or education necessary 
to find employment and who: 
    (1) receive aid to families with dependent children; 
    (2) have household income below the eligibility levels for 
aid to families with dependent children; or 
    (3) have household income within a range established by the 
commissioner. 
    (b) Child care services for the families receiving aid to 
families with dependent children must be made available as 
in-kind services, to cover any difference between the actual 
cost and the amount disregarded under the aid to families with 
dependent children program.  Child care services to families 
whose incomes are below the threshold of eligibility for aid to 
families with dependent children, but that are not receiving aid 
to families with dependent children, must be made available 
without cost to the families. 
    (c) Child care services to families with incomes in the 
commissioner's established range must be made available on a 
sliding fee basis.  The lower limit of the sliding fee range 
must be the eligibility limit for aid to families with dependent 
children.  The upper limit of the range must be neither less 
than 70 percent nor more than 90 percent of the state median 
income for a family of four, adjusted for family size.  
    (d) If a disproportionate amount of the available money is 
provided to any one of the groups described in subdivision 4, 
paragraph (a), the county board shall document to the 
commissioner the reason the group received a disproportionate 
share.  If a county projects that its child care allocation is 
insufficient to meet the needs of all eligible groups, it may 
prioritize among the groups to be served.  Counties shall assure 
that a person receiving child care assistance from the sliding 
fee program prior to July 1, 1987, continues to receive 
assistance, providing the person meets all other eligibility 
criteria.  Set-aside money must be prioritized by the state, and 
counties do not have discretion over the use of this money. 
    (e) Annual income of the applicant family is the current 
monthly income of the family multiplied by 12 or the income for 
the 12-month period immediately preceding the date of 
application, whichever provides the most accurate assessment of 
income available to the family.  Self-employment income must be 
calculated based on gross receipts less operating expenses.  
Income must be redetermined when the family's income changes, 
but no less often than every six months.  Income must be 
verified with documentary evidence.  If the applicant does not 
have sufficient evidence of income, verification must be 
obtained from the source of the income. 
    Sec. 229.  Minnesota Statutes 1986, section 268.91, 
subdivision 7, is amended to read:  
    Subd. 7.  [SLIDING FEE SCALE.] In setting the sliding fee 
schedule, the commissioner shall exclude from the amount of 
income used to determine eligibility an amount for federal and 
state income and social security taxes attributable to that 
income level according to federal and state standardized tax 
tables.  The commissioner shall base the parent fee on the 
ability of the family to pay for child care.  The fee schedule 
must be designed to use any available tax credits and to 
progress smoothly from appropriated assistance to assistance 
through tax credits. 
    Sec. 230.  Minnesota Statutes 1987 Supplement, section 
268.91, subdivision 12, is amended to read: 
    Subd. 12.  [FAIR HEARING PROCESS.] (a) Applicants and 
recipients have the option to request the county to conduct a 
conciliation conference to attempt to resolve complaints arising 
from any of the following actions:  
    (1) a determination of ineligibility for child care 
assistance; 
    (2) unauthorized termination of child care assistance; 
    (3) determination of the factors considered in setting the 
family fee; and 
    (4) income redetermination resulting in change of a family 
fee.  
    (b) The county shall notify the applicant or the recipient, 
in writing, of any adverse action.  The determination described 
in paragraph (a), clauses (1) and (3), must include written 
notice of the applicant's or recipient's right to the election 
described in paragraph (c), where and how to request the 
election, the time limit within which to make the request, and 
the reasons for the determination.  Notice of the proposed 
actions described in paragraph (a), clauses (2) and (4), must be 
mailed to the applicant or recipient at least 15 calendar days 
before the effective date of the action.  The notice must 
clearly state what action the county proposes to take, the 
effective date of the proposed action, the reasons for the 
proposed action, the necessary corrective measures, the option 
to request either a conciliation conference or an administrative 
hearing, where and how to make the request, the time limits 
within which a request must be made, and the consequence of the 
action.  
    (c) An applicant or recipient who receives a determination 
or notice of proposed action under paragraph (b) must mail or 
deliver either a written notice of request for a conciliation 
conference to the administering agency or a written notice of 
request for the hearing specified under paragraph (e) to the 
administering agency on or before the effective date of the 
proposed action or the date specified in the notice, or the 
action will be final.  
    (d) The county shall provide a conciliation conference 
within 30 days of receipt of a written request.  
    The county shall give the applicant or recipient ten 
calendar days' notice of the conference date.  The applicant or 
recipient and the county's representative have the right to 
appear, to bring witnesses, and to submit documentation.  The 
written request and the resolution, if any, of the conference 
shall be maintained as part of the official record.  The 
county's representative shall issue a written resolution only if 
mutual agreement is reached between the county's representative 
and the applicant or recipient.  The resolution must be signed 
by both parties and issued the same day as the conciliation 
conference is held.  Participating in a conciliation conference 
or signing a resolution does not constitute a waiver of the 
right to an administrative hearing.  
    An applicant or recipient may, within 15 calendar days of 
the conference, mail or deliver a written request to the 
administering agency for an administrative hearing.  Unless an 
appeal is requested, a determination, proposed action, or 
resolution of a conciliation conference will be final after the 
15-day period has passed.  
    (e) A fair hearing shall be conducted in the manner 
prescribed by section 268.10, subdivision 3.  A right to review 
will be provided in accordance with section 268.10, subdivision 
5.  The proposed action will not take effect until the appeal is 
decided by the administrative hearing process. 
    (a) An applicant or recipient adversely affected by a 
county agency action may request a fair hearing in accordance 
with section 256.045, subdivision 3. 
    (b) The county agency shall offer an informal conference to 
applicants and recipients adversely affected by an agency action 
to attempt to resolve the dispute.  The county agency shall 
advise adversely affected applicants and recipients that a 
request for a conference with the agency is optional and does 
not delay or replace the right to a fair hearing. 
    Sec. 231.  Minnesota Statutes 1986, section 268.911, 
subdivision 3, is amended to read: 
    Subd. 3.  [PROGRAM SERVICES.] The commissioner may make 
grants to public or private nonprofit entities to fund child 
care resource and referral programs.  Child care resource and 
referral programs must serve a defined geographic area. 
    (a) Each program shall identify all existing child care 
services through information provided by all relevant public and 
private agencies in the areas of service, and shall develop a 
resource file of the services which shall be maintained and 
updated at least quarterly.  These services must include family 
day care homes; public and private day care programs; full-time 
and part-time programs; infant, preschool, and extended care 
programs; and programs for school age children. 
    The resource file must include:  the type of program, hours 
of program service, ages of children served, fees, location of 
the program, eligibility requirements for enrollment, and 
transportation available to the program.  The file may also 
include program information and special needs services. 
    (b) Each program shall establish a referral process which 
responds to parental need for information and which fully 
recognizes confidentiality rights of parents.  The referral 
process must afford parents maximum access to all referral 
information.  This access must include telephone referral 
available for no less than 20 hours per week. 
    Each child care resource and referral agency shall 
publicize its services through popular media sources, agencies, 
employers, and other appropriate methods. 
    (c) Each program shall maintain ongoing documentation of 
requests for service.  All child care resource and referral 
agencies must maintain documentation of the number of calls and 
contacts to the child care information and referral agency or 
component.  A program may collect and maintain the following 
information: 
    (1) ages of children served; 
    (2) time category of child care request for each child; 
    (3) special time category, such as nights, weekends, and 
swing shift; and 
    (4) reason that the child care is needed. 
    (d) Each program shall have available the following 
information as an educational aid to parents: 
    (1) information on aspects of evaluating the quality and 
suitability of child care services, including licensing 
regulation, financial assistance available, child abuse 
reporting procedures, appropriate child development information; 
    (2) information on available parent, early childhood, and 
family education programs in the community. 
    (e) A program may provide technical assistance to existing 
and potential providers of all types of child care services and 
employers.  This assistance shall include: 
    (1) information on all aspects of initiating new child care 
services including licensing, zoning, program and budget 
development, and assistance in finding information from other 
sources; 
    (2) information and resources which help existing child 
care providers to maximize their ability to serve the children 
and parents of their community; 
    (3) dissemination of information on current public issues 
affecting the local and state delivery of child care services; 
    (4) facilitation of communication between existing child 
care providers and child-related services in the community 
served; and 
    (5) recruitment of licensed providers; and 
    (6) options, and the benefits available to employers 
utilizing the various options, to expand child care services to 
employees. 
    Services prescribed by this section must be designed to 
maximize parental choice in the selection of child care and to 
facilitate the maintenance and development of child care 
services and resources. 
    (f) Child care resource and referral information must be 
provided to all persons requesting services and to all types of 
child care providers and employers. 
    (g) Public or private entities may apply to the 
commissioner for funding.  The maximum amount of money which may 
be awarded to any entity for the provision of service under this 
subdivision is $60,000 per year.  A local match of up to 25 
percent is required. 
    Sec. 232.  Minnesota Statutes 1986, section 326.371, is 
amended to read:  
    326.371 [BAN ON LEAD IN PLUMBING.] 
    Lead pipe, solders, and flux containing more than 0.2 
percent lead, and pipes and pipe fittings containing more than 
eight percent lead shall not be used in any plumbing 
installation which conveys a potable water supply.  A Minnesota 
seller of lead solder, except for a seller whose primary 
business is contracting in plumbing, heating, and air 
conditioning, shall not sell any solder containing 0.2 percent 
lead unless the seller displays a sign which states, 

                            "Contains Lead 
    Minnesota law prohibits the use of this solder in any 
    plumbing installation which is connected to a potable water 
    supply." 
     Sec. 233.  Minnesota Statutes 1987 Supplement, section 
326.73, is amended to read:  
    326.73 [EMPLOYEE ASBESTOS CERTIFICATIONS.] 
    Before an employee performs asbestos-related work, the 
employee shall first obtain a certificate from the commissioner 
certifying that the employee is qualified to perform the work.  
No certificate shall be issued unless the employee has shown 
evidence of training or experience in the general commercial 
building construction trades, has taken a course of training in 
asbestos control and removal, passed an examination in those 
subjects, and demonstrated to the commissioner the ability to 
perform asbestos-related work safely in accordance with the 
current state-of-the-art technology.  The commissioner shall 
specify the course of training necessary.  The certificate 
issued by the commissioner shall be in writing, be dated when 
issued, contain an expiration date, be signed by the 
commissioner, and contain the name and address of the employee 
to whom it is issued.  The certificate shall be carried by the 
employee and be readily available for inspection by the 
commissioner, other public officials charged with the health, 
safety, and welfare of the state's citizens, and the contracting 
entity.  
    Sec. 234.  Minnesota Statutes 1986, section 462A.05, is 
amended by adding a subdivision to read: 
    Subd. 29.  [HOUSING GRANTS FOR HOMELESS INDIVIDUALS.] The 
agency may provide grants to eligible mortgagors for the purpose 
of purchasing, rehabilitating, and constructing housing for 
homeless individuals as defined in section 268.0111, subdivision 
4a.  The agency may determine the conditions, if any, under 
which all or a portion of the grant will be repaid and 
appropriate security, if any, for repayment of the grant.  In 
establishing this grant program, the agency must consult the 
commissioner of jobs and training.  The applicant must consult 
with advocates for the homeless, representatives from 
neighborhood groups and representatives of labor organizations 
in preparing the proposal. 
    Grants awarded under this section may not exceed $25,000 
per residential unit.  Priority must be given to viable 
proposals with the lowest total cost.  Applicants must consider 
the use of donated or leased, abandoned or empty dwellings owned 
by a public entity including, but not limited to, a housing 
redevelopment authority, community development authority, public 
housing authority, the federal Department of Housing and Urban 
Development, or the Farmers Home Administration.  Any 
residential unit purchased, rehabilitated, or constructed under 
this section must be allocated in the following order: 
    (1) homeless families with at least one dependent, 
    (2) other homeless individuals, 
    (3) other very low income families or individuals whose 
incomes are equal to or less than 30 percent of the median 
income for the Minneapolis-St. Paul metropolitan area, and 
    (4) families or individuals that receive public assistance 
and do not qualify in any other priority group. 
    Proposals must include a plan for (a) maintaining the 
ownership of the property and managing the dwelling for rental 
to homeless individuals and families and very low income 
families; (b) selling rehabilitated dwellings to homeless 
individuals and families or very low income families; or (c) 
selling, leasing, or conveying to organizations that will manage 
the dwelling for rental to homeless individuals and families and 
very low income families.  These organizations may include 
organizations awarded grants under section 268.39.  The homeless 
individuals or families or very low income families that may 
purchase dwellings under (b) must have incomes that are equal to 
or less than 30 percent of the median income for the 
Minneapolis-St. Paul metropolitan area. 
    Eligible mortgagors must demonstrate that the grants 
awarded under this section will not exceed 50 percent of the 
project's total cost.  A project's total cost includes, but is 
not limited to, acquisition costs, rehabilitation costs, and 
related costs.  In cases where the property is donated, the 
acquisition costs are the prerehabilitated estimated market 
value as established for property tax purposes.  Donated 
property may be used to satisfy the match requirement. 
    Sec. 235.  Minnesota Statutes 1986, section 462A.21, is 
amended by adding a subdivision to read: 
    Subd. 14.  It may make housing grants for homeless 
individuals as provided in section 462A.05, subdivision 29, and 
may pay the costs and expenses for the development and operation 
of the program. 
     Sec. 236.  Minnesota Statutes 1986, section 609.72, 
subdivision 1, is amended to read:  
    Subdivision 1.  Whoever does any of the following in a 
public or private place, knowing, or having reasonable grounds 
to know that it will, or will tend to, alarm, anger or disturb 
others or provoke an assault or breach of the peace, is guilty 
of disorderly conduct, which is a misdemeanor: 
    (1) Engages in brawling or fighting; or 
    (2) Disturbs an assembly or meeting, not unlawful in its 
character; or 
    (3) Engages in offensive, obscene, or abusive language or 
in boisterous and noisy conduct tending reasonably to arouse 
alarm, anger, or resentment in others.  
    A person does not violate this section if the person's 
disorderly conduct was caused by an epileptic seizure. 
    Sec. 237.  Minnesota Statutes 1986, section 611A.32, is 
amended by adding a subdivision to read: 
    Subd. 1a.  [PROGRAM FOR AMERICAN INDIAN WOMEN.] The 
commissioner shall establish at least one program under this 
section to provide emergency shelter services and support 
services to battered American Indian women.  The commissioner 
shall grant continuing operating expenses to the program 
established under this subdivision in the same manner as 
operating expenses are granted to programs established under 
subdivision 1. 
     Sec. 238.  Laws 1984, chapter 654, article 5, section 57, 
subdivision 1, as amended by Laws 1987, chapter 75, section 1, 
is amended to read: 
    Subdivision 1.  [RESTRICTED CONSTRUCTION OR MODIFICATION.] 
Through June 30, 1990, the following construction or 
modification may not be commenced: 
    (1) any erection, building, alteration, reconstruction, 
modernization, improvement, extension, lease, or other 
acquisition by or on behalf of a hospital that increases the bed 
capacity of a hospital, relocates hospital beds from one 
physical facility, complex, or site to another, or otherwise 
results in an increase or redistribution of hospital beds within 
the state; and 
    (2) the establishment of a new hospital. 
    This section does not apply to: 
    (1) construction or relocation within a county by a 
hospital, clinic, or other health care facility that is a 
national referral center engaged in substantial programs of 
patient care, medical research, and medical education meeting 
state and national needs that receives more than 40 percent of 
its patients from outside the state of Minnesota; 
    (2) a project for construction or modification for which a 
health care facility held an approved certificate of need on May 
1, 1984, regardless of the date of expiration of the certificate;
    (3) a project for which a certificate of need was denied 
prior to the date of enactment of this act if a timely appeal 
results in an order reversing the denial; 
    (4) a project exempted from certificate of need 
requirements by Laws 1981, chapter 200, section 2; 
    (5) a project involving consolidation of pediatric 
specialty hospital services within the Minneapolis-St. Paul 
metropolitan area that would not result in a net increase in the 
number of pediatric specialty hospital beds among the hospitals 
being consolidated; 
    (6) a project involving the temporary relocation of 
pediatric-orthopedic hospital beds to an existing licensed 
hospital that will allow for the reconstruction of a new 
philanthropic, pediatric-orthopedic hospital on an existing site 
and that will not result in a net increase in the number of 
hospital beds.  Upon completion of the reconstruction, the 
licenses of both hospitals must be reinstated at the capacity 
that existed on each site prior to the relocation; 
    (7) the relocation or redistribution of hospital beds 
within a hospital building or identifiable complex of buildings 
provided the relocation or redistribution does not result in:  
(i) an increase in the overall bed capacity at that site; (ii) 
relocation of hospital beds from one physical site or complex to 
another, or (iii) redistribution of hospital beds within the 
state or a region of the state; or 
    (8) relocation or redistribution of hospital beds within a 
hospital corporate system that involves the transfer of beds 
from a closed facility site or complex to an existing site or 
complex provided that:  (i) no more than 50 percent of the 
capacity of the closed facility is transferred; (ii) the 
capacity of the site or complex to which the beds are 
transferred does not increase by more than 50 percent; (iii) the 
beds are not transferred outside of a federal health systems 
agency boundary in place on July 1, 1983; and (iv) the 
relocation or redistribution does not involve the construction 
of a new hospital building; or 
    (9) a construction project involving up to 35 new beds in a 
psychiatric hospital in Rice county that primarily serves 
adolescents and that receives more than 70 percent of its 
patients from outside the state of Minnesota. 
    Sec. 239.  Laws 1987, chapter 337, section 131, is amended 
to read: 
    Sec. 131.  [REPEALER.] 
    Minnesota Statutes 1986, sections 62A.12; and 67A.43, 
subdivision 3, are repealed. 
    Minnesota Rules, parts 2700.2400; 2700.2410; 2700.2420; 
2700.2430; and 2700.2440, are repealed. 
    Section 123 is repealed effective July 1, 1988, if the 
project implementation phase has not begun by that date. 
     Sec. 240.  Laws 1987, chapter 403, article 1, section 4, 
subdivision 4, is amended to read: 
     Subd. 4.  Community Services 
  $ 1,921,000   $ 1,520,000 
 Of this appropriation, $200,000 the 
first year and $200,000 the second year 
are to provide for the local storage, 
transportation, processing, and 
distribution of United States 
Department of Agriculture surplus 
commodities.  The department of jobs 
and training shall report on the 
surplus commodities program to the 
state legislature by January 15 of each 
year. 
 Notwithstanding any law to the 
contrary, for the biennium ending June 
30, 1989, the commissioner of jobs and 
training shall transfer to the 
community services block grant program 
ten percent of the money received under 
the low-income home energy assistance 
block grant in each year of the 
biennium and shall expend all of the 
transferred money during the year of 
the transfer or the year following the 
transfer.  None of the transferred 
money may be used by the commissioner 
of jobs and training for administrative 
costs, except that up to two Up to 3.75 
percent of the transferred money may be 
used by the commissioner of jobs and 
training for administrative costs, 
except that up to 4.25 percent of the 
funds used to supplement the federal 
funding for Project Head Start may be 
used for administrative costs. 
 Twenty-five percent of the money 
transferred by the commissioner of jobs 
and training from the low-income home 
energy assistance block grant to the 
community services block grant shall be 
used to supplement the federal funding 
of Project Head Start for children from 
low-income families.  Notwithstanding 
any law to the contrary, these 
transferred funds shall be allocated 
through the existing Project Head Start 
formula to existing Project Head Start 
grantees for the purpose of expanding 
services to additional low-income 
families.  The transferred funds shall 
be expended according to the federal 
regulations governing Project Head 
Start, including Code of Federal 
Regulations, title 45, sections 1302 
through 1305.  Each local Project Head 
Start shall expend the supplemental 
funds during the year of their receipt 
or the year following their receipt.  
 The commissioner of jobs and training 
shall prepare an annual report to the 
legislature describing the uses and 
impacts of the Project Head Start 
supplemental funding.  The first annual 
report shall be delivered to the 
appropriate committees of the 
legislature on January 1 following the 
first full school year for which 
supplemental funding is available. 
 For the biennium ending June 30, 1989, 
the commissioner of jobs and training 
shall shift to the low-income home 
weatherization program at least five 
percent of money received under the 
low-income home energy assistance block 
grant in each year of the biennium and 
shall expend all of the transferred 
funds during the year of the transfer 
or the year following the transfer.  
None Up to 1.63 percent of the 
transferred money may be used by the 
commissioner of jobs and training for 
administrative costs.  
 To the extent allowed by federal 
regulations, the commissioner of jobs 
and training shall ensure that the same 
income eligibility criteria apply to 
both the weatherization program and the 
energy assistance program. 
 For the biennium ending June 30, 1989, 
no more than 1.11 percent of funds 
received under the total low-income 
home energy assistance program may be 
used by the commissioner for 
departmental administrative costs 1.63 
percent of funds remaining under the 
low-income home energy assistance 
program after transfers to community 
services block grants and the 
weatherization program may be used by 
the department for administrative costs.
 Discretionary money from the community 
services block grant (regular) must be 
used to supplement the appropriation 
for local storage, transportation, 
processing, and distribution of United 
States Department of Agriculture 
surplus commodities to the extent 
supplementary funding is required.  Any 
remaining funds shall be allocated to 
state-designated and state-recognized 
community action agencies, Indian 
reservations, and the Minnesota migrant 
council. 
 In the event that the federal office of 
community services does not recognize 
the Olmsted and Freeborn county 
community action agencies as eligible 
entities for full funding, the 
commissioner shall provide full funding 
for those agencies from discretionary 
funds resulting from block grant 
transfers to the community services 
block grant.  The balance of these 
funds may be used by the commissioner 
for discretionary purposes consistent 
with federal community services block 
grant guidelines stated in Public Law 
Number 97-35.  The commissioner shall 
by January 1, 1988, report to the 
legislature on the use of these funds. 
 The commissioner shall by January 1, 
1988, provide to the chairs of the 
health and human services divisions of 
the house appropriations committee and 
the senate finance committee a written 
plan describing how the department's 
division of community services will 
issue one contract for human service 
programs, with the community action 
agencies, the Indian reservations, and 
the Minnesota migrant council, 
including but not limited to, the 
community services block grant program, 
the low-income home weatherization 
program, the low-income energy 
assistance program, the USDA Surplus 
Commodities Program, and all other 
programs for which the division has 
contractual responsibility. 
    Sec. 241.  Laws 1987, chapter 403, article 2, section 34, 
is amended to read: 
    Sec. 34. [245.48] [MAINTENANCE OF EFFORT.] 
    Counties must continue to spend for mental health services, 
according to generally accepted budgeting and accounting 
principles, an amount equal to the total expenditures shown in 
the county's approved 1987 Community Social Services Act plan 
under "State CSSA, Title XX and County Tax" for services to 
persons with mental illness plus the total comparable figure for 
Rule 5 facilities under target populations other than mental 
illness in the approved 1987 CSSA plan.  
    Sec. 242.  Laws 1987, chapter 403, article 4, section 13, 
is amended to read: 
    Sec. 13.  [STUDY AND REPORT.] 
    (a) The interagency board for quality assurance shall study 
the following issues and report to the legislature by December 
15, 1988, on its findings and recommendations: 
    (1) the advisability of changing the definition of 
"hardship" for purposes of the nursing home moratorium; 
    (2) the advisability of defining the need for nursing home 
beds in terms of the population aged 75 and older; and 
    (3) the existence of a geographic maldistribution of 
long-term care beds and alternative care services in the state. 
    (b) In addition to the issues in paragraph (a), the 
interagency board shall study and make recommendations 
concerning the policy and fiscal impact of the changes made in 
Public Law Number 100-203 relating to the elimination of the 
intermediate care facility certification level in 1990.  The 
interagency board shall consider at least the following:  the 
need for continuation of the services currently offered by 
certified boarding care home beds, the need for additional beds 
in state licensed nursing homes, the fiscal impact associated 
with the reconstruction or replacement of facilities that do not 
meet nursing home standards, the costs of establishing an 
alternative funding source for the payment of services currently 
provided in these facilities, and the need to promulgate 
licensure standards.  If the interagency board recommends that 
facilities be licensed as nursing homes, the interagency board 
shall recommend specific procedures for the granting of the 
licenses and identify methods for the licensing or funding of 
facilities that may be considered out of compliance with federal 
law on October 1, 1990.  The board shall provide recommendations 
to the legislature for legislative changes that are necessary to 
implement the board's recommendations.  The costs associated 
with the board's recommendations must be provided to the 
commissioner of human services and included in the medical 
assistance forecast and the agency budget requests for the 
biennium ending June 30, 1991.  
    Sec. 243.  [MEDICAL ASSISTANCE; QUALIFIED OCCUPATIONAL 
THERAPIST.] 
    Notwithstanding Minnesota Rules, part 9500.1070, subpart 
13, item B, for purposes of medical assistance reimbursement, 
the term "qualified occupational therapist" includes a person 
who: 
    (1) has completed an occupational therapy educational 
program in a foreign school approved by the World Federation of 
Occupational Therapists; 
    (2) has at least ten years' experience working as a paid 
occupational therapist in the United States; and 
    (3) is eligible to write the national certification 
examination administered by the American Occupational Therapy 
Association for registration as an occupational therapist. 
    Sec. 244.  [NURSING HOME SPECIAL ASSESSMENT FOR SEWER 
RENTAL.] 
    Notwithstanding contrary provisions of Minnesota Statutes, 
section 256B.431, for purposes of determining the amount of a 
reported actual special assessment to be included in a nursing 
home's operating cost, the commissioner of human services shall 
include an expense charged to a nursing home by the municipality 
of Minneota through a sewer rental charge assessed against the 
nursing home for a wastewater treatment facility. 
    Sec. 245.  [REPORT ON HOSPITAL-ATTACHED NURSING HOME 
PROPERTY PAYMENTS.] 
    The commissioner of human services shall study 
property-related payments for hospital-attached nursing homes 
and report to the legislative commission on long-term health 
care by February 1, 1989, with recommendations on appropriate 
cost allocation methods to be used for property-related 
reimbursement. 
    Sec. 246.  [MEDICAL SCREENING.] 
    Subdivision 1.  [SCREENINGS.] The commissioner of health 
shall conduct a medical screening of a sample of people and 
family members of people who were employed at the Conwed 
Corporation plant in Cloquet, Minnesota, from January 1, 1958 to 
December 31, 1974.  The purpose of the screening is to study the 
existence of asbestos-related diseases among people employed at 
the plant during that time, evaluate their health care needs, 
and provide medical and scientific data to coordinate future 
health screening, counseling, and treatment activities among 
these people and their families. 
    Subd. 2.  [EXPERTS.] The commissioner of health may 
contract with local, state, or nationally recognized experts in 
the diagnosis and treatment of asbestos-related diseases for 
medical examinations of workers, scientific evaluations of data 
and consultations on the screening results. 
    Subd. 3.  [REPORT AND RECOMMENDATIONS.] The commissioner of 
health shall present a report and recommendations to the 
legislature on or before March 1, 1989, based on the findings of 
the medical screenings specified above.  The report shall 
address, but not be limited to: 
    (1) the actual and estimated extent and risks of 
asbestos-related disease among the people screened; 
    (2) the types of counseling and prevention services that 
the people screened may need and the methods of administering 
the services; and 
    (3) the estimated cost and effectiveness of screening, 
counseling, and preventive services for people described in 
subdivision 1 who were not included in the sample of people 
screened. 
    Sec. 247.  [157.045] [INCREASE IN FEES.] 
    For licenses issued for 1989 and succeeding years, the 
commissioner of health shall increase license fees for 
facilities licensed under chapters 157 and 327 to a level 
sufficient to recover all expenses related to the licensing, 
inspection, and enforcement activities prescribed in those 
chapters.  In calculating the fee increase, the commissioner 
shall include the salaries and expenses of 5.5 new positions 
required to meet the inspection frequency prescribed in 
Minnesota Statutes, section 157.04.  Fees collected must be 
deposited in the special revenue account. 
    Sec. 248.  [LOCAL INCOME ASSISTANCE FROM FEDERAL FOOD 
STAMPS.] 
    To the extent of available appropriations, the commissioner 
of human services shall contract with community outreach 
programs to encourage participation in the food stamp program of 
seniors, farmers, veterans, unemployed workers, low-income 
working heads of households, battered women residing in 
shelters, migrant workers, families with children, and other 
eligible individuals who are homeless.  For purposes of this 
section, "homeless" means that the individual lacks a fixed and 
regular nighttime residence or has a primary nighttime residence 
that is: 
    (1) a publicly supervised or privately operated shelter, 
including a welfare hotel or congregate shelter, designed to 
provide temporary living accommodations; 
    (2) an institution that provides a temporary residence for 
individuals who will be institutionalized; 
    (3) a temporary accommodation in the residence of another 
individual; or 
    (4) a public or private place not designed for, or 
ordinarily used as, a regular sleeping accommodation for human 
beings. 
    The commissioner shall seek federal reimbursement for state 
money used for grants and contracts under this section.  Federal 
money received is appropriated to the commissioner for purposes 
of this section.  The commissioner shall convene an advisory 
committee to help establish criteria for awarding grants, to 
make recommendations regarding grant proposals, to assist in the 
development of training and educational materials, and to 
participate in the evaluation of grant programs.  The grantees 
shall provide training for program workers, offer technical 
assistance, and prepare educational materials.  Grantees must 
demonstrate that grants were used to increase participation in 
the food stamp program by creating new outreach activities, and 
not by replacing existing activities.  No more than five percent 
of the appropriation for community outreach programs shall be 
used by the commissioner for the department's administrative 
costs.  The rulemaking requirements of Minnesota Statutes, 
chapter 14 do not apply to the procedures used by the 
commissioner to request and evaluate grant proposals and to 
award grants and contracts under this section.  Distribution of 
grant money must begin within three months after any transfer of 
funds from the commissioner of health to the commissioner of 
human services. 
    Sec. 249.  [HEALTHSPAN IMPLEMENTATION PLAN.] 
    The commissioner of human services, in consultation with 
the commissioners of health and commerce, shall develop a plan 
to implement the healthspan program to provide health coverage 
to uninsured individuals.  The plan must include at least the 
following: 
    (1) estimates of the number of people eligible for the 
program, the expected number of individuals who will enroll, and 
the costs of the program; 
    (2) a description of benefits to be offered; 
    (3) recommendations for methods to determine eligibility 
and collect premiums; 
    (4) strategies for contracting and marketing; 
    (5) strategies to preserve and enhance employer 
participation in the provision of health care coverage; 
    (6) strategies to coordinate or merge the program with 
health care programs such as general assistance medical care, 
the university hospital papers program at the University of 
Minnesota hospitals, Minnesota comprehensive health association, 
medical assistance, Medicare, the catastrophic health expense 
protection program, the children's health plan, and other 
similar programs; 
    (7) timelines for implementing the program, with specific 
implementation plans for the 1989-1991 biennium; 
    (8) methods of financing the program; and 
    (9) recommendations for legislation to implement the 
program. 
    The commissioner shall report to the legislature by January 
1, 1989, on options to implement the program. 
    Sec. 250.  [TRANSFER FOR ENVIRONMENTAL LABORATORY 
CERTIFICATION PROGRAM.] 
    An amount equal to the appropriation from the special 
revenue fund to the commissioner of health for implementation of 
the environmental laboratory certification program must be 
transferred from the laboratory certification account to the 
special revenue fund by June 30, 1992. 
    Sec. 251.  [DEMONSTRATION PROJECT.] 
    The commissioner of human services shall establish a 
demonstration project to increase the independence of people 
with epilepsy by providing training in independent living.  The 
commissioner shall award a grant for the demonstration project 
to a nonresidential program that provides medical monitoring and 
living skills training to people with epilepsy who live 
independently.  The grant awarded under this section must be 
used for salaries, administration, transportation, and other 
program costs.  The developmental disabilities planning section 
of the state planning agency shall consult with the commissioner 
of human services and shall evaluate the effectiveness of the 
epilepsy demonstration project in increasing independence of the 
people with epilepsy who are served by the project.  By December 
1, 1989, the developmental disabilities planning section shall 
present a report to the legislature with the evaluation and a 
recommendation on whether there is a need to continue or expand 
the program. 
    Sec. 252.  [PURPOSE FOR MINNESOTA INSTITUTE FOR ADDICTION 
AND STRESS RESEARCH.] 
    To place Minnesota in a leadership role for neurobiological 
research of addictive disorders and stress-related diseases, the 
legislature finds it necessary to establish a research institute 
dedicated to clinical and basic scientific investigation of 
addictive disorders and stress-related diseases.  Because of the 
critical relationship between addictive and stress-related 
disorders, the institute will study the neurobiological origins 
of stress and will investigate and develop therapies for other 
stress-related medical disorders that are not responsive to 
available medical therapies.  Regarding addictive disorders, the 
institute's primary objective is to develop and test new 
scientifically based therapy to reduce the rate of recidivism in 
the addicted population and lower the costs of therapy.  
Furthermore, the institute will stimulate and attract 
significant new research activity to Minnesota.  
    Sec. 253.  [LEAD CONTAMINATION; DEMONSTRATION PROJECTS.] 
    The department of health shall fund and participate in a 
two-year demonstration project to be undertaken by an 
organization serving a population at risk from lead 
contamination to monitor blood lead levels in pregnant women, 
provide information to pregnant patients about how to avoid high 
blood lead levels, and to provide intervention for pregnant 
patients whose blood lead levels exceed 12 micrograms per 
deciliter.  The purpose of the project is to establish an 
effective prototype method of monitoring, education, and 
intervention to prevent or reduce high blood lead levels in 
pregnant women.  By November 1, 1990, the center and the 
department shall report to the legislature on the outcome of the 
project. 
    The department shall also fund a project for the purpose of 
demonstrating the impact on blood lead levels in children, of 
soil, dust, paint, and interior and exterior lead cleanup and 
use of educational materials on proper handling of lead paint 
removal and cleanup.  The project must be undertaken by a 
community based organization and must include: 
    (1) neighborhood involvement and an educational community 
outreach component; 
    (2) a cost-benefit analysis; 
    (3) planning for a centrally located information and 
educational center to serve the community; and 
    (4) a final evaluation on the effectiveness of the project 
based on routes of exposure, statistical design of the project, 
and geographical distribution.  The project must include cleanup 
of lead contamination in a targeted portion of a neighborhood 
with known lead contamination.  Cleanup includes soil removal 
and replacement, landscaping and removal of loose paint.  The 
department shall test children who reside in the project area 
before cleanup and one year following cleanup for blood lead 
levels.  The evaluation required as part of the project must be 
presented to the legislature by January 1, 1990. 
    Sec. 254.  [REVIEW OF SMALL HOSPITAL RATES.] 
    The commissioner of human services shall, in conjunction 
with hospitals, review the adequacy of reimbursement for 
catastrophic cases for hospitals described in section 140, 
paragraph (c), in light of changes in case mix from the base 
year. 
    Sec. 255.  [STUDY OF RURAL HOSPITALS.] 
    The commissioner of health shall study the rural hospital 
system in the state and report to the legislature by February 1, 
1989, with a description of the financial condition of rural 
hospitals, including the identification of regions in the state 
where the closing of a financially distressed hospital will 
result in access problems for rural residents. 
    Sec. 256.  [ALTERNATIVE CARE GRANTS PILOT PROJECTS.] 
    Subdivision 1.  [SELECTION OF PROJECTS.] The commissioner 
of human services shall establish pilot projects to demonstrate 
the feasibility and cost-effectiveness of alternatives to 
nursing home care that involve providing coordinated alternative 
care grant services for all eligible residents in an identified 
apartment building or complex or other congregate residential 
setting.  The commissioner shall solicit proposals from counties 
and shall select up to four counties to participate, including 
at least one metropolitan county and one county in greater 
Minnesota.  The commissioner shall select counties for 
participation based on the extent to which a proposed project is 
likely to: 
    (1) meet the needs of low-income, frail elderly; 
    (2) enable clients to live as independently as possible; 
    (3) result in cost-savings by reducing the per person cost 
of alternative care grant services through the efficiencies of 
coordinated services; and 
    (4) facilitate the discharge of elderly persons from 
nursing homes to less restrictive settings or delay their entry 
into nursing homes.  
    Participating counties shall use existing alternative care 
grant allocations to pay for pilot project services.  The 
counties must contract with a medical assistance-certified home 
care agency to coordinate and deliver services and must 
demonstrate to the commissioner that quality assurance and 
auditing systems have been established.  Notwithstanding 
Minnesota Statutes, section 256B.091, and rules of the 
commissioner of human services relating to the alternative care 
grants program, the commissioner may authorize pilot projects to 
use pre-capitated rates; to provide expanded services such as 
chore services, activities, and meal planning, preparation, and 
serving; and to waive freedom of choice of vendor to the extent 
necessary to allow one vendor to provide services to all 
eligible persons in a residence or building.  The commissioner 
may apply for a waiver of federal requirements as necessary to 
implement the pilot projects. 
    Subd. 2.  [ELIGIBLE INDIVIDUALS.] An individual is eligible 
to receive project services if the individual: 
    (1) is receiving medical assistance or would be eligible 
for medical assistance within 180 days after admission to a 
nursing home; 
    (2) is residing in a nursing home or is at risk of nursing 
home placement; 
    (3) is able to direct his or her own care; 
    (4) has been prescreened by the county for eligibility and 
for appropriateness of service; and 
    (5) is otherwise eligible for alternative care grant 
services. 
    Subd. 3.  [REPORT.] The commissioner shall monitor and 
evaluate the pilot projects and report to the legislature by 
January 31, 1991.  The report must address at least the 
following: 
    (1) the extent to which each pilot project succeeded in 
moving elderly persons out of nursing homes into less 
restrictive settings or in delaying placement in a nursing home; 
    (2) the ability of each project to target low-income, frail 
elderly; 
    (3) the cost-effectiveness of each project, including the 
financial impact on the resident, the state, and the county; 
    (4) the success of each project in meeting other goals 
established by the commissioner; and 
    (5) recommendations on whether the pilot projects should be 
continued or expanded. 
    Sec. 257.  [FEASIBILITY STUDY FOR HABILITATION SERVICES.] 
    The commissioner of human services, in consultation with 
the commissioner of jobs and training, shall study the 
feasibility of providing medical assistance reimbursement to 
work activity programs for training and habilitative services 
provided to participants.  The commissioner shall report the 
findings to the legislature by December 1, 1988.  For the 
purposes of this section, a work activity program is as defined 
in section 129A.01. 
    Sec. 258.  [REPORT ON INTERMEDIATE CARE FACILITY RATES.] 
    The commissioner of human services shall report to the 
legislature by February 1, 1989, on the status of rulemaking to 
establish a new rate system for payments to intermediate care 
facilities for persons with mental retardation and related 
conditions, including a description of the proposed rules and an 
estimate of their fiscal impact. 
    Sec. 259.  [STUDY OF MEDICAL ASSISTANCE PAYMENTS FOR SWING 
BED CARE.] 
    The interagency board for quality assurance shall include 
in its report on nursing home bed distribution required under 
Laws 1987, chapter 403, article 4, section 13, a recommendation 
on whether medical assistance payments for swing bed care should 
continue beyond June 30, 1990. 
    Sec. 260.  [REPORT ON HUMAN IMMUNODEFICIENCY VIRUS 
TESTING.] 
    The commissioner of health shall submit a report to the 
legislature by February 15, 1989, that:  
    (1) identifies existing quality controls and standards for 
laboratories that perform human immunodeficiency virus testing 
and specifies whether additional quality assurance measures are 
needed to ensure accurate test results; and 
    (2) identifies the level of counseling and education that 
is occurring for individuals who are tested for the human 
immunodeficiency virus and specifies whether additional measures 
are needed to ensure that individuals tested for the human 
immunodeficiency virus are adequately counseled about the 
meaning of the test, test results, and steps the individual 
should take to protect the individual and others from infection. 
    Sec. 261.  [CHILD CARE SERVICES STUDY.] 
    The commissioner of human services shall study the existing 
public and private funding sources for child care services and 
the development of child care services, including the AFDC 
special needs program, the sliding fee child care program, the 
maternal and child nutrition program, county funding, Title XX 
funding, and private foundation, corporate, community social 
services act, or nonprofit funding to child care services 
providers and parents.  The study shall determine the extent to 
which: 
    (i) individual funding sources meet existing needs and what 
level of funding comes from each source; 
    (ii) the need for subsidized child care services for 
low-income parents is being met; 
    (iii) present funding mechanisms are efficient or can be 
made more efficient; 
    (iv) alternative or improved methods may encourage private 
funding for child care services; 
    (v) the funding level has an impact on availability of 
child care facilities; and 
    (vi) child care reimbursement rates are meeting actual 
costs for quality child care. 
    The commissioner shall report the results of the study, 
together with any proposed legislation to implement study 
recommendations, to the legislature by January 1, 1990. 
    Sec. 262.  [CHILD CARE INFORMATION NUMBER.] 
    By January 1, 1989, the council on children, youth, and 
families shall study and report to the legislature on the need 
for and the feasibility of a toll-free number to provide 
information and technical assistance to parents, child care 
providers, and potential child care providers.  The study shall 
include an assessment of need, cost, and potential impact. 
    Sec. 263.  [FARIBAULT REGIONAL CENTER.] 
    Subdivision 1.  [TASK FORCE.] The commissioner of the state 
planning agency shall appoint a 13-member task force to develop 
a plan to expand the use of the Faribault regional center.  The 
task force shall include four community representatives and one 
representative from each of the following entities:  Faribault 
regional center, Faribault Technical Institute, Faribault public 
schools, Academies for the Deaf and Blind, Wilson Center, Rice 
county, city of Faribault, Rice county district No. 1 hospital, 
and the department of human services. 
    Subd. 2.  [DUTIES OF COMMISSIONER.] The commissioner of the 
state planning agency shall provide a grant for a Faribault 
community task force to develop a plan for the future use of 
Faribault regional center.  The plan must assess the feasibility 
of providing educational services, nonresidential services, and 
care to a number of populations including, but not limited to, 
adolescents, veterans, and people who have developmental 
disabilities, chemical dependency, mental illness, or 
communicable diseases. 
    Subd. 3.  [REPORT.] The Faribault community task force must 
report the plan to the chairs of the health and human services 
committees of the house of representatives and senate by 
November 1, 1988.  The report must include a list of recommended 
services to be provided at Faribault regional center and must 
evaluate each recommendation. 
    Sec. 264.  [STUDY OF MANAGED CARE FOR MEDICAL ASSISTANCE 
AND GENERAL ASSISTANCE MEDICAL CARE RECIPIENTS.] 
     Subdivision 1.  [STUDY.] The commissioner of human services 
shall study the utilization patterns of individuals in the 
medical assistance and general assistance medical care 
programs.  The study will examine the applicability and 
usefulness of focused utilization review, case management 
services, and other managed care approaches to all or parts of 
these populations. 
     Subd. 2.  [FORMATION OF TASK FORCE.] The commissioner shall 
convene a task force composed of representatives from expert and 
interested parties to advise and assist the commissioner with 
the study in subdivision 1.  The task force shall include, at a 
minimum, representatives from the provider community, recipient 
groups, the departments of health and finance, and the 
University of Minnesota.  The analysis will be conducted by 
staff from the department of human services. 
    Subd. 3.  [OBJECTIVES.] The specific objectives of the task 
force shall be determined by the commissioner in consultation 
with the task force, and shall include at a minimum: 
    (a) to identify in the state and in selected geographic 
areas, patterns of utilization of health services, especially 
high frequency, high-cost use, and possible underutilization. 
    (b) to recommend interventions and an implementation plan 
consistent with the goals of the medical assistance and general 
assistance medical care programs to improve the management of 
health services to recipients identified as at-risk of 
inappropriately high or low utilization of care. 
    Subd. 4.  [REPORTING DATE.] The task force shall report its 
findings and recommendations to the commissioner and the 
legislature by September 30, 1988. 
    Sec. 265.  [APPROVED COMPLEMENT INCREASED.] 
    The complement of the office of administrative hearings is 
increased by one full-time equivalent position.  
    Sec. 266.  [RULES.] 
    The commissioner of human services may adopt rules to 
administer and implement the provisions of section 245.836.  
    Sec. 267.  [RULE CHANGES.] 
    The commissioner of jobs and training shall adopt rule 
amendments to Minnesota Rules, chapter 3300, including changes 
in the allocation formula for funds appropriated for extended 
employment programs, as necessary to effect the changes required 
by the legislature in sections 129A.01, subdivisions 5, 6, and 
7; 129A.02, subdivision 3; 129A.03; 129A.06, subdivision 1; 
129A.07, subdivision 1; 129A.08, subdivisions 1, 4, 4a, and 5; 
129A.09; and 129A.10. 
    This rule is exempt from the rulemaking provisions of 
Minnesota Statutes, chapter 14.  The commissioner must comply 
with Minnesota Statutes, section 14.38, subdivision 7, when 
adopting this rule amendment.  
    Sec. 268.  [INSTRUCTION TO REVISOR.] 
    (a) In the next edition of Minnesota Statutes, the revisor 
of statutes shall substitute in chapter 129A the term 
"rehabilitation facility" for the terms "long-term sheltered 
workshop," "workshop," or "sheltered workshop" in the form 
appropriate for the context.  
    In the next edition of Minnesota Statutes, the revisor of 
statutes shall substitute in chapter 129A the term "extended 
employment program participant" for the term "sheltered 
employee" in the form appropriate for the context.  
    The revisor shall make the substitutions required by this 
section in other places in Minnesota Statutes where the terms 
appear if they refer to the subject matter covered by chapter 
129A. 
    (b) In accordance with Minnesota Statutes 1986, section 
3C.10, the revisor of statutes shall renumber section 141, 
subdivisions 8a to 8y as a new section of Minnesota Statutes, 
chapter 256B. 
    The revisor of statutes shall renumber section 144, 
subdivisions 1j to 1r as a new section of Minnesota Statutes, 
chapter 256B. 
    The revisor of statutes shall correct cross-references in 
Minnesota Statutes and Minnesota Rules consistent with the 
renumbering.  
    Sec. 269.  [REPEALER.] 
    Subdivision 1.  Minnesota Statutes 1986, sections 144.388; 
153A.01; 153A.02; 153A.03; 153A.04; 153A.05; 153A.06; 153A.07; 
153A.08; 153A.09; 153A.10; 153A.11; 153A.12; 245.84, subdivision 
4; 245.86; 245.87; 246.023, subdivisions 2, 3, 4, and 5; and 
268.061; Minnesota Statutes 1987 Supplement, sections 129A.01, 
subdivision 8; 129A.07, subdivision 2; 129A.08, subdivision 3; 
148B.04, subdivision 1; and 256B.73, subdivision 10, are 
repealed.  Minnesota Statutes 1986, section 257.071, subdivision 
6, is repealed effective July 1, 1989.  
    Subd. 2.  Section 248 is repealed effective July 1, 1990. 
    Subd. 3.  Section 243 is repealed July 1, 1989. 
    Subd. 4.  Section 141, subdivision 8b, is repealed 
effective July 1, 1990.  
    Subd. 5.  Sections 50 to 54, and 252, are repealed 
effective July 1, 1991.  
    Sec. 270.  [EFFECTIVE DATE.] 
    Subdivision 1.  Sections 6, 11, 13, and 15 apply to any 
policy, plan, or contract issued or renewed on or after the date 
following final enactment. 
    Subd. 2.  Section 14 is effective the day after final 
enactment except that in the case of a plan maintained under one 
or more collective bargaining agreements between employee 
representatives and one or more employers ratified on or before 
April 7, 1986, section 14 is effective on the earlier of: 
    (1) the date on which the last of the collective bargaining 
agreements under which the plan is maintained, which were in 
effect on April 7, 1986, ends without regard to any extension of 
the agreement agreed to after April 7, 1986; or 
    (2) April 7, 1989. 
    Subd. 3.  Section 144, subdivisions 1f and 1m, are 
effective February 1, 1989. 
    Subd. 4.  Sections 193 to 204 are effective February 1, 
1989. 
    Subd. 5.  Sections 16 to 28, 267, and 268 are effective the 
day following final enactment and apply to allocations of funds 
appropriated for the extended employment programs administered 
under Minnesota Statutes, chapter 129A, made after July 1, 1988. 
    Subd. 6.  Sections 29, 32, 33 to 40, 46, 48, 49, 61, 62, 
84, 118 to 121, 158, 161, 163 to 168, 170, 178, 222, 238, 242 to 
244, 247, 249, and 263 to 265 are effective the day after final 
enactment.  
    Subd. 7.  Sections 150 and 151 are effective upon receiving 
approval of the health care financing administration.  
    Subd. 8.  Section 157 is effective, and applies to nursing 
home rate years that begin on or after, July 1, 1988.  
    Subd. 9.  Section 151 and that portion of section 150 
relating to the resource contribution of a spouse are effective 
upon receiving approval from the health care financing 
administration. 
    Approved April 28, 1988