Office of the Revisor of Statutes
Minnesota Session Laws - 1993, 1st Special Session
Key: (1) language to be deleted (2) new language
Laws of Minnesota, 1993 First Special Session
CHAPTER 6-S.F.No. 5
An act relating to legislative enactments; providing
for the correction of miscellaneous oversights,
inconsistencies, ambiguities, unintended results, and
technical errors of a noncontroversial nature;
amending Minnesota Statutes 1992, sections 16B.42,
subdivision 1; 115C.02, subdivision 14, as amended;
116.76, subdivision 1, as amended; 116.77, as amended;
116.82, subdivision 3, as amended; 124.914,
subdivision 4, as added; 256.969, by adding
subdivisions, as amended; 256B.057, subdivision 1, as
amended; 256B.0625, by adding a subdivision, as
amended; 256B.0913, subdivision 5, as amended;
256B.0915, subdivision 3; 256B.0915, subdivision 3, as
amended; 256D.02, subdivision 5, as amended; 256D.051,
subdivision 6, as amended; 257.071, subdivision 1, as
amended; 260.191, subdivisions 3a and 3b, as added;
295.50, subdivisions 3 and 4, as amended, and by
adding subdivisions; 295.51, subdivision 1, as
amended; 295.52, by adding a subdivision; 295.53,
subdivision 3, as amended, and by adding a
subdivision; 295.54, as amended; 298.28, subdivision
4, as amended; 477A.013, subdivision 1; Laws 1992,
chapter 549, article 9, section 19, as amended; Laws
1993, chapter 206, sections 8, subdivision 1; 25;
chapter 340, section 60; chapter 345, article 1,
sections 2, subdivision 2; and 8, subdivision 1;
article 2, section 5, subdivision 2; chapter 372,
section 8; 1993 Special Session H.F. No. 1, article 3,
section 29, subdivision 1; article 4, sections 4,
subdivision 5; 6, subdivision 6; repealing Laws 1993,
chapter 224, article 1, section 31; and chapter 337,
section 16.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1992, section 16B.42,
subdivision 1, is amended to read:
Subdivision 1. [COMPOSITION.] The commissioner of
administration shall appoint an intergovernmental information
systems advisory council, to serve at the pleasure of the
commissioner of administration, consisting of 25 members.
Fourteen members shall be appointed or elected officials of
local governments, seven shall be representatives of state
agencies, and four shall be selected from the community at
large. Further, the council shall be composed of (1) two
members from each of the following groups: counties outside of
the seven county metropolitan area, cities of the second and
third class outside the metropolitan area, cities of the second
and third class within the metropolitan area, and cities of the
fourth class; (2) one member from each of the following groups:
the metropolitan council, an outstate regional body, counties
within the metropolitan area, cities of the first class, school
districts in the metropolitan area, and school districts outside
the metropolitan area; (3) one member each from the state
departments of administration, education, human services,
revenue, planning and the legislative auditor; (4) one member
from the office of the state auditor; and (5) four members from
the state community at large. To the extent permitted by
resources the commissioner shall furnish staff and other
assistance as requested by the council. The terms,
compensation, and removal of members of the advisory council
shall be as provided in section 15.059, but the council does not
expire until June 30, 1993 1995.
Sec. 2. Minnesota Statutes 1992, section 115C.02,
subdivision 14, as amended by Laws 1993, chapter 341, section 3,
is amended to read:
Subd. 14. [TANK.] "Tank" means any one or a combination of
containers, vessels, and enclosures, including structures and
appurtenances connected to them, that is, or has been, used to
contain or dispense petroleum.
"Tank" does not include:
(1) a mobile storage tank with a capacity of 500 gallons or
less used to transport petroleum only on the person's private
property and which is used only for home heating fuel from one
location to another, except a mobile storage tank with a
capacity of 500 gallons or less used only to transport home
heating fuel on private property; or
(2) pipeline facilities, including gathering lines,
regulated under the Natural Gas Pipeline Safety Act of 1968,
United States Code, title 49, chapter 24, or the Hazardous
Liquid Pipeline Safety Act of 1979, United States Code, title
49, chapter 29.
Sec. 3. Minnesota Statutes 1992, section 116.76,
subdivision 1, as amended by Laws 1993, chapter 206, section 3,
is amended to read:
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to sections 116.76 to 116.82 116.83.
Sec. 4. Minnesota Statutes 1992, section 116.77, as
amended by Laws 1993, chapter 206, section 4, is amended to read:
116.77 [COVERAGE.]
Sections 116.75 to 116.82 116.83 and 609.671, subdivision
10, cover any person, including a veterinarian, who generates,
treats, stores, transports, or disposes of infectious or
pathological waste but not including infectious or pathological
waste generated by households, farm operations, or agricultural
businesses. Except as specifically provided, sections 116.75 to
116.83 do not limit or alter treatment or disposal methods for
infectious or pathological waste.
Sec. 5. Minnesota Statutes 1992, section 116.82,
subdivision 3, as amended by Laws 1993, chapter 206, section 5,
is amended to read:
Subd. 3. [LOCAL ENFORCEMENT.] Sections 116.76 to 116.81
may be enforced by a county by delegation of enforcement
authority granted to the commissioner of health and the agency
in section 144.99 116.83. Separate enforcement actions may not
be brought by a state agency and a county for the same
violations. The state or county may not bring an action that is
being enforced by the federal Office of Safety and Health
Administration.
Sec. 6. Minnesota Statutes 1992, section 124.914,
subdivision 4, as added by Laws 1993, chapter 224, article 6,
section 17, is amended to read:
Subd. 4. [1992 OPERATING DEBT.] (a) Each year, a district
that has filed a plan pursuant to section 121.917, subdivision
4, may levy, with the approval of the commissioner, to eliminate
a deficit in the net unappropriated balance in the operating
funds of the district, determined as of June 30, 1992, and
certified and adjusted by the commissioner. Each year this levy
may be an amount not to exceed the greater lesser of:
(1) an amount raised by a levy of a net tax rate of one
percent times the adjusted net tax capacity; or
(2) $100,000.
This amount shall be reduced by referendum revenue authorized
under section 124A.03 pursuant to the plan filed under section
121.917. However, the total amount of this levy for all years
it is made shall not exceed the amount of the deficit in the net
unappropriated balance in the operating funds of the district as
of June 30, 1992. When the cumulative levies made pursuant to
this subdivision equal the total amount permitted by this
subdivision, the levy shall be discontinued.
(b) A district, if eligible, may levy under this
subdivision or subdivision 2 or 3, or under section 122.531,
subdivision 4a, or Laws 1992, chapter 499, article 7, sections
16 or 17, but not under more than one.
(c) The proceeds of this levy shall be used only for cash
flow requirements and shall not be used to supplement district
revenues or income for the purposes of increasing the district's
expenditures or budgets.
(d) Any district that levies pursuant to this subdivision
shall certify the maximum levy allowable under section 124A.23,
subdivision 2, in that same year.
Sec. 7. Minnesota Statutes 1992, section 256.969,
subdivision 9a, as amended by Laws 1993, chapter 20, section 2,
and amended by 1993 Special Session H.F. No. 1, article 5,
section 21, is amended to read:
Subd. 9a. [DISPROPORTIONATE POPULATION ADJUSTMENTS UNTIL
JULY 1, 1993.] (a) For admissions occurring between January 1,
1993, and June 30, 1993, the adjustment under this subdivision
shall be paid to a hospital, excluding regional treatment
centers and facilities of the federal Indian Health Service,
with a medical assistance inpatient utilization rate in excess
of one standard deviation above the arithmetic mean. The
adjustment must be determined by multiplying the total of the
operating and property payment rates by the difference between
the hospital's actual medical assistance inpatient utilization
rate and the arithmetic mean for all hospitals excluding
regional treatment centers and facilities of the federal Indian
Health Service, and the result must be multiplied by 1.1. The
provisions of this paragraph are effective only if federal
matching funds are not available for all adjustments under this
subdivision and it is necessary to implement ratable reductions
under subdivision 9b 9.
Sec. 8. Minnesota Statutes 1992, section 256.969,
subdivision 22, as added by Laws 1993, chapter 20, section 5,
and amended by 1993 Special Session H.F. No. 1, article 5,
section 23, is amended to read:
Subd. 22. [HOSPITAL PAYMENT ADJUSTMENT.] For admissions
occurring from January 1, 1993, until June 30, 1993, the
commissioner shall adjust the medical assistance payment paid to
a hospital, excluding regional treatment centers and facilities
of the federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean.
The adjustment must be determined as follows:
(1) for a hospital with a medical assistance inpatient
utilization rate above the arithmetic mean for all hospitals
excluding regional treatment centers and facilities of the
federal Indian Health Service, the adjustment must be determined
by multiplying the total of the operating and property payment
rates by the difference between the hospital's actual medical
assistance inpatient utilization rate and the arithmetic mean
for all hospitals excluding regional treatment centers and
facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient
utilization rate above one standard deviation above the mean,
the adjustment must be determined by multiplying the adjustment
under clause (1) for that hospital by 1.1. Any payment under
this clause must be reduced by the amount of any payment
received under subdivision 9a. For purposes of this
subdivision, medical assistance does not include general
assistance medical care.
This subdivision is effective only if federal matching
funds are not available for all adjustments under this
subdivision and it is necessary to implement ratable reductions
under subdivision 9b 9.
Sec. 9. Minnesota Statutes 1992, section 256B.057,
subdivision 1, as amended by Laws 1993, chapter 345, article 9,
section 11, is amended to read:
Subdivision 1. [PREGNANT WOMEN AND INFANTS.] An infant
less than one year of age or a pregnant woman who has written
verification of a positive pregnancy test from a physician or
licensed registered nurse, is eligible for medical assistance if
countable family income is equal to or less than 275 percent of
the federal poverty guideline for the same family size. For
purposes of this subdivision, "countable family income" means
the amount of income considered available using the methodology
of the AFDC program, except for the earned income disregard and
employment deductions. An amount equal to the amount of earned
income exceeding 275 percent of the federal poverty guideline,
up to a maximum of the amount by which the combined total of 185
percent of the federal poverty guideline plus the earned income
disregards and deductions of the AFDC program exceeds 275
percent of the federal poverty guideline will be deducted for
pregnant women and infants less than one year of age.
Eligibility for a pregnant woman or infant less than one year of
age under this subdivision must be determined without regard to
asset standards established in section 256B.056, subdivision 3.
An infant born on or after January 1, 1991, to a woman who
was eligible for and receiving medical assistance on the date of
the child's birth shall continue to be eligible for medical
assistance without redetermination until the child's first
birthday, as long as the child remains in the woman's household.
Sec. 10. [CHILD WELFARE TARGETED CASE MANAGEMENT.]
Minnesota Statutes 1992, section 256B.0625, subdivision 32, as
added to section 256B.0625 by 1993 Special Session H.F. No. 1,
article 3, section 23, is amended to read:
Subd. 32. [CHILD WELFARE TARGETED CASE MANAGEMENT.]
Medical assistance, subject to federal approval, covers child
welfare targeted case management services as defined in section
256B.094 to children under age 21 who have been assessed and
determined in accordance with section 256F.10 256F.095 to be:
(1) at risk of placement or in placement as defined in
section 257.071, subdivision 1;
(2) at risk of maltreatment or experiencing maltreatment as
defined in section 626.556, subdivision 10e; or
(3) in need of protection or services as defined in section
260.015, subdivision 2a.
Sec. 11. The repeal of Minnesota Statutes, section
256B.0629 by Laws 1993, chapter 339 is of no effect and the
section is reenacted.
Sec. 12. [STATUTORY REFERENCE.] Minnesota Statutes 1992,
section 256B.0913, subdivision 5, as amended by 1993 Special
Session H.F. No. 1, article 5, section 63, is amended to read:
Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a)
Alternative care funding may be used for payment of costs of:
(1) adult foster care;
(2) adult day care;
(3) home health aide;
(4) homemaker services;
(5) personal care;
(6) case management;
(7) respite care;
(8) assisted living;
(9) residential care services;
(10) care-related supplies and equipment;
(11) meals delivered to the home;
(12) transportation;
(13) skilled nursing;
(14) chore services;
(15) companion services;
(16) nutrition services; and
(17) training for direct informal caregivers.
(b) The county agency must ensure that the funds are used
only to supplement and not supplant services available through
other public assistance or services programs. (c) Unless
specified in statute, the service standards for alternative care
services shall be the same as the service standards defined in
the elderly waiver. Persons or agencies must be employed by or
under a contract with the county agency or the public health
nursing agency of the local board of health in order to receive
funding under the alternative care program.
(d) The adult foster care rate shall be considered a
difficulty of care payment and shall not include room and
board. The adult foster care daily rate shall be negotiated
between the county agency and the foster care provider. The
rate established under this section shall not exceed 75 percent
of the state average monthly nursing home payment for the case
mix classification to which the individual receiving foster care
is assigned, and it must allow for other alternative care
services to be authorized by the case manager.
(e) Personal care services may be provided by a personal
care provider organization. A county agency may contract with a
relative of the client to provide personal care services, but
must ensure nursing supervision. Covered personal care services
defined in section 256B.0627, subdivision 4, must meet
applicable standards in Minnesota Rules, part 9505.0335.
(f) Costs for supplies and equipment that exceed $150 per
item per month must have prior approval from the commissioner.
A county may use alternative care funds to purchase supplies and
equipment from a non-Medicaid certified vendor if the cost for
the items is less than that of a Medicaid vendor.
(g) For purposes of this section, residential care services
are services which are provided to individuals living in
residential care homes. Residential care homes are currently
licensed as board and lodging establishments and are registered
with the department of health as providing special services.
Residential care services are defined as "supportive services"
and "health-related services." "Supportive services" means the
provision of up to 24-hour supervision and oversight.
Supportive services includes: (1) transportation, when provided
by the residential care center only; (2) socialization, when
socialization is part of the plan of care, has specific goals
and outcomes established, and is not diversional or recreational
in nature; (3) assisting clients in setting up meetings and
appointments; (4) assisting clients in setting up medical and
social services; (5) providing assistance with personal laundry,
such as carrying the client's laundry to the laundry room.
Assistance with personal laundry does not include any laundry,
such as bed linen, that is included in the room and board rate.
Health-related services are limited to minimal assistance with
dressing, grooming, and bathing and providing reminders to
residents to take medications that are self-administered or
providing storage for medications, if requested. Individuals
receiving residential care services cannot receive both personal
care services and residential care services.
(h) For the purposes of this section, "assisted living"
refers to supportive services provided by a single vendor to
clients who reside in the same apartment building of three or
more units. Assisted living services are defined as up to
24-hour supervision, and oversight, supportive services as
defined in clause (1), individualized home care aide tasks as
defined in clause (2), and individualized home management tasks
as defined in clause (3) provided to residents of a residential
center living in their units or apartments with a full kitchen
and bathroom. A full kitchen includes a stove, oven,
refrigerator, food preparation counter space, and a kitchen
utensil storage compartment. Assisted living services must be
provided by the management of the residential center or by
providers under contract with the management or with the county.
(1) Supportive services include:
(i) socialization, when socialization is part of the plan
of care, has specific goals and outcomes established, and is not
diversional or recreational in nature;
(ii) assisting clients in setting up meetings and
appointments; and
(iii) providing transportation, when provided by the
residential center only.
Individuals receiving assisted living services will not
receive both assisted living services and homemaking or personal
care services. Individualized means services are chosen and
designed specifically for each resident's needs, rather than
provided or offered to all residents regardless of their
illnesses, disabilities, or physical conditions.
(2) Home care aide tasks means:
(i) preparing modified diets, such as diabetic or low
sodium diets;
(ii) reminding residents to take regularly scheduled
medications or to perform exercises;
(iii) household chores in the presence of technically
sophisticated medical equipment or episodes of acute illness or
infectious disease;
(iv) household chores when the resident's care requires the
prevention of exposure to infectious disease or containment of
infectious disease; and
(v) assisting with dressing, oral hygiene, hair care,
grooming, and bathing, if the resident is ambulatory, and if the
resident has no serious acute illness or infectious disease.
Oral hygiene means care of teeth, gums, and oral prosthetic
devices.
(3) Home management tasks means:
(i) housekeeping;
(ii) laundry;
(iii) preparation of regular snacks and meals; and
(iv) shopping.
A person's eligibility to reside in the building must not
be contingent on the person's acceptance or use of the assisted
living services. Assisted living services as defined in this
section shall not be authorized in boarding and lodging
establishments licensed according to sections 157.01 to 157.031.
Reimbursement for assisted living services and residential
care services shall be made by the lead agency to the vendor as
a monthly rate negotiated with the county agency. The rate
shall not exceed the nonfederal share of the greater of either
the statewide or any of the geographic groups' weighted average
monthly medical assistance nursing facility payment rate of the
case mix resident class to which the 180-day eligible client
would be assigned under Minnesota Rules, parts 9549.0050 to
9549.0059, except for alternative care assisted living projects
established under chapter Laws 1988, chapter 689, article 2,
section 256, whose rates may not exceed 65 percent of either the
statewide or any of the geographic groups' weighted average
monthly medical assistance nursing facility payment rate of the
case mix resident class to which the 180-day eligible client
would be assigned under Minnesota Rules, parts 9549.0050 to
9549.0059. The rate may not cover rent and direct food costs.
(i) For purposes of this section, companion services are
defined as nonmedical care, supervision and oversight, provided
to a functionally impaired adult. Companions may assist the
individual with such tasks as meal preparation, laundry and
shopping, but do not perform these activities as discrete
services. The provision of companion services does not entail
hands-on medical care. Providers may also perform light
housekeeping tasks which are incidental to the care and
supervision of the recipient. This service must be approved by
the case manager as part of the care plan. Companion services
must be provided by individuals or nonprofit organizations who
are under contract with the local agency to provide the
service. Any person related to the waiver recipient by blood,
marriage or adoption cannot be reimbursed under this service.
Persons providing companion services will be monitored by the
case manager.
(j) For purposes of this section, training for direct
informal caregivers is defined as a classroom or home course of
instruction which may include: transfer and lifting skills,
nutrition, personal and physical cares, home safety in a home
environment, stress reduction and management, behavioral
management, long-term care decision making, care coordination
and family dynamics. The training is provided to an informal
unpaid caregiver of a 180-day eligible client which enables the
caregiver to deliver care in a home setting with high levels of
quality. The training must be approved by the case manager as
part of the individual care plan. Individuals, agencies, and
educational facilities which provide caregiver training and
education will be monitored by the case manager.
Sec. 13. Minnesota Statutes 1992, section 256B.0915,
subdivision 3, as amended by 1993 Special Session H.F. No. 1,
article 5, subdivision 72, is amended to read:
Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT, AND
FORECASTING.] (a) The number of medical assistance waiver
recipients that a county may serve must be allocated according
to the number of medical assistance waiver cases open on July 1
of each fiscal year. Additional recipients may be served with
the approval of the commissioner.
(b) The monthly limit for the cost of waivered services to
an individual waiver client shall be the statewide average
payment rate of the case mix resident class to which the waiver
client would be assigned under medical assistance case mix
reimbursement system. The statewide average payment rate is
calculated by determining the statewide average monthly nursing
home rate effective July 1 of the fiscal year in which the cost
is incurred, less the statewide average monthly income of
nursing home residents who are age 65 or older, and who are
medical assistance recipients in the month of March of the
previous state fiscal year. The following costs must be
included in determining the total monthly costs for the waiver
client:
(1) cost of all waivered services, including extended
medical supplies and equipment; and
(2) cost of skilled nursing, home health aide, and personal
care services reimbursable by medical assistance.
(c) Medical assistance funding for skilled nursing
services, home health aide, and personal care services for
waiver recipients must be approved by the case manager and
included in the individual care plan.
(d) Expenditures for extended medical supplies and
equipment that cost over $150 per month for both the elderly
waiver and the disabled waiver must have the commissioner's
prior approval.
(e) For the fiscal year beginning on July 1, 1993, and for
subsequent fiscal years, the commissioner of human services
shall not provide automatic annual inflation adjustments for
home- and community-based waivered services. The commissioner
of finance shall include as a budget change request in each
biennial detailed expenditure budget submitted to the
legislature under section 16A.11 annual adjustments in
reimbursement rates for home- and community-based waivered
services, based on the forecasted percentage change in the Home
Health Agency Market Basket of Operating Costs, for the fiscal
year beginning July 1, compared to the previous fiscal year,
unless otherwise adjusted by statute. The Home Health Agency
Market Basket of Operating Costs is published by Data Resources,
Inc. The forecast to be used is the one published for the
calendar quarter beginning January 1, six months prior to the
beginning of the fiscal year for which rates are set. The adult
foster care rate shall be considered a difficulty of care
payment and shall not include room and board.
(f) The adult foster care daily rate for the elderly and
disabled waivers shall be negotiated between the county agency
and the foster care provider. The rate established under this
section shall not exceed the state average monthly nursing home
payment for the case mix classification to which the individual
receiving foster care is assigned, and it must allow for other
waiver and medical assistance home care services to be
authorized by the case manager.
(g) The assisted living and residential care service rates
for elderly and disabled waivers shall be made to the vendor as
a monthly rate negotiated with the county agency. The rate
shall not exceed the nonfederal share of the greater of either
the statewide or any of the geographic groups' weighted average
monthly medical assistance nursing facility payment rate of the
case mix resident class to which the elderly or disabled client
would be assigned under Minnesota Rules, parts 9549.0050 to
9549.0059, except for alternative care assisted living projects
established under Laws 1988, chapter 689, article 2, section
256, whose rates may not exceed 65 percent of the greater of
either the statewide or any of the geographic groups' weighted
average monthly medical assistance nursing facility payment rate
for the case mix resident class to which the elderly or disabled
client would be assigned under Minnesota Rules, parts 9549.0050
to 9549.0059. The rate may not cover direct rent or food costs.
(h) The county shall negotiate individual rates with
vendors and may be reimbursed for actual costs up to the greater
of the county's current approved rate or 60 percent of the
maximum rate in fiscal year 1994 and 65 percent of the maximum
rate in fiscal year 1995 for each service within each program.
(i) On July 1, 1993, the commissioner shall increase the
maximum rate for home-delivered meals to $4.50 per meal.
(j) Reimbursement for the medical assistance recipients
under the approved waiver shall be made from the medical
assistance account through the invoice processing procedures of
the department's Medicaid Management Information System (MMIS),
only with the approval of the client's case manager. The budget
for the state share of the Medicaid expenditures shall be
forecasted with the medical assistance budget, and shall be
consistent with the approved waiver.
(k) Beginning July 1, 1991, the state shall reimburse
counties according to the payment schedule in section 256.025
for the county share of costs incurred under this subdivision on
or after January 1, 1991, for individuals who are receiving
medical assistance.
Sec. 14. [DEFINITION OF FAMILIES: RESIDENTIAL LEAD PAINT
DISPOSAL EFFECTIVE DATE.] Minnesota Statutes 1992, section
256D.02, subdivision 5, as amended by 1993 Special Session H.F.
No. 1, article 6, section 27, is amended to read:
Subd. 5. "Family" means the applicant or recipient and the
following persons who reside with the applicant or recipient:
(1) the applicant's spouse;
(2) any minor child of whom the applicant is a parent,
stepparent, or legal custodian, and that child's minor siblings,
including half-siblings and stepsiblings;
(3) the other parent of the applicant's minor child or
children together with that parent's minor children, and, if
that parent is a minor, his or her parents, stepparents, legal
guardians, and minor siblings; and
(4) if the applicant or recipient is a minor, the minor's
parents, stepparents, or legal guardians, and any other minor
children for whom those parents, stepparents, or legal guardians
are financially responsible.
For the period July 1, 1993, to June 30, 1995, a minor
child who is temporarily absent from the applicant's or
recipient's home due to placement in foster care paid for from
state or local funds, but who is expected to return within six
months of the month of departure, is considered to be residing
with the applicant or recipient.
A "family" must contain at least one minor child and at
least one of that child's natural or adoptive parents,
stepparents, or legal custodians.
Sec. 15. [STATUTORY REFERENCES.] Minnesota Statutes 1992,
section 256D.051, subdivision 6, as amended by 1993 Special
Session H.F. No. 1, article 6, section 32, is amended to read:
Subd. 6. [SERVICE COSTS.] The commissioner shall reimburse
92 percent of county agency expenditures for providing work
readiness services including direct participation expenses and
administrative costs, except as provided in section 256.017.
State work readiness funds shall be used only to pay the county
agency's and work readiness service provider's actual costs of
providing participant support services, direct program services,
and program administrative costs for persons who participate in
work readiness services. Beginning July 1, 1991, the average
annual reimbursable cost for providing work readiness services
to a recipient for whom an individualized employability
development plan is not completed must not exceed $60 for the
work readiness services, and $223 for necessary recipient
support services such as transportation or child care needed to
participate in work readiness services. If an individualized
employability development plan has been completed, the average
annual reimbursable cost for providing work readiness services
must not exceed $283, except that the total annual average
reimbursable cost shall not exceed $804 for recipients who
participate in a pilot project work experience program under
section 56 55, for all services and costs necessary to implement
the plan, including the costs of training, employment search
assistance, placement, work experience, on-the-job training,
other appropriate activities, the administrative and program
costs incurred in providing these services, and necessary
recipient support services such as tools, clothing, and
transportation needed to participate in work readiness
services. Beginning July 1, 1991, the state will reimburse
counties, up to the limit of state appropriations, according to
the payment schedule in section 256.025 for the county share of
costs incurred under this subdivision on or after January 1,
1991. Payment to counties under this subdivision is subject to
the provisions of section 256.017.
Sec. 16. Minnesota Statutes 1992, section 257.071,
subdivision 1, as amended by Laws 1993, chapter 291, section 2,
is amended to read:
Subdivision 1. [PLACEMENT; PLAN.] A case plan shall be
prepared within 30 days after any child is placed in a
residential facility by court order or by the voluntary release
of the child by the parent or parents.
For purposes of this section, a residential facility means
any group home, family foster home or other publicly supported
out-of-home residential facility, including any out-of-home
residential facility under contract with the state, county or
other political subdivision, or any agency thereof, to provide
those services or family foster care as defined in section
260.015, subdivision 7.
For the purposes of this section, a case plan means a
written document which is ordered by the court or which is
prepared by the social service agency responsible for the
residential facility placement and is signed by the parent or
parents, or other custodian, of the child, the child's legal
guardian, the social service agency responsible for the
residential facility placement, and, if possible, the child.
The document shall be explained to all persons involved in its
implementation, including the child who has signed the document,
and shall set forth:
(1) The specific reasons for the placement of the child in
a residential facility, including a description of the problems
or conditions in the home of the parent or parents which
necessitated removal of the child from home;
(2) The specific actions to be taken by the parent or
parents of the child to eliminate or correct the problems or
conditions identified in clause (1), and the time period during
which the actions are to be taken;
(3) The financial responsibilities and obligations, if any,
of the parents for the support of the child during the period
the child is in the residential facility;
(4) The visitation rights and obligations of the parent or
parents or other relatives as defined in section 260.181, if
such visitation is consistent with the best interest of the
child, during the period the child is in the residential
facility;
(5) The social and other supportive services to be provided
to the parent or parents of the child, the child, and the
residential facility during the period the child is in the
residential facility;
(6) The date on which the child is expected to be returned
to the home of the parent or parents;
(7) The nature of the effort to be made by the social
service agency responsible for the placement to reunite the
family; and
(8) Notice to the parent or parents that placement of the
child in foster care may result in termination of parental
rights but only after notice and a hearing as provided in
chapter 260.
The parent or parents and the child each shall have the
right to legal counsel in the preparation of the case plan and
shall be informed of the right at the time of placement of the
child. The child shall also have the right to a guardian ad
litem. If unable to employ counsel from their own resources,
the court shall appoint counsel upon the request of the parent
or parents or the child or the child's legal guardian. The
parent or parents may also receive assistance from any person or
social service agency in preparation of the case plan.
After the plan has been agreed upon by the parties
involved, the foster parents shall be fully informed of the
provisions of the case plan.
When an agency accepts a child for placement, the agency
shall determine whether the child has had a physical examination
by or under the direction of a licensed physician within the 12
months immediately preceding the date when the child came into
the agency's care. If there is documentation that the child has
had such an examination within the last 12 months, the agency is
responsible for seeing that the child has another physical
examination within one year of the documented examination and
annually in subsequent years. If the agency determines that the
child has not had a physical examination within the 12 months
immediately preceding placement, the agency shall ensure that
the child has the examination within 30 days of coming into the
agency's care and once a year in subsequent years.
Sec. 17. Minnesota Statutes 1992, section 260.191,
subdivision 3a, as added by Laws 1993, chapter 291, section 20,
is amended to read:
Subd. 3a. [COURT REVIEW OF OUT-OF-HOME PLACEMENTS.] If the
court places a child in a residential facility, as defined in
section 257.071, subdivision 1, the court shall review the
out-of-home placement at least every six months to determine
whether continued out-of-home placement is necessary and
appropriate or whether the child should be returned home. The
court shall review agency efforts pursuant to section 257.072,
subdivision 1, and order that the efforts continue if the agency
has failed to perform the duties under that section. The court
shall review the case plan and may modify the case plan as
provided under subdivisions 1e and 2. If the court orders
continued out-of-home placement, the court shall notify the
parents of the provisions of subdivision 3b.
Sec. 18. Minnesota Statutes 1992, section 260.191,
subdivision 3b, as added by Laws 1993, chapter 291, section 21,
is amended to read:
Subd. 3b. [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT
PLACEMENT DETERMINATION.] (a) If the court places a child in a
residential facility, as defined in section 257.071, subdivision
1, the court shall conduct a hearing to determine the permanent
status of the child not later than 12 months after the child was
placed out of the home of the parent. Not later than 30 days
prior to this hearing the responsible social service agency
shall file pleadings to establish the basis for the permanent
placement determination. Notice of the hearing and copies of
the pleadings must be provided pursuant to sections 260.135 and
260.141. If a termination of parental rights petition is filed
before the date required for the permanency planning
determination, no hearing need be conducted under this section.
The court shall determine whether the child is to be returned
home or, if not, what permanent placement is consistent with the
child's best interests. The "best interests of the child" means
all relevant factors to be considered and evaluated.
If the child is not returned to the home, the dispositions
available for permanent placement determination are permanent
legal and physical custody to a relative, adoption, or permanent
foster care. The court may order a child into permanent foster
care only if it finds that neither an award of legal and
physical custody to a relative, termination of parental rights,
nor adoption is in the child's best interests.
(b) The court may extend the time period for determination
of permanent placement to 18 months after the child was placed
in a residential facility if:
(1) there is a substantial probability that the child will
be returned home within the next six months;
(2) the agency has not made reasonable, or, in the case of
an Indian child, active efforts, to correct the conditions that
form the basis of the out-of-home placement; or
(3) extraordinary circumstances exist precluding a
permanent placement determination, in which case the court shall
make written findings documenting the extraordinary
circumstances and order one subsequent review after six months
to determine permanent placement.
(c) If the court determines that an adoptive placement is
in the best interests of the child, the social service agency
shall file a petition for termination of parental rights under
section 260.231. Nothing in this subdivision waives the
requirements of sections 260.221 to 260.245 with respect to
termination of parental rights.
(d) In ordering a permanent placement of a child, the court
must be governed by the best interests of the child, including a
review of the relationship between the child and relatives and
the child and other important persons with whom the child has
resided or had significant contact.
(e) Once a permanent placement determination has been made
and permanent placement has been established, further reviews
are only necessary if otherwise required by federal law, an
adoption has not yet been finalized, or there is a disruption of
the permanent placement. These reviews must take place no less
frequently than every six months.
(f) An order under this subdivision must include the
following detailed findings:
(1) how the child's best interests are served by the order;
(2) the nature and extent of the responsible social service
agency's reasonable efforts, or, in the case of an Indian child,
active efforts, to reunify the child with the parent or parents;
(3) the parent's or parents' efforts and ability to use
services to correct the conditions which led to the out-of-home
placement;
(4) whether the conditions which led to the out-of-home
placement have been corrected so that the child can return home;
and
(5) if the child cannot be returned home, whether there is
a substantial probability of the child being able to return home
in the next six months.
If the court orders the child placed in permanent foster
care, the court shall make findings that neither an award of
legal and physical custody to a relative, termination of
parental rights, nor adoption is in the child's best interests.
A court finding that extraordinary circumstances exist
precluding a permanent placement determination must be supported
by detailed factual findings regarding those circumstances.
Sec. 19. Minnesota Statutes 1992, section 295.50,
subdivision 3, as amended by Laws 1993, chapter 345, article 13,
section 3, is amended to read:
Subd. 3. [GROSS REVENUES.] "Gross revenues" are total
amounts received in money or otherwise by:
(1) a resident hospital for patient services;
(2) a resident surgical center for patient services;
(3) a nonresident hospital for patient services provided to
patients domiciled in Minnesota;
(4) a nonresident surgical center for patient services
provided to patients domiciled in Minnesota;
(5) a resident health care provider, other than a staff
model health carrier, for patient services;
(6) a nonresident health care provider for patient services
provided to an individual domiciled in Minnesota;
(7) a wholesale drug distributor for sale or distribution
of prescription drugs that are delivered: (i) to a Minnesota
resident by a wholesale drug distributor who is a nonresident
pharmacy directly, by common carrier, or by mail; or (ii) in
Minnesota by the wholesale drug distributor, by common carrier,
or by mail, unless the prescription drugs are delivered to
another wholesale drug distributor. Prescription drugs do not
include nutritional products as defined in Minnesota Rules, part
9505.0325; and
(8) a staff model health carrier as gross premiums for
enrollees, copayments, deductibles, coinsurance, and fees for
patient services covered under its contracts with groups and
enrollees;
(9) a resident pharmacy for medical supplies, appliances,
and equipment; and
(10) a nonresident pharmacy for medical supplies,
appliances, and equipment.
Sec. 20. Minnesota Statutes 1992, section 295.50,
subdivision 4, as amended by Laws 1993, chapter 345, article 13,
section 4, is amended to read:
Subd. 4. [HEALTH CARE PROVIDER.] (a) "Health care provider"
means:
(1) a person furnishing any or all of the following goods
or services directly to a patient or consumer: medical,
surgical, optical, visual, dental, hearing, nursing services,
drugs, medical supplies, medical appliances, laboratory,
diagnostic or therapeutic services, or any goods and services
not listed above that qualifies for reimbursement under the
medical assistance program provided under chapter 256B;
(2) a staff model health carrier; or
(3) a licensed ambulance service; or
(4) a pharmacy as defined in section 151.01.
(b) Health care provider does not include hospitals,
nursing homes licensed under chapter 144A, pharmacies, and
surgical centers.
Sec. 21. Minnesota Statutes 1992, section 295.50, is
amended by adding a subdivision to read:
Subd. 9a. [NONRESIDENT PHARMACY.] "Nonresident pharmacy"
means a pharmacy that is physically located outside Minnesota.
Sec. 22. Minnesota Statutes 1992, section 295.50, is
amended by adding a subdivision to read:
Subd. 10a. [PHARMACY.] "Pharmacy" means a pharmacy, as
defined in section 151.01.
Sec. 23. Minnesota Statutes 1992, section 295.50, is
amended by adding a subdivision to read:
Subd. 12a. [RESIDENT PHARMACY.] "Resident pharmacy" means
a pharmacy that is physically located inside Minnesota.
Sec. 24. Minnesota Statutes 1992, section 295.51,
subdivision 1, as amended by Laws 1993, chapter 345, article 13,
section 11, is amended to read:
Subdivision 1. [BUSINESS TRANSACTIONS IN MINNESOTA.] A
hospital, surgical center, pharmacy, or health care provider is
subject to tax under sections 295.50 to 295.58 if it is
"transacting business in Minnesota." A hospital, surgical
center, pharmacy, or health care provider is transacting
business in Minnesota only if it:
(1) maintains an office in Minnesota used in the trade or
business of providing patient services or medical supplies,
appliances, or equipment;
(2) has employees, representatives, or independent
contractors conducting business in Minnesota related to the
trade or business of providing patient services or medical
supplies, appliances, or equipment;
(3) regularly provides patient services or medical
supplies, appliances, or equipment to customers that receive the
services in Minnesota;
(4) regularly solicits business from potential customers in
Minnesota. A hospital, surgical center, pharmacy, or health
care provider is presumed to regularly solicit business within
Minnesota if it receives gross receipts for patient services or
medical supplies, appliances, or equipment from 20 or more
patients domiciled in Minnesota in a calendar year;
(5) regularly performs services outside Minnesota the
benefits of which are consumed in Minnesota;
(6) owns or leases tangible personal or real property
physically located in Minnesota and used in the trade or
business of providing patient services or medical supplies,
appliances, or equipment; or
(7) receives medical assistance payments from the state of
Minnesota.
Sec. 25. Minnesota Statutes 1992, section 295.52, is
amended by adding a subdivision to read:
Subd. 1b. [PHARMACY TAX.] A tax is imposed on each
pharmacy equal to two percent of its gross revenues.
Sec. 26. Minnesota Statutes 1992, section 295.53,
subdivision 3, as amended by Laws 1993, chapter 345, article 13,
section 16, is amended to read:
Subd. 3. [RESTRICTION ON ITEMIZATION.] A hospital,
surgical center, pharmacy, or health care provider must not
separately state the tax obligation under section 295.52 on
bills provided to individual patients.
Sec. 27. Minnesota Statutes 1992, section 295.53, is
amended by adding a subdivision to read:
Subd. 5. [DEDUCTIONS FOR PHARMACIES.] Pharmacies may
deduct from their gross revenues subject to tax payments for
medical supplies, appliances, and devices that are exempt under
subdivision 1, except payments under subdivision 1, clauses (3),
(6), (9), (11), and (14).
Sec. 28. Minnesota Statutes 1992, section 295.54, as
amended by Laws 1993, chapter 345, article 13, section 18, is
amended to read:
295.54 [CREDIT FOR TAXES PAID TO ANOTHER STATE.]
A resident hospital, resident surgical center, pharmacy, or
resident health care provider who is liable for taxes payable to
another state or province or territory of Canada measured by
gross receipts and is subject to tax under section 295.52 is
entitled to a credit for the tax paid to another state or
province or territory of Canada to the extent of the lesser of
(1) the tax actually paid to the other state or province or
territory of Canada, or (2) the amount of tax imposed by
Minnesota on the gross receipts subject to tax in the other
taxing jurisdictions.
Sec. 29. Laws 1992, chapter 549, article 9, section 19, as
amended by Laws 1993, chapter 345, article 13, section 22, is
amended to read:
Sec. 19. [295.582] [AUTHORITY.]
A hospital, surgical center, pharmacy, or health care
provider that is subject to a tax under section 295.52 may
transfer additional expense generated by section 295.52
obligations on to all third-party contracts for the purchase of
health care services on behalf of a patient or consumer. The
expense must not exceed two percent of the gross revenues
received under the third-party contract, including copayments
and deductibles paid by the individual patient or consumer. The
expense must not be generated on revenues derived from payments
that are excluded from the tax under section 295.53. All
third-party purchasers of health care services including, but
not limited to, third-party purchasers regulated under chapters
60A, 62A, 62C, 62D, 64B, or 62H, must pay the transferred
expense in addition to any payments due under existing or future
contracts with the hospital, surgical center, pharmacy, or
health care provider, to the extent allowed under federal law.
Nothing in this subdivision limits the ability of a hospital,
surgical center, pharmacy, or health care provider to recover
all or part of the section 295.52 obligation by other methods,
including increasing fees or charges.
Sec. 30. [EFFECTIVE DATE]
Sections 19 to 29 are effective for services performed and
goods sold after December 31, 1993.
Sec. 31. Subdivision 1. [CORRECTION.] Minnesota Statutes
1993, section 298.28, subdivision 4, as amended by Laws 1993,
chapter 375, article 16, section 2, is amended to read:
Subd. 4. [SCHOOL DISTRICTS.] (a) 27.5 cents per taxable
ton plus the increase provided in paragraph (d) must be
allocated to qualifying school districts to be distributed,
based upon the certification of the commissioner of revenue,
under paragraphs (b) and (c).
(b) 5.5 cents per taxable ton must be distributed to the
school districts in which the lands from which taconite was
mined or quarried were located or within which the concentrate
was produced. The distribution must be based on the
apportionment formula prescribed in subdivision 2.
(c)(i) 22 cents per taxable ton, less any amount
distributed under paragraph (e), shall be distributed to a group
of school districts comprised of those school districts in which
the taconite was mined or quarried or the concentrate produced
or in which there is a qualifying municipality as defined by
section 273.134 in direct proportion to school district indexes
as follows: for each school district, its pupil units
determined under section 124.17 for the prior school year shall
be multiplied by the ratio of the average adjusted net tax
capacity per pupil unit for school districts receiving aid under
this clause as calculated pursuant to chapter 124A for the
school year ending prior to distribution to the adjusted net tax
capacity per pupil unit of the district. Each district shall
receive that portion of the distribution which its index bears
to the sum of the indices for all school districts that receive
the distributions.
(ii) Notwithstanding clause (i), each school district that
receives a distribution under sections 298.018; 298.23 to
298.28, exclusive of any amount received under this clause;
298.34 to 298.39; 298.391 to 298.396; 298.405; or any law
imposing a tax on severed mineral values that is less than the
amount of its levy reduction under section 124.918, subdivision
8, for the second year prior to the year of the distribution
shall receive a distribution equal to the difference; the amount
necessary to make this payment shall be derived from
proportionate reductions in the initial distribution to other
school districts under clause (i).
(d) On July 15, in years prior to 1988, an amount equal to
the increase derived by increasing the amount determined by
paragraph (c) in the same proportion as the increase in the
steel mill products index over the base year of 1977 as provided
in section 298.24, subdivision 1, clause (a), shall be
distributed to Any school district described in paragraph (c)
where a levy increase pursuant to section 124A.03, subdivision
2, is authorized by referendum, shall receive a distribution
according to the following formula. On July 15, 1988, the
increase over the amount established for 1987 shall be
determined as if there had been an increase in the tax rate
under section 298.24, subdivision 1, paragraph (b), according to
the increase in the implicit price deflator. On July 15, 1989,
1990, and 1991, the increase over the amount established for the
prior year shall be determined according to the increase in the
implicit price deflator as provided in section 298.24,
subdivision 1, paragraph (a). In 1992 and 1993, the amount
distributed per ton shall be the same as that determined for
distribution in 1991. In 1994, the amount distributed per ton
shall be equal to the amount per ton distributed in 1991 under
this paragraph increased in the same proportion as the increase
between the fourth quarter of 1989 and the fourth quarter of
1992 in the implicit price deflator as defined in section
298.24, subdivision 1. On July 15, 1995, and subsequent years,
the increase over the amount established for the prior year
shall be determined according to the increase in the implicit
price deflator as provided in section 298.24, subdivision 1.
Each district shall receive the product of:
(i) $175 times the pupil units identified in section
124.17, subdivision 1, enrolled in the second previous year or
the 1983-1984 school year, whichever is greater, less the
product of 1.8 percent times the district's taxable net tax
capacity in the second previous year; times
(ii) the lesser of:
(A) one, or
(B) the ratio of the sum of the amount certified pursuant
to section 124A.03, subdivision 1g, in the previous year, plus
the amount certified pursuant to section 124A.03, subdivision
1i, in the previous year, plus the referendum aid according to
section 124A.03, subdivision 1h, for the current year, plus an
amount equal to the reduction under section 124A.03, subdivision
3b, to the product of 1.8 percent times the district's taxable
net tax capacity in the second previous year.
If the total amount provided by paragraph (d) is
insufficient to make the payments herein required then the
entitlement of $175 per pupil unit shall be reduced uniformly so
as not to exceed the funds available. Any amounts received by a
qualifying school district in any fiscal year pursuant to
paragraph (d) shall not be applied to reduce general education
aid which the district receives pursuant to section 124A.23 or
the permissible levies of the district. Any amount remaining
after the payments provided in this paragraph shall be paid to
the commissioner of iron range resources and rehabilitation who
shall deposit the same in the taconite environmental protection
fund and the northeast Minnesota economic protection trust fund
as provided in subdivision 11.
Each district receiving money according to this paragraph
shall reserve $25 times the number of pupil units in the
district. It may use the money for early childhood programs or
for outcome-based learning programs that enhance the academic
quality of the district's curriculum. The outcome-based
learning programs must be approved by the commissioner of
education.
(e) There shall be distributed to any school district the
amount which the school district was entitled to receive under
section 298.32 in 1975.
Subd. 2. [REPEALER.] Laws 1993, chapter 224, article 1,
section 31, is repealed.
Subd. 3. [EFFECTIVE DATE.] Subdivisions 1 and 2 are
effective for production year 1993, and thereafter.
Sec. 32. Minnesota Statutes 1992, section 477A.013,
subdivision 1, is amended to read:
Subdivision 1. [TOWNS.] In calendar year 1990, each town
that had levied for taxes payable in the prior year a local tax
rate of at least .008 shall receive a distribution equal to 106
percent of the amount received in 1989 under this subdivision.
In calendar years 1991 and 1992, each town that had levied for
taxes payable in the prior year a local tax rate of at least
.008 shall receive a distribution equal to the amount it
received in the previous year under this subdivision less any
permanent reductions made under section 477A.0132. In 1993 and
thereafter, each town that had levied for taxes payable in the
prior year a local tax rate of at least .008 shall receive a
distribution equal to the amount it received in 1992 before any
nonpermanent reductions made under section 477A.0132 plus $1 per
capita based on the town's population. In 1994 and thereafter
each town that had levied for taxes payable in the prior year a
local tax rate of at least .008 shall receive a distribution
equal to the amount it received in 1993 under this section
before any nonpermanent reductions made under section 477A.0132.
Sec. 33. Laws 1993, chapter 206, section 8, subdivision 1,
is amended to read:
Subdivision 1. [REMEDIES AVAILABLE.] The provisions of
chapters 103I and 157 and sections 115.71 to 115.82; 116.76 to
116.81; 144.12, subdivision 1, paragraphs (1), (2), (5), (6),
(10), (12), (13), (14), and (15); 144.121; 144.35; 144.381 to
144.385; 144.411 to 144.417; 144.491; 144.495; 144.71 to 144.76;
144.871 to 144.878; 144.992; 326.37 to 326.45; 326.57 to
326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules,
orders, stipulation agreements, settlements, compliance
agreements, licenses, registrations, certificates, and permits
adopted or issued by the department or under any other law now
in force or later enacted for the preservation of public health
may, in addition to provisions in other statutes, be enforced
under this section.
Sec. 34. Laws 1993, chapter 206, section 25, is amended to
read:
Sec. 25. [REPEALER.]
Minnesota Statutes 1992, sections 103I.701; 103I.705;
116.83; 144.1211; 144.386, subdivision 4; 144.73, subdivisions
2, 3, and 4; 144.76; 148.95; 157.081; 326.43; 326.53,
subdivision 2; 326.63; 326.78, subdivisions 4, 6, 7, and 8;
326.79; 326.80; 327.18; and 327.24, subdivisions 1 and 2, are
repealed.
Sec. 35. Laws 1993, chapter 340, section 60, is amended to
read:
Sec. 60. [REPEALER.]
(a) Minnesota Statutes 1992, section 256.979, is
subdivisions 1, 2, 3, and 4, are repealed.
(b) Minnesota Statutes 1992, section 609.37, is repealed.
Sec. 36. Laws 1993, chapter 345, article 1, section 2,
subdivision 2, is amended to read:
Subd. 2. [PURPOSE.] Sections 62N.01 to 62N.24 allow the
creation of integrated service networks that will be responsible
for arranging for or delivering a full array of health care
services, from routine primary and preventive care through acute
inpatient hospital care, to a defined population for a fixed
price from a purchaser.
Each integrated service network is accountable to keep its
total revenues within the limit of growth set by the
commissioner of health under section 62N.05, subdivision 2,
clause (1). Integrated service networks can be formed by health
care providers, health maintenance organizations, insurance
companies, employers, or other organizations. Competition
between integrated service networks on the quality and price of
health care services is encouraged.
Sec. 37. Laws 1993, chapter 345, article 1, section 8,
subdivision 1, is amended to read:
Subdivision 1. [UNREASONABLE EXPENSES.] No integrated
service network shall incur or pay for any expense of any nature
which is unreasonably high in relation to the value of the
service or goods provided. The commissioner shall implement and
enforce this section by rules adopted under this section.
In an effort to achieve the stated purposes of sections
62N.01 to 62N.22 62N.24; in order to safeguard the underlying
nonprofit status of integrated service networks; and to ensure
that payment of integrated service network money to any person
or organization results in a corresponding benefit to the
integrated service network and its enrollees; when determining
whether an integrated service network has incurred an
unreasonable expense in relation to payments made to a person or
organization, due consideration shall be given to, in addition
to any other appropriate factors, whether the officers and
trustees of the integrated service network have acted with good
faith and in the best interests of the integrated service
network in entering into, and performing under, a contract under
which the integrated service network has incurred an expense.
In addition to the compliance powers under subdivision 3, the
commissioner has standing to sue, on behalf of an integrated
service network, officers or trustees of the integrated service
network who have breached their fiduciary duty in entering into
and performing such contracts.
Sec. 38. Laws 1993, chapter 345, article 2, section 5,
subdivision 2, is amended to read:
Subd. 2. [ESTABLISHMENT.] The commissioner of health shall
establish limits on the increase in revenue for each health care
provider, for calendar years 1994 and 1995. The limits must be
the same as the annual rate of growth in health care spending
established under section 62J.04, subdivision 1, paragraph (b).
The commissioner may adjust final revenue figures for case mix
complexity, inpatient to outpatient conversion, payer mix,
out-of-period settlements, taxes, donations, grants, and
legislative initiatives that materially change health care
costs, as long as these adjustments are consistent with the
methodology submitted by the health care provider to the
commissioner, and approved by the commissioner as actuarially
justified. The methodology to be used for adjustments must be
submitted to the commissioner by September 1, 1993. A health
care provider's revenues for purposes of these growth limits are
net of the contributions, surcharges, taxes, and assessments
listed in section 62P.04, subdivision 2 1, that the health care
provider pays.
Sec. 39. Laws 1993, chapter 372, section 8, is amended to
read:
Sec. 8. [EFFECTIVE DATE.]
Sections 1 and 2 apply to all franchise contracts or
franchise transfer agreements entered into or renewed on or
after the effective date August 1, 1993, and apply as of July 1,
1993, that date to franchise contracts in effect on the
effective date August 1, 1993 that have no expiration date.
Sections 4 to 7 apply to all agreements for private label
purchases entered into or renewed on or after July 1, 1993, and
to all private label purchases occurring on or after that date.
Sec. 40. 1993 Special Session H.F. No. 1, article 3,
section 29, subdivision 1, is amended to read:
Subdivision 1. [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES
OF THE COMMISSIONER OF HUMAN SERVICES.] The commissioner of
human services may enter into an agreement with one or more
family services collaboratives to enhance federal reimbursement
under Title IV-E of the Social Security Act and federal
administrative reimbursement under Title XIX of the Social
Security Act. The commissioner shall have the following
authority and responsibilities regarding family services
collaboratives:
(1) the commissioner shall submit amendments to state plans
and seek waivers as necessary to implement the provisions of
this section;
(2) the commissioner shall pay the federal reimbursement
earned under this subdivision to each collaborative based on
their earnings. Notwithstanding section 256.025, subdivision 2,
payments to collaboratives for expenditures under this
subdivision will only be made of federal earnings from services
provided by the collaborative;
(3) the commissioner shall review expenditures of family
services collaboratives using reports specified in the agreement
with the collaborative to ensure that the base level of
expenditures is continued and new federal reimbursement is used
to expand education, social, health, or health-related services
to young children and their families;
(4) the commissioner may reduce, suspend, or eliminate a
family services collaborative's obligations to continue the base
level of expenditures or expansion of services if the
commissioner determines that one or more of the following
conditions apply:
(i) imposition of levy limits that significantly reduce
available funds for social, health, or health-related services
to families and children;
(ii) reduction in the net tax capacity of the taxable
property eligible to be taxed by the lead county or
subcontractor that significantly reduces available funds for
education, social, health, or health-related services to
families and children;
(iii) reduction in the number of children under age 19 in
the county, collaborative service delivery area, subcontractor's
district, or catchment area when compared to the number in the
base year using the most recent data provided by the state
demographer's office; or
(iv) termination of the federal revenue earned under the
family services collaborative agreement;
(5) the commissioner shall not use the federal
reimbursement earned under this subdivision in determining the
allocation or distribution of other funds to counties or
collaboratives;
(6) the commissioner may suspend, reduce, or terminate the
federal reimbursement to a provider that does not meet the
reporting or other requirements of this subdivision;
(7) the commissioner shall recover from the family services
collaborative any federal fiscal disallowances or sanctions for
audit exceptions directly attributable to the family services
collaborative's actions in the integrated fund, or the
proportional share if federal fiscal disallowances or sanctions
are based on a statewide random sample; and
(8) the commissioner shall establish criteria for the
family services collaborative for the accounting and financial
management system that will support claims for federal
reimbursement.
(b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The
family services collaborative shall have the following authority
and responsibilities regarding federal revenue enhancement:
(1) the family services collaborative shall be the party
with which the commissioner contracts. A lead county shall be
designated as the fiscal agency for reporting, claiming, and
receiving payments;
(2) the family services collaboratives may enter into
subcontracts with other counties, school districts, special
education cooperatives, municipalities, and other public and
nonprofit entities for purposes of identifying and claiming
eligible expenditures to enhance federal reimbursement, or to
expand education, social, health, or health-related services to
families and children;
(3) the family services collaborative must continue the
base level of expenditures for education, social, health, or
health-related services to families and children from any state,
county, federal, or other public or private funding source
which, in the absence of the new federal reimbursement earned
under this subdivision, would have been available for those
services, except as provided in subdivision 1, paragraph (a),
clause (4). The base year for purposes of this subdivision
shall be the four-quarter calendar year ending at least two
calendar quarters before the first calendar quarter in which the
new federal reimbursement is earned;
(4) the family services collaborative must use all new
federal reimbursement resulting from federal revenue enhancement
to expand expenditures for education, social, health, or
health-related services to families and children beyond the base
level, except as provided in subdivision 1, paragraph (a),
clause (4);
(5) the family services collaborative must ensure that
expenditures submitted for federal reimbursement are not made
from federal funds or funds used to match other federal funds.
Notwithstanding section 256B.19, subdivision 1, for the purposes
of family services collaborative expenditures under agreement
with the department, the nonfederal share of costs shall be
provided by the family services collaborative from sources other
than federal funds or funds used to match other federal funds;
(6) the family services collaborative must develop and
maintain an accounting and financial management system adequate
to support all claims for federal reimbursement, including a
clear audit trail and any provisions specified in the agreement;
and
(7) the family services collaborative shall submit an
annual report to the commissioner as specified in the agreement.
Sec. 41. 1993 Special Session H.F. No. 1, article 4,
section 4, subdivision 5, is amended to read:
Subd. 5. [VENDOR PAYMENT.] (a) For purposes of this
section, the vendor shall bill and the commissioner shall
reimburse for full-day or partial-day services that would
otherwise have been paid to the vendor for providing direct
services provided that:
(1) the vendor provides services and payments to the
business that enable the business to perform services for the
client that the vendor would otherwise need to perform; and
(2) any client for whom a rate will be billed was receiving
full-time services from the vendor on or before July 1, 1993,
and a the rate will allow the client to work with support in a
community business instead of receiving any other service from
the vendor.
(b) Medical assistance reimbursement of services provided
to persons receiving day training and habilitation services
under this section is subject to the limitations on
reimbursement for vocational services under federal law and
regulation.
Sec. 42. 1993 Special Session H.F. No. 1, article 4,
section 6, subdivision 6, is amended to read:
Subd. 6. [VARIANCES.] (a) 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 on forms
supplied by the commissioner with the recommended payment rates.
A variance to the rate maximum may be utilized for costs
associated with compliance with state administrative rules,
compliance with court orders, capital costs required for
continued licensure, increased insurance costs, start-up and
conversion costs for supported employment, direct service staff
salaries and benefits, transportation, and other program related
costs when any of the criteria in clauses (1) to (3) is also met:
(1) change is necessary to comply with licensing citations;
(2) a significant change is approved by the commissioner
under section 252.28 that is necessary to provide authorized
services to new clients with very severe self-injurious or
assaultive behavior, or medical conditions requiring delivery of
physician-prescribed medical interventions requiring one-to-one
staffing for at least 15 minutes each time they are performed,
or to new clients directly discharged to the vendor's program
from a regional treatment center; or
(3) a significant increase in the average level of staffing
is needed to provide authorized services approved by the
commissioner under section 252.28, that is necessitated by a
decrease in licensed capacity or loss of clientele when counties
choose alternative services under Laws 1992, chapter 513,
article 9, section 41.
A variance under this paragraph may be approved only if the
costs to the medical assistance program do not exceed the
medical assistance costs for all clients served by the
alternatives and all clients remaining in the existing services.
(b) A variance to the rate minimum may be granted when (1)
the county board contracts for increased services from a
vendor and for some or all individuals receiving services from
the vendor lower per unit fixed costs result or (2) when the
actual costs of delivering authorized service over a 12-month
contract period have decreased.
(c) The written variance request under this subdivision
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 and recommended an effective date for the
change in the rate.
(2) The vendor documents efforts to reallocate current
staff and any additional staffing needs cannot be met by using
temporary special needs rate exceptions under Minnesota Rules,
parts 9510.1020 to 9510.1140.
(3) The vendor documents that financial resources have been
reallocated before applying for a variance. No variance may be
granted for equipment, supplies, or other capital expenditures
when depreciation expense for repair and replacement of such
items is part of the current rate.
(4) For variances related to loss of clientele, the vendor
documents the other program and administrative expenses, if any,
that have been reduced.
(5) The county board submits verification of the conditions
for which the variance is requested, 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.
(6) The county board's recommended payment rates do not
exceed 95 percent of the greater of 125 percent of the current
statewide median or 125 percent of the regional average payment
rates, whichever is higher, for each of the regional commission
districts under sections 462.381 to 462.396 in which the vendor
is located except for the following: when a variance is
recommended to allow authorized service delivery to new clients
with severe self-injurious or assaultive behaviors or with
medical conditions requiring delivery of physician prescribed
medical interventions, or to persons being directly discharged
from a regional treatment center to the vendor's program, those
persons must be assigned a payment rate of 200 percent of the
current statewide average rates. All other clients receiving
services from the vendor must be assigned a payment rate equal
to the vendor's current rate unless the vendor's current rate
exceeds 95 percent of 125 percent of the statewide median or 125
percent of the regional average payment rates, whichever is
higher. When the vendor's rates exceed 95 percent of 125
percent of the statewide median or 125 percent of the regional
average rates, the maximum rates assigned to all other clients
must be equal to the greater of 95 percent of 125 percent of the
statewide median or 125 percent of the regional average rates.
The maximum payment rate that may be recommended for the vendor
under these conditions is determined by multiplying the number
of clients at each limit by the rate corresponding to that limit
and then dividing the sum by the total number of clients.
(7) The vendor has not received a variance under this
subdivision in the past 12 months.
(d) The commissioner shall have 60 calendar days from the
date of the receipt of the complete request to accept or reject
it, or the request shall be deemed to have been granted. If the
commissioner rejects the request, the commissioner shall state
in writing the specific objections to the request and the
reasons for its rejection.
Sec. 43. [EFFECTIVE DATE.]
Laws 1993, chapter 224, article 1, section 3, is effective
June 1, 1993.
Sec. 44. [EFFECTIVE DATE.]
If not otherwise provided, the sections of this act that
amend provisions of law passed during 1993 take effect at the
same time that the provisions that they amend take effect.
Presented to the governor May 27, 1993
Signed by the governor May 27, 1993, 4:25 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes