Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1998, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 407-S.F.No. 3346
An act relating to human services; appropriating
money; changing provisions for long-term care, health
care programs, and provisions including MA and GAMC,
MinnesotaCare, welfare reform, work first, compulsive
gambling, child welfare modifications and child
support, and regional treatment centers; providing
administrative penalties; providing for the recording
and reporting of abortion data; amending Minnesota
Statutes 1996, sections 62A.65, subdivision 5;
62D.042, subdivision 2; 62E.16; 62J.321, by adding a
subdivision; 62Q.095, subdivision 3; 144.226,
subdivision 3; 144.701, subdivisions 1, 2, and 4;
144.702, subdivisions 1, 2, and 8; 144.9501,
subdivisions 1, 17, 18, 20, 23, 30, 32, and by adding
subdivisions; 144.9502, subdivisions 3, 4, and 9;
144.9503, subdivisions 4, 6, and 7; 144.9504,
subdivisions 1, 3, 4, 5, 6, 7, 8, 9, and 10; 144.9505,
subdivisions 1, 4, and 5; 144.9506, subdivision 2;
144.9507, subdivisions 2, 3, and 4; 144.9508,
subdivisions 1, 3, 4, and by adding a subdivision;
144.9509, subdivision 2; 144.99, subdivision 1;
144A.04, subdivision 5; 144A.09, subdivision 1;
144A.44, subdivision 2; 145.11, by adding a
subdivision; 145A.15, subdivision 2; 157.15,
subdivisions 9, 12, 12a, 13, and 14; 214.03; 245.462,
subdivisions 4 and 8; 245.4871, subdivision 4;
245A.03, by adding subdivisions; 245A.035, subdivision
4; 245A.14, subdivision 4; 254A.17, subdivision 1, and
by adding a subdivision; 256.01, subdivision 12, and
by adding subdivisions; 256.014, subdivision 1;
256.969, subdivisions 16 and 17; 256B.03, subdivision
3; 256B.055, subdivision 7, and by adding a
subdivision; 256B.057, subdivision 3a, and by adding
subdivisions; 256B.0625, subdivisions 7, 17, 19a, 20,
34, 38, and by adding subdivisions; 256B.0627,
subdivision 4; 256B.0911, subdivision 4; 256B.0916;
256B.41, subdivision 1; 256B.431, subdivisions 2b, 2i,
4, 11, 22, and by adding subdivisions; 256B.501,
subdivisions 2 and 12; 256B.69, subdivision 22, and by
adding subdivisions; 256D.03, subdivision 4, and by
adding a subdivision; 256D.051, by adding a
subdivision; 256D.46, subdivision 2; 256I.04,
subdivisions 1, 3, and by adding a subdivision;
256I.05, subdivision 2; 257.42; 257.43; 259.24,
subdivision 1; 259.37, subdivision 2; 259.67,
subdivision 1; 260.011, subdivision 2; 260.141, by
adding a subdivision; 260.172, subdivision 1; 260.221,
as amended; 268.88; 268.92, subdivision 4; 609.115,
subdivision 9; and 626.556, by adding a subdivision;
Minnesota Statutes 1997 Supplement, sections 13.99, by
adding a subdivision; 60A.15, subdivision 1; 62D.11,
subdivision 1; 62J.69, subdivisions 1, 2, and by
adding subdivisions; 62J.71, subdivisions 1, 3, and 4;
62J.72, subdivision 1; 62J.75; 62Q.105, subdivision 1;
62Q.30; 103I.208, subdivision 2; 119B.01, subdivision
16; 119B.02; 123.70, subdivision 10, as amended;
144.1494, subdivision 1; 144.218, subdivision 2;
144.226, subdivision 4; 144.9504, subdivision 2;
144.9506, subdivision 1; 144A.071, subdivision 4a;
144A.4605, subdivision 4; 157.16, subdivision 3;
171.29, subdivision 2; 214.32, subdivision 1; 245A.03,
subdivision 2; 245A.04, subdivisions 3b and 3d;
245B.06, subdivision 2; 256.01, subdivision 2;
256.031, subdivision 6; 256.741, by adding a
subdivision; 256.82, subdivision 2; 256.9657,
subdivision 3; 256.9685, subdivision 1; 256.9864;
256B.04, subdivision 18; 256B.056, subdivisions 1a and
4; 256B.06, subdivision 4; 256B.062; 256B.0625,
subdivision 31a; 256B.0627, subdivisions 5 and 8;
256B.0635, by adding a subdivision; 256B.0645;
256B.0911, subdivisions 2 and 7; 256B.0913,
subdivision 14; 256B.0915, subdivisions 1d and 3;
256B.0951, by adding a subdivision; 256B.431,
subdivisions 3f and 26; 256B.433, subdivision 3a;
256B.434, subdivision 10; 256B.69, subdivisions 2 and
3a; 256B.692, subdivisions 2 and 5; 256B.77,
subdivisions 3, 7a, 10, and 12; 256D.03, subdivision
3; 256D.05, subdivision 8; 256F.05, subdivision 8;
256J.02, subdivision 4; 256J.03; 256J.08, subdivisions
11, 26, 28, 40, 60, 68, 73, 83, and by adding
subdivisions; 256J.09, subdivisions 6 and 9; 256J.11,
subdivision 2, as amended; 256J.12; 256J.14; 256J.15,
subdivision 2; 256J.20, subdivisions 2 and 3; 256J.21;
256J.24, subdivisions 1, 2, 3, 4, 7, and by adding
subdivisions; 256J.26, subdivisions 1, 2, 3, and 4;
256J.28, subdivisions 1, 2, and by adding a
subdivision; 256J.30, subdivisions 10 and 11; 256J.31,
subdivisions 5, 10, and by adding a subdivision;
256J.32, subdivisions 4, 6, and by adding a
subdivision; 256J.33, subdivisions 1 and 4; 256J.35;
256J.36; 256J.37, subdivisions 1, 2, 9, and by adding
subdivisions; 256J.38, subdivision 1; 256J.39,
subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45,
subdivisions 1, 2, and by adding a subdivision;
256J.46, subdivisions 1, 2, and 2a; 256J.47,
subdivision 4; 256J.48, subdivisions 2 and 3; 256J.49,
subdivision 4; 256J.50, subdivision 5, and by adding
subdivisions; 256J.515; 256J.52, subdivision 4, and by
adding subdivisions; 256J.54, subdivisions 2, 3, 4,
and 5; 256J.55, subdivision 5; 256J.56; 256J.57,
subdivision 1; 256J.645, subdivision 3; 256J.74,
subdivision 2, and by adding a subdivision; 256K.03,
subdivision 5; 256L.01; 256L.02, subdivision 3, and by
adding a subdivision; 256L.03, subdivisions 1, 3, 4,
5, and by adding subdivisions; 256L.04, subdivisions
1, 2, 7, 8, 9, 10, and by adding subdivisions;
256L.05, subdivisions 2, 3, 4, and by adding
subdivisions; 256L.06, subdivision 3; 256L.07;
256L.09, subdivisions 2, 4, and 6; 256L.11,
subdivision 6; 256L.12, subdivision 5; 256L.15;
256L.17, by adding a subdivision; 257.071, subdivision
1d; 257.85, subdivision 5; 259.22, subdivision 4;
259.47, subdivision 3; 259.58; 259.60, subdivision 2;
260.012; 260.015, subdivisions 2a and 29; 260.161,
subdivision 2; 260.191, subdivisions 1, 1a, 3a, and
3b; 260.241, subdivision 3; and 270A.03, subdivision
5; Laws 1994, chapter 633, article 7, section 3; Laws
1997, chapter 195, section 5; chapter 203, article 4,
section 64; article 9, section 21; chapter 207,
section 7; chapter 225, article 2, section 64; and
chapter 248, section 46, as amended; proposing coding
for new law in Minnesota Statutes, chapters 62J; 62Q;
144; 145; 245; 256; 256B; 256D; and 256J; repealing
Minnesota Statutes 1996, sections 62J.685; 144.0721,
subdivision 3a; 144.491; 144.9501, subdivisions 12,
14, and 16; 144.9503, subdivisions 5, 8, and 9;
157.15, subdivision 15; 256.031, subdivisions 1, 2, 3,
and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and
6; 256.034; 256.035; 256.036; 256.0361; 256.047;
256.0475; 256.048; and 256.049; Minnesota Statutes
1997 Supplement, sections 62D.042, subdivision 3;
144.0721, subdivision 3; 256.031, subdivisions 5 and
6; 256.033, subdivisions 1 and 1a; 256B.057,
subdivision 1a; 256B.062; 256B.0913, subdivision 15;
256J.25; 256J.28, subdivision 4; 256J.32, subdivision
5; 256J.34, subdivision 5; 256L.04, subdivisions 3, 4,
5, and 6; 256L.06, subdivisions 1 and 2; 256L.08;
256L.09, subdivision 3; 256L.13; and 256L.14; Laws
1997, chapter 85, article 1, sections 61 and 71; and
article 3, section 55.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
APPROPRIATIONS
Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]
The sums shown in the columns marked "APPROPRIATIONS" are
appropriated from the general fund, or any other fund named, to
the agencies and for the purposes specified in the following
sections of this article, to be available for the fiscal years
indicated for each purpose. The figures "1998" and "1999" where
used in this article, mean that the appropriation or
appropriations listed under them are available for the fiscal
year ending June 30, 1998, or June 30, 1999, respectively.
Where a dollar amount appears in parentheses, it means a
reduction of an appropriation.
SUMMARY BY FUND
APPROPRIATIONS BIENNIAL
1998 1999 TOTAL
General $ (139,959,000)$ (161,811,000)$ (301,770,000)
State Government
Special Revenue 113,000 231,000 344,000
Health Care Access
Fund (3,130,000) (14,203,000) (17,333,000)
TOTAL $ (142,976,000)$ (175,783,000)$ (318,759,000)
APPROPRIATIONS
Available for the Year
Ending June 30
1998 1999
Sec. 2. COMMISSIONER OF
HUMAN SERVICES
Subdivision 1. Total
Appropriation $ (143,089,000)$ (196,131,000)
Summary by Fund
General (139,959,000) (181,669,000)
Health Care Access (3,130,000) (14,462,000)
This appropriation is taken from the
appropriation in Laws 1997, chapter
203, article 1, section 2.
The amounts that are added to or
reduced from the appropriation for each
program are specified in the following
subdivisions.
Subd. 2. Children's Grants
-0- 1,618,000
[CRISIS NURSERY PROGRAMS.] Of this
appropriation, $200,000 in fiscal year
1999 is from the general fund to the
commissioner to contract for technical
assistance with counties and private
nonprofit agencies that are interested
in developing a crisis nursery
program. The technical assistance must
be designed to assist interested
counties in building capacity to
develop and maintain a crisis nursery
program in the county. The grant
amounts must not exceed $20,000. To be
eligible to receive a grant under this
program, the county must not have an
existing crisis nursery program and
must not be a metropolitan county, as
that term is defined in Minnesota
Statutes, section 473.121. Grants must
be distributed by award letters to
agencies demonstrating a need for
crisis nursery services and documenting
community support for these efforts.
This appropriation shall not become
part of base level funding for the
2000-2001 biennium.
[CHILDREN'S MENTAL HEALTH SERVICES.]
(a) Of this appropriation, $300,000 in
fiscal year 1999 is from the general
fund for the commissioner to award
grants to counties that have a
relatively low net tax capacity to
provide children's mental health
services to children and families
residing outside of a metropolitan
statistical area, as that term is
defined by the United States Census
Bureau. Funds shall be used to provide
services according to an individual
family community support plan as
described in Minnesota Statutes,
section 245.4881, subdivision 4. The
plan must be developed using a process
that enhances consumer empowerment.
Counties with an approved children's
mental health collaborative may
integrate funds appropriated for fiscal
years 1998 and 1999 with existing funds
to meet the needs identified in the
child's individual family community
support plan.
(b) In awarding grants to counties
under this provision, the commissioner
shall follow the process established in
Minnesota Statutes, section 245.4886,
subdivision 2. The commissioner shall
give priority for funding to counties
that continued to spend for mental
health services specified in Minnesota
Statutes, sections 245.461 to 245.486
and 245.487 to 245.4888, according to
generally accepted accounting
principles, in an amount equal to the
total expenditures shown in the
county's approved 1987 CSSA plan for
services to persons with mental illness
plus the comparable figure for
facilities licensed under Minnesota
Rules, chapter 9545, for target
populations other than mental illness
in the county's approved 1989 CSSA
plan. The commissioner shall ensure
that grant funds are not used to
replace existing funds.
[PRIMARY SUPPORT TO IMPLEMENT THE
INDIAN FAMILY PRESERVATION ACT.] For
fiscal year 1998, $100,000 of federal
funds are transferred from the state's
federal TANF block grant and added to
the state's allocation of federal Title
XX block grant funds. Notwithstanding
the provisions of Minnesota Statutes
1997 Supplement, section 256E.07, the
commissioner shall use $100,000 of the
state's Title XX block grant funds for
a grant under Minnesota Statutes,
section 257.3571, subdivision 1, to an
Indian organization licensed as an
adoption agency. The grant must be
used to provide primary support for
implementation of the Minnesota Indian
Family Preservation Act and compliance
with the Indian Child Welfare Act.
This appropriation must be used
according to the requirements of United
States Code, title 42, section
604(d)(3)(B). This appropriation is
available until June 30, 1999.
[ADOPTION ASSISTANCE CARRYFORWARD.] Of
the appropriation in Laws 1997, chapter
203, section 2, subdivision 3, for
children's grants for fiscal year 1998,
$600,000 of the amount appropriated for
the adoption assistance program is
available for the same purpose in
fiscal year 1999. The amount carried
forward shall become part of the base
for the adoption assistance program in
the 2000-2001 biennial budget.
[FAMILY PRESERVATION PROGRAM FUNDING.]
$10,200,000 is transferred in fiscal
year 1999 from the state's federal TANF
block grant to the state's federal
Title XX block grant. Notwithstanding
the provisions of Minnesota Statutes
1997 Supplement, section 256E.07, in
fiscal year 1999 the commissioner shall
transfer $10,000,000 of the state's
Title XX block grant funds to the
family preservation program under
Minnesota Statutes, chapter 256F. The
commissioner shall transfer $200,000 to
the commissioner of health for the
program under Minnesota Statutes,
section 145A.15, that funds home
visiting projects; these transferred
funds are available until expended.
The commissioners shall ensure that
money allocated to counties under this
provision must be used in accordance
with the requirements of United States
Code, title 42, section 604(d)(3)(B).
These are one-time appropriations that
shall not be added to the base for
these programs for the 2000-2001
biennial budget.
Subd. 3. Basic Health Care Grants
(97,529,000) (146,802,000)
Summary by Fund
General (94,591,000) (128,833,000)
Health Care Access (2,938,000) (17,969,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Minnesota Care Grants
Health Care Access Fund
(2,938,000) (17,969,000)
[SUBSIDIZED FAMILY HEALTH COVERAGE.] Of
this appropriation, $500,000 from the
health care access fund in fiscal year
1999 is to implement the
employer-subsidized health coverage
program described in article 5, section
45.
(b) MA Basic Health Care Grants-
Families and Children
General (32,047,000) (65,249,000)
[FETAL ALCOHOL SYNDROME MEDICAL
ASSISTANCE FEDERAL MATCH.] The
commissioner shall claim all available
federal match under Title XIX for the
fetal alcohol syndrome/fetal alcohol
effect initiatives. Grants and
projects shall be developed which focus
treatment on community-based options
which consider the availability of
federal match.
(c) MA Basic Health Care Grants-
Elderly and Disabled
General (25,643,000) (40,952,000)
(d) General Assistance Medical Care
General (36,901,000) (22,632,000)
[PRESCRIPTION DRUG BENEFIT.] (a) If, by
September 15, 1998, federal approval is
obtained to provide a prescription drug
benefit for qualified Medicare
beneficiaries at no less than 100
percent of the federal poverty
guidelines and service-limited Medicare
beneficiaries under Minnesota Statutes,
section 256B.057, subdivision 3a, at no
less than 120 percent of federal
poverty guidelines, the commissioner of
human services shall not implement the
senior citizen drug program under
Minnesota Statutes, section 256.955,
but shall implement a drug benefit in
accordance with the approved waiver.
Upon approval of this waiver, the total
appropriation for the senior citizen
drug program under Laws 1997, chapter
225, article 7, section 2, shall be
transferred to the medical assistance
account to fund the federally approved
coverage for eligible persons for
fiscal year 1999.
(b) The commissioner may seek approval
for a higher copayment for eligible
persons above 100 percent of the
federal poverty guidelines.
(c) The commissioner shall report by
October 15, 1998, to the chairs of the
health and human services policy and
fiscal committees of the house and
senate whether the waiver referred to
in paragraph (a) has been approved and
will be implemented or whether the
state senior citizen drug program will
be implemented.
(d) If the commissioner does not
receive federal waiver approval at or
above the level of eligibility defined
in paragraph (a), the commissioner
shall implement the program under
Minnesota Statutes, section 256.955.
[HEALTH CARE ACCESS FUND TRANSFERS TO
THE GENERAL FUND.] Notwithstanding Laws
1997, chapter 203, article 1, section
2, subdivision 5, the commissioner
shall transfer funds from the health
care access fund to the general fund to
offset the projected savings to general
assistance medical care (GAMC) that
would result from the transition of
GAMC parents and adults without
children to MinnesotaCare. For fiscal
year 1998, the amount transferred from
the health care access fund to the
general fund shall be $13,700,000. The
amount of transfer for fiscal year 1999
shall be $2,659,000.
Subd. 4. Basic Health Care Management
(192,000) 2,448,000
Summary by Fund
General -0- 25,000
Health Care Access (192,000) 2,423,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Health Care Policy Administration
General -0- 25,000
Health Care Access (192,000) 354,000
[DELAY IN TRANSFERRING GAMC CLIENTS.]
Due to delaying the transfer of GAMC
clients to MinnesotaCare until January
1, 2000, $192,000 in fiscal year 1998
health care access fund administrative
funds, appropriated in Laws 1997,
chapter 225, article 7, section 2,
subdivision 1, are canceled.
[HEALTH CARE MANUAL PRODUCTION COSTS.]
For the biennium ending June 30, 1999,
the commissioner may charge a fee for
the health care manual. The difference
between the cost of producing and
distributing the department of human
services health care manual, and the
fees paid by individuals and private
entities on January 1, 1998, is
appropriated to the commissioner to
defray manual production and
distribution costs. The commissioner
must provide the health care manual to
government agencies and nonprofit
agencies serving the legal and social
service needs of clients at no cost to
those agencies.
[TRANSFER.] For fiscal years 2000 and
2001, the commissioner of finance shall
transfer from the health care access
fund to the general fund an amount to
cover the expenditures associated with
the services provided to pregnant women
and children under the age of two
enrolled in the MinnesotaCare program.
Notwithstanding section 7, this
provision expires on July 1, 2001.
[FEDERAL CONTINGENCY RESERVE LIMIT.]
Notwithstanding Minnesota Statutes,
section 16A.76, subdivision 2, the
federal contingency reserve limit shall
be reduced for fiscal years 1999, 2000,
and 2001 by the cumulative amount of
the expenditures associated with
services provided to pregnant women and
children enrolled in the MinnesotaCare
program in these fiscal years.
Notwithstanding section 7, this
provision expires on July 1, 2001.
[MINNESOTACARE OUTREACH FEDERAL
MATCHING FUNDS.] Any federal matching
funds received as a result of the
MinnesotaCare outreach activities
authorized by Laws 1997, chapter 225,
article 7, section 2, subdivision 1,
shall be deposited in the health care
access fund and dedicated to the
commissioner of human services to be
used for those outreach purposes.
(b) Health Care Operations
Health Care Access -0- 2,069,000
[MINNESOTACARE OUTREACH.] Unexpended
money in fiscal year 1998 for
MinnesotaCare outreach activities
appropriated in Laws 1997, chapter 225,
article 7, section 2, subdivision 1,
does not cancel, but is available for
those purposes in fiscal year 1999.
Subd. 5. State-Operated Services
-0- (254,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) RTC Facilities
-0- 700,000
[LEAVE LIABILITIES.] The accrued leave
liabilities of state employees
transferred to state-operated community
services programs may be paid from the
appropriation for state-operated
services in Laws 1997, chapter 203,
article 1, section 2, subdivision 7,
paragraph (a). Funds set aside for
this purpose shall not exceed the
amount of the actual leave liability
calculated as of June 30, 1999, and
shall be available until expended.
This provision is effective the day
following final enactment.
[GRAVE MARKERS.] Of the $195,000
retained by the commissioner from the
$200,000 appropriation in Laws 1997,
chapter 203, article 1, section 2,
subdivision 7, paragraph (a), for grave
markers at regional treatment centers,
$29,250 is for community organizing,
coordination, fundraising, and
administration.
[RTC BUILDING AND SPACE ANALYSIS.] Of
this appropriation, $50,000 from the
general fund in fiscal year 1999 is for
the commissioner to conduct an analysis
of surplus land and buildings on the
regional treatment center campuses and
to develop recommendations for future
utilization of this property. The
commissioner shall report to the
legislature by January 15, 1999, with
recommendations for an orderly process
to sell, lease, demolish, transfer, or
otherwise dispose of unneeded buildings
and land.
(b) State-Operated Community
Services - DD
-0- (954,000)
Subd. 6. Continuing Care and
Community Support Grants
(36,806,000) (9,289,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Community Services Block Grants
130,000 846,000
[WILKIN COUNTY FLOOD COSTS.] Of this
appropriation, $130,000 for fiscal year
1998 is to reimburse Wilkin county for
flood-related human service and public
health costs which cannot be reimbursed
through any other source.
(b) Aging Adult Service Grants
-0- 250,000
[METROPOLITAN AREA AGENCY ON AGING.] Of
this appropriation, $100,000 in fiscal
year 1999 from the general fund is for
the commissioner for the metropolitan
area agency on aging to provide
technical support and planning services
to enable older adults to remain living
in the community. This appropriation
shall not cancel but is available until
expended.* (The preceding text
beginning "[METROPOLITAN AREA AGENCY ON
AGING.]" was vetoed by the governor.)
[HOME SHARING.] Of this appropriation,
$150,000 in fiscal year 1999 is from
the general fund to the commissioner
for the home-sharing program under
Minnesota Statutes, section 256.973,
which links elderly, disabled, and
families together to share a home.
(c) Deaf and Hard-of-Hearing
Services Grants
-0- 234,000
[SERVICES FOR DEAF-BLIND PERSONS.] Of
this appropriation, $150,000 in fiscal
year 1999 is for the following:
(1) $100,000 for a grant to Deaf Blind
Services Minnesota, Inc., in order to
provide services to deaf-blind children
and their families. The services
include providing intervenors to assist
deaf-blind children in participating in
their community and providing family
education specialists to teach siblings
and parents skills to support the
deaf-blind child in the family.
(2) $50,000 is for a grant to Deaf
Blind Services Minnesota, Inc., and
Duluth Lighthouse for the Blind, Inc.,
in order to provide assistance to
deaf-blind persons who are working
toward establishing and maintaining
independence.
(d) Mental Health Grants
100,000 1,803,000
[DD CRISIS INTERVENTION PROJECT.] Of
this appropriation, $125,000 in fiscal
year 1999 is from the general fund to
the commissioner for start-up operating
and training costs for the action,
support, and prevention project of
southeastern Minnesota. This
appropriation is to provide crisis
intervention through community-based
services in the private sector to
persons with developmental disabilities
under Laws 1995, chapter 207, article
3, section 22. This appropriation
shall not become part of base level
funding for the 2000-2001 biennium.
[FLOOD COSTS.] Of this appropriation,
$100,000 for fiscal year 1998 and
$700,000 for fiscal year 1999 is to pay
for flood-related mental health
services and to reimburse mental health
centers for the cost of disruptions in
the mental health centers' other
services that were caused by diversion
of staff to flood efforts. Funding is
limited to costs for services which
cannot be reimbursed through any other
source in counties officially declared
as disaster areas.
[COMPULSIVE GAMBLING CARRYFORWARD.]
Unexpended funds appropriated to the
commissioner for compulsive gambling
programs for fiscal year 1998 do not
cancel but are available for these
purposes for fiscal year 1999.
(e) Developmental Disabilities
Support Grants
-0- 162,000
(f) Medical Assistance Long-Term
Care Waivers and Home Care
(3,936,000) (2,435,000)
[JULY 1, 1998, PROVIDER RATE INCREASE.]
(1) Effective for services rendered on
or after July 1, 1998, the commissioner
shall increase reimbursement or
allocation rates by three percent, and
county boards shall adjust provider
contracts as needed, for home and
community-based waiver services for
persons with mental retardation or
related conditions under Minnesota
Statutes, section 256B.501; home and
community-based waiver services for the
elderly under Minnesota Statutes,
section 256B.0915; waivered services
under community alternatives for
disabled individuals under Minnesota
Statutes, section 256B.49; community
alternative care waivered services
under Minnesota Statutes, section
256B.49; traumatic brain injury
waivered services under Minnesota
Statutes, section 256B.49; nursing
services and home health services under
Minnesota Statutes, section 256B.0625,
subdivision 6a; personal care services
and nursing supervision of personal
care services under Minnesota Statutes,
section 256B.0625, subdivision 19a;
private duty nursing services under
Minnesota Statutes, section 256B.0625,
subdivision 7; day training and
habilitation services for adults with
mental retardation or related
conditions under Minnesota Statutes,
sections 252.40 to 252.46; physical
therapy services under Minnesota
Statutes, sections 256B.0625,
subdivision 8, and 256D.03, subdivision
4; occupational therapy services under
Minnesota Statutes, sections 256B.0625,
subdivision 8a, and 256D.03,
subdivision 4; speech-language therapy
services under Minnesota Statutes,
section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0390;
respiratory therapy services under
Minnesota Statutes, section 256D.03,
subdivision 4, and Minnesota Rules,
part 9505.0295; dental services under
Minnesota Statutes, sections 256B.0625,
subdivision 9, and 256D.03, subdivision
4; alternative care services under
Minnesota Statutes, section 256B.0913;
adult residential program grants under
Minnesota Rules, parts 9535.2000 to
9535.3000; adult and family community
support grants under Minnesota Rules,
parts 9535.1700 to 9535.1760;
semi-independent living services under
Minnesota Statutes, section 252.275,
including SILS funding under county
social services grants formerly funded
under Minnesota Statutes, chapter 256I;
day treatment under Minnesota Rules,
part 9505.0323; the skills training
component of (a) family community
support services under Minnesota
Statutes, section 256B.0625,
subdivisions 5 and 35, (b) therapeutic
support of foster care under Minnesota
Statutes, section 256B.0625,
subdivisions 5 and 36, and (c)
home-based treatment under Minnesota
Rules, part 9505.0324; and community
support services for deaf and
hard-of-hearing adults with mental
illness who use or wish to use sign
language as their primary means of
communication.
(2) Effective January 1, 1999, the
commissioner shall increase capitation
rates in the prepaid medical assistance
program, prepaid general assistance
medical care program, and prepaid
MinnesotaCare program as appropriate to
reflect the rate increases in paragraph
(l).
(3) It is the intention of the
legislature that the compensation
packages of staff within each service
be increased by three percent.
(4) Section 7, sunset of uncodified
language, does not apply to this
provision.
(g) Medical Assistance Long-Term
Care Facilities
(24,318,000) (16,911,000)
[ICFs/MR AND NURSING FACILITY
FLOOD-RELATED REPORTING.] For the
reporting year ending December 31,
1997, for ICFs/MR that temporarily
admitted victims of the flood of 1997,
the resident days related to the
temporary placement of persons not
formally admitted who continued to be
billed under the evacuated facility's
provider number shall not be counted in
the cost report submitted to calculate
October 1, 1998, rates, and the
additional expenditures shall be
considered nonallowable.
For the reporting year ending September
30, 1997, for nursing facilities that
temporarily admitted victims of the
flood of 1997, the resident days
related to the temporary placement of
persons not formally admitted who
continued to be billed under the
evacuated facility's provider number
shall not be counted in the cost report
submitted to calculate July 1, 1998,
rates, and the additional expenditures
shall be considered nonallowable.
[ICF/MR DISALLOWANCES.] Of this
appropriation, $65,000 in fiscal year
1999 is from the general fund to the
commissioner for the purpose of
reimbursing a 12-bed ICF/MR in Stearns
county and a 12-bed ICF/MR in Sherburne
county for disallowances resulting from
field audit findings. The commissioner
shall exempt these facilities from the
provisions of Minnesota Statutes,
section 256B.501, subdivision 5b,
paragraph (d), clause (6), for the rate
years beginning October 1, 1997, and
October 1, 1998. Section 10, sunset of
uncodified language, does not apply to
this provision.
[NURSING HOME MORATORIUM EXCEPTIONS.]
Base level funding for medical
assistance long-term care facilities is
increased by $255,000 in fiscal year
2000 and by $278,000 in fiscal year
2001 for the additional medical
assistance costs of the nursing home
moratorium exceptions under Minnesota
Statutes 1997 Supplement, section
144A.071, subdivision 4a, paragraphs
(w) and (x). Notwithstanding the
provisions of section 7, sunset of
uncodified language, this provision
shall not expire.
(h) Alternative Care Grants
-0- 22,663,000
(i) Group Residential Housing
(8,782,000) (8,408,000)
[SERVICES TO DEAF PERSONS WITH MENTAL
ILLNESS.] Of this appropriation,
$65,000 in fiscal year 1999 is from the
general fund to the commissioner for a
grant to a nonprofit agency that
currently serves deaf and
hard-of-hearing adults with mental
illness through residential programs
and supported housing outreach
activities. The grant must be used to
continue or maintain community support
services for deaf and hard-of-hearing
adults with mental illness who use or
wish to use sign language as their
primary means of communication. This
appropriation is in addition to the
appropriation in Laws 1997, chapter
203, article 1, section 2, subdivision
8, paragraph (d), for a grant to this
nonprofit agency. This appropriation
shall not become part of base level
funding for the 2000-2001 biennium.
(j) Chemical Dependency
Entitlement Grants
-0- (7,893,000)
[CHEMICAL DEPENDENCY RESERVE ACCOUNT.]
For fiscal year 1999, $3,000,000 is
canceled from the chemical dependency
reserve account within the consolidated
chemical dependency treatment fund to
the general fund.
(k) Chemical Dependency
Nonentitlement Grants
-0- 400,000
[MATCHING GRANT FOR YOUTH ALCOHOL
TREATMENT.] Of this appropriation,
$400,000 in fiscal year 1999 is from
the general fund for the commissioner
to provide a grant to the board of
directors of the Minnesota Indian
Primary Residential Treatment Center,
Inc., to build a youth alcohol
treatment wing at the Mash-Ka-Wisen
Treatment Center. This appropriation
is available only if matched by a
$1,500,000 federal grant and a $100,000
grant from state Indian bands.
[MATCHING GRANT FOR PROJECT TURNABOUT.]
If money is appropriated in fiscal year
1999 to the commissioner from the
lottery prize fund, the money shall be
used to provide a grant for capital
improvements to Project Turnabout in
Granite Falls. A local match is
required before the commissioner may
release this appropriation to the
facility. The facility shall receive
state funds equal to the amount of
local matching funds provided, up to
the limit of this appropriation.
Subd. 7. Continuing Care and
Community Support Management
-0- 25,000
[REGION 10 COMMISSION CARRYOVER
AUTHORITY.] Any unspent portion of the
appropriation to the commissioner in
Laws 1997, chapter 203, article 1,
section 2, subdivision 9, for the
region 10 quality assurance commission
for fiscal year 1998 shall not cancel
but shall be available for the
commission for fiscal year 1999.
[STUDY OF DAY TRAINING CAPITAL NEEDS.]
(a) Of this appropriation, $25,000 in
fiscal year 1999 is from the general
fund to the commissioner to conduct a
study to:
(1) determine the extent to which day
training and habilitation programs have
unmet capital improvement needs;
(2) ascertain the degree to which these
unmet capital needs impact consumers of
day training and habilitation programs;
(3) determine the state's role and
responsibility in meeting the capital
improvement needs of day training and
habilitation programs; and
(4) examine the relationship among the
state, counties, and community
resources in meeting the capital
improvement needs of day training and
habilitation programs.
(b) The commissioner shall report to
the legislature by January 15, 1999,
the results of the study along with
recommendations for involving the
state, counties, and community
resources in collaborative initiatives
to assist in meeting the capital
improvement needs of day training and
habilitation programs.
(c) This appropriation shall not become
part of base level funding for the
2000-2001 biennium.* (The preceding
text beginning "[STUDY OF DAY TRAINING
CAPITAL NEEDS.]" was vetoed by the
governor.)
Subd. 8. Economic Support Grants
(8,562,000) (44,961,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Assistance to Families Grants
1,173,000 (32,282,000)
[FEDERAL TANF FUNDS.] Notwithstanding
any contrary provisions of Laws 1997,
chapter 203, article 1, section 2,
subdivision 12, federal TANF block
grant funds are appropriated to the
commissioner in amounts up to
$230,200,000 in fiscal year 1998 and
$285,990,000 in fiscal year 1999.
Additional federal TANF funds may be
expended but only to the extent that an
equal amount of state funds have been
transferred to the TANF reserve under
Minnesota Statutes, section 256J.03.
[TRANSFER OF STATE MONEY FROM TANF
RESERVE.] For fiscal year 1999,
$5,416,000 is appropriated from the
state money in the TANF reserve to the
commissioner for the purposes of
funding the Minnesota food assistance
program under Minnesota Statutes,
section 256D.053, and the eligibility
of legal noncitizens who were not
Minnesota residents on March 1, 1997,
for the general assistance program
under the amendments to Minnesota
Statutes, section 256D.05, subdivision
8, in article 6.
[TRANSFER OF FEDERAL TANF FUNDS TO
CHILD CARE DEVELOPMENT FUND.] $791,000
is transferred in fiscal year 1999 from
the state's federal TANF block grant to
the state's child care development
fund, and is appropriated to the
commissioner of children, families, and
learning for the purposes of Minnesota
Statutes, section 119B.05.
[TRANSFER FROM STATE TANF RESERVE.]
Notwithstanding the provisions of
Minnesota Statutes, section 256J.03,
$7,799,000 is transferred from the
state TANF reserve account to the
general fund in fiscal year 2000.
Notwithstanding section 7, this
provision expires on July 1, 2000.
(b) Work Grants
-0- (1,000,000)
[FOOD STAMP EMPLOYMENT AND TRAINING
APPROPRIATION REDUCTION.] The
appropriation in Laws 1997, chapter
203, article 1, section 2, subdivision
10, paragraph (b), for fiscal year 1999
for work grants is reduced by
$1,000,000. This reduction shall be
taken from the fiscal year 1999
appropriation for the food stamp
employment and training program.
(c) Child Support Enforcement
-0- (1,100,000)
[CHILD SUPPORT CARRYOVER AUTHORITY.]
Any unspent portion of the
appropriation to the commissioner in
Laws 1997, chapter 203, article 1,
section 2, subdivision 10, for child
support enforcement activities for
fiscal year 1998 shall not cancel but
shall be available to the commissioner
for fiscal year 1999. The
appropriation in Laws 1997, chapter
203, article 1, section 2, subdivision
10, for child support enforcement
activities for fiscal year 1999 is
reduced by $1,100,000. This reduction
shall not reduce base level funding for
these activities for the 2000-2001
biennium.
(d) General Assistance
(6,933,000) (6,321,000)
(e) Minnesota Supplemental Aid
(2,802,000) (4,258,000)
Subd. 9. Economic Support
Management
Health Care Access -0- 1,084,000
[ASSESSMENT OF AFFORDABLE HOUSING
SUPPLY.] The commissioner of human
services shall assess the statewide
supply of affordable housing for all
MFIP-S and GA recipients, and report to
the legislature by January 15, 1999, on
the results of this assessment.
Sec. 3. COMMISSIONER OF HEALTH
Subdivision 1. Total
Appropriation -0- 20,147,000
Summary by Fund
General -0- 19,780,000
State Government
Special Revenue -0- 108,000
Health Care Access -0- 259,000
This appropriation is added to the
appropriation in Laws 1997, chapter
203, article 1, section 3.
The amounts that may be spent from this
appropriation for each program are
specified in the following subdivisions.
Subd. 2. Health Systems
and Special Populations -0- 15,459,000
Summary by Fund
General -0- 15,200,000
Health Care Access -0- 259,000
[FETAL ALCOHOL SYNDROME.] (a) Of this
appropriation, $5,000,000 in fiscal
year 1999 is from the general fund to
the commissioner for the fetal alcohol
syndrome/fetal alcohol effect (FAS/FAE)
initiatives specified in paragraphs (b)
to (k).
(b) Of the amount in paragraph (a),
$200,000 is transferred to the
commissioner of children, families, and
learning for school-based pilot
programs to identify and implement
effective educational strategies for
individuals with FAS/FAE.
(c) Of the amount in paragraph (a),
$800,000 is for the public awareness
campaign under Minnesota Statutes,
section 145.9266, subdivision 1.
(d) Of the amount in paragraph (a),
$400,000 is to develop a statewide
network of regional FAS diagnostic
clinics under Minnesota Statutes,
section 145.9266, subdivision 2.
(e) Of the amount in paragraph (a),
$150,000 is for professional training
about FAS under Minnesota Statutes,
section 145.9266, subdivision 3.
(f) Of the amount in paragraph (a),
$350,000 is for the fetal alcohol
coordinating board under Minnesota
Statutes, section 145.9266, subdivision
6.
(g) Of the amount in paragraph (a),
$800,000 is transferred to the
commissioner of human services to
expand the maternal and child health
social service programs under Minnesota
Statutes, section 254A.17, subdivision
1. Of this amount, $184,000 shall be
used by the commissioner of human
services to eliminate the asset
standards for medical assistance
eligibility for pregnant women.
(h) Of the amount in paragraph (a),
$200,000 is for the commissioner to
study the extent of fetal alcohol
syndrome in the state.
(i) Of the amount in paragraph (a),
$400,000 is transferred to the
commissioner of human services for the
intervention and advocacy program under
Minnesota Statutes, section 254A.17,
subdivision 1b.
(j) Of the amount in paragraph (a),
$850,000 is for the FAS community grant
program under Minnesota Statutes,
section 145.9266, subdivision 4.
(k) Of the amount in paragraph (a),
$850,000 is transferred to the
commissioner of human services to
expand treatment services and halfway
houses for pregnant women and women
with children who abuse alcohol during
pregnancy.
[RURAL PHYSICIAN LOAN FORGIVENESS
BUDGET REQUEST.] The budget request for
the rural physician loan forgiveness
program in the 2000-2001 biennial
budget shall detail the amount of funds
carried forward and obligations
canceled.
[CONSUMER ADVISORY BOARD.] Of the
general fund appropriation for fiscal
year 1999, $50,000 is to the
commissioner to reimburse members of
the consumer advisory board for travel,
food, and lodging expenses incurred by
board members in the course of
conducting board duties.
[MEDICAL EDUCATION AND RESEARCH TRUST
FUND.] Of the general fund
appropriation, $10,000,000 in fiscal
year 1999 is to the commissioner for
the medical education and research
trust fund. Of this amount, $5,000,000
shall become part of base level funding
for the biennium beginning July 1, 1999.
[MERC FEDERAL FINANCIAL PARTICIPATION.]
(1) The commissioner of human services
shall seek to maximize federal
financial participation for payments
for medical education and research
costs.
(2) If the commissioner of human
services determines that federal
financial participation is available
for the fiscal year 1999 appropriation
for the medical education and research
trust fund under this subdivision, the
commissioner of health shall transfer
to the commissioner of human services
the amount of state funds necessary to
maximize the federal funds.
(3) The transferred amount, plus the
federal financial participation amount,
shall be distributed to medical
assistance providers according to the
distribution methodology of the medical
education research trust fund
established under Minnesota Statutes,
section 62J.69.
[DIABETES PREVENTION.] Of this
appropriation, $50,000 in fiscal year
1999 from the general fund is to the
commissioner for statewide activities
related to general diabetes prevention,
the development and dissemination of
prevention materials to health care
providers, and for other statewide
activities related to diabetes
prevention and control for targeted
populations who are at high risk for
developing diabetes or health
complications from diabetes.
Subd. 3. Health Protection -0- 4,688,000
Summary by Fund
General -0- 4,580,000
State Government
Special Revenue -0- 108,000
[FOOD, BEVERAGE, AND LODGING PROGRAM
STAFF RESTORATION.] Of the
appropriation from the state government
special revenue fund, $101,000 in
fiscal year 1999 is for the
commissioner to restore staffing for
the food, beverage, and lodging program.
[OCCUPATIONAL RESPIRATORY DISEASE
INFORMATION SYSTEM.] Of the general
fund appropriation, $250,000 in fiscal
year 1999 is to design an occupational
respiratory disease information
system. This appropriation is
available until expended. This
appropriation is added to the base for
the 2000-2001 biennial budget.
[LEAD-SAFE PROPERTY CERTIFICATION
PROGRAM.] Of this appropriation,
$75,000 in fiscal year 1999 is from the
general fund to the commissioner for
the purposes of the lead-safe property
certification program under Minnesota
Statutes, section 144.9511.
[INFECTION CONTROL.] Of the general
fund appropriation, $200,000 in fiscal
year 1999 is for infection control
activities, including training and
technical assistance of health care
personnel to prevent and control
disease outbreaks, and for hospital and
public health laboratory testing and
other activities to monitor trends in
drug-resistant infections.
[CANCER SCREENING.] Of the general fund
appropriation, $1,255,000 in fiscal
year 1999 is for increased cancer
screening and diagnostic services for
women, particularly underserved women,
and to improve cancer screening rates
for the general population. Of this
amount, at least $855,000 is for grants
to support local boards of health in
providing outreach and coordination and
to reimburse health care providers for
screening and diagnostic tests, and up
to $400,000 is for technical
assistance, consultation, and outreach.
[SEXUALLY TRANSMITTED DISEASE.] (a) of
this appropriation, $300,000 in fiscal
year 1999 is from the general fund to
the commissioner to do the following,
in consultation with the HIV/STD
prevention task force and the
commissioner of children, families, and
learning:
(1) $100,000 to conduct a statewide
assessment of need and capacity to
prevent and treat sexually transmitted
diseases and prepare a comprehensive
plan for how to prevent and treat
sexually transmitted diseases,
including strategies for reducing
infection and for increasing access to
treatment;
(2) $150,000 to conduct research on the
prevalence of sexually transmitted
diseases among populations at highest
risk for infection. The research may
be done in collaboration with the
University of Minnesota and nonprofit
community health clinics; and
(3) $50,000 to conduct laboratory
screenings for sexually transmitted
diseases at no charge to patients
participating in epidemiological
research activities specified in clause
(2).
(b) This appropriation shall not become
part of the base for the 2000-2001
biennium.
Sec. 4. HEALTH-RELATED BOARDS
Subdivision 1. Total
Appropriation 113,000 123,000
This appropriation is added to the
appropriation in Laws 1997, chapter
203, article 1, section 5.
The appropriations in this section are
from the state government special
revenue fund.
[NO SPENDING IN EXCESS OF REVENUES.]
The commissioner of finance shall not
permit the allotment, encumbrance, or
expenditure of money appropriated in
this section in excess of the
anticipated biennial revenues or
accumulated surplus revenues from fees
collected by the boards. Neither this
provision nor Minnesota Statutes,
section 214.06, applies to transfers
from the general contingent account.
Subd. 2. Board of Medical
Practice 80,000 90,000
This appropriation is added to the
appropriation in Laws 1997, chapter
203, article 1, section 5, subdivision
6, and is for the health professional
services activity.
Subd. 3. Board of Veterinary
Medicine 33,000 33,000
This appropriation is added to the
appropriation in Laws 1997, chapter
203, article 1, section 5, subdivision
14, and is for national examination
costs.
Sec. 5. EMERGENCY MEDICAL
SERVICES BOARD
General -0- 78,000
This appropriation is added to the
appropriation in Laws 1997, chapter
203, article 1, section 6.
[EMERGENCY MEDICAL SERVICES
COMMUNICATIONS NEEDS ASSESSMENT.] (a)
Of this appropriation, $78,000 in
fiscal year 1999 is from the general
fund to the board to conduct an
emergency medical services needs
assessment for areas outside the
seven-county metropolitan area. The
assessment shall determine the current
status of and need for emergency
medical services communications
equipment. All regional emergency
medical services programs designated by
the board under Minnesota Statutes 1997
Supplement, section 144E.50, shall
cooperate in the preparation of the
assessment.
(b) The appropriation for this project
shall be distributed through the
emergency medical services system fund
under Minnesota Statutes, section
144E.50, through a request-for-proposal
process. The board must select a
regional EMS program that receives at
least 20 percent of its funding from
nonstate sources to conduct the
assessment. The request for proposals
must be issued by August 1, 1998.
(c) A final report with recommendations
shall be presented to the board and the
legislature by July 1, 1999.
(d) This appropriation shall not become
part of base level funding for the
2000-2001 biennium.
Sec. 6. [CARRYOVER LIMITATION.] None
of the appropriations in this act which
are allowed to be carried forward from
fiscal year 1998 to fiscal year 1999
shall become part of the base level
funding for the 2000-2001 biennial
budget, unless specifically directed by
the legislature.
Sec. 7. [SUNSET OF UNCODIFIED
LANGUAGE.] All uncodified language
contained in this article expires on
June 30, 1999, unless a different
expiration date is explicit.
Sec. 8. [EFFECTIVE DATE.]
The appropriations and reductions for fiscal year 1998 in
this article are effective the day following final enactment.
ARTICLE 2
HEALTH DEPARTMENT AND HEALTH PROFESSIONALS
Section 1. Minnesota Statutes 1997 Supplement, section
13.99, is amended by adding a subdivision to read:
Subd. 19m. [DATA HELD BY OFFICE OF HEALTH CARE CONSUMER
ASSISTANCE, ADVOCACY, AND INFORMATION.] Consumer complaint data
collected or maintained by the office of health care consumer
assistance, advocacy, and information under sections 62J.77 and
62J.80 are classified under section 62J.79, subdivision 4.
Sec. 2. Minnesota Statutes 1997 Supplement, section
62D.11, subdivision 1, is amended to read:
Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health
maintenance organization shall establish and maintain a
complaint system, as required under section 62Q.105 to provide
reasonable procedures for the resolution of written complaints
initiated by or on behalf of enrollees concerning the provision
of health care services. "Provision of health services"
includes, but is not limited to, questions of the scope of
coverage, quality of care, and administrative operations. The
health maintenance organization must inform enrollees that they
may choose to use alternative dispute resolution arbitration to
appeal a health maintenance organization's internal appeal
decision. The health maintenance organization must also inform
enrollees that they have the right to use arbitration to appeal
a health maintenance organization's internal appeal decision not
to certify an admission, procedure, service, or extension of
stay under section 62M.06. If an enrollee chooses to use an
alternative dispute resolution process arbitration, the health
maintenance organization must participate.
Sec. 3. Minnesota Statutes 1996, section 62J.321, is
amended by adding a subdivision to read:
Subd. 5a. [PRESCRIPTION DRUG PRICE DISCLOSURE
DATA.] Notwithstanding subdivisions 1 and 5, data collected
under section 62J.381 shall be classified as public data.
Sec. 4. [62J.381] [PRESCRIPTION DRUG PRICE DISCLOSURE.]
By April 1, 1999, and annually thereafter, hospitals
licensed under chapter 144 and group purchasers required to file
a full report under section 62J.38 and the rules promulgated
thereunder, must submit to the commissioner of health the total
amount of:
(1) aggregate purchases of or payments for prescription
drugs; and
(2) aggregate cash rebates, discounts, other payments
received, and any fees associated with education, data
collection, research, training, or market share movement, which
are received during the previous calendar year from a
manufacturer as defined under section 151.44, paragraph (c), or
wholesale drug distributor as defined under section 151.44,
paragraph (d).
The data collected under this section shall be distributed
through the information clearinghouse under section 62J.2930.
The identification of individual manufacturers or wholesalers or
specific drugs shall not be required under this section.
Sec. 5. Minnesota Statutes 1997 Supplement, section
62J.69, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following definitions apply:
(a) "Medical education" means the accredited clinical
training of physicians (medical students and residents), doctor
of pharmacy practitioners, doctors of chiropractic, dentists,
advanced practice nurses (clinical nurse specialist, certified
registered nurse anesthetists, nurse practitioners, and
certified nurse midwives), and physician assistants.
(b) "Clinical training" means accredited training for the
health care practitioners listed in paragraph (a) that is funded
and was historically funded in part by inpatient patient care
revenues and that occurs in both either an inpatient and or
ambulatory patient care settings training site.
(c) "Trainee" means students involved in an accredited
clinical training program for medical education as defined in
paragraph (a).
(d) "Eligible trainee" means a student involved in an
accredited training program for medical education as defined in
paragraph (a), which meets the definition of clinical training
in paragraph (b), who is in a training site that is located in
Minnesota and which has a medical assistance provider number.
(e) "Health care research" means approved clinical,
outcomes, and health services investigations that are funded by
patient out-of-pocket expenses or a third-party payer.
(e) (f) "Commissioner" means the commissioner of health.
(f) (g) "Teaching institutions" means any hospital, medical
center, clinic, or other organization that currently sponsors or
conducts accredited medical education programs or clinical
research in Minnesota.
(h) "Accredited training" means training provided by a
program that is accredited through an organization recognized by
the department of education or the health care financing
administration as the official accrediting body for that program.
(i) "Sponsoring institution" means a hospital, school, or
consortium located in Minnesota that sponsors and maintains
primary organizational and financial responsibility for an
accredited medical education program in Minnesota and which is
accountable to the accrediting body.
Sec. 6. Minnesota Statutes 1997 Supplement, section
62J.69, subdivision 2, is amended to read:
Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND
RESEARCH.] (a) The commissioner may establish a trust fund for
the purposes of funding medical education and research
activities in the state of Minnesota.
(b) By January 1, 1997, the commissioner may appoint an
advisory committee to provide advice and oversight on the
distribution of funds from the medical education and research
trust fund. If a committee is appointed, the commissioner
shall: (1) consider the interest of all stakeholders when
selecting committee members; (2) select members that represent
both urban and rural interest; and (3) select members that
include ambulatory care as well as inpatient perspectives. The
commissioner shall appoint to the advisory committee
representatives of the following groups: medical researchers,
public and private academic medical centers, managed care
organizations, Blue Cross and Blue Shield of Minnesota,
commercial carriers, Minnesota Medical Association, Minnesota
Nurses Association, medical product manufacturers, employers,
and other relevant stakeholders, including consumers. The
advisory committee is governed by section 15.059, for membership
terms and removal of members and will sunset on June 30, 1999.
(c) Eligible applicants for funds are accredited medical
education teaching institutions, consortia, and programs
operating in Minnesota. Applications must be submitted by the
sponsoring institution on behalf of the teaching program, and
must be received by September 30 of each year for distribution
in January of the following year. An application for funds must
include the following:
(1) the official name and address of the sponsoring
institution and the official name and address of the facility or
program programs on whose behalf the institution is applying for
funding;
(2) the name, title, and business address of those persons
responsible for administering the funds;
(3) the total number, type, and specialty orientation of
eligible Minnesota-based trainees in for each accredited medical
education program for which funds are being sought the type and
specialty orientation of trainees in the program, the name,
address, and medical assistance provider number of each training
site used in the program, the total number of trainees at each
site, and the total number of eligible trainees at each training
site;
(4) audited clinical training costs per trainee for each
medical education program where available or estimates of
clinical training costs based on audited financial data;
(5) a description of current sources of funding for medical
education costs including a description and dollar amount of all
state and federal financial support, including Medicare direct
and indirect payments;
(6) other revenue received for the purposes of clinical
training; and
(7) a statement identifying unfunded costs; and
(8) other supporting information the commissioner, with
advice from the advisory committee, determines is necessary for
the equitable distribution of funds.
(d) The commissioner shall distribute medical education
funds to all qualifying applicants based on the following basic
criteria: (1) total medical education funds available; (2)
total eligible trainees in each eligible education program; and
(3) the statewide average cost per trainee, by type of trainee,
in each medical education program. Funds distributed shall not
be used to displace current funding appropriations from federal
or state sources. Funds shall be distributed to the sponsoring
institutions indicating the amount to be paid to each of the
sponsor's medical education programs based on the criteria in
this paragraph. Sponsoring institutions which receive funds
from the trust fund must distribute approved funds to the
medical education program according to the commissioner's
approval letter. Further, programs must distribute funds among
the sites of training based on the percentage of total program
training performed at each site. as specified in the
commissioner's approval letter. Any funds not distributed as
directed by the commissioner's approval letter shall be returned
to the medical education and research trust fund within 30 days
of a notice from the commissioner. The commissioner shall
distribute returned funds to the appropriate entities in
accordance with the commissioner's approval letter.
(e) Medical education programs receiving funds from the
trust fund must submit annual cost and program reports a medical
education and research grant verification report (GVR) through
the sponsoring institution based on criteria established by the
commissioner. If the sponsoring institution fails to submit the
GVR by the stated deadline, or to request and meet the deadline
for an extension, the sponsoring institution is required to
return the full amount of the medical education and research
trust fund grant to the medical education and research trust
fund within 30 days of a notice from the commissioner. The
commissioner shall distribute returned funds to the appropriate
entities in accordance with the commissioner's approval letter.
The reports must include:
(1) the total number of eligible trainees in the program;
(2) the programs and residencies funded, the amounts of
trust fund payments to each program, and within each program,
the percentage dollar amount distributed to each training site;
and
(3) the average cost per trainee and a detailed breakdown
of the components of those costs;
(4) other state or federal appropriations received for the
purposes of clinical training;
(5) other revenue received for the purposes of clinical
training; and
(6) other information the commissioner, with advice from
the advisory committee, deems appropriate to evaluate the
effectiveness of the use of funds for clinical training.
The commissioner, with advice from the advisory committee,
will provide an annual summary report to the legislature on
program implementation due February 15 of each year.
(f) The commissioner is authorized to distribute funds made
available through:
(1) voluntary contributions by employers or other entities;
(2) allocations for the department of human services to
support medical education and research; and
(3) other sources as identified and deemed appropriate by
the legislature for inclusion in the trust fund.
(g) The advisory committee shall continue to study and make
recommendations on:
(1) the funding of medical research consistent with work
currently mandated by the legislature and under way at the
department of health; and
(2) the costs and benefits associated with medical
education and research.
Sec. 7. Minnesota Statutes 1997 Supplement, section
62J.69, is amended by adding a subdivision to read:
Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN
SERVICES.] (a) The amount transferred according to section
256B.69, subdivision 5c, shall be distributed to qualifying
applicants based on a distribution formula that reflects a
summation of two factors:
(1) an education factor, which is determined by the total
number of eligible trainees and the total statewide average
costs per trainee, by type of trainee, in each program; and
(2) a public program volume factor, which is determined by
the total volume of public program revenue received by each
training site as a percentage of all public program revenue
received by all training sites in the trust fund pool.
In this formula, the education factor shall be weighted at
50 percent and the public program volume factor shall be
weighted at 50 percent.
(b) Public program revenue for the formula in paragraph (a)
shall include revenue from medical assistance, prepaid medical
assistance, general assistance medical care, and prepaid general
assistance medical care.
(c) Training sites that receive no public program revenue
shall be ineligible for payments from the prepaid medical
assistance program transfer pool.
Sec. 8. Minnesota Statutes 1997 Supplement, section
62J.69, is amended by adding a subdivision to read:
Subd. 5. [REVIEW OF ELIGIBLE PROVIDERS.] (a) Provider
groups added after January 1, 1998, to the list of providers
eligible for the trust fund shall not receive funding from the
trust fund without prior evaluation by the commissioner and the
medical education and research costs advisory committee. The
evaluation shall consider the degree to which the training of
the provider group:
(1) takes place in patient care settings, which are
consistent with the purposes of this section;
(2) is funded with patient care revenues;
(3) takes place in patient care settings, which face
increased financial pressure as a result of competition with
nonteaching patient care entities; and
(4) emphasizes primary care or specialties, which are in
undersupply in Minnesota.
Results of this evaluation shall be reported to the
legislative commission on health care access. The legislative
commission on health care access must approve funding for the
provider group prior to their receiving any funding from the
trust fund. In the event that a reviewed provider group is not
approved by the legislative commission on health care access,
trainees in that provider group shall be considered ineligible
trainees for the trust fund distribution.
(b) The commissioner and the medical education and research
costs advisory committee may also review provider groups, which
were added to the eligible list of provider groups prior to
January 1, 1998, to assure that the trust fund money continues
to be distributed consistent with the purpose of this section.
The results of any such reviews must be reported to the
legislative commission on health care access. Trainees in
provider groups, which were added prior to January 1, 1998, and
which are reviewed by the commissioner and the medical education
and research costs advisory committee, shall be considered
eligible trainees for purposes of the trust fund distribution
unless and until the legislative commission on health care
access disapproves their eligibility, in which case they shall
be considered ineligible trainees.
Sec. 9. [62J.701] [GOVERNMENTAL PROGRAMS.]
Beginning January 1, 1999, the provisions in paragraphs (a)
to (d) apply.
(a) For purposes of sections 62J.695 to 62J.80, the
requirements and other provisions that apply to health plan
companies also apply to governmental programs.
(b) For purposes of this section, "governmental programs"
means the medical assistance program, the MinnesotaCare program,
the general assistance medical care program, the state employee
group insurance program, the public employees insurance program
under section 43A.316, and coverage provided by political
subdivisions under section 471.617.
(c) Notwithstanding paragraph (a), section 62J.72 does not
apply to the fee-for-service programs under medical assistance,
MinnesotaCare, and general assistance medical care.
(d) If a state commissioner or local unit of government
contracts with a health plan company or a third party
administrator, the contract may assign any obligations under
paragraph (a) to the health plan company or third party
administrator. Nothing in this paragraph shall be construed to
remove or diminish any enforcement responsibilities of the
commissioners of health or commerce provided in sections 62J.695
to 62J.80.
Sec. 10. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.] The
following types of agreements and directives are contrary to
state public policy, are prohibited under this section, and are
null and void:
(1) any agreement or directive that prohibits a health care
provider from communicating with an enrollee with respect to the
enrollee's health status, health care, or treatment options, if
the health care provider is acting in good faith and within the
provider's scope of practice as defined by law;
(2) any agreement or directive that prohibits a health care
provider from making a recommendation regarding the suitability
or desirability of a health plan company, health insurer, or
health coverage plan for an enrollee, unless the provider has a
financial conflict of interest in the enrollee's choice of
health plan company, health insurer, or health coverage plan;
(3) any agreement or directive that prohibits a provider
from providing testimony, supporting or opposing legislation, or
making any other contact with state or federal legislators or
legislative staff or with state and federal executive branch
officers or staff;
(4) any agreement or directive that prohibits a health care
provider from disclosing accurate information about whether
services or treatment will be paid for by a patient's health
plan company or health insurer or health coverage plan; and
(5) any agreement or directive that prohibits a health care
provider from informing an enrollee about the nature of the
reimbursement methodology used by an enrollee's health plan
company, health insurer, or health coverage plan to pay the
provider.
Sec. 11. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 3, is amended to read:
Subd. 3. [RETALIATION PROHIBITED.] No person, health plan
company, or other organization may take retaliatory action
against a health care provider solely on the grounds that the
provider:
(1) refused to enter into an agreement or provide services
or information in a manner that is prohibited under this section
or took any of the actions listed in subdivision 1;
(2) disclosed accurate information about whether a health
care service or treatment is covered by an enrollee's health
plan company, health insurer, or health coverage plan; or
(3) discussed diagnostic, treatment, or referral options
that are not covered or are limited by the enrollee's health
plan company, health insurer, or health coverage plan;
(4) criticized coverage of the enrollee's health plan
company, health insurer, or health coverage plan; or
(5) expressed personal disagreement with a decision made by
a person, organization, or health care provider regarding
treatment or coverage provided to a patient of the provider, or
assisted or advocated for the patient in seeking reconsideration
of such a decision, provided the health care provider makes it
clear that the provider is acting in a personal capacity and not
as a representative of or on behalf of the entity that made the
decision.
Sec. 12. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 4, is amended to read:
Subd. 4. [EXCLUSION.] (a) Nothing in this section
prohibits a health plan an entity that is subject to this
section from taking action against a provider if the health plan
entity has evidence that the provider's actions are illegal,
constitute medical malpractice, or are contrary to accepted
medical practices.
(b) Nothing in this section prohibits a contract provision
or directive that requires any contracting party to keep
confidential or to not use or disclose the specific amounts paid
to a provider, provider fee schedules, provider salaries, and
other proprietary information of a specific health plan or
health plan company entity that is subject to this section.
Sec. 13. Minnesota Statutes 1997 Supplement, section
62J.72, subdivision 1, is amended to read:
Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan
company, as defined under section 62J.70, subdivision 3, a
health care network cooperative as defined under section 62R.04,
subdivision 3, and a health care provider as defined under
section 62J.70, subdivision 2, shall, during open enrollment,
upon enrollment, and annually thereafter, provide enrollees with
a description of the general nature of the reimbursement
methodologies used by the health plan company, health insurer,
or health coverage plan to pay providers. The description must
explain clearly any aspect of the reimbursement methodology that
creates a financial incentive for the health care provider to
limit or restrict the health care provided to enrollees. An
entity required to disclose shall also disclose if no
reimbursement methodology is used that creates a financial
incentive for the health care provider to limit or restrict the
health care provided to enrollees. This description may be
incorporated into the member handbook, subscriber contract,
certificate of coverage, or other written enrollee
communication. The general reimbursement methodology shall be
made available to employers at the time of open enrollment.
(b) Health plan companies, health care network
cooperatives, and providers must, upon request, provide an
enrollee with specific information regarding the reimbursement
methodology, including, but not limited to, the following
information:
(1) a concise written description of the provider payment
plan, including any incentive plan applicable to the enrollee;
(2) a written description of any incentive to the provider
relating to the provision of health care services to enrollees,
including any compensation arrangement that is dependent on the
amount of health coverage or health care services provided to
the enrollee, or the number of referrals to or utilization of
specialists; and
(3) a written description of any incentive plan that
involves the transfer of financial risk to the health care
provider.
(c) The disclosure statement describing the general nature
of the reimbursement methodologies must comply with the
Readability of Insurance Policies Act in chapter 72C.
Notwithstanding any other law to the contrary, the disclosure
statement may voluntarily be filed with the commissioner for
approval and must be filed with and approved by the commissioner
prior to its use.
(d) A disclosure statement that has voluntarily been filed
with the commissioner for approval under chapter 72C or
voluntarily filed with the commissioner for approval for
purposes other than pursuant to chapter 72C paragraph (c) is
deemed approved 30 days after the date of filing, unless
approved or disapproved by the commissioner on or before the end
of that 30-day period.
(e) The disclosure statement describing the general nature
of the reimbursement methodologies must be provided upon request
in English, Spanish, Vietnamese, and Hmong. In addition,
reasonable efforts must be made to provide information contained
in the disclosure statement to other non-English-speaking
enrollees.
(f) Health plan companies and providers may enter into
agreements to determine how to respond to enrollee requests
received by either the provider or the health plan company.
This subdivision does not require disclosure of specific amounts
paid to a provider, provider fee schedules, provider salaries,
or other proprietary information of a specific health plan
company or health insurer or health coverage plan or provider.
Sec. 14. Minnesota Statutes 1997 Supplement, section
62J.75, is amended to read:
62J.75 [CONSUMER ADVISORY BOARD.]
(a) The consumer advisory board consists of 18 members
appointed in accordance with paragraph (b). All members must be
public, consumer members who:
(1) do not have and never had a material interest in either
the provision of health care services or in an activity directly
related to the provision of health care services, such as health
insurance sales or health plan administration;
(2) are not registered lobbyists; and
(3) are not currently responsible for or directly involved
in the purchasing of health insurance for a business or
organization.
(b) The governor, the speaker of the house of
representatives, and the subcommittee on committees of the
committee on rules and administration of the senate shall each
appoint two six members. The Indian affairs council, the
council on affairs of Chicano/Latino people, the council on
Black Minnesotans, the council on Asian-Pacific Minnesotans,
mid-Minnesota legal assistance, and the Minnesota chamber of
commerce shall each appoint one member. The member appointed by
the Minnesota chamber of commerce must represent small business
interests. The health care campaign of Minnesota, Minnesotans
for affordable health care, and consortium for citizens with
disabilities shall each appoint two members. Members serve
without compensation or reimbursement for expenses. Members may
be compensated in accordance with section 15.059, subdivision 3,
except that members shall not receive per diem compensation or
reimbursements for child care expenses.
(c) The board shall advise the commissioners of health and
commerce on the following:
(1) the needs of health care consumers and how to better
serve and educate the consumers on health care concerns and
recommend solutions to identified problems; and
(2) consumer protection issues in the self-insured market,
including, but not limited to, public education needs.
The board also may make recommendations to the legislature
on these issues.
(d) The board and this section expire June 30, 2001.
Sec. 15. [62J.77] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] For purposes of sections
62J.77 to 62J.80, the terms defined in this section have the
meanings given them.
Subd. 2. [ENROLLEE.] "Enrollee" means a natural person
covered by a health plan company, health insurance, or health
coverage plan and includes an insured, policyholder, subscriber,
contract holder, member, covered person, or certificate holder.
Subd. 3. [PATIENT.] "Patient" means a former, current, or
prospective patient of a health care provider.
Subd. 4. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Sec. 16. [62J.78] [ESTABLISHMENT; ORGANIZATION.]
Subdivision 1. [GENERAL.] The commissioner shall establish
within the department of health the office of health care
consumer assistance, advocacy, and information to provide
assistance, advocacy, and information to all health care
consumers within the state. The office shall have no regulatory
power or authority, shall be separated from all regulatory
functions within the department of health, and shall not provide
legal representation in a court of law.
Subd. 2. [EXECUTIVE DIRECTOR.] An executive director shall
be appointed by the commissioner, in consultation with the
consumer advisory board, and shall report directly to the
commissioner. The executive director must be selected without
regard to political affiliation and must be a person who has
knowledge and experience concerning the needs and rights of
health care consumers and must be qualified to analyze questions
of law, administrative functions, and public policy. No person
may serve as executive director while holding another public
office. The director shall serve in the unclassified service.
Subd. 3. [STAFF.] The executive director shall appoint at
least nine consumer advocates to discharge the responsibilities
and duties of the office.
Subd. 4. [TRAINING.] The executive director shall ensure
that the consumer advocates are adequately trained.
Subd. 5. [STATEWIDE ADVOCACY.] The executive director
shall assign a consumer advocate to represent each regional
coordinating board's geographic area.
Subd. 6. [FINANCIAL INTEREST.] The executive director and
staff must not have any direct personal financial interest in
the health care system, except as an individual consumer of
health care services.
Subd. 7. [ADMINISTRATION.] To the extent practical, the
office of health care consumer assistance, advocacy, and
information and all ombudsman offices with health care
responsibilities shall have their telephone systems linked in
order to facilitate immediate referrals.
Sec. 17. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF
HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.]
Subdivision 1. [DUTIES.] (a) The office of health care
consumer assistance, advocacy, and information shall provide
information and assistance to all health care consumers by:
(1) assisting patients and enrollees in understanding and
asserting their contractual and legal rights, including the
rights under an alternative dispute resolution process. This
assistance may include advocacy for enrollees in administrative
proceedings or other formal or informal dispute resolution
processes;
(2) assisting enrollees in obtaining health care referrals
under their health plan company, health insurance, or health
coverage plan;
(3) assisting patients and enrollees in accessing the
services of governmental agencies, regulatory boards, and other
state consumer assistance programs, ombudsman, or advocacy
services whenever appropriate so that the patient or enrollee
can take full advantage of existing mechanisms for resolving
complaints;
(4) referring patients and enrollees to governmental
agencies and regulatory boards for the investigation of health
care complaints and for enforcement action;
(5) educating and training enrollees about their health
plan company, health insurance, or health coverage plan in order
to enable them to assert their rights and to understand their
responsibilities;
(6) assisting enrollees in receiving a timely resolution of
their complaints;
(7) monitoring health care complaints addressed by the
office to identify specific complaint patterns or areas of
potential improvement;
(8) recommending to health plan companies ways to identify
and remove any barriers that might delay or impede the health
plan company's effort to resolve consumer complaints; and
(9) in performing the duties specified in clauses (1) to
(8), taking into consideration the special situations of
patients and enrollees who have unique culturally defined needs.
(b) The executive director shall prioritize the duties
listed in this subdivision within the appropriations allocated.
Subd. 2. [COMMUNICATION.] (a) The executive director shall
meet at least six times per year with the consumer advisory
board. The executive director shall share all public
information obtained by the office of health care consumer
assistance, advocacy, and information with the consumer advisory
board in order to assist the consumer advisory board in its role
of advising the commissioners of health and commerce and the
legislature in accordance with section 62J.75.
(b) The executive director shall have the authority to make
recommendations to the legislature on any issue related to the
needs and interests of health care consumers.
Subd. 3. [REPORTS.] Beginning July 1, 1999, the executive
director, on at least a quarterly basis, shall provide data from
the health care complaints addressed by the office to the
commissioners of health and commerce, the consumer advisory
board, the Minnesota council of health plans, and the Insurance
Federation of Minnesota. Beginning January 15, 2000, the
executive director must make an annual written report to the
legislature regarding activities of the office, including
recommendations on improving health care consumer assistance and
complaint resolution processes.
Subd. 4. [DATA PRIVACY.] (a) Consumer complaint data,
including medical records and other documentation, provided by a
patient or enrollee to the office of health care consumer
assistance, advocacy, and information shall be classified as
private data on individuals under section 13.02, subdivision 12.
(b) Except as provided in paragraph (a), all data collected
or maintained by the office in the course of assisting a patient
or enrollee in resolving a complaint, including data collected
or maintained for the purpose of assistance during a formal or
informal dispute resolution process, shall be classified as
investigative data under section 13.39 except that inactive
investigative data shall be classified as private data on
individuals under section 13.02, subdivision 12.
Sec. 18. [62J.80] [RETALIATION.]
A health plan company or health care provider shall not
retaliate or take adverse action against an enrollee or patient
who, in good faith, makes a complaint against a health plan
company or health care provider. If retaliation is suspected,
the executive director may report it to the appropriate
regulatory authority.
Sec. 19. Minnesota Statutes 1996, section 62Q.095,
subdivision 3, is amended to read:
Subd. 3. [MANDATORY OFFERING TO ENROLLEES.] (a) Each
health plan company shall offer to enrollees the option of
receiving covered services through the expanded network of
allied independent health providers established under
subdivisions 1 and 2. This expanded network option may be
offered as a separate health plan. The network may establish
separate premium rates and cost-sharing requirements for this
expanded network plan, as long as these premium rates and
cost-sharing requirements are actuarially justified and approved
by the commissioner. This subdivision does not apply to
Medicare, medical assistance, general assistance medical care,
and MinnesotaCare. This subdivision is effective January 1,
1995, and applies to health plans issued or renewed, or offers
of health plans to be issued or renewed, on or after January 1,
1995, except that this subdivision is effective January 1, 1996,
for collective bargaining agreements of the department of
employee relations and the University of Minnesota.
(b) Information on this expanded provider network option
must be provided by each health plan company during open
enrollment and upon enrollment.
Sec. 20. Minnesota Statutes 1997 Supplement, section
62Q.105, subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT.] Each health plan company
shall establish and make available to enrollees, by July 1, 1998
1999, an informal complaint resolution process that meets the
requirements of this section. A health plan company must make
reasonable efforts to resolve enrollee complaints, and must
inform complainants in writing of the company's decision within
30 days of receiving the complaint. The complaint resolution
process must treat the complaint and information related to it
as required under sections 72A.49 to 72A.505.
Sec. 21. [62Q.107] [PROHIBITED PROVISION; EFFECT OF DENIAL
OF CLAIM.]
Beginning January 1, 1999, no health plan, including the
coverages described in section 62A.011, subdivision 3, clauses
(7) and (10), may specify a standard of review upon which a
court may review denial of a claim or of any other decision made
by a health plan company with respect to an enrollee. This
section prohibits limiting court review to a determination of
whether the health plan company's decision is arbitrary and
capricious, an abuse of discretion, or any other standard less
favorable to the enrollee than a preponderance of the evidence.
Sec. 22. Minnesota Statutes 1997 Supplement, section
62Q.30, is amended to read:
62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION
PROCESS.]
The commissioner shall establish an expedited fact finding
and dispute resolution process to assist enrollees of health
plan companies with contested treatment, coverage, and service
issues to be in effect July 1, 1998 1999. If the disputed issue
relates to whether a service is appropriate and necessary, the
commissioner shall issue an order only after consulting with
appropriate experts knowledgeable, trained, and practicing in
the area in dispute, reviewing pertinent literature, and
considering the availability of satisfactory alternatives. The
commissioner shall take steps including but not limited to
fining, suspending, or revoking the license of a health plan
company that is the subject of repeated orders by the
commissioner that suggests a pattern of inappropriate
underutilization.
Sec. 23. Minnesota Statutes 1997 Supplement, section
103I.208, subdivision 2, is amended to read:
Subd. 2. [PERMIT FEE.] The permit fee to be paid by a
property owner is:
(1) for a well that is not in use under a maintenance
permit, $100 annually;
(2) for construction of a monitoring well, $120, which
includes the state core function fee;
(3) for a monitoring well that is unsealed under a
maintenance permit, $100 annually;
(4) for monitoring wells used as a leak detection device at
a single motor fuel retail outlet or, a single petroleum bulk
storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee is $120,
which includes the state core function fee, per site regardless
of the number of wells constructed on the site, and the annual
fee for a maintenance permit for unsealed monitoring wells is
$100 per site regardless of the number of monitoring wells
located on site;
(5) for a groundwater thermal exchange device, in addition
to the notification fee for wells, $120, which includes the
state core function fee;
(6) for a vertical heat exchanger, $120;
(7) for a dewatering well that is unsealed under a
maintenance permit, $100 annually for each well, except a
dewatering project comprising more than five wells shall be
issued a single permit for $500 annually for wells recorded on
the permit; and
(8) for excavating holes for the purpose of installing
elevator shafts, $120 for each hole.
Sec. 24. Minnesota Statutes 1997 Supplement, section
123.70, subdivision 10, as amended by Laws 1998, chapter 305,
section 4, is amended to read:
Subd. 10. A statement required to be submitted under
subdivisions 1, 2, and 4 to document evidence of immunization
shall include month, day, and year for immunizations
administered after January 1, 1990.
(a) For persons enrolled in grades 7 and 12 during the
1996-1997 school term, the statement must indicate that the
person has received a dose of tetanus and diphtheria toxoid no
earlier than 11 years of age.
(b) Except as specified in paragraph (e), for persons
enrolled in grades 7, 8, and 12 during the 1997-1998 school
term, the statement must indicate that the person has received a
dose of tetanus and diphtheria toxoid no earlier than 11 years
of age.
(c) Except as specified in paragraph (e), for persons
enrolled in grades 7 through 12 during the 1998-1999 school term
and for each year thereafter, the statement must indicate that
the person has received a dose of tetanus and diphtheria toxoid
no earlier than 11 years of age.
(d) For persons enrolled in grades 7 through 12 during the
1996-1997 school year and for each year thereafter, the
statement must indicate that the person has received at least
two doses of vaccine against measles, mumps, and rubella, given
alone or separately and given not less than one month apart.
(e) A person who has received at least three doses of
tetanus and diphtheria toxoids, with the most recent dose given
after age six and before age 11, is not required to have
additional immunization against diphtheria and tetanus until ten
years have elapsed from the person's most recent dose of tetanus
and diphtheria toxoid.
(f) The requirement for hepatitis B vaccination shall apply
to persons enrolling in kindergarten beginning with the
2000-2001 school term.
(g) The requirement for hepatitis B vaccination shall apply
to persons enrolling in kindergarten through grade 7 beginning
with the 2007-2008 2001-2002 school term.
Sec. 25. Minnesota Statutes 1997 Supplement, section
144.1494, subdivision 1, is amended to read:
Subdivision 1. [CREATION OF ACCOUNT.] A rural physician
education account is established in the health care access
fund. The commissioner shall use money from the account to
establish a loan forgiveness program for medical residents
agreeing to practice in designated rural areas, as defined by
the commissioner. Appropriations made to this account do not
cancel and are available until expended, except that at the end
of each biennium the commissioner shall cancel to the health
care access fund any remaining unobligated balance in this
account.
Sec. 26. [144.6905] [OCCUPATIONAL RESPIRATORY DISEASE
INFORMATION SYSTEM ADVISORY GROUP.]
Subdivision 1. [ADVISORY GROUP.] The commissioner of
health shall convene an occupational respiratory disease
advisory group and shall consult with the group on the
development, implementation, and ongoing operation of an
occupational respiratory disease information system. Membership
in the group shall include representatives of academia,
government, industry, labor, medicine, and consumers from areas
of the state targeted by the information system. From members
of the advisory group, the commissioner shall form a technical
and medical committee to create information system protocols and
a legal and policy committee to address data privacy issues.
The advisory group is governed by section 15.059, except that
members shall not receive per diem compensation.
Subd. 2. [DATA PROVISIONS.] No individually identifying
data shall be collected or entered into the occupational
respiratory disease information system without further action of
the legislature.
Sec. 27. Minnesota Statutes 1996, section 144.701,
subdivision 1, is amended to read:
Subdivision 1. [CONSUMER INFORMATION.] The commissioner of
health shall ensure that the total costs, total
revenues, overall utilization, and total services of each
hospital and each outpatient surgical center are reported to the
public in a form understandable to consumers.
Sec. 28. Minnesota Statutes 1996, section 144.701,
subdivision 2, is amended to read:
Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of
health shall compile relevant financial and accounting,
utilization, and services data concerning hospitals and
outpatient surgical centers in order to have statistical
information available for legislative policy making.
Sec. 29. Minnesota Statutes 1996, section 144.701,
subdivision 4, is amended to read:
Subd. 4. [FILING FEES.] Each report which is required to
be submitted to the commissioner of health under sections
144.695 to 144.703 and which is not submitted to a voluntary,
nonprofit reporting organization in accordance with section
144.702 shall be accompanied by a filing fee in an amount
prescribed by rule of the commissioner of health. Fees received
pursuant to this subdivision shall be deposited in the general
fund of the state treasury. Upon the withdrawal of approval of
a reporting organization, or the decision of the commissioner to
not renew a reporting organization, fees collected under section
144.702 shall be submitted to the commissioner and deposited in
the general fund. Fees received under this subdivision shall be
deposited in a revolving fund and are appropriated to the
commissioner of health for the purposes of sections 144.695 to
144.703. The commissioner shall report the termination or
nonrenewal of the voluntary reporting organization to the chair
of the health and human services subdivision of the
appropriations committee of the house of representatives, to the
chair of the health and human services division of the finance
committee of the senate, and the commissioner of finance.
Sec. 30. Minnesota Statutes 1996, section 144.702,
subdivision 1, is amended to read:
Subdivision 1. [REPORTING THROUGH A REPORTING
ORGANIZATION.] A hospital or outpatient surgical center may
agree to submit its financial, utilization, and services reports
to a voluntary, nonprofit reporting organization whose reporting
procedures have been approved by the commissioner of health in
accordance with this section. Each report submitted to the
voluntary, nonprofit reporting organization under this section
shall be accompanied by a filing fee.
Sec. 31. Minnesota Statutes 1996, section 144.702,
subdivision 2, is amended to read:
Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING
PROCEDURES.] The commissioner of health may approve voluntary
reporting procedures consistent with written operating
requirements for the voluntary, nonprofit reporting organization
which shall be established annually by the commissioner. These
written operating requirements shall specify reports, analyses,
and other deliverables to be produced by the voluntary,
nonprofit reporting organization, and the dates on which those
deliverables must be submitted to the commissioner. These
written operating requirements shall specify deliverable dates
sufficient to enable the commissioner of health to process and
report health care cost information system data to the
commissioner of human services by August 15 of each year. The
commissioner of health shall, by rule, prescribe standards for
submission of data by hospitals and outpatient surgical centers
to the voluntary, nonprofit reporting organization or to the
commissioner. These standards shall provide for:
(a) the filing of appropriate financial, utilization, and
services information with the reporting organization;
(b) adequate analysis and verification of that financial,
utilization, and services information; and
(c) timely publication of the costs, revenues, and rates of
individual hospitals and outpatient surgical centers prior to
the effective date of any proposed rate increase. The
commissioner of health shall annually review the procedures
approved pursuant to this subdivision.
Sec. 32. Minnesota Statutes 1996, section 144.702,
subdivision 8, is amended to read:
Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING
ORGANIZATION.] The commissioner may withdraw approval of any
voluntary, nonprofit reporting organization for failure on the
part of the voluntary, nonprofit reporting organization to
comply with the written operating requirements under subdivision
2. Upon the effective date of the withdrawal, all funds
collected by the voluntary, nonprofit reporting organization
under section 144.701, subdivision 4 1, but not expended shall
be deposited in the general fund a revolving fund and are
appropriated to the commissioner of health for the purposes of
sections 144.695 to 144.703.
The commissioner may choose not to renew approval of a
voluntary, nonprofit reporting organization if the organization
has failed to perform its obligations satisfactorily under the
written operating requirements under subdivision 2.
Sec. 33. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR
REPORTING ORGANIZATIONS.]
Subdivision 1. [AUTHORIZATION.] The commissioner may issue
an order to the voluntary, nonprofit reporting organization
requiring violations to be corrected and administratively assess
monetary penalties for violations of sections 144.695 to 144.703
or rules, written operating requirements, orders, stipulation
agreements, settlements, or compliance agreements adopted,
enforced, or issued by the commissioner.
Subd. 2. [CONTENTS OF ORDER.] An order assessing an
administrative penalty under this section must include:
(1) a concise statement of the facts alleged to constitute
a violation;
(2) a reference to the section of law, rule, written
operating requirement, order, stipulation agreement, settlement,
or compliance agreement that has been violated;
(3) a statement of the amount of the administrative penalty
to be imposed and the factors upon which the penalty is based;
(4) a statement of the corrective actions necessary to
correct the violation; and
(5) a statement of the right to request a hearing according
to sections 14.57 to 14.62.
Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner
may issue an order assessing an administrative penalty and
requiring the violations cited in the order be corrected within
30 calendar days from the date the order is received. Before
the 31st day after the order was received, the voluntary,
nonprofit reporting organization that is subject to the order
shall provide the commissioner with information demonstrating
that the violation has been corrected or that a corrective plan
acceptable to the commissioner has been developed. The
commissioner shall determine whether the violation has been
corrected and notify the voluntary, nonprofit reporting
organization of the commissioner's determination.
Subd. 4. [PENALTY.] If the commissioner determines that
the violation has been corrected or an acceptable corrective
plan has been developed, the penalty may be forgiven, except
where there are repeated or serious violations, the commissioner
may issue an order with a penalty that will not be forgiven
after corrective action is taken. Unless there is a request for
review of the order under subdivision 6 before the penalty is
due, the penalty is due and payable:
(1) on the 31st calendar day after the order was received,
if the voluntary, nonprofit reporting organization fails to
provide information to the commissioner showing that the
violation has been corrected or that appropriate steps have been
taken toward correcting the violation;
(2) on the 20th day after the voluntary, nonprofit
reporting organization receives the commissioner's determination
that the information provided is not sufficient to show that
either the violation has been corrected or that appropriate
steps have been taken toward correcting the violation; or
(3) on the 31st day after the order was received where the
penalty is for repeated or serious violations and according to
the order issued, the penalty will not be forgiven after
corrective action is taken.
All penalties due under this section are payable to the
treasurer, state of Minnesota, and shall be deposited in the
general fund.
Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The
maximum amount of an administrative penalty order is $5,000 for
each specific violation identified in an inspection,
investigation, or compliance review, up to an annual maximum
total for all violations of ten percent of the fees collected by
the voluntary, nonprofit reporting organization under section
144.702, subdivision 1. The annual maximum is based on a
reporting year.
(b) In determining the amount of the administrative
penalty, the commissioner shall consider the following:
(1) the willfulness of the violation;
(2) the gravity of the violation;
(3) the history of past violations;
(4) the number of violations;
(5) the economic benefit gained by the person allowing or
committing the violation; and
(6) other factors as justice may require, if the
commissioner specifically identifies the additional factors in
the commissioner's order.
(c) In determining the amount of a penalty for a violation
subsequent to an initial violation under paragraph (a), the
commissioner shall also consider:
(1) the similarity of the most recent previous violation
and the violation to be penalized;
(2) the time elapsed since the last violation; and
(3) the response of the voluntary, nonprofit reporting
organization to the most recent previous violation.
Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL
ORDER.] A request for hearing must be in writing, delivered to
the commissioner by certified mail within 20 calendar days after
the receipt of the order, and specifically state the reasons for
seeking review of the order. The commissioner must initiate a
hearing within 30 calendar days from the date of receipt of the
written request for hearing. The hearing shall be conducted
pursuant to the contested case procedures in sections 14.57 to
14.62. No earlier than ten calendar days after and within 30
calendar days of receipt of the presiding administrative law
judge's report, the commissioner shall, based on all relevant
facts, issue a final order modifying, vacating, or making the
original order permanent. If, within 20 calendar days of
receipt of the original order, the voluntary, nonprofit
reporting organization fails to request a hearing in writing,
the order becomes the final order of the commissioner.
Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF
PENALTY.] Once the commissioner issues a final order, any
penalty due under that order shall be paid within 30 calendar
days after the date of the final order, unless review of the
final order is requested. The final order of the commissioner
may be appealed in the manner prescribed in sections 14.63 to
14.69. If the final order is reviewed and upheld, the penalty
shall be paid 30 calendar days after the date of the decision of
the reviewing court. Failure to request an administrative
hearing pursuant to subdivision 6 shall constitute a waiver of
the right to further agency or judicial review of the final
order.
Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If,
upon reinspection, or in the determination of the commissioner,
it is found that any deficiency specified in the order has not
been corrected or an acceptable corrective plan has not been
developed, the voluntary, nonprofit reporting organization is in
noncompliance. The commissioner shall issue a notice of
noncompliance and may impose any additional remedy available
under this chapter.
Subd. 9. [ENFORCEMENT.] The attorney general may proceed
on behalf of the commissioner to enforce penalties that are due
and payable under this section in any manner provided by law for
the collection of debts.
Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING
ORGANIZATION.] The commissioner may withdraw or not renew
approval of any voluntary, nonprofit reporting organization for
failure on the part of the voluntary, nonprofit reporting
organization to pay penalties owed under this section.
Subd. 11. [CUMULATIVE REMEDY.] The authority of the
commissioner to issue an administrative penalty order is in
addition to other lawfully available remedies.
Subd. 12. [MEDIATION.] In addition to review under
subdivision 6, the commissioner is authorized to enter into
mediation concerning an order issued under this section if the
commissioner and the voluntary, nonprofit reporting organization
agree to mediation.
Sec. 34. Minnesota Statutes 1996, section 144.9501,
subdivision 1, is amended to read:
Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509
may be cited as the "childhood Lead Poisoning Prevention Act."
Sec. 35. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 4a. [ASSESSING AGENCY.] "Assessing agency" means the
commissioner or a board of health with authority and
responsibility to conduct lead risk assessments in response to
reports of children or pregnant women with elevated blood lead
levels.
Sec. 36. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 6b. [CLEARANCE INSPECTION.] "Clearance inspection"
means a visual identification of deteriorated paint and bare
soil and a resampling and analysis of interior dust lead
concentrations in a residence to ensure that the lead standards
established in rules adopted under section 144.9508 are not
exceeded.
Sec. 37. Minnesota Statutes 1996, section 144.9501,
subdivision 17, is amended to read:
Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard reduction"
means action undertaken in response to a lead order to make a
residence, child care facility, school, or playground lead-safe
by complying with the lead standards and methods adopted under
section 144.9508, by:
(1) a property owner or lead contractor complying persons
hired by the property owner to comply with a lead order issued
under section 144.9504; or
(2) a swab team service provided in response to a lead
order issued under section 144.9504; or
(3) a renter residing at a rental property or one or more
volunteers to comply with a lead order issued under section
144.9504.
Sec. 38. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 17a. [LEAD HAZARD SCREEN.] "Lead hazard screen"
means visual identification of the existence and location of any
deteriorated paint, collection and analysis of dust samples, and
visual identification of the existence and location of bare soil.
Sec. 39. Minnesota Statutes 1996, section 144.9501,
subdivision 18, is amended to read:
Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a
qualitative or quantitative analytical inspection of a residence
for deteriorated paint or bare soil and the collection of
samples of deteriorated paint, bare soil, dust, or drinking
water for analysis to determine if the lead concentrations in
the samples exceed standards adopted under section 144.9508.
Lead inspection includes the clearance inspection after the
completion of a lead order measurement of the lead content of
paint and a visual identification of the existence and location
of bare soil.
Sec. 40. Minnesota Statutes 1996, section 144.9501,
subdivision 20, is amended to read:
Subd. 20. [LEAD ORDER.] "Lead order" means a legal
instrument to compel a property owner to engage in lead hazard
reduction according to the specifications given by the
inspecting assessing agency.
Sec. 41. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20a. [LEAD PROJECT DESIGNER.] "Lead project designer"
means an individual who is responsible for planning the
site-specific performance of lead abatement or lead hazard
reduction and who has been licensed by the commissioner under
section 144.9505.
Sec. 42. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20b. [LEAD RISK ASSESSMENT.] "Lead risk assessment"
means a quantitative measurement of the lead content of paint,
interior dust, and bare soil to determine compliance with the
standards established under section 144.9508.
Sec. 43. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20c. [LEAD RISK ASSESSOR.] "Lead risk assessor"
means an individual who performs lead risk assessments or lead
inspections and who has been licensed by the commissioner under
section 144.9506.
Sec. 44. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 22a. [LEAD SUPERVISOR.] "Lead supervisor" means an
individual who is responsible for the on-site performance of
lead abatement or lead hazard reduction and who has been
licensed by the commissioner under section 144.9505.
Sec. 45. Minnesota Statutes 1996, section 144.9501,
subdivision 23, is amended to read:
Subd. 23. [LEAD WORKER.] "Lead worker" means any person
who is certified an individual who performs lead abatement or
lead hazard reduction and who has been licensed by the
commissioner under section 144.9505.
Sec. 46. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 25a. [PLAY AREA.] "Play area" means any established
area where children play, or on residential property, any
established area where children play or bare soil is accessible
to children.
Sec. 47. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 28a. [STANDARD.] "Standard" means a quantitative
assessment of lead in any environmental media or consumer
product, or a work practice or method that reduces the
likelihood of lead exposure.
Sec. 48. Minnesota Statutes 1996, section 144.9501,
subdivision 30, is amended to read:
Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" means a
person who is certified an individual who performs swab team
services and who has been licensed by the commissioner as a lead
worker under section 144.9505.
Sec. 49. Minnesota Statutes 1996, section 144.9501,
subdivision 32, is amended to read:
Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary
lead hazard reduction" means action undertaken by a property
owner with the intention to engage in lead hazard reduction or
abatement lead hazard reduction activities defined in
subdivision 17, but not undertaken in response to the issuance
of a lead order.
Sec. 50. Minnesota Statutes 1996, section 144.9502,
subdivision 3, is amended to read:
Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a)
Every hospital, medical clinic, medical laboratory, or other
facility, or individual performing blood lead analysis shall
report the results after the analysis of each specimen analyzed,
for both capillary and venous specimens, and epidemiologic
information required in this section to the commissioner of
health, within the time frames set forth in clauses (1) and (2):
(1) within two working days by telephone, fax, or
electronic transmission, with written or electronic confirmation
within one month, for a venous blood lead level equal to or
greater than 15 micrograms of lead per deciliter of whole blood;
or
(2) within one month in writing or by electronic
transmission, for a any capillary result or for a venous blood
lead level less than 15 micrograms of lead per deciliter of
whole blood.
(b) If a blood lead analysis is performed outside of
Minnesota and the facility performing the analysis does not
report the blood lead analysis results and epidemiological
information required in this section to the commissioner, the
provider who collected the blood specimen must satisfy the
reporting requirements of this section. For purposes of this
section, "provider" has the meaning given in section 62D.02,
subdivision 9.
(c) The commissioner shall coordinate with hospitals,
medical clinics, medical laboratories, and other facilities
performing blood lead analysis to develop a universal reporting
form and mechanism.
The reporting requirements of this subdivision shall expire
on December 31, 1997. Beginning January 1, 1998, every
hospital, medical clinic, medical laboratory, or other facility
performing blood lead analysis shall report the results within
two working days by telephone, fax, or electronic transmission,
with written or electronic confirmation within one month, for
capillary or venous blood lead level equal to the level for
which reporting is recommended by the Center for Disease Control.
Sec. 51. Minnesota Statutes 1996, section 144.9502,
subdivision 4, is amended to read:
Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC
INFORMATION.] The blood lead analysis reports required in this
section must specify:
(1) whether the specimen was collected as a capillary or
venous sample;
(2) the date the sample was collected;
(3) the results of the blood lead analysis;
(4) the date the sample was analyzed;
(5) the method of analysis used;
(6) the full name, address, and phone number of the
laboratory performing the analysis;
(7) the full name, address, and phone number of the
physician or facility requesting the analysis;
(8) the full name, address, and phone number of the person
with the elevated blood lead level, and the person's birthdate,
gender, and race.
Sec. 52. Minnesota Statutes 1996, section 144.9502,
subdivision 9, is amended to read:
Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any law
to the contrary, including section 13.05, subdivision 9, data
collected by the commissioner of health about persons with
elevated blood lead levels, including analytic results from
samples of paint, soil, dust, and drinking water taken from the
individual's home and immediate property, shall be private and
may only be used by the commissioner of health, the commissioner
of labor and industry, authorized agents of Indian tribes, and
authorized employees of local boards of health for the purposes
set forth in this section.
Sec. 53. Minnesota Statutes 1996, section 144.9503,
subdivision 4, is amended to read:
Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must
include the use of swab team services in census tracts
identified at high risk for toxic lead exposure as identified by
the commissioner under this section. The swab team services may
be provided based on visual inspections lead hazard screens
whenever possible and must at least include lead
hazard management reduction for deteriorated interior lead-based
paint, bare soil, and dust.
Sec. 54. Minnesota Statutes 1996, section 144.9503,
subdivision 6, is amended to read:
Subd. 6. [VOLUNTARY LEAD ABATEMENT OR LEAD HAZARD
REDUCTION.] The commissioner shall monitor the lead abatement or
lead hazard reduction methods adopted under section 144.9508 in
cases of voluntary lead abatement or lead hazard reduction. All
contractors persons hired to do voluntary lead abatement or lead
hazard reduction must be licensed lead contractors by the
commissioner under section 144.9505 or 144.9506. Renters and
volunteers performing lead abatement or lead hazard reduction
must be trained and licensed as lead supervisors or lead
workers. If a property owner does not use a lead contractor
hire a person for voluntary lead abatement or lead hazard
reduction, the property owner shall provide the commissioner
with a work plan for lead abatement or lead hazard reduction at
least ten working days before beginning the lead abatement or
lead hazard reduction. The work plan must include the details
required in section 144.9505, and notice as to when
lead abatement or lead hazard reduction activities will begin.
Within the limits of appropriations, the commissioner shall
review work plans and shall approve or disapprove them as to
compliance with the requirements in section 144.9505. No
penalty shall be assessed against a property owner for
discontinuing voluntary lead hazard reduction before completion
of the work plan, provided that the property owner discontinues
the plan lead hazard reduction in a manner that leaves the
property in a condition no more hazardous than its condition
before the work plan implementation.
Sec. 55. Minnesota Statutes 1996, section 144.9503,
subdivision 7, is amended to read:
Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July
1, 1995, and amended and updated as necessary, the commissioner
shall develop in cooperation with the commissioner of
administration provisions and procedures to define
lead-safe informational directives for residential remodeling,
renovation, installation, and rehabilitation activities that are
not lead hazard reduction, but may disrupt lead-based paint
surfaces.
(b) The provisions and procedures shall define lead-safe
directives for nonlead hazard reduction activities including
preparation, cleanup, and disposal procedures. The directives
shall be based on the different levels and types of work
involved and the potential for lead hazards. The directives
shall address activities including painting; remodeling;
weatherization; installation of cable, wire, plumbing, and gas;
and replacement of doors and windows. The commissioners of
health and administration shall consult with representatives of
builders, weatherization providers, nonprofit rehabilitation
organizations, each of the affected trades, and housing and
redevelopment authorities in developing the directives and
procedures. This group shall also make recommendations for
consumer and contractor education and training. The
commissioner of health shall report to the legislature by
February 15, 1996, regarding development of the provisions
required under this subdivision paragraph.
(c) By January 1, 1999, the commissioner, in cooperation
with interested and informed persons and using the meeting
structure and format developed in paragraph (b), shall develop
lead-safe informational directives on the following topics:
(1) maintaining floors, walls, and ceilings;
(2) maintaining and repairing porches;
(3) conducting a risk evaluation for lead; and
(4) prohibited practices when working with lead.
The commissioner shall report to the legislature by January 1,
1999, regarding development of the provisions required under
this paragraph.
Sec. 56. Minnesota Statutes 1996, section 144.9504,
subdivision 1, is amended to read:
Subdivision 1. [JURISDICTION.] (a) A board of health
serving cities of the first class must conduct lead inspections
risk assessments for purposes of secondary prevention, according
to the provisions of this section. A board of health not
serving cities of the first class must conduct lead inspections
risk assessments for the purposes of secondary prevention,
unless they certify certified in writing to the commissioner by
January 1, 1996, that they desire desired to relinquish these
duties back to the commissioner. At the discretion of the
commissioner, a board of health may relinquish the authority and
duty to perform lead risk assessments for secondary prevention
by so certifying in writing to the commissioner by December 31,
1999. At the discretion of the commissioner, a board of health
may, upon written request to the commissioner, resume these
duties.
(b) Inspections Lead risk assessments must be conducted by
a board of health serving a city of the first class. The
commissioner must conduct lead inspections risk assessments in
any area not including cities of the first class where a board
of health has relinquished to the commissioner the
responsibility for lead inspections risk assessments. The
commissioner shall coordinate with the board of health to ensure
that the requirements of this section are met.
(c) The commissioner may assist boards of health by
providing technical expertise, equipment, and personnel to
boards of health. The commissioner may provide laboratory or
field lead-testing equipment to a board of health or may
reimburse a board of health for direct costs associated with
lead inspections risk assessments.
(d) The commissioner shall enforce the rules under section
144.9508 in cases of voluntary lead hazard reduction.
Sec. 57. Minnesota Statutes 1997 Supplement, section
144.9504, subdivision 2, is amended to read:
Subd. 2. [LEAD INSPECTION RISK ASSESSMENT.] (a)
An inspecting assessing agency shall conduct a lead inspection
risk assessment of a residence according to the venous blood
lead level and time frame set forth in clauses (1) to (5) for
purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than 70 micrograms of lead
per deciliter of whole blood;
(2) within five working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 45 micrograms
of lead per deciliter of whole blood;
(3) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead
level equal to or greater than 20 micrograms of lead per
deciliter of whole blood;
(4) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead
level that persists in the range of 15 to 19 micrograms of lead
per deciliter of whole blood for 90 days after initial
identification; or
(5) within ten working days of a pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than ten micrograms of lead
per deciliter of whole blood.
(b) Within the limits of available state and federal
appropriations, an inspecting assessing agency may also conduct
a lead inspection risk assessment for children with any elevated
blood lead level.
(c) In a building with two or more dwelling units, an
inspecting assessing agency shall inspect the individual unit in
which the conditions of this section are met and shall also
inspect all common areas. If a child visits one or more other
sites such as another residence, or a residential or commercial
child care facility, playground, or school, the inspecting
assessing agency shall also inspect the other sites.
The inspecting assessing agency shall have one additional day
added to the time frame set forth in this subdivision to
complete the lead inspection risk assessment for each additional
site.
(d) Within the limits of appropriations, the inspecting
assessing agency shall identify the known addresses for the
previous 12 months of the child or pregnant female with venous
blood lead levels of at least 20 micrograms per deciliter for
the child or at least ten micrograms per deciliter for the
pregnant female; notify the property owners, landlords, and
tenants at those addresses that an elevated blood lead level was
found in a person who resided at the property; and give them a
copy of the lead inspection risk assessment guide. The
inspecting assessing agency shall provide the notice required by
this subdivision without identifying the child or pregnant
female with the elevated blood lead level. The inspecting
assessing agency is not required to obtain the consent of the
child's parent or guardian or the consent of the pregnant female
for purposes of this subdivision. This information shall be
classified as private data on individuals as defined under
section 13.02, subdivision 12.
(e) The inspecting assessing agency shall conduct the lead
inspection risk assessment according to rules adopted by the
commissioner under section 144.9508. An inspecting assessing
agency shall have lead inspections risk assessments performed by
lead inspectors risk assessors licensed by the commissioner
according to rules adopted under section 144.9508. If a
property owner refuses to allow an inspection a lead risk
assessment, the inspecting assessing agency shall begin legal
proceedings to gain entry to the property and the time frame for
conducting a lead inspection risk assessment set forth in this
subdivision no longer applies. An inspector A lead risk
assessor or inspecting assessing agency may observe the
performance of lead hazard reduction in progress and shall
enforce the provisions of this section under section 144.9509.
Deteriorated painted surfaces, bare soil, and dust, and drinking
water must be tested with appropriate analytical equipment to
determine the lead content, except that deteriorated painted
surfaces or bare soil need not be tested if the property owner
agrees to engage in lead hazard reduction on those
surfaces. The lead content of drinking water must be measured
if a probable source of lead exposure is not identified by
measurement of lead in paint, bare soil, or dust. Within a
standard metropolitan statistical area, an assessing agency may
order lead hazard reduction of bare soil without measuring the
lead content of the bare soil if the property is in a census
tract in which soil sampling has been performed according to
rules established by the commissioner and at least 25 percent of
the soil samples contain lead concentrations above the standard
in section 144.9508.
(f) A lead inspector risk assessor shall notify the
commissioner and the board of health of all violations of lead
standards under section 144.9508, that are identified in a
lead inspection risk assessment conducted under this section.
(g) Each inspecting assessing agency shall establish an
administrative appeal procedure which allows a property owner to
contest the nature and conditions of any lead order issued by
the inspecting assessing agency. Inspecting Assessing agencies
must consider appeals that propose lower cost methods that make
the residence lead safe.
(h) Sections 144.9501 to 144.9509 neither authorize nor
prohibit an inspecting assessing agency from charging a property
owner for the cost of a lead inspection risk assessment.
Sec. 58. Minnesota Statutes 1996, section 144.9504,
subdivision 3, is amended to read:
Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a
lead inspection risk assessment or following a lead order, the
inspecting assessing agency shall ensure that a family will
receive a visit at their residence by a swab team worker or
public health professional, such as a nurse, sanitarian, public
health educator, or other public health professional. The swab
team worker or public health professional shall inform the
property owner, landlord, and the tenant of the health-related
aspects of lead exposure; nutrition; safety measures to minimize
exposure; methods to be followed before, during, and after the
lead hazard reduction process; and community, legal, and housing
resources. If a family moves to a temporary residence during
the lead hazard reduction process, lead education services
should be provided at the temporary residence whenever feasible.
Sec. 59. Minnesota Statutes 1996, section 144.9504,
subdivision 4, is amended to read:
Subd. 4. [LEAD INSPECTION RISK ASSESSMENT GUIDES.] (a) The
commissioner of health shall develop or purchase lead inspection
risk assessment guides that enable parents and other caregivers
to assess the possible lead sources present and that suggest
lead hazard reduction actions. The guide must provide
information on lead hazard reduction and disposal methods,
sources of equipment, and telephone numbers for additional
information to enable the persons to either select a lead
contractor persons licensed by the commissioner under section
144.9505 or 144.9506 to perform lead hazard reduction or perform
the lead hazard reduction themselves. The guides must explain:
(1) the requirements of this section and rules adopted
under section 144.9508;
(2) information on the administrative appeal procedures
required under this section;
(3) summary information on lead-safe directives;
(4) be understandable at an eighth grade reading level; and
(5) be translated for use by non-English-speaking persons.
(b) An inspecting assessing agency shall provide the lead
inspection risk assessment guides at no cost to:
(1) parents and other caregivers of children who are
identified as having blood lead levels of at least ten
micrograms of lead per deciliter of whole blood;
(2) all property owners who are issued housing code or lead
orders requiring lead hazard reduction of lead sources and all
occupants of those properties; and
(3) occupants of residences adjacent to the inspected
property.
(c) An inspecting assessing agency shall provide the lead
inspection risk assessment guides on request to owners or
occupants of residential property, builders, contractors,
inspectors, and the public within the jurisdiction of
the inspecting assessing agency.
Sec. 60. Minnesota Statutes 1996, section 144.9504,
subdivision 5, is amended to read:
Subd. 5. [LEAD ORDERS.] An inspecting assessing agency,
after conducting a lead inspection risk assessment, shall order
a property owner to perform lead hazard reduction on all lead
sources that exceed a standard adopted according to section
144.9508. If lead inspections risk assessments and lead orders
are conducted at times when weather or soil conditions do not
permit the lead inspection risk assessment or lead hazard
reduction, external surfaces and soil lead shall be inspected,
and lead orders complied with, if necessary, at the first
opportunity that weather and soil conditions allow. If the
paint standard under section 144.9508 is violated, but the paint
is intact, the inspecting assessing agency shall not order the
paint to be removed unless the intact paint is a known source of
actual lead exposure to a specific person. Before the
inspecting assessing agency may order the intact paint to be
removed, a reasonable effort must be made to protect the child
and preserve the intact paint by the use of guards or other
protective devices and methods. Whenever windows and doors or
other components covered with deteriorated lead-based paint have
sound substrate or are not rotting, those components should be
repaired, sent out for stripping or be planed down to remove
deteriorated lead-based paint or covered with protective guards
instead of being replaced, provided that such an activity is the
least cost method. However, a property owner who has been
ordered to perform lead hazard reduction may choose any method
to address deteriorated lead-based paint on windows, doors, or
other components, provided that the method is approved in rules
adopted under section 144.9508 and that it is appropriate to the
specific property. Lead orders must require that any source of
damage, such as leaking roofs, plumbing, and windows, be
repaired or replaced, as needed, to prevent damage to
lead-containing interior surfaces. The inspecting assessing
agency is not required to pay for lead hazard reduction. Lead
orders must be issued within 30 days of receiving the blood lead
level analysis. The inspecting assessing agency shall enforce
the lead orders issued to a property owner under this section.
A copy of the lead order must be forwarded to the commissioner.
Sec. 61. Minnesota Statutes 1996, section 144.9504,
subdivision 6, is amended to read:
Subd. 6. [SWAB TEAM SERVICES.] After a lead inspection
risk assessment or after issuing lead orders, the inspecting
assessing agency, within the limits of appropriations and
availability, shall offer the property owner the services of a
swab team free of charge and, if accepted, shall send a swab
team within ten working days to the residence to perform swab
team services as defined in section 144.9501. If the inspecting
assessing agency provides swab team services after a
lead inspection risk assessment, but before the issuance of a
lead order, swab team services do not need to be repeated after
the issuance of the lead order if the swab team services
fulfilled the lead order. Swab team services are not considered
completed until the clearance inspection required under this
section shows that the property is lead safe.
Sec. 62. Minnesota Statutes 1996, section 144.9504,
subdivision 7, is amended to read:
Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits
of appropriations, the inspecting assessing agency shall ensure
that residents are relocated from rooms or dwellings during a
lead hazard reduction process that generates leaded dust, such
as removal or disruption of lead-based paint or plaster that
contains lead. Residents shall not remain in rooms or dwellings
where the lead hazard reduction process is occurring. An
inspecting assessing agency is not required to pay for
relocation unless state or federal funding is available for this
purpose. The inspecting assessing agency shall make an effort
to assist the resident in locating resources that will provide
assistance with relocation costs. Residents shall be allowed to
return to the residence or dwelling after completion of the lead
hazard reduction process. An inspecting assessing agency shall
use grant funds under section 144.9507 if available, in
cooperation with local housing agencies, to pay for moving costs
and rent for a temporary residence for any low-income resident
temporarily relocated during lead hazard reduction. For
purposes of this section, "low-income resident" means any
resident whose gross household income is at or below 185 percent
of federal poverty level.
(b) A resident of rental property who is notified by an
inspecting assessing agency to vacate the premises during lead
hazard reduction, notwithstanding any rental agreement or lease
provisions:
(1) shall not be required to pay rent due the landlord for
the period of time the tenant vacates the premises due to lead
hazard reduction;
(2) may elect to immediately terminate the tenancy
effective on the date the tenant vacates the premises due to
lead hazard reduction; and
(3) shall not, if the tenancy is terminated, be liable for
any further rent or other charges due under the terms of the
tenancy.
(c) A landlord of rental property whose tenants vacate the
premises during lead hazard reduction shall:
(1) allow a tenant to return to the dwelling unit after
lead hazard reduction and clearance inspection, required under
this section, is completed, unless the tenant has elected to
terminate the tenancy as provided for in paragraph (b); and
(2) return any security deposit due under section 504.20
within five days of the date the tenant vacates the unit, to any
tenant who terminates tenancy as provided for in paragraph (b).
Sec. 63. Minnesota Statutes 1996, section 144.9504,
subdivision 8, is amended to read:
Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners
shall comply with lead orders issued under this section within
60 days or be subject to enforcement actions as provided under
section 144.9509. For orders or portions of orders concerning
external lead hazards, property owners shall comply within 60
days, or as soon thereafter as weather permits. If the property
owner does not use a lead contractor hire a person licensed by
the commissioner under section 144.9505 for compliance with the
lead orders, the property owner shall submit a work plan to
the inspecting assessing agency within 30 days after receiving
the orders. The work plan must include the details required in
section 144.9505 as to how the property owner intends to comply
with the lead orders and notice as to when lead hazard reduction
activities will begin. Within the limits of appropriations, the
commissioner shall review plans and shall approve or disapprove
them as to compliance with the requirements in section 144.9505,
subdivision 5. Renters and volunteers performing lead abatement
or lead hazard reduction must be trained and licensed as lead
supervisors or lead workers under section 144.9505.
Sec. 64. Minnesota Statutes 1996, section 144.9504,
subdivision 9, is amended to read:
Subd. 9. [CLEARANCE INSPECTION.] After completion of swab
team services and compliance with the lead orders by the
property owner, including any repairs ordered by a local housing
or building inspector, the inspecting assessing agency shall
conduct a clearance inspection by visually inspecting the
residence for visual identification of deteriorated paint and
bare soil and retest the dust lead concentration in the
residence to assure that violations of the lead standards under
section 144.9508 no longer exist. The inspecting assessing
agency is not required to test a dwelling unit after lead hazard
reduction that was not ordered by the inspecting assessing
agency.
Sec. 65. Minnesota Statutes 1996, section 144.9504,
subdivision 10, is amended to read:
Subd. 10. [CASE CLOSURE.] A lead inspection risk
assessment is completed and the responsibility of the inspecting
assessing agency ends when all of the following conditions are
met:
(1) lead orders are written on all known sources of
violations of lead standards under section 144.9508;
(2) compliance with all lead orders has been completed; and
(3) clearance inspections demonstrate that no deteriorated
lead paint, bare soil, or lead dust levels exist that exceed the
standards adopted under section 144.9508.
Sec. 66. Minnesota Statutes 1996, section 144.9505,
subdivision 1, is amended to read:
Subdivision 1. [LICENSING AND CERTIFICATION.] (a) Lead
contractors A person shall, before performing abatement or lead
hazard reduction or providing planning services for lead
abatement or lead hazard reduction, obtain a license from the
commissioner as a lead supervisor, lead worker, or lead project
designer. Workers for lead contractors shall obtain
certification from the commissioner. The commissioner shall
specify training and testing requirements for licensure and
certification as required in section 144.9508 and shall charge a
fee for the cost of issuing a license or certificate and for
training provided by the commissioner. Fees collected under
this section shall be set in amounts to be determined by the
commissioner to cover but not exceed the costs of adopting rules
under section 144.9508, the costs of licensure, certification,
and training, and the costs of enforcing licenses and
certificates under this section. License fees shall be
nonrefundable and must be submitted with each application in the
amount of $50 for each lead supervisor, lead worker, or lead
inspector and $100 for each lead project designer, lead risk
assessor, or certified firm. All fees received shall be paid
into the state treasury and credited to the lead abatement
licensing and certification account and are appropriated to the
commissioner to cover costs incurred under this section and
section 144.9508.
(b) Contractors Persons shall not advertise or otherwise
present themselves as lead contractors supervisors, lead
workers, or lead project designers unless they have lead
contractor licenses issued by the department of health
commissioner under section 144.9505.
Sec. 67. Minnesota Statutes 1996, section 144.9505,
subdivision 4, is amended to read:
Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD
REDUCTION WORK.] (a) At least five working days before starting
work at each lead abatement or lead hazard reduction worksite,
the person performing the lead abatement or lead hazard
reduction work shall give written notice and an approved work
plan as required in this section to the commissioner and the
appropriate board of health. Within the limits of
appropriations, the commissioner shall review plans and shall
approve or disapprove them as to compliance with the
requirements in subdivision 5.
(b) This provision does not apply to swab team workers
performing work under an order of an inspecting assessing agency.
Sec. 68. Minnesota Statutes 1996, section 144.9505,
subdivision 5, is amended to read:
Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.]
(a) A lead contractor person who performs lead abatement or lead
hazard reduction shall present a lead abatement or lead hazard
reduction work plan to the property owner with each bid or
estimate for lead abatement or lead hazard reduction work.
The work plan does not replace or supersede more stringent
contractual agreements. A written lead abatement or lead hazard
reduction work plan must be prepared which describes the
equipment and procedures to be used throughout the lead
abatement or lead hazard reduction work project. At a minimum,
the work plan must describe:
(1) the building area and building components to be worked
on;
(2) the amount of lead-containing material to be removed,
encapsulated, or enclosed;
(3) the schedule to be followed for each work stage;
(4) the workers' personal protection equipment and
clothing;
(5) the dust suppression and debris containment methods;
(6) the lead abatement or lead hazard reduction methods to
be used on each building component;
(7) cleaning methods;
(8) temporary, on-site waste storage, if any; and
(9) the methods for transporting waste material and its
destination.
(b) A lead contractor The work plan shall itemize the costs
for each item listed in paragraph (a) and for any other expenses
associated with the lead abatement or lead hazard reduction work
and shall present these costs be presented to the property owner
with any bid or estimate for lead abatement or lead hazard
reduction work.
(c) A lead contractor The person performing the lead
abatement or lead hazard reduction shall keep a copy of the work
plan readily available at the worksite for the duration of the
project and present it to the inspecting assessing agency on
demand.
(d) A lead contractor The person performing the lead
abatement or lead hazard reduction shall keep a copy of the work
plan on record for one year after completion of the project and
shall present it to the inspecting assessing agency on demand.
(e) This provision does not apply to swab team workers
performing work under an order of an inspecting assessing agency
or providing services at no cost to a property owner with
funding under a state or federal grant.
Sec. 69. Minnesota Statutes 1997 Supplement, section
144.9506, subdivision 1, is amended to read:
Subdivision 1. [LICENSE REQUIRED.] (a) A lead
inspector person shall obtain a license as a lead inspector or a
lead risk assessor before performing lead inspections, lead
hazard screens, or lead risk assessments and shall renew
it annually as required in rules adopted under section 144.9508.
The commissioner shall charge a fee and require annual refresher
training, as specified in this section. A lead inspector or
lead risk assessor shall have the lead inspector's license or
lead risk assessor's license readily available at all times
at an a lead inspection site or lead risk assessment site and
make it available, on request, for inspection examination by the
inspecting assessing agency with jurisdiction over the site. A
license shall not be transferred. License fees shall be
nonrefundable and must be submitted with each application in the
amount of $50 for each lead inspector and $100 for each lead
risk assessor.
(b) Individuals shall not advertise or otherwise present
themselves as lead inspectors or lead risk assessors unless
licensed by the commissioner.
(c) An individual may use sodium rhodizonate to test paint
for the presence of lead without obtaining a lead inspector or
lead risk assessor license, but must not represent the test as a
lead inspection or lead risk assessment.
Sec. 70. Minnesota Statutes 1996, section 144.9506,
subdivision 2, is amended to read:
Subd. 2. [LICENSE APPLICATION.] An application for a
license or license renewal shall be on a form provided by the
commissioner and shall include:
(1) a $50 nonrefundable fee, in a form approved by the
commissioner; and
(2) evidence that the applicant has successfully completed
a lead inspector training course approved under this section or
from another state with which the commissioner has established
reciprocity. The fee required in this section is waived for
federal, state, or local government employees within Minnesota.
Sec. 71. Minnesota Statutes 1996, section 144.9507,
subdivision 2, is amended to read:
Subd. 2. [LEAD INSPECTION RISK ASSESSMENT CONTRACTS.] The
commissioner shall, within available federal or state
appropriations, contract with boards of health to conduct
lead inspections risk assessments to determine sources of lead
contamination and to issue and enforce lead orders according to
section 144.9504.
Sec. 72. Minnesota Statutes 1996, section 144.9507,
subdivision 3, is amended to read:
Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The
commissioner shall, within the limits of available
appropriations, contract with boards of health for temporary
housing, to be used in meeting relocation requirements in
section 144.9504, and award grants to boards of health for the
purposes of paying housing and relocation costs under section
144.9504. The commissioner may use up to 15 percent of the
available appropriations to provide temporary lead-safe housing
in areas of the state in which the commissioner has the duty
under section 144.9504 to perform secondary prevention.
Sec. 73. Minnesota Statutes 1996, section 144.9507,
subdivision 4, is amended to read:
Subd. 4. [LEAD CLEANUP EQUIPMENT AND MATERIAL GRANTS TO
NONPROFIT ORGANIZATIONS.] (a) The commissioner shall, within the
limits of available state or federal appropriations, provide
funds for lead cleanup equipment and materials under a grant
program to nonprofit community-based organizations in areas at
high risk for toxic lead exposure, as provided for in section
144.9503.
(b) Nonprofit community-based organizations in areas at
high risk for toxic lead exposure may apply for grants from the
commissioner to purchase lead cleanup equipment and materials
and to pay for training for staff and volunteers for lead
licensure under sections 144.9505 and 144.9506.
(c) For purposes of this section, lead cleanup equipment
and materials means high efficiency particle accumulator (HEPA)
and wet vacuum cleaners, wash water filters, mops, buckets,
hoses, sponges, protective clothing, drop cloths, wet scraping
equipment, secure containers, dust and particle containment
material, and other cleanup and containment materials to remove
loose paint and plaster, patch plaster, control household dust,
wax floors, clean carpets and sidewalks, and cover bare soil.
(d) The grantee's staff and volunteers may make lead
cleanup equipment and materials available to residents and
property owners and instruct them on the proper use of the
equipment. Lead cleanup equipment and materials must be made
available to low-income households, as defined by federal
guidelines, on a priority basis at no fee. Other households may
be charged on a sliding fee scale.
(e) The grantee shall not charge a fee for services
performed using the equipment or materials.
(f) Any funds appropriated for purposes of this subdivision
that are not awarded, due to a lack of acceptable proposals for
the full amount appropriated, may be used for any purpose
authorized in this section.
Sec. 74. Minnesota Statutes 1996, section 144.9508,
subdivision 1, is amended to read:
Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner
shall adopt, by rule, visual inspection and sampling and
analysis methods for:
(1) lead inspections under section 144.9504, lead hazard
screens, lead risk assessments, and clearance inspections;
(2) environmental surveys of lead in paint, soil, dust, and
drinking water to determine census tracts that are areas at high
risk for toxic lead exposure;
(3) soil sampling for soil used as replacement soil; and
(4) drinking water sampling, which shall be done in
accordance with lab certification requirements and analytical
techniques specified by Code of Federal Regulations, title 40,
section 141.89; and
(5) sampling to determine whether at least 25 percent of
the soil samples collected from a census tract within a standard
metropolitan statistical area contain lead in concentrations
that exceed 100 parts per million.
Sec. 75. Minnesota Statutes 1996, section 144.9508, is
amended by adding a subdivision to read:
Subd. 2a. [LEAD STANDARDS FOR EXTERIOR SURFACES AND STREET
DUST.] The commissioner may, by rule, establish lead standards
for exterior horizontal surfaces, concrete or other impervious
surfaces, and street dust on residential property to protect the
public health and the environment.
Sec. 76. Minnesota Statutes 1996, section 144.9508,
subdivision 3, is amended to read:
Subd. 3. [LEAD CONTRACTORS AND WORKERS LICENSURE AND
CERTIFICATION.] The commissioner shall adopt rules to license
lead contractors and to certify supervisors, lead workers of
lead contractors who perform lead abatement or lead hazard
reduction, lead project designers, lead inspectors, and lead
risk assessors. The commissioner shall also adopt rules
requiring certification of firms that perform lead abatement,
lead hazard reduction, lead hazard screens, or lead risk
assessments. The commissioner shall require periodic renewal of
licenses and certificates and shall establish the renewal
periods.
Sec. 77. Minnesota Statutes 1996, section 144.9508,
subdivision 4, is amended to read:
Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall
establish by rule a permit fee to be paid by a training course
provider on application for a training course permit or renewal
period for each lead-related training course required for
certification or licensure. The commissioner shall establish
criteria in rules for the content and presentation of training
courses intended to qualify trainees for licensure under
subdivision 3. Training course permit fees shall be
nonrefundable and must be submitted with each application in the
amount of $500 for an initial training course, $250 for renewal
of a permit for an initial training course, $250 for a refresher
training course, and $125 for renewal of a permit of a refresher
training course.
Sec. 78. Minnesota Statutes 1996, section 144.9509,
subdivision 2, is amended to read:
Subd. 2. [DISCRIMINATION.] A person who discriminates
against or otherwise sanctions an employee who complains to or
cooperates with the inspecting assessing agency in administering
sections 144.9501 to 144.9509 is guilty of a petty misdemeanor.
Sec. 79. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.]
Subdivision 1. [LEAD-SAFE PROPERTY CERTIFICATION PROGRAM
ESTABLISHED.] (a) The commissioner shall establish, within the
limits of available appropriations, recommended protocols for a
voluntary lead-safe property certification program for
residential properties. This program shall involve an initial
property certification process, a property condition report, and
a lead-safe property certification booklet.
(b) The commissioner shall establish recommended protocols
for an initial property certification process composed of the
following:
(1) a lead hazard screen, which shall include a visual
evaluation of a residential property for both deteriorated paint
and bare soil; and
(2) a quantitative measure of lead in dust within the
structure and in common areas as determined by rule adopted
under authority of section 144.9508.
(c) The commissioner shall establish forms, checklists, and
protocols for conducting a property condition report. A
property condition report is an evaluation of property
components, without regard to aesthetic considerations, to
determine whether any of the following conditions are likely to
occur within one year of the report:
(1) that paint will become chipped, flaked, or cracked;
(2) that structural defects in the roof, windows, or
plumbing will fail and cause paint to deteriorate;
(3) that window wells or window troughs will not be
cleanable and washable;
(4) that windows will generate dust due to friction;
(5) that cabinet, room, and threshold doors will rub
against casings or have repeated contact with painted surfaces;
(6) that floors will not be smooth and cleanable and
carpeted floors will not be cleanable;
(7) that soil will not remain covered;
(8) that bare soil in vegetable and flower gardens will not
(i) be inaccessible to children or (ii) be tested to determine
if it is below the soil standard under section 144.9508;
(9) that parking areas will not remain covered by an
impervious surface or gravel;
(10) that covered soil will erode, particularly in play
areas; and
(11) that gutters and down spouts will not function
correctly.
(d) The commissioner shall develop a lead-safe property
certification booklet that contains the following:
(1) information on how property owners and their
maintenance personnel can perform essential maintenance
practices to correct any of the property component conditions
listed in paragraph (c) that may occur;
(2) the lead-safe work practices fact sheets created under
section 144.9503, subdivision 7;
(3) forms, checklists, and copies of recommended lead-safe
property certification certificates; and
(4) an educational sheet for landlords to give to tenants
on the importance of having tenants inform property owners or
designated maintenance staff of one or more of the conditions
listed in paragraph (c).
Subd. 2. [CONDITIONS FOR CERTIFICATION.] A property shall
be certified as lead safe only if the following conditions are
met:
(1) the property passes the initial certification process
in subdivision 1;
(2) the property owner agrees in writing to perform
essential maintenance practices;
(3) the property owner agrees in writing to use lead-safe
work practices, as provided for under section 144.9503,
subdivision 7;
(4) the property owner performs essential maintenance as
the need arises or uses maintenance personnel who have completed
a U.S. Environmental Protection Agency- or Minnesota department
of health-approved maintenance training program or course to
perform essential maintenance;
(5) the lead-safe property certification booklet is
distributed to the property owner, maintenance personnel, and
tenants at the completion of the initial certification process;
and
(6) a copy of the lead-safe property certificate is filed
with the commissioner along with a $5 filing fee.
Subd. 3. [LEAD STANDARDS.] Lead standards used in this
section shall be those approved by the commissioner under
section 144.9508.
Subd. 4. [LEAD RISK ASSESSORS.] Lead-safe property
certifications shall only be performed by lead risk assessors
licensed by the commissioner under section 144.9506.
Subd. 5. [EXPIRATION.] Lead-safe property certificates are
valid for one year.
Subd. 6. [LIST OF CERTIFIED PROPERTIES.] Within the limits
of available appropriations, the commissioner shall maintain a
list of all properties certified as lead-safe under this section
and make it freely available to the public.
Subd. 7. [RE-APPLICATION.] Properties failing the initial
property certification may re-apply for a lead-safe property
certification by having a new initial certification process
performed and by correcting any condition listed by the licensed
lead risk assessor in the property condition report. Properties
that fail the initial property certification process must have
the condition corrected by the property owner, by trained
maintenance staff, or by a contractor with personnel licensed
for lead hazard reduction or lead abatement work by the
commissioner under section 144.9505, in order to have the
property certified.
Sec. 80. Minnesota Statutes 1996, section 144.99,
subdivision 1, is amended to read:
Subdivision 1. [REMEDIES AVAILABLE.] The provisions of
chapters 103I and 157 and sections 115.71 to 115.77; 144.12,
subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13),
(14), and (15); 144.121; 144.1222; 144.35; 144.381 to 144.385;
144.411 to 144.417; 144.491; 144.495; 144.71 to 144.74; 144.9501
to 144.9509; 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. 81. Minnesota Statutes 1996, section 144A.44,
subdivision 2, is amended to read:
Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These
rights are established for the benefit of persons who receive
home care services. "Home care services" means home care
services as defined in section 144A.43, subdivision 3. A home
care provider may not require a person to surrender these rights
as a condition of receiving services. A guardian or conservator
or, when there is no guardian or conservator, a designated
person, may seek to enforce these rights. This statement of
rights does not replace or diminish other rights and liberties
that may exist relative to persons receiving home care services,
persons providing home care services, or providers licensed
under Laws 1987, chapter 378. A copy of these rights must be
provided to an individual at the time home care services are
initiated. The copy shall also contain the address and phone
number of the office of health facility complaints and the
office of the ombudsman for older Minnesotans and a brief
statement describing how to file a complaint with that office
these offices. Information about how to contact the office of
the ombudsman for older Minnesotans shall be included in notices
of change in client fees and in notices where home care
providers initiate transfer or discontinuation of services.
Sec. 82. Minnesota Statutes 1997 Supplement, section
144A.4605, subdivision 4, is amended to read:
Subd. 4. [LICENSE REQUIRED.] (a) A housing with services
establishment registered under chapter 144D that is required to
obtain a home care license must obtain an assisted living home
care license according to this section or a class A or class E
license according to rule. A housing with services
establishment that obtains a class E license under this
subdivision remains subject to the payment limitations in
sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915,
subdivision 3, paragraph (g).
(b) A board and lodging establishment registered for
special services as of December 31, 1996, and also registered as
a housing with services establishment under chapter 144D, must
deliver home care services according to sections 144A.43 to
144A.49, and may apply for a waiver from requirements under
Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a
licensed agency under the standards of section 157.17. Such
waivers as may be granted by the department will expire upon
promulgation of home care rules implementing section 144A.4605.
(c) An adult foster care provider licensed by the
department of human services and registered under chapter 144D
may continue to provide health-related services under its foster
care license until the promulgation of home care rules
implementing this section.
Sec. 83. [145.905] [LOCATION FOR BREAST-FEEDING.]
A mother may breast-feed in any location, public or
private, where the mother and child are otherwise authorized to
be, irrespective of whether the nipple of the mother's breast is
uncovered during or incidental to the breast-feeding.
Sec. 84. [145.9261] [ABSTINENCE EDUCATION GRANT PROGRAM.]
The commissioner of health shall expend federal funds for
abstinence education programs provided under United States Code,
title 42, section 710, and state matching funds for abstinence
education programs only to an abstinence education program that
complies with the state plan that has been submitted to and
approved by the federal Department of Health and Human Services.
Sec. 85. [145.9266] [FETAL ALCOHOL SYNDROME.]
Subdivision 1. [PUBLIC AWARENESS.] The commissioner of
health shall design and implement an ongoing statewide campaign
to raise public awareness about fetal alcohol syndrome and other
effects of prenatal alcohol exposure. The campaign shall
include messages directed to the general population as well as
culturally specific and community-based messages. A toll-free
resource and referral telephone line shall be included in the
messages. The commissioner of health shall conduct an
evaluation to determine the effectiveness of the campaign.
Subd. 2. [STATEWIDE NETWORK OF FAS DIAGNOSTIC CLINICS.] A
statewide network of regional fetal alcohol syndrome diagnostic
clinics shall be developed between the department of health and
the University of Minnesota. This collaboration shall be based
on a statewide needs assessment and shall include involvement
from consumers, providers, and payors. By the end of calendar
year 1998, a plan shall be developed for the clinic network, and
shall include a comprehensive evaluation component. Sites shall
be established in calendar year 1999. The commissioner shall
not access or collect individually identifiable data for the
statewide network of regional fetal alcohol syndrome diagnostic
clinics. Data collected at the clinics shall be maintained
according to applicable data privacy laws, including section
144.335.
Subd. 3. [PROFESSIONAL TRAINING ABOUT FAS.] (a) The
commissioner of health, in collaboration with the board of
medical practice, the board of nursing, and other professional
boards and state agencies, shall develop curricula and materials
about fetal alcohol syndrome for professional training of health
care providers, social service providers, educators, and
judicial and corrections systems professionals. The training
and curricula shall increase knowledge and develop practical
skills of professionals to help them address the needs of
at-risk pregnant women and the needs of individuals affected by
fetal alcohol syndrome or fetal alcohol effects and their
families.
(b) Training for health care providers shall focus on skill
building for screening, counseling, referral, and follow-up for
women using or at risk of using alcohol while pregnant.
Training for health care professionals shall include methods for
diagnosis and evaluation of fetal alcohol syndrome and fetal
alcohol effects. Training for education, judicial, and
corrections professionals shall involve effective education
strategies, methods to identify the behaviors and learning
styles of children with alcohol-related birth defects, and
methods to identify available referral and community resources.
(c) Training for social service providers shall focus on
resources for assessing, referring, and treating at-risk
pregnant women, changes in the mandatory reporting and
commitment laws, and resources for affected children and their
families.
Subd. 4. [FAS COMMUNITY GRANT PROGRAM.] The commissioner
of health shall administer a grant program to provide money to
community organizations and coalitions to collaborate on fetal
alcohol syndrome prevention and intervention strategies and
activities. The commissioner shall disburse grant money through
a request for proposal process or sole-source distribution where
appropriate, and shall include at least one grant award for
transitional skills and services for individuals with fetal
alcohol syndrome or fetal alcohol effects.
Subd. 5. [SCHOOL PILOT PROGRAMS.] (a) The commissioner of
children, families, and learning shall award up to four grants
to schools for pilot programs to identify and implement
effective educational strategies for individuals with fetal
alcohol syndrome and other alcohol-related birth defects.
(b) One grant shall be awarded in each of the following age
categories:
(1) birth to three years;
(2) three to five years;
(3) six to 12 years; and
(4) 13 to 18 years.
(c) Grant proposals must include an evaluation plan,
demonstrate evidence of a collaborative or multisystem approach,
provide parent education and support, and show evidence of a
child- and family-focused approach consistent with
research-based educational practices and other guidelines
developed by the department of children, families, and learning.
(d) Children participating in the pilot program sites may
be identified through child find activities or a diagnostic
clinic. No identification activity may be undertaken without
the consent of a child's parent or guardian.
Subd. 6. [FETAL ALCOHOL COORDINATING BOARD; DUTIES.] (a)
The fetal alcohol coordinating board consists of:
(1) the commissioners of health, human services,
corrections, public safety, economic security, and children,
families, and learning;
(2) the director of the office of strategic and long-range
planning;
(3) the chair of the maternal and child health advisory
task force established by section 145.881, or the chair's
designee;
(4) a representative of the University of Minnesota
academic health center, appointed by the provost;
(5) five members from the general public appointed by the
governor, one of whom must be a family member of an individual
with fetal alcohol syndrome or fetal alcohol effect; and
(6) one member from the judiciary appointed by the chief
justice of the supreme court.
Terms, compensation, removal, and filling of vacancies of
appointed members are governed by section 15.0575. The board
shall elect a chair from its membership to serve a one-year
term. The commissioner of health shall provide staff and
consultant support for the board. Support must be provided
based on an annual budget and work plan developed by the board.
The board shall contract with the department of health for
necessary administrative services. Administrative services
include personnel, budget, payroll, and contract
administration. The board shall adopt an annual budget and work
program.
(b) Board duties include:
(1) reviewing programs of state agencies that involve fetal
alcohol syndrome and coordinating those that are
interdepartmental in nature;
(2) providing an integrated and comprehensive approach to
fetal alcohol syndrome prevention and intervention strategies
both at a local and statewide level;
(3) approving on an annual basis the statewide public
awareness campaign as designed and implemented by the
commissioner of health under subdivision 1;
(4) reviewing fetal alcohol syndrome community grants
administered by the commissioner of health under subdivision 4;
and
(5) submitting a report to the governor on January 15 of
each odd-numbered year summarizing board operations, activities,
findings, and recommendations, and fetal alcohol syndrome
activities throughout the state.
(c) The board expires on January 1, 2001.
Subd. 7. [FEDERAL FUNDS; CONTRACTS; DONATIONS.] The fetal
alcohol coordinating board may apply for, receive, and disburse
federal funds made available to the state by federal law or
rules adopted for any purpose related to the powers and duties
of the board. The board shall comply with any requirements of
federal law, rules, and regulations in order to apply for,
receive, and disburse funds. The board may contract with or
provide grants to public and private nonprofit entities. The
board may accept donations or grants from any public or private
entity. Money received by the board must be deposited in a
separate account in the state treasury and invested by the state
board of investment. The amount deposited, including investment
earnings, is appropriated to the board to carry out its duties.
Money deposited in the state treasury shall not cancel.
Sec. 86. Minnesota Statutes 1996, section 145A.15,
subdivision 2, is amended to read:
Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is
authorized to award grants to programs that meet the
requirements of subdivision 3 and include a strong child abuse
and neglect prevention focus for families in need of services.
Priority will be given to families considered to be in need of
additional services. These families include, but are not
limited to, families with:
(1) adolescent parents;
(2) a history of alcohol and other drug abuse;
(3) a history of child abuse, domestic abuse, or other
types of violence in the family of origin;
(4) a history of domestic abuse, rape, or other forms of
victimization;
(5) reduced cognitive functioning;
(6) a lack of knowledge of child growth and development
stages;
(7) low resiliency to adversities and environmental
stresses; or
(8) lack of sufficient financial resources to meet their
needs.
(b) Grants made under this section shall be used to fund
existing and new home visiting programs. In awarding grants
under this section, the commissioner shall give priority to new
home visiting programs with local matching funds.
Sec. 87. Minnesota Statutes 1996, section 157.15,
subdivision 9, is amended to read:
Subd. 9. [MOBILE FOOD UNIT.] "Mobile food unit" means a
food and beverage service establishment that is a vehicle
mounted unit, either motorized or trailered, operating no more
than 14 21 days annually at any one place or is operated in
conjunction with a permanent business licensed under this
chapter or chapter 28A at the site of the permanent business by
the same individual or company, and readily movable, without
disassembling, for transport to another location.
Sec. 88. Minnesota Statutes 1996, section 157.15,
subdivision 12, is amended to read:
Subd. 12. [RESTAURANT.] "Restaurant" means a food and
beverage service establishment, whether the establishment serves
alcoholic or nonalcoholic beverages, which operates from a
location for more than 14 21 days annually. Restaurant does not
include a food cart or a mobile food unit.
Sec. 89. Minnesota Statutes 1996, section 157.15,
subdivision 12a, is amended to read:
Subd. 12a. [SEASONAL PERMANENT FOOD STAND.] "Seasonal
permanent food stand" means a food and beverage service
establishment which is a permanent food service stand or
building, but which operates no more than 14 21 days annually.
Sec. 90. Minnesota Statutes 1996, section 157.15,
subdivision 13, is amended to read:
Subd. 13. [SEASONAL TEMPORARY FOOD STAND.] "Seasonal
temporary food stand" means a food and beverage service
establishment that is a food stand which is disassembled and
moved from location to location, but which operates no more than
14 21 days annually at any one location.
Sec. 91. Minnesota Statutes 1996, section 157.15,
subdivision 14, is amended to read:
Subd. 14. [SPECIAL EVENT FOOD STAND.] "Special event food
stand" means a food and beverage service establishment which is
used in conjunction with celebrations and special events, and
which operates once or twice no more than three times annually
for no more than seven ten total days.
Sec. 92. Minnesota Statutes 1997 Supplement, section
157.16, subdivision 3, is amended to read:
Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The
following fees are required for food and beverage service
establishments, hotels, motels, lodging establishments, and
resorts licensed under this chapter. Food and beverage service
establishments must pay the highest applicable fee under
paragraph (e), clause (1), (2), (3), or (4), and establishments
serving alcohol must pay the highest applicable fee under
paragraph (e), clause (6) or (7).
(b) All food and beverage service establishments, except
special event food stands, and all hotels, motels, lodging
establishments, and resorts shall pay an annual base fee of $100.
(c) A special event food stand shall pay a flat fee
of $60 $30 annually. "Special event food stand" means a fee
category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special
event food stand as defined in section 157.15.
(d) A special event food stand-limited shall pay a flat fee
of $30.
(e) In addition to the base fee in paragraph (b), each food
and beverage service establishment, other than a special event
food stand, and each hotel, motel, lodging establishment, and
resort shall pay an additional annual fee for each fee category
as specified in this paragraph:
(1) Limited food menu selection, $30. "Limited food menu
selection" means a fee category that provides one or more of the
following:
(i) prepackaged food that receives heat treatment and is
served in the package;
(ii) frozen pizza that is heated and served;
(iii) a continental breakfast such as rolls, coffee, juice,
milk, and cold cereal;
(iv) soft drinks, coffee, or nonalcoholic beverages; or
(v) cleaning for eating, drinking, or cooking utensils,
when the only food served is prepared off site.
(2) Small establishment, including boarding establishments,
$55. "Small establishment" means a fee category that has no
salad bar and meets one or more of the following:
(i) possesses food service equipment that consists of no
more than a deep fat fryer, a grill, two hot holding containers,
and one or more microwave ovens;
(ii) serves dipped ice cream or soft serve frozen desserts;
(iii) serves breakfast in an owner-occupied bed and
breakfast establishment;
(iv) is a boarding establishment; or
(v) meets the equipment criteria in clause (3), item (i) or
(ii), and has a maximum patron seating capacity of not more than
50.
(3) Medium establishment, $150. "Medium establishment"
means a fee category that meets one or more of the following:
(i) possesses food service equipment that includes a range,
oven, steam table, salad bar, or salad preparation area;
(ii) possesses food service equipment that includes more
than one deep fat fryer, one grill, or two hot holding
containers; or
(iii) is an establishment where food is prepared at one
location and served at one or more separate locations.
Establishments meeting criteria in clause (2), item (v),
are not included in this fee category.
(4) Large establishment, $250. "Large establishment" means
either:
(i) a fee category that (A) meets the criteria in clause
(3), items (i) or (ii), for a medium establishment, (B) seats
more than 175 people, and (C) offers the full menu selection an
average of five or more days a week during the weeks of
operation; or
(ii) a fee category that (A) meets the criteria in clause
(3), item (iii), for a medium establishment, and (B) prepares
and serves 500 or more meals per day.
(5) Other food and beverage service, including food carts,
mobile food units, seasonal temporary food stands, and seasonal
permanent food stands, $30.
(6) Beer or wine table service, $30. "Beer or wine table
service" means a fee category where the only alcoholic beverage
service is beer or wine, served to customers seated at tables.
(7) Alcoholic beverage service, other than beer or wine
table service, $75.
"Alcohol beverage service, other than beer or wine table
service" means a fee category where alcoholic mixed drinks are
served or where beer or wine are served from a bar.
(8) Lodging per sleeping accommodation unit, $4, including
hotels, motels, lodging establishments, and resorts, up to a
maximum of $400. "Lodging per sleeping accommodation unit"
means a fee category including the number of guest rooms,
cottages, or other rental units of a hotel, motel, lodging
establishment, or resort; or the number of beds in a dormitory.
(9) First public swimming pool, $100; each additional
public swimming pool, $50. "Public swimming pool" means a fee
category that has the meaning given in Minnesota Rules, part
4717.0250, subpart 8.
(10) First spa, $50; each additional spa, $25. "Spa pool"
means a fee category that has the meaning given in Minnesota
Rules, part 4717.0250, subpart 9.
(11) Private sewer or water, $30. "Individual private
water" means a fee category with a water supply other than a
community public water supply as defined in Minnesota Rules,
chapter 4720. "Individual private sewer" means a fee category
with an individual sewage treatment system which uses subsurface
treatment and disposal.
(f) (e) A fee is not required for a food and beverage
service establishment operated by a school as defined in
sections 120.05 and 120.101.
(g) (f) A fee of $150 for review of the construction plans
must accompany the initial license application for food and
beverage service establishments, hotels, motels, lodging
establishments, or resorts.
(h) (g) When existing food and beverage service
establishments, hotels, motels, lodging establishments, or
resorts are extensively remodeled, a fee of $150 must be
submitted with the remodeling plans.
(i) (h) Seasonal temporary food stands, and special event
food stands, and special event food stands-limited are not
required to submit construction or remodeling plans for review.
Sec. 93. Minnesota Statutes 1996, section 214.03, is
amended to read:
214.03 [STANDARDIZED TESTS.]
Subdivision 1. [STANDARDIZED TESTS USED.] All state
examining and licensing boards, other than the state board of
law examiners, the state board of professional responsibility or
any other board established by the supreme court to regulate the
practice of law and judicial functions, shall use national
standardized tests for the objective, nonpractical portion of
any examination given to prospective licensees to the extent
that such national standardized tests are appropriate, except
when the subject matter of the examination relates to the
application of Minnesota law to the profession or calling being
licensed.
Subd. 2. [HEALTH-RELATED BOARDS; SPECIAL ACCOUNT.] An
account is established in the special revenue fund where a
health-related licensing board may deposit applicants' payments
for national or regional standardized tests. Money in the
account is appropriated to each board that has deposited monies
into the account, in an amount equal to the amount deposited by
the board, to pay for the use of national or regional
standardized tests.
Sec. 94. Minnesota Statutes 1997 Supplement, section
214.32, subdivision 1, is amended to read:
Subdivision 1. [MANAGEMENT.] (a) A health professionals
services program committee is established, consisting of one
person appointed by each participating board, with each
participating board having one vote. The committee shall
designate one board to provide administrative management of the
program, set the program budget and the pro rata share of
program expenses to be borne by each participating board,
provide guidance on the general operation of the program,
including hiring of program personnel, and ensure that the
program's direction is in accord with its authority. No more
than half plus one of the members of the committee may be of one
gender. If the participating boards change which board is
designated to provide administrative management of the program,
any appropriation remaining for the program shall transfer to
the newly designated board on the effective date of the change.
The participating boards must inform the appropriate legislative
committees and the commissioner of finance of any change in the
administrative management of the program, and the amount of any
appropriation transferred under this provision.
(b) The designated board, upon recommendation of the health
professional services program committee, shall hire the program
manager and employees and pay expenses of the program from funds
appropriated for that purpose. The designated board may apply
for grants to pay program expenses and may enter into contracts
on behalf of the program to carry out the purposes of the
program. The participating boards shall enter into written
agreements with the designated board.
(c) An advisory committee is established to advise the
program committee consisting of:
(1) one member appointed by each of the following: the
Minnesota Academy of Physician Assistants, the Minnesota Dental
Association, the Minnesota Chiropractic Association, the
Minnesota Licensed Practical Nurse Association, the Minnesota
Medical Association, the Minnesota Nurses Association, and the
Minnesota Podiatric Medicine Association;
(2) one member appointed by each of the professional
associations of the other professions regulated by a
participating board not specified in clause (1); and
(3) two public members, as defined by section 214.02.
Members of the advisory committee shall be appointed for two
years and members may be reappointed.
No more than half plus one of the members of the committee
may be of one gender.
The advisory committee expires June 30, 2001.
Sec. 95. Minnesota Statutes 1996, section 254A.17,
subdivision 1, is amended to read:
Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a)
The commissioner shall fund maternal and child health and social
service programs designed to improve the health and functioning
of children born to mothers using alcohol and controlled
substances. Comprehensive programs shall include immediate and
ongoing intervention, treatment, and coordination of medical,
educational, and social services through a child's preschool
years. Programs shall also include research and evaluation to
identify methods most effective in improving outcomes among this
high-risk population. The commissioner shall ensure that the
programs are available on a statewide basis to the extent
possible with available funds.
(b) The commissioner of human services shall develop models
for the treatment of children ages 6 to 12 who are in need of
chemical dependency treatment. The commissioner shall fund at
least two pilot projects with qualified providers to provide
nonresidential treatment for children in this age group. Model
programs must include a component to monitor and evaluate
treatment outcomes.
Sec. 96. Minnesota Statutes 1996, section 254A.17, is
amended by adding a subdivision to read:
Subd. 1b. [INTERVENTION AND ADVOCACY PROGRAM.] Within the
limits of money available, the commissioner of human services
shall fund voluntary hospital-based outreach programs targeted
at women who deliver children affected by prenatal alcohol or
drug use. The program shall help women obtain treatment, stay
in recovery, and plan any future pregnancies. An advocate shall
be assigned to each woman in the program to provide guidance and
advice with respect to treatment programs, child safety and
parenting, housing, family planning, and any other personal
issues that are barriers to remaining free of chemical
dependence. The commissioner shall develop an evaluation
component and provide centralized coordination of the evaluation
process.
Sec. 97. Minnesota Statutes 1996, section 268.92,
subdivision 4, is amended to read:
Subd. 4. [LEAD CONTRACTORS SUPERVISOR OR CERTIFIED FIRM.]
(a) Eligible organizations and lead contractors supervisors or
certified firms may participate in the swab team program. An
eligible organization receiving a grant under this section must
assure that all participating lead contractors supervisors or
certified firms are licensed and that all swab team workers are
certified by the department of health under section 144.9505.
Eligible organizations and lead contractors supervisors or
certified firms may distinguish between interior and exterior
services in assigning duties and may participate in the program
by:
(1) providing on-the-job training for swab team workers;
(2) providing swab team services to meet the requirements
of sections 144.9503, subdivision 4, and 144.9504, subdivision
6;
(3) providing a removal and replacement component using
skilled craft workers under subdivision 7;
(4) providing lead testing according to subdivision 7a;
(5) providing lead dust cleaning supplies, as described in
section 144.9503 144.9507, subdivision 5 4,
paragraph (b) (c), to residents; or
(6) having a swab team worker instruct residents and
property owners on appropriate lead control techniques,
including the lead-safe directives developed by the commissioner
of health.
(b) Participating lead contractors supervisors or certified
firms must:
(1) demonstrate proof of workers' compensation and general
liability insurance coverage;
(2) be knowledgeable about lead abatement requirements
established by the Department of Housing and Urban Development
and the Occupational Safety and Health Administration and lead
hazard reduction requirements and lead-safe directives of the
commissioner of health;
(3) demonstrate experience with on-the-job training
programs;
(4) demonstrate an ability to recruit employees from areas
at high risk for toxic lead exposure; and
(5) demonstrate experience in working with low-income
clients.
Sec. 98. [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC
HEALTH CENTER.]
The University of Minnesota academic health center, after
consultation with the health care community and the medical
education and research costs advisory committee, is requested to
report to the commissioner of health and the legislative
commission on health care access by January 15, 1999, on plans
for the strategic direction and vision of the academic health
center. The report shall address plans for the ongoing
assessment of health provider workforce needs; plans for the
ongoing assessment of the educational needs of health
professionals and the implications for their education and
training programs; and plans for ongoing, meaningful input from
the health care community on health-related research and
education programs administered by the academic health center.
Sec. 99. [ADVICE AND RECOMMENDATIONS.]
The commissioners of health and commerce shall convene an
ad hoc advisory panel of selected representatives of health plan
companies, purchasers, and provider groups engaged in the
practice of health care in Minnesota, and interested
legislators. This advisory panel shall meet and assist the
commissioners in developing measures to prevent discrimination
against providers and provider groups in managed care in
Minnesota and clarify the requirements of Minnesota Statutes,
section 62Q.23, paragraph (c). Any such measures shall be
reported to the legislature prior to November 15, 1998.
Sec. 100. [OMBUDSMAN STUDY.]
The ombudsman for mental health and mental retardation and
the ombudsman for older Minnesotans shall convene a work group
to develop recommendations for interagency cooperation and/or
the consolidation of all health-related ombudsman and advocacy
programs provided by state agencies and to address issues to
improve ombudsmen and advocacy services to health care
consumers, including ease of access, timeliness of response, and
quality of outcome. In developing its recommendations, the work
group shall consider the unique needs of different populations
of health care consumers. It shall also consider:
(1) seamless access for health care consumers;
(2) consumer outreach methods;
(3) opportunities to share resources and training;
(4) nonduplication of effort; and
(5) the feasibility of colocation.
In developing its recommendations, the work group shall
confer with and have representatives of consumers, advocacy
organizations, the consumer advisory board, the office of health
care consumer assistance, advocacy, and information, affected
state agencies, the board on aging, and the advisory committee
to the ombudsman for mental health and mental retardation. The
work group shall make recommendations on how to better
coordinate consumer services and submit a report to the
legislature by December 15, 1999.
Sec. 101. [COMPLAINT PROCESS STUDY.]
The complaint process work group established by the
commissioners of health and commerce as required under Laws
1997, chapter 237, section 20, shall continue to meet to develop
a complaint resolution process for health plan companies to make
available to enrollees as required under Minnesota Statutes,
sections 62Q.105, 62Q.11, and 62Q.30. The commissioners of
health and commerce shall submit a progress report to the
legislative commission on health care access by September 15,
1998, and shall submit final recommendations to the legislature,
including draft legislation on developing such a process by
November 15, 1998. The recommendations must also include, in
consultation with the work group, a permanent method of
financing the office of health care consumer assistance,
advocacy, and information.
Sec. 102. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.]
The commissioner of health shall convene an advisory task
force to study issues related to the building codes and safety
standards that residential hospice facilities must meet for
licensure and to make recommendations on changes to these
standards. Task force membership shall include representatives
of residential hospices, pediatric residential hospices, the
Minnesota hospice organization, the Minnesota department of
health, and other interested parties. The task force is
governed by Minnesota Statutes, section 15.059, subdivision 6.
The task force shall submit recommendations and any draft
legislation to the legislature by January 15, 1999.
Sec. 103. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.]
Until October 31, 1998, the board of dietetics and
nutrition practice may waive the requirements for licensure as a
dietitian established in Minnesota Statutes, section 148.624,
subdivision 1, clause (1), and may issue a license to an
applicant who meets the qualifications for licensure specified
in Minnesota Statutes, section 148.627, subdivision 1. A waiver
may be granted in cases in which unusual or extraordinary
job-related circumstances prevented an applicant from applying
for licensure during the transition period specified in
Minnesota Statutes, section 148.627, subdivision 1. An
applicant must request a waiver in writing and must explain the
circumstances that prevented the applicant from applying for
licensure during the transition period.
Sec. 104. [UNITED STATES NUCLEAR REGULATORY COMMISSION
AGREEMENT.]
Subdivision 1. [AGREEMENT AUTHORIZED.] In order to have a
comprehensive program to protect the public from radiation
hazards, the governor may enter into an agreement with the
United States Nuclear Regulatory Commission, under the Atomic
Energy Act of 1954, United States Code, title 42, section 2021,
paragraph (b). The agreement may allow the state to assume
regulation over nonpower plant radiation hazards including
certain by-product, source, and special nuclear materials not
sufficient to form a critical mass. The agreement must be
approved in law prior to being implemented.
Subd. 2. [HEALTH DEPARTMENT DESIGNATED LEAD.] The
department of health is designated as the lead agency to pursue
an agreement on behalf of the governor, and for any assumption
of specified licensing and regulatory authority from the Nuclear
Regulatory Commission under an agreement. The commissioner may
enter into negotiations with the Nuclear Regulatory Commission
for that purpose. The commissioner of health shall establish an
advisory group to assist in preparing the state to meet the
requirements for achieving an agreement.
Subd. 3. [RULES.] The commissioner of health may adopt
rules for the state assumption of regulation under an agreement
under this section, including the licensing and regulation of
by-product, source, and special nuclear material not sufficient
to form a critical mass.
Subd. 4. [TRANSITION.] A person who, on the effective date
of an agreement under this section, possesses a Nuclear
Regulatory Commission license that is subject to the agreement
shall be deemed to possess a similar license issued by the
department of health. Licenses shall expire on the expiration
date specified in the federal license.
Subd. 5. [SUNSET.] An agreement entered into before August
2, 2002, shall remain in effect until terminated or suspended
under the Atomic Energy Act of 1954, United States Code, title
42, section 2021, paragraph (j). The governor may not enter
into an initial agreement with the Nuclear Regulatory Commission
after August 1, 2002. If an agreement is not entered into, any
rules adopted under this section are repealed on that date.
Sec. 105. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.]
The commissioner of health shall conduct a study of the
incidence and prevalence of fetal alcohol syndrome in Minnesota.
The commissioner shall not collect individually identifiable
data for this study.
Sec. 106. [MEDICAL EDUCATION AND RESEARCH TRUST FUND
STUDY.]
The commissioner of health shall review the current medical
education and research costs advisory committee structure and
composition and recommend methods to ensure balanced and
appropriate representation of major training programs. The
commissioner shall also review the statutory formula for the
prepaid medical assistance carve out to determine if any
adjustments should be made to correct existing or potential
inequities on current training programs. The commissioner shall
determine if there should be other criteria for weighting future
distributions of medical education and research funds beyond the
current statutory criteria, including the criteria that trainees
continue to practice in Minnesota. The commissioner shall
report the findings and recommendations to the legislative
commission on health care access by December 15, 1998.
Sec. 107. [FUNDING FOR IMMUNIZATIONS.]
The commissioner of health, in consultation with the
commissioner of children, families, and learning,
representatives of school nurses, and other interested parties,
shall develop recommendations on how to provide ongoing funding
for school districts to implement the provisions of Minnesota
Statutes, section 123.70. These recommendations shall specify
any statutory changes needed for their implementation. The
commissioners of health and of children, families, and learning
shall consider the recommendations in developing their budget
requests for the 2000-2001 biennial budget. The recommendations
and any draft legislation needed to implement the
recommendations shall be submitted to the chairs of the senate
health and family security budget division, the house health and
human services finance division, the senate K-12 education
budget division, and the house K-12 education finance division
by December 15, 1998.
Sec. 108. [BOARD OF REHABILITATION THERAPY.]
The commissioner of health shall convene a work group to
study the feasibility and need of creating a separate board of
rehabilitation therapy to regulate rehabilitation therapy
occupations, including physical therapists, occupational
therapists, speech-language pathologists, audiologists, and
hearing instrument dispensers. The work group shall consist of
members representing physical therapists, occupational
therapists, speech-language pathologists, audiologists, hearing
instrument dispensers, and any other related occupation group
that the commissioner determines should be included. The
commissioner, in consultation with the work group, shall submit
to the legislature by January 15, 1999, recommendations on
establishing a board of rehabilitation therapy and on the
appropriate occupational groups to be regulated by this board.
Sec. 109. [REPEALER.]
Minnesota Statutes 1996, sections 62J.685; 144.491;
144.9501, subdivisions 12, 14, and 16; and 144.9503,
subdivisions 5, 8, and 9; and 157.15, subdivision 15, are
repealed.
Sec. 110. [EFFECTIVE DATES.]
(a) Sections 2, 8, 20, 22, 34 to 80, 93, 94, and 97 to 108
are effective the day following final enactment.
(b) Sections 9 to 13, 21, and 81 are effective January 1,
1999.
ARTICLE 3
LONG-TERM CARE
Section 1. Minnesota Statutes 1996, section 144A.04,
subdivision 5, is amended to read:
Subd. 5. [ADMINISTRATORS.] Except as otherwise provided by
this subdivision, a nursing home must have a full time licensed
nursing home administrator serving the facility. In any nursing
home of less than 25 31 beds, the director of nursing services
may also serve as the licensed nursing home administrator. Two
nursing homes under common ownership having a total of 150 beds
or less and located within 75 miles of each other may share the
services of a licensed administrator if the administrator
divides full-time work week between the two facilities in
proportion to the number of beds in each facility. Every
nursing home shall have a person-in-charge on the premises at
all times in the absence of the licensed administrator. The
name of the person in charge must be posted in a conspicuous
place in the facility. The commissioner of health shall by rule
promulgate minimum education and experience requirements for
persons-in-charge, and may promulgate rules specifying the times
of day during which a licensed administrator must be on the
nursing home's premises. In the absence of rules adopted by the
commissioner governing the division of an administrator's time
between two nursing homes, the administrator shall designate and
post the times the administrator will be on site in each home on
a regular basis. A nursing home may employ as its administrator
the administrator of a hospital licensed pursuant to sections
144.50 to 144.56 if the individual is licensed as a nursing home
administrator pursuant to section 144A.20 and the nursing home
and hospital have a combined total of 150 beds or less and are
located within one mile of each other. A nonproprietary
retirement home having fewer than 15 licensed nursing home beds
may share the services of a licensed administrator with a
nonproprietary nursing home, having fewer than 150 licensed
nursing home beds, that is located within 25 miles of the
retirement home. A nursing home which is located in a facility
licensed as a hospital pursuant to sections 144.50 to 144.56,
may employ as its administrator the administrator of the
hospital if the individual meets minimum education and long term
care experience criteria set by rule of the commissioner of
health.
Sec. 2. Minnesota Statutes 1997 Supplement, section
144A.071, subdivision 4a, is amended to read:
Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the
best interest of the state to ensure that nursing homes and
boarding care homes continue to meet the physical plant
licensing and certification requirements by permitting certain
construction projects. Facilities should be maintained in
condition to satisfy the physical and emotional needs of
residents while allowing the state to maintain control over
nursing home expenditure growth.
The commissioner of health in coordination with the
commissioner of human services, may approve the renovation,
replacement, upgrading, or relocation of a nursing home or
boarding care home, under the following conditions:
(a) to license or certify beds in a new facility
constructed to replace a facility or to make repairs in an
existing facility that was destroyed or damaged after June 30,
1987, by fire, lightning, or other hazard provided:
(i) destruction was not caused by the intentional act of or
at the direction of a controlling person of the facility;
(ii) at the time the facility was destroyed or damaged 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;
(iii) the net proceeds from an insurance settlement for the
damages caused by the hazard are applied to the cost of the new
facility or repairs;
(iv) 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;
(v) 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; and
(vi) the commissioner determines that the replacement beds
are needed to prevent an inadequate supply of beds.
Project construction costs incurred for repairs authorized under
this clause shall not be considered in the dollar threshold
amount defined in subdivision 2;
(b) 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 $750,000;
(c) to license or certify beds in a project recommended for
approval under section 144A.073;
(d) 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;
(e) 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, or in a facility that
was granted an exception to the moratorium under section
144A.073, and if the cost of any remodeling of the facility does
not exceed $750,000. If boarding care beds are licensed as
nursing home beds, the number of boarding care beds in the
facility must not increase beyond the number remaining at the
time of the upgrade in licensure. The provisions contained in
section 144A.073 regarding the upgrading of the facilities do
not apply to facilities that satisfy these requirements;
(f) 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 St. 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 paragraph;
(g) to license and certify nursing home beds to replace
currently licensed and certified boarding care beds which may be
located either in a remodeled or renovated boarding care or
nursing home facility or in a remodeled, renovated, newly
constructed, or replacement nursing home facility within the
identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located,
provided that the number of boarding care beds in the facility
or complex are decreased by the number to be licensed as nursing
home beds and further provided that, if the total costs of new
construction, replacement, remodeling, or renovation exceed ten
percent of the appraised value of the facility or $200,000,
whichever is less, 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 new construction, replacement, remodeling, or
renovation. The provisions contained in section 144A.073
regarding the upgrading of facilities do not apply to facilities
that satisfy these requirements;
(h) to license as a nursing home and certify as a nursing
facility a facility that is licensed as a boarding care facility
but not certified under the medical assistance program, but only
if the commissioner of human services certifies to the
commissioner of health that licensing the facility as a nursing
home and certifying the facility as a nursing facility will
result in a net annual savings to the state general fund of
$200,000 or more;
(i) to certify, after September 30, 1992, and prior to July
1, 1993, existing nursing home beds in a facility that was
licensed and in operation prior to January 1, 1992;
(j) to license and certify new nursing home beds to replace
beds in a facility condemned acquired by the Minneapolis
community development agency as part of an economic
redevelopment plan activities in a city of the first class,
provided the new facility is located within one mile three miles
of the site of the old facility. Operating and property costs
for the new facility must be determined and allowed
under existing reimbursement rules section 256B.431 or 256B.434;
(k) to license and certify up to 20 new nursing home beds
in a community-operated hospital and attached convalescent and
nursing care facility with 40 beds on April 21, 1991, that
suspended operation of the hospital in April 1986. The
commissioner of human services shall provide the facility with
the same per diem property-related payment rate for each
additional licensed and certified bed as it will receive for its
existing 40 beds;
(l) to license or certify beds in renovation, replacement,
or upgrading projects as defined in section 144A.073,
subdivision 1, so long as the cumulative total costs of the
facility's remodeling projects do not exceed $750,000;
(m) to license and certify beds that are moved from one
location to another for the purposes of converting up to five
four-bed wards to single or double occupancy rooms in a nursing
home that, as of January 1, 1993, was county-owned and had a
licensed capacity of 115 beds;
(n) to allow a facility that on April 16, 1993, was a
106-bed licensed and certified nursing facility located in
Minneapolis to layaway all of its licensed and certified nursing
home beds. These beds may be relicensed and recertified in a
newly-constructed teaching nursing home facility affiliated with
a teaching hospital upon approval by the legislature. The
proposal must be developed in consultation with the interagency
committee on long-term care planning. The beds on layaway
status shall have the same status as voluntarily delicensed and
decertified beds, except that beds on layaway status remain
subject to the surcharge in section 256.9657. This layaway
provision expires July 1, 1998;
(o) to allow a project which will be completed in
conjunction with an approved moratorium exception project for a
nursing home in southern Cass county and which is directly
related to that portion of the facility that must be repaired,
renovated, or replaced, to correct an emergency plumbing problem
for which a state correction order has been issued and which
must be corrected by August 31, 1993;
(p) to allow a facility that on April 16, 1993, was a
368-bed licensed and certified nursing facility located in
Minneapolis to layaway, upon 30 days prior written notice to the
commissioner, up to 30 of the facility's licensed and certified
beds by converting three-bed wards to single or double
occupancy. Beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds except that beds on
layaway status remain subject to the surcharge in section
256.9657, remain subject to the license application and renewal
fees under section 144A.07 and shall be subject to a $100 per
bed reactivation fee. In addition, at any time within three
years of the effective date of the layaway, the beds on layaway
status may be:
(1) relicensed and recertified upon relocation and
reactivation of some or all of the beds to an existing licensed
and certified facility or facilities located in Pine River,
Brainerd, or International Falls; provided that the total
project construction costs related to the relocation of beds
from layaway status for any facility receiving relocated beds
may not exceed the dollar threshold provided in subdivision 2
unless the construction project has been approved through the
moratorium exception process under section 144A.073;
(2) relicensed and recertified, upon reactivation of some
or all of the beds within the facility which placed the beds in
layaway status, if the commissioner has determined a need for
the reactivation of the beds on layaway status.
The property-related payment rate of a facility placing
beds on layaway status must be adjusted by the incremental
change in its rental per diem after recalculating the rental per
diem as provided in section 256B.431, subdivision 3a, paragraph
(d). The property-related payment rate for a facility
relicensing and recertifying beds from layaway status must be
adjusted by the incremental change in its rental per diem after
recalculating its rental per diem using the number of beds after
the relicensing to establish the facility's capacity day
divisor, which shall be effective the first day of the month
following the month in which the relicensing and recertification
became effective. Any beds remaining on layaway status more
than three years after the date the layaway status became
effective must be removed from layaway status and immediately
delicensed and decertified;
(q) to license and certify beds in a renovation and
remodeling project to convert 12 four-bed wards into 24 two-bed
rooms, expand space, and add improvements in a nursing home
that, as of January 1, 1994, met the following conditions: the
nursing home was located in Ramsey county; had a licensed
capacity of 154 beds; and had been ranked among the top 15
applicants by the 1993 moratorium exceptions advisory review
panel. The total project construction cost estimate for this
project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process;
(r) to license and certify up to 117 beds that are
relocated from a licensed and certified 138-bed nursing facility
located in St. Paul to a hospital with 130 licensed hospital
beds located in South St. Paul, provided that the nursing
facility and hospital are owned by the same or a related
organization and that prior to the date the relocation is
completed the hospital ceases operation of its inpatient
hospital services at that hospital. After relocation, the
nursing facility's status under section 256B.431, subdivision
2j, shall be the same as it was prior to relocation. The
nursing facility's property-related payment rate resulting from
the project authorized in this paragraph shall become effective
no earlier than April 1, 1996. For purposes of calculating the
incremental change in the facility's rental per diem resulting
from this project, the allowable appraised value of the nursing
facility portion of the existing health care facility physical
plant prior to the renovation and relocation may not exceed
$2,490,000;
(s) to license and certify two beds in a facility to
replace beds that were voluntarily delicensed and decertified on
June 28, 1991;
(t) to allow 16 licensed and certified beds located on July
1, 1994, in a 142-bed nursing home and 21-bed boarding care home
facility in Minneapolis, notwithstanding the licensure and
certification after July 1, 1995, of the Minneapolis facility as
a 147-bed nursing home facility after completion of a
construction project approved in 1993 under section 144A.073, to
be laid away upon 30 days' prior written notice to the
commissioner. Beds on layaway status shall have the same status
as voluntarily delicensed or decertified beds except that they
shall remain subject to the surcharge in section 256.9657. The
16 beds on layaway status may be relicensed as nursing home beds
and recertified at any time within five years of the effective
date of the layaway upon relocation of some or all of the beds
to a licensed and certified facility located in Watertown,
provided that the total project construction costs related to
the relocation of beds from layaway status for the Watertown
facility may not exceed the dollar threshold provided in
subdivision 2 unless the construction project has been approved
through the moratorium exception process under section 144A.073.
The property-related payment rate of the facility placing
beds on layaway status must be adjusted by the incremental
change in its rental per diem after recalculating the rental per
diem as provided in section 256B.431, subdivision 3a, paragraph
(d). The property-related payment rate for the facility
relicensing and recertifying beds from layaway status must be
adjusted by the incremental change in its rental per diem after
recalculating its rental per diem using the number of beds after
the relicensing to establish the facility's capacity day
divisor, which shall be effective the first day of the month
following the month in which the relicensing and recertification
became effective. Any beds remaining on layaway status more
than five years after the date the layaway status became
effective must be removed from layaway status and immediately
delicensed and decertified;
(u) to license and certify beds that are moved within an
existing area of a facility or to a newly constructed addition
which is built for the purpose of eliminating three- and
four-bed rooms and adding space for dining, lounge areas,
bathing rooms, and ancillary service areas in a nursing home
that, as of January 1, 1995, was located in Fridley and had a
licensed capacity of 129 beds;
(v) to relocate 36 beds in Crow Wing county and four beds
from Hennepin county to a 160-bed facility in Crow Wing county,
provided all the affected beds are under common ownership;
(w) to license and certify a total replacement project of
up to 49 beds located in Norman county that are relocated from a
nursing home destroyed by flood and whose residents were
relocated to other nursing homes. The operating cost payment
rates for the new nursing facility shall be determined based on
the interim and settle-up payment provisions of Minnesota Rules,
part 9549.0057, and the reimbursement provisions of section
256B.431, except that subdivision 26, paragraphs (a) and (b),
shall not apply until the second rate year after the settle-up
cost report is filed. Property-related reimbursement rates
shall be determined under section 256B.431, taking into account
any federal or state flood-related loans or grants provided to
the facility;
(x) to license and certify a total replacement project of
up to 129 beds located in Polk county that are relocated from a
nursing home destroyed by flood and whose residents were
relocated to other nursing homes. The operating cost payment
rates for the new nursing facility shall be determined based on
the interim and settle-up payment provisions of Minnesota Rules,
part 9549.0057, and the reimbursement provisions of section
256B.431, except that subdivision 26, paragraphs (a) and (b),
shall not apply until the second rate year after the settle-up
cost report is filed. Property-related reimbursement rates
shall be determined under section 256B.431, taking into account
any federal or state flood-related loans or grants provided to
the facility; or
(y) to license and certify beds in a renovation and
remodeling project to convert 13 three-bed wards into 13 two-bed
rooms and 13 single-bed rooms, expand space, and add
improvements in a nursing home that, as of January 1, 1994, met
the following conditions: the nursing home was located in
Ramsey county, was not owned by a hospital corporation, had a
licensed capacity of 64 beds, and had been ranked among the top
15 applicants by the 1993 moratorium exceptions advisory review
panel. The total project construction cost estimate for this
project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process.;
(z) to license and certify up to 150 nursing home beds to
replace an existing 285 bed nursing facility located in St.
Paul. The replacement project shall include both the renovation
of existing buildings and the construction of new facilities at
the existing site. The reduction in the licensed capacity of
the existing facility shall occur during the construction
project as beds are taken out of service due to the construction
process. Prior to the start of the construction process, the
facility shall provide written information to the commissioner
of health describing the process for bed reduction, plans for
the relocation of residents, and the estimated construction
schedule. The relocation of residents shall be in accordance
with the provisions of law and rule; or
(aa) to allow the commissioner of human services to license
an additional 36 beds to provide residential services for the
physically handicapped under Minnesota Rules, parts 9570.2000 to
9570.3400, in a 198-bed nursing home located in Red Wing,
provided that the total number of licensed and certified beds at
the facility does not increase.
Sec. 3. Minnesota Statutes 1996, section 144A.09,
subdivision 1, is amended to read:
Subdivision 1. [SPIRITUAL MEANS FOR HEALING.] No rule
established Sections 144A.04, subdivision 5, and 144A.18 to
144A.27, and rules adopted under sections 144A.01 to 144A.16
other than a rule relating to sanitation and safety of premises,
to cleanliness of operation, or to physical equipment shall do
not apply to a nursing home conducted by and for the adherents
of any recognized church or religious denomination for the
purpose of providing care and treatment for those who select and
depend upon spiritual means through prayer alone, in lieu of
medical care, for healing.
Sec. 4. Minnesota Statutes 1996, section 256B.431,
subdivision 2i, is amended 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. For the rate period beginning October 1, 1992, and for
rate years beginning after June 30, 1993, the amount of the
surcharge under section 256.9657, subdivision 1, shall be
included in the plant operations and maintenance operating cost
category. The surcharge shall be an allowable cost for the
purpose of establishing the payment rate.
(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
Effective October July 1, 1988 1998, to June 30, 1990
2000, the commissioner shall add the appropriate make available
the salary adjustment per diem calculated in clause (1) or (2)
to the total operating cost payment rate of each nursing
facility reimbursed under this section or section 256B.434. The
salary adjustment per diem for each nursing facility must be
determined as follows:
(1) For each nursing facility 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 3.0 percent and then
dividing the resulting amount by the nursing facility's actual
resident days; and.
(2) For each nursing facility 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 facility that receives a salary adjustment per
diem pursuant to this subdivision shall adjust nursing facility
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 facility complied with this
requirement. The commissioner shall report the extent to which
each nursing facility complied with the legislative commission
on long-term care by August 1, 1990.
(3) A nursing facility may apply for the salary adjustment
per diem calculated under clauses (1) and (2). The application
must be made to the commissioner and contain a plan by which the
nursing facility will distribute the salary adjustment to
employees of the nursing facility. In order to apply for a
salary adjustment, a nursing facility reimbursed under section
256B.434, must report the information required by clause (1) or
(2) in the application, in the manner specified by the
commissioner. For nursing facilities in which the employees are
represented by an exclusive bargaining representative, an
agreement negotiated and agreed to by the employer and the
exclusive bargaining representative, after July 1, 1998, may
constitute the plan for the salary distribution. The
commissioner shall review the plan to ensure that the salary
adjustment per diem is used solely to increase the compensation
of nursing home facility employees. To be eligible, a facility
must submit its plan for the salary distribution by December 31,
1998. If a facility's plan for salary distribution is effective
for its employees after July 1, 1998, the salary adjustment cost
per diem shall be effective the same date as its plan.
(4) Additional costs incurred by nursing facilities as a
result of this salary adjustment are not allowable costs for
purposes of the September 30, 1998, cost report.
(d) [NEW BASE YEAR.] The commissioner shall establish new
base years for both the reporting year ending September 30,
1989, and the reporting year ending September 30, 1990. In
establishing new base years, the commissioner must take into
account:
(1) statutory changes made in geographic groups;
(2) redefinitions of cost categories; and
(3) reclassification, pass-through, or exemption of certain
costs such as public employee retirement act contributions.
(e) [NEW BASE YEAR.] The commissioner shall establish a
new base year for the reporting years ending September 30, 1991,
and September 30, 1992. In establishing a new base year, the
commissioner must take into account:
(1) statutory changes made in geographic groups;
(2) redefinitions of cost categories; and
(3) reclassification, pass-through, or exemption of certain
costs.
Sec. 5. Minnesota Statutes 1996, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2s. [NONALLOWABLE COST.] Costs incurred for any
activities which are directed at or are intended to influence or
dissuade employees in the exercise of their legal rights to
freely engage in the process of selecting an exclusive
representative for the purpose of collective bargaining with
their employer shall not be allowable for purposes of setting
payment rates.
Sec. 6. Minnesota Statutes 1997 Supplement, section
256B.431, subdivision 3f, is amended 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. For the rate year beginning July 1, 1989,
the replacement-cost-new per bed limit for a single bedroom must
be $49,907 adjusted according to Minnesota Rules, part
9549.0060, subpart 4, item A, subitem (1). Beginning January 1,
1990, 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). Beginning January 1, 1991, the
replacement-cost-new per bed limits will be adjusted annually as
specified in Minnesota Rules, part 9549.0060, subpart 4, item A,
subitem (1), except that the index utilized will be the Bureau
of the Census: Composite fixed-weighted price index as
published in the C30 Report, Value of New Construction Put in
Place.
(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 facilities 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 facilities except those whose average length of stay in
a skilled level of care within a nursing facility is 180 days or
less, the commissioner shall use 95 percent of capacity days.
For a nursing facility whose average length of stay in a skilled
level of care within a nursing facility 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 facility'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 facility'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. For the
rate period beginning October 1, 1992, the equipment allowance
for each nursing facility shall be increased by 28 percent. For
rate years beginning after June 30, 1993, the allowance must be
adjusted annually for inflation.
(e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND
INTEREST EXPENSE.] For rate years beginning on or after July 1,
1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall
not apply to outstanding related organization debt incurred
prior to May 23, 1983, provided that the debt was an allowable
debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the
debt is subject to repayment through annual principal payments,
and the nursing facility demonstrates to the commissioner's
satisfaction that the interest rate on the debt was less than
market interest rates for similar arms-length transactions at
the time the debt was incurred. If the debt was incurred due to
a sale between family members, the nursing facility must also
demonstrate that the seller no longer participates in the
management or operation of the nursing facility. Debts meeting
the conditions of this paragraph are subject to all other
provisions of Minnesota Rules, parts 9549.0010 to 9549.0080.
(f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES
WITH OPERATING LEASES.] For rate years beginning on or after
July 1, 1990, a nursing facility with operating lease costs
incurred for the nursing facility's buildings shall receive its
building capital allowance computed in accordance with Minnesota
Rules, part 9549.0060, subpart 8. If an operating lease
provides that the lessee's rent is adjusted to recognize
improvements made by the lessor and related debt, the costs for
capital improvements and related debt shall be allowed in the
computation of the lessee's building capital allowance, provided
that reimbursement for these costs under an operating lease
shall not exceed the rate otherwise paid.
Sec. 7. Minnesota Statutes 1996, 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
facility 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 facility
or for the added beds. For newly constructed nursing facilities
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 facilities which
provide care under a lesser care level than the level for which
the nursing facility is certified.
(b) For the rate years beginning on or after July 1, 1985,
a newly constructed nursing facility 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.
(d) A facility that meets the criteria of paragraph (c)
shall submit annual cost reports on forms prescribed by the
commissioner.
(e) (c) For the rate year beginning July 1, 1985, each
nursing facility 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 facility.
From July 1, 1985, until the total payment rate becomes
effective, the commissioner shall make payments to each nursing
facility 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.
(f) (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 facility upon death
of an owner;
(2) the sale or transfer of a nursing facility due to
serious illness or disability of an owner as defined under the
social security act;
(3) the sale or transfer of the nursing facility 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 facility 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 facility 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.
Sec. 8. Minnesota Statutes 1996, section 256B.431,
subdivision 11, is amended to read:
Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR
CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota
Rules, part 9549.0060, subpart 13, item H, to the contrary, for
the rate year beginning July 1, 1990, a nursing facility leased
prior to January 1, 1986, and currently subject to adverse
licensure action under section 144A.04, subdivision 4, paragraph
(a), or section 144A.11, subdivision 2, and whose ownership
changes prior to July 1, 1990, shall be allowed a
property-related payment equal to the lesser of its current
lease obligation divided by its capacity days as determined in
Minnesota Rules, part 9549.0060, subpart 11, as modified by
subdivision 3f, paragraph (c), or the frozen property-related
payment rate in effect for the rate year beginning July 1,
1989. For rate years beginning on or after July 1, 1991, the
property-related payment rate shall be its rental rate computed
using the previous owner's allowable principal and interest
expense as allowed by the department prior to that prior owner's
sale and lease-back transaction of December 1985.
(b) Notwithstanding other provisions of applicable law, a
nursing facility licensed for 122 beds on January 1, 1998, and
located in Columbia Heights shall have its property-related
payment rate set under this subdivision. The commissioner shall
make a rate adjustment by adding $2.41 to the facility's July 1,
1997, property-related payment rate. The adjusted
property-related payment rate shall be effective for rate years
beginning on or after July 1, 1998. The adjustment in this
paragraph shall remain in effect so long as the facility's rates
are set under this section. If the facility participates in the
alternative payment system under section 256B.434, the
adjustment in this paragraph shall be included in the facility's
contract payment rate. If historical rates or property costs
recognized under this section become the basis for future
medical assistance payments to the facility under a managed
care, capitation, or other alternative payment system, the
adjustment in this paragraph shall be included in the
computation of the facility's payments.
Sec. 9. Minnesota Statutes 1996, section 256B.431,
subdivision 22, is amended to read:
Subd. 22. [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The
nursing facility reimbursement changes in paragraphs (a) to (e)
apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this
section, and are effective for rate years beginning on or after
July 1, 1993, unless otherwise indicated.
(a) In addition to the approved pension or profit sharing
plans allowed by the reimbursement rule, the commissioner shall
allow those plans specified in Internal Revenue Code, sections
403(b) and 408(k).
(b) The commissioner shall allow as workers' compensation
insurance costs under section 256B.421, subdivision 14, the
costs of workers' compensation coverage obtained under the
following conditions:
(1) a plan approved by the commissioner of commerce as a
Minnesota group or individual self-insurance plan as provided in
section 79A.03;
(2) a plan in which:
(i) the nursing facility, directly or indirectly, purchases
workers' compensation coverage in compliance with section
176.181, subdivision 2, from an authorized insurance carrier;
(ii) a related organization to the nursing facility
reinsures the workers' compensation coverage purchased, directly
or indirectly, by the nursing facility; and
(iii) all of the conditions in clause (4) are met;
(3) a plan in which:
(i) the nursing facility, directly or indirectly, purchases
workers' compensation coverage in compliance with section
176.181, subdivision 2, from an authorized insurance carrier;
(ii) the insurance premium is calculated retrospectively,
including a maximum premium limit, and paid using the paid loss
retro method; and
(iii) all of the conditions in clause (4) are met;
(4) additional conditions are:
(i) the costs of the plan are allowable under the federal
Medicare program;
(ii) the reserves for the plan are maintained in an account
controlled and administered by a person which is not a related
organization to the nursing facility;
(iii) the reserves for the plan cannot be used, directly or
indirectly, as collateral for debts incurred or other
obligations of the nursing facility or related organizations to
the nursing facility;
(iv) if the plan provides workers' compensation coverage
for non-Minnesota nursing facilities, the plan's cost
methodology must be consistent among all nursing facilities
covered by the plan, and if reasonable, is allowed
notwithstanding any reimbursement laws regarding cost allocation
to the contrary;
(v) central, affiliated, corporate, or nursing facility
costs related to their administration of the plan are costs
which must remain in the nursing facility's administrative cost
category and must not be allocated to other cost categories; and
(vi) required security deposits, whether in the form of
cash, investments, securities, assets, letters of credit, or in
any other form are not allowable costs for purposes of
establishing the facilities payment rate.; and
(vii) for the rate year beginning on July 1, 1998, a group
of nursing facilities related by common ownership that
self-insures workers' compensation may allocate its directly
identified costs of self-insuring its Minnesota nursing facility
workers among those nursing facilities in the group that are
reimbursed under this section or section 256B.434. The method
of cost allocation shall be based on the ratio of each nursing
facility's total allowable salaries and wages to that of the
nursing facility group's total allowable salaries and wages,
then similarly allocated within each nursing facility's
operating cost categories. The costs associated with the
administration of the group's self-insurance plan must remain
classified in the nursing facility's administrative cost
category. A written request of the nursing facility group's
election to use this alternate method of allocation of
self-insurance costs must be received by the commissioner no
later than May 1, 1998, to take effect July 1, 1998, or such
costs shall continue to be allocated under the existing cost
allocation methods. Once a nursing facility group elects this
method of cost allocation for its workers' compensation
self-insurance costs, it shall remain in effect until such time
as the group no longer self-insures these costs;
(5) any costs allowed pursuant to clauses (1) to (3) are
subject to the following requirements:
(i) if the nursing facility is sold or otherwise ceases
operations, the plan's reserves must be subject to an
actuarially based settle-up after 36 months from the date of
sale or the date on which operations ceased. The facility's
medical assistance portion of the total excess plan reserves
must be paid to the state within 30 days following the date on
which excess plan reserves are determined;
(ii) any distribution of excess plan reserves made to or
withdrawals made by the nursing facility or a related
organization are applicable credits and must be used to reduce
the nursing facility's workers' compensation insurance costs in
the reporting period in which a distribution or withdrawal is
received;
(iii) if reimbursement for the plan is sought under the
federal Medicare program, and is audited pursuant to the
Medicare program, the nursing facility must provide a copy of
Medicare's final audit report, including attachments and
exhibits, to the commissioner within 30 days of receipt by the
nursing facility or any related organization. The commissioner
shall implement the audit findings associated with the plan upon
receipt of Medicare's final audit report. The department's
authority to implement the audit findings is independent of its
authority to conduct a field audit.
(c) In the determination of incremental increases in the
nursing facility's rental rate as required in subdivisions 14 to
21, except for a refinancing permitted under subdivision 19, the
commissioner must adjust the nursing facility's property-related
payment rate for both incremental increases and decreases in
recomputations of its rental rate;
(d) A nursing facility's administrative cost limitation
must be modified as follows:
(1) if the nursing facility's licensed beds exceed 195
licensed beds, the general and administrative cost category
limitation shall be 13 percent;
(2) if the nursing facility's licensed beds are more than
150 licensed beds, but less than 196 licensed beds, the general
and administrative cost category limitation shall be 14 percent;
or
(3) if the nursing facility's licensed beds is less than
151 licensed beds, the general and administrative cost category
limitation shall remain at 15 percent.
(e) The care related operating rate shall be increased by
eight cents to reimburse facilities for unfunded federal
mandates, including costs related to hepatitis B vaccinations.
(f) For the rate year beginning on July 1, 1998, a group of
nursing facilities related by common ownership that self-insures
group health, dental, or life insurance may allocate its
directly identified costs of self-insuring its Minnesota nursing
facility workers among those nursing facilities in the group
that are reimbursed under this section or section 256B.434. The
method of cost allocation shall be based on the ratio of each
nursing facility's total allowable salaries and wages to that of
the nursing facility group's total allowable salaries and wages,
then similarly allocated within each nursing facility's
operating cost categories. The costs associated with the
administration of the group's self-insurance plan must remain
classified in the nursing facility's administrative cost
category. A written request of the nursing facility group's
election to use this alternate method of allocation of
self-insurance costs must be received by the commissioner no
later than May 1, 1998, to take effect July 1, 1998, or those
self-insurance costs shall continue to be allocated under the
existing cost allocation methods. Once a nursing facility group
elects this method of cost allocation for its group health,
dental, or life insurance self-insurance costs, it shall remain
in effect until such time as the group no longer self-insures
these costs.
Sec. 10. Minnesota Statutes 1997 Supplement, section
256B.431, subdivision 26, is amended to read:
Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT
BEGINNING JULY 1, 1997.] The nursing facility reimbursement
changes in paragraphs (a) to (f) shall apply in the sequence
specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and
this section, beginning July 1, 1997.
(a) For rate years beginning on or after July 1, 1997, the
commissioner shall limit a nursing facility's allowable
operating per diem for each case mix category for each rate year.
The commissioner shall group nursing facilities into two groups,
freestanding and nonfreestanding, within each geographic group,
using their operating cost per diem for the case mix A
classification. A nonfreestanding nursing facility is a nursing
facility whose other operating cost per diem is subject to the
hospital attached, short length of stay, or the rule 80 limits.
All other nursing facilities shall be considered freestanding
nursing facilities. The commissioner shall then array all
nursing facilities in each grouping by their allowable case mix
A operating cost per diem. In calculating a nursing facility's
operating cost per diem for this purpose, the commissioner shall
exclude the raw food cost per diem related to providing special
diets that are based on religious beliefs, as determined in
subdivision 2b, paragraph (h). For those nursing facilities in
each grouping whose case mix A operating cost per diem:
(1) is at or below the median of the array, the
commissioner shall limit the nursing facility's allowable
operating cost per diem for each case mix category to the lesser
of the prior reporting year's allowable operating cost per diem
as specified in Laws 1996, chapter 451, article 3, section 11,
paragraph (h), plus the inflation factor as established in
paragraph (d), clause (2), increased by two percentage points,
or the current reporting year's corresponding allowable
operating cost per diem; or
(2) is above the median of the array, the commissioner
shall limit the nursing facility's allowable operating cost per
diem for each case mix category to the lesser of the prior
reporting year's allowable operating cost per diem as specified
in Laws 1996, chapter 451, article 3, section 11, paragraph (h),
plus the inflation factor as established in paragraph (d),
clause (2), increased by one percentage point, or the current
reporting year's corresponding allowable operating cost per diem.
For purposes of paragraph (a), if a nursing facility
reports on its cost report a reduction in cost due to a refund
or credit for a rate year beginning on or after July 1, 1998,
the commissioner shall increase that facility's spend-up limit
for the rate year following the current rate year by the amount
of the cost reduction divided by its resident days for the
reporting year preceding the rate year in which the adjustment
is to be made.
(b) For rate years beginning on or after July 1, 1997, the
commissioner shall limit the allowable operating cost per diem
for high cost nursing facilities. After application of the
limits in paragraph (a) to each nursing facility's operating
cost per diem, the commissioner shall group nursing facilities
into two groups, freestanding or nonfreestanding, within each
geographic group. A nonfreestanding nursing facility is a
nursing facility whose other operating cost per diem are subject
to hospital attached, short length of stay, or rule 80 limits.
All other nursing facilities shall be considered freestanding
nursing facilities. The commissioner shall then array all
nursing facilities within each grouping by their allowable case
mix A operating cost per diem. In calculating a nursing
facility's operating cost per diem for this purpose, the
commissioner shall exclude the raw food cost per diem related to
providing special diets that are based on religious beliefs, as
determined in subdivision 2b, paragraph (h). For those nursing
facilities in each grouping whose case mix A operating cost per
diem exceeds 1.0 standard deviation above the median, the
commissioner shall reduce their allowable operating cost per
diem by three percent. For those nursing facilities in each
grouping whose case mix A operating cost per diem exceeds 0.5
standard deviation above the median but is less than or equal to
1.0 standard deviation above the median, the commissioner shall
reduce their allowable operating cost per diem by two percent.
However, in no case shall a nursing facility's operating cost
per diem be reduced below its grouping's limit established at
0.5 standard deviations above the median.
(c) For rate years beginning on or after July 1, 1997, the
commissioner shall determine a nursing facility's efficiency
incentive by first computing the allowable difference, which is
the lesser of $4.50 or the amount by which the facility's other
operating cost limit exceeds its nonadjusted other operating
cost per diem for that rate year. The commissioner shall
compute the efficiency incentive by:
(1) subtracting the allowable difference from $4.50 and
dividing the result by $4.50;
(2) multiplying 0.20 by the ratio resulting from clause
(1), and then;
(3) adding 0.50 to the result from clause (2); and
(4) multiplying the result from clause (3) times the
allowable difference.
The nursing facility's efficiency incentive payment shall
be the lesser of $2.25 or the product obtained in clause (4).
(d) For rate years beginning on or after July 1, 1997, the
forecasted price index for a nursing facility's allowable
operating cost per diem shall be determined under clauses (1)
and (2) using the change in the Consumer Price Index-All Items
(United States city average) (CPI-U) as forecasted by Data
Resources, Inc. The commissioner shall use the indices as
forecasted in the fourth quarter of the calendar year preceding
the rate year, subject to subdivision 2l, paragraph (c).
(1) The CPI-U forecasted index for allowable operating cost
per diem shall be based on the 21-month period from the midpoint
of the nursing facility's reporting year to the midpoint of the
rate year following the reporting year.
(2) For rate years beginning on or after July 1, 1997, the
forecasted index for operating cost limits referred to in
subdivision 21, paragraph (b), shall be based on the CPI-U for
the 12-month period between the midpoints of the two reporting
years preceding the rate year.
(e) After applying these provisions for the respective rate
years, the commissioner shall index these allowable operating
cost per diem by the inflation factor provided for in paragraph
(d), clause (1), and add the nursing facility's efficiency
incentive as computed in paragraph (c).
(f) For rate years beginning on or after July 1, 1997, the
total operating cost payment rates for a nursing facility shall
be the greater of the total operating cost payment rates
determined under this section or the total operating cost
payment rates in effect on June 30, 1997, subject to rate
adjustments due to field audit or rate appeal resolution. This
provision shall not apply to subsequent field audit adjustments
of the nursing facility's operating cost rates for rate years
beginning on or after July 1, 1997.
(g) For the rate years beginning on July 1, 1997, and July
1, 1998, and July 1, 1999, a nursing facility licensed for 40
beds effective May 1, 1992, with a subsequent increase of 20
Medicare/Medicaid certified beds, effective January 26, 1993, in
accordance with an increase in licensure is exempt from
paragraphs (a) and (b).
(h) For a nursing facility whose construction project was
authorized according to section 144A.073, subdivision 5,
paragraph (g), the operating cost payment rates for the third
location shall be determined based on Minnesota Rules, part
9549.0057. Paragraphs (a) and (b) shall not apply until the
second rate year after the settle-up cost report is filed.
Notwithstanding subdivision 2b, paragraph (g), real estate taxes
and special assessments payable by the third location, a
501(c)(3) nonprofit corporation, shall be included in the
payment rates determined under this subdivision for all
subsequent rate years.
(i) For the rate year beginning July 1, 1997, the
commissioner shall compute the payment rate for a nursing
facility licensed for 94 beds on September 30, 1996, that
applied in October 1993 for approval of a total replacement
under the moratorium exception process in section 144A.073, and
completed the approved replacement in June 1995, with other
operating cost spend-up limit under paragraph (a), increased by
$3.98, and after computing the facility's payment rate according
to this section, the commissioner shall make a one-year positive
rate adjustment of $3.19 for operating costs related to the
newly constructed total replacement, without application of
paragraphs (a) and (b). The facility's per diem, before the
$3.19 adjustment, shall be used as the prior reporting year's
allowable operating cost per diem for payment rate calculation
for the rate year beginning July 1, 1998. A facility described
in this paragraph is exempt from paragraph (b) for the rate
years beginning July 1, 1997, and July 1, 1998.
(j) For the purpose of applying the limit stated in
paragraph (a), a nursing facility in Kandiyohi county licensed
for 86 beds that was granted hospital-attached status on
December 1, 1994, shall have the prior year's allowable
care-related per diem increased by $3.207 and the prior year's
other operating cost per diem increased by $4.777 before adding
the inflation in paragraph (d), clause (2), for the rate year
beginning on July 1, 1997.
(k) For the purpose of applying the limit stated in
paragraph (a), a 117 bed nursing facility located in Pine county
shall have the prior year's allowable other operating cost per
diem increased by $1.50 before adding the inflation in paragraph
(d), clause (2), for the rate year beginning on July 1, 1997.
(l) For the purpose of applying the limit under paragraph
(a), a nursing facility in Hibbing licensed for 192 beds shall
have the prior year's allowable other operating cost per diem
increased by $2.67 before adding the inflation in paragraph (d),
clause (2), for the rate year beginning July 1, 1997.
Sec. 11. Minnesota Statutes 1996, section 256B.431, is
amended by adding a subdivision to read:
Subd. 27. [CHANGES TO NURSING FACILITY REIMBURSEMENT
BEGINNING JULY 1, 1998.] (a) For the purpose of applying the
limit stated in subdivision 26, paragraph (a), a nursing
facility in Hennepin county licensed for 181 beds on September
30, 1996, shall have the prior year's allowable care-related per
diem increased by $1.455 and the prior year's other operating
cost per diem increased by $0.439 before adding the inflation in
subdivision 26, paragraph (d), clause (2), for the rate year
beginning on July 1, 1998.
(b) For the purpose of applying the limit stated in
subdivision 26, paragraph (a), a nursing facility in Hennepin
county licensed for 161 beds on September 30, 1996, shall have
the prior year's allowable care-related per diem increased by
$1.154 and the prior year's other operating cost per diem
increased by $0.256 before adding the inflation in subdivision
26, paragraph (d), clause (2), for the rate year beginning on
July 1, 1998.
(c) For the purpose of applying the limit stated in
subdivision 26, paragraph (a), a nursing facility in Ramsey
county licensed for 176 beds on September 30, 1996, shall have
the prior year's allowable care-related per diem increased by
$0.803 and the prior year's other operating cost per diem
increased by $0.272 before adding the inflation in subdivision
26, paragraph (d), clause (2), for the rate year beginning on
July 1, 1998.
(d) For the purpose of applying the limit stated in
subdivision 26, paragraph (a), a nursing facility in Brown
county licensed for 86 beds on September 30, 1996, shall have
the prior year's allowable care-related per diem increased by
$0.850 and the prior year's other operating cost per diem
increased by $0.275 before adding the inflation in subdivision
26, paragraph (d), clause (2), for the rate year beginning on
July 1, 1998.
(e) For the rate year beginning July 1, 1998, the
commissioner shall compute the payment rate for a nursing
facility, which was licensed for 110 beds on May 1, 1997, was
granted approval in January 1994 for a replacement and
remodeling project under the moratorium exception process in
section 144A.073, and completed the approved replacement and
remodeling project on March 14, 1997, by increasing the other
operating cost spend-up limit under paragraph (a) by $1.64.
After computing the facility's payment rate for the rate year
beginning July 1, 1998, according to this section, the
commissioner shall make a one-year positive rate adjustment of
48 cents for increased real estate taxes resulting from
completion of the moratorium exception project, without
application of paragraphs (a) and (b).
(f) For the rate year beginning July 1, 1998, the
commissioner shall compute the payment rate for a nursing
facility exempted from care-related limits under subdivision 2b,
paragraph (d), clause (2), with a minimum of three-quarters of
its beds licensed to provide residential services for the
physically handicapped under Minnesota Rules, parts 9570.2000 to
9570.3400, with the care-related spend-up limit under
subdivision 26, paragraph (a), increased by $13.21 for the rate
year beginning July 1, 1998, without application of subdivision
26, paragraph (b). For rate years beginning on or after July 1,
1999, the commissioner shall exclude that amount in calculating
the facility's operating cost per diem for purposes of applying
subdivision 26, paragraph (b).
(g) For the rate year beginning July 1, 1998, a nursing
facility in Canby, Minnesota, licensed for 75 beds shall be
reimbursed without the limitation imposed under subdivision 26,
paragraph (a), and for rate years beginning on or after July 1,
1999, its base costs shall be calculated on the basis of its
September 30, 1997, cost report.
(h) The nursing facility reimbursement changes in
paragraphs (i) and (j) shall apply in the sequence specified in
this section and Minnesota Rules, parts 9549.0010 to 9549.0080,
beginning July 1, 1998.
(i) For rate years beginning on or after July 1, 1998, the
operating cost limits established in subdivisions 2, 2b, 2i, 3c,
and 22, paragraph (d), and any previously effective
corresponding limits in law or rule shall not apply, except that
these cost limits shall still be calculated for purposes of
determining efficiency incentive per diems. For rate years
beginning on or after July 1, 1998, the total operating cost
payment rates for a nursing facility shall be the greater of the
total operating cost payment rates determined under this section
or the total operating cost payment rates in effect on June 30,
1998, subject to rate adjustments due to field audit or rate
appeal resolution.
(j) For rate years beginning on or after July 1, 1998, the
operating cost per diem referred to in subdivision 26, paragraph
(a), clauses (1) and (2), is the sum of the care-related and
other operating per diems for a given case mix class. Any
reductions to the combined operating per diem shall be divided
proportionately between the care-related and other operating per
diems.
(k) For rate years beginning on or after July 1, 1998, the
commissioner shall modify the determination of the spend-up
limits referred to in subdivision 26, paragraph (a), by indexing
each group's previous year's median value by the factor in
subdivision 26, paragraph (d), clause (2), plus one percentage
point.
(l) For rate years beginning on or after July 1, 1998, the
commissioner shall modify the determination of the high cost
limits referred to in subdivision 26, paragraph (b), by indexing
each group's previous year's high cost per diem limits at .5 and
one standard deviations above the median by the factor in
subdivision 26, paragraph (d), clause (2), plus one percentage
point.
Sec. 12. Minnesota Statutes 1997 Supplement, section
256B.433, subdivision 3a, is amended to read:
Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY
BILLING.] The provisions of subdivision 3 do not apply to
nursing facilities that are reimbursed according to the
provisions of section 256B.431 and are located in a county
participating in the prepaid medical assistance
program. Nursing facilities that are reimbursed according to
the provisions of section 256B.434 and are located in a county
participating in the prepaid medical assistance program are
exempt from the maximum therapy rent revenue provisions of
subdivision 3, paragraph (c).
Sec. 13. Minnesota Statutes 1997 Supplement, section
256B.434, subdivision 10, is amended to read:
Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by
federal law, (1) a facility that has entered into a contract
under this section is not required to file a cost report, as
defined in Minnesota Rules, part 9549.0020, subpart 13, for any
year after the base year that is the basis for the calculation
of the contract payment rate for the first rate year of the
alternative payment demonstration project contract; and (2) a
facility under contract is not subject to audits of historical
costs or revenues, or paybacks or retroactive adjustments based
on these costs or revenues, except audits, paybacks, or
adjustments relating to the cost report that is the basis for
calculation of the first rate year under the contract.
(b) A facility that is under contract with the commissioner
under this section is not subject to the moratorium on licensure
or certification of new nursing home beds in section 144A.071,
unless the project results in a net increase in bed capacity or
involves relocation of beds from one site to another. Contract
payment rates must not be adjusted to reflect any additional
costs that a nursing facility incurs as a result of a
construction project undertaken under this paragraph. In
addition, as a condition of entering into a contract under this
section, a nursing facility must agree that any future medical
assistance payments for nursing facility services will not
reflect any additional costs attributable to the sale of a
nursing facility under this section and to construction
undertaken under this paragraph that otherwise would not be
authorized under the moratorium in section 144A.073. Nothing in
this section prevents a nursing facility participating in the
alternative payment demonstration project under this section
from seeking approval of an exception to the moratorium through
the process established in section 144A.073, and if approved the
facility's rates shall be adjusted to reflect the cost of the
project. Nothing in this section prevents a nursing facility
participating in the alternative payment demonstration project
from seeking legislative approval of an exception to the
moratorium under section 144A.071, and, if enacted, the
facility's rates shall be adjusted to reflect the cost of the
project.
(c) Notwithstanding section 256B.48, subdivision 6,
paragraphs (c), (d), and (e), and pursuant to any terms and
conditions contained in the facility's contract, a nursing
facility that is under contract with the commissioner under this
section is in compliance with section 256B.48, subdivision 6,
paragraph (b), if the facility is Medicare certified.
(d) Notwithstanding paragraph (a), if by April 1, 1996, the
health care financing administration has not approved a required
waiver, or the health care financing administration otherwise
requires cost reports to be filed prior to the waiver's
approval, the commissioner shall require a cost report for the
rate year.
(e) A facility that is under contract with the commissioner
under this section shall be allowed to change therapy
arrangements from an unrelated vendor to a related vendor during
the term of the contract. The commissioner may develop
reasonable requirements designed to prevent an increase in
therapy utilization for residents enrolled in the medical
assistance program.
Sec. 14. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM
EFFECTIVE JULY 1, 2000.]
Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the
commissioner shall implement a performance-based contracting
system to replace the current method of setting operating cost
payment rates under sections 256B.431 and 256B.434 and Minnesota
Rules, parts 9549.0010 to 9549.0080. A nursing facility in
operation on May 1, 1998, with payment rates not established
under section 256B.431 or 256B.434 on that date, is ineligible
for this performance-based contracting system. In determining
prospective payment rates of nursing facility services, the
commissioner shall distinguish between operating costs and
property-related costs. The commissioner of finance shall
include an annual inflationary adjustment in operating costs for
nursing facilities using the inflation factor specified in
subdivision 3 as a budget change request in each biennial
detailed expenditure budget submitted to the legislature under
section 16A.11. Property related payment rates, including real
estate taxes and special assessments, shall be determined under
section 256B.431 or 256B.434 or under a new property-related
reimbursement system, if one is implemented by the commissioner
under subdivision 3.
Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based
contract with each nursing facility must include provisions that:
(1) apply the resident case mix assessment provisions of
Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or
another assessment system, with the goal of moving to a single
assessment system;
(2) monitor resident outcomes through various methods, such
as quality indicators based on the minimum data set and other
utilization and performance measures;
(3) require the establishment and use of a continuous
quality improvement process that integrates information from
quality indicators and regular resident and family satisfaction
interviews;
(4) require annual reporting of facility statistical
information, including resident days by case mix category,
productive nursing hours, wages and benefits, and raw food costs
for use by the commissioner in the development of facility
profiles that include trends in payment and service utilization;
(5) require from each nursing facility an annual certified
audited financial statement consisting of a balance sheet,
income and expense statements, and an opinion from either a
licensed or certified public accountant, if a certified audit
was prepared, or unaudited financial statements if no certified
audit was prepared; and
(6) establish additional requirements and penalties for
nursing facilities not meeting the standards set forth in the
performance-based contract.
(b) The commissioner may develop additional incentive-based
payments for achieving outcomes specified in each contract. The
specified facility-specific outcomes must be measurable and
approved by the commissioner.
(c) The commissioner may also contract with nursing
facilities in other ways through requests for proposals,
including contracts on a risk or nonrisk basis, with nursing
facilities or consortia of nursing facilities, to provide
comprehensive long-term care coverage on a premium or capitated
basis.
Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years
beginning on or after July 1, 2000, within the limits of
appropriations specifically for this purpose, the commissioner
shall determine operating cost payment rates for each licensed
and certified nursing facility by indexing its operating cost
payment rates in effect on June 30, 2000, for inflation. The
inflation factor to be used must be based on the change in the
Consumer Price Index-All Items, United States city average
(CPI-U) as forecasted by Data Resources, Inc. in the fourth
quarter preceding the rate year. The CPI-U forecasted index for
operating cost payment rates shall be based on the 12-month
period from the midpoint of the nursing facility's prior rate
year to the midpoint of the rate year for which the operating
payment rate is being determined.
(b) Beginning July 1, 2000, each nursing facility subject
to a performance-based contract under this section shall choose
one of two methods of payment for property related costs:
(1) the method established in section 256B.434; or
(2) the method established in section 256B.431.
Once the nursing facility has made the election in paragraph
(b), that election shall remain in effect for at least four
years or until an alternative property payment system is
developed.
(c) For rate years beginning on or after July 1, 2000, the
commissioner may implement a new method of payment for property
related costs that addresses the capital needs of nursing
facilities. Notwithstanding paragraph (b), the new property
payment system or systems, if implemented, shall replace the
current method of setting property payment rates under sections
256B.431 and 256B.434.
Sec. 15. Minnesota Statutes 1996, section 256B.501,
subdivision 12, is amended to read:
Subd. 12. [ICF/MR SALARY ADJUSTMENTS.] For the rate period
beginning January Effective July 1, 1992 1998, and ending
September 30, 1993 to September 30, 2000, the commissioner shall
add make available the appropriate salary adjustment cost per
diem calculated in paragraphs (a) to (d) (e) to the total
operating cost payment rate of each facility subject to
reimbursement under this section and Laws 1993 First Special
Session, chapter 1, article 4, section 11. The salary
adjustment cost per diem must be determined as follows:
(a) [COMPUTATION AND REVIEW GUIDELINES.] Except as
provided in paragraph (c), A state-operated community service,
and any facility whose payment rates are governed by closure
agreements, receivership agreements, or Minnesota Rules, part
9553.0075, are is not eligible for a salary adjustment otherwise
granted under this subdivision. For purposes of the salary
adjustment per diem computation and reviews in this subdivision,
the term "salary adjustment cost" means the facility's allowable
program operating cost category employee training expenses, and
the facility's allowable salaries, payroll taxes, and fringe
benefits. The term does not include these same salary-related
costs for both administrative or central office employees.
For the purpose of determining the amount of salary
adjustment to be granted under this subdivision, the
commissioner must use the reporting year ending December 31,
1990 1996, as the base year for the salary adjustment per diem
computation. For the purpose of both years' salary adjustment
cost review, the commissioner must use the facility's salary
adjustment cost for the reporting year ending December 31, 1991,
as the base year. If the base year and the reporting years
subject to review include salary cost reclassifications made by
the department, the commissioner must reconcile those
differences before completing the salary adjustment per diem
review.
(b) [SALARY ADJUSTMENT PER DIEM COMPUTATION.] For the rate
period beginning January 1, 1992 July 1, 1998, each facility
shall receive a salary adjustment cost per diem equal to its
salary adjustment costs multiplied by 1-1/2 3.0 percent, and
then divided by the facility's resident days.
(c) [ADJUSTMENTS FOR NEW FACILITIES.] For newly
constructed or newly established facilities, except for
state-operated community services, whose payment rates are
governed by Minnesota Rules, part 9553.0075, if the settle-up
cost report includes a reporting year which is subject to review
under this subdivision, the commissioner shall adjust the rule
provision governing the maximum settle-up payment rate by
increasing the .4166 percent for each full month of the
settle-up cost report to .7083. For any subsequent rate period
which is authorized for salary adjustments under this
subdivision, the commissioner shall compute salary adjustment
cost per diems by annualizing the salary adjustment costs for
the settle-up cost report period and treat that period as the
base year for purposes of reviewing salary adjustment cost per
diems.
(d) [SALARY ADJUSTMENT PER DIEM REVIEW.] The commissioner
shall review the implementation of the salary adjustments on a
per diem basis. For reporting years ending December 31, 1992,
and December 31, 1993, the commissioner must review and
determine the amount of change in salary adjustment costs in
both of the above reporting years over the base year after the
reporting year ending December 31, 1993. The commissioner must
inflate the base year's salary adjustment costs by the
cumulative percentage increase granted in paragraph (b), plus
three percentage points for each of the two years reviewed. The
commissioner must then compare each facility's salary adjustment
costs for the reporting year divided by the facility's resident
days for both reporting years to the base year's inflated salary
adjustment cost divided by the facility's resident days for the
base year. If the facility has had a one-time program operating
cost adjustment settle-up during any of the reporting years
subject to review, the commissioner must remove the per diem
effect of the one-time program adjustment before completing the
review and per diem comparison.
The review and per diem comparison must be done by the
commissioner after the reporting year ending December 31, 1993.
If the salary adjustment cost per diem for the reporting years
being reviewed is less than the base year's inflated salary
adjustment cost per diem, the commissioner must recover the
difference within 120 days after the date of written notice.
The amount of the recovery shall be equal to the per diem
difference multiplied by the facility's resident days in the
reporting years being reviewed. Written notice of the amount
subject to recovery must be given by the commissioner following
both reporting years reviewed. Interest charges must be
assessed by the commissioner after the 120th day of that notice
at the same interest rate the commissioner assesses for other
balance outstanding.
(c) [SUBMITTAL OF PLAN.] A facility may apply for the
salary adjustment per diem calculated under this subdivision.
The application must be made to the commissioner and contain a
plan by which the facility will distribute the salary adjustment
to employees of the facility. For facilities in which the
employees are represented by an exclusive bargaining
representative, an agreement negotiated and agreed to by the
employer and the exclusive bargaining representative, after July
1, 1998, may constitute the plan for the salary distribution.
The commissioner shall review the plan to ensure that the salary
adjustment per diem is used solely to increase the compensation
of facility employees. To be eligible, a facility must submit
its plan for the salary distribution by December 31, 1998. If a
facility's plan for salary distribution is effective for its
employees after July 1, 1998, the salary adjustment cost per
diem shall be effective the same date as its plan.
(d) [COST REPORT.] Additional costs incurred by facilities
as a result of this salary adjustment are not allowable costs
for purposes of the December 31, 1998, cost report.
(e) [SALARY ADJUSTMENT.] In order to apply for a salary
adjustment, a facility reimbursed under Laws 1993, First Special
Session chapter 1, article 4, section 11, must report the
information referred to in paragraph (a) in the application, in
the manner specified by the commissioner.
Sec. 16. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM
EFFECTIVE OCTOBER 1, 2000.]
Subdivision 1. [IN GENERAL.] Effective October 1, 2000,
the commissioner shall implement a performance-based contracting
system to replace the current method of setting total cost
payment rates under section 256B.501 and Minnesota Rules, parts
9553.0010 to 9553.0080. In determining prospective payment
rates of intermediate care facilities for persons with mental
retardation or related conditions, the commissioner shall index
each facility's total payment rate by an inflation factor as
described in subdivision 3. The commissioner of finance shall
include annual inflation adjustments in operating costs for
intermediate care facilities for persons with mental retardation
and related conditions as a budget change request in each
biennial detailed expenditure budget submitted to the
legislature under section 16A.11.
Subd. 2. [CONTRACT PROVISIONS.] The performance-based
contract with each intermediate care facility must include
provisions for:
(1) modifying payments when significant changes occur in
the needs of the consumers;
(2) monitoring service quality using performance indicators
that measure consumer outcomes;
(3) the establishment and use of continuous quality
improvement processes using the results attained through service
quality monitoring;
(4) the annual reporting of facility statistical
information on all supervisory personnel, direct care personnel,
specialized support personnel, hours, wages and benefits,
staff-to-consumer ratios, and staffing patterns;
(5) annual aggregate facility financial information or an
annual certified audited financial statement, including a
balance sheet and income and expense statements for each
facility, if a certified audit was prepared; and
(6) additional requirements and penalties for intermediate
care facilities not meeting the standards set forth in the
performance-based contract.
Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years
beginning on or after October 1, 2000, within the limits of
appropriations specifically for this purpose, the commissioner
shall determine the total payment rate for each licensed and
certified intermediate care facility by indexing the total
payment rate in effect on September 30, 2000, for inflation.
The inflation factor to be used must be based on the change in
the Consumer Price Index-All Items, United States city average
(CPI-U) as forecasted by Data Resources, Inc. in the first
quarter of the calendar year during which the rate year begins.
The CPI-U forecasted index for total payment rates shall be
based on the 12-month period from the midpoint of the facility's
prior rate year to the midpoint of the rate year for which the
operating payment rate is being determined.
Sec. 17. Minnesota Statutes 1996, section 256B.69, is
amended by adding a subdivision to read:
Subd. 25. [CONTINUATION OF PAYMENTS THROUGH DISCHARGE.] In
the event a medical assistance recipient or beneficiary enrolled
in a health plan under this section is denied nursing facility
services after residing in the facility for more than 180 days,
any denial of medical assistance payment to a provider under
this section shall be prospective only and payments to the
provider shall continue until the resident is discharged or 30
days after the effective date of the service denial, whichever
is sooner.
Sec. 18. Minnesota Statutes 1996, section 256I.04,
subdivision 1, is amended to read:
Subdivision 1. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An
individual is eligible for and entitled to a group residential
housing payment to be made on the individual's behalf if the
county agency has approved the individual's residence in a group
residential housing setting and the individual meets the
requirements in paragraph (a) or (b).
(a) The individual is aged, blind, or is over 18 years of
age and disabled as determined under the criteria used by the
title II program of the Social Security Act, and meets the
resource restrictions and standards of the supplemental security
income program, and the individual's countable income after
deducting the (1) exclusions and disregards of the SSI
program and, (2) the medical assistance personal needs allowance
under section 256B.35, and (3) an amount equal to the income
actually made available to a community spouse by an elderly
waiver recipient under the provisions of sections 256B.0575,
paragraph (a), clause (4), and 256B.058, subdivision 2, is less
than the monthly rate specified in the county agency's agreement
with the provider of group residential housing in which the
individual resides.
(b) The individual meets a category of eligibility under
section 256D.05, subdivision 1, paragraph (a), and the
individual's resources are less than the standards specified by
section 256D.08, and the individual's countable income as
determined under sections 256D.01 to 256D.21, less the medical
assistance personal needs allowance under section 256B.35 is
less than the monthly rate specified in the county agency's
agreement with the provider of group residential housing in
which the individual resides.
Sec. 19. Minnesota Statutes 1996, section 256I.04,
subdivision 3, is amended to read:
Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP
RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter
into agreements for new group residential housing beds with
total rates in excess of the MSA equivalent rate except: (1)
for group residential housing establishments meeting the
requirements of subdivision 2a, clause (2) with department
approval; (2) for group residential housing establishments
licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
provided the facility is needed to meet the census reduction
targets for persons with mental retardation or related
conditions at regional treatment centers; (3) to ensure
compliance with the federal Omnibus Budget Reconciliation Act
alternative disposition plan requirements for inappropriately
placed persons with mental retardation or related conditions or
mental illness; (4) up to 80 beds in a single, specialized
facility located in Hennepin county that will provide housing
for chronic inebriates who are repetitive users of
detoxification centers and are refused placement in emergency
shelters because of their state of intoxication., and planning
for the specialized facility must have been initiated before
July 1, 1991, in anticipation of receiving a grant from the
housing finance agency under section 462A.05, subdivision 20a,
paragraph (b); or (5) notwithstanding the provisions of
subdivision 2a, for up to 180 190 supportive housing units in
Anoka, Dakota, Hennepin, or Ramsey county for homeless adults
with a mental illness, a history of substance abuse, or human
immunodeficiency virus or acquired immunodeficiency syndrome.
For purposes of this section, "homeless adult" means a person
who is living on the street or in a shelter or is evicted from a
dwelling unit or discharged from a regional treatment center,
community hospital, or residential treatment program and has no
appropriate housing available and lacks the resources and
support necessary to access appropriate housing. At least 70
percent of the supportive housing units must serve homeless
adults with mental illness, substance abuse problems, or human
immunodeficiency virus or acquired immunodeficiency syndrome who
are about to be or, within the previous six months, has been
discharged from a regional treatment center, or a
state-contracted psychiatric bed in a community hospital, or a
residential mental health or chemical dependency treatment
program. If a person meets the requirements of subdivision 1,
paragraph (a), and receives a federal Section 8 or state housing
subsidy, the group residential housing rate for that person is
limited to the supplementary rate under section 256I.05,
subdivision 1a, and is determined by subtracting the amount of
the person's countable income that exceeds the MSA equivalent
rate from the group residential housing supplementary rate. A
resident in a demonstration project site who no longer
participates in the demonstration program shall retain
eligibility for a group residential housing payment in an amount
determined under section 256I.06, subdivision 8, using the MSA
equivalent rate. Service funding under section 256I.05,
subdivision 1a, will end June 30, 1997, if federal matching
funds are available and the services can be provided through a
managed care entity. If federal matching funds are not
available, then service funding will continue under section
256I.05, subdivision 1a.
(b) A county agency may enter into a group residential
housing agreement for beds with rates in excess of the MSA
equivalent rate in addition to those currently covered under a
group residential housing agreement if the additional beds are
only a replacement of beds with rates in excess of the MSA
equivalent rate which have been made available due to closure of
a setting, a change of licensure or certification which removes
the beds from group residential housing payment, or as a result
of the downsizing of a group residential housing setting. The
transfer of available beds from one county to another can only
occur by the agreement of both counties.
Sec. 20. Minnesota Statutes 1996, section 256I.04, is
amended by adding a subdivision to read:
Subd. 4. [RENTAL ASSISTANCE.] For participants in the
Minnesota supportive housing demonstration program under
subdivision 3, paragraph (a), clause (5), notwithstanding the
provisions of section 256I.06, subdivision 8, the amount of the
group residential housing payment for room and board must be
calculated by subtracting 30 percent of the recipient's adjusted
income as defined by the United States Department of Housing and
Urban Development for the Section 8 program from the fair market
rent established for the recipient's living unit by the federal
Department of Housing and Urban Development. This payment shall
be regarded as a state housing subsidy for the purposes of
subdivision 3. Notwithstanding the provisions of section
256I.06, subdivision 6, the recipient's countable income will
only be adjusted when a change of greater than $100 in a month
occurs or upon annual redetermination of eligibility, whichever
is sooner. The commissioner is directed to study the
feasibility of developing a rental assistance program to serve
persons traditionally served in group residential housing
settings and report to the legislature by February 15, 1999.
Sec. 21. Minnesota Statutes 1996, section 256I.05,
subdivision 2, is amended to read:
Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group
residential housing rate does not apply to a residence 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. Notwithstanding the provisions of
subdivision 1c, the rate paid to a facility reimbursed under
this subdivision shall be determined under Minnesota Rules,
parts 9510.0010 to 9510.0480 section 256B.431, or under section
256B.434 if the facility is accepted by the commissioner for
participation in the alternative payment demonstration project.
Sec. 22. Laws 1997, chapter 207, section 7, is amended to
read:
Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON
COUNTY.]
(a) Notwithstanding Minnesota Statutes, sections 92.45 and
282.018, subdivision 1, and the public sale provisions of
Minnesota Statutes, chapter 282, Carlton county may sell by
private sale the tax-forfeited land described in paragraph (d)
under the remaining provisions of Minnesota Statutes, chapter
282.
(b) The land described in paragraph (d) may be sold by
private sale. The consideration for the conveyance must include
the taxes due on the property and any penalties, interest, and
costs shall be the appraised value of the land. If the lands
are sold, the conveyance must reserve to the state a
conservation perpetual easement, in a form prescribed by the
commissioner of natural resources, for the land within 100 feet
of the ordinary high water level of Slaughterhouse creek for
public angler access and stream habitat protection and
enhancement for the benefit of the state of Minnesota,
department of natural resources, over the following lands:
A strip of land lying in the North 6.66 acres of the West
Half of the Northeast Quarter of the Southwest Quarter of
Section 6, Township 48 North, Range 16 West, Carlton county.
Said strip lying 100 feet on each side of the centerline of
Slaughterhouse Creek.
(c) The conveyance must be in a form approved by the
attorney general.
(d) The land to be conveyed is located in Carlton county
and is described as:
North 6.66 acres of the West Half of the Northeast Quarter
of the Southwest Quarter, subject to pipeline easement, Section
6, Township 48 North, Range 16 West, City of Carlton.
(e) Carlton county has determined that this sale best
serves the land management interests of Carlton county.
Sec. 23. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT
SYSTEM.]
(a) By January 15, 1999, the commissioner shall make
recommendations to the chairs of the health and human services
policy and fiscal committees on the repeal of specific statutes
and rules as well as any other additional recommendations
related to implementation of sections 11 and 12.
(b) In developing recommendations for nursing facility
reimbursement, the commissioner shall consider making each
nursing facility's total payment rates, both operating and
property rate components, prospective. The commissioner shall
involve nursing facility industry and consumer representatives
in the development of these recommendations.
(c) In making recommendations for ICF/MR reimbursement, the
commissioner may consider methods of establishing payment rates
that take into account individual client costs and needs,
include provisions to establish links between performance
indicators and reimbursement and other performance incentives,
and allow local control over resources necessary for local
agencies to set rates and contract with ICF/MR facilities. In
addition, the commissioner may establish methods that provide
information to consumers regarding service quality as measured
by performance indicators. The commissioner shall involve
ICF/MR industry and consumer representatives in the development
of these recommendations.
Sec. 24. [APPROVAL EXTENDED.]
Notwithstanding Minnesota Statutes, section 144A.073,
subdivision 3, the commissioner of health shall grant an
additional 18 months of approval for a proposed exception to the
nursing home licensure and certification moratorium, if the
proposal is to replace a 96-bed nursing home facility in Carlton
county and if initial approval for the proposal was granted in
November 1996.
Sec. 25. [EFFECTIVE DATE.]
Sections 1, 3, 22, and 24 are effective the day following
final enactment.
ARTICLE 4
HEALTH CARE PROGRAMS, INCLUDING MA AND GAMC
Section 1. Minnesota Statutes 1997 Supplement, section
171.29, subdivision 2, is amended to read:
Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's
license has been revoked as provided in subdivision 1, except
under section 169.121 or 169.123, shall pay a $30 fee before the
driver's license is reinstated.
(b) A person whose driver's license has been revoked as
provided in subdivision 1 under section 169.121 or 169.123 shall
pay a $250 fee plus a $10 surcharge before the driver's license
is reinstated. The $250 fee is to be credited as follows:
(1) Twenty percent shall be credited to the trunk highway
fund.
(2) Fifty-five percent shall be credited to the general
fund.
(3) Eight percent shall be credited to a separate account
to be known as the bureau of criminal apprehension account.
Money in this account may be appropriated to the commissioner of
public safety and the appropriated amount shall be apportioned
80 percent for laboratory costs and 20 percent for carrying out
the provisions of section 299C.065.
(4) Twelve percent shall be credited to a separate account
to be known as the alcohol-impaired driver education account.
Money in the account is appropriated as follows:
(i) The first $200,000 in a fiscal year is to the
commissioner of children, families, and learning for programs in
elementary and secondary schools.
(ii) The remainder credited in a fiscal year is
appropriated to the commissioner of transportation to be spent
as grants to the Minnesota highway safety center at St. Cloud
State University for programs relating to alcohol and highway
safety education in elementary and secondary schools.
(5) Five percent shall be credited to a separate account to
be known as the traumatic brain injury and spinal cord injury
account. $100,000 is annually appropriated from the account to
the commissioner of human services for traumatic brain injury
case management services. The remaining money in the account is
annually appropriated to the commissioner of health to be used
as follows: 35 percent for a contract with a qualified
community-based organization to provide information, resources,
and support to assist persons with traumatic brain injury and
their families to access services, and 65 percent to establish
and maintain the traumatic brain injury and spinal cord injury
registry created in section 144.662 and to reimburse the
commissioner of economic security for the reasonable cost of
services provided under section 268A.03, clause (o). For the
purposes of this clause, a "qualified community-based
organization" is a private, not-for-profit organization of
consumers of traumatic brain injury services and their family
members. The organization must be registered with the United
States Internal Revenue Service under the provisions of section
501(c)(3) as a tax exempt organization and must have as its
purposes:
(i) the promotion of public, family, survivor, and
professional awareness of the incidence and consequences of
traumatic brain injury;
(ii) the provision of a network of support for persons with
traumatic brain injury, their families, and friends;
(iii) the development and support of programs and services
to prevent traumatic brain injury;
(iv) the establishment of education programs for persons
with traumatic brain injury; and
(v) the empowerment of persons with traumatic brain injury
through participation in its governance.
No patient's name, identifying information or identifiable
medical data will be disclosed to the organization without the
informed voluntary written consent of the patient or patient's
guardian, or if the patient is a minor, of the parent or
guardian of the patient.
(c) The $10 surcharge shall be credited to a separate
account to be known as the remote electronic alcohol monitoring
pilot program account. The commissioner shall transfer the
balance of this account to the commissioner of finance on a
monthly basis for deposit in the general fund.
Sec. 2. Minnesota Statutes 1996, section 245.462,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGER.] (a) "Case manager" means an
individual employed by the county or other entity authorized by
the county board to provide case management services specified
in section 245.4711. A case manager must 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
adults 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 adults 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
adults 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.
Until June 30, 1999, a refugee an immigrant who does not
have the qualifications specified in this subdivision may
provide case management services to adult refugees immigrants
with serious and persistent mental illness who are members of
the same ethnic group as the case manager if the person: (1) is
actively pursuing credits toward the completion of a bachelor's
degree in one of the behavioral sciences or a related field from
an accredited college or university; (2) completes 40 hours of
training as specified in this subdivision; and (3) receives
clinical supervision at least once a week until the requirements
of obtaining a bachelor's degree and 2,000 hours of supervised
experience this subdivision are met.
(b) The commissioner may approve waivers submitted by
counties to allow case managers without a bachelor's degree but
with 6,000 hours of supervised experience in the delivery of
services to adults with mental illness if the person:
(1) meets the qualifications for a mental health
practitioner in subdivision 26;
(2) has completed 40 hours of training approved by the
commissioner in case management skills and in the
characteristics and needs of adults with serious and persistent
mental illness; and
(3) demonstrates that the 6,000 hours of supervised
experience are in identifying functional needs of persons with
mental illness, coordinating assessment information and making
referrals to appropriate service providers, coordinating a
variety of services to support and treat persons with mental
illness, and monitoring to ensure appropriate provision of
services. The county board is responsible to verify that all
qualifications, including content of supervised experience, have
been met.
Sec. 3. Minnesota Statutes 1996, section 245.462,
subdivision 8, is amended to read:
Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day
treatment services," or "day treatment program" means a
structured program of treatment and care provided to an adult in
or by: (1) a hospital accredited by the joint commission on
accreditation of health organizations and licensed under
sections 144.50 to 144.55; (2) a community mental health center
under section 245.62; or (3) an entity that is under contract
with the county board to operate a program that meets the
requirements of section 245.4712, subdivision 2, and Minnesota
Rules, parts 9505.0170 to 9505.0475. Day treatment consists of
group psychotherapy and other intensive therapeutic services
that are provided at least one day a week for a minimum
three-hour time block by a multidisciplinary staff under the
clinical supervision of a mental health professional. The
services are aimed at stabilizing the adult's mental health
status, providing mental health services, and developing and
improving the adult's independent living and socialization
skills. The goal of day treatment is to reduce or relieve
mental illness and to enable the adult to live in the
community. Day treatment services are not a part of inpatient
or residential treatment services. Day treatment services are
distinguished from day care by their structured therapeutic
program of psychotherapy services. The commissioner may limit
medical assistance reimbursement for day treatment to 15 hours
per week per person instead of the three hours per day per
person specified in Minnesota Rules, part 9505.0323, subpart 15.
Sec. 4. Minnesota Statutes 1996, section 245.4871,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGER.] (a) "Case manager" means an
individual employed by the county or other entity authorized by
the county board to provide case management services specified
in subdivision 3 for the child with severe emotional disturbance
and the child's family. A case manager must have experience and
training in working with children.
(b) A case manager must:
(1) have at least a bachelor's degree in one of the
behavioral sciences or a related field from an accredited
college or university;
(2) have at least 2,000 hours of supervised experience in
the delivery of mental health services to children;
(3) have experience and training in identifying and
assessing a wide range of children's needs; and
(4) be knowledgeable about local community resources and
how to use those resources for the benefit of children and their
families.
(c) The case manager may be a member of any professional
discipline that is part of the local system of care for children
established by the county board.
(d) The case manager must meet in person with a mental
health professional at least once each month to obtain clinical
supervision.
(e) Case managers with a bachelor's degree but without
2,000 hours of supervised experience in the delivery of mental
health services to children with emotional disturbance must:
(1) begin 40 hours of training approved by the commissioner
of human services in case management skills and in the
characteristics and needs of children with severe emotional
disturbance before beginning to provide case management
services; and
(2) 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 experience is
met.
(f) Clinical supervision must be documented in the child's
record. When the case manager is not a mental health
professional, the county board must provide or contract for
needed clinical supervision.
(g) The county board must ensure that the case manager has
the freedom to access and coordinate the services within the
local system of care that are needed by the child.
(h) Until June 30, 1999, a refugee an immigrant who does
not have the qualifications specified in this subdivision may
provide case management services to child refugees immigrants
with severe emotional disturbance of the same ethnic group as
the refugee immigrant if the person:
(1) is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or related
fields at an accredited college or university;
(2) completes 40 hours of training as specified in this
subdivision; and
(3) receives clinical supervision at least once a week
until the requirements of obtaining a bachelor's degree and
2,000 hours of supervised experience are met.
(i) The commissioner may approve waivers submitted by
counties to allow case managers without a bachelor's degree but
with 6,000 hours of supervised experience in the delivery of
services to children with severe emotional disturbance if the
person:
(1) meets the qualifications for a mental health
practitioner in subdivision 26;
(2) has completed 40 hours of training approved by the
commissioner in case management skills and in the
characteristics and needs of children with severe emotional
disturbance; and
(3) demonstrates that the 6,000 hours of supervised
experience are in identifying functional needs of children with
severe emotional disturbance, coordinating assessment
information and making referrals to appropriate service
providers, coordinating a variety of services to support and
treat children with severe emotional disturbance, and monitoring
to ensure appropriate provision of services. The county board
is responsible to verify that all qualifications, including
content of supervised experience, have been met.
Sec. 5. Minnesota Statutes 1996, section 256.01, is
amended by adding a subdivision to read:
Subd. 16. [INFORMATION FOR PERSONS WITH LIMITED
ENGLISH-LANGUAGE PROFICIENCY.] By July 1, 1998, the commissioner
shall implement a procedure for public assistance applicants and
recipients to identify a language preference other than English
in order to receive information pertaining to the public
assistance programs in that preferred language.
Sec. 6. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.]
Subdivision 1. [ESTABLISHMENT.] The commissioner of human
services shall establish and administer a program to pay for
costs of drugs prescribed exclusively for post-kidney transplant
maintenance when those costs are not otherwise reimbursed by a
third-party payer. The commissioner may contract with a
nonprofit entity to administer this program.
Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for
the program, an applicant must satisfy the following
requirements:
(1) the applicant's family gross income must not exceed 275
percent of the federal poverty level; and
(2) the applicant must be a Minnesota resident who has
resided in Minnesota for at least 12 months.
An applicant shall not be excluded because the applicant
received the transplant outside the state of Minnesota, so long
as the other requirements are met.
Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments
made for each eligible recipient shall be based on the following:
(1) available funds; and
(2) the cost of the post-kidney transplant maintenance
drugs.
(b) The payment rate under this program must be no greater
than the medical assistance reimbursement rate for the
prescribed drug.
(c) Payments shall be made to or on behalf of an eligible
recipient for the cost of the post-kidney transplant maintenance
drugs that is not covered, reimbursed, or eligible for
reimbursement by any other third party or government entity,
including, but not limited to, private or group health
insurance, medical assistance, Medicare, the Veterans
Administration, the senior citizen drug program established
under section 256.955, or under any waiver arrangement received
by the state to provide a prescription drug benefit for
qualified Medicare beneficiaries or service-limited Medicare
beneficiaries.
(d) The commissioner may restrict or categorize payments to
meet the appropriation allocated for this program.
(e) Any cost of the post-kidney transplant maintenance
drugs that is not reimbursed under this program is the
responsibility of the program recipient.
Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain
a drug formulary that includes all drugs eligible for
reimbursement by the program. The commissioner may use the drug
formulary established under section 256B.0625, subdivision 13.
The commissioner shall establish an internal review procedure
for updating the formulary that allows for the addition and
deletion of drugs to the formulary. The drug formulary must be
reviewed at least quarterly per fiscal year.
Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept
funding from other public or private sources.
Subd. 6. [SUNSET.] This program expires on July 1, 2000.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256.9657, subdivision 3, is amended to read:
Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY
INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1,
1992, each health maintenance organization with a certificate of
authority issued by the commissioner of health under chapter 62D
and each community integrated service network licensed by the
commissioner under chapter 62N shall pay to the commissioner of
human services a surcharge equal to six-tenths of one percent of
the total premium revenues of the health maintenance
organization or community integrated service network as reported
to the commissioner of health according to the schedule in
subdivision 4.
(b) For purposes of this subdivision, total premium revenue
means:
(1) premium revenue recognized on a prepaid basis from
individuals and groups for provision of a specified range of
health services over a defined period of time which is normally
one month, excluding premiums paid to a health maintenance
organization or community integrated service network from the
Federal Employees Health Benefit Program;
(2) premiums from Medicare wrap-around subscribers for
health benefits which supplement Medicare coverage;
(3) Medicare revenue, as a result of an arrangement between
a health maintenance organization or a community integrated
service network and the health care financing administration of
the federal Department of Health and Human Services, for
services to a Medicare beneficiary, excluding Medicare revenue
that states are prohibited from taxing under sections 4001 and
4002 of Public Law Number 105-33 received by a health
maintenance organization or community integrated service network
through risk sharing or Medicare Choice Plus contracts; and
(4) medical assistance revenue, as a result of an
arrangement between a health maintenance organization or
community integrated service network and a Medicaid state
agency, for services to a medical assistance beneficiary.
If advance payments are made under clause (1) or (2) to the
health maintenance organization or community integrated service
network for more than one reporting period, the portion of the
payment that has not yet been earned must be treated as a
liability.
(c) When a health maintenance organization or community
integrated service network merges or consolidates with or is
acquired by another health maintenance organization or community
integrated service network, the surviving corporation or the new
corporation shall be responsible for the annual surcharge
originally imposed on each of the entities or corporations
subject to the merger, consolidation, or acquisition, regardless
of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under
chapter 62N.
(d) Effective July 1 of each year, the surviving
corporation's or the new corporation's surcharge shall be based
on the revenues earned in the second previous calendar year by
all of the entities or corporations subject to the merger,
consolidation, or acquisition regardless of whether one of the
entities or corporations does not retain a certificate of
authority under chapter 62D or a license under chapter 62N until
the total premium revenues of the surviving corporation include
the total premium revenues of all the merged entities as
reported to the commissioner of health.
(e) When a health maintenance organization or community
integrated service network, which is subject to liability for
the surcharge under this chapter, transfers, assigns, sells,
leases, or disposes of all or substantially all of its property
or assets, liability for the surcharge imposed by this chapter
is imposed on the transferee, assignee, or buyer of the health
maintenance organization or community integrated service network.
(f) In the event a health maintenance organization or
community integrated service network converts its licensure to a
different type of entity subject to liability for the surcharge
under this chapter, but survives in the same or substantially
similar form, the surviving entity remains liable for the
surcharge regardless of whether one of the entities or
corporations does not retain a certificate of authority under
chapter 62D or a license under chapter 62N.
(g) The surcharge assessed to a health maintenance
organization or community integrated service network ends when
the entity ceases providing services for premiums and the
cessation is not connected with a merger, consolidation,
acquisition, or conversion.
Sec. 8. Minnesota Statutes 1997 Supplement, section
256.9685, subdivision 1, is amended to read:
Subdivision 1. [AUTHORITY.] The commissioner shall
establish procedures for determining medical assistance and
general assistance medical care payment rates under a
prospective payment system for inpatient hospital services in
hospitals that qualify as vendors of medical assistance. The
commissioner shall establish, by rule, procedures for
implementing this section and sections 256.9686, 256.969, and
256.9695. The medical assistance payment rates must 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
recipients in efficiently and economically operated hospitals.
Services must meet the requirements of section 256B.04,
subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be
eligible for payment.
Sec. 9. Minnesota Statutes 1996, section 256.969,
subdivision 16, is amended to read:
Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.] Indian
health service Facilities of the Indian health service and
facilities operated by a tribe or tribal organization under
funding authorized by title III of the Indian Self-Determination
and Education Assistance Act, Public Law Number 93-638, or by
United States Code, title 25, chapter 14, subchapter II,
sections 450f to 450n, are exempt from the rate establishment
methods required by this section and shall be reimbursed at
charges as limited to the amount allowed under federal law paid
according to the rate published by the United States assistant
secretary for health under authority of United States Code,
title 42, sections 248A and 248B.
Sec. 10. Minnesota Statutes 1996, section 256.969,
subdivision 17, is amended to read:
Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.]
Out-of-state hospitals that are located within a Minnesota local
trade area and that have more than 20 admissions in the base
year shall have rates established using the same procedures and
methods that apply to Minnesota hospitals. For this subdivision
and subdivision 18, local trade area means a county contiguous
to Minnesota and located in a metropolitan statistical area as
determined by Medicare for October 1 prior to the most current
rebased rate year. Hospitals that are not required by law to
file information in a format necessary to establish rates shall
have rates established based on the commissioner's estimates of
the information. Relative values of the diagnostic categories
shall not be redetermined under this subdivision until required
by rule. Hospitals affected by this subdivision shall then be
included in determining relative values. However, hospitals
that have rates established based upon the commissioner's
estimates of information shall not be included in determining
relative values. This subdivision is effective for hospital
fiscal years beginning on or after July 1, 1988. A hospital
shall provide the information necessary to establish rates under
this subdivision at least 90 days before the start of the
hospital's fiscal year.
Sec. 11. Minnesota Statutes 1996, section 256B.03,
subdivision 3, is amended to read:
Subd. 3. [AMERICAN INDIAN HEALTH FUNDING TRIBAL PURCHASING
MODEL.] (a) Notwithstanding subdivision 1 and sections 256B.0625
and 256D.03, subdivision 4, paragraph (f) (i), the commissioner
may make payments to federally recognized Indian tribes with a
reservation in the state to provide medical assistance and
general assistance medical care to Indians, as defined under
federal law, who reside on or near the reservation. The
payments may be made in the form of a block grant or other
payment mechanism determined in consultation with the tribe.
Any alternative payment mechanism agreed upon by the tribes and
the commissioner under this subdivision is not dependent upon
county or health plan agreement but is intended to create a
direct payment mechanism between the state and the tribe for the
administration of the medical assistance program and general
assistance medical care programs, and for covered services.
(b) A tribe that implements a purchasing model under this
subdivision shall report to the commissioner at least annually
on the operation of the model. The commissioner and the tribe
shall cooperatively determine the data elements, format, and
timetable for the report.
(c) For purposes of this subdivision, "Indian tribe" means
a tribe, band, or nation, or other organized group or community
of Indians that is recognized as eligible for the special
programs and services provided by the United States to Indians
because of their status as Indians and for which a reservation
exists as is consistent with Public Law Number 100-485, as
amended.
(d) Payments under this subdivision may not result in an
increase in expenditures that would not otherwise occur in the
medical assistance program under this chapter or the general
assistance medical care program under chapter 256D.
Sec. 12. [256B.038] [PROVIDER RATE INCREASES AFTER JUNE
30, 1999.]
(a) For fiscal years beginning on or after July 1, 1999,
the commissioner of finance shall include an annual inflationary
adjustment in payment rates for the services listed in paragraph
(b) as a budget change request in each biennial detailed
expenditure budget submitted to the legislature under section
16A.11. The adjustment shall be accomplished by indexing the
rates in effect for inflation based on the change in the
Consumer Price Index-All Items (United States city
average)(CPI-U) as forecasted by Data Resources, Inc., in the
fourth quarter of the prior year for the calendar year during
which the rate increase occurs.
(b) Within the limits of appropriations specifically for
this purpose, the commissioner shall apply the rate increases in
paragraph (a) to home and community-based waiver services for
persons with mental retardation or related conditions under
section 256B.501; home and community-based waiver services for
the elderly under section 256B.0915; waivered services under
community alternatives for disabled individuals under section
256B.49; community alternative care waivered services under
section 256B.49; traumatic brain injury waivered services under
section 256B.49; nursing services and home health services under
section 256B.0625, subdivision 6a; personal care services and
nursing supervision of personal care services under section
256B.0625, subdivision 19a; private duty nursing services under
section 256B.0625, subdivision 7; day training and habilitation
services for adults with mental retardation or related
conditions under sections 252.40 to 252.46; physical therapy
services under sections 256B.0625, subdivision 8, and 256D.03,
subdivision 4; occupational therapy services under sections
256B.0625, subdivision 8a, and 256D.03, subdivision 4;
speech-language therapy services under section 256D.03,
subdivision 4, and Minnesota Rules, part 9505.0390; respiratory
therapy services under section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0295; physician services under
section 256B.0625, subdivision 3; dental services under sections
256B.0625, subdivision 9, and 256D.03, subdivision 4;
alternative care services under section 256B.0913; adult
residential program grants under Minnesota Rules, parts
9535.2000 to 9535.3000; adult and family community support
grants under Minnesota Rules, parts 9535.1700 to 9535.1760; and
semi-independent living services under section 252.275,
including SILS funding under county social services grants
formerly funded under chapter 256I.
(c) The commissioner shall increase prepaid medical
assistance program capitation rates as appropriate to reflect
the rate increases in this section.
(d) In implementing this section, the commissioner shall
consider proposing a schedule to equalize rates paid by
different programs for the same service.
Sec. 13. Minnesota Statutes 1996, section 256B.055,
subdivision 7, is amended to read:
Subd. 7. [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 or, who would meet those requirements except for excess
income or assets, and who meets the other eligibility
requirements of this section.
Effective February 1, 1989, and to the extent allowed by
federal law the commissioner shall deduct state and federal
income taxes and federal insurance contributions act payments
withheld from the individual's earned income in determining
eligibility under this subdivision.
Sec. 14. Minnesota Statutes 1996, section 256B.055, is
amended by adding a subdivision to read:
Subd. 7a. [SPECIAL CATEGORY FOR DISABLED
CHILDREN.] Medical assistance may be paid for a person who is
under age 18 and who meets income and asset eligibility
requirements of the Supplemental Security Income program if the
person was receiving Supplemental Security Income payments on
the date of enactment of section 211(a) of Public Law Number
104-193, the Personal Responsibility and Work Opportunity Act of
1996, and the person would have continued to receive the
payments except for the change in the childhood disability
criteria in section 211(a) of Public Law Number 104-193.
Sec. 15. Minnesota Statutes 1997 Supplement, section
256B.056, subdivision 1a, is amended to read:
Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless
specifically required by state law or rule or federal law or
regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons
whose eligibility category is based on blindness, disability, or
age of 65 or more years, the methodologies for the supplemental
security income program shall be used, except that payments made
according to a court order for the support of children shall be
excluded from income in an amount not to exceed the difference
between the applicable income standard used in the state's
medical assistance program for aged, blind, and disabled persons
and the applicable income standard used in the state's medical
assistance program for families with children. Exclusion of
court-ordered child support payments is subject to the condition
that if there has been a change in the financial circumstances
of the person with the legal obligation to pay support since the
support order was entered, the person with the legal obligation
to pay support has petitioned for modification of the support
order. For families and children, which includes all other
eligibility categories, the methodologies under the state's AFDC
plan in effect as of July 16, 1996, as required by the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law Number 104-193, shall be used. Effective
upon federal approval, in-kind contributions to, and payments
made on behalf of, a recipient, by an obligor, in satisfaction
of or in addition to a temporary or permanent order for child
support or maintenance, shall be considered income to the
recipient. For these purposes, a "methodology" does not include
an asset or income standard, or accounting method, or method of
determining effective dates.
Sec. 16. Minnesota Statutes 1997 Supplement, section
256B.056, subdivision 4, is amended to read:
Subd. 4. [INCOME.] To be eligible for medical assistance,
a person must not have, or anticipate receiving, semiannual
income in excess of 120 percent of the income standards by
family size used under the aid to families with dependent
children state plan as of July 16, 1996, as required by the
Personal Responsibility and Work Opportunity Reconciliation Act
of 1996 (PRWORA), Public Law Number 104-193, except
that eligible under section 256B.055, subdivision 7, and
families and children may have an income up to 133-1/3 percent
of the AFDC income standard in effect under the July 16, 1996,
AFDC state plan. For rate years beginning on or after July 1,
1999, the commissioner shall consider increasing the base AFDC
standard in effect July 16, 1996, by an amount equal to the
percent change in the Consumer Price Index for all urban
consumers for the previous October compared to one year
earlier. 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.
Veterans aid and attendance benefits and Veterans Administration
unusual medical expense payments are considered income to the
recipient.
Sec. 17. Minnesota Statutes 1996, section 256B.057,
subdivision 3a, is amended to read:
Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B
PREMIUMS.] A person who would otherwise be eligible as a
qualified Medicare beneficiary under subdivision 3, except the
person's income is in excess of the limit, is eligible for
medical assistance reimbursement of Medicare Part B premiums if
the person's income is less than 110 120 percent of the official
federal poverty guidelines for the applicable family size. The
income limit shall increase to 120 percent of the official
federal poverty guidelines for the applicable family size on
January 1, 1995.
Sec. 18. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1,
1998, to the extent of the federal allocation to Minnesota, a
person, who would otherwise be eligible as a qualified Medicare
beneficiary under subdivision 3, except that the person's income
is in excess of the limit, is eligible as a qualifying
individual according to the following criteria:
(1) if the person's income is greater than 120 percent, but
less than 135 percent of the official federal poverty guidelines
for the applicable family size, the person is eligible for
medical assistance reimbursement of Medicare Part B premiums; or
(2) if the person's income is equal to or greater than 135
percent but less than 175 percent of the official federal
poverty guidelines for the applicable family size, the person is
eligible for medical assistance reimbursement of that portion of
the Medicare Part B premium attributable to an increase in Part
B expenditures which resulted from the shift of home care
services from Medicare Part A to Medicare Part B under Public
Law Number 105-33, section 4732, the Balanced Budget Act of 1997.
The commissioner shall limit enrollment of qualifying
individuals under this subdivision according to the requirements
of Public Law Number 105-33, section 4732.
Sec. 19. Minnesota Statutes 1997 Supplement, section
256B.06, subdivision 4, is amended to read:
Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for
medical assistance is limited to citizens of the United States,
qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States.
(b) "Qualified noncitizen" means a person who meets one of
the following immigration criteria:
(1) admitted for lawful permanent residence according to
United States Code, title 8;
(2) admitted to the United States as a refugee according to
United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title
8, section 1158;
(4) granted withholding of deportation according to United
States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according to
United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to United
States Code, title 8, section 1153(a)(7); or
(7) determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996, title V of the
Omnibus Consolidated Appropriations Bill, Public Law Number
104-200;
(8) is a child of a noncitizen determined to be a battered
noncitizen by the United States Attorney General according to
the Illegal Immigration Reform and Immigrant Responsibility Act
of 1996, title V, of the Omnibus Consolidated Appropriations
Bill, Public Law Number 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined
in section 501(e) of Public Law Number 96-422, the Refugee
Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the
United States before August 22, 1996, who otherwise meet the
eligibility requirements of chapter 256B, are eligible for
medical assistance with federal financial participation.
(d) All qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the
eligibility requirements of chapter 256B, are eligible for
medical assistance with federal financial participation through
November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who
entered the United States on or after August 22, 1996, and who
otherwise meet the eligibility requirements of chapter 256B are
eligible for medical assistance with federal participation for
five years if they meet one of the following criteria:
(i) refugees admitted to the United States according to
United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States
Code, title 8, section 1158;
(iii) persons granted withholding of deportation according
to United States Code, title 8, section 1253(h);
(iv) veterans of the United States Armed Forces with an
honorable discharge for a reason other than noncitizen status,
their spouses and unmarried minor dependent children; or
(v) persons on active duty in the United States Armed
Forces, other than for training, their spouses and unmarried
minor dependent children.
Beginning December 1, 1996, qualified noncitizens who do
not meet one of the criteria in items (i) to (v) are eligible
for medical assistance without federal financial participation
as described in paragraph (j).
(e) Noncitizens who are not qualified noncitizens as
defined in paragraph (b), who are lawfully residing in the
United States and who otherwise meet the eligibility
requirements of chapter 256B, are eligible for medical
assistance under clauses (1) to (3). These individuals must
cooperate with the Immigration and Naturalization Service to
pursue any applicable immigration status, including citizenship,
that would qualify them for medical assistance with federal
financial participation.
(1) Persons who were medical assistance recipients on
August 22, 1996, are eligible for medical assistance with
federal financial participation through December 31, 1996.
(2) Beginning January 1, 1997, persons described in clause
(1) are eligible for medical assistance without federal
financial participation as described in paragraph (j).
(3) Beginning December 1, 1996, persons residing in the
United States prior to August 22, 1996, who were not receiving
medical assistance and persons who arrived on or after August
22, 1996, are eligible for medical assistance without federal
financial participation as described in paragraph (j).
(f) Nonimmigrants who otherwise meet the eligibility
requirements of chapter 256B are eligible for the benefits as
provided in paragraphs (g) to (i). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes
listed in United States Code, title 8, section 1101(a)(15).
(g) Payment shall also be made for care and services that
are furnished to noncitizens, regardless of immigration status,
who otherwise meet the eligibility requirements of chapter 256B,
if such care and services are necessary for the treatment of an
emergency medical condition, except for organ transplants and
related care and services and routine prenatal care.
(h) For purposes of this subdivision, the term "emergency
medical condition" means a medical condition that meets the
requirements of United States Code, title 42, section 1396b(v).
(i) Pregnant noncitizens who are undocumented or
nonimmigrants, who otherwise meet the eligibility requirements
of chapter 256B, are eligible for medical assistance payment
without federal financial participation for care and services
through the period of pregnancy, and 60 days postpartum, except
for labor and delivery.
(j) Qualified noncitizens as described in paragraph (d),
and all other noncitizens lawfully residing in the United States
as described in paragraph (e), who are ineligible for medical
assistance with federal financial participation and who
otherwise meet the eligibility requirements of chapter 256B and
of this paragraph, are eligible for medical assistance without
federal financial participation. Qualified noncitizens as
described in paragraph (d) are only eligible for medical
assistance without federal financial participation for five
years from their date of entry into the United States.
(k) The commissioner shall submit to the legislature by
December 31, 1998, a report on the number of recipients and cost
of coverage of care and services made according to paragraphs
(i) and (j).
Sec. 20. Minnesota Statutes 1996, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 3a. [GENDER REASSIGNMENT SURGERY.] Gender
reassignment surgery and other gender reassignment medical
procedures including drug therapy for gender reassignment are
not covered unless the individual began receiving gender
reassignment services prior to July 1, 1998.
Sec. 21. Minnesota Statutes 1996, section 256B.0625,
subdivision 7, is amended to read:
Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers
private duty nursing services in a recipient's home. Recipients
who are authorized to receive private duty nursing services in
their home may use approved hours outside of the home during
hours when normal life activities take them outside of their
home and when, without the provision of private duty nursing,
their health and safety would be jeopardized. To use private
duty nursing services at school, the recipient or responsible
party must provide written authorization in the care plan
identifying the chosen provider and the daily amount of services
to be used at school. Medical assistance does not cover private
duty nursing services for residents of a hospital, nursing
facility, intermediate care facility, or a health care facility
licensed by the commissioner of health, except as authorized in
section 256B.64 for ventilator-dependent recipients in hospitals
or unless a resident who is otherwise eligible is on leave from
the facility and the facility either pays for the private duty
nursing services or forgoes the facility per diem for the leave
days that private duty nursing services are used. Total hours
of service and payment allowed for services outside the home
cannot exceed that which is otherwise allowed in an in-home
setting according to section 256B.0627. All private duty
nursing services must be provided according to the limits
established under section 256B.0627. Private duty nursing
services may not be reimbursed if the nurse is the spouse of the
recipient or the parent or foster care provider of a recipient
who is under age 18, or the recipient's legal guardian.
Sec. 22. Minnesota Statutes 1996, section 256B.0625,
subdivision 17, is amended to read:
Subd. 17. [TRANSPORTATION COSTS.] (a) 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 subdivision, a person who is
incapable of transport by taxicab or bus shall be considered to
be nonambulatory.
(b) Medical assistance covers special transportation, as
defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
if the provider receives and maintains a current physician's
order by the recipient's attending physician certifying that the
recipient has a physical or mental impairment that would
prohibit the recipient from safely accessing and using a bus,
taxi, other commercial transportation, or private automobile.
Special transportation includes driver-assisted service to
eligible individuals. Driver-assisted service includes
passenger pickup at and return to the individual's residence or
place of business, assistance with admittance of the individual
to the medical facility, and assistance in passenger securement
or in securing of wheelchairs or stretchers in the vehicle. The
commissioner shall establish maximum medical assistance
reimbursement rates for special transportation services for
persons who need a wheelchair lift van or stretcher-equipped
vehicle and for those who do not need a wheelchair lift van or
stretcher-equipped vehicle. The average of these two rates per
trip must not exceed $14 $15 for the base rate and $1.10 $1.20
per mile. Special transportation provided to nonambulatory
persons who do not need a wheelchair lift van or
stretcher-equipped vehicle, may be reimbursed at a lower rate
than special transportation provided to persons who need a
wheelchair lift van or stretcher-equipped vehicle.
Sec. 23. Minnesota Statutes 1996, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for
services rendered on or after July 1, 1999, medical assistance
payments for ambulance services shall be increased by five
percent.
Sec. 24. Minnesota Statutes 1996, section 256B.0625,
subdivision 19a, is amended to read:
Subd. 19a. [PERSONAL CARE SERVICES.] Medical assistance
covers personal care services in a recipient's home. To qualify
for personal care services, recipients or responsible parties
must be able to identify the recipient's needs, direct and
evaluate task accomplishment, and provide for health and
safety. Approved hours may be used outside the home when normal
life activities take them outside the home and when, without the
provision of personal care, their health and safety would be
jeopardized. To use personal care services at school, the
recipient or responsible party must provide written
authorization in the care plan identifying the chosen provider
and the daily amount of services to be used at school. Total
hours for services, whether actually performed inside or outside
the recipient's home, cannot exceed that which is otherwise
allowed for personal care services in an in-home setting
according to section 256B.0627. Medical assistance does not
cover personal care services for residents of a hospital,
nursing facility, intermediate care facility, health care
facility licensed by the commissioner of health, or unless a
resident who is otherwise eligible is on leave from the facility
and the facility either pays for the personal care services or
forgoes the facility per diem for the leave days that personal
care services are used. All personal care services must be
provided according to section 256B.0627. Personal care services
may not be reimbursed if the personal care assistant is the
spouse or legal guardian of the recipient or the parent of a
recipient under age 18, or the responsible party or the foster
care provider of a recipient who cannot direct the recipient's
own care unless, in the case of a foster care provider, a county
or state case manager visits the recipient as needed, but not
less than every six months, to monitor the health and safety of
the recipient and to ensure the goals of the care plan are met.
Parents of adult recipients, adult children of the recipient or
adult siblings of the recipient may be reimbursed for personal
care services if they are not the recipient's legal guardian and
are granted a waiver under section 256B.0627.
Sec. 25. Minnesota Statutes 1996, section 256B.0625,
subdivision 20, is amended to read:
Subd. 20. [MENTAL ILLNESS HEALTH CASE MANAGEMENT.] (a) To
the extent authorized by rule of the state agency, medical
assistance covers case management services to persons with
serious and persistent mental illness or subject to federal
approval, and children with severe emotional disturbance.
Services provided under this section must meet the relevant
standards in sections 245.461 to 245.4888, the Comprehensive
Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules
governing family community support services as defined in
section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for
children with severe emotional disturbance when these services
meet the program standards in Minnesota Rules, parts 9520.0900
to 9520.0926 and 9505.0322, excluding subpart 6 subparts 6 and
10.
(b) In counties where fewer than 50 percent of children
estimated to be eligible under medical assistance to receive
case management services for children with severe emotional
disturbance actually receive these services in state fiscal year
1995, community mental health centers serving those counties,
entities meeting program standards in Minnesota Rules, parts
9520.0570 to 9520.0870, and other entities authorized by the
commissioner are eligible for medical assistance reimbursement
for case management services for children with severe emotional
disturbance when these services meet the program standards in
Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,
excluding subpart 6.
(c) Medical assistance and MinnesotaCare payment for mental
health case management shall be made on a monthly basis. In
order to receive payment for an eligible child, the provider
must document at least a face-to-face contact with the child,
the child's parents, or the child's legal representative. To
receive payment for an eligible adult, the provider must
document at least a face-to-face contact with the adult or the
adult's legal representative.
(d) Payment for mental health case management provided by
county or state staff shall be based on the monthly rate
methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental
health, and within mental health, separate rates for children
and adults.
(e) Payment for mental health case management provided by
county-contracted vendors shall be based on a monthly rate
negotiated by the host county. The negotiated rate must not
exceed the rate charged by the vendor for the same service to
other payers. If the service is provided by a team of
contracted vendors, the county may negotiate a team rate with a
vendor who is a member of the team. The team shall determine
how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county,
except to reimburse the county for advance funding provided by
the county to the vendor.
(f) If the service is provided by a team which includes
contracted vendors and county or state staff, the costs for
county or state staff participation in the team shall be
included in the rate for county-provided services. In this
case, the contracted vendor and the county may each receive
separate payment for services provided by each entity in the
same month. In order to prevent duplication of services, the
county must document, in the recipient's file, the need for team
case management and a description of the roles of the team
members.
(g) The commissioner shall calculate the nonfederal share
of actual medical assistance and general assistance medical care
payments for each county, based on the higher of calendar year
1995 or 1996, by service date, project that amount forward to
1999, and transfer one-half of the result from medical
assistance and general assistance medical care to each county's
mental health grants under sections 245.4886 and 256E.12 for
calendar year 1999. The annualized minimum amount added to each
county's mental health grant shall be $3,000 per year for
children and $5,000 per year for adults. The commissioner may
reduce the statewide growth factor in order to fund these
minimums. The annualized total amount transferred shall become
part of the base for future mental health grants for each county.
(h) Any net increase in revenue to the county as a result
of the change in this section must be used to provide expanded
mental health services as defined in sections 245.461 to
245.4888, the Comprehensive Adult and Children's Mental Health
Acts, excluding inpatient and residential treatment. For
adults, increased revenue may also be used for services and
consumer supports which are part of adult mental health projects
approved under Laws 1997, chapter 203, article 7, section 25.
For children, increased revenue may also be used for respite
care and nonresidential individualized rehabilitation services
as defined in section 245.492, subdivisions 17 and 23.
"Increased revenue" has the meaning given in Minnesota Rules,
part 9520.0903, subpart 3.
(i) Notwithstanding section 256B.19, subdivision 1, the
nonfederal share of costs for mental health case management
shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other
than federal funds or funds used to match other federal funds.
(j) The commissioner may suspend, reduce, or terminate the
reimbursement to a provider that does not meet the reporting or
other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is
responsible for any federal disallowances. The county may share
this responsibility with its contracted vendors.
(k) The commissioner shall set aside a portion of the
federal funds earned under this section to repay the special
revenue maximization account under section 256.01, subdivision
2, clause (15). The repayment is limited to:
(1) the costs of developing and implementing this section;
and
(2) programming the information systems.
(l) Notwithstanding section 256.025, subdivision 2,
payments to counties for case management expenditures under this
section shall only be made from federal earnings from services
provided under this section. Payments to contracted vendors
shall include both the federal earnings and the county share.
(m) Notwithstanding section 256B.041, county payments for
the cost of mental health case management services provided by
county or state staff shall not be made to the state treasurer.
For the purposes of mental health case management services
provided by county or state staff under this section, the
centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services
provided under this section.
(n) Case management services under this subdivision do not
include therapy, treatment, legal, or outreach services.
(o) If the recipient is a resident of a nursing facility,
intermediate care facility, or hospital, and the recipient's
institutional care is paid by medical assistance, payment for
case management services under this subdivision is limited to
the last 30 days of the recipient's residency in that facility
and may not exceed more than two months in a calendar year.
(p) Payment for case management services under this
subdivision shall not duplicate payments made under other
program authorities for the same purpose.
(q) By July 1, 2000, the commissioner shall evaluate the
effectiveness of the changes required by this section, including
changes in number of persons receiving mental health case
management, changes in hours of service per person, and changes
in caseload size.
(r) For each calendar year beginning with the calendar year
2001, the annualized amount of state funds for each county
determined under paragraph (g) shall be adjusted by the county's
percentage change in the average number of clients per month who
received case management under this section during the fiscal
year that ended six months prior to the calendar year in
question, in comparison to the prior fiscal year.
Sec. 26. Minnesota Statutes 1997 Supplement, section
256B.0625, subdivision 31a, is amended to read:
Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
SYSTEMS.] (a) Medical assistance covers augmentative and
alternative communication systems consisting of electronic or
nonelectronic devices and the related components necessary to
enable a person with severe expressive communication limitations
to produce or transmit messages or symbols in a manner that
compensates for that disability.
(b) By January 1, 1998, the commissioner, in cooperation
with the commissioner of administration, shall establish an
augmentative and alternative communication system purchasing
program within a state agency or by contract with a qualified
private entity. The purpose of this service is to facilitate
ready availability of the augmentative and alternative
communication systems needed to meet the needs of persons with
severe expressive communication limitations in an efficient and
cost-effective manner. This program shall:
(1) coordinate purchase and rental of augmentative and
alternative communication systems;
(2) negotiate agreements with manufacturers and vendors for
purchase of components of these systems, for warranty coverage,
and for repair service;
(3) when efficient and cost-effective, maintain and
refurbish if needed, an inventory of components of augmentative
and alternative communication systems for short- or long-term
loan to recipients;
(4) facilitate training sessions for service providers,
consumers, and families on augmentative and alternative
communication systems; and
(5) develop a recycling program for used augmentative and
alternative communications systems to be reissued and used for
trials and short-term use, when appropriate.
The availability of components of augmentative and
alternative communication systems through this program is
subject to prior authorization requirements established under
subdivision 25 Until the volume of systems purchased increases
to allow a discount price, the commissioner shall reimburse
augmentative and alternative communication manufacturers and
vendors at the manufacturer's suggested retail price for
augmentative and alternative communication systems and related
components. The commissioner shall separately reimburse
providers for purchasing and integrating individual
communication systems which are unavailable as a package from an
augmentative and alternative communication vendor.
(c) Reimbursement rates established by this purchasing
program are not subject to Minnesota Rules, part 9505.0445, item
S or T.
Sec. 27. Minnesota Statutes 1996, section 256B.0625,
subdivision 34, is amended to read:
Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.]
Medical assistance payments to American Indian health services
facilities for outpatient medical services billed after June 30,
1990, must be facilities of the Indian health service and
facilities operated by a tribe or tribal organization under
funding authorized by United States Code, title 25, sections
450f to 450n, or title III of the Indian Self-Determination and
Education Assistance Act, Public Law Number 93-638, shall be at
the option of the facility in accordance with the rate published
by the United States Assistant Secretary for Health under the
authority of United States Code, title 42, sections 248(a) and
249(b). General assistance medical care payments to facilities
of the American Indian health services and facilities operated
by a tribe or tribal organization for the provision of
outpatient medical care services billed after June 30, 1990,
must be in accordance with the general assistance medical care
rates paid for the same services when provided in a facility
other than an American a facility of the Indian health
service or a facility operated by a tribe or tribal organization.
Sec. 28. Minnesota Statutes 1996, section 256B.0625,
subdivision 38, is amended to read:
Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments
for mental health services covered under the medical assistance
program that are provided by masters-prepared mental health
professionals shall be 80 percent of the rate paid to
doctoral-prepared professionals. Payments for mental health
services covered under the medical assistance program that are
provided by masters-prepared mental health professionals
employed by community mental health centers shall be 100 percent
of the rate paid to doctoral-prepared professionals. For
purposes of reimbursement of mental health professionals under
the medical assistance program, all social workers who:
(1) have received a master's degree in social work from a
program accredited by the council on social work education;
(2) are licensed at the level of graduate social worker or
independent social worker; and
(3) are practicing clinical social work under appropriate
supervision, as defined by section 148B.18; meet all
requirements under Minnesota Rules, part 9505.0323, subpart 24,
and shall be paid accordingly.
Sec. 29. Minnesota Statutes 1996, section 256B.0627,
subdivision 4, is amended to read:
Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care
services that are eligible for payment are the following:
(1) bowel and bladder care;
(2) skin care to maintain the health of the skin;
(3) repetitive maintenance range of motion, muscle
strengthening exercises, and other tasks specific to maintaining
a recipient's optimal level of function;
(4) respiratory assistance;
(5) transfers and ambulation;
(6) bathing, grooming, and hairwashing necessary for
personal hygiene;
(7) turning and positioning;
(8) assistance with furnishing medication that is
self-administered;
(9) application and maintenance of prosthetics and
orthotics;
(10) cleaning medical equipment;
(11) dressing or undressing;
(12) assistance with eating and meal preparation and
necessary grocery shopping;
(13) accompanying a recipient to obtain medical diagnosis
or treatment;
(14) assisting, monitoring, or prompting the recipient to
complete the services in clauses (1) to (13);
(15) redirection, monitoring, and observation that are
medically necessary and an integral part of completing the
personal care services described in clauses (1) to (14);
(16) redirection and intervention for behavior, including
observation and monitoring;
(17) interventions for seizure disorders, including
monitoring and observation if the recipient has had a seizure
that requires intervention within the past three months; and
(18) tracheostomy suctioning using a clean procedure if the
procedure is properly delegated by a registered nurse. Before
this procedure can be delegated to a personal care assistant, a
registered nurse must determine that the tracheostomy suctioning
can be accomplished utilizing a clean rather than a sterile
procedure and must ensure that the personal care assistant has
been taught the proper procedure; and
(19) incidental household services that are an integral
part of a personal care service described in clauses (1) to
(17) (18).
For purposes of this subdivision, monitoring and observation
means watching for outward visible signs that are likely to
occur and for which there is a covered personal care service or
an appropriate personal care intervention. For purposes of this
subdivision, a clean procedure refers to a procedure that
reduces the numbers of microorganisms or prevents or reduces the
transmission of microorganisms from one person or place to
another. A clean procedure may be used beginning 14 days after
insertion.
(b) The personal care services that are not eligible for
payment are the following:
(1) services not ordered by the physician;
(2) assessments by personal care provider organizations or
by independently enrolled registered nurses;
(3) services that are not in the service plan;
(4) services provided by the recipient's spouse, legal
guardian for an adult or child recipient, or parent of a
recipient under age 18;
(5) services provided by a foster care provider of a
recipient who cannot direct the recipient's own care, unless
monitored by a county or state case manager under section
256B.0625, subdivision 19a;
(6) services provided by the residential or program license
holder in a residence for more than four persons;
(7) services that are the responsibility of a residential
or program license holder under the terms of a service agreement
and administrative rules;
(8) sterile procedures;
(9) injections of fluids into veins, muscles, or skin;
(10) services provided by parents of adult recipients,
adult children or adult siblings of the recipient, unless these
relatives meet one of the following hardship criteria and the
commissioner waives this requirement:
(i) the relative resigns from a part-time or full-time job
to provide personal care for the recipient;
(ii) the relative goes from a full-time to a part-time job
with less compensation to provide personal care for the
recipient;
(iii) the relative takes a leave of absence without pay to
provide personal care for the recipient;
(iv) the relative incurs substantial expenses by providing
personal care for the recipient; or
(v) because of labor conditions or intermittent hours of
care needed, the relative is needed in order to provide an
adequate number of qualified personal care assistants to meet
the medical needs of the recipient;
(11) homemaker services that are not an integral part of a
personal care services;
(12) home maintenance, or chore services;
(13) services not specified under paragraph (a); and
(14) services not authorized by the commissioner or the
commissioner's designee.
Sec. 30. Minnesota Statutes 1997 Supplement, section
256B.0627, subdivision 5, is amended to read:
Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance
payments for home care services shall be limited according to
this subdivision.
(a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
recipient may receive the following home care services during a
calendar year:
(1) any initial assessment;
(2) up to two reassessments per year done to determine a
recipient's need for personal care services; and
(3) up to five skilled nurse visits.
(b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
services above the limits in paragraph (a) must receive the
commissioner's prior authorization, except when:
(1) the home care services were required to treat an
emergency medical condition that if not immediately treated
could cause a recipient serious physical or mental disability,
continuation of severe pain, or death. The provider must
request retroactive authorization no later than five working
days after giving the initial service. The provider must be
able to substantiate the emergency by documentation such as
reports, notes, and admission or discharge histories;
(2) the home care services were provided on or after the
date on which the recipient's eligibility began, but before the
date on which the recipient was notified that the case was
opened. Authorization will be considered if the request is
submitted by the provider within 20 working days of the date the
recipient was notified that the case was opened;
(3) a third-party payor for home care services has denied
or adjusted a payment. Authorization requests must be submitted
by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the
request;
(4) the commissioner has determined that a county or state
human services agency has made an error; or
(5) the professional nurse determines an immediate need for
up to 40 skilled nursing or home health aide visits per calendar
year and submits a request for authorization within 20 working
days of the initial service date, and medical assistance is
determined to be the appropriate payer.
(c) [RETROACTIVE AUTHORIZATION.] A request for retroactive
authorization will be evaluated according to the same criteria
applied to prior authorization requests.
(d) [ASSESSMENT AND SERVICE PLAN.] Assessments under
section 256B.0627, subdivision 1, paragraph (a), shall be
conducted initially, and at least annually thereafter, in person
with the recipient and result in a completed service plan using
forms specified by the commissioner. Within 30 days of
recipient or responsible party request for home care services,
the assessment, the service plan, and other information
necessary to determine medical necessity such as diagnostic or
testing information, social or medical histories, and hospital
or facility discharge summaries shall be submitted to the
commissioner. For personal care services:
(1) The amount and type of service authorized based upon
the assessment and service plan will follow the recipient if the
recipient chooses to change providers.
(2) If the recipient's medical need changes, the
recipient's provider may assess the need for a change in service
authorization and request the change from the county public
health nurse. Within 30 days of the request, the public health
nurse will determine whether to request the change in services
based upon the provider assessment, or conduct a home visit to
assess the need and determine whether the change is appropriate.
(3) To continue to receive personal care services when the
recipient displays no significant change, the county public
health nurse has the option to review with the commissioner, or
the commissioner's designee, the service plan on record and
receive authorization for up to an additional 12 months at a
time for up to three years. after the first year, the recipient
or the responsible party, in conjunction with the public health
nurse, may complete a service update on forms developed by the
commissioner. The service update may substitute for the annual
reassessment described in subdivision 1.
(e) [PRIOR AUTHORIZATION.] The commissioner, or the
commissioner's designee, shall review the assessment, the
service plan, and any additional information that is submitted.
The commissioner shall, within 30 days after receiving a
complete request, assessment, and service plan, authorize home
care services as follows:
(1) [HOME HEALTH SERVICES.] All home health services
provided by a licensed nurse or a home health aide must be prior
authorized by the commissioner or the commissioner's designee.
Prior authorization must be based on medical necessity and
cost-effectiveness when compared with other care options. When
home health services are used in combination with personal care
and private duty nursing, the cost of all home care services
shall be considered for cost-effectiveness. The commissioner
shall limit nurse and home health aide visits to no more than
one visit each per day.
(2) [PERSONAL CARE SERVICES.] (i) All personal care
services and registered nurse supervision must be prior
authorized by the commissioner or the commissioner's designee
except for the assessments established in paragraph (a). The
amount of personal care services authorized must be based on the
recipient's home care rating. A child may not be found to be
dependent in an activity of daily living if because of the
child's age an adult would either perform the activity for the
child or assist the child with the activity and the amount of
assistance needed is similar to the assistance appropriate for a
typical child of the same age. Based on medical necessity, the
commissioner may authorize:
(A) up to two times the average number of direct care hours
provided in nursing facilities for the recipient's comparable
case mix level; or
(B) up to three times the average number of direct care
hours provided in nursing facilities for recipients who have
complex medical needs or are dependent in at least seven
activities of daily living and need physical assistance with
eating or have a neurological diagnosis; or
(C) up to 60 percent of the average reimbursement rate, as
of July 1, 1991, for care provided in a regional treatment
center for recipients who have Level I behavior, plus any
inflation adjustment as provided by the legislature for personal
care service; or
(D) up to the amount the commissioner would pay, as of July
1, 1991, plus any inflation adjustment provided for home care
services, for care provided in a regional treatment center for
recipients referred to the commissioner by a regional treatment
center preadmission evaluation team. For purposes of this
clause, home care services means all services provided in the
home or community that would be included in the payment to a
regional treatment center; or
(E) up to the amount medical assistance would reimburse for
facility care for recipients referred to the commissioner by a
preadmission screening team established under section 256B.0911
or 256B.092; and
(F) a reasonable amount of time for the provision of
nursing supervision of personal care services.
(ii) The number of direct care hours shall be determined
according to the annual cost report submitted to the department
by nursing facilities. The average number of direct care hours,
as established by May 1, 1992, shall be calculated and
incorporated into the home care limits on July 1, 1992. These
limits shall be calculated to the nearest quarter hour.
(iii) The home care rating shall be determined by the
commissioner or the commissioner's designee based on information
submitted to the commissioner by the county public health nurse
on forms specified by the commissioner. The home care rating
shall be a combination of current assessment tools developed
under sections 256B.0911 and 256B.501 with an addition for
seizure activity that will assess the frequency and severity of
seizure activity and with adjustments, additions, and
clarifications that are necessary to reflect the needs and
conditions of recipients who need home care including children
and adults under 65 years of age. The commissioner shall
establish these forms and protocols under this section and shall
use an advisory group, including representatives of recipients,
providers, and counties, for consultation in establishing and
revising the forms and protocols.
(iv) A recipient shall qualify as having complex medical
needs if the care required is difficult to perform and because
of recipient's medical condition requires more time than
community-based standards allow or requires more skill than
would ordinarily be required and the recipient needs or has one
or more of the following:
(A) daily tube feedings;
(B) daily parenteral therapy;
(C) wound or decubiti care;
(D) postural drainage, percussion, nebulizer treatments,
suctioning, tracheotomy care, oxygen, mechanical ventilation;
(E) catheterization;
(F) ostomy care;
(G) quadriplegia; or
(H) other comparable medical conditions or treatments the
commissioner determines would otherwise require institutional
care.
(v) A recipient shall qualify as having Level I behavior if
there is reasonable supporting evidence that the recipient
exhibits, or that without supervision, observation, or
redirection would exhibit, one or more of the following
behaviors that cause, or have the potential to cause:
(A) injury to the recipient's own body;
(B) physical injury to other people; or
(C) destruction of property.
(vi) Time authorized for personal care relating to Level I
behavior in subclause (v), items (A) to (C), shall be based on
the predictability, frequency, and amount of intervention
required.
(vii) A recipient shall qualify as having Level II behavior
if the recipient exhibits on a daily basis one or more of the
following behaviors that interfere with the completion of
personal care services under subdivision 4, paragraph (a):
(A) unusual or repetitive habits;
(B) withdrawn behavior; or
(C) offensive behavior.
(viii) A recipient with a home care rating of Level II
behavior in subclause (vii), items (A) to (C), shall be rated as
comparable to a recipient with complex medical needs under
subclause (iv). If a recipient has both complex medical needs
and Level II behavior, the home care rating shall be the next
complex category up to the maximum rating under subclause (i),
item (B).
(3) [PRIVATE DUTY NURSING SERVICES.] All private duty
nursing services shall be prior authorized by the commissioner
or the commissioner's designee. Prior authorization for private
duty nursing services shall be based on medical necessity and
cost-effectiveness when compared with alternative care options.
The commissioner may authorize medically necessary private duty
nursing services in quarter-hour units when:
(i) the recipient requires more individual and continuous
care than can be provided during a nurse visit; or
(ii) the cares are outside of the scope of services that
can be provided by a home health aide or personal care assistant.
The commissioner may authorize:
(A) up to two times the average amount of direct care hours
provided in nursing facilities statewide for case mix
classification "K" as established by the annual cost report
submitted to the department by nursing facilities in May 1992;
(B) private duty nursing in combination with other home
care services up to the total cost allowed under clause (2);
(C) up to 16 hours per day if the recipient requires more
nursing than the maximum number of direct care hours as
established in item (A) and the recipient meets the hospital
admission criteria established under Minnesota Rules, parts
9505.0500 to 9505.0540.
The commissioner may authorize up to 16 hours per day of
medically necessary private duty nursing services or up to 24
hours per day of medically necessary private duty nursing
services until such time as the commissioner is able to make a
determination of eligibility for recipients who are
cooperatively applying for home care services under the
community alternative care program developed under section
256B.49, or until it is determined by the appropriate regulatory
agency that a health benefit plan is or is not required to pay
for appropriate medically necessary health care services.
Recipients or their representatives must cooperatively assist
the commissioner in obtaining this determination. Recipients
who are eligible for the community alternative care program may
not receive more hours of nursing under this section than would
otherwise be authorized under section 256B.49.
(4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is
ventilator-dependent, the monthly medical assistance
authorization for home care services shall not exceed what the
commissioner would pay for care at the highest cost hospital
designated as a long-term hospital under the Medicare program.
For purposes of this clause, home care services means all
services provided in the home that would be included in the
payment for care at the long-term hospital.
"Ventilator-dependent" means an individual who receives
mechanical ventilation for life support at least six hours per
day and is expected to be or has been dependent for at least 30
consecutive days.
(f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
or the commissioner's designee shall determine the time period
for which a prior authorization shall be effective. If the
recipient continues to require home care services beyond the
duration of the prior authorization, the home care provider must
request a new prior authorization. Under no circumstances,
other than the exceptions in paragraph (b), shall a prior
authorization be valid prior to the date the commissioner
receives the request or for more than 12 months. A recipient
who appeals a reduction in previously authorized home care
services may continue previously authorized services, other than
temporary services under paragraph (h), pending an appeal under
section 256.045. The commissioner must provide a detailed
explanation of why the authorized services are reduced in amount
from those requested by the home care provider.
(g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or
the commissioner's designee shall determine the medical
necessity of home care services, the level of caregiver
according to subdivision 2, and the institutional comparison
according to this subdivision, the cost-effectiveness of
services, and the amount, scope, and duration of home care
services reimbursable by medical assistance, based on the
assessment, primary payer coverage determination information as
required, the service plan, the recipient's age, the cost of
services, the recipient's medical condition, and diagnosis or
disability. The commissioner may publish additional criteria
for determining medical necessity according to section 256B.04.
(h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
The agency nurse, the independently enrolled private duty nurse,
or county public health nurse may request a temporary
authorization for home care services by telephone. The
commissioner may approve a temporary level of home care services
based on the assessment, and service or care plan information,
and primary payer coverage determination information as required.
Authorization for a temporary level of home care services
including nurse supervision is limited to the time specified by
the commissioner, but shall not exceed 45 days, unless extended
because the county public health nurse has not completed the
required assessment and service plan, or the commissioner's
determination has not been made. The level of services
authorized under this provision shall have no bearing on a
future prior authorization.
(i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.]
Home care services provided in an adult or child foster care
setting must receive prior authorization by the department
according to the limits established in paragraph (a).
The commissioner may not authorize:
(1) home care services that are the responsibility of the
foster care provider under the terms of the foster care
placement agreement and administrative rules. Requests for home
care services for recipients residing in a foster care setting
must include the foster care placement agreement and
determination of difficulty of care;
(2) personal care services when the foster care license
holder is also the personal care provider or personal care
assistant unless the recipient can direct the recipient's own
care, or case management is provided as required in section
256B.0625, subdivision 19a;
(3) personal care services when the responsible party is an
employee of, or under contract with, or has any direct or
indirect financial relationship with the personal care provider
or personal care assistant, unless case management is provided
as required in section 256B.0625, subdivision 19a;
(4) home care services when the number of foster care
residents is greater than four unless the county responsible for
the recipient's foster placement made the placement prior to
April 1, 1992, requests that home care services be provided, and
case management is provided as required in section 256B.0625,
subdivision 19a; or
(5) home care services when combined with foster care
payments, other than room and board payments that exceed the
total amount that public funds would pay for the recipient's
care in a medical institution.
Sec. 31. Minnesota Statutes 1997 Supplement, section
256B.0627, subdivision 8, is amended to read:
Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.]
(a) Medical assistance payments for personal care assistance
shared care shall be limited according to this subdivision.
(b) Recipients of personal care assistant services may
share staff and the commissioner shall provide a rate system for
shared personal care assistant services. For two persons
sharing care, the rate system paid to a provider shall not
exceed 1-1/2 times the amount rate paid for providing services
to one person serving a single individual, and shall increase
incrementally by one-half the cost of serving a single person,
for each person served. A personal care assistant may not serve
more than three children in a single setting. for three persons
sharing care, the rate paid to a provider shall not exceed twice
the rate paid for serving a single individual. These rates
apply only to situations in which all recipients were present
and received shared care on the date for which the service is
billed. No more than three persons may receive shared care from
a personal care assistant in a single setting.
(c) Shared care is the provision of personal care services
by a personal care assistant to two or three recipients at the
same time and in the same setting. For the purposes of this
subdivision, "setting" means:
(1) the home or foster care home of one of the individual
recipients; or
(2) a child care program in which all recipients served by
one personal care assistant are participating, which is licensed
under chapter 245A or operated by a local school district or
private school.
The provisions of this subdivision do not apply when a
personal care assistant is caring for multiple recipients in
more than one setting.
(d) The recipient or the recipient's responsible party, in
conjunction with the county public health nurse, shall determine:
(1) whether shared care is an appropriate option based on
the individual needs and preferences of the recipient; and
(2) the amount of shared care allocated as part of the
overall authorization of personal care services.
The recipient or the responsible party, in conjunction with
the supervising registered nurse, shall approve the setting,
grouping, and arrangement of shared care based on the individual
needs and preferences of the recipients. Decisions on the
selection of recipients to share care must be based on the ages
of the recipients, compatibility, and coordination of their care
needs.
(e) The following items must be considered by the recipient
or the responsible party and the supervising nurse, and
documented in the recipient's care plan:
(1) the additional qualifications needed by the personal
care assistant to provide care to several recipients in the same
setting;
(2) the additional training and supervision needed by the
personal care assistant to ensure that the needs of the
recipient are met appropriately and safely. The provider must
provide on-site supervision by a registered nurse within the
first 14 days of shared care, and monthly thereafter;
(3) the setting in which the shared care will be provided;
(4) the ongoing monitoring and evaluation of the
effectiveness and appropriateness of the service and process
used to make changes in service or setting; and
(5) a contingency plan which accounts for absence of the
recipient in a shared care setting due to illness or other
circumstances and staffing contingencies.
(f) The provider must offer the recipient or the
responsible party the option of shared or individual personal
care assistant care. The recipient or the responsible party can
withdraw from participating in a shared care arrangement at any
time.
(g) In addition to documentation requirements under
Minnesota Rules, part 9505.2175, a personal care provider must
meet documentation requirements for shared personal care
services and must document the following in the health service
record for each individual recipient sharing care:
(1) authorization by the recipient or the recipient's
responsible party, if any, for the maximum number of shared care
hours per week chosen by the recipient;
(2) authorization by the recipient or the recipient's
responsible party, if any, for personal care services provided
outside the recipient's residence;
(3) authorization by the recipient or the recipient's
responsible party, if any, for others to receive shared care in
the recipient's residence;
(4) revocation by the recipient or the recipient's
responsible party, if any, of the shared care authorization, or
the shared care to be provided to others in the recipient's
residence, or the shared care to be provided outside the
recipient's residence;
(5) supervision of the shared care by the supervisory
nurse, including the date, time of day, number of hours spent
supervising the provision of shared care services, whether the
supervision was face-to-face or another method of supervision,
changes in the recipient's condition, shared care scheduling
issues and recommendations;
(6) documentation by the personal care assistant of
telephone calls or other discussions with the supervisory nurse
regarding services being provided to the recipient; and
(7) daily documentation of the shared care services
provided by each identified personal care assistant including:
(i) the names of each recipient receiving shared care
together;
(ii) the setting for the day's care, including the starting
and ending times that the recipient received shared care; and
(iii) notes by the personal care assistant regarding
changes in the recipient's condition, problems that may arise
from the sharing of care, scheduling issues, care issues, and
other notes as required by the supervising nurse.
(h) Unless otherwise provided in this subdivision, all
other statutory and regulatory provisions relating to personal
care services apply to shared care services.
Nothing in this subdivision shall be construed to reduce
the total number of hours authorized for an individual recipient.
Sec. 32. Minnesota Statutes 1997 Supplement, section
256B.0645, is amended to read:
256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN
ELIGIBILITY.]
Payment to a provider for a health care service provided to
a general assistance medical care recipient who is later
determined eligible for medical assistance or MinnesotaCare
according to section 256L.14 256L.03, subdivision 1a, for the
period in which the health care service was provided, shall be
considered payment in full, and shall not may be adjusted due to
the change in eligibility. This section applies does not apply
to both fee-for-service payments and payments made to health
plans on a prepaid capitated basis.
Sec. 33. Minnesota Statutes 1997 Supplement, section
256B.0911, subdivision 2, is amended to read:
Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.]
All applicants to Medicaid certified nursing facilities must be
screened prior to admission, regardless of income, assets, or
funding sources, except the following:
(1) patients who, having entered acute care facilities from
certified nursing facilities, are returning to a certified
nursing facility;
(2) residents transferred from other certified nursing
facilities located within the state of Minnesota;
(3) individuals who have a contractual right to have their
nursing facility care paid for indefinitely by the veteran's
administration;
(4) individuals who are enrolled in the Ebenezer/Group
Health social health maintenance organization project, or
enrolled in a demonstration project under section 256B.69,
subdivision 18 8, at the time of application to a nursing home;
(5) individuals previously screened and currently being
served under the alternative care program or under a home and
community-based services waiver authorized under section 1915(c)
of the Social Security Act; or
(6) individuals who are admitted to a certified nursing
facility for a short-term stay, which, based upon a physician's
certification, is expected to be 14 days or less in duration,
and who have been screened and approved for nursing facility
admission within the previous six months. This exemption
applies only if the screener determines at the time of the
initial screening of the six-month period that it is appropriate
to use the nursing facility for short-term stays and that there
is an adequate plan of care for return to the home or
community-based setting. If a stay exceeds 14 days, the
individual must be referred no later than the first county
working day following the 14th resident day for a screening,
which must be completed within five working days of the
referral. Payment limitations in subdivision 7 will apply to an
individual found at screening to not meet the level of care
criteria for admission to a certified nursing facility.
Regardless of the exemptions in clauses (2) to (6), persons
who have a diagnosis or possible diagnosis of mental illness,
mental retardation, or a related condition must receive a
preadmission screening before admission unless the admission
prior to screening is authorized by the local mental health
authority or the local developmental disabilities case manager,
or unless authorized by the county agency according to Public
Law Number 101-508.
Before admission to a Medicaid certified nursing home or
boarding care home, all persons must be screened and approved
for admission through an assessment process. The nursing
facility is authorized to conduct case mix assessments which are
not conducted by the county public health nurse under Minnesota
Rules, part 9549.0059. The designated county agency is
responsible for distributing the quality assurance and review
form for all new applicants to nursing homes.
Other persons who are not applicants to nursing facilities
must be screened if a request is made for a screening.
Sec. 34. Minnesota Statutes 1996, section 256B.0911,
subdivision 4, is amended to read:
Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING
TEAM.] (a) The county shall:
(1) provide information and education to the general public
regarding availability of the preadmission screening program;
(2) accept referrals from individuals, families, human
service and health professionals, and hospital and nursing
facility personnel;
(3) assess the health, psychological, and social needs of
referred individuals and identify services needed to maintain
these persons in the least restrictive environments;
(4) determine if the individual screened needs nursing
facility level of care;
(5) assess specialized service needs based upon an
evaluation by:
(i) a qualified independent mental health professional for
persons with a primary or secondary diagnosis of a serious
mental illness; and
(ii) a qualified mental retardation professional for
persons with a primary or secondary diagnosis of mental
retardation or related conditions. For purposes of this clause,
a qualified mental retardation professional must meet the
standards for a qualified mental retardation professional in
Code of Federal Regulations, title 42, section 483.430;
(6) make recommendations for individuals screened regarding
cost-effective community services which are available to the
individual;
(7) make recommendations for individuals screened regarding
nursing home placement when there are no cost-effective
community services available;
(8) develop an individual's community care plan and provide
follow-up services as needed; and
(9) prepare and submit reports that may be required by the
commissioner of human services.
(b) The screener shall document that the most
cost-effective alternatives available were offered to the
individual or the individual's legal representative. For
purposes of this section, "cost-effective alternatives" means
community services and living arrangements that cost the same or
less than nursing facility care.
(c) Screeners shall adhere to the level of care criteria
for admission to a certified nursing facility established under
section 144.0721.
(d) For persons who are eligible for medical assistance or
who would be eligible within 180 days of admission to a nursing
facility and who are admitted to a nursing facility, the nursing
facility must include a screener or the case manager in the
discharge planning process for those individuals who the team
has determined have discharge potential. The screener or the
case manager must ensure a smooth transition and follow-up for
the individual's return to the community.
Screeners shall cooperate with other public and private
agencies in the community, in order to offer a variety of
cost-effective services to the disabled and elderly. The
screeners shall encourage the use of volunteers from families,
religious organizations, social clubs, and similar civic and
service organizations to provide services.
Sec. 35. Minnesota Statutes 1997 Supplement, section
256B.0911, subdivision 7, is amended to read:
Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.]
(a) Medical assistance reimbursement for nursing facilities
shall be authorized for a medical assistance recipient only if a
preadmission screening has been conducted prior to admission or
the local county agency has authorized an exemption. Medical
assistance reimbursement for nursing facilities shall not be
provided for any recipient who the local screener has determined
does not meet the level of care criteria for nursing facility
placement or, if indicated, has not had a level II PASARR
evaluation completed unless an admission for a recipient with
mental illness is approved by the local mental health authority
or an admission for a recipient with mental retardation or
related condition is approved by the state mental retardation
authority. The county preadmission screening team may deny
certified nursing facility admission using the level of care
criteria established under section 144.0721 and deny medical
assistance reimbursement for certified nursing facility care.
Persons receiving care in a certified nursing facility or
certified boarding care home who are reassessed by the
commissioner of health according to section 144.0722 and
determined to no longer meet the level of care criteria for a
certified nursing facility or certified boarding care home may
no longer remain a resident in the certified nursing facility or
certified boarding care home and must be relocated to the
community if the persons were admitted on or after July 1, 1998.
(b) Persons receiving services under section 256B.0913,
subdivisions 1 to 14, or 256B.0915 who are reassessed and found
to not meet the level of care criteria for admission to a
certified nursing facility or certified boarding care home may
no longer receive these services if persons were admitted to the
program on or after July 1, 1998. The commissioner shall make a
request to the health care financing administration for a waiver
allowing screening team approval of Medicaid payments for
certified nursing facility care. An individual has a choice and
makes the final decision between nursing facility placement and
community placement after the screening team's recommendation,
except as provided in paragraphs (b) and (c).
(c) The local county mental health authority or the state
mental retardation authority under Public Law Numbers 100-203
and 101-508 may prohibit admission to a nursing facility, if the
individual does not meet the nursing facility level of care
criteria or needs specialized services as defined in Public Law
Numbers 100-203 and 101-508. For purposes of this section,
"specialized services" for a person with mental retardation or a
related condition means "active treatment" as that term is
defined in Code of Federal Regulations, title 42, section
483.440(a)(1).
(d) Upon the receipt by the commissioner of approval by the
Secretary of Health and Human Services of the waiver requested
under paragraph (a), the local screener shall deny medical
assistance reimbursement for nursing facility care for an
individual whose long-term care needs can be met in a
community-based setting and whose cost of community-based home
care services is less than 75 percent of the average payment for
nursing facility care for that individual's case mix
classification, and who is either:
(i) a current medical assistance recipient being screened
for admission to a nursing facility; or
(ii) an individual who would be eligible for medical
assistance within 180 days of entering a nursing facility and
who meets a nursing facility level of care.
(e) Appeals from the screening team's recommendation or the
county agency's final decision shall be made according to
section 256.045, subdivision 3.
Sec. 36. Minnesota Statutes 1997 Supplement, section
256B.0913, subdivision 14, is amended to read:
Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a)
Reimbursement for expenditures for the alternative care services
as approved by the client's case manager shall be through the
invoice processing procedures of the department's Medicaid
Management Information System (MMIS). To receive reimbursement,
the county or vendor must submit invoices within 12 months
following the date of service. The county agency and its
vendors under contract shall not be reimbursed for services
which exceed the county allocation.
(b) If a county collects less than 50 percent of the client
premiums due under subdivision 12, the commissioner may withhold
up to three percent of the county's final alternative care
program allocation determined under subdivisions 10 and 11.
(c) For fiscal years beginning on or after July 1, 1993,
the commissioner of human services shall not provide automatic
annual inflation adjustments for alternative care 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 alternative care 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.
(d) 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 alternative care service.
Notwithstanding any other rule or statutory provision to the
contrary, the commissioner shall not be authorized to increase
rates by an annual inflation factor, unless so authorized by the
legislature.
(e) (d) On July 1, 1993, the commissioner shall increase
the maximum rate for home delivered meals to $4.50 per meal.
Sec. 37. Minnesota Statutes 1997 Supplement, section
256B.0915, subdivision 1d, is amended to read:
Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND
RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the
provisions of section 256B.056, the commissioner shall make the
following amendment to the medical assistance elderly waiver
program effective July 1, 1997 1999, or upon federal approval,
whichever is later.
A recipient's maintenance needs will be an amount equal to
the Minnesota supplemental aid equivalent rate as defined in
section 256I.03, subdivision 5, plus the medical assistance
personal needs allowance as defined in section 256B.35,
subdivision 1, paragraph (a), when applying posteligibility
treatment of income rules to the gross income of elderly waiver
recipients, except for individuals whose income is in excess of
the special income standard according to Code of Federal
Regulations, title 42, section 435.236. Recipient maintenance
needs shall be adjusted under this provision each July 1.
(b) The commissioner of human services shall secure
approval of additional elderly waiver slots sufficient to serve
persons who will qualify under the revised income standard
described in paragraph (a) before implementing section
256B.0913, subdivision 16.
(c) In implementing this subdivision, the commissioner
shall consider allowing persons who would otherwise be eligible
for the alternative care program but would qualify for the
elderly waiver with a spenddown to remain on the alternative
care program.
Sec. 38. Minnesota Statutes 1997 Supplement, section
256B.0915, subdivision 3, 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 the medical assistance case mix
reimbursement system. If medical supplies and equipment or
adaptations are or will be purchased for an elderly waiver
services recipient, the costs may be prorated on a monthly basis
throughout the year in which they are purchased. If the monthly
cost of a recipient's other waivered services exceeds the
monthly limit established in this paragraph, the annual cost of
the waivered services shall be determined. In this event, the
annual cost of waivered services shall not exceed 12 times the
monthly limit calculated in this paragraph. 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 annual cost
divided by 12 of elderly or disabled waivered services for a
person who is a nursing facility resident at the time of
requesting a determination of eligibility for elderly or
disabled waivered services shall be the greater of the monthly
payment for: (i) the resident class assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, for that resident in the
nursing facility where the resident currently resides; or (ii)
the statewide average payment of the case mix resident class to
which the resident would be assigned under the medical
assistance case mix reimbursement system, provided that the
limit under this clause only applies to persons discharged from
a nursing facility and found eligible for waivered services on
or after July 1, 1997. 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, private duty nursing, 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) For both the elderly waiver and the nursing facility
disabled waiver, a county may purchase extended supplies and
equipment without prior approval from the commissioner when
there is no other funding source and the supplies and equipment
are specified in the individual's care plan as medically
necessary to enable the individual to remain in the community
according to the criteria in Minnesota Rules, part 9505.0210,
items A and B. A county is not required to contract with a
provider of supplies and equipment if the monthly cost of the
supplies and equipment is less than $250.
(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; the rate must allow for other
waiver and medical assistance home care services to be
authorized by the case manager.
(g) (f) The assisted living and residential care service
rates for elderly and community alternatives for disabled
individuals (CADI) waivers shall be made to the vendor as a
monthly rate negotiated with the county agency based on an
individualized service plan for each resident. 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, unless the services are provided by a home care
provider licensed by the department of health and are provided
in a building that is registered as a housing with services
establishment under chapter 144D and that provides 24-hour
supervision. For alternative care assisted living projects
established under Laws 1988, chapter 689, article 2, section
256, monthly 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) (g) 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) (h) On July 1, 1993, the commissioner shall increase
the maximum rate for home-delivered meals to $4.50 per meal.
(j) (i) 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) (j) 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.
(l) (k) For the community alternatives for disabled
individuals waiver, and nursing facility disabled waivers,
county may use waiver funds for the cost of minor adaptations to
a client's residence or vehicle without prior approval from the
commissioner if there is no other source of funding and the
adaptation:
(1) is necessary to avoid institutionalization;
(2) has no utility apart from the needs of the client; and
(3) meets the criteria in Minnesota Rules, part 9505.0210,
items A and B.
For purposes of this subdivision, "residence" means the client's
own home, the client's family residence, or a family foster
home. For purposes of this subdivision, "vehicle" means the
client's vehicle, the client's family vehicle, or the client's
family foster home vehicle.
(m) (l) The commissioner shall establish a maximum rate
unit for baths provided by an adult day care provider that are
not included in the provider's contractual daily or hourly rate.
This maximum rate must equal the home health aide extended rate
and shall be paid for baths provided to clients served under the
elderly and disabled waivers.
Sec. 39. Minnesota Statutes 1996, section 256B.0916, is
amended to read:
256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES;
MANAGEMENT AND ALLOCATION RESPONSIBILITIES.]
(a) The commissioner shall expand availability of home and
community-based services for persons with mental retardation and
related conditions to the extent allowed by federal law and
regulation and shall assist counties in transferring persons
from semi-independent living services to home and
community-based services. The commissioner may transfer funds
from the state semi-independent living services account
available under section 252.275, subdivision 8, and state
community social services aids available under section 256E.15
to the medical assistance account to pay for the nonfederal
share of nonresidential and residential home and community-based
services authorized under section 256B.092 for persons
transferring from semi-independent living services.
(b) Upon federal approval, county boards are not
responsible for funding semi-independent living services as a
social service for those persons who have transferred to the
home and community-based waiver program as a result of the
expansion under this subdivision. The county responsibility for
those persons transferred shall be assumed under section
256B.092. Notwithstanding the provisions of section 252.275,
the commissioner shall continue to allocate funds under that
section for semi-independent living services and county boards
shall continue to fund services under sections 256E.06 and
256E.14 for those persons who cannot access home and
community-based services under section 256B.092.
(c) Eighty percent of the state funds made available to the
commissioner under section 252.275 as a result of persons
transferring from the semi-independent living services program
to the home and community-based services program shall be used
to fund additional persons in the semi-independent living
services program.
(d) Beginning August 1, 1998, the commissioner shall issue
an annual report on the home and community-based waiver for
persons with mental retardation or related conditions, that
includes a list of the counties in which less than 95 percent of
the allocation provided, excluding the county waivered services
reserve, has been committed for two or more quarters during the
previous state fiscal year. For each listed county, the report
shall include the amount of funds allocated but not used, the
number and ages of individuals screened and waiting for
services, the services needed, a description of the technical
assistance provided by the commissioner to assist the counties
in jointly planning with other counties in order to serve more
persons, and additional actions which will be taken to serve
those screened and waiting for services.
(e) The commissioner shall make available to interested
parties, upon request, financial information by county including
the amount of resources allocated for the home and
community-based waiver for persons with mental retardation and
related conditions, the resources committed, the number of
persons screened and waiting for services, the type of services
requested by those waiting, and the amount of allocated
resources not committed.
Sec. 40. Minnesota Statutes 1997 Supplement, section
256B.0951, is amended by adding a subdivision to read:
Subd. 7. [WAIVER OF RULES.] The commissioner of health may
exempt residents of intermediate care facilities for persons
with mental retardation (ICFs/MR) who participate in the
three-year quality assurance pilot project established in
section 256B.095 from the requirements of Minnesota Rules,
chapter 4665, upon approval by the federal government of a
waiver of federal certification requirements for ICFs/MR. The
commissioners of health and human services shall apply for any
necessary waivers as soon as practicable and shall submit the
concept paper to the federal government by June 1, 1998.
Sec. 41. Minnesota Statutes 1996, section 256B.41,
subdivision 1, is amended to read:
Subdivision 1. [AUTHORITY.] The commissioner shall
establish, by rule, procedures for determining rates for care of
residents of nursing facilities which qualify as vendors of
medical assistance, and for implementing the provisions of this
section and sections 256B.421, 256B.431, 256B.432, 256B.433,
256B.47, 256B.48, 256B.50, and 256B.502. 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
nursing facilities and shall specify the costs that are
allowable for establishing payment rates through medical
assistance.
Sec. 42. Minnesota Statutes 1996, 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 facility's cost report of allowable operating costs
incurred by the nursing facility 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, and size
of the nursing facility, and the costs that must be incurred for
the care of residents in an efficiently and economically
operated nursing facility. In developing the geographic groups
for purposes of reimbursement under this section, the
commissioner shall ensure that nursing facilities 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
facilities 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, 1989, facilities
located in geographic group I as described in Minnesota Rules,
part 9549.0052, on January 1, 1989, 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 facilities 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 facility payment rates, the commissioner
shall divide the allowable historical operating costs by the
actual number of resident days, except that where a nursing
facility 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 facilities 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 facilities 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 facilities 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 facility shall receive an operating cost
payment rate equal to the sum of the nursing facility'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 facility'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 facility'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 facility as an operating cost of that nursing
facility. Allowable costs under this subdivision for payments
made by a nonprofit nursing facility that are in lieu of real
estate taxes shall not exceed the amount which the nursing
facility would have paid to a city or township and county for
fire, police, sanitation services, and road maintenance costs
had real estate taxes been levied on that property for those
purposes. 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 facilities 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 facility as an operating cost of that
nursing facility. For rate years beginning on or after July 1,
1989, the commissioner shall include a nursing facility's
reported public employee retirement act contribution for the
reporting year as apportioned to the care-related operating cost
categories and other operating cost categories multiplied by the
appropriate composite index or indices established pursuant to
paragraph (e) as costs under this paragraph. Total adjusted
real estate tax liability, payments in lieu of real estate tax,
actual special assessments paid, the indexed public employee
retirement act contribution, and license fees paid as required
by the Minnesota department of health, for each nursing facility
(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 care-related
operating cost limits 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), unless otherwise indicated in this paragraph.
(h) For rate years beginning on or after July 1, 1987, the
commissioner shall adjust the rates of a nursing facility that
meets the criteria for the special dietary needs of its
residents and the requirements in section 31.651. The
adjustment for raw food cost shall be the difference between the
nursing facility'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.
(i) For the cost report year ending September 30, 1996, and
for all subsequent reporting years, certified nursing facilities
must identify, differentiate, and record resident day statistics
for residents in case mix classification A who, on or after July
1, 1996, meet the modified level of care criteria in section
144.0721. The resident day statistics shall be separated into
case mix classification A-1 for any resident day meeting the
high-function class A level of care criteria and case mix
classification A-2 for other case mix class A resident days.
Sec. 43. Minnesota Statutes 1996, section 256B.501,
subdivision 2, is amended to read:
Subd. 2. [AUTHORITY.] The commissioner shall establish
procedures and rules for determining rates for care of residents
of intermediate care facilities for persons with mental
retardation or related conditions which qualify as providers of
medical assistance and waivered services. Approved rates shall
be established on the basis of methods and standards that the
commissioner finds adequate to provide for the costs that must
be incurred for the quality care of residents in efficiently and
economically operated facilities and services. The procedures
shall specify the costs that are allowable for payment through
medical assistance. The commissioner may use experts from
outside the department in the establishment of the procedures.
Sec. 44. Minnesota Statutes 1997 Supplement, section
256B.69, subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For the purposes of this section,
the following terms have the meanings given.
(a) "Commissioner" means the commissioner of human services.
For the remainder of this section, the commissioner's
responsibilities for methods and policies for implementing the
project will be proposed by the project advisory committees and
approved by the commissioner.
(b) "Demonstration provider" means a health maintenance
organization or, community integrated service network, or
accountable provider network authorized and operating under
chapter 62D or, 62N, or 62T that participates in the
demonstration project according to criteria, standards, methods,
and other requirements established for the project and approved
by the commissioner. Notwithstanding the above, Itasca county
may continue to participate as a demonstration provider until
July 1, 2000.
(c) "Eligible individuals" means those persons eligible for
medical assistance benefits as defined in sections 256B.055,
256B.056, and 256B.06.
(d) "Limitation of choice" means suspending freedom of
choice while allowing eligible individuals to choose among the
demonstration providers.
(e) This paragraph supersedes paragraph (c) as long as the
Minnesota health care reform waiver remains in effect. When the
waiver expires, this paragraph expires and the commissioner of
human services shall publish a notice in the State Register and
notify the revisor of statutes. "Eligible individuals" means
those persons eligible for medical assistance benefits as
defined in sections 256B.055, 256B.056, and 256B.06.
Notwithstanding sections 256B.055, 256B.056, and 256B.06, an
individual who becomes ineligible for the program because of
failure to submit income reports or recertification forms in a
timely manner, shall remain enrolled in the prepaid health plan
and shall remain eligible to receive medical assistance coverage
through the last day of the month following the month in which
the enrollee became ineligible for the medical assistance
program.
Sec. 45. Minnesota Statutes 1997 Supplement, section
256B.69, subdivision 3a, is amended to read:
Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when
implementing the general assistance medical care, or medical
assistance prepayment program within a county, must include the
county board in the process of development, approval, and
issuance of the request for proposals to provide services to
eligible individuals within the proposed county. County boards
must be given reasonable opportunity to make recommendations
regarding the development, issuance, review of responses, and
changes needed in the request for proposals. The commissioner
must provide county boards the opportunity to review each
proposal based on the identification of community needs under
chapters 145A and 256E and county advocacy activities. If a
county board finds that a proposal does not address certain
community needs, the county board and commissioner shall
continue efforts for improving the proposal and network prior to
the approval of the contract. The county board shall make
recommendations regarding the approval of local networks and
their operations to ensure adequate availability and access to
covered services. The provider or health plan must respond
directly to county advocates and the state prepaid medical
assistance ombudsperson regarding service delivery and must be
accountable to the state regarding contracts with medical
assistance and general assistance medical care funds. The
county board may recommend a maximum number of participating
health plans after considering the size of the enrolling
population; ensuring adequate access and capacity; considering
the client and county administrative complexity; and considering
the need to promote the viability of locally developed health
plans. The county board or a single entity representing a group
of county boards and the commissioner shall mutually select
health plans for participation at the time of initial
implementation of the prepaid medical assistance program in that
county or group of counties and at the time of contract renewal.
The commissioner shall also seek input for contract requirements
from the county or single entity representing a group of county
boards at each contract renewal and incorporate those
recommendations into the contract negotiation process. The
commissioner, in conjunction with the county board, shall
actively seek to develop a mutually agreeable timetable prior to
the development of the request for proposal, but counties must
agree to initial enrollment beginning on or before January 1,
1999, in either the prepaid medical assistance and general
assistance medical care programs or county-based purchasing
under section 256B.692. At least 90 days before enrollment in
the medical assistance and general assistance medical care
prepaid programs begins in a county in which the prepaid
programs have not been established, the commissioner shall
provide a report to the chairs of senate and house committees
having jurisdiction over state health care programs which
verifies that the commissioner complied with the requirements
for county involvement that are specified in this subdivision.
(b) The commissioner shall seek a federal waiver to allow a
fee-for-service plan option to MinnesotaCare enrollees. The
commissioner shall develop an increase of the premium fees
required under section 256L.06 up to 20 percent of the premium
fees for the enrollees who elect the fee-for-service option.
Prior to implementation, the commissioner shall submit this fee
schedule to the chair and ranking minority member of the senate
health care committee, the senate health care and family
services funding division, the house of representatives health
and human services committee, and the house of representatives
health and human services finance division.
(c) At the option of the county board, the board may
develop contract requirements related to the achievement of
local public health goals to meet the health needs of medical
assistance and general assistance medical care enrollees. These
requirements must be reasonably related to the performance of
health plan functions and within the scope of the medical
assistance and general assistance medical care benefit sets. If
the county board and the commissioner mutually agree to such
requirements, the department shall include such requirements in
all health plan contracts governing the prepaid medical
assistance and general assistance medical care programs in that
county at initial implementation of the program in that county
and at the time of contract renewal. The county board may
participate in the enforcement of the contract provisions
related to local public health goals.
(d) For counties in which prepaid medical assistance and
general assistance medical care programs have not been
established, the commissioner shall not implement those programs
if a county board submits acceptable and timely preliminary and
final proposals under section 256B.692, until county-based
purchasing is no longer operational in that county. For
counties in which prepaid medical assistance and general
assistance medical care programs are in existence on or after
September 1, 1997, the commissioner must terminate contracts
with health plans according to section 256B.692, subdivision 5,
if the county board submits and the commissioner accepts
preliminary and final proposals according to that subdivision.
The commissioner is not required to terminate contracts that
begin on or after September 1, 1997, according to section
256B.692 until two years have elapsed from the date of initial
enrollment.
(e) In the event that a county board or a single entity
representing a group of county boards and the commissioner
cannot reach agreement regarding: (i) the selection of
participating health plans in that county; (ii) contract
requirements; or (iii) implementation and enforcement of county
requirements including provisions regarding local public health
goals, the commissioner shall resolve all disputes after taking
into account the recommendations of a three-person mediation
panel. The panel shall be composed of one designee of the
president of the association of Minnesota counties, one designee
of the commissioner of human services, and one designee of the
commissioner of health.
(f) If a county which elects to implement county-based
purchasing ceases to implement county-based purchasing, it is
prohibited from assuming the responsibility of county-based
purchasing for a period of five years from the date it
discontinues purchasing.
(g) Notwithstanding the requirement in this subdivision
that a county must agree to initial enrollment on or before
January 1, 1999, the commissioner shall grant a delay of up to
nine months in the implementation of the county-based purchasing
authorized in section 256B.692 if the county or group of
counties has submitted a preliminary proposal for county-based
purchasing by September 1, 1997, has not already implemented the
prepaid medical assistance program before January 1, 1998, and
has submitted a written request for the delay to the
commissioner by July 1, 1998. In order for the delay to be
continued, the county or group of counties must also submit to
the commissioner the following information by December 1, 1998.
The information must:
(1) identify the proposed date of implementation, not later
than October 1, 1999;
(2) include copies of the county board resolutions which
demonstrate the continued commitment to the implementation of
county-based purchasing by the proposed date. County board
authorization may remain contingent on the submission of a final
proposal which meets the requirements of section 256B.692,
subdivision 5, paragraph (b);
(3) demonstrate actions taken for the establishment of a
governance structure between the participating counties and
describe how the fiduciary responsibilities of county-based
purchasing will be allocated between the counties, if more than
one county is involved in the proposal;
(4) describe how the risk of a deficit will be managed in
the event expenditures are greater than total capitation
payments. This description must identify how any of the
following strategies will be used:
(i) risk contracts with licensed health plans;
(ii) risk arrangements with providers who are not licensed
health plans;
(iii) risk arrangements with other licensed insurance
entities; and
(iv) funding from other county resources;
(5) include, if county-based purchasing will not contract
with licensed health plans or provider networks, letters of
interest from local providers in at least the categories of
hospital, physician, mental health, and pharmacy which express
interest in contracting for services. These letters must
recognize any risk transfer identified in clause (4), item (ii);
and
(6) describe the options being considered to obtain the
administrative services required in section 256B.692,
subdivision 3, clauses (3) and (5).
(h) For counties which receive a delay under this
subdivision, the final proposals required under section
256B.692, subdivision 5, paragraph (b), must be submitted at
least six months prior to the requested implementation date.
Authority to implement county-based purchasing remains
contingent on approval of the final proposal as required under
section 256B.692.
(i) If the commissioner is unable to provide
county-specific, individual-level fee-for-service claims to
counties by June 4, 1998, the commissioner shall grant a delay
under paragraph (g) of up to 12 months in the implementation of
county-based purchasing, and shall require implementation not
later than January 1, 2000. In order to receive an extension of
the proposed date of implementation under this paragraph, a
county or group of counties must submit a written request for
the extension to the commissioner by August 1, 1998, must submit
the information required under paragraph (g) by December 1,
1998, and must submit a final proposal as provided under
paragraph (h).
Sec. 46. Minnesota Statutes 1996, section 256B.69,
subdivision 22, is amended to read:
Subd. 22. [IMPACT ON PUBLIC OR TEACHING HOSPITALS AND
COMMUNITY CLINICS.] (a) Before implementing prepaid programs in
counties with a county operated or affiliated public teaching
hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid
program creates for the hospital and allow the county or
hospital the opportunity to participate in the program, provided
the terms of participation in the program are competitive with
the terms of other participants.
(b) Prepaid health plans serving counties with a nonprofit
community clinic or community health services agency must
contract with the clinic or agency to provide services to
clients who choose to receive services from the clinic or
agency, if the clinic or agency agrees to payment rates that are
competitive with rates paid to other health plan providers for
the same or similar services.
(c) For purposes of this subdivision, "nonprofit community
clinic" includes, but is not limited to, a community mental
health center as defined in sections 245.62 and 256B.0625,
subdivision 5.
Sec. 47. Minnesota Statutes 1996, section 256B.69, is
amended by adding a subdivision to read:
Subd. 26. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on
or after January 1, 1999, for American Indian recipients of
medical assistance who are required to enroll with a
demonstration provider under subdivision 4 or in a county-based
purchasing entity, if applicable, under section 256B.692,
medical assistance shall cover health care services provided at
American Indian health services facilities and facilities
operated by a tribe or tribal organization under funding
authorized by United States Code, title 25, sections 450f to
450n, or title III of the Indian Self-Determination and
Education Assistance Act, Public Law Number 93-638, if those
services would otherwise be covered under section 256B.0625.
Payments for services provided under this subdivision shall be
made on a fee-for-service basis, and may, at the option of the
tribe or tribal organization, be made according to rates
authorized under sections 256.969, subdivision 16, and
256B.0625, subdivision 34. Implementation of this purchasing
model is contingent on federal approval.
(b) The commissioner of human services, in consultation
with the tribal governments, shall develop a plan for tribes to
assist in the enrollment process for American Indian recipients
enrolled in the prepaid medical assistance program under this
section or the prepaid general assistance medical care program
under section 256D.03, subdivision 4, paragraph (d). This plan
also shall address how tribes will be included in ensuring the
coordination of care for American Indian recipients between
Indian health service or tribal providers and other providers.
(c) For purposes of this subdivision, "American Indian" has
the meaning given to persons to whom services will be provided
for in Code of Federal Regulations, title 42, section 36.12.
(d) This subdivision also applies to American Indian
recipients of general assistance medical care and to the prepaid
general assistance medical care program under section 256D.03,
subdivision 4, paragraph (d).
Sec. 48. Minnesota Statutes 1996, section 256B.69, is
amended by adding a subdivision to read:
Subd. 27. [INFORMATION FOR PERSONS WITH LIMITED
ENGLISH-LANGUAGE PROFICIENCY.] Managed care contracts entered
into under this section and sections 256D.03, subdivision 4,
paragraph (d), and 256L.12 must require demonstration providers
to inform enrollees that upon request the enrollee can obtain a
certificate of coverage in the following languages: Spanish,
Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian. Upon
request, the demonstration provider must provide the enrollee
with a certificate of coverage in the specified language of
preference.
Sec. 49. Minnesota Statutes 1997 Supplement, section
256B.692, subdivision 2, is amended to read:
Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.]
Notwithstanding chapters 62D and 62N, a county that elects to
purchase medical assistance and general assistance medical care
in return for a fixed sum without regard to the frequency or
extent of services furnished to any particular enrollee is not
required to obtain a certificate of authority under chapter 62D
or 62N. A county that elects to purchase medical assistance and
general assistance medical care services under this section must
satisfy the commissioner of health that the requirements of
chapter 62D, applicable to health maintenance organizations, or
chapter 62N, applicable to community integrated service
networks, will be met. A county must also assure the
commissioner of health that the requirements of section sections
62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all
applicable provisions of chapter 62Q, including sections 62Q.07;
62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135;
62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43;
62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201
will be met. All enforcement and rulemaking powers available
under chapters 62D and, 62J, 62M, 62N, and 62Q are hereby
granted to the commissioner of health with respect to counties
that purchase medical assistance and general assistance medical
care services under this section.
Sec. 50. Minnesota Statutes 1997 Supplement, section
256B.692, subdivision 5, is amended to read:
Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1,
1997, a county board that wishes to purchase or provide health
care under this section must submit a preliminary proposal that
substantially demonstrates the county's ability to meet all the
requirements of this section in response to criteria for
proposals issued by the department on or before July 1, 1997.
Counties submitting preliminary proposals must establish a local
planning process that involves input from medical assistance and
general assistance medical care recipients, recipient advocates,
providers and representatives of local school districts, labor,
and tribal government to advise on the development of a final
proposal and its implementation.
(b) The county board must submit a final proposal on or
before July 1, 1998, that demonstrates the ability to meet all
the requirements of this section, including beginning enrollment
on January 1, 1999, unless a delay has been granted under
section 256B.69, subdivision 3a, paragraph (g).
(c) After January 1, 1999, for a county in which the
prepaid medical assistance program is in existence, the county
board must submit a preliminary proposal at least 15 months
prior to termination of health plan contracts in that county and
a final proposal six months prior to the health plan contract
termination date in order to begin enrollment after the
termination. Nothing in this section shall impede or delay
implementation or continuation of the prepaid medical assistance
and general assistance medical care programs in counties for
which the board does not submit a proposal, or submits a
proposal that is not in compliance with this section.
(d) The commissioner is not required to terminate contracts
for the prepaid medical assistance and prepaid general
assistance medical care programs that begin on or after
September 1, 1997, in a county for which a county board has
submitted a proposal under this paragraph, until two years have
elapsed from the date of initial enrollment in the prepaid
medical assistance and prepaid general assistance medical care
programs.
Sec. 51. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 3, is amended to read:
Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A
county authority that elects to participate in a demonstration
project for people with disabilities under this section is not
required to obtain a certificate of authority under chapter 62D
or 62N. A county authority that elects to participate in a
demonstration project for people with disabilities under this
section must assure the commissioner of health that the
requirements of chapters 62D and 62N, and section 256B.692,
subdivision 2, are met. All enforcement and rulemaking powers
available under chapters 62D and, 62J, 62M, 62N, and 62Q are
granted to the commissioner of health with respect to the county
authorities that contract with the commissioner to purchase
services in a demonstration project for people with disabilities
under this section.
Sec. 52. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 7a, is amended to read:
Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible
for the demonstration project as provided in this subdivision.
(b) "Eligible individuals" means those persons living in
the demonstration site who are eligible for medical assistance
and are disabled based on a disability determination under
section 256B.055, subdivisions 7 and 12, or who are eligible for
medical assistance and have been diagnosed as having:
(1) serious and persistent mental illness as defined in
section 245.462, subdivision 20;
(2) severe emotional disturbance as defined in section
245.487, subdivision 6; or
(3) mental retardation, or being a mentally retarded person
as defined in section 252A.02, or a related condition as defined
in section 252.27, subdivision 1a.
Other individuals may be included at the option of the county
authority based on agreement with the commissioner.
(c) Eligible individuals residing on a federally recognized
Indian reservation may be excluded from participation in the
demonstration project at the discretion of the tribal government
based on agreement with the commissioner, in consultation with
the county authority.
(d) Eligible individuals include individuals in excluded
time status, as defined in chapter 256G. Enrollees in excluded
time at the time of enrollment shall remain in excluded time
status as long as they live in the demonstration site and shall
be eligible for 90 days after placement outside the
demonstration site if they move to excluded time status in a
county within Minnesota other than their county of financial
responsibility.
(e) A person who is a sexual psychopathic personality as
defined in section 253B.02, subdivision 18a, or a sexually
dangerous person as defined in section 253B.02, subdivision 18b,
is excluded from enrollment in the demonstration project.
Sec. 53. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 10, is amended to read:
Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall
pay a capitation payment to the county authority and, when
applicable under subdivision 6, paragraph (a), to the service
delivery organization for each medical assistance eligible
enrollee. The commissioner shall develop capitation payment
rates for the initial contract period for each demonstration
site in consultation with an independent actuary, to ensure that
the cost of services under the demonstration project does not
exceed the estimated cost for medical assistance services for
the covered population under the fee-for-service system for the
demonstration period. For each year of the demonstration
project, the capitation payment rate shall be based on 96
percent of the projected per person costs that would otherwise
have been paid under medical assistance fee-for-service during
each of those years. Rates shall be adjusted within the limits
of the available risk adjustment technology, as mandated by
section 62Q.03. In addition, the commissioner shall implement
appropriate risk and savings sharing provisions with county
administrative entities and, when applicable under subdivision
6, paragraph (a), service delivery organizations within the
projected budget limits. Capitation rates shall be adjusted, at
least annually, to include any rate increases and payments for
expanded or newly covered services for eligible individuals.
The initial demonstration project rate shall include an amount
in addition to the fee-for-service payments to adjust for
underutilization of dental services. Any savings beyond those
allowed for the county authority, county administrative entity,
or service delivery organization shall be first used to meet the
unmet needs of eligible individuals. Payments to providers
participating in the project are exempt from the requirements of
sections 256.966 and 256B.03, subdivision 2.
(b) The commissioner shall monitor and evaluate annually
the effect of the discount on consumers, the county authority,
and providers of disability services. Findings shall be
reported and recommendations made, as appropriate, to ensure
that the discount effect does not adversely affect the ability
of the county administrative entity or providers of services to
provide appropriate services to eligible individuals, and does
not result in cost shifting of eligible individuals to the
county authority.
Sec. 54. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 12, is amended to read:
Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this
section, "service coordinator" means an individual selected by
the enrollee or the enrollee's legal representative and
authorized by the county administrative entity or service
delivery organization to work in partnership with the enrollee
to develop, coordinate, and in some instances, provide supports
and services identified in the personal support plan. Service
coordinators may only provide services and supports if the
enrollee is informed of potential conflicts of interest, is
given alternatives, and gives informed consent. Eligible
service coordinators are individuals age 18 or older who meet
the qualifications as described in paragraph (b). Enrollees,
their legal representatives, or their advocates are eligible to
be service coordinators if they have the capabilities to perform
the activities and functions outlined in paragraph (b).
Providers licensed under chapter 245A to provide residential
services, or providers who are providing residential services
covered under the group residential housing program may not act
as service coordinator for enrollees for whom they provide
residential services. This does not apply to providers of
short-term detoxification services. Each county administrative
entity or service delivery organization may develop further
criteria for eligible vendors of service coordination during the
demonstration period and shall determine whom it contracts with
or employs to provide service coordination. County
administrative entities and service delivery organizations may
pay enrollees or their advocates or legal representatives for
service coordination activities.
(b) The service coordinator shall act as a facilitator,
working in partnership with the enrollee to ensure that their
needs are identified and addressed. The level of involvement of
the service coordinator shall depend on the needs and desires of
the enrollee. The service coordinator shall have the knowledge,
skills, and abilities to, and is responsible for:
(1) arranging for an initial assessment, and periodic
reassessment as necessary, of supports and services based on the
enrollee's strengths, needs, choices, and preferences in life
domain areas;
(2) developing and updating the personal support plan based
on relevant ongoing assessment;
(3) arranging for and coordinating the provisions of
supports and services, including knowledgeable and skilled
specialty services and prevention and early intervention
services, within the limitations negotiated with the county
administrative entity or service delivery organization;
(4) assisting the enrollee and the enrollee's legal
representative, if any, to maximize informed choice of and
control over services and supports and to exercise the
enrollee's rights and advocate on behalf of the enrollee;
(5) monitoring the progress toward achieving the enrollee's
outcomes in order to evaluate and adjust the timeliness and
adequacy of the implementation of the personal support plan;
(6) facilitating meetings and effectively collaborating
with a variety of agencies and persons, including attending
individual family service plan and individual education plan
meetings when requested by the enrollee or the enrollee's legal
representative;
(7) soliciting and analyzing relevant information;
(8) communicating effectively with the enrollee and with
other individuals participating in the enrollee's plan;
(9) educating and communicating effectively with the
enrollee about good health care practices and risk to the
enrollee's health with certain behaviors;
(10) having knowledge of basic enrollee protection
requirements, including data privacy;
(11) informing, educating, and assisting the enrollee in
identifying available service providers and accessing needed
resources and services beyond the limitations of the medical
assistance benefit set covered services; and
(12) providing other services as identified in the personal
support plan.
(c) For the demonstration project, the qualifications and
standards for service coordination in this section shall replace
comparable existing provisions of existing statutes and rules
governing case management for eligible individuals.
(d) The provisions of this subdivision apply only to the
demonstration sites that begin implementation on July 1,
1998 designated by the commissioner under subdivision 5. All
other demonstration sites must comply with laws and rules
governing case management services for eligible individuals in
effect when the site begins the demonstration project.
Sec. 55. Minnesota Statutes 1996, section 256D.03,
subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a)
For a person who is eligible under subdivision 3, paragraph (a),
clause (3), general assistance medical care covers, except as
provided in paragraph (c):
(1) inpatient hospital services;
(2) outpatient hospital services;
(3) services provided by Medicare certified rehabilitation
agencies;
(4) prescription drugs and other products recommended
through the process established in section 256B.0625,
subdivision 13;
(5) equipment necessary to administer insulin and
diagnostic supplies and equipment for diabetics to monitor blood
sugar level;
(6) eyeglasses and eye examinations provided by a physician
or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray services;
(10) physician's services;
(11) medical transportation;
(12) chiropractic services as covered under the medical
assistance program;
(13) podiatric services;
(14) dental services;
(15) outpatient services provided by a mental health center
or clinic that is under contract with the county board and is
established under section 245.62;
(16) day treatment services for mental illness provided
under contract with the county board;
(17) prescribed medications for persons who have been
diagnosed as mentally ill as necessary to prevent more
restrictive institutionalization;
(18) case management services for a person with serious and
persistent mental illness who would be eligible for medical
assistance except that the person resides in an institution for
mental diseases;
(19) psychological services, medical supplies and
equipment, and Medicare premiums, coinsurance and deductible
payments;
(20) (19) medical equipment not specifically listed in this
paragraph when the use of the equipment will prevent the need
for costlier services that are reimbursable under this
subdivision;
(21) (20) services performed by a certified pediatric nurse
practitioner, a certified family nurse practitioner, a certified
adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, or a certified geriatric nurse practitioner
in independent practice, if the services are otherwise covered
under this chapter as a physician service, and if the service is
within the scope of practice of the nurse practitioner's license
as a registered nurse, as defined in section 148.171; and
(22) (21) services of a certified public health nurse or a
registered nurse practicing in a public health nursing clinic
that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the
scope of practice of the public health nurse's license as a
registered nurse, as defined in section 148.171.
(b) Except as provided in paragraph (c), for a recipient
who is eligible under subdivision 3, paragraph (a), clause (1)
or (2), general assistance medical care covers the services
listed in paragraph (a) with the exception of special
transportation services.
(c) Gender reassignment surgery and related services are
not covered services under this subdivision unless the
individual began receiving gender reassignment services prior to
July 1, 1995.
(d) In order to contain costs, the commissioner of human
services shall select vendors of medical care who can provide
the most economical care consistent with high medical standards
and shall where possible contract with organizations on a
prepaid capitation basis to provide these services. The
commissioner shall consider proposals by counties and vendors
for prepaid health plans, competitive bidding programs, block
grants, or other vendor payment mechanisms designed to provide
services in an economical manner or to control utilization, with
safeguards to ensure that necessary services are provided.
Before implementing prepaid programs in counties with a county
operated or affiliated public teaching hospital or a hospital or
clinic operated by the University of Minnesota, the commissioner
shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to
participate in the program in a manner that reflects the risk of
adverse selection and the nature of the patients served by the
hospital, provided the terms of participation in the program are
competitive with the terms of other participants considering the
nature of the population served. Payment for services provided
pursuant to this subdivision shall be as provided to medical
assistance vendors of these services under sections 256B.02,
subdivision 8, and 256B.0625. For payments made during fiscal
year 1990 and later years, the commissioner shall consult with
an independent actuary in establishing prepayment rates, but
shall retain final control over the rate methodology.
Notwithstanding the provisions of subdivision 3, an individual
who becomes ineligible for general assistance medical care
because of failure to submit income reports or recertification
forms in a timely manner, shall remain enrolled in the prepaid
health plan and shall remain eligible for general assistance
medical care coverage through the last day of the month in which
the enrollee became ineligible for general assistance medical
care.
(e) The commissioner of human services may reduce payments
provided under sections 256D.01 to 256D.21 and 261.23 in order
to remain within the amount appropriated for general assistance
medical care, within the following restrictions.:
(i) For the period July 1, 1985 to December 31, 1985,
reductions below the cost per service unit allowable under
section 256.966, are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 30 percent; payments for all other
inpatient hospital care may be reduced no more than 20 percent.
Reductions below the payments allowable under general assistance
medical care for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than ten percent.
(ii) For the period January 1, 1986 to December 31, 1986,
reductions below the cost per service unit allowable under
section 256.966 are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 20 percent; payments for all other
inpatient hospital care may be reduced no more than 15 percent.
Reductions below the payments allowable under general assistance
medical care for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than five percent.
(iii) For the period January 1, 1987 to June 30, 1987,
reductions below the cost per service unit allowable under
section 256.966 are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 15 percent; payments for all other
inpatient hospital care may be reduced no more than ten
percent. Reductions below the payments allowable under medical
assistance for the remaining general assistance medical care
services allowable under this subdivision may be reduced no more
than five percent.
(iv) For the period July 1, 1987 to June 30, 1988,
reductions below the cost per service unit allowable under
section 256.966 are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 15 percent; payments for all other
inpatient hospital care may be reduced no more than five percent.
Reductions below the payments allowable under medical assistance
for the remaining general assistance medical care services
allowable under this subdivision may be reduced no more than
five percent.
(v) For the period July 1, 1988 to June 30, 1989,
reductions below the cost per service unit allowable under
section 256.966 are permitted only as follows: payments for
inpatient and outpatient hospital care provided in response to a
primary diagnosis of chemical dependency or mental illness may
be reduced no more than 15 percent; payments for all other
inpatient hospital care may not be reduced. Reductions below
the payments allowable under medical assistance for the
remaining general assistance medical care services allowable
under this subdivision may be reduced no more than five percent.
(f) There shall be no copayment required of any recipient
of benefits for any services provided under this subdivision. A
hospital receiving a reduced payment as a result of this section
may apply the unpaid balance toward satisfaction of the
hospital's bad debts.
(f) (g) Any county may, from its own resources, provide
medical payments for which state payments are not made.
(g) (h) Chemical dependency services that are reimbursed
under chapter 254B must not be reimbursed under general
assistance medical care.
(h) (i) The maximum payment for new vendors enrolled in the
general assistance medical care program after the base year
shall be determined from the average usual and customary charge
of the same vendor type enrolled in the base year.
(i) (j) The conditions of payment for services under this
subdivision are the same as the conditions specified in rules
adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.
Sec. 56. Minnesota Statutes 1996, section 256D.03, is
amended by adding a subdivision to read:
Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective for
services rendered on or after July 1, 1999, general assistance
medical care payments for ambulance services shall be increased
by five percent.
Sec. 57. Laws 1997, chapter 195, section 5, is amended to
read:
Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.]
The commissioner of health shall create a unique category
of licensure as appropriate for providers offering, providing,
or arranging personal care assistant services to more than one
individual. The commissioner shall work with the department of
human services, providers, consumers, and advocates in
developing the licensure standards. The licensure standards
must include requirements for providers to provide consumers
advance written notice of service termination, a service
transition plan, and an appeal process. If the commissioner
determines there are costs related to rulemaking under this
section, the commissioner shall include a budget request for
this item in the 2000-2001 biennial budget. Prior to
promulgating the rule, the commissioner shall submit the
proposed rule to the legislature by January 15, 1999.
Sec. 58. Laws 1997, chapter 203, article 4, section 64, is
amended to read:
Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.]
The commissioner of human services shall appoint a task
force that includes representatives of counties, health plans,
consumers, and legislators to study the impact of the expansion
of the elderly waiver program under section 4 and to make
recommendations for any changes in law necessary to facilitate
an efficient and equitable relationship between the elderly
waiver program and the Minnesota senior health options project.
Based on the results of the task force study, the commissioner
may seek any federal waivers needed to improve the relationship
between the elderly waiver and the Minnesota senior health
options project. The commissioner shall report the results of
the task force study to the legislature by January 15, 1998 July
1, 2000.
Sec. 59. [OFFSET OF HMO SURCHARGE.]
Beginning October 1, 1998, and ending December 31, 1998,
the commissioner of human services shall offset monthly charges
for the health maintenance organization surcharge by the monthly
amount the health maintenance organization overpaid from August
1, 1997, to September 30, 1998, due to taxation of Medicare
revenues prohibited by Minnesota Statutes, section 256.9657,
subdivision 3.
Sec. 60. [MR/RC WAIVER PROPOSAL.]
By November 15, 1998, the commissioner of human services
shall provide to the chairs of the house health and human
services finance division and the senate health and family
security finance division a detailed budget proposal for
providing services under the home and community-based waiver for
persons with mental retardation or related conditions to those
individuals who are screened and waiting for services.
Sec. 61. [HIV HEALTH CARE ACCESS STUDY.]
The commissioner of human services shall study, in
consultation with the commissioner of health and a task force of
affected community stakeholders, the impact of positive patient
responses to new HIV treatment on re-entry to the workplace,
including, but not limited to, addressing continued access to
health care and disability benefits. The commissioner shall
submit a report on the study with recommendations to the
legislature by January 15, 1999.
Sec. 62. [MENTAL HEALTH REPORT.]
(a) By December 1, 1998, the commissioner of human services
shall report to the legislature on recommendations to maximize
federal funding for mental health services for children and
adults. In developing the recommendations, the commissioner
shall seek advice from a children's and adults' mental health
services stakeholders advisory group including representatives
of state and county government, private and state-operated
mental health providers, mental health consumers, family
members, and advocates.
(b) The report shall include a proposal developed in
conjunction with the counties that does not shift caseload
growth to counties after July 1, 1999, and recommendations on
whether the state should directly participate in medical
assistance mental health case management by funding a portion of
the nonfederal share of Medicaid.
Sec. 63. [CONSUMER PRICE INDEX REPORT.]
By January 15, 1999, and each year thereafter, the
commissioner of human services shall report to the chair of the
senate health and family security budget division and the chair
of the house health and human services budget division on the
cost of increasing the income standard under Minnesota Statutes,
section 256B.056, subdivision 4, and the provider rates under
Minnesota Statutes, section 256B.038, by an amount equal to the
percent change in the Consumer Price Index for all urban
consumers for the previous October compared to one year earlier.
Sec. 64. [TRANSLATING AND INTERPRETING INFORMATION FOR
PERSONS WITH LIMITED ENGLISH-LANGUAGE PROFICIENCY.]
(a) The commissioner shall develop a plan to serve public
assistance applicants and recipients who have limited
English-language proficiency that ensures that the state is in
compliance with title VI of the Civil Rights Act and Minnesota
Statutes, section 363.073, and any other laws or regulations
that prohibit discrimination.
(b) The commissioner shall convene an advisory committee
that consists of members of bilingual community groups, county
human service agencies, health plans, health care providers,
advocacy groups, and other state agencies to assist in
developing the plan.
(c) The commissioner shall submit the plan and any fiscal
estimates necessary to implement the plan to the chairs of the
health and human services policy and finance divisions by
December 15, 1998.
(d) Until the plan under paragraph (c) is implemented, the
commissioner is required to include a language block on notices
from county agencies that deny, reduce, or terminate benefits
which states:
"IMPORTANT! This notice affects your rights and should be
translated immediately. If you need help translating this
notice, call your county worker."
Notices from MinnesotaCare that deny, reduce, or terminate
benefits must include a language block which states:
"IMPORTANT! This notice affects your rights and should be
translated immediately. If you need help translating this
notice, call your enrollment representative."
The notice must include a telephone number for the MinnesotaCare
enrollment representative.
(e) Until the plan under paragraph (c) is implemented, the
commissioner shall require a managed care plan under contract
with the commissioner of human services that issues a notice
that denies, reduces, or terminates coverage to include a
language block, which states:
"IMPORTANT! This notice affects your rights and should be
translated immediately."
The notice shall include the telephone number of a person to
contact who can assist the enrollee in translating the notice.
Sec. 65. [UNCOMPENSATED CARE STUDY.]
The commissioner of health, in consultation with the
commissioner of human services, associations representing
Minnesota counties, consumer advocates, associations
representing health care providers and institutions, and
representatives of institutions providing a disproportionate
share of uncompensated medical care shall submit to the
legislature by January 15, 1999, a report and recommendations on
the provision and financing of uncompensated care in Minnesota.
The report must:
(1) document the extent of uncompensated care provided in
Minnesota;
(2) discuss the feasibility of and evaluate options for
financing uncompensated care, including but not limited to:
(i) modifying the eligibility standards for the
MinnesotaCare and general assistance medical care programs; and
(ii) allowing providers to bill other counties for
uncompensated care provided to residents of those counties;
(3) evaluate approaches used by other states to monitor and
finance uncompensated care; and
(4) describe alternative approaches to encourage health
care coverage.
Sec. 66. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC
SERVICES.]
(a) The threshold limits for fee-for-service medical
assistance rehabilitative and therapeutic services for January
1, 1998 through June 30, 1999, shall be the limits prescribed in
the department of human services health care programs provider
manual for calendar year 1997. Rehabilitative and therapeutic
services are: occupational therapy services provided to medical
assistance recipients pursuant to Minnesota Statutes, section
256B.0625, subdivision 8a; physical therapy services provided to
medical assistance recipients pursuant to Minnesota Statutes,
section 256B.0625, subdivision 8; and speech language pathology
services provided to medical assistance recipients pursuant to
Minnesota Rules, part 9505.0390.
(b) The commissioner of human services, in consultation
with the department of human services rehabilitative work group,
shall report to the chair of the senate health and family
security committee and the chair of the house health and human
services committee by January 15, 1999, recommendations and
proposed legislation for the appropriate level of rehabilitative
services delivered to medical assistance recipients before prior
authorization. The recommendations shall also include proposed
legislation to clarify the rehabilitative and therapeutic
benefit set for medical assistance, as well as the appropriate
response time for requests for prior authorization.
Sec. 67. [DENTAL SERVICES REIMBURSEMENT AND ACCESS STUDY.]
(a) The commissioner of human services, in consultation
with the commissioner of health, shall report to the legislature
by December 15, 1998, on the costs of providing dental care
services to recipients of the medical assistance, general
assistance medical care and MinnesotaCare programs and the
reimbursement level of those programs under fee-for-service and
under managed care plans. Costs shall include both base level
and incremental costs of providing services to public program
recipients. In completing the study, the commissioner shall
review existing dental practice literature on dental practice
expenses, and conduct a random survey of dental practices in the
state to establish usual and customary fees for a subset of
common dental procedures. The commissioner shall compare
private insurance reimbursement for a subset of common dental
procedures with reimbursement levels for public programs. In
determining private insurance reimbursement, the commissioner
may obtain reimbursement data from health plans insuring or
providing dental care services. Data obtained by the
commissioner shall be nonpublic and subject to Minnesota
Statutes, section 62J.321. The commissioner may include in the
report related information on the costs of other health care
professionals and reimbursement levels by public and private
payers.
(b) The commissioner of human services shall present
recommendations to the legislature by February 1, 1999, on how
access to dental services for medical assistance, general
assistance medical care, and MinnesotaCare recipients can be
expanded. The commissioner shall also determine which areas of
the state are experiencing a significant access problem. In
developing recommendations, the commissioner shall evaluate the
feasibility of a disproportionate share adjustment for dental
services.
Sec. 68. [RECYCLING PILOT PROJECT.]
The commissioner of human services, in cooperation with the
system of technology to achieve results (STAR) program, shall
award a grant on a competitive basis to a qualified agency for
the establishment of a pilot project to:
(1) obtain, refurbish, and recycle augmentative and
alternative communication systems in order to allow their reuse
for trials and short-term use by persons with severe expressive
communication limitations; and
(2) provide training related to the use of augmentative and
alternative communication systems.
The commissioner shall award the grant as soon as possible after
July 1, 1998, and shall report to the legislature by January 15,
1999, on the activities of the grantee.
Sec. 69. [REPEALER.]
Minnesota Statutes 1996, section 144.0721, subdivision 3a;
and Minnesota Statutes 1997 Supplement, sections 144.0721,
subdivision 3; and 256B.0913, subdivision 15, are repealed.
Sec. 70. [EFFECTIVE DATES.]
(a) Sections 5, 31, 40, 45, 50, and 66 are effective the
day following final enactment.
(b) Sections 10 and 48 are effective January 1, 1999.
(c) Sections 23, 25, 55, and 56 are effective July 1, 1999.
(d) Sections 14 and 19 are effective retroactive to July 1,
1997.
(e) Section 7 is effective retroactive to August 1, 1997.
(f) Sections 3 and 44 are effective 30 days following final
enactment.
(g) Section 32 is effective for changes in eligibility that
occur on or after July 1, 1998.
ARTICLE 5
MINNESOTACARE
Section 1. Minnesota Statutes 1997 Supplement, section
60A.15, subdivision 1, is amended to read:
Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or
before April 1, June 1, and December 1 of each year, every
domestic and foreign company, including town and farmers' mutual
insurance companies, domestic mutual insurance companies, marine
insurance companies, health maintenance organizations, community
integrated service networks, and nonprofit health service plan
corporations, shall pay to the commissioner of revenue
installments equal to one-third of the insurer's total estimated
tax for the current year. Except as provided in paragraphs (d),
(e), (h), and (i), installments must be based on a sum equal to
two percent of the premiums described in paragraph (b).
(b) Installments under paragraph (a), (d), or (e) are
percentages of gross premiums less return premiums on all direct
business received by the insurer in this state, or by its agents
for it, in cash or otherwise, during such year.
(c) Failure of a company to make payments of at least
one-third of either (1) the total tax paid during the previous
calendar year or (2) 80 percent of the actual tax for the
current calendar year shall subject the company to the penalty
and interest provided in this section, unless the total tax for
the current tax year is $500 or less.
(d) For health maintenance organizations, nonprofit health
service plan corporations, and community integrated service
networks, the installments must be based on an amount determined
under paragraph (h) or (i).
(e) For purposes of computing installments for town and
farmers' mutual insurance companies and for mutual property
casualty companies with total assets on December 31, 1989, of
$1,600,000,000 or less, the following rates apply:
(1) for all life insurance, two percent;
(2) for town and farmers' mutual insurance companies and
for mutual property and casualty companies with total assets of
$5,000,000 or less, on all other coverages, one percent; and
(3) for mutual property and casualty companies with total
assets on December 31, 1989, of $1,600,000,000 or less, on all
other coverages, 1.26 percent.
(f) If the aggregate amount of premium tax payments under
this section and the fire marshal tax payments under section
299F.21 made during a calendar year is equal to or exceeds
$120,000, all tax payments in the subsequent calendar year must
be paid by means of a funds transfer as defined in section
336.4A-104, paragraph (a). The funds transfer payment date, as
defined in section 336.4A-401, must be on or before the date the
payment is due. If the date the payment is due is not a funds
transfer business day, as defined in section 336.4A-105,
paragraph (a), clause (4), the payment date must be on or before
the funds transfer business day next following the date the
payment is due.
(g) Premiums under medical assistance, general assistance
medical care, the MinnesotaCare program, and the Minnesota
comprehensive health insurance plan and all payments, revenues,
and reimbursements received from the federal government for
Medicare-related coverage as defined in section 62A.31,
subdivision 3, paragraph (e), are not subject to tax under this
section.
(h) For calendar years 1998 and 1999, the installments for
health maintenance organizations, community integrated service
networks, and nonprofit health service plan corporations must be
based on an amount equal to one percent of premiums described
under paragraph (b). Health maintenance organizations,
community integrated service networks, and nonprofit health
service plan corporations that have met the cost containment
goals established under section 62J.04 in the individual and
small employer market for calendar year 1996 are exempt from
payment of the tax imposed under this section for premiums paid
after March 30, 1997, and before April 1, 1998. Health
maintenance organizations, community integrated service
networks, and nonprofit health service plan corporations that
have met the cost containment goals established under section
62J.04 in the individual and small employer market for calendar
year 1997 are exempt from payment of the tax imposed under this
section for premiums paid after March 30, 1998, and before April
1, 1999.
(i) For calendar years after 1999, the commissioner of
finance shall determine the balance of the health care access
fund on September 1 of each year beginning September 1, 1999.
If the commissioner determines that there is no structural
deficit for the next fiscal year, no tax shall be imposed under
paragraph (d) for the following calendar year. If the
commissioner determines that there will be a structural deficit
in the fund for the following fiscal year, then the
commissioner, in consultation with the commissioner of revenue,
shall determine the amount needed to eliminate the structural
deficit and a tax shall be imposed under paragraph (d) for the
following calendar year. The commissioner shall determine the
rate of the tax as either one-quarter of one percent, one-half
of one percent, three-quarters of one percent, or one percent of
premiums described in paragraph (b), whichever is the lowest of
those rates that the commissioner determines will produce
sufficient revenue to eliminate the projected structural
deficit. The commissioner of finance shall publish in the State
Register by October 1 of each year the amount of tax to be
imposed for the following calendar year. In determining the
structural balance of the health care access fund for fiscal
years 2000 and 2001, the commissioner shall disregard the
transfer amount from the health care access fund to the general
fund for expenditures associated with the services provided to
pregnant women and children under the age of two enrolled in the
MinnesotaCare program.
(j) In approving the premium rates as required in sections
62L.08, subdivision 8, and 62A.65, subdivision 3, the
commissioners of health and commerce shall ensure that any
exemption from the tax as described in paragraphs (h) and (i) is
reflected in the premium rate.
Sec. 2. Minnesota Statutes 1997 Supplement, section
256B.04, subdivision 18, is amended to read:
Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state
agency may take applications for medical assistance and conduct
eligibility determinations for MinnesotaCare enrollees who are
required to apply for medical assistance according to section
256L.03, subdivision 3, paragraph (b).
Sec. 3. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 1c. [NO ASSET TEST FOR PREGNANT WOMEN.] Beginning
September 30, 1998, eligibility for medical assistance for a
pregnant woman must be determined without regard to asset
standards established in section 256B.056, subdivision 3.
Sec. 4. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT
REQUIREMENT.] Unless a federal waiver of the maintenance of
effort requirement of section 2105(d) of title XXI of the
Balanced Budget Act of 1997, Public Law Number 105-33, Statutes
at Large, volume 111, page 251, is granted by the federal
Department of Health and Human Services by September 30, 1998,
eligibility for children under age 21 must be determined without
regard to asset standards established in section 256B.056,
subdivision 3. The commissioner of human services shall publish
a notice in the State Register upon receipt of a federal waiver.
Sec. 5. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 8. [CHILDREN UNDER AGE TWO.] Medical assistance may
be paid for a child under two years of age whose countable
family income is above 275 percent of the federal poverty
guidelines for the same size family but less than or equal to
280 percent of the federal poverty guidelines for the same size
family.
Sec. 6. Minnesota Statutes 1997 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
who is not eligible for medical assistance under chapter 256B,
including eligibility for medical assistance based on a
spenddown of excess income according to section 256B.056,
subdivision 5, or MinnesotaCare as defined in clause
(4) paragraph (b), except as provided in paragraph (b) (c); and:
(1) who is receiving assistance under section 256D.05,
except for families with children who are eligible under
Minnesota family investment program-statewide (MFIP-S), who is
having a payment made on the person's behalf under sections
256I.01 to 256I.06, or who resides in group residential housing
as defined in chapter 256I and can meet a spenddown using the
cost of remedial services received through group residential
housing; or
(2)(i) who is a resident of Minnesota; and whose equity in
assets is not in excess of $1,000 per assistance unit. Exempt
assets, the reduction of excess assets, and the waiver of excess
assets must conform to the medical assistance program in chapter
256B, with the following exception: the maximum amount of
undistributed funds in a trust that could be distributed to or
on behalf of the beneficiary by the trustee, assuming the full
exercise of the trustee's discretion under the terms of the
trust, must be applied toward the asset maximum; and
(ii) who has countable income not in excess of the
assistance standards established in section 256B.056,
subdivision 4, or whose excess income is spent down according to
section 256B.056, subdivision 5, using a six-month budget
period. The method for calculating earned income disregards and
deductions for a person who resides with a dependent child under
age 21 shall follow section 256B.056, subdivision 1a. However,
if a disregard of $30 and one-third of the remainder has been
applied to the wage earner's income, the disregard shall not be
applied again until the wage earner's income has not been
considered in an eligibility determination for general
assistance, general assistance medical care, medical assistance,
or MFIP-S for 12 consecutive months. The earned income and work
expense deductions for a person who does not reside with a
dependent child under age 21 shall be the same as the method
used to determine eligibility for a person under section
256D.06, subdivision 1, except the disregard of the first $50 of
earned income is not allowed; or
(3) who would be eligible for medical assistance except
that the person resides in a facility that is determined by the
commissioner or the federal Health Care Financing Administration
to be an institution for mental diseases.; or
(4) who is ineligible for medical assistance under chapter
256B or general assistance medical care under any other
provision of this section, and is receiving care and
rehabilitation services from a nonprofit center established to
serve victims of torture. These individuals are eligible for
general assistance medical care only for the period during which
they are receiving services from the center. During this period
of eligibility, individuals eligible under this clause shall not
be required to participate in prepaid general assistance medical
care.
(4) (b) Beginning July 1, 1998 January 1, 2000, applicants
or recipients who meet all eligibility requirements of
MinnesotaCare as defined in sections 256L.01 to 256L.16, and are:
(i) adults with dependent children under 21 whose gross
family income is equal to or less than 275 percent of the
federal poverty guidelines; or
(ii) adults without children with earned income and whose
family gross income is between 75 percent of the federal poverty
guidelines and the amount set by section 256L.04, subdivision 7,
shall be terminated from general assistance medical care upon
enrollment in MinnesotaCare.
(b) (c) For services rendered on or after July 1, 1997,
eligibility is limited to one month prior to application if the
person is determined eligible in the prior month. A
redetermination of eligibility must occur every 12 months.
Beginning July 1, 1998 January 1, 2000, Minnesota health care
program applications completed by recipients and applicants who
are persons described in paragraph (a) (b), clause (4), may be
returned to the county agency to be forwarded to the department
of human services or sent directly to the department of human
services for enrollment in MinnesotaCare. If all other
eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be
available in any month during which a MinnesotaCare eligibility
determination and enrollment are pending. Upon notification of
eligibility for MinnesotaCare, notice of termination for
eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility
requirements of this subdivision are met, eligibility for
general assistance medical care shall be available until
enrollment in MinnesotaCare subject to the provisions of
paragraph (d) (e).
(c) (d) The date of an initial Minnesota health care
program application necessary to begin a determination of
eligibility shall be the date the applicant has provided a name,
address, and social security number, signed and dated, to the
county agency or the department of human services. If the
applicant is unable to provide an initial application when
health care is delivered due to a medical condition or
disability, a health care provider may act on the person's
behalf to complete the initial application. The applicant must
complete the remainder of the application and provide necessary
verification before eligibility can be determined. The county
agency must assist the applicant in obtaining verification if
necessary.
(d) (e) County agencies are authorized to use all automated
databases containing information regarding recipients' or
applicants' income in order to determine eligibility for general
assistance medical care or MinnesotaCare. Such use shall be
considered sufficient in order to determine eligibility and
premium payments by the county agency.
(e) (f) General assistance medical care is not available
for a person in a correctional facility unless the person 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, and 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.
(f) (g) General assistance medical care is not available
for applicants or recipients who do not cooperate with the
county agency to meet the requirements of medical assistance.
General assistance medical care is limited to payment of
emergency services only for applicants or recipients as
described in paragraph (a) (b), clause (4), whose MinnesotaCare
coverage is denied or terminated for nonpayment of premiums as
required by sections 256L.06 to 256L.08 and 256L.07.
(g) (h) In determining the amount of assets of an
individual, there shall be included any asset or interest in an
asset, including an asset excluded under paragraph (a), that was
given away, sold, or disposed of for less than fair market value
within the 60 months preceding application for general
assistance medical care or during the period of eligibility.
Any transfer described in this paragraph shall be presumed to
have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes
convincing evidence to establish that the transaction was
exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair
market value at the time it was given away, sold, or disposed
of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility,
including partial months, shall be calculated by dividing the
uncompensated transfer amount by the average monthly per person
payment made by the medical assistance program to skilled
nursing facilities for the previous calendar year. The
individual shall remain ineligible until this fixed period has
expired. The period of ineligibility may exceed 30 months, and
a reapplication for benefits after 30 months from the date of
the transfer shall not result in eligibility unless and until
the period of ineligibility has expired. The period of
ineligibility begins in the month the transfer was reported to
the county agency, or if the transfer was not reported, the
month in which the county agency discovered the transfer,
whichever comes first. For applicants, the period of
ineligibility begins on the date of the first approved
application.
(h) (i) When determining eligibility for any state benefits
under this subdivision, the income and resources of all
noncitizens shall be deemed to include their sponsor's income
and resources as defined in the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, title IV, Public Law
Number 104-193, sections 421 and 422, and subsequently set out
in federal rules.
(i) (j)(1) An undocumented noncitizen or a nonimmigrant is
ineligible for general assistance medical care other than
emergency services. For purposes of this subdivision, a
nonimmigrant is an individual in one or more of the classes
listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the
United States without the approval or acquiescence of the
Immigration and Naturalization Service.
(j) (2) This paragraph does not apply to a child under age
18, to a Cuban or Haitian entrant as defined in Public Law
Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen
who is aged, blind, or disabled as defined in Code of Federal
Regulations, title 42, sections 435.520, 435.530, 435.531,
435.540, and 435.541, or effective October 1, 1998, to an
individual eligible for general assistance medical care under
paragraph (a), clause (4), who cooperates with the Immigration
and Naturalization Service to pursue any applicable immigration
status, including citizenship, that would qualify the individual
for medical assistance with federal financial participation.
(k) (3) For purposes of paragraphs (f) and (i) this
paragraph, "emergency services" has the meaning given in Code of
Federal Regulations, title 42, section 440.255(b)(1), except
that it also means services rendered because of suspected or
actual pesticide poisoning.
(l) (k) Notwithstanding any other provision of law, a
noncitizen who is ineligible for medical assistance due to the
deeming of a sponsor's income and resources, is ineligible for
general assistance medical care.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256L.01, is amended to read:
256L.01 [DEFINITIONS.]
Subdivision 1. [SCOPE.] For purposes of sections 256L.01
to 256L.10 256L.18, the following terms shall have the meanings
given them.
Subd. 1a. [CHILD.] "Child" means an individual under 21
years of age, including the unborn child of a pregnant woman, an
emancipated minor, and an emancipated minor's spouse.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means
those health care providers who provide covered health services
to medical assistance recipients under rules established by the
commissioner for that program.
Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with
children" means:
(1) parents, their children, and dependent siblings
residing in the same household; or
(2) grandparents, foster parents, relative caretakers as
defined in the medical assistance program, or legal guardians;
their wards who are children; and dependent siblings residing in
the same household.
(b) The term includes children and dependent siblings who
are temporarily absent from the household in settings such as
schools, camps, or visitation with noncustodial parents.
(c) For purposes of this subdivision, a dependent sibling
means an unmarried child who is a full-time student under the
age of 25 years who is financially dependent upon a parent,
grandparent, foster parent, relative caretaker, or legal
guardian. Proof of school enrollment is required.
Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross
individual or gross family income" for farm and nonfarm
self-employed means income calculated using as the baseline the
adjusted gross income reported on the applicant's federal income
tax form for the previous year and adding back in reported
depreciation, carryover loss, and net operating loss amounts
that apply to the business in which the family is currently
engaged. Applicants shall report the most recent financial
situation of the family if it has changed from the period of
time covered by the federal income tax form. The report may be
in the form of percentage increase or decrease.
Subd. 5. [INCOME.] "Income" has the meaning given for
earned and unearned income for families and children in the
medical assistance program, according to the state's aid to
families with dependent children plan in effect as of July 16,
1996. The definition does not include medical assistance income
methodologies and deeming requirements. The earned income of
full-time and part-time students under age 19 is not counted as
income. Public assistance payments and supplemental security
income are not excluded income.
Sec. 8. Minnesota Statutes 1997 Supplement, section
256L.02, subdivision 3, is amended to read:
Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner
shall manage spending for the MinnesotaCare program in a manner
that maintains a minimum reserve in accordance with section
16A.76. As part of each state revenue and expenditure forecast,
the commissioner must make a quarterly an assessment of the
expected expenditures for the covered services for the remainder
of the current biennium and for the following biennium. The
estimated expenditure, including the reserve requirements
described in section 16A.76, shall be compared to an estimate of
the revenues that will be deposited available in the health care
access fund. Based on this comparison, and after consulting
with the chairs of the house ways and means committee and the
senate finance committee, and the legislative commission on
health care access, the commissioner shall, as necessary, make
the adjustments specified in paragraph (b) to ensure that
expenditures remain within the limits of available revenues for
the remainder of the current biennium and for the following
biennium. The commissioner shall not hire additional staff
using appropriations from the health care access fund until the
commissioner of finance makes a determination that the
adjustments implemented under paragraph (b) are sufficient to
allow MinnesotaCare expenditures to remain within the limits of
available revenues for the remainder of the current biennium and
for the following biennium.
(b) The adjustments the commissioner shall use must be
implemented in this order: first, stop enrollment of single
adults and households without children; second, upon 45 days'
notice, stop coverage of single adults and households without
children already enrolled in the MinnesotaCare program; third,
upon 90 days' notice, decrease the premium subsidy amounts by
ten percent for families with gross annual income above 200
percent of the federal poverty guidelines; fourth, upon 90 days'
notice, decrease the premium subsidy amounts by ten percent for
families with gross annual income at or below 200 percent; and
fifth, require applicants to be uninsured for at least six
months prior to eligibility in the MinnesotaCare program. If
these measures are insufficient to limit the expenditures to the
estimated amount of revenue, the commissioner shall further
limit enrollment or decrease premium subsidies.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256L.02, is amended by adding a subdivision to read:
Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER
AGE TWO.] For fiscal years beginning on or after July 1, 1999,
the state cost of health care services provided to MinnesotaCare
enrollees who are pregnant women or children under age two shall
be paid out of the general fund rather than the health care
access fund. If the commissioner of finance decides to pay for
these costs using a source other than the general fund, the
commissioner shall include the change as a budget initiative in
the biennial or supplemental budget, and shall not change the
funding source through a forecast modification.
Sec. 10. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 1, is amended to read:
Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health
services" means the health services reimbursed under chapter
256B, with the exception of inpatient hospital services, special
education services, private duty nursing services, adult dental
care services other than preventive services, orthodontic
services, nonemergency medical transportation services, personal
care assistant and case management services, nursing home or
intermediate care facilities services, inpatient mental health
services, and chemical dependency services. Effective July 1,
1998, adult dental care for nonpreventive services with the
exception of orthodontic services is available to persons who
qualify under section 256L.04, subdivisions 1 to 7, or 256L.13,
with family gross income equal to or less than 175 percent of
the federal poverty guidelines. Outpatient mental health
services covered under the MinnesotaCare program are limited to
diagnostic assessments, psychological testing, explanation of
findings, medication management by a physician, day treatment,
partial hospitalization, and individual, family, and group
psychotherapy.
No public funds shall be used for coverage of abortion
under MinnesotaCare except where the life of the female would be
endangered or substantial and irreversible impairment of a major
bodily function would result if the fetus were carried to term;
or where the pregnancy is the result of rape or incest.
Covered health services shall be expanded as provided in
this section.
Sec. 11. Minnesota Statutes 1997 Supplement, section
256L.03, is amended by adding a subdivision to read:
Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND
CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.]
Beginning January 1, 1999, children and pregnant women are
eligible for coverage of all services that are eligible for
reimbursement under the medical assistance program according to
chapter 256B, except that abortion services under MinnesotaCare
shall be limited as provided under section 256L.03, subdivision
1. Pregnant women and children are exempt from the provisions
of subdivision 5, regarding copayments. Pregnant women and
children who are lawfully residing in the United States but who
are not "qualified noncitizens" under title IV of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996,
Public Law Number 104-193, Statutes at Large, volume 110, page
2105, are eligible for coverage of all services provided under
the medical assistance program according to chapter 256B.
Sec. 12. Minnesota Statutes 1997 Supplement, section
256L.03, is amended by adding a subdivision to read:
Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL
ASSISTANCE SERVICES.] Beginning January 1, 1999, a woman who is
enrolled in MinnesotaCare when her pregnancy is diagnosed is
eligible for coverage of all services provided under the medical
assistance program according to chapter 256B retroactive to the
date the pregnancy is medically diagnosed. Copayments totaling
$30 or more, paid after the date the pregnancy is diagnosed,
shall be refunded.
Sec. 13. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 3, is amended to read:
Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a) Beginning July
1, 1993, Covered health services shall include inpatient
hospital services, including inpatient hospital mental health
services and inpatient hospital and residential chemical
dependency treatment, subject to those limitations necessary to
coordinate the provision of these services with eligibility
under the medical assistance spenddown. Prior to July 1, 1997,
the inpatient hospital benefit for adult enrollees is subject to
an annual benefit limit of $10,000. Effective July 1, 1997, The
inpatient hospital benefit for adult enrollees who qualify under
section 256L.04, subdivision 7, or who qualify under section
256L.04, subdivisions 1 to 6 and 2, or 256L.13 with family gross
income that exceeds 175 percent of the federal poverty
guidelines and who are not pregnant, is subject to an annual
limit of $10,000.
(b) Enrollees who qualify under section 256L.04,
subdivision 7, or who qualify under section 256L.04,
subdivisions 1 to 6, or 256L.13 with family gross income that
exceeds 175 percent of the federal poverty guidelines and who
are not pregnant, and are determined by the commissioner to have
a basis of eligibility for medical assistance shall apply for
and cooperate with the requirements of medical assistance by the
last day of the third month following admission to an inpatient
hospital. If an enrollee fails to apply for medical assistance
within this time period, the enrollee and the enrollee's family
shall be disenrolled from the plan and they may not reenroll
until 12 calendar months have elapsed. Enrollees and enrollees'
families disenrolled for not applying for or not cooperating
with medical assistance may not reenroll.
(c) Admissions for inpatient hospital services paid for
under section 256L.11, subdivision 3, must be certified as
medically necessary in accordance with Minnesota Rules, parts
9505.0500 to 9505.0540, except as provided in clauses (1) and
(2):
(1) all admissions must be certified, except those
authorized under rules established under section 254A.03,
subdivision 3, or approved under Medicare; and
(2) payment under section 256L.11, subdivision 3, shall be
reduced by five percent for admissions for which certification
is requested more than 30 days after the day of admission. The
hospital may not seek payment from the enrollee for the amount
of the payment reduction under this clause.
(d) Any enrollee or family member of an enrollee who has
previously been permanently disenrolled from MinnesotaCare for
not applying for and cooperating with medical assistance shall
be eligible to reenroll if 12 calendar months have elapsed since
the date of disenrollment.
Sec. 14. Minnesota Statutes 1997 Supplement, section
256L.03, is amended by adding a subdivision to read:
Subd. 3a. [INTERPRETER SERVICES.] Covered services include
sign and spoken language interpreter services that assist an
enrollee in obtaining covered health care services.
Sec. 15. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 4, is amended to read:
Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The
commissioner shall coordinate the provision of hospital
inpatient services under the MinnesotaCare program with enrollee
eligibility under the medical assistance spenddown, and shall
apply to the secretary of health and human services for any
necessary federal waivers or approvals.
Sec. 16. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 5, is amended to read:
Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare
benefit plan shall include the following copayments and
coinsurance requirements:
(1) ten percent of the paid charges for inpatient hospital
services for adult enrollees not eligible for medical
assistance, subject to an annual inpatient out-of-pocket maximum
of $1,000 per individual and $3,000 per family;
(2) $3 per prescription for adult enrollees;
(3) $25 for eyeglasses for adult enrollees; and
(4) effective July 1, 1998, 50 percent of the
fee-for-service rate for adult dental care services other than
preventive care services for persons eligible under section
256L.04, subdivisions 1 to 7, or 256L.13, with income equal to
or less than 175 percent of the federal poverty guidelines.
Prior to July 1, 1997, enrollees who are not eligible for
medical assistance with or without a spenddown shall be
financially responsible for the coinsurance amount and amounts
which exceed the $10,000 benefit limit. Effective July 1, 1997,
adult enrollees who qualify under section 256L.04, subdivision
7, or who qualify under section 256L.04, subdivisions 1 to 6, or
256L.13 with family gross income that exceeds 175 percent of the
federal poverty guidelines and who are not pregnant, and who are
not eligible for medical assistance with or without a spenddown,
shall be financially responsible for the coinsurance amount and
amounts which exceed the $10,000 inpatient hospital benefit
limit.
When a MinnesotaCare enrollee becomes a member of a prepaid
health plan, or changes from one prepaid health plan to another
during a calendar year, any charges submitted towards the
$10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that
were submitted or incurred prior to enrollment, or prior to the
change in health plans, shall be disregarded.
Sec. 17. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 1, is amended to read:
Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF
ELIGIBILITY FAMILIES WITH CHILDREN.] (a) [CHILDREN.] Prior to
October 1, 1992, "eligible persons" means children who are one
year of age or older but less than 18 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 without a spenddown under chapter 256B and
who are not otherwise insured for the covered services. 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 18 years old. Families with
children with family income equal to or less than 275 percent of
the federal poverty guidelines for the applicable family size
shall be eligible for MinnesotaCare according to this section.
All other provisions of sections 256L.01 to 256L.18, including
the insurance-related barriers to enrollment under section
256L.07, shall apply unless otherwise specified.
(b) [EXPANSION OF ELIGIBILITY.] Eligibility for
MinnesotaCare shall be expanded as provided in subdivisions 3 to
7, except children who meet the criteria in this subdivision
shall continue to be enrolled pursuant to this subdivision. The
enrollment requirements in this paragraph apply to enrollment
under subdivisions 1 to 7. Parents who enroll in the
MinnesotaCare program must also enroll their children and
dependent siblings, if the children and their dependent siblings
are eligible. Children and dependent siblings may be enrolled
separately without enrollment by parents. However, if one
parent in the household enrolls, both parents must enroll,
unless other insurance is available. If one child from a family
is enrolled, all children must be enrolled, unless other
insurance is available. If one spouse in a household enrolls,
the other spouse in the household must also enroll, unless other
insurance is available. Families cannot choose to enroll only
certain uninsured members. For purposes of this section, a
"dependent sibling" means an unmarried child who is a full-time
student under the age of 25 years who is financially dependent
upon a parent. Proof of school enrollment will be required.
(c) [CONTINUATION OF ELIGIBILITY.] Individuals who
initially enroll in the MinnesotaCare program under the
eligibility criteria in subdivisions 3 to 7 remain eligible for
the MinnesotaCare program, regardless of age, place of
residence, or the presence or absence of children in the same
household, as long as all other eligibility criteria are met and
residence in Minnesota and continuous enrollment in the
MinnesotaCare program or medical assistance are maintained. In
order for either parent or either spouse in a household to
remain enrolled, both must remain enrolled, unless other
insurance is available.
Sec. 18. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 2, is amended to read:
Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY
LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be
eligible for MinnesotaCare, individuals and families must
cooperate with the state agency to identify potentially liable
third party payers and assist the state in obtaining third party
payments. "Cooperation" includes, but is not limited to,
identifying any third party who may be liable for care and
services provided under MinnesotaCare to the enrollee, providing
relevant information to assist the state in pursuing a
potentially liable third party, and completing forms necessary
to recover third party payments.
(b) A parent, guardian, or child enrolled in the
MinnesotaCare program must cooperate with the department of
human services and the local agency in establishing the
paternity of an enrolled child and in obtaining medical care
support and payments for the child and any other person for whom
the person can legally assign rights, in accordance with
applicable laws and rules governing the medical assistance
program. A child shall not be ineligible for or disenrolled
from the MinnesotaCare program solely because the child's parent
or guardian fails to cooperate in establishing paternity or
obtaining medical support.
Sec. 19. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 7, is amended to read:
Subd. 7. [ADDITION OF SINGLE ADULTS AND HOUSEHOLDS WITH NO
CHILDREN.] (a) Beginning October 1, 1994, the definition of
"eligible persons" is expanded to include all individuals and
households with no children who have gross family incomes that
are equal to or less than 125 percent of the federal poverty
guidelines and who are not eligible for medical assistance
without a spenddown under chapter 256B.
(b) Beginning July 1, 1997, The definition of eligible
persons is expanded to include includes all individuals and
households with no children who have gross family incomes that
are equal to or less than 175 percent of the federal poverty
guidelines and who are not eligible for medical assistance
without a spenddown under chapter 256B.
(c) All eligible persons under paragraphs (a) and (b) are
eligible for coverage through the MinnesotaCare program but must
pay a premium as determined under sections 256L.07 and 256L.08.
Individuals and families whose income is greater than the limits
established under section 256L.08 may not enroll in the
MinnesotaCare program.
Sec. 20. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 7a. [INELIGIBILITY.] Applicants whose income is
greater than the limits established under this section may not
enroll in the MinnesotaCare program.
Sec. 21. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 8, is amended to read:
Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL
ASSISTANCE.] (a) Individuals who apply for MinnesotaCare receive
supplemental security income or retirement, survivors, or
disability benefits due to a disability, or other
disability-based pension, who qualify under section 256L.04,
subdivision 7, but who are potentially eligible for medical
assistance without a spenddown shall be allowed to enroll in
MinnesotaCare for a period of 60 days, so long as the applicant
meets all other conditions of eligibility. The commissioner
shall identify and refer the applications of such individuals to
their county social service agency. The county and the
commissioner shall cooperate to ensure that the individuals
obtain medical assistance coverage for any months for which they
are eligible.
(b) The enrollee must cooperate with the county social
service agency in determining medical assistance eligibility
within the 60-day enrollment period. Enrollees who do not apply
for and cooperate with medical assistance within the 60-day
enrollment period, and their other family members, shall be
disenrolled from the plan within one calendar month. Persons
disenrolled for nonapplication for medical assistance may not
reenroll until they have obtained a medical assistance
eligibility determination for the family member or members who
were referred to the county agency. Persons disenrolled for
noncooperation with medical assistance may not reenroll until
they have cooperated with the county agency and have obtained a
medical assistance eligibility determination.
(c) Beginning January 1, 2000, counties that choose to
become MinnesotaCare enrollment sites shall consider
MinnesotaCare applications of individuals described in paragraph
(a) to also be applications for medical assistance and shall
first determine whether medical assistance eligibility exists.
Adults with children with family income under 175 percent of the
federal poverty guidelines for the applicable family size,
pregnant women, and children who qualify under subdivision 1 who
are potentially eligible for medical assistance without a
spenddown may choose to enroll in either MinnesotaCare or
medical assistance.
(d) The commissioner shall redetermine provider payments
made under MinnesotaCare to the appropriate medical assistance
payments for those enrollees who subsequently become eligible
for medical assistance.
Sec. 22. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 9, is amended to read:
Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person
cannot have coverage under both MinnesotaCare and general
assistance medical care in the same month. Eligibility for
MinnesotaCare cannot be replaced by eligibility for general
assistance medical care, and eligibility for general assistance
medical care cannot be replaced by eligibility for MinnesotaCare.
Sec. 23. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 10, is amended to read:
Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED
AVAILABLE; DOCUMENTATION.] When determining eligibility for any
federal or state benefits under sections 256L.01 to 256L.16
256L.18, the income and resources of all noncitizens whose
sponsor signed an affidavit of support as defined under United
States Code, title 8, section 1183a, shall be deemed to include
their sponsors' income and resources as defined in the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996,
title IV, Public Law Number 104-193, sections 421 and 422, and
subsequently set out in federal rules. To be eligible for the
program, noncitizens must provide documentation of their
immigration status.
Sec. 24. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 12. [PERSONS IN DETENTION.] Beginning January 1,
1999, an applicant residing in a correctional or detention
facility is not eligible for MinnesotaCare. An enrollee
residing in a correctional or detention facility is not eligible
at renewal of eligibility under section 256L.05, subdivision 3b.
Sec. 25. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE
CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning
January 1, 1999, in families that include a grandparent,
relative caretaker as defined in the medical assistance program,
foster parent, or legal guardian, the grandparent, relative
caretaker, foster parent, or legal guardian may apply as a
family or may apply separately for the children. If the
caretaker applies separately for the children, only the
children's income is counted. If the grandparent, relative
caretaker, foster parent, or legal guardian applies with the
children, their income is included in the gross family income
for determining eligibility and premium amount.
Sec. 26. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S
BEHALF.] Beginning January 1, 1999, a family member who is age
18 or over or who is an authorized representative, as defined in
the medical assistance program, may apply on an applicant's
behalf.
Sec. 27. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 2, is amended to read:
Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall
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 individual
and family income, earned and unearned, including such as the
most recent income tax return, wage slips, or other
documentation that is determined by the commissioner as
necessary to verify income eligibility. The commissioner shall
perform random audits to verify reported income and
eligibility. The commissioner may execute data sharing
arrangements with the department of revenue and any other
governmental agency in order to perform income verification
related to eligibility and premium payment under the
MinnesotaCare program.
Sec. 28. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 3, is amended to read:
Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date
of coverage is the first day of the month following the month in
which eligibility is approved and the first premium payment has
been received. As provided in section 256B.057, coverage for
newborns is automatic from the date of birth and must be
coordinated with other health coverage. The effective date of
coverage for eligible newborns or eligible newly adoptive
children added to a family receiving covered health services is
the date of entry into the family. The effective date of
coverage for other new recipients added to the family receiving
covered health services is the first day of the month following
the month in which eligibility is approved and the first premium
payment has been received or at renewal, whichever the family
receiving covered health services prefers. All eligibility
criteria must be met by the family at the time the new family
member is added. The income of the new family member is
included with the family's gross income and the adjusted premium
begins in the month the new family member is added. The premium
must be received eight working days prior to the end of the
month for coverage to begin the following month. Benefits are
not available until the day following discharge if an enrollee
is hospitalized on the first day of coverage. Notwithstanding
any other law to the contrary, benefits under sections 256L.01
to 256L.10 256L.18 are secondary to a plan of insurance or
benefit program under which an eligible person may have coverage
and the commissioner shall use cost avoidance techniques to
ensure coordination of any other health coverage for eligible
persons. The commissioner shall identify eligible persons who
may have coverage or benefits under other plans of insurance or
who become eligible for medical assistance.
Sec. 29. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 3a. [RENEWAL OF ELIGIBILITY.] Beginning January 1,
1999, an enrollee's eligibility must be renewed every 12
months. The 12-month period begins in the month after the month
the application is approved.
Sec. 30. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 3b. [REAPPLICATION.] Beginning January 1, 1999,
families and individuals must reapply after a lapse in coverage
of one calendar month or more and must meet all eligibility
criteria.
Sec. 31. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 4, is amended to read:
Subd. 4. [APPLICATION PROCESSING.] The commissioner of
human services shall determine an applicant's eligibility for
MinnesotaCare no more than 30 days from the date that the
application is received by the department of human services.
Beginning January 1, 2000, this requirement also applies to
local county human services agencies that determine eligibility
for MinnesotaCare. To prevent processing delays, applicants
who, from the information provided on the application, appear to
meet eligibility requirements shall be enrolled. The enrollee
must provide all required verifications within 30 days of
enrollment or coverage from the program shall be terminated.
Enrollees who are determined to be ineligible when verifications
are provided shall be disenrolled from the program.
Sec. 32. Minnesota Statutes 1997 Supplement, section
256L.06, subdivision 3, is amended to read:
Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a)
Premiums are dedicated to the commissioner for MinnesotaCare.
The commissioner shall make an annual redetermination of
continued eligibility and identify people who may become
eligible for medical assistance.
(b) The commissioner shall develop and implement procedures
to: (1) require enrollees to report changes in income; (2)
adjust sliding scale premium payments, based upon changes in
enrollee income; and (3) disenroll enrollees from MinnesotaCare
for failure to pay required premiums. Beginning July 1, 1998,
failure to pay includes payment with a dishonored check and the
commissioner may demand a guaranteed form of payment as the only
means to replace a dishonored check.
(c) Premiums are calculated on a calendar month basis and
may be paid on a monthly, quarterly, or annual basis, with the
first payment due upon notice from the commissioner of the
premium amount required. The commissioner shall inform
applicants and enrollees of these premium payment options.
Premium payment is required before enrollment is complete and to
maintain eligibility in MinnesotaCare.
(d) Nonpayment of the premium will result in disenrollment
from the plan within one calendar month after the due date.
Persons disenrolled for nonpayment or who voluntarily terminate
coverage from the program may not reenroll until four calendar
months have elapsed. Persons disenrolled for nonpayment or who
voluntarily terminate coverage from the program may not reenroll
for four calendar months unless the person demonstrates good
cause for nonpayment. Good cause does not exist if a person
chooses to pay other family expenses instead of the premium.
The commissioner shall define good cause in rule.
Sec. 33. Minnesota Statutes 1997 Supplement, section
256L.07, is amended to read:
256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON
SLIDING SCALE.]
Subdivision 1. [GENERAL REQUIREMENTS.] Families and
individuals who enroll on or after October 1, 1992, are eligible
for subsidized premium payments based on a sliding scale under
section 256L.08 only if the family or individual meets the
requirements in subdivisions 2 and 3. Children already enrolled
in the children's health plan as of September 30, 1992, eligible
under section 256L.04, subdivision 1, paragraph (a), children
who enroll in the MinnesotaCare program after September 30,
1992, pursuant to Laws 1992, chapter 549, article 4, section 17,
and children who enroll under section 256L.04, subdivision 6,
are eligible for subsidized premium payments without meeting
these requirements, as long as they maintain continuous coverage
in the MinnesotaCare plan or medical assistance. (a) Children
enrolled in the original children's health plan as of September
30, 1992, children who enrolled in the MinnesotaCare program
after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross
incomes that are equal to or less than 150 percent of the
federal poverty guidelines are eligible for subsidized premium
payments without meeting the requirements of subdivision 2, as
long as they maintain continuous coverage in the MinnesotaCare
program or medical assistance. Children who apply for
MinnesotaCare on or after the implementation date of the
employer-subsidized health coverage program as described in
section 45, who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines, must
meet the requirements of subdivision 2 to be eligible for
MinnesotaCare.
(b) Families and individuals who initially enrolled in
MinnesotaCare under section 256L.04, and whose income increases
above the limits established in section 256L.08, may continue
enrollment and pay the full cost of coverage. Families enrolled
in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above 275 percent of the federal poverty
guidelines, are no longer eligible for the program and shall be
disenrolled by the commissioner. Individuals enrolled in
MinnesotaCare under section 256L.04, subdivision 7, whose income
increases above 175 percent of the federal poverty guidelines
are no longer eligible for the program and shall be disenrolled
by the commissioner. For persons disenrolled under this
subdivision, MinnesotaCare coverage terminates the last day of
the calendar month following the month in which the commissioner
determines that the income of a family or individual, determined
over a four-month period as required by section 256L.15,
subdivision 2, exceeds program income limits.
(c) Notwithstanding paragraph (b), individuals and families
may remain enrolled in MinnesotaCare if ten percent of their
annual income is less than the annual premium for a policy with
a $500 deductible available through the Minnesota comprehensive
health association. Individuals and families who are no longer
eligible for MinnesotaCare under this subdivision shall be given
an 18-month notice period from the date that ineligibility is
determined before disenrollment.
Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED
COVERAGE.] (a) To be eligible for subsidized premium payments
based on a sliding scale, a family or individual must not have
access to subsidized health coverage through an employer, and
must not have had access to subsidized health coverage through
an employer for the 18 months prior to application for
subsidized coverage under the MinnesotaCare program. The
requirement that the family or individual must not have had
access to employer-subsidized coverage during the previous 18
months does not apply if: (1) employer-subsidized coverage was
lost due to the death of an employee or divorce; (2)
employer-subsidized coverage was lost because an individual
became ineligible for coverage as a child or dependent; or (3)
employer-subsidized coverage was lost for reasons that would not
disqualify the individual for unemployment benefits under
section 268.09 and the family or individual has not had access
to employer-subsidized coverage since the loss of coverage. If
employer-subsidized coverage was lost for reasons that
disqualify an individual for unemployment benefits under section
268.09, children of that individual are exempt from the
requirement of no access to employer subsidized coverage for the
18 months prior to application, as long as the children have not
had access to employer subsidized coverage since the
disqualifying event. The requirement that the. A family or
individual must not have had access to employer-subsidized
coverage during the previous 18 months does apply if whose
employer-subsidized coverage is lost due to an employer
terminating health care coverage as an employee benefit during
the previous 18 months is not eligible.
(b) For purposes of this requirement, subsidized health
coverage means health coverage for which the employer pays at
least 50 percent of the cost of coverage for the employee,
excluding dependent coverage or dependent, or a higher
percentage as specified by the commissioner. Children are
eligible for employer-subsidized coverage through either parent,
including the noncustodial parent. The commissioner must treat
employer contributions to Internal Revenue Code Section 125
plans and any other employer benefits intended to pay health
care costs as qualified employer subsidies toward the cost of
health coverage for employees for purposes of this subdivision.
Subd. 3. [PERIOD UNINSURED OTHER HEALTH COVERAGE.] To be
eligible for subsidized premium payments based on a sliding
scale, (a) Families and individuals initially enrolled in the
MinnesotaCare program under section 256L.04, subdivisions 5 and
7, must have had no health coverage while enrolled or for at
least four months prior to application and renewal. Children
enrolled in the original children's health plan and children in
families with income equal to or less than 150 percent of the
federal poverty guidelines, who have other health insurance, are
eligible if the other health coverage meets the requirements of
Minnesota Rules, part 9506.0020, subpart 3, item B. The
commissioner may change this eligibility criterion for sliding
scale premiums in order to remain within the limits of available
appropriations. The requirement of at least four months of no
health coverage prior to application for the MinnesotaCare
program does not apply to: newborns.
(1) families, children, and individuals who apply for the
MinnesotaCare program upon termination from or as required by
the medical assistance program, general assistance medical care
program, or coverage under a regional demonstration project for
the uninsured funded under section 256B.73, the Hennepin county
assured care program, or the Group Health, Inc., community
health plan;
(2) families and individuals initially enrolled under
section 256L.04, subdivisions 1, paragraph (a), and 3;
(3) children enrolled pursuant to Laws 1992, chapter 549,
article 4, section 17; or
(4) individuals currently serving or who have served in the
military reserves, and dependents of these individuals, if these
individuals: (i) reapply for MinnesotaCare coverage after a
period of active military service during which they had been
covered by the Civilian Health and Medical Program of the
Uniformed Services (CHAMPUS); (ii) were covered under
MinnesotaCare immediately prior to obtaining coverage under
CHAMPUS; and (iii) have maintained continuous coverage.
(b) For purposes of this section, medical assistance,
general assistance medical care, and civilian health and medical
program of the uniformed service, CHAMPUS, are not considered
insurance or health coverage.
(c) For purposes of this section, Medicare part A or B
coverage under title XVIII of the Social Security Act, United
States Code, title 42, sections 1395c to 1395w-4, is considered
health coverage. An applicant or enrollee may not refuse
Medicare coverage to establish eligibility for MinnesotaCare.
Sec. 34. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 2, is amended to read:
Subd. 2. [RESIDENCY REQUIREMENT.] (a) Prior to July 1,
1997, to be eligible for health coverage under the MinnesotaCare
program, families and individuals must be permanent residents of
Minnesota.
(b) Effective July 1, 1997, To be eligible for health
coverage under the MinnesotaCare program, adults without
children must be permanent residents of Minnesota.
(c) Effective July 1, 1997, (b) To be eligible for health
coverage under the MinnesotaCare program, pregnant women,
families, and children must meet the residency requirements as
provided by Code of Federal Regulations, title 42, section
435.403, except that the provisions of section 256B.056,
subdivision 1, shall apply upon receipt of federal approval.
Sec. 35. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 4, is amended to read:
Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For
purposes of this section, a permanent Minnesota resident is a
person who has demonstrated, through persuasive and objective
evidence, that the person is domiciled in the state and intends
to live in the state permanently.
(b) To be eligible as a permanent resident, all applicants
an applicant must demonstrate the requisite intent to live in
the state permanently by:
(1) showing that the applicant maintains a residence at a
verified address other than a place of public accommodation,
through the use of evidence of residence described in section
256D.02, subdivision 12a, clause (1);
(2) demonstrating that the applicant has been continuously
domiciled in the state for no less than 180 days immediately
before the application; and
(3) signing an affidavit declaring that (A) the applicant
currently resides in the state and intends to reside in the
state permanently; and (B) the applicant did not come to the
state for the primary purpose of obtaining medical coverage or
treatment.
(c) A person who is temporarily absent from the state does
not lose eligibility for MinnesotaCare. "Temporarily absent
from the state" means the person is out of the state for a
temporary purpose and intends to return when the purpose of the
absence has been accomplished. A person is not temporarily
absent from the state if another state has determined that the
person is a resident for any purpose. If temporarily absent
from the state, the person must follow the requirements of the
health plan in which he or she is enrolled to receive services.
Sec. 36. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 6, is amended to read:
Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day
requirement in subdivision 4, paragraph (b), clause (2), is
determined by a court to be unconstitutional, the commissioner
of human services shall impose a 12-month preexisting condition
exclusion on coverage for persons who have been domiciled in the
state for less than 180 days.
Sec. 37. Minnesota Statutes 1997 Supplement, section
256L.11, subdivision 6, is amended to read:
Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the
MinnesotaCare program for inpatient hospital services provided
to MinnesotaCare enrollees eligible under section 256L.04,
subdivision 7, or who qualify under section 256L.04,
subdivisions 1 to 6 and 2, or 256L.13 with family gross income
that exceeds 175 percent of the federal poverty guidelines and
who are not pregnant, who are 18 years old or older on the date
of admission to the inpatient hospital must be in accordance
with paragraphs (a) and (b). Payment for adults who are not
pregnant and are eligible under section 256L.04, subdivisions
1 to 6 and 2, or 256L.13, and whose incomes are equal to or less
than 175 percent of the federal poverty guidelines, shall be as
provided for under paragraph (c).
(a) If the medical assistance rate minus any copayment
required under section 256L.03, subdivision 4, is less than or
equal to the amount remaining in the enrollee's benefit limit
under section 256L.03, subdivision 3, payment must be the
medical assistance rate minus any copayment required under
section 256L.03, subdivision 4. The hospital must not seek
payment from the enrollee in addition to the copayment. The
MinnesotaCare payment plus the copayment must be treated as
payment in full.
(b) If the medical assistance rate minus any copayment
required under section 256L.03, subdivision 4, is greater than
the amount remaining in the enrollee's benefit limit under
section 256L.03, subdivision 3, payment must be the lesser of:
(1) the amount remaining in the enrollee's benefit limit;
or
(2) charges submitted for the inpatient hospital services
less any copayment established under section 256L.03,
subdivision 4.
The hospital may seek payment from the enrollee for the
amount by which usual and customary charges exceed the payment
under this paragraph. If payment is reduced under section
256L.03, subdivision 3, paragraph (c) (b), the hospital may not
seek payment from the enrollee for the amount of the reduction.
(c) For admissions occurring during the period of July 1,
1997, through June 30, 1998, for adults who are not pregnant and
are eligible under section 256L.04, subdivisions 1 to 6 and
2, or 256L.13, and whose incomes are equal to or less than 175
percent of the federal poverty guidelines, the commissioner
shall pay hospitals directly, up to the medical assistance
payment rate, for inpatient hospital benefits in excess of the
$10,000 annual inpatient benefit limit.
Sec. 38. Minnesota Statutes 1997 Supplement, section
256L.12, subdivision 5, is amended to read:
Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.]
MinnesotaCare enrollees who become eligible for medical
assistance or general assistance medical care will remain in the
same managed care plan if the managed care plan has a contract
for that population. Effective January 1, 1998, MinnesotaCare
enrollees who were formerly eligible for general assistance
medical care pursuant to section 256D.03, subdivision 3, within
six months of MinnesotaCare enrollment and were enrolled in a
prepaid health plan pursuant to section 256D.03, subdivision 4,
paragraph (d), must remain in the same managed care plan if the
managed care plan has a contract for that population. Contracts
between the department of human services and managed care plans
must include MinnesotaCare, and medical assistance and may, at
the option of the commissioner of human services, also include
general assistance medical care. Managed care plans must
participate in the MinnesotaCare and general assistance medical
care programs under a contract with the department of human
services in service areas where they participate in the medical
assistance program.
Sec. 39. Minnesota Statutes 1997 Supplement, section
256L.15, is amended to read:
256L.15 [PREMIUMS.]
Subdivision 1. [PREMIUM DETERMINATION.] Families and with
children enrolled according to sections 256L.13 to 256L.16 and
individuals shall pay a premium determined according to a
sliding fee based on the cost of coverage as a percentage of the
family's gross family income. Pregnant women and children under
age two are exempt from the provisions of section 256L.06,
subdivision 3, paragraph (b), clause (3), requiring
disenrollment for failure to pay premiums. For pregnant women,
this exemption continues until the first day of the month
following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of
premiums, shall be disenrolled on the first of the month
following the 60th day postpartum for the penalty period that
otherwise applies under section 256L.06, unless they begin
paying premiums.
Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer
the following payment options to an enrollee:
(1) payment by check;
(2) payment by credit card;
(3) payment by recurring automatic checking withdrawal;
(4) payment by one-time electronic transfer of funds;
(5) payment by wage withholding with the consent of the
employer and the employee; or
(6) payment by using state tax refund payments.
At application or reapplication, a MinnesotaCare applicant
or enrollee may authorize the commissioner to use the Revenue
Recapture Act in chapter 270A to collect funds from the
applicant's or enrollee's state income tax refund for the
purposes of meeting all or part of the applicant's or enrollee's
MinnesotaCare premium obligation for the forthcoming year. The
applicant or enrollee may authorize the commissioner to apply
for the state working family tax credit on behalf of the
applicant or enrollee. The setoff due under this subdivision
shall not be subject to the $10 fee under section 270A.07,
subdivision 1.
Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums
are not refundable.
Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS
INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a
sliding fee scale to determine the percentage of
gross individual or family income that households at different
income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on
the enrollee's gross individual or family income during the
previous four months. The sliding fee scale begins with a
premium of 1.5 percent of gross individual or family income for
individuals or families with incomes below the limits for the
medical assistance program for families and children and
proceeds through the following evenly spaced steps: 1.8, 2.3,
3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are
matched to evenly spaced income steps ranging from the medical
assistance income limit for families and children to 275 percent
of the federal poverty guidelines for the applicable family
size. The sliding fee scale and percentages are not subject to
the provisions of chapter 14. If a family or individual reports
increased income after enrollment, premiums shall not be
adjusted until eligibility renewal.
Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium
of $48 is required for all children who are eligible according
to section 256L.13, subdivision 4 in families with income at or
less than 150 percent of federal poverty guidelines.
Sec. 40. Minnesota Statutes 1997 Supplement, section
256L.17, is amended by adding a subdivision to read:
Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT
REQUIREMENT.] Unless a federal waiver of the maintenance of
effort requirements of section 2105(d) of title XXI of the
Balanced Budget Act of 1997, Public Law Number 105-33, Statutes
at Large, volume 111, page 251, is granted by the federal
Department of Health and Human Services by September 30, 1998,
this section does not apply to children. The commissioner shall
publish a notice in the State Register upon receipt of a federal
waiver.
Sec. 41. Minnesota Statutes 1997 Supplement, section
270A.03, subdivision 5, is amended to read:
Subd. 5. [DEBT.] "Debt" means a legal obligation of a
natural person to pay a fixed and certain amount of money, which
equals or exceeds $25 and which is due and payable to a claimant
agency. The term includes criminal fines imposed under section
609.10 or 609.125 and restitution. A debt may arise under a
contractual or statutory obligation, a court order, or other
legal obligation, but need not have been reduced to judgment.
A debt includes any legal obligation of a current recipient
of assistance which is based on overpayment of an assistance
grant where that payment is based on a client waiver or an
administrative or judicial finding of an intentional program
violation; or where the debt is owed to a program wherein the
debtor is not a client at the time notification is provided to
initiate recovery under this chapter and the debtor is not a
current recipient of food stamps, transitional child care, or
transitional medical assistance.
A debt does not include any legal obligation to pay a
claimant agency for medical care, including hospitalization if
the income of the debtor at the time when the medical care was
rendered does not exceed the following amount:
(1) for an unmarried debtor, an income of $6,400 or less;
(2) for a debtor with one dependent, an income of $8,200 or
less;
(3) for a debtor with two dependents, an income of $9,700
or less;
(4) for a debtor with three dependents, an income of
$11,000 or less;
(5) for a debtor with four dependents, an income of $11,600
or less; and
(6) for a debtor with five or more dependents, an income of
$12,100 or less.
The income amounts in this subdivision shall be adjusted
for inflation for debts incurred in calendar years 1991 and
thereafter. The dollar amount of each income level that applied
to debts incurred in the prior year shall be increased in the
same manner as provided in section 290.06, subdivision 2d, for
the expansion of the tax rate brackets.
Debt also includes an agreement to pay a MinnesotaCare
premium, regardless of the dollar amount of the premium
authorized under section 256L.15, subdivision 1a.
Sec. 42. Laws 1997, chapter 225, article 2, section 64, is
amended to read:
Sec. 64. [EFFECTIVE DATE.]
Section 8 is effective for payments made for MinnesotaCare
services on or after July 1, 1996. Section 23 is effective the
day following final enactment. Section 46 is effective January
1, 1998, and applies to high deductible health plans issued or
renewed on or after that date.
Sec. 43. [FEDERAL EARNED INCOME TAX CREDIT.]
The commissioner of human services shall seek a federal
waiver from the appropriate federal agency to allow the state to
use the federal earned income tax credit for payment of state
subsidized health care premiums.
Sec. 44. [INPATIENT HOSPITAL COPAYMENT.]
If federal approval of a waiver to obtain federal Medicaid
funding for coverage provided to parents enrolled in the
MinnesotaCare program is contingent upon not applying the
inpatient hospital services copayment under Minnesota Statutes,
section 256L.03, subdivision 5, clause (1), then the inpatient
hospital services copayment shall not be applied to enrollees
for whom the state receives federal Medicaid funding.
Sec. 45. [EMPLOYER-SUBSIDIZED HEALTH COVERAGE PROGRAM.]
Subdivision 1. [PLAN SUBMITTAL.] The commissioner of human
services shall submit to the health care financing
administration a plan to obtain federal funding, according to
section 2105(c)(3) of the Balanced Budget Act of 1997, Public
Law Number 105-33, to subsidize health insurance coverage for
families who are ineligible for the MinnesotaCare program, due
to the availability of employer-subsidized insurance as defined
in Minnesota Statutes, section 256L.07, subdivision 2. The
program shall pay the difference between:
(1) what the family would have paid under the sliding
premium scale specified in Minnesota Statutes, section 256L.15,
subdivision 2, up to a maximum of five percent of the family's
income, had the family been covered under MinnesotaCare; and
(2) the required employee contribution for
employer-subsidized health coverage.
Subd. 2. [CONSULTATION AND PLAN SUBMITTAL.] In developing
the plan, the commissioner shall consult with the legislative
commission on health care access. The commissioner shall submit
the plan and draft legislation to the legislature by December
15, 1998, and shall not implement the plan without legislative
approval.
Subd. 3. [PHASE-OUT OF MINNESOTACARE ELIGIBILITY.] As part
of the plan submitted to the legislature under subdivision 2,
the commissioner shall include a process to phase out
MinnesotaCare eligibility for children who have access to
employer-subsidized health coverage as defined under Minnesota
Statutes, section 256L.07, subdivision 2, and who:
(1) enrolled in the original children's health plan as of
September 30, 1992;
(2) enrolled in the MinnesotaCare program after September
30, 1992, according to Laws 1992, chapter 549, article 4,
section 17; or
(3) have family gross incomes that are equal to or less
than 150 percent of the federal poverty guidelines.
Sec. 46. [STATE CHILDREN'S HEALTH INSURANCE PROGRAM.]
Subdivision 1. [AUTHORITY.] The commissioner is authorized
to claim enhanced federal matching funds under sections
2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public
Law Number 105-33, for any and all state or local expenditures
eligible as child health assistance for targeted low-income
children and health service initiatives for low-income
children. If required by federal law or regulations, the
commissioner is authorized to establish accounts, make
appropriate payments, and receive reimbursement from state and
local entities providing child health assistance or health
services for low-income children, in order to obtain enhanced
federal matching funds. Enhanced federal matching funds
received as a result of providing health care coverage
authorized under this section shall be deposited in the health
care access fund. Enhanced federal matching funds received as a
result of outreach activities described in subdivision 2, clause
(2), shall be dedicated to the commissioner of human services to
be used for those outreach purposes.
Subd. 2. [ENHANCED MATCHING FUNDS FOR CHILDREN'S HEALTH
CARE INITIATIVES.] The commissioner shall submit to the health
care financing administration all plans and waiver requests
necessary to obtain enhanced matching funds under the state
children's health insurance program established as Title 21 of
the Balanced Budget Act of 1997, Public Law Number 105-33, for:
(1) expenditures made under Minnesota Statutes, section
256B.057, subdivision 8;
(2) MinnesotaCare outreach activities authorized by Laws
1997, chapter 225, article 7, section 2, subdivision 1; and
(3) expenditures made under the MinnesotaCare program, the
medical assistance program, or any initiative authorized by the
legislature including an initiative to subsidize health
insurance coverage for families who are ineligible for
MinnesotaCare due to the availability of employer-subsidized
insurance.
The commissioner shall submit to the legislature, by
January 15, 1999, all statutory changes necessary to receive
enhanced federal matching funds.
Sec. 47. [REVISOR'S INSTRUCTION.]
In each section of Minnesota Statutes referred to in column
A, the revisor of statutes shall delete the reference in column
B and insert the reference in column C.
Column A Column B Column C
256B.057, subd. 1a 256L.08 256L.15
256B.0645 256L.14 256L.03, subd. 1a
256L.16 256L.14 256L.03, subd. 1a
Sec. 48. [REPEALER.]
Minnesota Statutes 1997 Supplement, sections 256B.057,
subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06,
subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13;
and 256L.14, are repealed.
Sec. 49. [EFFECTIVE DATES.]
(a) Sections 2, 7, 8, 10, 13, 15, 16, 17 to 23, 27, 28, 31
to 39, 41, 47, and 48 are effective January 1, 1999.
(b) Sections 4, 5, and 40 are effective September 30, 1998.
(c) Section 6 is effective July 1, 1998, except paragraph
(a), clause (4), which is effective October 1, 1998.
(d) Sections 14 and 42 to 46 are effective the day
following final enactment.
ARTICLE 6
WELFARE REFORM; WORK FIRST; ASSISTANCE PROGRAM
AND CHILD SUPPORT CHANGES; AND LICENSING
Section 1. Minnesota Statutes 1997 Supplement, section
119B.01, subdivision 16, is amended to read:
Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year
families" means families who have received AFDC, or who were
eligible to receive AFDC after choosing to discontinue receipt
of the cash portion of MFIP-S assistance under section 256J.31,
subdivision 12, for at least three of the last six months before
losing eligibility for AFDC due to increased hours of
employment, or increased income from employment or child or
spousal support, or the loss of income disregards due to time
limitations.
Sec. 2. Minnesota Statutes 1997 Supplement, section
119B.02, is amended to read:
119B.02 [DUTIES OF COMMISSIONER.]
Subdivision 1. [CHILD CARE SERVICES.] The commissioner
shall develop standards for county and human services boards to
provide child care services to enable eligible families to
participate in employment, training, or education programs.
Within the limits of available appropriations, the commissioner
shall distribute money to counties to reduce the costs of child
care for eligible families. The commissioner shall adopt rules
to govern the program in accordance with this section. The
rules must establish a sliding schedule of fees for parents
receiving child care services. The rules shall provide that
funds received as a lump sum payment of child support arrearages
shall not be counted as income to a family in the month received
but shall be prorated over the 12 months following receipt and
added to the family income during those months. In the rules
adopted under this section, county and human services boards
shall be authorized to establish policies for payment of child
care spaces for absent children, when the payment is required by
the child's regular provider. The rules shall not set a maximum
number of days for which absence payments can be made, but
instead shall direct the county agency to set limits and pay for
absences according to the prevailing market practice in the
county. County policies for payment of absences shall be
subject to the approval of the commissioner. The commissioner
shall maximize the use of federal money in section 256.736 and
other programs that provide federal or state reimbursement for
child care services for low-income families who are in
education, training, job search, or other activities allowed
under those programs. Money appropriated under this section
must be coordinated with the programs that provide federal
reimbursement for child care services to accomplish this
purpose. Federal reimbursement obtained must be allocated to
the county that spent money for child care that is federally
reimbursable under programs that provide federal reimbursement
for child care services. The counties shall use the federal
money to expand child care services. The commissioner may adopt
rules under chapter 14 to implement and coordinate federal
program requirements.
Subd. 2. [CONTRACTUAL AGREEMENTS WITH TRIBES.] The
commissioner may enter into contractual agreements with a
federally recognized Indian tribe with a reservation in
Minnesota to carry out the responsibilities of county human
service agencies to the extent necessary for the tribe to
operate child care assistance programs under sections 119B.03
and 119B.05. An agreement may allow for the tribe to be
reimbursed for child care assistance services provided under
section 119B.05. The commissioner shall consult with the
affected county or counties in the contractual agreement
negotiations, if the county or counties wish to be included, in
order to avoid the duplication of county and tribal child care
services. Funding to support services under section 119B.03 may
be transferred to the federally recognized Indian tribe with a
reservation in Minnesota from allocations available to counties
in which reservation boundaries lie. When funding is
transferred under section 119B.03, the amount shall be
commensurate to estimates of the proportion of reservation
residents with characteristics identified in section 119B.03,
subdivision 6, to the total population of county residents with
those same characteristics.
Sec. 3. Minnesota Statutes 1996, section 245A.03, is
amended by adding a subdivision to read:
Subd. 2b. [EXCEPTION.] The provision in subdivision 2,
clause (2), does not apply to:
(1) a child care provider who as an applicant for licensure
or as a license holder has received a license denial under
section 245A.05, a fine under section 245A.06, or a sanction
under section 245A.07 from the commissioner that has not been
reversed on appeal; or
(2) a child care provider, or a child care provider who has
a household member who, as a result of a licensing process, has
a disqualification under this chapter that has not been set
aside by the commissioner.
Sec. 4. Minnesota Statutes 1996, section 245A.03, is
amended by adding a subdivision to read:
Subd. 4. [EXCLUDED CHILD CARE PROGRAMS; RIGHT TO SEEK
LICENSURE.] Nothing in this section shall prohibit a child care
program that is excluded from licensure under subdivision 2,
clause (2), or under Laws 1997, chapter 248, section 46, as
amended by Laws 1997, First Special Session chapter 5, section
10, from seeking a license under this chapter. The commissioner
shall ensure that any application received from such an excluded
provider is processed in the same manner as all other
applications for licensed family day care.
Sec. 5. Minnesota Statutes 1996, section 245A.14,
subdivision 4, is amended to read:
Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential
child care programs serving 14 or fewer children that are
conducted at a location other than the license holder's own
residence shall be licensed under this section and the rules
governing family day care or group family day care if:
(a) the license holder is the primary provider of care;
(b) and the nonresidential child care program is conducted
in a dwelling that is located on a residential lot; and or
(c) the license holder complies with all other requirements
of sections 245A.01 to 245A.15 and the rules governing family
day care or group family day care.
(b) the license holder is an employer who may or may not be
the primary provider of care, and the purpose for the child care
program is to provide child care services to children of the
license holder's employees.
Sec. 6. Minnesota Statutes 1997 Supplement, section
245B.06, subdivision 2, is amended to read:
Subd. 2. [RISK MANAGEMENT PLAN.] The license holder must
develop and document in writing a risk management plan that
incorporates the individual abuse prevention plan as required in
chapter 245C section 245A.65. License holders jointly providing
services to a consumer shall coordinate and use the resulting
assessment of risk areas for the development of this plan. Upon
initiation of services, the license holder will have in place an
initial risk management plan that identifies areas in which the
consumer is vulnerable, including health, safety, and
environmental issues and the supports the provider will have in
place to protect the consumer and to minimize these risks. The
plan must be changed based on the needs of the individual
consumer and reviewed at least annually.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256.01, subdivision 2, is amended to read:
Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of
section 241.021, subdivision 2, the commissioner of human
services shall:
(1) Administer and supervise all forms of public assistance
provided for by state law and other welfare activities or
services as are vested in the commissioner. Administration and
supervision of human services activities or services includes,
but is not limited to, assuring timely and accurate distribution
of benefits, completeness of service, and quality program
management. In addition to administering and supervising human
services activities vested by law in the department, the
commissioner shall have the authority to:
(a) require county agency participation in training and
technical assistance programs to promote compliance with
statutes, rules, federal laws, regulations, and policies
governing human services;
(b) monitor, on an ongoing basis, the performance of county
agencies in the operation and administration of human services,
enforce compliance with statutes, rules, federal laws,
regulations, and policies governing welfare services and promote
excellence of administration and program operation;
(c) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit
determinations;
(d) require county agencies to make an adjustment to the
public assistance benefits issued to any individual consistent
with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;
(e) delay or deny payment of all or part of the state and
federal share of benefits and administrative reimbursement
according to the procedures set forth in section 256.017; and
(f) make contracts with and grants to public and private
agencies and organizations, both profit and nonprofit, and
individuals, using appropriated funds; and
(g) enter into contractual agreements with federally
recognized Indian tribes with a reservation in Minnesota to the
extent necessary for the tribe to operate a federally approved
family assistance program or any other program under the
supervision of the commissioner. The commissioner shall consult
with the affected county or counties in the contractual
agreement negotiations, if the county or counties wish to be
included, in order to avoid the duplication of county and tribal
assistance program services. The commissioner may establish
necessary accounts for the purposes of receiving and disbursing
funds as necessary for the operation of the programs.
(2) Inform county agencies, on a timely basis, of changes
in statute, rule, federal law, regulation, and policy necessary
to county agency administration of the programs.
(3) Administer and supervise all child welfare activities;
promote the enforcement of laws protecting handicapped,
dependent, neglected and delinquent children, and children born
to mothers who were not married to the children's fathers at the
times of the conception nor at the births of the children;
license and supervise child-caring and child-placing agencies
and institutions; supervise the care of children in boarding and
foster homes or in private institutions; and generally perform
all functions relating to the field of child welfare now vested
in the state board of control.
(4) Administer and supervise all noninstitutional service
to handicapped persons, including those who are visually
impaired, hearing impaired, or physically impaired or otherwise
handicapped. The commissioner may provide and contract for the
care and treatment of qualified indigent children in facilities
other than those located and available at state hospitals when
it is not feasible to provide the service in state hospitals.
(5) Assist and actively cooperate with other departments,
agencies and institutions, local, state, and federal, by
performing services in conformity with the purposes of Laws
1939, chapter 431.
(6) Act as the agent of and cooperate with the federal
government in matters of mutual concern relative to and in
conformity with the provisions of Laws 1939, chapter 431,
including the administration of any federal funds granted to the
state to aid in the performance of any functions of the
commissioner as specified in Laws 1939, chapter 431, and
including the promulgation of rules making uniformly available
medical care benefits to all recipients of public assistance, at
such times as the federal government increases its participation
in assistance expenditures for medical care to recipients of
public assistance, the cost thereof to be borne in the same
proportion as are grants of aid to said recipients.
(7) Establish and maintain any administrative units
reasonably necessary for the performance of administrative
functions common to all divisions of the department.
(8) Act as designated guardian of both the estate and the
person of all the wards of the state of Minnesota, whether by
operation of law or by an order of court, without any further
act or proceeding whatever, except as to persons committed as
mentally retarded. For children under the guardianship of the
commissioner whose interests would be best served by adoptive
placement, the commissioner may contract with a licensed
child-placing agency to provide adoption services. A contract
with a licensed child-placing agency must be designed to
supplement existing county efforts and may not replace existing
county programs, unless the replacement is agreed to by the
county board and the appropriate exclusive bargaining
representative or the commissioner has evidence that child
placements of the county continue to be substantially below that
of other counties.
(9) Act as coordinating referral and informational center
on requests for service for newly arrived immigrants coming to
Minnesota.
(10) The specific enumeration of powers and duties as
hereinabove set forth shall in no way be construed to be a
limitation upon the general transfer of powers herein contained.
(11) Establish county, regional, or statewide schedules of
maximum fees and charges which may be paid by county agencies
for medical, dental, surgical, hospital, nursing and nursing
home care and medicine and medical supplies under all programs
of medical care provided by the state and for congregate living
care under the income maintenance programs.
(12) Have the authority to conduct and administer
experimental projects to test methods and procedures of
administering assistance and services to recipients or potential
recipients of public welfare. To carry out such experimental
projects, it is further provided that the commissioner of human
services is authorized to waive the enforcement of existing
specific statutory program requirements, rules, and standards in
one or more counties. The order establishing the waiver shall
provide alternative methods and procedures of administration,
shall not be in conflict with the basic purposes, coverage, or
benefits provided by law, and in no event shall the duration of
a project exceed four years. It is further provided that no
order establishing an experimental project as authorized by the
provisions of this section shall become effective until the
following conditions have been met:
(a) The secretary of health, education, and welfare of the
United States has agreed, for the same project, to waive state
plan requirements relative to statewide uniformity.
(b) A comprehensive plan, including estimated project
costs, shall be approved by the legislative advisory commission
and filed with the commissioner of administration.
(13) According to federal requirements, establish
procedures to be followed by local welfare boards in creating
citizen advisory committees, including procedures for selection
of committee members.
(14) Allocate federal fiscal disallowances or sanctions
which are based on quality control error rates for the aid to
families with dependent children, Minnesota family investment
program-statewide, medical assistance, or food stamp program in
the following manner:
(a) One-half of the total amount of the disallowance shall
be borne by the county boards responsible for administering the
programs. For the medical assistance, MFIP-S, and AFDC
programs, disallowances shall be shared by each county board in
the same proportion as that county's expenditures for the
sanctioned program are to the total of all counties'
expenditures for the AFDC, MFIP-S, and medical assistance
programs. For the food stamp program, sanctions shall be shared
by each county board, with 50 percent of the sanction being
distributed to each county in the same proportion as that
county's administrative costs for food stamps are to the total
of all food stamp administrative costs for all counties, and 50
percent of the sanctions being distributed to each county in the
same proportion as that county's value of food stamp benefits
issued are to the total of all benefits issued for all
counties. Each county shall pay its share of the disallowance
to the state of Minnesota. When a county fails to pay the
amount due hereunder, the commissioner may deduct the amount
from reimbursement otherwise due the county, or the attorney
general, upon the request of the commissioner, may institute
civil action to recover the amount due.
(b) Notwithstanding the provisions of paragraph (a), if the
disallowance results from knowing noncompliance by one or more
counties with a specific program instruction, and that knowing
noncompliance is a matter of official county board record, the
commissioner may require payment or recover from the county or
counties, in the manner prescribed in paragraph (a), an amount
equal to the portion of the total disallowance which resulted
from the noncompliance, and may distribute the balance of the
disallowance according to paragraph (a).
(15) Develop and implement special projects that maximize
reimbursements and result in the recovery of money to the
state. For the purpose of recovering state money, the
commissioner may enter into contracts with third parties. Any
recoveries that result from projects or contracts entered into
under this paragraph shall be deposited in the state treasury
and credited to a special account until the balance in the
account reaches $1,000,000. When the balance in the account
exceeds $1,000,000, the excess shall be transferred and credited
to the general fund. All money in the account is appropriated
to the commissioner for the purposes of this paragraph.
(16) Have the authority to make direct payments to
facilities providing shelter to women and their children
according to section 256D.05, subdivision 3. Upon the written
request of a shelter facility that has been denied payments
under section 256D.05, subdivision 3, the commissioner shall
review all relevant evidence and make a determination within 30
days of the request for review regarding issuance of direct
payments to the shelter facility. Failure to act within 30 days
shall be considered a determination not to issue direct payments.
(17) Have the authority to establish and enforce the
following county reporting requirements:
(a) The commissioner shall establish fiscal and statistical
reporting requirements necessary to account for the expenditure
of funds allocated to counties for human services programs.
When establishing financial and statistical reporting
requirements, the commissioner shall evaluate all reports, in
consultation with the counties, to determine if the reports can
be simplified or the number of reports can be reduced.
(b) The county board shall submit monthly or quarterly
reports to the department as required by the commissioner.
Monthly reports are due no later than 15 working days after the
end of the month. Quarterly reports are due no later than 30
calendar days after the end of the quarter, unless the
commissioner determines that the deadline must be shortened to
20 calendar days to avoid jeopardizing compliance with federal
deadlines or risking a loss of federal funding. Only reports
that are complete, legible, and in the required format shall be
accepted by the commissioner.
(c) If the required reports are not received by the
deadlines established in clause (b), the commissioner may delay
payments and withhold funds from the county board until the next
reporting period. When the report is needed to account for the
use of federal funds and the late report results in a reduction
in federal funding, the commissioner shall withhold from the
county boards with late reports an amount equal to the reduction
in federal funding until full federal funding is received.
(d) A county board that submits reports that are late,
illegible, incomplete, or not in the required format for two out
of three consecutive reporting periods is considered
noncompliant. When a county board is found to be noncompliant,
the commissioner shall notify the county board of the reason the
county board is considered noncompliant and request that the
county board develop a corrective action plan stating how the
county board plans to correct the problem. The corrective
action plan must be submitted to the commissioner within 45 days
after the date the county board received notice of noncompliance.
(e) The final deadline for fiscal reports or amendments to
fiscal reports is one year after the date the report was
originally due. If the commissioner does not receive a report
by the final deadline, the county board forfeits the funding
associated with the report for that reporting period and the
county board must repay any funds associated with the report
received for that reporting period.
(f) The commissioner may not delay payments, withhold
funds, or require repayment under paragraph (c) or (e) if the
county demonstrates that the commissioner failed to provide
appropriate forms, guidelines, and technical assistance to
enable the county to comply with the requirements. If the
county board disagrees with an action taken by the commissioner
under paragraph (c) or (e), the county board may appeal the
action according to sections 14.57 to 14.69.
(g) Counties subject to withholding of funds under
paragraph (c) or forfeiture or repayment of funds under
paragraph (e) shall not reduce or withhold benefits or services
to clients to cover costs incurred due to actions taken by the
commissioner under paragraph (c) or (e).
(18) Allocate federal fiscal disallowances or sanctions for
audit exceptions when federal fiscal disallowances or sanctions
are based on a statewide random sample for the foster care
program under title IV-E of the Social Security Act, United
States Code, title 42, in direct proportion to each county's
title IV-E foster care maintenance claim for that period.
(19) Be responsible for ensuring the detection, prevention,
investigation, and resolution of fraudulent activities or
behavior by applicants, recipients, and other participants in
the human services programs administered by the department.
(20) Require county agencies to identify overpayments,
establish claims, and utilize all available and cost-beneficial
methodologies to collect and recover these overpayments in the
human services programs administered by the department.
(21) Have the authority to administer a drug rebate program
for drugs purchased pursuant to the senior citizen drug program
established under section 256.955 after the beneficiary's
satisfaction of any deductible established in the program. The
commissioner shall require a rebate agreement from all
manufacturers of covered drugs as defined in section 256B.0625,
subdivision 13. For each drug, the amount of the rebate shall
be equal to the basic rebate as defined for purposes of the
federal rebate program in United States Code, title 42, section
1396r-8(c)(1). This basic rebate shall be applied to
single-source and multiple-source drugs. The manufacturers must
provide full payment within 30 days of receipt of the state
invoice for the rebate within the terms and conditions used for
the federal rebate program established pursuant to section 1927
of title XIX of the Social Security Act. The manufacturers must
provide the commissioner with any information necessary to
verify the rebate determined per drug. The rebate program shall
utilize the terms and conditions used for the federal rebate
program established pursuant to section 1927 of title XIX of the
Social Security Act.
Sec. 8. Minnesota Statutes 1996, section 256.014,
subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The
commissioner of human services shall establish and enhance
computer systems necessary for the efficient operation of the
programs the commissioner supervises, including:
(1) management and administration of the food stamp and
income maintenance programs, including the electronic
distribution of benefits;
(2) management and administration of the child support
enforcement program; and
(3) administration of medical assistance and general
assistance medical care.
The commissioner shall distribute the nonfederal share of
the costs of operating and maintaining the systems to the
commissioner and to the counties participating in the system in
a manner that reflects actual system usage, except that the
nonfederal share of the costs of the MAXIS computer system and
child support enforcement systems shall be borne entirely by the
commissioner. Development costs must not be assessed against
county agencies.
The commissioner may enter into contractual agreements with
federally recognized Indian tribes with a reservation in
Minnesota to participate in state-operated computer systems
related to the management and administration of the food stamp,
income maintenance, child support enforcement, and medical
assistance and general assistance medical care programs to the
extent necessary for the tribe to operate a federally approved
family assistance program or any other program under the
supervision of the commissioner.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256.031, subdivision 6, is amended to read:
Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with
the federal government, the field trials of the Minnesota family
investment plan will end June 30, 1998.
(b) Families in the comparison group under subdivision 3,
paragraph (d), clause (i), receiving aid to families with
dependent children under sections 256.72 to 256.87, and STRIDE
services under section 256.736 will continue in those programs
until June 30, 1998. After June 30, 1998, families who cease
receiving assistance under the Minnesota family investment plan
and comparison group families who cease receiving assistance
under AFDC and STRIDE who are eligible for the Minnesota family
investment program-statewide (MFIP-S), medical assistance,
general assistance medical care, or the food stamp program shall
be placed with their consent on the programs for which they are
eligible.
(c) Families who cease receiving assistance under the MFIP
and comparison families who cease receiving assistance under
AFDC and STRIDE who are ineligible for MFIP-S due to increased
income from employment, or increased child or spousal support or
a combination of employment income and child or spousal support,
shall be eligible for transition year child care under section
119B.05, and extended medical assistance under section
256B.0635. For the purpose of assistance for transition year
child care and determining receipt of extended medical
assistance, receipt of AFDC and MFIP shall be considered to be
the same as receipt of MFIP-S.
Sec. 10. Minnesota Statutes 1997 Supplement, section
256.741, is amended by adding a subdivision to read:
Subd. 2a. [FAMILIES-FIRST DISTRIBUTION OF CHILD SUPPORT
ARREARAGES.] When the public authority collects support
arrearages on behalf of an individual who is receiving
assistance provided under MFIP or MFIP-R under this chapter,
MFIP-S under chapter 256J, or work first under chapter 256K, and
the public authority has the option of applying the collection
to arrears permanently assigned to the state or to arrears
temporarily assigned to the state, the public authority shall
first apply the collection to satisfy those arrears that are
permanently assigned to the state.
Sec. 11. Minnesota Statutes 1997 Supplement, section
256.9864, is amended to read:
256.9864 [REPORTS BY RECIPIENT.]
(a) An assistance unit with a recent work history or with
earned income shall report monthly to the county 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, as specified by the state agency.
(b) An assistance unit required to submit a report on the
form designated by the commissioner and within ten days of the
due date or the date of the significant change, whichever is
later, or otherwise report significant changes which would
affect eligibility or assistance amounts, is considered to have
continued its application for assistance effective the date the
required report is received by the county agency, if a complete
report is received within a calendar 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
county agency.
Sec. 12. Minnesota Statutes 1997 Supplement, section
256B.062, is amended to read:
256B.062 [CONTINUED ELIGIBILITY.]
Medical assistance may be paid for persons who received aid
to families with dependent children in at least three of the six
months preceding the month in which the person became ineligible
for aid to families with dependent children, if the
ineligibility was due to an increase in hours of employment or
employment income or due to the loss of an earned income
disregard. A person who is eligible for extended medical
assistance is entitled to six months of assistance without
reapplication, unless the assistance unit ceases to include a
dependent child. For a person under 21 years of age, medical
assistance may not be discontinued within the six-month period
of extended eligibility until it has been determined that the
person is not otherwise eligible for medical assistance.
Medical assistance may be continued for an additional six months
if the person meets all requirements for the additional six
months, according to Title XIX of the Social Security Act, as
amended by section 303 of the Family Support Act of 1988, Public
Law Number 100-485. This section is repealed effective March 31
July 1, 1998.
Sec. 13. Minnesota Statutes 1997 Supplement, section
256B.0635, is amended by adding a subdivision to read:
Subd. 3. [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO
OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.] Upon federal
approval, medical assistance is available to persons who
received MFIP-S in at least three of the six months preceding
the month in which the person opted to discontinue receiving
MFIP-S cash assistance under section 256J.31, subdivision 12. A
person who is eligible for medical assistance under this section
may receive medical assistance without reapplication as long as
the person meets MFIP-S eligibility requirements, unless the
assistance unit does not include a dependent child. Medical
assistance may be paid pursuant to subdivisions 1 and 2 for
persons who are no longer eligible for MFIP-S due to increased
employment or child support. A person may be eligible for
MinnesotaCare due to increased employment or child support, and
as such must be informed of the option to transition onto
MinnesotaCare.
Sec. 14. Minnesota Statutes 1997 Supplement, section
256D.05, subdivision 8, is amended to read:
Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997,
citizenship requirements for applicants and recipients under
sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to
256D.21 shall be determined the same as under section 256J.11,
except that legal noncitizens who are applicants or recipients
must have been residents of Minnesota on March 1, 1997. Legal
noncitizens who arrive in Minnesota after March 1, 1997, and
become elderly or disabled after that date, and are otherwise
eligible for general assistance can receive benefits under this
section. The income and assets of sponsors of noncitizens shall
be deemed available to general assistance applicants and
recipients according to the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, Public Law Number
104-193, title IV, sections 421 and 422, and subsequently set
out in federal rules.
(b) As a condition of eligibility, each legal adult
noncitizen in the assistance unit who has resided in the country
for four years or more and who is under 70 years of age must:
(1) be enrolled in a literacy class, English as a second
language class, or a citizen class;
(2) be applying for admission to a literacy class, English
as a second language class, and is on a waiting list;
(3) be in the process of applying for a waiver from the
Immigration and Naturalization Service of the English language
or civics requirements of the citizenship test;
(4) have submitted an application for citizenship to the
Immigration and Naturalization Service and is waiting for a
testing date or a subsequent swearing in ceremony; or
(5) have been denied citizenship due to a failure to pass
the test after two attempts or because of an inability to
understand the rights and responsibilities of becoming a United
States citizen, as documented by the Immigration and
Naturalization Service or the county.
If the county social service agency determines that a legal
noncitizen subject to the requirements of this subdivision will
require more than one year of English language training, then
the requirements of clause (1) or (2) shall be imposed after the
legal noncitizen has resided in the country for three years.
Individuals who reside in a facility licensed under chapter
144A, 144D, 245A, or 256I are exempt from the requirements of
this section.
Sec. 15. Minnesota Statutes 1996, section 256D.051, is
amended by adding a subdivision to read:
Subd. 19. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR
PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.]
(a) To the extent of available resources, the commissioner
may waive the $400 service cost limit specified in subdivision 6
for county agencies who propose to provide enhanced services
under the food stamp employment and training program to
hard-to-employ individuals. A "hard-to-employ individual" is
defined as:
(1) a recipient of general assistance under chapter 256D;
or
(2) an individual with at least one of the following three
barriers to employment:
(i) the individual has not completed secondary school or
obtained a general equivalency development diploma or an adult
diploma, and has low skills in reading or mathematics;
(ii) the individual requires substance abuse treatment for
employment; and
(iii) the individual has a poor work history.
(b) To obtain a waiver, the county agency must submit a
waiver request to the commissioner. The request must specify:
(1) the number of hard-to-employ individuals the agency
plans to serve;
(2) the nature of the enhanced employment and training
services the agency will provide; and
(3) the agency's plan for providing referrals for substance
abuse assessment and treatment for hard-to-employ individuals
who require substance abuse treatment for employment.
Sec. 16. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.]
Subdivision 1. [PROGRAM ESTABLISHED.] For the period of
July 1, 1998, to June 30, 1999, the Minnesota food assistance
program is established to provide food assistance to legal
noncitizens residing in this state who are ineligible to
participate in the federal Food Stamp Program solely due to the
provisions of section 402 or 403 of Public Law Number 104-193,
as authorized by Title VII of the 1997 Emergency Supplemental
Appropriations Act, Public Law Number 105-18.
Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for
the Minnesota food assistance program, all of the following
conditions must be met:
(1) the applicant must meet the initial and ongoing
eligibility requirements for the federal Food Stamp Program,
except for the applicant's ineligible immigration status;
(2) the applicant must be either a qualified noncitizen as
defined in section 256J.08, subdivision 73, or a noncitizen
otherwise residing lawfully in the United States;
(3) the applicant must be a resident of the state; and
(4) the applicant must not be receiving assistance under
the MFIP-S or the work first program.
Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the
Minnesota food assistance program shall follow exactly the
regulations for the federal Food Stamp Program, except for the
provisions pertaining to immigration status under sections 402
or 403 of Public Law Number 104-193.
(b) The county agency shall use the income, budgeting, and
benefit allotment regulations of the federal Food Stamp Program
to calculate an eligible recipient's monthly Minnesota food
assistance program benefit. Until September 30, 1998, eligible
recipients under this subdivision shall receive the average per
person food stamp issuance in Minnesota in the fiscal year
ending June 30, 1997. Beginning October 1, 1998, eligible
recipients shall receive the same level of benefits as those
provided by the federal Food Stamp Program to similarly situated
citizen recipients. The monthly Minnesota food assistance
program benefits shall not exceed an amount equal to the amount
of federal Food Stamp Program benefits the household would
receive if all members of the household were eligible for the
federal Food Stamp Program.
(c) Minnesota food assistance program benefits must be
disregarded as income in all programs that do not count food
stamps as income.
(d) The county agency must redetermine a Minnesota food
assistance program recipient's eligibility for the federal Food
Stamp Program when the agency receives information that the
recipient's legal immigration status has changed in such a way
that would make the recipient potentially eligible for the
federal Food Stamp Program.
(e) Until October 1, 1998, the commissioner may provide
benefits under this section in cash.
Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall
submit a state plan to the secretary of agriculture to allow the
commissioner to purchase federal Food Stamp Program benefits for
each Minnesota food assistance program recipient who is
ineligible to participate in the federal Food Stamp Program
solely due to the provisions of section 402 or 403 of Public Law
Number 104-193, as authorized by Title VII of the 1997 Emergency
Supplemental Appropriations Act, Public Law Number 105-18. The
commissioner shall enter into a contract as necessary with the
secretary to use the existing federal Food Stamp Program
benefits delivery system for the purposes of administering the
Minnesota food assistance program under this section.
Sec. 17. Minnesota Statutes 1996, section 256D.46,
subdivision 2, is amended to read:
Subd. 2. [INCOME AND RESOURCE TEST.] All income and
resources available to the recipient must be considered in
determining the recipient's ability to meet the emergency need.
Property that can be liquidated in time to resolve the emergency
and income, (excluding Minnesota supplemental aid issued for
current month's need) an amount equal to the Minnesota
supplemental aid standard of assistance, that is normally
disregarded or excluded under the Minnesota supplemental aid
program must be considered available to meet the emergency need.
Sec. 18. Minnesota Statutes 1997 Supplement, section
256J.02, subdivision 4, is amended to read:
Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations
of title I of Public Law Number 104-193, the Personal
Responsibility and Work Opportunity Reconciliation Act of
1996, as amended, the legislature may transfer money from the
TANF block grant to the child care fund under chapter 119B, or
the Title XX block grant under section 256E.07.
Sec. 19. Minnesota Statutes 1997 Supplement, section
256J.03, is amended to read:
256J.03 [TANF RESERVE ACCOUNT.]
Subdivision 1. The Minnesota family investment
program-statewide/TANF TANF reserve account is created in the
state treasury. Funds retained or deposited in the TANF reserve
shall include: (1) funds designated by the legislature and; (2)
unexpended state funds resulting from the acceleration of TANF
expenditures under subdivision 2; (3) earnings available from
the federal TANF block grant appropriated to the commissioner
but not expended in the biennium beginning July 1, 1997, shall
be retained; and (4) TANF funds available in fiscal years 1998,
1999, 2000, and 2001 that are not spent or not budgeted to be
spent in those years.
Funds deposited in the reserve account to must be expended
for the Minnesota family investment program-statewide in fiscal
year 2000 and subsequent fiscal years and directly related state
programs for the purposes in subdivision 3.
Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF
FUNDS.] The commissioner may expend federal TANF block grant
funds in excess of appropriated levels for the purpose of
accelerating federal funding of the MFIP program. By the end of
the fiscal year in which the additional federal expenditures are
made, the commissioner must deposit into the reserve account an
amount of unexpended state funds appropriated for assistance to
families grants, AFDC, and MFIP equal to the additional federal
expenditures. Reserve funds may be spent as TANF appropriations
if insufficient TANF funds are available because of acceleration.
Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the
reserve account may be used for the following purposes:
(1) unanticipated TANF block grant maintenance of effort
shortfalls;
(2) MFIP cost increases due to reduced federal revenues and
federal law changes;
(3) one-half of the MFIP general fund cost increase in
fiscal year 2000 and subsequent fiscal years due to caseload
increases over fiscal year 1999; and
(4) transfers allowed under section 256J.02, subdivision 4.
Sec. 20. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 11, is amended to read:
Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's
natural or adoptive parent or parents and stepparent who live in
the home with the minor child. For purposes of determining
eligibility for this program, caregiver also means any of the
following individuals, if adults, who live with and provide care
and support to a minor child when the minor child's natural or
adoptive parent or parents or stepparents do not reside in the
same home: legal custodians custodian or guardian, grandfather,
grandmother, brother, sister, stepfather, stepmother,
stepbrother, stepsister, uncle, aunt, first cousin or first
cousin once removed, nephew, niece, person of preceding
generation as denoted by prefixes of "great," "great-great," or
"great-great-great," or a spouse of any person named in the
above groups even after the marriage ends by death or divorce.
Sec. 21. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 24a. [DISQUALIFIED.] "Disqualified" means being
ineligible to receive MFIP-S due to noncooperation with program
requirements. Except for persons whose disqualification is
based on fraud, a disqualified person can take action to correct
the reason for ineligibility.
Sec. 22. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 26, is amended to read:
Subd. 26. [EARNED INCOME.] "Earned income" means cash or
in-kind income earned through the receipt of wages, salary,
commissions, profit from employment activities, net profit from
self-employment activities, payments made by an employer for
regularly accrued vacation or sick leave, and any other profit
from activity earned through effort or labor. The income must
be in return for, or as a result of, legal activity.
Sec. 23. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 28, is amended to read:
Subd. 28. [EMERGENCY.] "Emergency" means a situation or a
set of circumstances that causes or threatens to cause
destitution to a minor child family with a child under age 21.
Sec. 24. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 40, is amended to read:
Subd. 40. [GROSS EARNED INCOME.] "Gross earned income"
means earned income from employment before mandatory and
voluntary payroll deductions. Gross earned income includes
salaries, wages, tips, gratuities, commissions, incentive
payments from work or training programs, payments made by an
employer for regularly accrued vacation or sick leave, and
profits from other activity earned by an individual's effort or
labor. Gross earned income includes uniform and meal allowances
if federal income tax is deducted from the allowance. Gross
earned income includes flexible work benefits received from an
employer if the employee has the option of receiving the benefit
or benefits in cash. For self-employment, gross earned income
is the nonexcluded income minus expenses for the business.
Sec. 25. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate
transitional standard" means a combination of the cash
assistance a family with no other income would have received in
the state of previous residence and the Minnesota food portion
for the appropriate size family.
Sec. 26. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any
person who is under a legal obligation to provide care for a
minor and who is in fact providing care for a minor. For an
Indian child, "custodian" means any Indian person who has legal
custody of an Indian child under tribal law or custom, under
state law, or to whom temporary physical care, custody, and
control has been transferred by the parent of the child, as
provided in section 257.351, subdivision 8.
Sec. 27. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 60, is amended to read:
Subd. 60. [MINOR CHILD.] "Minor child" means a child who
is living in the same home of a parent or other caregiver, is
not the parent of a child in the home, and is either less than
18 years of age or is under the age of 19 years and is regularly
attending as a full-time student and is expected to complete a
high school or in a secondary school or pursuing a full-time
secondary level course of vocational or technical training
designed to fit students for gainful employment before reaching
age 19.
Sec. 28. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent"
means a minor child's parent who does not live in the same home
as the child.
Sec. 29. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 68, is amended to read:
Subd. 68. [PERSONAL PROPERTY.] "Personal property" means
an item of value that is not real property, including the value
of a contract for deed held by a seller, assets held in trust on
behalf of members of an assistance unit, cash surrender value of
life insurance, value of a prepaid burial, savings account,
value of stocks and bonds, and value of retirement accounts.
Sec. 30. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 73, is amended to read:
Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen"
means a person:
(1) who was lawfully admitted for permanent residence
pursuant to United States Code, title 8;
(2) who was admitted to the United States as a refugee
pursuant to United States Code, title 8; section 1157;
(3) whose deportation is being withheld pursuant to United
States Code, title 8, section 1253(h);
(4) who was paroled for a period of at least one year
pursuant to United States Code, title 8, section 1182(d)(5);
(5) who was granted conditional entry pursuant to United
State Code, title 8, section 1153(a)(7);
(6) who was granted asylum pursuant to United States Code,
title 8, section 1158; or
(7) determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996, Title V of the
Omnibus Consolidated Appropriations Bill, Public Law Number
104-208;
(8) who is a child of a noncitizen determined to be a
battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Responsibility
Act of 1996, title V, Public Law Number 104-200; or
(9) who was admitted as a Cuban or Haitian entrant.
Sec. 31. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 82a. [SHARED HOUSEHOLD STANDARD.] "Shared household
standard" means the basic standard used when the household
includes an unrelated member. The cash portion of the shared
household standard is equal to 90 percent of the cash portion of
the transitional standard. The cash portion of the shared
household standard plus the food portion equals the full shared
household standard.
Sec. 32. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 82b. [SHELTER COSTS.] "Shelter costs" means rent,
manufactured home lot rental costs, or monthly principal,
interest, insurance premiums, and property taxes due for
mortgages or contracts for deed.
Sec. 33. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 83, is amended to read:
Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means
a decline in gross income of 35 36 percent or more from the
income used to determine the grant for the current month.
Sec. 34. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 86a. [UNRELATED MEMBER.] "Unrelated member" means an
individual in the household who does not meet the definition of
an eligible caregiver, but does not include an individual who
provides child care to a child in the assistance unit.
Sec. 35. Minnesota Statutes 1997 Supplement, section
256J.09, subdivision 6, is amended to read:
Subd. 6. [INVALID REASON FOR DELAY.] A county agency must
not delay a decision on eligibility or delay issuing the
assistance payment except to establish state residence as
provided in section 256J.12 by:
(1) treating the 30-day processing period as a waiting
period;
(2) delaying approval or issuance of the assistance payment
pending the decision of the county board; or
(3) awaiting the result of a referral to a county agency in
another county when the county receiving the application does
not believe it is the county of financial responsibility.
Sec. 36. Minnesota Statutes 1997 Supplement, section
256J.09, subdivision 9, is amended to read:
Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An
addendum to an existing application must be used to add persons
to an assistance unit regardless of whether the persons being
added are required to be in the assistance unit. When a person
is added by addendum to an assistance unit, eligibility for that
person begins on the first of the month the addendum was filed
except as provided in section 256J.74, subdivision 2, clause (1).
(b) An overpayment must be determined when a change in
household composition is not reported within the deadlines in
section 256J.30, subdivision 9. Any overpayment must be
calculated from the month of the change including the needs,
income, and assets of any individual who is required to be
included in the assistance unit under section 256J.24,
subdivision 2. Individuals not included in the assistance unit
who are identified in section 256J.37, subdivisions 1 to 2, must
have their income and assets considered when determining the
amount of the overpayment.
Sec. 37. Minnesota Statutes 1997 Supplement, section
256J.11, subdivision 2, as amended by Laws 1997, Third Special
Session chapter 1, is amended to read:
Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period
September 1, 1997, to October 31, 1997, noncitizens who do not
meet one of the exemptions in section 412 of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996,
but were residing in this state as of July 1, 1997, are eligible
for the 6/10 of the average value of food stamps for the same
family size and composition until MFIP-S is operative in the
noncitizen's county of financial responsibility and thereafter,
the 6/10 of the food portion of MFIP-S. However, federal food
stamp dollars cannot be used to fund the food portion of MFIP-S
benefits for an individual under this subdivision.
(b) For the period November 1, 1997, to June 30, 1998 1999,
noncitizens who do not meet one of the exemptions in section 412
of the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, but were residing in this state as
of July 1, 1997, and are receiving cash assistance under the
AFDC, family general assistance, MFIP or MFIP-S programs are
eligible for the average value of food stamps for the same
family size and composition until MFIP-S is operative in the
noncitizen's county of financial responsibility and thereafter,
the food portion of MFIP-S. However, federal food stamp dollars
cannot be used to fund the food portion of MFIP-S benefits for
an individual under this subdivision. The assistance provided
under this subdivision, which is designated as a supplement to
replace lost benefits under the federal food stamp program, must
be disregarded as income in all programs that do not count food
stamps as income where the commissioner has the authority to
make the income disregard determination for the program.
(c) The commissioner shall submit a state plan to the
secretary of agriculture to allow the commissioner to purchase
federal Food Stamp Program benefits in an amount equal to the
MFIP-S food portion for each legal noncitizen receiving MFIP-S
assistance who is ineligible to participate in the federal Food
Stamp Program solely due to the provisions of section 402 or 403
of Public Law Number 104-193, as authorized by Title VII of the
1997 Emergency Supplemental Appropriations Act, Public Law
Number 105-18. The commissioner shall enter into a contract as
necessary with the secretary to use the existing federal Food
Stamp Program benefits delivery system for the purposes of
administering the food portion of MFIP-S under this subdivision.
Sec. 38. Minnesota Statutes 1997 Supplement, section
256J.12, is amended to read:
256J.12 [MINNESOTA RESIDENCE.]
Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC
or MFIP-S, whichever is in effect, a family an assistance unit
must have established residency in this state which means
the family assistance unit is present in the state and intends
to remain here. A person who lives in this state and who
entered this state with a job commitment or to seek employment
in this state, whether or not that person is currently employed,
meets the criteria in this subdivision.
Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.] A family An
assistance unit is considered to have established residency in
this state only when a child or caregiver has resided in this
state for at least 30 days with the intention of making the
person's home here and not for any temporary purpose. The birth
of a child in Minnesota to a member of the assistance unit does
not automatically establish the residency in this state under
this subdivision of the other members of the assistance unit.
Time spent in a shelter for battered women shall count toward
satisfying the 30-day residency requirement.
Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day
residency requirement where unusual hardship would result from
denial of assistance.
(b) For purposes of this section, unusual hardship means a
family an assistance unit:
(1) is without alternative shelter; or
(2) is without available resources for food.
(c) For purposes of this subdivision, the following
definitions apply (1) "metropolitan statistical area" is as
defined by the U.S. Census Bureau; (2) "alternative shelter"
includes any shelter that is located within the metropolitan
statistical area containing the county and for which the family
is eligible, provided the family assistance unit does not have
to travel more than 20 miles to reach the shelter and has access
to transportation to the shelter. Clause (2) does not apply to
counties in the Minneapolis-St. Paul metropolitan statistical
area.
(d) Applicants are considered to meet the residency
requirement under subdivision 1a if they once resided in
Minnesota and:
(1) joined the United States armed services, returned to
Minnesota within 30 days of leaving the armed services, and
intend to remain in Minnesota; or
(2) left to attend school in another state, paid
nonresident tuition or Minnesota tuition rates under a
reciprocity agreement, and returned to Minnesota within 30 days
of graduation with the intent to remain in Minnesota.
(e) The 30-day residence requirement is met when:
(1) a minor child or a minor caregiver moves from another
state to the residence of a relative caregiver;
(2) the minor caregiver applies for and receives family
cash assistance;
(3) the relative caregiver chooses not to be part of the
MFIP-S assistance unit; and
(4) the relative caregiver has resided in Minnesota for at
least 30 days prior to the date the assistance unit applies for
cash assistance.
(f) Ineligible mandatory unit members who have resided in
Minnesota for 12 months immediately before the unit's date of
application establish the other assistance unit members'
eligibility for the MFIP-S transitional standard.
Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined
in section 256J.08, and their immediate families are exempt from
the requirements of subdivisions 1 and 1a, provided the migrant
worker provides verification that the migrant family worked in
this state within the last 12 months and earned at least $1,000
in gross wages during the time the migrant worker worked in this
state.
Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid
to an eligible family assistance unit in which all members have
resided in this state for fewer than 12 consecutive calendar
months immediately preceding the date of application shall be at
the standard and in the form specified in section 256J.43.
Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this
section is enjoined from implementation or found
unconstitutional by any court of competent jurisdiction, the
remaining subdivisions shall remain valid and shall be given
full effect.
Sec. 39. Minnesota Statutes 1997 Supplement, section
256J.14, is amended to read:
256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.]
(a) The definitions in this paragraph only apply to this
subdivision.
(1) "Household of a parent, legal guardian, or other adult
relative" means the place of residence of:
(i) a natural or adoptive parent;
(ii) a legal guardian according to appointment or
acceptance under section 260.242, 525.615, or 525.6165, and
related laws; or
(iii) a caregiver as defined in section 256J.08,
subdivision 11; or
(iv) an appropriate adult relative designated by a county
agency.
(2) "Adult-supervised supportive living arrangement" means
a private family setting which assumes responsibility for the
care and control of the minor parent and minor child, or other
living arrangement, not including a public institution, licensed
by the commissioner of human services which ensures that the
minor parent receives adult supervision and supportive services,
such as counseling, guidance, independent living skills
training, or supervision.
(b) A minor parent and the minor child who is in the care
of the minor parent must reside in the household of a parent,
legal guardian, other appropriate adult relative, or other
caregiver, or in an adult-supervised supportive living
arrangement in order to receive MFIP-S unless:
(1) the minor parent has no living parent, other
appropriate adult relative, or legal guardian whose whereabouts
is known;
(2) no living parent, other appropriate adult relative, or
legal guardian of the minor parent allows the minor parent to
live in the parent's, appropriate other adult relative's, or
legal guardian's home;
(3) the minor parent lived apart from the minor parent's
own parent or legal guardian for a period of at least one year
before either the birth of the minor child or the minor parent's
application for MFIP-S;
(4) the physical or emotional health or safety of the minor
parent or minor child would be jeopardized if the minor parent
and the minor child resided in the same residence with the minor
parent's parent, other appropriate adult relative, or legal
guardian; or
(5) an adult supervised supportive living arrangement is
not available for the minor parent and the dependent child in
the county in which the minor parent and child currently resides
reside. If an adult supervised supportive living arrangement
becomes available within the county, the minor parent and child
must reside in that arrangement.
(c) Minor applicants must be informed orally and in writing
about the eligibility requirements and their rights and
obligations under the MFIP-S program. The county must advise
the minor of the possible exemptions and specifically ask
whether one or more of these exemptions is applicable. If the
minor alleges one or more of these exemptions, then the county
must assist the minor in obtaining the necessary verifications
to determine whether or not these exemptions apply.
(d) If the county worker has reason to suspect that the
physical or emotional health or safety of the minor parent or
minor child would be jeopardized if they resided with the minor
parent's parent, other adult relative, or legal guardian, then
the county worker must make a referral to child protective
services to determine if paragraph (b), clause (4), applies. A
new determination by the county worker is not necessary if one
has been made within the last six months, unless there has been
a significant change in circumstances which justifies a new
referral and determination.
(e) If a minor parent is not living with a parent or, legal
guardian, or other adult relative due to paragraph (b), clause
(1), (2), or (4), the minor parent must reside, when possible,
in a living arrangement that meets the standards of paragraph
(a), clause (2).
(f) When a minor parent and minor child live with another a
parent, other adult relative, legal guardian, or in an
adult-supervised supportive living arrangement, MFIP-S must be
paid, when possible, in the form of a protective payment on
behalf of the minor parent and minor child in accordance with
according to section 256J.39, subdivisions 2 to 4.
Sec. 40. Minnesota Statutes 1997 Supplement, section
256J.15, subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.] To receive
assistance under MFIP-S, when a member of an assistance unit who
is on strike, or when an individual identified under section
256J.37, subdivisions 1 to 2, whose income and assets must be
considered when determining the unit's eligibility is on strike,
the assistance unit must have been an receiving MFIP-S
participant on the day before the strike, or have been eligible
for MFIP-S on the day before the strike.
The county agency must count the striker's prestrike
earnings as current earnings. When A significant change cannot
be invoked when a member of an assistance unit, or an individual
identified under section 256J.37, subdivisions 1 to 2, is on
strike. A member of an assistance unit who, or an individual
identified under section 256J.37, subdivisions 1 to 2, is not
considered a striker when that person is not in the bargaining
unit that voted for the strike and does not cross the picket
line for fear of personal injury, the assistance unit member is
not a striker. Except for a member of an assistance unit who is
not in the bargaining unit that voted for the strike and who
does not cross the picket line for fear of personal injury, a
significant change cannot be invoked as a result of a labor
dispute.
Sec. 41. Minnesota Statutes 1997 Supplement, section
256J.20, subdivision 2, is amended to read:
Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real
property by an applicant or participant is subject to the
limitations in paragraphs (a) and (b).
(a) A county agency shall exclude the homestead of an
applicant or participant according to clauses (1) to (4) (5):
(1) an applicant or participant who is purchasing real
property through a contract for deed and using that property as
a home is considered the owner of real property;
(2) the total amount of land that can be excluded under
this subdivision is limited to surrounding property which is not
separated from the home by intervening property owned by
others. Additional property must be assessed as to its legal
and actual availability according to subdivision 1;
(3) when real property that has been used as a home by a
participant is sold, the county agency must treat the cash
proceeds from the sale as excluded property for six months when
the participant intends to reinvest the proceeds in another home
and maintains those proceeds, unused for other purposes, in a
separate account; and
(4) when the homestead is jointly owned, but the client
does not reside in it because of legal separation, pending
divorce, or battering or abuse by the spouse or partner, the
homestead is excluded.; and
(5) the homestead shall continue to be excluded if it is
temporarily unoccupied due to employment, illness, or as the
result of compliance with a county-approved employability plan.
The education, training, or job search must be within the state,
but can be outside the immediate geographic area. A homestead
temporarily unoccupied because it is not habitable due to a
casualty or natural disaster is excluded. The homestead is
excluded during periods only if the client intends to return to
it.
(b) The equity value of real property that is not excluded
under paragraph (a) and which is legally available must be
applied against the limits in subdivision 3. When the equity
value of the real property exceeds the limits under subdivision
3, the applicant or participant may qualify to receive
assistance when the applicant or participant continues to make a
good faith effort to sell the property and signs a legally
binding agreement to repay the amount of assistance, less child
support collected by the agency. Repayment must be made within
five working days after the property is sold. Repayment to the
county agency must be in the amount of assistance received or
the proceeds of the sale, whichever is less.
Sec. 42. Minnesota Statutes 1997 Supplement, section
256J.20, subdivision 3, is amended to read:
Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for
MFIP-S, the equity value of all nonexcluded real and personal
property of the assistance unit must not exceed $2,000 for
applicants and $5,000 for ongoing recipients participants. The
value of assets in clauses (1) to (18) (20) must be excluded
when determining the equity value of real and personal property:
(1) a licensed vehicles vehicle up to a total market loan
value of less than or equal to $7,500. The county agency shall
apply any excess market loan value as if it were equity value to
the asset limit described in this section. If the assistance
unit owns more than one licensed vehicle, the county agency
shall determine the vehicle with the highest market loan value
and count only the market loan value over $7,500. The county
agency shall count the market loan value of all other vehicles
and apply this amount as if it were equity value to the asset
limit described in this section. The value of special equipment
for a handicapped member of the assistance unit is excluded. To
establish the market loan value of vehicles, a county agency
must use the N.A.D.A. Official Used Car Guide, Midwest Edition,
for newer model cars. The N.A.D.A. Official Used Car Guide,
Midwest Edition, is incorporated by reference. When a vehicle
is not listed in the guidebook, or when the applicant or
participant disputes the loan value listed in the guidebook as
unreasonable given the condition of the particular vehicle, the
county agency may require the applicant or participant to
document the loan value by securing a written statement from a
motor vehicle dealer licensed under section 168.27, stating the
amount that the dealer would pay to purchase the vehicle. The
county agency shall reimburse the applicant or participant for
the cost of a written statement that documents a lower loan
value;
(2) the value of life insurance policies for members of the
assistance unit;
(3) one burial plot per member of an assistance unit;
(4) the value of personal property needed to produce earned
income, including tools, implements, farm animals, inventory,
business loans, business checking and savings accounts used at
least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if the vehicles
are essential for the self-employment business;
(5) the value of personal property not otherwise specified
which is commonly used by household members in day-to-day living
such as clothing, necessary household furniture, equipment, and
other basic maintenance items essential for daily living;
(6) the value of real and personal property owned by a
recipient of Supplemental Security Income or Minnesota
supplemental aid;
(7) the value of corrective payments, but only for the
month in which the payment is received and for the following
month;
(8) a mobile home used by an applicant or participant as
the applicant's or participant's home;
(9) money in a separate escrow account that is needed to
pay real estate taxes or insurance and that is used for this
purpose;
(10) money held in escrow to cover employee FICA, employee
tax withholding, sales tax withholding, employee worker
compensation, business insurance, property rental, property
taxes, and other costs that are paid at least annually, but less
often than monthly;
(11) monthly assistance and, emergency assistance, and
diversionary payments for the current month's needs;
(12) the value of school loans, grants, or scholarships for
the period they are intended to cover;
(13) payments listed in section 256J.21, subdivision 2,
clause (9), which are held in escrow for a period not to exceed
three months to replace or repair personal or real property;
(14) income received in a budget month through the end of
the budget payment month;
(15) savings from earned income of a minor child or a minor
parent that are set aside in a separate account designated
specifically for future education or employment costs;
(16) the federal earned income tax credit and, Minnesota
working family credit, state and federal income tax refunds,
state homeowners and renters credits under chapter 290A,
property tax rebates under Laws 1997, chapter 231, article 1,
section 16, and other federal or state tax rebates in the month
received and the following month;
(17) payments excluded under federal law as long as those
payments are held in a separate account from any nonexcluded
funds; and
(18) money received by a participant of the corps to career
program under section 84.0887, subdivision 2, paragraph (b), as
a postservice benefit under the federal Americorps Act;
(19) the assets of children ineligible to receive MFIP-S
benefits because foster care or adoption assistance payments are
made on their behalf; and
(20) the assets of persons whose income is excluded under
section 256J.21, subdivision 2, clause 43.
Sec. 43. Minnesota Statutes 1997 Supplement, section
256J.21, is amended to read:
256J.21 [INCOME LIMITATIONS.]
Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S
eligibility, the county agency must evaluate income received by
members of an assistance unit, or by other persons whose income
is considered available to the assistance unit, and only count
income that is available to the member of the assistance unit.
Income is available if the individual has legal access to the
income. All payments, unless specifically excluded in
subdivision 2, must be counted as income.
Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be
excluded in determining a family's available income:
(1) payments for basic care, difficulty of care, and
clothing allowances received for providing family foster care to
children or adults under Minnesota Rules, parts 9545.0010 to
9545.0260 and 9555.5050 to 9555.6265, and payments received and
used for care and maintenance of a third-party beneficiary who
is not a household member;
(2) reimbursements for employment training received through
the Job Training Partnership Act, United States Code, title 29,
chapter 19, sections 1501 to 1792b;
(3) reimbursement for out-of-pocket expenses incurred while
performing volunteer services, jury duty, or employment;
(4) all educational assistance, except the county agency
must count graduate student teaching assistantships,
fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary
educational expenses, shall count scholarships or grants awarded
to graduate students that do not require teaching or research as
unearned income;
(5) loans, regardless of purpose, from public or private
lending institutions, governmental lending institutions, or
governmental agencies;
(6) loans from private individuals, regardless of purpose,
provided an applicant or participant documents that the lender
expects repayment;
(7)(i) state and federal income tax refunds; and
(ii) federal income tax refunds;
(8)(i) state and federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter
290A;
(iv) property tax rebates under Laws 1997, chapter 231,
article 1, section 16; and
(v) other federal or state tax rebates;
(9) funds received for reimbursement, replacement, or
rebate of personal or real property when these payments are made
by public agencies, awarded by a court, solicited through public
appeal, or made as a grant by a federal agency, state or local
government, or disaster assistance organizations, subsequent to
a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to
pay medical, funeral, and burial expenses, or to repair or
replace insured property;
(11) reimbursements for medical expenses that cannot be
paid by medical assistance;
(12) payments by a vocational rehabilitation program
administered by the state under chapter 268A, except those
payments that are for current living expenses;
(13) in-kind income, including any payments directly made
by a third party to a provider of goods and services;
(14) assistance payments to correct underpayments, but only
for the month in which the payment is received;
(15) emergency assistance payments;
(16) funeral and cemetery payments as provided by section
256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding
$30 per participant in a calendar month;
(18) any form of energy assistance payment made through
Public Law Number 97-35, Low-Income Home Energy Assistance Act
of 1981, payments made directly to energy providers by other
public and private agencies, and any form of credit or rebate
payment issued by energy providers;
(19) Supplemental Security Income, including retroactive
payments;
(20) Minnesota supplemental aid, including retroactive
payments;
(21) proceeds from the sale of real or personal property;
(22) adoption assistance payments under section 259.67;
(23) state-funded family subsidy program payments made
under section 252.32 to help families care for children with
mental retardation or related conditions;
(24) interest payments and dividends from property that is
not excluded from and that does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver or minor child who
is at least a half-time student in an approved secondary
education program;
(27) income earned by a caregiver under age 20 who is at
least a half-time student in an approved secondary education
program;
(28) MFIP-S child care payments under section 119B.05;
(29) all other payments made through MFIP-S to support a
caregiver's pursuit of greater self-support;
(30) income a participant receives related to shared living
expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966,
United States Code, title 42, chapter 13A, sections 1771 to
1790;
(33) benefits provided by the women, infants, and children
(WIC) nutrition program, United States Code, title 42, chapter
13A, section 1786;
(34) benefits from the National School Lunch Act, United
States Code, title 42, chapter 13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the
Uniform Relocation Assistance and Real Property Acquisition
Policies Act of 1970, United States Code, title 42, chapter 61,
subchapter II, section 4636, or the National Housing Act, United
States Code, title 12, chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States
Code, title 19, chapter 12, part 2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and
Aleuts under United States Code, title 50, sections 1989 to
1989d;
(38) payments to veterans or their dependents as a result
of legal settlements regarding Agent Orange or other chemical
exposure under Public Law Number 101-239, section 10405,
paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from
the MFIP-S program consideration in federal law, state law, or
federal regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under
Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi
Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs
reservations and payments to members of the White Earth Band,
under United States Code, title 25, chapter 9, section 331, and
chapter 16, section 1407;
(42) all income of the minor parent's parent and stepparent
when determining the grant for the minor parent in households
that include a minor parent living with a parent or stepparent
on MFIP-S with other dependent children; and
(43) income of the minor parent's parent and stepparent
equal to 200 percent of the federal poverty guideline for a
family size not including the minor parent and the minor
parent's child in households that include a minor parent living
with a parent or stepparent not on MFIP-S when determining the
grant for the minor parent. The remainder of income is deemed
as specified in section 256J.37, subdivision 1 1b;
(44) payments made to children eligible for relative
custody assistance under section 257.85;
(45) vendor payments for goods and services made on behalf
of a client unless the client has the option of receiving the
payment in cash; and
(46) the principal portion of a contract for deed payment.
Subd. 3. [INITIAL INCOME TEST.] The county agency shall
determine initial eligibility by considering all earned and
unearned income that is not excluded under subdivision 2. To be
eligible for MFIP-S, the assistance unit's countable income
minus the disregards in paragraphs (a) and (b) must be below the
transitional standard of assistance according to section 256J.24
for that size assistance unit.
(a) The initial eligibility determination must disregard
the following items:
(1) the employment disregard is 18 percent of the gross
earned income whether or not the member is working full time or
part time;
(2) dependent care costs must be deducted from gross earned
income for the actual amount paid for dependent care up to the a
maximum disregard allowed of $200 per month for each child less
than two years of age, and $175 per month for each child two
years of age and older under this chapter and chapter 119B; and
(3) all payments made according to a court order
for spousal support or the support of children not living in the
assistance unit's household shall be disregarded from the income
of the person with the legal obligation to pay support, provided
that, if there has been a change in the financial circumstances
of the person with the legal obligation to pay support since the
support order was entered, the person with the legal obligation
to pay support has petitioned for a modification of the support
order; and
(4) an allocation for the unmet need of an ineligible
spouse or an ineligible child under the age of 21 for whom the
caregiver is financially responsible and who lives with the
caregiver according to section 256J.36.
(b) Notwithstanding paragraph (a), when determining initial
eligibility for applicants who have applicant units when at
least one member has received AFDC, family general assistance,
MFIP, MFIP-R, work first, or MFIP-S in this state within four
months of the most recent application for MFIP-S, the employment
disregard for all unit members is 36 percent of the gross earned
income.
After initial eligibility is established, the assistance
payment calculation is based on the monthly income test.
Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF
ASSISTANCE PAYMENT.] The county agency shall determine ongoing
eligibility and the assistance payment amount according to the
monthly income test. To be eligible for MFIP-S, the result of
the computations in paragraphs (a) to (e) must be at least $1.
(a) Apply a 36 percent income disregard to gross earnings
and subtract this amount from the family wage level. If the
difference is equal to or greater than the transitional
standard, the assistance payment is equal to the transitional
standard. If the difference is less than the transitional
standard, the assistance payment is equal to the difference.
The employment disregard in this paragraph must be deducted
every month there is earned income.
(b) All payments made according to a court order
for spousal support or the support of children not living in the
assistance unit's household must be disregarded from the income
of the person with the legal obligation to pay support, provided
that, if there has been a change in the financial circumstances
of the person with the legal obligation to pay support since the
support order was entered, the person with the legal obligation
to pay support has petitioned for a modification of the court
order.
(c) An allocation for the unmet need of an ineligible
spouse or an ineligible child under the age of 21 for whom the
caregiver is financially responsible and who lives with the
caregiver must be made according to section 256J.36.
(d) Subtract unearned income dollar for dollar from the
transitional standard to determine the assistance payment amount.
(d) (e) When income is both earned and unearned, the amount
of the assistance payment must be determined by first treating
gross earned income as specified in paragraph (a). After
determining the amount of the assistance payment under paragraph
(a), unearned income must be subtracted from that amount dollar
for dollar to determine the assistance payment amount.
(e) (f) When the monthly income is greater than the
transitional or family wage level standard after applicable
deductions and the income will only exceed the standard for one
month, the county agency must suspend the assistance payment for
the payment month.
Subd. 5. [DISTRIBUTION OF INCOME.] The income of all
members of the assistance unit must be counted. Income may also
be deemed from ineligible persons to the assistance unit.
Income must be attributed to the person who earns it or to the
assistance unit according to paragraphs (a) to (c).
(a) Funds distributed from a trust, whether from the
principal holdings or sale of trust property or from the
interest and other earnings of the trust holdings, must be
considered income when the income is legally available to an
applicant or participant. Trusts are presumed legally available
unless an applicant or participant can document that the trust
is not legally available.
(b) Income from jointly owned property must be divided
equally among property owners unless the terms of ownership
provide for a different distribution.
(c) Deductions are not allowed from the gross income of a
financially responsible household member or by the members of an
assistance unit to meet a current or prior debt.
Sec. 44. Minnesota Statutes 1997 Supplement, section
256J.24, subdivision 1, is amended to read:
Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S
assistance unit is either a group of individuals with at least
one minor child who live together whose needs, assets, and
income are considered together and who receive MFIP-S
assistance, or a pregnant woman and her spouse who receives
receive MFIP-S assistance.
Individuals identified in subdivision 2 must be included in
the MFIP-S assistance unit. Individuals identified in
subdivision 3 must be excluded from the assistance unit are
ineligible to receive MFIP-S. Individuals identified in
subdivision 4 may be included in the assistance unit at their
option. Individuals not included in the assistance unit who are
identified in section 256J.37, subdivision subdivisions 1 or to
2, must have their income and assets considered when determining
eligibility and benefits for an MFIP-S assistance unit. All
assistance unit members, whether mandatory or elective, who live
together and for whom one caregiver or two caregivers apply must
be included in a single assistance unit.
Sec. 45. Minnesota Statutes 1997 Supplement, section
256J.24, subdivision 2, is amended to read:
Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except
for minor caregivers and their children who are must be in a
separate assistance unit from the other persons in the
household, when the following individuals live together, they
must be included in the assistance unit:
(1) a minor child, including a pregnant minor;
(2) the minor child's siblings, half-siblings, and
step-siblings; and
(3) the minor child's natural, adoptive parents, and
stepparents; and
(4) the spouse of a pregnant woman.
Sec. 46. Minnesota Statutes 1997 Supplement, section
256J.24, subdivision 3, is amended to read:
Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN
ASSISTANCE UNIT.] (a) The following individuals must be excluded
from an assistance unit who are part of the assistance unit
determined under subdivision 2 are ineligible to receive MFIP-S:
(1) individuals receiving Supplemental Security Income or
Minnesota supplemental aid;
(2) individuals living at home while performing
court-imposed, unpaid community service work due to a criminal
conviction;
(3) individuals disqualified from the food stamp program or
MFIP-S, until the disqualification ends;
(4) children on whose behalf federal, state or local foster
care payments under title IV-E of the Social Security Act are
made, except as provided in section sections 256J.13,
subdivision 2, and 256J.74, subdivision 2; and
(5) children receiving ongoing monthly adoption assistance
payments under section 269.67 259.67.
(b) The exclusion of a person under this subdivision does
not alter the mandatory assistance unit composition.
Sec. 47. Minnesota Statutes 1997 Supplement, section
256J.24, subdivision 4, is amended to read:
Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE
ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may
choose to be in the assistance unit, if the caregiver is not
required to be in the assistance unit under subdivision 2. If
the relative eligible caregiver chooses to be in the assistance
unit, that person's spouse must also be in the unit.
(b) Any minor child not related as a sibling, stepsibling,
or adopted sibling to the minor child in the unit, but for whom
there is an eligible caregiver may elect to be in the unit.
(c) A foster care provider of a minor child who is
receiving federal, state, or local foster care maintenance
payments may elect to receive MFIP-S if the provider meets the
definition of caregiver under section 256J.08, subdivision 11.
If the provider chooses to receive MFIP-S, the spouse of the
provider must also be included in the assistance unit with the
provider. The provider and spouse are eligible for assistance
even if the only minor child living in the provider's home is
receiving foster care maintenance payments.
(d) The adult caregiver or caregivers of a minor parent are
eligible to be a separate assistance unit from the minor parent
and the minor parent's child when:
(1) the adult caregiver or caregivers have no other minor
children in the household;
(2) the minor parent and the minor parent's child are
living together with the adult caregiver or caregivers; and
(3) the minor parent and the minor parent's child receive
MFIP-S, or would be eligible to receive MFIP-S, if they were not
receiving SSI benefits.
Sec. 48. Minnesota Statutes 1997 Supplement, section
256J.24, is amended by adding a subdivision to read:
Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL
STANDARD.] The commissioner shall adjust the food portion of the
MFIP-S transitional standard by October 1 each year beginning
October 1998 to reflect the cost-of-living adjustments to the
Food Stamp Program. The commissioner shall annually publish in
the State Register the transitional standard for an assistance
unit of sizes 1 to 10.
Sec. 49. Minnesota Statutes 1997 Supplement, section
256J.24, subdivision 7, is amended to read:
Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage
level standard is 110 percent of the transitional standard under
subdivision 5 and is the standard used when there is earned
income in the assistance unit. As specified in section 256J.21,
earned income is subtracted from the family wage level to
determine the amount of the assistance payment. Assistance
payments may not exceed the shared household standard or the
transitional standard for the assistance unit, whichever is less.
Sec. 50. Minnesota Statutes 1997 Supplement, section
256J.24, is amended by adding a subdivision to read:
Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE
UNITS.] Payments for shelter up to the amount of the cash
portion of MFIP-S benefits for which the assistance unit is
eligible shall be vendor paid for as many months as the
assistance unit is eligible or six months, whichever comes
first. The residual amount of the grant after vendor payment,
if any, must be paid to the MFIP-S caregiver.
Sec. 51. Minnesota Statutes 1997 Supplement, section
256J.24, is amended by adding a subdivision to read:
Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP-S.] (a) Except
as prohibited in paragraph (b), the county agency must use the
shared household standard when the household includes one or
more unrelated members, as that term is defined in section
256J.08, subdivision 86a. The county agency must use the shared
household standard, unless a member of the assistance unit is a
victim of domestic violence and has an approved safety plan,
regardless of the number of unrelated members in the household.
(b) The county agency must not use the shared household
standard when all unrelated members are one of the following:
(1) a recipient of public assistance benefits, including
food stamps, Supplemental Security Income, adoption assistance,
relative custody assistance, or foster care payments;
(2) a roomer or boarder, or a person to whom the assistance
unit is paying room or board;
(3) a minor;
(4) a minor caregiver living with the minor caregiver's
parents or in an approved supervised living arrangement; or
(5) a caregiver who is not the parent of the minor child in
the assistance unit.
(c) The shared household standard must be discontinued if
it is not approved by the United States Department of
Agriculture under the MFIP-S waiver.
Sec. 52. Minnesota Statutes 1997 Supplement, section
256J.26, subdivision 1, is amended to read:
Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a)
Applicants or recipients participants who have been convicted of
a drug offense after July 1, 1997, may, if otherwise eligible,
receive AFDC or MFIP-S benefits subject to the following
conditions:
(1) Benefits for the entire assistance unit must be paid in
vendor form for shelter and utilities during any time the
applicant is part of the assistance unit;.
(2) The convicted applicant or recipient participant shall
be subject to random drug testing as a condition of continued
eligibility and is subject to sanctions under section 256J.46
following any positive test for an illegal controlled substance,
except that the grant must continue to be vendor paid under
clause (1).
For purposes of this subdivision, section 256J.46 is
effective July 1, 1997.
This subdivision also applies to persons who receive food
stamps under section 115 of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996. is subject to the
following sanctions:
(i) for failing a drug test the first time, the
participant's grant shall be reduced by ten percent of the
MFIP-S transitional standard, the shared household standard, or
the interstate transitional standard, whichever is applicable
prior to making vendor payments for shelter and utility costs;
or
(ii) for failing a drug test two or more times, the
residual amount of the participant's grant after making vendor
payments for shelter and utility costs, if any, must be reduced
by an amount equal to 30 percent of the MFIP-S transitional
standard, the shared household standard, or the interstate
transitional standard, whichever is applicable.
(b) Applicants or participants who have been convicted of a
drug offense after July 1, 1997, may, if otherwise eligible,
receive food stamps if the convicted applicant or participant is
subject to random drug testing as a condition of continued
eligibility. Following a positive test for an illegal
controlled substance, the applicant is subject to the following
sanctions:
(1) for failing a drug test the first time, food stamps
shall be reduced by ten percent of the applicable food stamp
allotment; and
(2) for failing a drug test two or more times, food stamps
shall be reduced by an amount equal to 30 percent of the
applicable food stamp allotment.
(b) (c) For the purposes of this subdivision, "drug offense"
means a conviction that occurred after July 1, 1997, of sections
152.021 to 152.025, 152.0261, or 152.096. Drug offense also
means a conviction in another jurisdiction of the possession,
use, or distribution of a controlled substance, or conspiracy to
commit any of these offenses, if the offense occurred after July
1, 1997, and the conviction is a felony offense in that
jurisdiction, or in the case of New Jersey, a high misdemeanor.
Sec. 53. Minnesota Statutes 1997 Supplement, section
256J.26, subdivision 2, is amended to read:
Subd. 2. [PAROLE VIOLATORS.] An individual violating a
condition of probation or parole or supervised release imposed
under federal law or the law of any state is ineligible to
receive disqualified from receiving AFDC or MFIP-S.
Sec. 54. Minnesota Statutes 1997 Supplement, section
256J.26, subdivision 3, is amended to read:
Subd. 3. [FLEEING FELONS.] An individual who is fleeing to
avoid prosecution, or custody, or confinement after conviction
for a crime that is a felony under the laws of the jurisdiction
from which the individual flees, or in the case of New Jersey,
is a high misdemeanor, is ineligible to receive disqualified
from receiving AFDC or MFIP-S.
Sec. 55. Minnesota Statutes 1997 Supplement, section
256J.26, subdivision 4, is amended to read:
Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON
FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An
individual who is convicted in federal or state court of having
made a fraudulent statement or representation with respect to
the place of residence of the individual in order to receive
assistance simultaneously from two or more states is ineligible
to receive disqualified from receiving AFDC or MFIP-S for ten
years beginning on the date of the conviction.
Sec. 56. Minnesota Statutes 1997 Supplement, section
256J.28, subdivision 1, is amended to read:
Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP
ASSISTANCE.] The following households are entitled to expedited
issuance of food stamp assistance:
(1) households with less than $150 in monthly gross income
provided their liquid assets do not exceed $100;
(2) migrant or seasonal farm worker households who are
destitute as defined in Code of Federal Regulations, title 7,
subtitle B, chapter 2, subchapter C, part 273, section 273.10,
paragraph (e)(3), provided their liquid assets do not exceed
$100; and
(3) eligible households whose combined monthly gross income
and liquid resources are less than the household's monthly rent
or mortgage and utilities.
The benefits issued through expedited issuance of food
stamp assistance must be deducted from the amount of the full
monthly MFIP-S assistance payment and a supplemental payment for
the difference must be issued. For any month an individual
receives expedited Food Stamp Program benefits, the individual
is not eligible for the MFIP-S food portion of assistance.
Sec. 57. Minnesota Statutes 1997 Supplement, section
256J.28, subdivision 2, is amended to read:
Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE
ASSISTANCE UNIT.] (a) For household members who purchase and
prepare food with the MFIP-S assistance unit but are not part of
the assistance unit, the county agency must determine a separate
food stamp benefit based on regulations agreed upon with the
United States Department of Agriculture.
(b) This subdivision does not apply to optional members who
have chosen not to be in the assistance unit.
(c) (b) Fair hearing requirements for persons who receive
food stamps under this subdivision are governed by section
256.045, and Code of Federal Regulations, title 7, subtitle B,
chapter II, part 273, section 273.15.
Sec. 58. Minnesota Statutes 1997 Supplement, section
256J.28, is amended by adding a subdivision to read:
Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED
WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing
in a battered woman's shelter may receive food stamps or the
food portion twice in a month if the unit that initially
received the food stamps or food portion included the alleged
abuser.
Sec. 59. Minnesota Statutes 1997 Supplement, section
256J.30, subdivision 10, is amended to read:
Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The
caregiver of a minor child must cooperate with the county agency
to identify and provide information to assist the county agency
in pursuing third-party liability for medical services.
(b) A caregiver must assign to the department any rights to
health insurance policy benefits the caregiver has during the
period of MFIP-S eligibility.
(c) A caregiver must identify any third party who may be
liable for care and services available under the medical
assistance program on behalf of the applicant or participant and
all other assistance unit members.
(d) When a participant refuses to identify any third party
who may be liable for care and services, the recipient must be
sanctioned as provided in section 256J.46, subdivision 1. The
recipient is also ineligible for medical assistance for a
minimum of one month and until the recipient cooperates with the
requirements of this subdivision.
Sec. 60. Minnesota Statutes 1997 Supplement, section
256J.30, subdivision 11, is amended to read:
Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE
RIGHTS.] To be eligible An assistance unit is ineligible for
MFIP-S, unless the caregiver must assign assigns all rights to
child support and spousal maintenance benefits according
to sections 256.74, subdivision 5, and section 256.741, if
enacted.
Sec. 61. Minnesota Statutes 1997 Supplement, section
256J.31, subdivision 5, is amended to read:
Subd. 5. [MAILING OF NOTICE.] The notice of adverse action
shall be issued according to paragraphs (a) to (c).
(a) A county agency shall mail a notice of adverse action
at least ten days before the effective date of the adverse
action, except as provided in paragraphs (b) and (c).
(b) A county agency must mail a notice of adverse action at
least five days before the effective date of the adverse action
when the county agency has factual information that requires an
action to reduce, suspend, or terminate assistance based on
probable fraud.
(c) A county agency shall mail a notice of adverse action
before or on the effective date of the adverse action when the
county agency:
(1) receives the caregiver's signed monthly MFIP-S
household report form that includes information that requires
payment reduction, suspension, or termination;
(2) is informed of the death of a participant or the payee;
(3) receives a signed statement from the caregiver that
assistance is no longer wanted;
(4) receives a signed statement from the caregiver that
provides information that requires the termination or reduction
of assistance;
(5) verifies that a member of the assistance unit is absent
from the home and does not meet temporary absence provisions in
section 256J.13;
(6) verifies that a member of the assistance unit has
entered a regional treatment center or a licensed residential
facility for medical or psychological treatment or
rehabilitation;
(7) verifies that a member of an assistance unit has been
placed in foster care, and the provisions of section 256J.13,
subdivision 2, paragraph (b) (c), clause (2), do not apply;
(8) verifies that a member of an assistance unit has been
approved to receive assistance by another state; or
(9) cannot locate a caregiver.
Sec. 62. Minnesota Statutes 1997 Supplement, section
256J.31, subdivision 10, is amended to read:
Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or
earnings of a caregiver while participating in full or part-time
employment or training shall be protected from garnishment.
This protection for earnings shall extend for a period of six
months from the date of termination from MFIP-S.
Sec. 63. Minnesota Statutes 1997 Supplement, section
256J.31, is amended by adding a subdivision to read:
Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A
participant may discontinue receipt of the cash assistance
portion of MFIP-S assistance and retain eligibility for child
care assistance under section 119B.05 and for medical assistance
under sections 256B.055, subdivision 3a, and 256B.0635.
Sec. 64. Minnesota Statutes 1997 Supplement, section
256J.32, subdivision 4, is amended to read:
Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall
verify the following at application:
(1) identity of adults;
(2) presence of the minor child in the home, if
questionable;
(3) relationship of a minor child to caregivers in the
assistance unit;
(4) age, if necessary to determine MFIP-S eligibility;
(5) immigration status;
(6) social security number in accordance with according to
the requirements of section 256J.30, subdivision 12;
(7) income;
(8) self-employment expenses used as a deduction;
(9) source and purpose of deposits and withdrawals from
business accounts;
(10) spousal support and child support payments made to
persons outside the household;
(11) real property;
(12) vehicles;
(13) checking and savings accounts;
(14) savings certificates, savings bonds, stocks, and
individual retirement accounts;
(15) pregnancy, if related to eligibility;
(16) inconsistent information, if related to eligibility;
(17) medical insurance;
(18) anticipated graduation date of an 18-year-old;
(19) burial accounts;
(20) school attendance, if related to eligibility; and
(21) residence;
(22) a claim of domestic violence if used as a basis for a
deferral or exemption from the 60-month time limit in section
256J.42 or employment and training services requirements in
section 256J.56; and
(23) disability if used as an exemption from employment and
training services requirements under section 256J.56.
Sec. 65. Minnesota Statutes 1997 Supplement, section
256J.32, subdivision 6, is amended to read:
Subd. 6. [RECERTIFICATION.] The county agency shall
recertify eligibility in an annual face-to-face interview with
the participant and verify the following:
(1) presence of the minor child in the home, if
questionable;
(2) income, unless excluded, including self-employment
expenses used as a deduction or deposits or withdrawals from
business accounts;
(3) assets when the value is within $200 of the asset
limit; and
(4) inconsistent information, if related to eligibility.
Sec. 66. Minnesota Statutes 1997 Supplement, section
256J.32, is amended by adding a subdivision to read:
Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF
PRIVATE DATA.] County agencies in consultation with the
commissioner of human services shall provide notification to
undocumented persons regarding the release of personal data to
the Immigration and Naturalization Service and develop protocol
regarding the release or sharing of data about undocumented
persons with the Immigration and Naturalization Service as
required under sections 404, 434, and 411A of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996.
Sec. 67. Minnesota Statutes 1997 Supplement, section
256J.33, subdivision 1, is amended to read:
Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county
agency must determine MFIP-S eligibility prospectively for a
payment month based on retrospectively assessing income and the
county agency's best estimate of the circumstances that will
exist in the payment month.
Except as described in section 256J.34, subdivision 1, when
prospective eligibility exists, a county agency must calculate
the amount of the assistance payment using retrospective
budgeting. To determine MFIP-S eligibility and the assistance
payment amount, a county agency must apply countable income,
described in section 256J.37, subdivisions 3 to 10, received by
members of an assistance unit or by other persons whose income
is counted for the assistance unit, described under sections
256J.21 and 256J.37, subdivisions 1 and to 2.
This income must be applied to the transitional standard,
shared household standard, or family wage standard subject to
this section and sections 256J.34 to 256J.36. Income received
in a calendar month and not otherwise excluded under section
256J.21, subdivision 2, must be applied to the needs of an
assistance unit.
Sec. 68. Minnesota Statutes 1997 Supplement, section
256J.33, subdivision 4, is amended to read:
Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply
the monthly income test retrospectively for each month of MFIP-S
eligibility. An assistance unit is not eligible when the
countable income equals or exceeds the transitional standard,
the shared household standard, or the family wage level for the
assistance unit. The income applied against the monthly income
test must include:
(1) gross earned income from employment, prior to mandatory
payroll deductions, voluntary payroll deductions, wage
authorizations, and after the disregards in section 256J.21,
subdivision 3 4, and the allocations in section 256J.36, unless
the employment income is specifically excluded under section
256J.21, subdivision 2;
(2) gross earned income from self-employment less
deductions for self-employment expenses in section 256J.37,
subdivision 5, but prior to any reductions for personal or
business state and federal income taxes, personal FICA, personal
health and life insurance, and after the disregards in section
256J.21, subdivision 3 4, and the allocations in section
256J.36;
(3) unearned income after deductions for allowable expenses
in section 256J.37, subdivision 9, and allocations in section
256J.36, unless the income has been specifically excluded in
section 256J.21, subdivision 2;
(4) gross earned income from employment as determined under
clause (1) which is received by a member of an assistance unit
who is a minor child or minor caregiver and less than a
half-time student;
(5) child support and spousal support received or
anticipated to be received by an assistance unit;
(6) the income of a parent when that parent is not included
in the assistance unit;
(7) the income of an eligible relative and spouse who seek
to be included in the assistance unit; and
(8) the unearned income of a minor child included in the
assistance unit.
Sec. 69. Minnesota Statutes 1997 Supplement, section
256J.35, is amended to read:
256J.35 [AMOUNT OF ASSISTANCE PAYMENT.]
Except as provided in paragraphs (a) to (c) (d), the amount
of an assistance payment is equal to the difference between the
transitional standard, shared household standard, or the
Minnesota family wage level in section 256J.24, whichever is
less, and countable income.
(a) When MFIP-S eligibility exists for the month of
application, the amount of the assistance payment for the month
of application must be prorated from the date of application or
the date all other eligibility factors are met for that
applicant, whichever is later. This provision applies when an
applicant loses at least one day of MFIP-S eligibility.
(b) MFIP-S overpayments to an assistance unit must be
recouped according to section 256J.38, subdivision 4.
(c) An initial assistance payment must not be made to an
applicant who is not eligible on the date payment is made.
(d) An individual whose needs have been otherwise provided
for in another state, in whole or in part by county, state, or
federal dollars during a month, is ineligible to receive MFIP-S
for the month.
Sec. 70. Minnesota Statutes 1997 Supplement, section
256J.36, is amended to read:
256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD
MEMBERS.]
Except as prohibited in paragraphs (a) and (b), an
allocation of income is allowed from the caregiver's income to
meet the unmet need of an ineligible spouse or an ineligible
child under the age of 21 for whom the caregiver is financially
responsible who also lives with the caregiver. An allocation is
allowed from the caregiver's income to meet the need of an
ineligible or excluded person. That allocation is allowed in an
amount up to the difference between the MFIP-S family allowance
transitional standard for the assistance unit when that excluded
or ineligible person is included in the assistance unit and the
MFIP-S family allowance for the assistance unit when
the excluded or ineligible person is not included in the
assistance unit. These allocations must be deducted from the
caregiver's counted earnings and from unearned income subject to
paragraphs (a) and (b).
(a) Income of a minor child in the assistance unit must not
be allocated to meet the need of a an ineligible person who is
not a member of the assistance unit, including the child's
parent, even when that parent is the payee of the child's income.
(b) Income of an assistance unit a caregiver must not be
allocated to meet the needs of a disqualified person ineligible
for failure to cooperate with program requirements including
child support requirements, a person ineligible due to fraud, or
a relative caregiver and the caregiver's spouse who opt out of
the assistance unit.
Sec. 71. Minnesota Statutes 1997 Supplement, section
256J.37, subdivision 1, is amended to read:
Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD
MEMBERS.] Unless otherwise provided under subdivision 1a or 1b,
the income of ineligible household members must be deemed after
allowing the following disregards:
(1) the first 18 percent of the excluded ineligible family
member's gross earned income;
(2) amounts the ineligible person actually paid to
individuals not living in the same household but whom the
ineligible person claims or could claim as dependents for
determining federal personal income tax liability;
(3) child or spousal support paid to a person who lives
outside of the household all payments made by the ineligible
person according to a court order for spousal support or the
support of children not living in the assistance unit's
household, provided that, if there has been a change in the
financial circumstances of the ineligible person since the
support order was entered, the ineligible person has petitioned
for a modification of the support order; and
(4) an amount for the needs of the ineligible person and
other persons who live in the household but are not included in
the assistance unit and are or could be claimed by an ineligible
person as dependents for determining federal personal income tax
liability. This amount is equal to the difference between the
MFIP-S need transitional standard when the excluded ineligible
person is included in the assistance unit and the MFIP-S need
transitional standard when the excluded ineligible person is not
included in the assistance unit.
Sec. 72. Minnesota Statutes 1997 Supplement, section
256J.37, is amended by adding a subdivision to read:
Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The
income of disqualified members must be deemed after allowing the
following disregards:
(1) the first 18 percent of the disqualified member's gross
earned income;
(2) amounts the disqualified member actually paid to
individuals not living in the same household but whom the
disqualified member claims or could claim as dependents for
determining federal personal income tax liability;
(3) all payments made by the disqualified member according
to a court order for spousal support or the support of children
not living in the assistance unit's household, provided that, if
there has been a change in the financial circumstances of the
disqualified member's legal obligation to pay support since the
support order was entered, the disqualified member has
petitioned for a modification of the support order; and
(4) an amount for the needs of other persons who live in
the household but are not included in the assistance unit and
are or could be claimed by the disqualified member as dependents
for determining federal personal income tax liability. This
amount is equal to the difference between the MFIP-S
transitional standard when the ineligible person is included in
the assistance unit and the MFIP-S transitional standard when
the ineligible person is not included in the assistance unit.
An amount shall not be allowed for the needs of a disqualified
member.
Sec. 73. Minnesota Statutes 1997 Supplement, section
256J.37, is amended by adding a subdivision to read:
Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR
CAREGIVERS.] In households where minor caregivers live with a
parent or parents who do not receive MFIP-S, the income of the
parents must be deemed after allowing the following disregards:
(1) income of the parents equal to 200 percent of the
federal poverty guideline for a family size not including the
minor parent and the minor parent's child in the household
according to section 256J.21, subdivision 2, clause (43);
(2) 18 percent of the parents' gross earned income;
(3) amounts the parents actually paid to individuals not
living in the same household but whom the parents claim or could
claim as dependents for determining federal personal income tax
liability; and
(4) all payments made by parents according to a court order
for spousal support or the support of children not living in the
parent's household, provided that, if there has been a change in
the financial circumstances of the parent's legal obligation to
pay support since the support order was entered, the parents
have petitioned for a modification of the support order.
Sec. 74. Minnesota Statutes 1997 Supplement, section
256J.37, subdivision 2, is amended to read:
Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF
NONCITIZENS.] All income and assets of a sponsor, or sponsor's
spouse, who executed an affidavit of support for a noncitizen
must be deemed to be unearned income of the noncitizen as
specified in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law Number 104-193,
sections 421 and 422, and subsequently set out in federal
rules. If a noncitizen applies for or receives MFIP-S, the
county must deem the income and assets of the noncitizen's
sponsor and the sponsor's spouse who have signed an affidavit of
support for the noncitizen as specified in Public Law Number
104-193, title IV, sections 421 and 422, the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996.
The income of a sponsor and the sponsor's spouse is considered
unearned income of the noncitizen. The assets of a sponsor and
the sponsor's spouse are considered available assets of the
noncitizen.
Sec. 75. Minnesota Statutes 1997 Supplement, section
256J.37, subdivision 9, is amended to read:
Subd. 9. [UNEARNED INCOME.] (a) The county agency must
apply unearned income, including housing subsidies as in
paragraph (b), to the transitional standard. When determining
the amount of unearned income, the county agency must deduct the
costs necessary to secure payments of unearned income. These
costs include legal fees, medical fees, and mandatory deductions
such as federal and state income taxes.
(b) Effective July 1, 1998 1999, the county agency shall
count $100 of the value of public and assisted rental subsidies
provided through the Department of Housing and Urban Development
(HUD) as unearned income. The full amount of the subsidy must
be counted as unearned income when the subsidy is less than $100.
Sec. 76. Minnesota Statutes 1997 Supplement, section
256J.38, subdivision 1, is amended to read:
Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant
or former participant receives an overpayment due to agency,
client, or ATM error, or due to assistance received while an
appeal is pending and the participant or former participant is
determined ineligible for assistance or for less assistance than
was received, the county agency must recoup or recover the
overpayment under using the conditions of this
section. following methods:
(1) reconstruct each affected budget month and
corresponding payment month;
(2) use the policies and procedures that were in effect for
the payment month; and
(3) do not allow employment disregards in section 256J.21,
subdivision 3 or 4, in the calculation of the overpayment when
the unit has not reported within two calendar months following
the end of the month in which the income was received.
Sec. 77. Minnesota Statutes 1997 Supplement, section
256J.39, subdivision 2, is amended to read:
Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to
paying assistance directly to a participant may be used when:
(1) a county agency determines that a vendor payment is the
most effective way to resolve an emergency situation pertaining
to basic needs;
(2) a caregiver makes a written request to the county
agency asking that part or all of the assistance payment be
issued by protective or vendor payments for shelter and utility
service only. The caregiver may withdraw this request in
writing at any time;
(3) a caregiver has exhibited a continuing pattern of
mismanaging funds as determined by the county agency;
(4) the vendor payment is part of a sanction under section
256J.46, subdivision 2; or
(5) (4) the vendor payment is required under section
256J.24, subdivision 8, 256J.26, or 256J.43;
(5) protective payments are required for minor parents
under section 256J.14; or
(6) a caregiver has exhibited a continuing pattern of
mismanaging funds as determined by the county agency.
The director of a county agency must approve a proposal for
protective or vendor payment for money mismanagement when there
is a pattern of mismanagement under clause (6). During the time
a protective or vendor payment is being made, the county agency
must provide services designed to alleviate the causes of the
mismanagement.
The continuing need for and method of payment must be
documented and reviewed every 12 months. The director of a
county agency must approve the continuation of protective or
vendor payments. when it appears that the need for protective or
vendor payments will continue or is likely to continue beyond
two years because the county agency's efforts have not resulted
in sufficiently improved use of assistance on behalf of the
minor child, judicial appointment of a legal guardian or other
legal representative must be sought by the county agency.
Sec. 78. Minnesota Statutes 1997 Supplement, section
256J.395, is amended to read:
256J.395 [VENDOR PAYMENT OF RENT SHELTER COSTS AND
UTILITIES.]
Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1,
1997, when a county is required to provide assistance to
a recipient participant in vendor form for rent shelter costs
and utilities under this chapter, or chapter 256, 256D, or 256K,
the cost of utilities for a given family may be assumed to be:
(1) the average of the actual monthly cost of utilities for
that family for the prior 12 months at the family's current
residence, if applicable;
(2) the monthly plan amount, if any, set by the local
utilities for that family at the family's current residence; or
(3) the estimated monthly utility costs for the dwelling in
which the family currently resides.
(b) For purposes of this section, "utility" means any of
the following: municipal water and sewer service; electric,
gas, or heating fuel service; or wood, if that is the heating
source.
(c) In any instance where a vendor payment for rent is
directed to a landlord not legally entitled to the payment, the
county social services agency shall immediately institute
proceedings to collect the amount of the vendored rent payment,
which shall be considered a debt under section 270A.03,
subdivision 5.
Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county
agency is required to provide assistance to a participant in
vendor payment form for shelter costs or utilities under
subdivision 1, and the participant does not give the agency the
information needed to pay the vendor, the county agency shall
notify the participant of the intent to terminate assistance by
mail at least ten days before the effective date of the adverse
action.
(b) The notice of action shall include a request for
information about:
(1) the amount of the participant's shelter costs or
utilities;
(2) the due date of the shelter costs or utilities; and
(3) the name and address of the landlord, contract for deed
holder, mortgage company, and utility vendor.
(c) If the participant fails to provide the requested
information by the effective date of the adverse action, the
county must terminate the MFIP-S grant. If the applicant or
participant verifies they do not have shelter costs or utility
obligations, the county shall not terminate assistance if the
assistance unit is otherwise eligible.
Subd. 3. [DISCONTINUING VENDOR PAYMENTS DUE TO DISPUTE
WITH LANDLORD.] The county agency shall discontinue vendor
payments for shelter costs imposed under this chapter when the
vendor payment interferes with the participant's right to
withhold rent due to a dispute with the participant's landlord
in accordance with federal, state, or local housing laws.
Sec. 79. Minnesota Statutes 1997 Supplement, section
256J.42, is amended to read:
256J.42 [60-MONTH TIME LIMIT.]
Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions
in this section and in section 256J.11, subdivision 2, an
assistance unit in which any adult caregiver has received 60
months of cash assistance funded in whole or in part by the TANF
block grant in this or any other state or United States
territory, MFIP-S, AFDC, or family general assistance, funded in
whole or in part by state appropriations, is ineligible to
receive MFIP-S. Any cash assistance funded with TANF dollars in
this or any other state or United States territory, or MFIP-S
assistance funded in whole or in part by state appropriations,
that was received by the unit on or after the date TANF was
implemented, including any assistance received in states or
United States territories of prior residence, counts toward the
60-month limitation. The 60-month limit applies to a minor who
is the head of a household or who is married to the head of a
household except under subdivision 5. The 60-month time period
does not need to be consecutive months for this provision to
apply.
(b) Months before July 1998 in which individuals receive
assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R
comparison group family under sections 256.031 to 256.0361 or
sections 256.047 to 256.048 are not included in the 60-month
time limit.
Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual
whose needs have been otherwise provided for in another state,
in whole or in part by the TANF block grant during a month, is
ineligible to receive MFIP-S for the month.
Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In
determining the number of months for which an adult has received
assistance under MFIP-S, the county agency must disregard any
month during which the adult lived on an Indian reservation if,
during the month:
(1) at least 1,000 individuals were living on the
reservation; and
(2) at least 50 percent of the adults living on the
reservation were unemployed not employed.
Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash
assistance received by an assistance unit in a month when a
caregiver is complying with a safety plan under the MFIP-S
employment and training component does not count toward the
60-month limitation on assistance.
Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash
assistance received by an assistance unit does not count toward
the 60-month limit on assistance during a month in which
the parental caregiver is in the category in section 256J.56,
clause (1). The exemption applies for the period of time the
caregiver belongs to one of the categories specified in this
subdivision.
(b) From July 1, 1997, until the date MFIP-S is operative
in the caregiver's county of financial responsibility, any cash
assistance received by a caregiver who is complying with
sections 256.73, subdivision 5a, and 256.736, if applicable,
does not count toward the 60-month limit on assistance.
Thereafter, any cash assistance received by a minor caregiver
who is complying with the requirements of sections 256J.14 and
256J.54, if applicable, does not count towards the 60-month
limit on assistance.
(c) Any diversionary assistance or emergency assistance
received does not count toward the 60-month limit.
(d) Any cash assistance received by an 18- or 19-year-old
caregiver who is complying with the requirements of section
256J.54 does not count toward the 60-month limit.
Sec. 80. Minnesota Statutes 1997 Supplement, section
256J.43, is amended to read:
256J.43 [INTERSTATE PAYMENT STANDARDS.]
Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the
amount of assistance paid to an eligible family unit in which
all members have resided in this state for fewer than 12
consecutive calendar months immediately preceding the date of
application shall be the lesser of either the payment interstate
transitional standard that would have been received by
the family assistance unit from the state of immediate prior
residence, or the amount calculated in accordance with AFDC or
MFIP-S standards. The lesser payment must continue until
the family assistance unit meets the 12-month requirement. An
assistance unit that has not resided in Minnesota for 12 months
from the date of application is not exempt from the interstate
payment provisions solely because a child is born in Minnesota
to a member of the assistance unit. Payment must be calculated
by applying this state's budgeting policies, and the unit's net
income must be deducted from the payment standard in the other
state or in this state, whichever is lower. Payment shall be
made in vendor form for rent shelter and utilities, up to the
limit of the grant amount, and residual amounts, if any, shall
be paid directly to the assistance unit.
(b) During the first 12 months a family an assistance unit
resides in this state, the number of months that a family unit
is eligible to receive AFDC or MFIP-S benefits is limited to the
number of months the family assistance unit would have been
eligible to receive similar benefits in the state of immediate
prior residence.
(c) This policy applies whether or not the family
assistance unit received similar benefits while residing in the
state of previous residence.
(d) When a family an assistance unit moves to this state
from another state where the family assistance unit has
exhausted that state's time limit for receiving benefits under
that state's TANF program, the family unit will not be eligible
to receive any AFDC or MFIP-S benefits in this state for 12
months from the date the family assistance unit moves here.
(e) For the purposes of this section, "state of immediate
prior residence" means:
(1) the state in which the applicant declares the applicant
spent the most time in the 30 days prior to moving to this
state; or
(2) the state in which an applicant who is a migrant worker
maintains a home.
(f) The commissioner shall annually verify and update all
other states' payment standards as they are to be in effect in
July of each year.
(g) Applicants must provide verification of their state of
immediate prior residence, in the form of tax statements, a
driver's license, automobile registration, rent receipts, or
other forms of verification approved by the commissioner.
(h) Migrant workers, as defined in section 256J.08, and
their immediate families are exempt from this section, provided
the migrant worker provides verification that the migrant family
worked in this state within the last 12 months and earned at
least $1,000 in gross wages during the time the migrant worker
worked in this state.
Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an
assistance unit that has met the requirements of section
256J.12, the number of months that the assistance unit receives
benefits under the interstate payment standards in this section
is not affected by an absence from Minnesota for fewer than 30
consecutive days.
(b) For an assistance unit that has met the requirements of
section 256J.12, the number of months that the assistance unit
receives benefits under the interstate payment standards in this
section is not affected by an absence from Minnesota for more
than 30 consecutive days but fewer than 90 consecutive days,
provided the assistance unit continues to maintain a residence
in Minnesota during the period of absence.
Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT
POLICY.] Applicants who lived in another state in the 12 months
prior to applying for assistance are exempt from the interstate
payment policy for the months that a member of the unit:
(1) served in the United States armed services, provided
the person returned to Minnesota within 30 days of leaving the
armed forces, and intends to remain in Minnesota;
(2) attended school in another state, paid nonresident
tuition or Minnesota tuition rates under a reciprocity
agreement, provided the person left Minnesota specifically to
attend school and returned to Minnesota within 30 days of
graduation with the intent to remain in Minnesota; or
(3) meets the following criteria:
(i) a minor child or a minor caregiver moves from another
state to the residence of a relative caregiver;
(ii) the minor caregiver applies for and receives family
cash assistance;
(iii) the relative caregiver chooses not to be part of the
MFIP-S assistance unit; and
(iv) the relative caregiver has resided in Minnesota for at
least 12 months from the date the assistance unit applies for
cash assistance.
Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible
mandatory unit members who have resided in Minnesota for 12
months immediately before the unit's date of application
establish the other assistance unit members' eligibility for the
MFIP-S transitional standard.
Sec. 81. Minnesota Statutes 1997 Supplement, section
256J.45, subdivision 1, is amended to read:
Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A
county agency must provide each MFIP-S caregiver with a
face-to-face orientation. The caregiver must attend the
orientation. The county agency must inform the caregiver that
failure to attend the orientation is considered a first an
occurrence of noncompliance with program requirements, and will
result in the imposition of a sanction under section
256J.46. If the client complies with the orientation
requirement prior to the first day of the month in which the
grant reduction is proposed to occur, the orientation sanction
shall be lifted.
Sec. 82. Minnesota Statutes 1997 Supplement, section
256J.45, subdivision 2, is amended to read:
Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation
must consist of a presentation that informs caregivers of:
(1) the necessity to obtain immediate employment;
(2) the work incentives under MFIP-S;
(3) the requirement to comply with the employment plan and
other requirements of the employment and training services
component of MFIP-S, including a description of the range of
work and training activities that are allowable under MFIP-S to
meet the individual needs of participants;
(4) the consequences for failing to comply with the
employment plan and other program requirements, and that the
county agency may not impose a sanction when failure to comply
is due to the unavailability of child care or other
circumstances where the participant has good cause under section
256J.45, subdivision 3;
(5) the rights, responsibilities, and obligations of
participants;
(6) the types and locations of child care services
available through the county agency;
(7) the availability and the benefits of the early
childhood health and developmental screening under sections
123.701 to 123.74;
(8) the caregiver's eligibility for transition year child
care assistance under section 119B.05;
(9) the caregiver's eligibility for extended medical
assistance when the caregiver loses eligibility for MFIP-S due
to increased earnings or increased child or spousal support; and
(10) the caregiver's option to choose an employment and
training provider and information about each provider, including
but not limited to, services offered, program components, job
placement rates, job placement wages, and job retention rates;
(11) the caregiver's option to request approval of an
education and training plan according to section 256J.52; and
(12) the work study programs available under the higher
educational system.
Sec. 83. Minnesota Statutes 1997 Supplement, section
256J.45, is amended by adding a subdivision to read:
Subd. 3. [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING
ORIENTATION.] (a) The county agency shall not impose the
sanction under section 256J.46 if it determines that the
participant has good cause for failing to attend orientation.
Good cause exists when:
(1) appropriate child care is not available;
(2) the participant is ill or injured;
(3) a family member is ill and needs care by the
participant that prevents the participant from attending
orientation;
(4) the caregiver is unable to secure necessary
transportation;
(5) the caregiver is in an emergency situation that
prevents orientation attendance;
(6) the orientation conflicts with the caregiver's work,
training, or school schedule; or
(7) the caregiver documents other verifiable impediments to
orientation attendance beyond the caregiver's control.
(b) Counties must work with clients to provide child care
and transportation necessary to ensure a caregiver has every
opportunity to attend orientation.
Sec. 84. Minnesota Statutes 1997 Supplement, section
256J.46, subdivision 1, is amended to read:
Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING
WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without
good cause to comply with the requirements of this chapter, and
who is not subject to a sanction under subdivision 2, shall be
subject to a sanction as provided in this subdivision.
A sanction under this subdivision becomes effective ten
days after the month following the month in which a required
notice is given. A sanction must not be imposed when a
participant comes into compliance with the requirements for
orientation under section 256J.45 or third party liability for
medical services under section 256J.30, subdivision 10, prior to
the effective date of the sanction. A sanction must not be
imposed when a participant comes into compliance with the
requirements for employment and training services under sections
256J.49 to 256J.72 ten days prior to the effective date of the
sanction. For purposes of this subdivision, each month that a
participant fails to comply with a requirement of this chapter
shall be considered a separate occurrence of noncompliance. A
participant who has had one or more sanctions imposed must
remain in compliance with the provisions of this chapter for six
months in order for a subsequent occurrence of noncompliance to
be considered a first occurrence.
(b) Sanctions for noncompliance shall be imposed as follows:
(1) For the first occurrence of noncompliance by a
participant in a single-parent household or by one participant
in a two-parent household, the participant's assistance unit's
grant shall be reduced by ten percent of the applicable MFIP-S
transitional standard, the shared household standard, or the
interstate transitional standard for an assistance unit of the
same size, whichever is applicable, with the residual paid to
the participant. The reduction in the grant amount must be in
effect for a minimum of one month and shall be removed in the
month following the month that the participant returns to
compliance.
(2) For a second or subsequent occurrence of noncompliance,
or when both participants in a two-parent household are out of
compliance at the same time, the participant's rent assistance
unit's shelter costs shall be vendor paid up to the amount of
the cash portion of the MFIP-S grant for which the participant's
assistance unit is eligible. At county option,
the participant's assistance unit's utilities may also be vendor
paid up to the amount of the cash portion of the MFIP-S grant
remaining after vendor payment of the participant's rent
assistance unit's shelter costs. The vendor payment of rent
and, if in effect, utilities, must be in effect for six months
from the date that a sanction is imposed under this clause. The
residual amount of the grant after vendor payment, if any, must
be reduced by an amount equal to 30 percent of the applicable
MFIP-S transitional standard, the shared household standard, or
the interstate transitional standard for an assistance unit of
the same size, whichever is applicable, before the residual is
paid to the participant assistance unit. The reduction in the
grant amount must be in effect for a minimum of one month and
shall be removed in the month following the month that the a
participant in a one-parent household returns to compliance. In
a two-parent household, the grant reduction must be in effect
for a minimum of one month and shall be removed in the month
following the month both participants return to compliance. The
vendor payment of rent shelter costs and, if applicable,
utilities shall be removed six months after the month in which
the participant returns or participants return to compliance.
(c) No later than during the second month that a sanction
under paragraph (b), clause (2), is in effect due to
noncompliance with employment services, the participant's case
file must be reviewed to determine if:
(i) the continued noncompliance can be explained and
mitigated by providing a needed preemployment activity, as
defined in section 256J.49, subdivision 13, clause (16);
(ii) the participant qualifies for a good cause exception
under section 256J.57; or
(iii) the participant qualifies for an exemption under
section 256J.56.
If the lack of an identified activity can explain the
noncompliance, the county must work with the participant to
provide the identified activity, and the county must restore the
participant's grant amount to the full amount for which the
assistance unit is eligible. The grant must be restored
retroactively to the first day of the month in which the
participant was found to lack preemployment activities or to
qualify for an exemption or good cause exception.
If the participant is found to qualify for a good cause
exception or an exemption, the county must restore the
participant's grant to the full amount for which the assistance
unit is eligible. If the participant's grant is restored under
this paragraph, the vendor payment of rent and if applicable,
utilities, shall be removed six months after the month in which
the sanction was imposed and the county must consider a
subsequent occurrence of noncompliance to be a first occurrence.
Sec. 85. Minnesota Statutes 1997 Supplement, section
256J.46, subdivision 2, is amended to read:
Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT
REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to
cooperate, as determined by the child support enforcement
agency, with support requirements under section 256.741, if
enacted, shall be subject to sanction as specified in this
subdivision. The assistance unit's grant must be reduced by 25
percent of the applicable transitional standard. The residual
amount of the grant, if any, must be paid to the caregiver. A
sanction under this subdivision becomes effective ten days after
the first month following the month in which a required notice
is given. A sanction must not be imposed when a caregiver comes
into compliance with the requirements under section 256.741
prior to the effective date of the sanction. The sanction must
be in effect for a minimum of one month and shall be removed
only when in the month following the month that the caregiver
cooperates with the support requirements. Each month that an
MFIP-S caregiver fails to comply with the requirements of
section 256.741 must be considered a separate occurrence of
noncompliance. An MFIP-S caregiver who has had one or more
sanctions imposed must remain in compliance with the
requirements of section 256.741 for six months in order for a
subsequent sanction to be considered a first occurrence.
Sec. 86. Minnesota Statutes 1997 Supplement, section
256J.46, subdivision 2a, is amended to read:
Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the
provisions of subdivisions 1 and 2, for a participant subject to
a sanction for refusal to comply with child support requirements
under subdivision 2 and subject to a concurrent sanction for
refusal to cooperate with other program requirements under
subdivision 1, sanctions shall be imposed in the manner
prescribed in this subdivision.
A participant who has had one or more sanctions imposed
under this subdivision must remain in compliance with the
provisions of this chapter for six months in order for a
subsequent occurrence of noncompliance to be considered a first
occurrence. Any vendor payment of rent shelter costs or
utilities under this subdivision must remain in effect for six
months after the month in which the participant is no longer
subject to sanction under subdivision 1.
(b) If the participant was subject to sanction for:
(i) noncompliance under subdivision 1 before being subject
to sanction for noncooperation under subdivision 2; or
(ii) noncooperation under subdivision 2 before being
subject to sanction for noncompliance under subdivision 1;
the participant shall be sanctioned as provided in subdivision
1, paragraph (b), clause (2), and the requirement that the
county conduct a review as specified in subdivision 1, paragraph
(c), remains in effect.
(c) A participant who first becomes subject to sanction
under both subdivisions 1 and 2 in the same month is subject to
sanction as follows:
(i) in the first month of noncompliance and noncooperation,
the participant's grant must be reduced by 25 percent of the
applicable transitional standard, with any residual amount paid
to the participant;
(ii) in the second and subsequent months of noncompliance
and noncooperation, the participant shall be sanctioned as
provided in subdivision 1, paragraph (b), clause (2).
The requirement that the county conduct a review as
specified in subdivision 1, paragraph (c), remains in effect.
(d) A participant remains subject to sanction under
subdivision 2 if the participant:
(i) returns to compliance and is no longer subject to
sanction under subdivision 1; or
(ii) has the sanction under subdivision 1, paragraph (b),
removed upon completion of the review under subdivision 1,
paragraph (c).
A participant remains subject to sanction under subdivision
1, paragraph (b), if the participant cooperates and is no longer
subject to sanction under subdivision 2.
Sec. 87. Minnesota Statutes 1997 Supplement, section
256J.47, subdivision 4, is amended to read:
Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE;
AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary
assistance, the family is ineligible for MFIP-S, emergency
assistance, and emergency general assistance for a period of
time. To determine the period of ineligibility, the county
shall use the following formula: regardless of household
changes, the county agency must calculate the number of days of
ineligibility by dividing the diversionary assistance issued by
the transitional standard a family of the same size and
composition would have received under MFIP-S, or if applicable
the interstate transitional standard, multiplied by 30,
truncating the result. The ineligibility period begins the date
the diversionary assistance is issued.
Sec. 88. Minnesota Statutes 1997 Supplement, section
256J.48, subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility
provisions of this chapter, any family without resources
immediately available to meet emergency needs identified in
subdivision 3 shall be eligible for an emergency grant under the
following conditions:
(1) a family member has resided in this state for at least
30 days;
(2) the family is without resources immediately available
to meet emergency needs;
(3) assistance is necessary to avoid destitution or provide
emergency shelter arrangements; and
(4) the family's destitution or need for shelter or
utilities did not arise because the child or relative caregiver
refused without good cause under section 256J.57 to accept
employment or training for employment in this state or another
state; and
(5) at least one child or pregnant woman in the emergency
assistance unit meets MFIP-S citizenship requirements in section
256J.11.
Sec. 89. Minnesota Statutes 1997 Supplement, section
256J.48, subdivision 3, is amended to read:
Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to
the following:
(a) [RENT.] A county agency may deny assistance to prevent
eviction from rented or leased shelter of an otherwise eligible
applicant when the county agency determines that an applicant's
anticipated income will not cover continued payment for shelter,
subject to conditions in clauses (1) to (3):
(1) a county agency must not deny assistance when an
applicant can document that the applicant is unable to locate
habitable shelter, unless the county agency can document that
one or more habitable shelters are available in the community
that will result in at least a 20 percent reduction in monthly
expense for shelter and that this shelter will be cost-effective
for the applicant;
(2) when no alternative shelter can be identified by either
the applicant or the county agency, the county agency shall not
deny assistance because anticipated income will not cover rental
obligation; and
(3) when cost-effective alternative shelter is identified,
the county agency shall issue assistance for moving expenses as
provided in paragraph (d) (e).
(b) [DEFINITIONS.] For purposes of paragraph (a), the
following definitions apply (1) "metropolitan statistical area"
is as defined by the United States Census Bureau; (2)
"alternative shelter" includes any shelter that is located
within the metropolitan statistical area containing the county
and for which the applicant is eligible, provided the applicant
does not have to travel more than 20 miles to reach the shelter
and has access to transportation to the shelter. Clause (2)
does not apply to counties in the Minneapolis-St. Paul
metropolitan statistical area.
(c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county
agency shall issue assistance for mortgage or contract for deed
arrearages on behalf of an otherwise eligible applicant
according to clauses (1) to (4):
(1) assistance for arrearages must be issued only when a
home is owned, occupied, and maintained by the applicant;
(2) assistance for arrearages must be issued only when no
subsequent foreclosure action is expected within the 12 months
following the issuance;
(3) assistance for arrearages must be issued only when an
applicant has been refused refinancing through a bank or other
lending institution and the amount payable, when combined with
any payments made by the applicant, will be accepted by the
creditor as full payment of the arrearage;
(4) costs paid by a family which are counted toward the
payment requirements in this clause are: principal and interest
payments on mortgages or contracts for deed, balloon payments,
homeowner's insurance payments, manufactured home lot rental
payments, and tax or special assessment payments related to the
homestead. Costs which are not counted include closing costs
related to the sale or purchase of real property.
To be eligible for assistance for costs specified in clause
(4) which are outstanding at the time of foreclosure, an
applicant must have paid at least 40 percent of the family's
gross income toward these costs in the month of application and
the 11-month period immediately preceding the month of
application.
When an applicant is eligible under clause (4), a county
agency shall issue assistance up to a maximum of four times the
MFIP-S transitional standard for a comparable assistance unit.
(d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall
issue assistance for damage or utility deposits when necessary
to alleviate the emergency. The county may require that
assistance paid in the form of a damage deposit or a utility
deposit, less any amount retained by the landlord to remedy a
tenant's default in payment of rent or other funds due to the
landlord under a rental agreement, or to restore the premises to
the condition at the commencement of the tenancy, ordinary wear
and tear excepted, be returned to the county when the individual
vacates the premises or be paid to the recipient's new landlord
as a vendor payment. The county may require that assistance
paid in the form of a utility deposit less any amount retained
to satisfy outstanding utility costs be returned to the county
when the person vacates the premises, or be paid for the
person's new housing unit as a vendor payment. The vendor
payment of returned funds shall not be considered a new use of
emergency assistance.
(e) [MOVING EXPENSES.] A county agency shall issue
assistance for expenses incurred when a family must move to a
different shelter according to clauses (1) to (4):
(1) moving expenses include the cost to transport personal
property belonging to a family, the cost for utility connection,
and the cost for securing different shelter;
(2) moving expenses must be paid only when the county
agency determines that a move is cost-effective;
(3) moving expenses must be paid at the request of an
applicant, but only when destitution or threatened destitution
exists; and
(4) moving expenses must be paid when a county agency
denies assistance to prevent an eviction because the county
agency has determined that an applicant's anticipated income
will not cover continued shelter obligation in paragraph (a).
(f) [HOME REPAIRS.] A county agency shall pay for repairs
to the roof, foundation, wiring, heating system, chimney, and
water and sewer system of a home that is owned and lived in by
an applicant.
The applicant shall document, and the county agency shall
verify the need for and method of repair.
The payment must be cost-effective in relation to the
overall condition of the home and in relation to the cost and
availability of alternative housing.
(g) [UTILITY COSTS.] Assistance for utility costs must be
made when an otherwise eligible family has had a termination or
is threatened with a termination of municipal water and sewer
service, electric, gas or heating fuel service, or lacks wood
when that is the heating source, subject to the conditions in
clauses (1) and (2):
(1) a county agency must not issue assistance unless the
county agency receives confirmation from the utility provider
that assistance combined with payment by the applicant will
continue or restore the utility; and
(2) a county agency shall not issue assistance for utility
costs unless a family paid at least eight percent of the
family's gross income toward utility costs due during the
preceding 12 months.
Clauses (1) and (2) must not be construed to prevent the
issuance of assistance when a county agency must take immediate
and temporary action necessary to protect the life or health of
a child.
(h) [SPECIAL DIETS.] Effective January 1, 1998, a county
shall pay for special diets or dietary items for MFIP-S
participants. Persons receiving emergency assistance funds for
special diets or dietary items are also eligible to receive
emergency assistance for shelter and utility emergencies, if
otherwise eligible. The need for special diets or dietary items
must be prescribed by a licensed physician. Costs for special
diets shall be determined as percentages of the allotment for a
one-person household under the Thrifty Food Plan as defined by
the United States Department of Agriculture. The types of diets
and the percentages of the Thrifty Food Plan that are covered
are as follows:
(1) high protein diet, at least 80 grams daily, 25 percent
of Thrifty Food Plan;
(2) controlled protein diet, 40 to 60 grams and requires
special products, 100 percent of Thrifty Food Plan;
(3) controlled protein diet, less than 40 grams and
requires special products, 125 percent of Thrifty Food Plan;
(4) low cholesterol diet, 25 percent of Thrifty Food Plan;
(5) high residue diet, 20 percent of Thrifty Food Plan;
(6) pregnancy and lactation diet, 35 percent of Thrifty
Food Plan;
(7) gluten-free diet, 25 percent of Thrifty Food Plan;
(8) lactose-free diet, 25 percent of Thrifty Food Plan;
(9) antidumping diet, 15 percent of Thrifty Food Plan;
(10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or
(11) ketogenic diet, 25 percent of Thrifty Food Plan.
Sec. 90. Minnesota Statutes 1997 Supplement, section
256J.49, subdivision 4, is amended to read:
Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.]
"Employment and training service provider" means:
(1) a public, private, or nonprofit employment and training
agency certified by the commissioner of economic security under
sections 268.0122, subdivision 3, and 268.871, subdivision 1, or
is approved under section 256J.51 and is included in the county
plan submitted under section 256J.50, subdivision 7; or
(2) a public, private, or nonprofit agency that is not
certified by the commissioner under clause (1), but with which a
county has contracted to provide employment and training
services and which is included in the county's plan submitted
under section 256J.50, subdivision 7; or
(3) a county agency, if the county is certified under
clause (1) has opted to provide employment and training services
and the county has indicated that fact in the plan submitted
under section 256J.50, subdivision 7.
Notwithstanding section 268.871, an employment and training
services provider meeting this definition may deliver employment
and training services under this chapter.
Sec. 91. Minnesota Statutes 1997 Supplement, section
256J.50, subdivision 5, is amended to read:
Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND
TWO-PARENT CASES.] (a) A county must establish a uniform
schedule for requiring participation by single parents.
Mandatory participation must be required within six months of
eligibility for cash assistance. For two-parent cases,
participation is required concurrent with the receipt of MFIP-S
cash assistance.
(b) Beginning January 1, 1998, with the exception of
caregivers required to attend high school under the provisions
of section 256J.54, subdivision 5, MFIP caregivers, upon
completion of the secondary assessment, must develop an
employment plan and participate in work activities.
(c) Upon completion of the secondary assessment:
(1) In single-parent families with no children under six
years of age, the job counselor and the caregiver must develop
an employment plan that includes 20 to 35 hours per week of work
activities for the period January 1, 1998, to September 30,
1998; 25 to 35 hours of work activities per week in federal
fiscal year 1999; and 30 to 35 hours per week of work activities
in federal fiscal year 2000 and thereafter.
(2) In single-parent families with a child under six years
of age, the job counselor and the caregiver must develop an
employment plan that includes 20 to 35 hours per week of work
activities.
(3) In two-parent families, the job counselor and the
caregivers must develop employment plans which result in a
combined total of at least 55 hours per week of work activities.
Sec. 92. Minnesota Statutes 1997 Supplement, section
256J.50, is amended by adding a subdivision to read:
Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC
VIOLENCE.] County agencies and their contractors must provide
universal notification to all applicants and recipients of
MFIP-S that:
(1) referrals to counseling and supportive services are
available for victims of domestic violence;
(2) nonpermanent resident battered individuals married to
United States citizens or permanent residents may be eligible to
petition for permanent residency under the federal Violence
Against Women Act, and that referrals to appropriate legal
services are available;
(3) victims of domestic violence are exempt from the
60-month limit on assistance while the individual is complying
with an approved safety plan, as defined in section 256J.49,
subdivision 11; and
(4) victims of domestic violence may choose to be exempt or
deferred from work requirements for up to 12 months while the
individual is complying with an approved safety plan as defined
in section 256J.49, subdivision 11.
Notification must be in writing and orally at the time of
application and recertification, when the individual is referred
to the title IV-D child support agency, and at the beginning of
any job training or work placement assistance program.
Sec. 93. Minnesota Statutes 1997 Supplement, section
256J.50, is amended by adding a subdivision to read:
Subd. 11. [COORDINATION.] The county agency and the county
agency's employment and training providers must consult and
coordinate with other providers of employment and training
services to identify existing resources, in order to prevent
duplication of services, to assure that other programs' services
are available to enable participants to achieve
self-sufficiency, and to assure that costs for these other
services for which participants are eligible are not incurred by
MFIP-S. At a minimum, the county agency and its providers must
coordinate with Jobs Training and Partnership Act providers and
with any other relevant employment, training, and education
programs in the county.
Sec. 94. Minnesota Statutes 1997 Supplement, section
256J.515, is amended to read:
256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.]
During the first meeting with participants, job counselors
must ensure that an overview of employment and training services
is provided that: (1) stresses the necessity and opportunity of
immediate employment,; (2) outlines the job search resources
offered,; (3) outlines education or training opportunities
available; (4) describes the range of work activities, including
activities under section 256J.49, subdivision 13, clause (18),
that are allowable under MFIP-S to meet the individual needs of
participants; (5) explains the requirements to comply with an
employment plan and; (6) explains the consequences for failing
to comply,; and (7) explains the services that are available to
support job search and work and education.
Sec. 95. Minnesota Statutes 1997 Supplement, section
256J.52, subdivision 4, is amended to read:
Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor
must conduct a secondary assessment for those participants who:
(1) in the judgment of the job counselor, have barriers to
obtaining employment that will not be overcome with a job search
support plan under subdivision 3;
(2) have completed eight weeks of job search under
subdivision 3 without obtaining suitable employment; or
(3) have not received a secondary assessment, are working
at least 20 hours per week, and the participant, job counselor,
or county agency requests a secondary assessment; or
(4) have an existing job search plan or employment plan
developed for another program or are already involved in
training or education activities under section 256J.55,
subdivision 5.
(b) In the secondary assessment the job counselor must
evaluate the participant's skills and prior work experience,
family circumstances, interests and abilities, need for
preemployment activities, supportive or educational services,
and the extent of any barriers to employment. The job counselor
must use the information gathered through the secondary
assessment to develop an employment plan under subdivision 5.
(c) The provider shall make available to participants
information regarding additional vendors or resources which
provide employment and training services that may be available
to the participant under a plan developed under this section.
The information must include a brief summary of services
provided and related performance indicators. Performance
indicators must include, but are not limited to, the average
time to complete program offerings, placement rates, entry and
average wages, and retention rates. To be included in the
information given to participants, a vendor or resource must
provide counties with relevant information in the format
required by the county.
Sec. 96. Minnesota Statutes 1997 Supplement, section
256J.52, is amended by adding a subdivision to read:
Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT
EDUCATION AND TRAINING.] After a caregiver receiving MFIP-S has
been employed for six consecutive months, during which time the
caregiver works on average more than 20 hours per week, the
caregiver's job counselor shall inform the caregiver that the
caregiver may request a secondary assessment described in
subdivision 4 and shall provide information about:
(1) part-time education and training options available to
the caregiver; and
(2) child care and transportation resources available to
support postemployment education and training.
Sec. 97. Minnesota Statutes 1997 Supplement, section
256J.52, is amended by adding a subdivision to read:
Subd. 9. [TRAINING CONCURRENT WITH EMPLOYMENT.] An MFIP
caregiver who is meeting the minimum hourly work participation
requirements under the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 through employment must
be allowed to meet any additional MFIP-S hourly work
participation requirements through training or education that
meets the requirements of section 256J.53.
Sec. 98. Minnesota Statutes 1997 Supplement, section
256J.54, subdivision 2, is amended to read:
Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT
PLAN.] For caregivers who are under age 18 without a high school
diploma or its equivalent, the assessment under subdivision 1
and the employment plan under subdivision 3 must be completed by
the social services agency under section 257.33. For caregivers
who are age 18 or 19 without a high school diploma or its
equivalent, the assessment under subdivision 1 and the
employment plan under subdivision 3 must be completed by the job
counselor. The social services agency or the job counselor
shall consult with representatives of educational agencies that
are required to assist in developing educational plans under
section 126.235.
Sec. 99. Minnesota Statutes 1997 Supplement, section
256J.54, subdivision 3, is amended to read:
Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job
counselor or county social services agency identifies an
appropriate educational option for a caregiver under the age of
20 without a high school diploma or its equivalent, it the job
counselor or agency must develop an employment plan which
reflects the identified option. The plan must specify that
participation in an educational activity is required, what
school or educational program is most appropriate, the services
that will be provided, the activities the caregiver will take
part in, including child care and supportive services, the
consequences to the caregiver for failing to participate or
comply with the specified requirements, and the right to appeal
any adverse action. The employment plan must, to the extent
possible, reflect the preferences of the caregiver.
Sec. 100. Minnesota Statutes 1997 Supplement, section
256J.54, subdivision 4, is amended to read:
Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job
counselor determines that there is no appropriate educational
option for a caregiver who is age 18 or 19 without a high school
diploma or its equivalent, the job counselor must develop an
employment plan, as defined in section 256J.49, subdivision 5,
for the caregiver. If the county social services agency
determines that school attendance is not appropriate for a
caregiver under age 18 without a high school diploma or its
equivalent, the county agency shall refer the caregiver to
social services for services as provided in section 257.33.
Sec. 101. Minnesota Statutes 1997 Supplement, section
256J.54, subdivision 5, is amended to read:
Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding
the provisions of section 256J.56, minor parents, or 18- or
19-year-old parents without a high school diploma or its
equivalent must attend school unless:
(1) transportation services needed to enable the caregiver
to attend school are not available;
(2) appropriate child care services needed to enable the
caregiver to attend school are not available;
(3) the caregiver is ill or incapacitated seriously enough
to prevent attendance at school; or
(4) the caregiver is needed in the home because of the
illness or incapacity of another member of the household. This
includes a caregiver of a child who is younger than six weeks of
age.
(b) The caregiver must be enrolled in a secondary school
and meeting the school's attendance requirements. The county,
social service agency, or job counselor must verify at least
once per quarter that the caregiver is meeting the school's
attendance requirements. An enrolled caregiver is considered to
be meeting the attendance requirements when the school is not in
regular session, including during holiday and summer breaks.
Sec. 102. Minnesota Statutes 1997 Supplement, section
256J.55, subdivision 5, is amended to read:
Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job
counselor approval, if a participant is already complying with a
job search support or employment plan that was developed for a
different program or is already involved in education or
training activities, the participant may utilize continue that
plan and that program's services, subject to the requirements of
subdivision 3, to be in compliance with sections 256J.52 to
256J.57 so long as or activity if the plan meets, or is modified
to meet, the requirements of those sections 256J.52 to 256J.57,
and if the participant is concurrently employed and the
combination of the hours spent in education or training and
employment meets the hourly participation requirements. The
participant is not required to be employed if the number of
hours per week the participant is in education or training meets
the hourly work participation requirements.
Sec. 103. Minnesota Statutes 1997 Supplement, section
256J.56, is amended to read:
256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT;
EXEMPTIONS.]
(a) An MFIP-S caregiver is exempt from the requirements of
sections 256J.52 to 256J.55 if the caregiver belongs to any of
the following groups:
(1) individuals who are age 60 or older;
(2) individuals who are suffering from a professionally
certified permanent or temporary illness, injury, or incapacity
which is expected to continue for more than 30 days and which
prevents the person from obtaining or retaining employment.
Persons in this category with a temporary illness, injury, or
incapacity must be reevaluated at least quarterly;
(3) caregivers whose presence in the home is required
because of the professionally certified illness or incapacity of
another member in the assistance unit, a relative in the
household, or a foster child in the household;
(4) women who are pregnant, if the pregnancy has resulted
in a professionally certified incapacity that prevents the woman
from obtaining or retaining employment;
(5) caregivers of a child under the age of one year who
personally provide full-time care for the child. This exemption
may be used for only 12 months in a lifetime. In two-parent
households, only one parent or other relative may qualify for
this exemption;
(6) individuals who are single parents, or one parent in a
two-parent family, employed at least 40 hours per week or at
least 30 hours per week and engaged in job search for at least
an additional ten 35 hours per week;
(7) individuals experiencing a personal or family crisis
that makes them incapable of participating in the program, as
determined by the county agency. If the participant does not
agree with the county agency's determination, the participant
may seek professional certification, as defined in section
256J.08, that the participant is incapable of participating in
the program.
Persons in this exemption category must be reevaluated
every 60 days; or
(8) second parents in two-parent families, provided the
second parent is employed for 20 or more hours per week,
provided the first parent is employed at least 35 hours per week.
A caregiver who is exempt under clause (5) must enroll in
and attend an early childhood and family education class, a
parenting class, or some similar activity, if available, during
the period of time the caregiver is exempt under this section.
Notwithstanding section 256J.46, failure to attend the required
activity shall not result in the imposition of a sanction.
(b) The county agency must provide employment and training
services to MFIP-S caregivers who are exempt under this section,
but who volunteer to participate. Exempt volunteers may request
approval for any work activity under section 256J.49,
subdivision 13. The hourly participation requirements for
nonexempt caregivers under section 256J.50, subdivision 5, do
not apply to exempt caregivers who volunteer to participate.
Sec. 104. Minnesota Statutes 1997 Supplement, section
256J.57, subdivision 1, is amended to read:
Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The
county agency shall not impose the sanction under section
256J.46 if it determines that the participant has good cause for
failing to comply with the requirements of section 256J.45 or
sections 256J.52 to 256J.55. Good cause exists when:
(1) appropriate child care is not available;
(2) the job does not meet the definition of suitable
employment;
(3) the participant is ill or injured;
(4) a family member of the assistance unit, a relative in
the household, or a foster child in the household is ill and
needs care by the participant that prevents the participant from
complying with the job search support plan or employment plan;
(5) the parental caregiver is unable to secure necessary
transportation;
(6) the parental caregiver is in an emergency situation
that prevents compliance with the job search support plan or
employment plan;
(7) the schedule of compliance with the job search support
plan or employment plan conflicts with judicial proceedings;
(8) the parental caregiver is already participating in
acceptable work activities;
(9) the employment plan requires an educational program for
a caregiver under age 20, but the educational program is not
available;
(10) activities identified in the job search support plan
or employment plan are not available;
(11) the parental caregiver is willing to accept suitable
employment, but suitable employment is not available; or
(12) the parental caregiver documents other verifiable
impediments to compliance with the job search support plan or
employment plan beyond the parental caregiver's control.
Sec. 105. Minnesota Statutes 1997 Supplement, section
256J.645, subdivision 3, is amended to read:
Subd. 3. [FUNDING.] If the commissioner and an Indian
tribe are parties to an agreement under this subdivision, the
agreement may annually provide to the Indian tribe the funding
amount in clause (1) or (2):
(1) if the Indian tribe operated a tribal STRIDE program
during state fiscal year 1997, the amount to be provided is the
amount the Indian tribe received from the state for operation of
its tribal STRIDE program in state fiscal year 1997, except that
the amount provided for a fiscal year may increase or decrease
in the same proportion that the total amount of state and
federal funds available for MFIP-S employment and training
services increased or decreased that fiscal year; or
(2) if the Indian tribe did not operate a tribal STRIDE
program during state fiscal year 1997, the commissioner may
provide to the Indian tribe for the first year of operations the
amount determined by multiplying the state allocation for MFIP-S
employment and training services to each county agency in the
Indian tribe's service delivery area by the percentage of MFIP-S
recipients in that county who were members of the Indian tribe
during the previous state fiscal year. The resulting amount
shall also be the amount that the commissioner may provide to
the Indian tribe annually thereafter through an agreement under
this subdivision, except that the amount provided for a fiscal
year may increase or decrease in the same proportion that the
total amount of state and federal funds available for MFIP-S
employment and training services increased or decreased that
fiscal year.
Sec. 106. Minnesota Statutes 1997 Supplement, section
256J.74, subdivision 2, is amended to read:
Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county
agency must not count an applicant or participant as a member of
more than one assistance unit in a given payment month, except
as provided in clauses (1) and (2).
(1) A participant who is a member of an assistance unit in
this state is eligible to be included in a second assistance
unit in the first full month that after the month the
participant leaves the first assistance unit and lives with
a joins the second assistance unit.
(2) An applicant whose needs are met through foster care
that is reimbursed under title IV-E of the Social Security Act
for the first part of an application month is eligible to
receive assistance for the remaining part of the month in which
the applicant returns home. Title IV-E payments and adoption
assistance payments must be considered prorated payments rather
than a duplication of MFIP-S need.
Sec. 107. Minnesota Statutes 1997 Supplement, section
256J.74, is amended by adding a subdivision to read:
Subd. 5. [FOOD STAMPS.] For any month an individual
receives Food Stamp Program benefits, the individual is not
eligible for the MFIP-S food portion of assistance, except as
provided under section 256J.28, subdivision 5.
Sec. 108. [256J.77] [AGING OF CASH BENEFITS.]
Cash benefits under chapters 256D, 256J, and 256K by
warrants or electronic benefit transfer that have not been
accessed within 90 days of issuance shall be canceled. Cash
benefits may be replaced after they are canceled, for up to one
year after the date of issuance, if failure to do so would place
the client or family at risk. For purposes of this section,
"accessed" means cashing a warrant or making at least one
withdrawal from benefits deposited in an electronic benefit
account.
Sec. 109. Minnesota Statutes 1997 Supplement, section
256K.03, subdivision 5, is amended to read:
Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be
exempt from the job search requirements and development of a job
search plan and an employability development plan under
subdivisions 3, 4, and 8 if the applicant belongs to any of the
following groups:
(1) caregivers under age 20 who have not completed a high
school education and are attending high school on a full-time
basis;
(2) individuals who are age 60 or older;
(3) (2) individuals who are suffering from a professionally
certified permanent or temporary illness, injury, or incapacity
which is expected to continue for more than 30 days and which
prevents the person from obtaining or retaining employment.
Persons in this category with a temporary illness, injury, or
incapacity must be reevaluated at least quarterly;
(4) (3) caregivers whose presence in the home is needed
because of the professionally certified illness or incapacity of
another member in the assistance unit, a relative in the
household, or a foster child in the household;
(5) (4) women who are pregnant, if it the pregnancy has
been medically verified resulted in a professionally certified
incapacity that the child is expected to be born within the next
six months prevents the woman from obtaining and retaining
employment;
(6) (5) caregivers or other caregiver relatives of a child
under the age of three one year who personally provide full-time
care for the child. This exemption may be used for only 12
months in a lifetime. In two-parent households, only one parent
or other relative may qualify for this exemption;
(7) (6) individuals who are single parents or one parent in
a two-parent family employed at least 30 35 hours per week;
(8) individuals for whom participation would require a
round trip commuting time by available transportation of more
than two hours, excluding transporting of children for child
care;
(9) individuals for whom lack of proficiency in English is
a barrier to employment, provided such individuals are
participating in an intensive program which lasts no longer than
six months and is designed to remedy their language deficiency;
(10) individuals who, because of advanced age or lack of
ability, are incapable of gaining proficiency in English, as
determined by the county social worker, shall continue to be
exempt under this subdivision and are not subject to the
requirement that they be participating in a language program;
(11) (7) individuals under such duress that they are
incapable of participating in the program, as determined by the
county social worker experiencing a personal or family crisis
that makes them incapable of participating in the program, as
determined by the county agency. If the participant does not
agree with the county agency's determination, the participant
may seek professional certification, as defined in section
256J.08, that the participant is incapable of participating in
the program. Persons in this exemption category must be
reevaluated every 60 days; or
(12) individuals in need of refresher courses for purposes
of obtaining professional certification or licensure.
(b) In a two-parent family, only one caregiver may be
exempted under paragraph (a), clauses (4) and (6).
(8) second parents in two-parent families employed for 20
or more hours per week provided the first parent is employed at
least 35 hours per week.
(b) A caregiver who is exempt under clause (5) must enroll
in and attend an early childhood and family education class, a
parenting class, or some similar activity, if available, during
the period of time the caregiver is exempt under this section.
Notwithstanding section 256J.46, failure to attend the required
activity shall not result in the imposition of a sanction.
Sec. 110. Minnesota Statutes 1996, section 268.88, is
amended to read:
268.88 [LOCAL SERVICE UNIT PLANS.]
(a) By April 15, 1991 1999, and by April 15 of each second
year thereafter, local service units shall prepare and submit to
the commissioner a plan that covers the next two state fiscal
years. At least 30 days prior to submission of the plan, the
local service unit shall solicit comments from the public on the
contents of the proposed plan. The commissioner shall notify
each local service unit within 60 days of receipt of its plan
that the plan has been approved or disapproved. The plan must
include:
(1) a statement of objectives for the employment and
training services the local service unit administers;
(2) the establishment of job placement and job retention
goals, the establishment of public assistance caseload reduction
goals, and the strategies and programs that will be used to
achieve these goals;
(3) a statement of whether the goals from the preceding
year were met and an explanation if the local service unit
failed to meet the goals;
(4) the amount proposed to be allocated to each employment
and training service;
(5) the proposed types of employment and training services
the local service unit plans to utilize;
(6) a description of how the local service unit will use
funds provided under section 256.736 to meet the requirements of
that section. The description must include the two work
programs required by section 256.736, subdivision 10, paragraph
(a), clause (13), what services will be provided, number of
clients served, per service expenditures, type of clients
served, and projected outcomes chapter 256J to meet the
requirements of that chapter. The description must include what
services will be provided, per service expenditures, an estimate
of how many employment and training slots the local service unit
will provide, how many dollars the local service unit will
provide per slot per provider, how many participants per slot,
an estimate of the ratio of participants per job counselor, and
proposed uses for any residual funds not included in slot
allocations to providers;
(7) a report on the use of wage subsidies, grant
diversions, community investment programs, and other services
administered under this chapter;
(8) a performance review of the employment and training
service providers delivering employment and training services
for the local service unit;
(9) a copy of any contract between the local service unit
and an employment and training service provider including
expected outcomes and service levels for public assistance
clients; and
(10) a copy of any other agreements between educational
institutions, family support services, and child care providers;
and
(11) a description of how the local service unit ensures
compliance with section 256J.06, requiring community involvement
in the administration of MFIP-S.
(b) In counties with a city of the first class, the county
and the city shall develop and submit a joint plan. The plan
may not be submitted until agreed to by both the city and the
county. The plan must provide for the direct allocation of
employment and training money to the city and the county unless
waived by either. If the county and the city cannot concur on a
plan, the commissioner shall resolve their dispute. In counties
in which a federally recognized Indian tribe is operating an
employment and training program under an agreement with the
commissioner of human services, the plan must provide that the
county will coordinate its employment and training programs,
including developing a system for referrals, sanctions, and the
provision of supporting services such as access to child care
funds and transportation with programs operated by the Indian
tribe. The plan may not be given final approval by the
commissioner until the tribal unit and county have submitted
written agreement on these provisions in the plan. If the
county and Indian tribe cannot agree on these provisions, the
local service unit shall notify the commissioner of economic
security and the commissioners of economic security and human
services shall resolve the dispute.
(c) The commissioner may withhold the distribution of
employment and training money from a local service unit that
does not submit a plan to the commissioner by the date set by
this section, and shall withhold the distribution of employment
and training money from a local service unit whose plan has been
disapproved by the commissioner until an acceptable amended plan
has been submitted.
(d) Beginning April 15, 1992, and by April 15 of each
second year thereafter, local service units must prepare and
submit to the commissioner an interim year plan update that
deals with performance in that state fiscal year and changes
anticipated for the second year of the biennium. The update
must include information about employment and training programs
addressed in the local service unit's two-year plan and shall be
completed in accordance with criteria established by the
commissioner.
Sec. 111. Laws 1997, chapter 203, article 9, section 21,
is amended to read:
Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.]
(a) Beginning July 1, 1999 2000, the following persons will
be ineligible for general assistance and general assistance
medical care under Minnesota Statutes, chapter 256D, group
residential housing under Minnesota Statutes, chapter 256I, and
MFIP-S assistance under Minnesota Statutes, chapter 256J, funded
with state money:
(1) persons who are terminated from or denied Supplemental
Security Income due to the 1996 changes in the federal law
making persons whose alcohol or drug addiction is a material
factor contributing to the person's disability ineligible for
Supplemental Security Income, and are eligible for general
assistance under Minnesota Statutes, section 256D.05,
subdivision 1, paragraph (a), clause (17), general assistance
medical care under Minnesota Statutes, chapter 256D, or group
residential housing under Minnesota Statutes, chapter 256I;
(2) legal noncitizens who are ineligible for Supplemental
Security Income due to the 1996 changes in federal law making
certain noncitizens ineligible for these programs due to their
noncitizen status; and
(3) legal noncitizens who are eligible for MFIP-S
assistance, either the cash assistance portion or the food
assistance portion, funded entirely with state money.
(b) State money that remains unspent on June 30, 1999, due
to changes in federal law enacted after May 12, 1997, that
reduce state spending for legal noncitizens or for persons whose
alcohol or drug addiction is a material factor contributing to
the person's disability, or enacted after February 1, 1998, that
reduce state spending for food benefits for legal noncitizens
shall not cancel and shall be deposited in the TANF reserve
account.
Sec. 112. Laws 1997, chapter 248, section 46, as amended
by Laws 1997, First Special Session chapter 5, section 10, is
amended to read:
Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM
EXPANSION.]
(a) Notwithstanding Minnesota Statutes, section 245A.03,
subdivision 2, clause (2), until June 30, 1999, nonresidential
child care programs or services that are provided by an
unrelated individual to persons from two or three other
unrelated families are excluded from the licensure provisions of
Minnesota Statutes, chapter 245A, provided that:
(1) the individual provides services at any one time to no
more than four children who are unrelated to the individual;
(2) no more than two of the children are under two years of
age; and
(3) the total number of children being cared for at any one
time does not exceed five.
(b) Paragraph (a), clauses (1) to (3), do not apply to:
(1) nonresidential programs that are provided by an
unrelated individual to persons from a single related family.;
(2) a child care provider whose child care services meet
the criteria in paragraph (a), clauses (1) to (3), but who
chooses to apply for licensure;
(3) a child care provider who, as an applicant for
licensure or as a license holder, has received a license denial
under Minnesota Statutes, section 245A.05, a fine under
Minnesota Statutes, section 245A.06, or a sanction under
Minnesota Statutes, section 245A.07, from the commissioner that
has not been reversed on appeal; or
(4) a child care provider, or a child care provider who has
a household member who, as a result of a licensing process, has
a disqualification under Minnesota Statutes, chapter 245A, that
has not been set aside by the commissioner.
Sec. 113. [REPORT REQUIRED.]
Beginning January 1, 1999, the commissioner shall report
annually to the legislature on January 15 on the percent, for
each of the four quarters of the immediate preceding year, of
the MFIP-S caseload participants who are exempt from work under
the provisions of Minnesota Statutes, section 256J.56, clause
(2) or (3).
Sec. 114. [REPORT; NONCERTIFIED PROVIDERS.]
Beginning January 15, 1999, the commissioner of economic
security, in conjunction with the commissioner of human
services, shall report annually on the use in MFIP-S of
employment and training providers. The report shall include
information on the number and types of noncertified providers.
Sec. 115. [SCREENING AND REFERRAL GUIDELINES FOR
PARTICIPANTS WITH DRUG AND ALCOHOL PROBLEMS.]
The commissioner of human services shall develop guidelines
for county agencies and their contractors to identify
participants who have alcohol or drug problems that require
treatment. The guidelines must provide for:
(1) the use of simplified written and verbal screening
tools as part of the intake process;
(2) referral for clinical assessment and appropriate
treatment, if needed; and
(3) training for caseworkers to administer the screening
protocols and refer participants to services.
Sec. 116. [EBT TRANSACTION COSTS; APPROVAL FROM
LEGISLATURE.]
The commissioner of human services shall request and
receive approval from the legislature before adjusting the
payment to retailers for electronic benefit transfer transaction
costs.
Sec. 117. [STUDY; MFIP-S EXIT LEVEL; ELIMINATION OF
SHELTER EXPENSE DEDUCTION.]
The commissioner shall consider recommending to the 1999
legislature:
(1) adjustments to the MFIP-S earned income disregard,
family wage level, or transitional standard, which will ensure
that participants do not lose eligibility for MFIP-S until their
income reaches at least 120 percent of the 1999 federal poverty
level; and
(2) proposals responding to the effect of the elimination
of the food stamp shelter expense deduction on food spending and
food sufficiency of MFIP-S families paying greater than 50
percent of their income toward housing costs. The
commissioner's recommendations should include information on the
number of families losing greater than 20 percent of their food
benefits, the number losing between ten percent and 20 percent
and the number losing zero percent to ten percent, and the
characteristics of families receiving less food assistance under
MFIP-S. The commissioner may collaborate with private or
nonprofit entities, if necessary, to provide this information.
Sec. 118. [REPEALER.]
(a) Minnesota Statutes 1997 Supplement, section 256J.28,
subdivision 4, is repealed effective January 1, 1998.
(b) Minnesota Statutes 1997 Supplement, section 256J.25;
and Laws 1997, chapter 85, article 1, sections 61 and 71, and
article 3, section 55, are repealed.
(c) Minnesota Statutes 1996, sections 256.031, subdivisions
1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and
6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475;
256.048; and 256.049; and Minnesota Statutes 1997 Supplement,
sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1
and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34,
subdivision 5, are repealed effective July 1, 1998.
(d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110;
9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160;
9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and
9500.9220, are repealed effective July 1, 1998.
Sec. 119. [EFFECTIVE DATES.]
(a) Sections 2, 4, 7, 8, 19, 90, 95, and 102 are effective
the day following final enactment.
(b) Section 9 is effective June 1, 1998.
(c) Section 10 is effective October 1, 1998.
(d) Section 50 is effective for all applications for MFIP-S
made on or after July 1, 1998.
(e) Section 12 is effective March 30, 1998.
(f) Section 51 is effective for MFIP-S applications
received on or after January 1, 1999, and for all MFIP-S
recertifications occurring on or after January 1, 1999.
ARTICLE 7
REGIONAL TREATMENT CENTERS
Section 1. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.]
Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding
Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335,
subdivision 3, or any other law to the contrary, the
commissioner of administration may convey all, or any part of,
the land and associated buildings described in subdivision 3 to
Anoka county after the commissioner of human services declares
said property surplus to its needs.
Subd. 2. [FORM.] (a) The conveyance shall be in a form
approved by the attorney general.
(b) The conveyance is subject to a scenic easement, as
defined in Minnesota Statutes, section 103F.311, subdivision 6,
to be under the custodial control of the commissioner of natural
resources, on that portion of the conveyed land that is
designated for inclusion in the wild and scenic river system
under Minnesota Statutes, section 103F.325. The scenic easement
shall allow for continued use of the structures located within
the easement and for development of a walking path within the
easement.
(c) The conveyance shall restrict use of the land to
governmental, including recreational, purposes and shall provide
that ownership of any portion of the land that ceases to be used
for such purposes shall revert to the state of Minnesota.
(d) The commissioner of administration may convey any part
of the property described in subdivision 3 any time after the
land is declared surplus by the commissioner of human services
and the execution and recording of the scenic easement under
paragraph (b) has been completed.
(e) Notwithstanding any law, regulation, or ordinance to
the contrary, the instrument of conveyance to Anoka county may
be recorded in the office of the Anoka county recorder without
compliance with any subdivision requirement.
Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for
Grant Street, Northview Lane, Garfield Street, 5th Avenue, and
state trunk highway No. 288, also known as 4th Avenue, the land
to be conveyed may include all, or part of, that which is
described as follows:
(1) all that part of Government Lots 3 and 4 and that part
of the Southeast Quarter of the Southwest Quarter, all in
Section 31, Township 32 North, Range 24 West, Anoka county,
Minnesota, described as follows:
Beginning at the southwest corner of said Southeast Quarter
of the Southwest Quarter of Section 31; thence North 13
degrees 16 minutes 11 seconds East, assumed bearing, 473.34
feet; thence North 07 degrees 54 minutes 43 seconds East
186.87 feet; thence North 14 degrees 08 minutes 33 seconds
West 154.77 feet; thence North 62 degrees 46 minutes 44
seconds West 526.92 feet; thence North 25 degrees 45
minutes 30 seconds East 74.43 feet; thence northerly 88.30
feet along a tangential curve concave to the west having a
radius of 186.15 feet and a central angle of 27 degrees 10
minutes 50 seconds; thence North 01 degrees 25 minutes 20
seconds West, tangent to said curve, 140.53 feet; thence
North 71 degrees 56 minutes 34 seconds West to the
southeasterly shoreline of the Rum river; thence
southwesterly along said shoreline to the south line of
said Government Lot 4; thence easterly along said south
line to the point of beginning. For the purpose of this
description the south line of said Southeast Quarter of the
Southwest Quarter of Section 31 has an assumed bearing of
North 89 degrees 08 minutes 19 seconds East;
(2) Government Lot 1, Section 6, Township 31 North, Range
24 West, Anoka county, Minnesota; EXCEPT that part platted as
Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part
lying southerly of the westerly extension of the south line of
Block 6, Woodbury's Addition to the city of Anoka, Anoka county,
Minnesota, and lying westerly of the west line of said plat of
Grant Properties, said line also being the centerline of 4th
Avenue;
(3) all that part of said Block 6, Woodbury's Addition to
the city of Anoka lying westerly of Northview 1st Addition,
Anoka county, Minnesota;
(4) all that part of said Northview 1st Addition lying
westerly of the east line of Lots 11 through 20, Block 1,
inclusive, thereof; and
(5) all that part of the Northeast Quarter of the Northwest
Quarter of said Section 6, Township 31 North, Range 24 West,
Anoka county, Minnesota, lying northerly of the centerline of
Grant Street as defined by said plat of Grant Properties and
lying westerly of said east line of Lots 11 through 20, Block 1,
inclusive, Northview 1st Addition and said line's extension
north and south.
Subd. 4. [DETERMINATION.] The commissioner of human
services has determined that the land described in subdivision 3
will no longer be needed for the Anoka metro regional treatment
center upon the completion of the state facilities currently
under construction and the completion of renovation work to
state buildings that are not located on the land described in
subdivision 3. The state's land and building management
interests may best be served by conveying all, or part of, the
land and associated buildings located on the land described in
subdivision 3.
Sec. 2. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.]
Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding
Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335,
subdivision 3, or any other law to the contrary, the
commissioner of administration may convey all, or any part of,
the land and the state building located on the land described in
subdivision 3, to Crow Wing county after the commissioner of
human services declares the property surplus to its needs.
Subd. 2. [FORM.] (a) The conveyance shall be in a form
approved by the attorney general.
(b) The conveyance shall restrict use of the land to county
governmental purposes, including community corrections programs,
and shall provide that ownership of any portion of the land or
building that ceases to be used for such purposes shall revert
to the state of Minnesota.
Subd. 3. [LAND DESCRIPTION.] That part of the Northeast
Quarter (NE l/4) of Section 30, Township 45 North, Range 30
West, Crow Wing county, Minnesota, described as follows:
Commencing at the southeast corner of said Northeast
quarter; thence North 00 degrees 46 minutes 05 seconds
West, bearing based on the Crow Wing county Coordinate
Database NAD 83/94, 1520.06 feet along the east line of
said Northeast quarter to the point of beginning; thence
continue North 00 degrees 46 minutes 05 seconds West 634.14
feet along said east line of the Northeast quarter; thence
South 89 degrees 13 minutes 20 seconds West 550.00 feet;
thence South 18 degrees 57 minutes 23 seconds East 115.59
feet; thence South 42 degrees 44 minutes 39 seconds East
692.37 feet; thence South 62 degrees 46 minutes 19 seconds
East 20.24 feet; thence North 89 degrees 13 minutes 55
seconds East 33.00 feet to the point of beginning.
Containing 4.69 acres, more or less. Subject to the
right-of-way of the Township road along the east side
thereof, subject to other easements, reservations, and
restrictions of record, if any.
Subd. 4. [DETERMINATION.] The commissioner of human
services has determined that the land described in subdivision 3
and the building on the land will not be needed for future
operations of the Brainerd regional human services center. The
state's land management interests would best be served by
conveying the land to Crow Wing county for governmental use.
ARTICLE 8
COMPULSIVE GAMBLING AND MISCELLANEOUS
Section 1. Minnesota Statutes 1996, section 62A.65,
subdivision 5, is amended to read:
Subd. 5. [PORTABILITY OF COVERAGE.] (a) No individual
health plan may be offered, sold, issued, or with respect to
children age 18 or under renewed, to a Minnesota resident that
contains a preexisting condition limitation, preexisting
condition exclusion, or exclusionary rider, unless the
limitation or exclusion is permitted under this subdivision,
provided that, except for children age 18 or under, underwriting
restrictions may be retained on individual contracts that are
issued without evidence of insurability as a replacement for
prior individual coverage that was sold before May 17, 1993.
The individual may be subjected to an 18-month preexisting
condition limitation, unless the individual has maintained
continuous coverage as defined in section 62L.02. The
individual must not be subjected to an exclusionary rider. An
individual who has maintained continuous coverage may be
subjected to a one-time preexisting condition limitation of up
to 12 months, with credit for time covered under qualifying
coverage as defined in section 62L.02, at the time that the
individual first is covered under an individual health plan by
any health carrier. Credit must be given for all qualifying
coverage with respect to all preexisting conditions, regardless
of whether the conditions were preexisting with respect to any
previous qualifying coverage. The individual must not be
subjected to an exclusionary rider. Thereafter, the individual
must not be subject to any preexisting condition limitation,
preexisting condition exclusion, or exclusionary rider under an
individual health plan by any health carrier, except an
unexpired portion of a limitation under prior coverage, so long
as the individual maintains continuous coverage as defined in
section 62L.02.
(b) A health carrier must offer an individual health plan
to any individual previously covered under a group health plan
issued by that health carrier, regardless of the size of the
group, so long as the individual maintained continuous coverage
as defined in section 62L.02. Beginning January 1, 1999, if the
individual has available any continuation coverage provided
under sections 62A.146; 62A.148; 62A.17, subdivisions 1 and 2;
62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or continuation
coverage provided under federal law, the health carrier need not
offer coverage under this paragraph until the individual has
exhausted the continuation coverage. The offer must not be
subject to underwriting, except as permitted under this
paragraph. A health plan issued under this paragraph must be a
qualified plan as defined in section 62E.02 and must not contain
any preexisting condition limitation, preexisting condition
exclusion, or exclusionary rider, except for any unexpired
limitation or exclusion under the previous coverage. The
individual health plan must cover pregnancy on the same basis as
any other covered illness under the individual health plan. The
initial premium rate for the individual health plan must comply
with subdivision 3. The premium rate upon renewal must comply
with subdivision 2. In no event shall the premium rate exceed
90 percent of the premium charged for comparable individual
coverage by the Minnesota comprehensive health association, and
the premium rate must be less than that amount if necessary to
otherwise comply with this section. An individual health plan
offered under this paragraph to a person satisfies the health
carrier's obligation to offer conversion coverage under section
62E.16, with respect to that person. Coverage issued under this
paragraph must provide that it cannot be canceled or nonrenewed
as a result of the health carrier's subsequent decision to leave
the individual, small employer, or other group market. Section
72A.20, subdivision 28, applies to this paragraph.
Sec. 2. Minnesota Statutes 1996, section 62D.042,
subdivision 2, is amended to read:
Subd. 2. [BEGINNING ORGANIZATIONS NET WORTH REQUIREMENTS.]
(a) Beginning organizations shall maintain net worth of at least
8-1/3 percent of the sum of all expenses expected to be incurred
in the 12 months following the date the certificate of authority
is granted, or $1,500,000, whichever is greater.
(b) After the first full calendar year of operation,
organizations shall maintain net worth of at least 8-1/3 percent
and at most 16-2/3 25 percent of the sum of all expenses
incurred during the most recent calendar year, but in no case
shall net worth fall below $1,000,000.
(c) Notwithstanding paragraphs (a) and (b), any health
maintenance organization owned by a political subdivision of
this state, which has a higher than average percentage of
enrollees who are enrolled in medical assistance or general
assistance medical care, may exceed the maximum net worth limits
provided in paragraphs (a) and (b), with the advance approval of
the commissioner.
Sec. 3. Minnesota Statutes 1996, section 62E.16, is
amended to read:
62E.16 [POLICY CONVERSION RIGHTS.]
Every program of self-insurance, policy of group accident
and health insurance or contract of coverage by a health
maintenance organization written or renewed in this state, shall
include, in addition to the provisions required by section
62A.17, the right to convert to an individual coverage qualified
plan without the addition of underwriting restrictions if after
the individual insured has exhausted any continuation coverage
provided under section 62A.146; 62A.148; 62A.17, subdivisions 1
and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or
continuation coverage provided under federal law, if any
continuation coverage is available to the individual, and then
leaves the group regardless of the reason for leaving the group
or if an employer member of a group ceases to remit payment so
as to terminate coverage for its employees, or upon cancellation
or termination of the coverage for the group except where
uninterrupted and continuous group coverage is otherwise
provided to the group. If the health maintenance organization
has canceled coverage for the group because of a loss of
providers in a service area, the health maintenance organization
shall arrange for other health maintenance or indemnity
conversion options that shall be offered to enrollees without
the addition of underwriting restrictions. The required
conversion contract must treat pregnancy the same as any other
covered illness under the conversion contract. The person may
exercise this right to conversion within 30 days of exhausting
any continuation coverage provided under section 62A.146;
62A.148; 62A.17, subdivisions 1 and 2; 62A.20; or 62A.21, or
continuation coverage provided under federal law, and then
leaving the group or within 30 days following receipt of due
notice of cancellation or termination of coverage of the group
or of the employer member of the group and upon payment of
premiums from the date of termination or cancellation. Due
notice of cancellation or termination of coverage for a group or
of the employer member of the group shall be provided to each
employee having coverage in the group by the insurer,
self-insurer or health maintenance organization canceling or
terminating the coverage except where reasonable evidence
indicates that uninterrupted and continuous group coverage is
otherwise provided to the group. Every employer having a policy
of group accident and health insurance, group subscriber or
contract of coverage by a health maintenance organization shall,
upon request, provide the insurer or health maintenance
organization a list of the names and addresses of covered
employees. Plans of health coverage shall also include a
provision which, upon the death of the individual in whose name
the contract was issued, permits every other individual then
covered under the contract to elect, within the period specified
in the contract, to continue coverage under the same or a
different contract without the addition of underwriting
restrictions until the individual would have ceased to have been
entitled to coverage had the individual in whose name the
contract was issued lived. An individual conversion contract
issued by a health maintenance organization shall not be deemed
to be an individual enrollment contract for the purposes of
section 62D.10. An individual health plan offered under section
62A.65, subdivision 5, paragraph (b), to a person satisfies the
health carrier's obligation to offer conversion coverage under
this section with respect to that person.
Sec. 4. [62Q.096] [CREDENTIALING OF PROVIDERS.]
If a health plan company has initially credentialed, as
providers in its provider network, individual providers employed
by or under contract with an entity that: (1) is authorized to
bill under section 256B.0625, subdivision 5; (2) meets the
requirements of Minnesota Rules, parts 9520.0750 to 9520.0870;
(3) is designated an essential community provider under section
62Q.19; and (4) is under contract with the health plan company
to provide mental health services, the health plan company must
continue to credential at least the same number of providers
from that entity, as long as those providers meet the health
plan company's credentialing standards. A health plan company
shall not refuse to credential these providers on the grounds
that their provider network has a sufficient number of providers
of that type.
Sec. 5. [245.982] [PROGRAM SUPPORT.]
In order to address the problem of gambling in this state,
the compulsive gambling fund should attempt to assess the
beneficiaries of gambling, on a percentage basis according to
the revenue they receive from gambling, for the costs of
programs to help problem gamblers and their families. In that
light, the governor is requested to contact the chairs of the 11
tribal governments in this state and request a contribution of
funds for the compulsive gambling program. The governor should
seek a total supplemental contribution of $643,000. Funds
received from the tribal governments in this state shall be
deposited in the Indian gaming revolving account.
Sec. 6. Minnesota Statutes 1997 Supplement, section
256F.05, subdivision 8, is amended to read:
Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A
county which has not demonstrated that year that its family
preservation core services are developed as provided in
subdivision 1a, must use its family preservation fund grant
exclusively for family preservation services defined in section
256F.03, subdivision 5, paragraphs (a), (b), (c), and (e).
(b) A county which has demonstrated that year that its
family preservation core services are developed becomes eligible
either to continue using its family preservation fund grant as
provided in paragraph (a), or to exercise the expanded service
option under paragraph (c).
(c) The expanded service option permits an eligible county
to use its family preservation fund grant for child welfare
preventive services. For purposes of this section, child
welfare preventive services are those services directed toward a
specific child or family that further the goals of section
256F.01 and include assessments, family preservation services,
service coordination, community-based treatment, crisis nursery
services when the parents retain custody and there is no
voluntary placement agreement with a child-placing agency,
respite care except when it is provided under a medical
assistance waiver, home-based services, and other related
services. For purposes of this section, child welfare
preventive services shall not include shelter care or other
placement services under the authority of the court or public
agency to address an emergency. To exercise this option, an
eligible county must notify the commissioner in writing of its
intention to do so no later than 30 days into the quarter during
which it intends to begin or in its county plan, as provided in
section 256F.04, subdivision 2. Effective with the first day of
that quarter, the county must maintain its base level of
expenditures for child welfare preventive services and use the
family preservation fund to expand them. The base level of
expenditures for a county shall be that established under
section 256F.10, subdivision 7. For counties which have no such
base established, a comparable base shall be established with
the base year being the calendar year ending at least two
calendar quarters before the first calendar quarter in which the
county exercises its expanded service option. The commissioner
shall, at the request of the counties, reduce, suspend, or
eliminate either or both of a county's obligations to continue
the base level of expenditures and to expand child welfare
preventive services under extraordinary circumstances.
(d) Notwithstanding paragraph (a), a county that is
participating in the child protection assessments or
investigations community collaboration pilot program under
section 626.5560, or in the concurrent permanency planning pilot
program under section 257.0711, may use its family preservation
fund grant for those programs.
Sec. 7. Minnesota Statutes 1996, section 609.115,
subdivision 9, is amended to read:
Subd. 9. [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If
a person is convicted of a felony for theft under section
609.52, embezzlement of public funds under section 609.54, or
forgery under section 609.625, 609.63, or 609.631, the probation
officer shall determine in the report prepared under subdivision
1 whether or not compulsive gambling contributed to the
commission of the offense. If so, the report shall contain the
results of a compulsive gambling assessment conducted in
accordance with this subdivision. The probation officer shall
make an appointment for the offender to undergo the assessment
if so indicated.
(b) The compulsive gambling assessment report must include
a recommended level of treatment for the offender if the
assessor concludes that the offender is in need of compulsive
gambling treatment. The assessment must be conducted by an
assessor qualified under section 245.98, subdivision 2a, to
perform these assessments or to provide compulsive gambling
treatment. An assessor providing a compulsive gambling
assessment may not have any direct or shared financial interest
or referral relationship resulting in shared financial gain with
a treatment provider. If an independent assessor is not
available, the probation officer may use the services of an
assessor with a financial interest or referral relationship as
authorized under rules adopted by the commissioner of human
services under section 245.98, subdivision 2a.
(c) The commissioner of human services shall reimburse the
assessor for the costs associated with a compulsive gambling
assessment at a rate established by the commissioner up to a
maximum of $100 for each assessment. The commissioner shall
reimburse these costs after receiving written verification from
the probation officer that the assessment was performed and
found acceptable.
Sec. 8. Laws 1994, chapter 633, article 7, section 3, is
amended to read:
Sec. 3. [INDIAN GAMING REVOLVING ACCOUNT.]
Funds received from the attorney general Indian tribal
governments and the Minnesota state lottery shall deposit be
deposited in a separate account in the state treasury all money
received from Indian tribal governments for the purpose of
defraying the attorney general's costs in providing legal
services with respect to Indian gaming. Money in the account is
appropriated to the attorney general for that
purpose contributing to the compulsive gambling program.
Sec. 9. [PREVALENCE STUDY.]
If funding is available, the compulsive gambling program
shall provide baseline prevalence studies to identify those at
highest risk of developing a compulsive gambling problem,
including a replication in 1999 of the 1994 adult prevalence
survey.
Sec. 10. [EXTENDING ASSESSMENTS TO BANKRUPTCY AND FAMILY
COURT PROCEEDINGS.]
If funding is available, the commissioner of human services
shall study whether problem gambling assessments should be
provided or required for individuals involved in bankruptcy or
family court proceedings, and report to the legislature by
December 15, 1998.
Sec. 11. [COMPULSIVE GAMBLING APPROPRIATION.]
(a) In addition to any other appropriations, $340,000 is
appropriated annually from the Minnesota lottery prize fund to
the Indian gaming revolving account in Laws 1994, chapter 633,
article 7, section 3, and transferred to the commissioner of
human services for the compulsive gambling program. The funds
provided under Minnesota Statutes, section 245.982, are to be
transferred from the Indian gaming revolving account to the
commissioner of human services for purposes of paragraph (d).
(b) Of the funds appropriated under this section, $290,000
in fiscal year 1999 is appropriated for the establishment of
fee-for-service projects. Fee-for-service funds under this
appropriation may be awarded on a per-client basis to existing
treatment centers and may be in addition to grants the centers
currently receive. Baseline grants based on the last fiscal
year client numbers and units of services provided constitute
minimum appropriations to existing treatment centers, and upon
meeting the contracted level of services, the treatment centers
are eligible for fee-for-service funds on a per-client basis in
addition to grants.
(c) Of the funds appropriated under this section, $50,000
in fiscal year 1999 is appropriated for the operation of
prevention and education programs aimed at helping adult and
adolescent gamblers.
(d) Of the funds provided under Minnesota Statutes, section
245.982, up to $30,000 in fiscal year 1999 may be used for the
completion of the prevalence study in section 9, up to $10,000
in fiscal year 1999 may be used for the study in section 10
related to extending assessments to bankruptcy and family court
proceedings, and up to $50,000 in fiscal year 1999 may be used
for the operation of the hotline. The commissioner may
prioritize the initiatives under this paragraph as the
commissioner deems appropriate. Any funding remaining must be
used for purposes of treatment under paragraph (b) and
prevention under paragraph (c), and the funds must be
appropriated at a two-to-one ratio, respectively.
Sec. 12. [TOWN OF WHITE, ST. LOUIS COUNTY.]
Subdivision 1. [TRANSFER.] Notwithstanding any provision
of Minnesota Statutes to the contrary, the town of White is
hereby authorized to transfer the following property and any
buildings, equipment, and other improvements located thereon to
the White community hospital corporation, a nonprofit
corporation organized and existing under Minnesota Statutes,
chapter 317:
That part of the southeast quarter of southwest quarter (SE
1/4 of SW 1/4), section 10, township 58 north of range 15 west
of the fourth principal meridian, according to the United States
government survey thereof, St. Louis county, Minnesota,
described as follows:
Commencing at the southeast corner of said SE 1/4 of SW
1/4, section 10, township 58, range 15, thence proceeding north
along the east line thereof for a distance of 550 feet; thence
west and parallel to the south line thereof for a distance of
800 feet; thence south and parallel to the east line thereof,
for a distance of 550 feet to the south line; thence east along
said south line thereof, for a distance of 800 feet to the point
of beginning.
Subd. 2. [NO CONSIDERATION OR ELECTION REQUIRED.] The
transfer authorized by subdivision 1 shall be without
consideration and no vote of the electors of the town of White
or city of Aurora shall be required.
Subd. 3. [USE; PUBLIC PROPERTY.] The property legally
described in subdivision 1 shall be used for health care and
related purposes and shall be considered public property for
purposes of Minnesota Statutes, section 16A.695. The activities
conducted on the property described in subdivision 1 by the
White community hospital corporation, its successors and assigns
shall be considered a governmental program as authorized by
Minnesota Statutes, chapter 447.
Subd. 4. [NAME.] The public name of the buildings and
improvements located on the real property legally described in
subdivision 1 shall always include the words "White community."
Sec. 13. [CITY OF EVELETH; LOAN FORGIVENESS.]
Notwithstanding the provisions of any other law or charter,
the city of Eveleth may, by resolution of its city council,
forgive all or any portion of the principal and interest due or
to become due to the city, pursuant to any loan or loans made by
the city, in an amount not exceeding $100,000, prior to January
1, 1998, to any hospital, nursing home, other health care
facility or corporation, partnership, or limited liability
company operating such a facility within the city of Eveleth.
Sec. 14. [REPEALER.]
(a) Minnesota Rules, part 2740.1600, subpart 1, is repealed.
(b) Minnesota Statutes 1997 Supplement, section 62D.042,
subdivision 3, is repealed.
Sec. 15. [EFFECTIVE DATES.]
(a) Sections 2 and 4 are effective January 1, 1999.
(b) Section 3 is effective January 1, 1999, and applies to
any individual who has continuation coverage available on or
after that date.
(c) Section 12 is effective upon compliance with Minnesota
Statutes, section 645.021, subdivision 2.
(d) Section 13 is effective the day following final
enactment without local approval according to Minnesota
Statutes, section 645.023, subdivision 1, clause (a).
(e) Section 14, paragraph (a), is effective January 1, 1999.
(f) Section 14, paragraph (b), is effective the day
following final enactment.
ARTICLE 9
CHILD WELFARE MODIFICATIONS
Section 1. Minnesota Statutes 1997 Supplement, section
144.218, subdivision 2, is amended to read:
Subd. 2. [ADOPTION OF FOREIGN PERSONS.] In proceedings for
the adoption of a person who was born in a foreign country, the
court, upon evidence presented by the commissioner of human
services from information secured at the port of entry, or upon
evidence from other reliable sources, may make findings of fact
as to the date and place of birth and parentage. Upon receipt
of certified copies of the court findings and the order or
decree of adoption or a certified copy of a decree issued under
section 259.60, the state registrar shall register a birth
certificate in the new name of the adopted person. The
certified copies of the court findings and the order or, decree
of adoption, or decree issued under section 259.60 are
confidential, pursuant to section 13.02, subdivision 3, and
shall not be disclosed except pursuant to court order or section
144.1761. The birth certificate shall state the place of birth
as specifically as possible, and that the certificate is not
evidence of United States citizenship.
Sec. 2. Minnesota Statutes 1996, section 144.226,
subdivision 3, is amended to read:
Subd. 3. [BIRTH CERTIFICATE COPY SURCHARGE.] In addition
to any fee prescribed under subdivision 1, there shall be a
surcharge of $3 for each certified copy of a birth certificate,
and for a certification that the record cannot be found. The
local or state registrar shall forward this amount to the
commissioner of finance for deposit into the account for the
children's trust fund for the prevention of child abuse
established under section 119A.12. This surcharge shall not be
charged under those circumstances in which no fee for a
certified copy of a birth certificate is permitted under
subdivision 1, paragraph (a). Upon certification by the
commissioner of finance that the assets in that fund exceed
$20,000,000, this surcharge shall be discontinued.
Sec. 3. Minnesota Statutes 1997 Supplement, section
144.226, subdivision 4, is amended to read:
Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee
prescribed under subdivision 1, there is a nonrefundable
surcharge of $3 for each certified and noncertified birth or
death record, and for a certification that the record cannot be
found. The local or state registrar shall forward this amount
to the state treasurer to be deposited into the state government
special revenue fund. This surcharge shall not be charged under
those circumstances in which no fee for a birth or death record
is permitted under subdivision 1, paragraph (a). This surcharge
requirement expires June 30, 2002.
Sec. 4. Minnesota Statutes 1997 Supplement, section
245A.03, subdivision 2, is amended to read:
Subd. 2. [EXCLUSION FROM LICENSURE.] Sections 245A.01 to
245A.16 do not apply to:
(1) residential or nonresidential programs that are
provided to a person by an individual who is related unless the
residential program is a child foster care placement made by a
local social services agency or a licensed child-placing agency,
except as provided in subdivision 2a;
(2) nonresidential programs that are provided by an
unrelated individual to persons from a single related family;
(3) residential or nonresidential programs that are
provided to adults who do not abuse chemicals or who do not have
a chemical dependency, a mental illness, mental retardation or a
related condition, a functional impairment, or a physical
handicap;
(4) sheltered workshops or work activity programs that are
certified by the commissioner of economic security;
(5) programs for children enrolled in kindergarten to the
12th grade and prekindergarten special education in a school as
defined in section 120.101, subdivision 4, and programs serving
children in combined special education and regular
prekindergarten programs that are operated or assisted by the
commissioner of children, families, and learning;
(6) nonresidential programs primarily for children that
provide care or supervision, without charge for ten or fewer
days a year, and for periods of less than three hours a day
while the child's parent or legal guardian is in the same
building as the nonresidential program or present within another
building that is directly contiguous to the building in which
the nonresidential program is located;
(7) nursing homes or hospitals licensed by the commissioner
of health except as specified under section 245A.02;
(8) board and lodge facilities licensed by the commissioner
of health that provide services for five or more persons whose
primary diagnosis is mental illness who have refused an
appropriate residential program offered by a county agency.
This exclusion expires on July 1, 1990;
(9) homes providing programs for persons placed there by a
licensed agency for legal adoption, unless the adoption is not
completed within two years;
(10) programs licensed by the commissioner of corrections;
(11) recreation programs for children or adults that
operate for fewer than 40 calendar days in a calendar year or
programs operated by a park and recreation board of a city of
the first class whose primary purpose is to provide social and
recreational activities to school age children, provided the
program is approved by the park and recreation board;
(12) programs operated by a school as defined in section
120.101, subdivision 4, whose primary purpose is to provide
child care to school-age children, provided the program is
approved by the district's school board;
(13) Head Start nonresidential programs which operate for
less than 31 days in each calendar year;
(14) noncertified boarding care homes unless they provide
services for five or more persons whose primary diagnosis is
mental illness or mental retardation;
(15) nonresidential programs for nonhandicapped children
provided for a cumulative total of less than 30 days in any
12-month period;
(16) residential programs for persons with mental illness,
that are located in hospitals, until the commissioner adopts
appropriate rules;
(17) the religious instruction of school-age children;
Sabbath or Sunday schools; or the congregate care of children by
a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its
regular worship;
(18) camps licensed by the commissioner of health under
Minnesota Rules, chapter 4630;
(19) mental health outpatient services for adults with
mental illness or children with emotional disturbance;
(20) residential programs serving school-age children whose
sole purpose is cultural or educational exchange, until the
commissioner adopts appropriate rules;
(21) unrelated individuals who provide out-of-home respite
care services to persons with mental retardation or related
conditions from a single related family for no more than 90 days
in a 12-month period and the respite care services are for the
temporary relief of the person's family or legal representative;
(22) respite care services provided as a home and
community-based service to a person with mental retardation or a
related condition, in the person's primary residence;
(23) community support services programs as defined in
section 245.462, subdivision 6, and family community support
services as defined in section 245.4871, subdivision 17;
(24) the placement of a child by a birth parent or legal
guardian in a preadoptive home for purposes of adoption as
authorized by section 259.47; or
(25) settings registered under chapter 144D which provide
home care services licensed by the commissioner of health to
fewer than seven adults.
For purposes of clause (6), a building is directly
contiguous to a building in which a nonresidential program is
located if it shares a common wall with the building in which
the nonresidential program is located or is attached to that
building by skyway, tunnel, atrium, or common roof.
Sec. 5. Minnesota Statutes 1996, section 245A.035,
subdivision 4, is amended to read:
Subd. 4. [APPLICANT STUDY.] When the county agency has
received the information required by section 245A.04,
subdivision 3, paragraph (b), the county agency shall begin an
applicant study according to the procedures in section 245A.04,
subdivision 3. The commissioner may issue an emergency license
upon recommendation of the county agency once the initial
inspection has been successfully completed and the information
necessary to begin the applicant background study has been
provided. If the county agency does not recommend that the
emergency license be granted, the agency shall notify the
relative in writing that the agency is recommending denial to
the commissioner; shall remove any child who has been placed in
the home prior to licensure; and shall inform the relative in
writing of the procedure to request review pursuant to
subdivision 6. An emergency license shall be effective until a
child foster care license is granted or denied, but shall in no
case remain in effect more than 90 120 days from the date of
placement.
Sec. 6. Minnesota Statutes 1997 Supplement, section
245A.04, subdivision 3b, is amended to read:
Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The
individual who is the subject of the disqualification may
request a reconsideration of the disqualification.
The individual must submit the request for reconsideration
to the commissioner in writing. A request for reconsideration
for an individual who has been sent a notice of disqualification
under subdivision 3a, paragraph (b), clause (1) or (2), must be
submitted within 30 calendar days of the disqualified
individual's receipt of the notice of disqualification. A
request for reconsideration for an individual who has been sent
a notice of disqualification under subdivision 3a, paragraph
(b), clause (3), must be submitted within 15 calendar days of
the disqualified individual's receipt of the notice of
disqualification. Removal of a disqualified individual from
direct contact shall be ordered if the individual does not
request reconsideration within the prescribed time, and for an
individual who submits a timely request for reconsideration, if
the disqualification is not set aside. The individual must
present information showing that:
(1) the information the commissioner relied upon is
incorrect or inaccurate. If the basis of a reconsideration
request is that a maltreatment determination or disposition
under section 626.556 or 626.557 is incorrect, and the
commissioner has issued a final order in an appeal of that
determination or disposition under section 256.045, the
commissioner's order is conclusive on the issue of maltreatment;
or
(2) the subject of the study does not pose a risk of harm
to any person served by the applicant or license holder.
(b) The commissioner may set aside the disqualification
under this section if the commissioner finds that the
information the commissioner relied upon is incorrect or the
individual does not pose a risk of harm to any person served by
the applicant or license holder. In determining that an
individual does not pose a risk of harm, the commissioner shall
consider the consequences of the event or events that lead to
disqualification, whether there is more than one disqualifying
event, the vulnerability of the victim at the time of the event,
the time elapsed without a repeat of the same or similar event,
documentation of successful completion by the individual studied
of training or rehabilitation pertinent to the event, and any
other information relevant to reconsideration. In reviewing a
disqualification under this section, the commissioner shall give
preeminent weight to the safety of each person to be served by
the license holder or applicant over the interests of the
license holder or applicant.
(c) Unless the information the commissioner relied on in
disqualifying an individual is incorrect, the commissioner may
not set aside the disqualification of an individual in
connection with a license to provide family day care for
children, foster care for children in the provider's own home,
or foster care or day care services for adults in the provider's
own home if:
(1) less than ten years have passed since the discharge of
the sentence imposed for the offense; and the individual has
been convicted of a violation of any offense listed in sections
609.20 (manslaughter in the first degree), 609.205 (manslaughter
in the second degree), criminal vehicular homicide under 609.21
(criminal vehicular homicide and injury), 609.215 (aiding
suicide or aiding attempted suicide), felony violations under
609.221 to 609.2231 (assault in the first, second, third, or
fourth degree), 609.713 (terroristic threats), 609.235 (use of
drugs to injure or to facilitate crime), 609.24 (simple
robbery), 609.245 (aggravated robbery), 609.25 (kidnapping),
609.255 (false imprisonment), 609.561 or 609.562 (arson in the
first or second degree), 609.71 (riot), burglary in the first or
second degree under 609.582 (burglary), 609.66 (dangerous
weapon), 609.665 (spring guns), 609.67 (machine guns and
short-barreled shotguns), 609.749 (harassment; stalking),
152.021 or 152.022 (controlled substance crime in the first or
second degree), 152.023, subdivision 1, clause (3) or (4), or
subdivision 2, clause (4) (controlled substance crime in the
third degree), 152.024, subdivision 1, clause (2), (3), or (4)
(controlled substance crime in the fourth degree), 609.224,
subdivision 2, paragraph (c) (fifth-degree assault by a
caregiver against a vulnerable adult), 609.228 (great bodily
harm caused by distribution of drugs), 609.23 (mistreatment of
persons confined), 609.231 (mistreatment of residents or
patients), 609.2325 (criminal abuse of a vulnerable adult),
609.233 (criminal neglect of a vulnerable adult), 609.2335
(financial exploitation of a vulnerable adult), 609.234 (failure
to report), 609.265 (abduction), 609.2664 to 609.2665
(manslaughter of an unborn child in the first or second degree),
609.267 to 609.2672 (assault of an unborn child in the first,
second, or third degree), 609.268 (injury or death of an unborn
child in the commission of a crime), 617.293 (disseminating or
displaying harmful material to minors), 609.378 (neglect or
endangerment of a child), a gross misdemeanor offense under
609.377 (malicious punishment of a child), 609.72, subdivision 3
(disorderly conduct against a vulnerable adult); or an attempt
or conspiracy to commit any of these offenses, as each of these
offenses is defined in Minnesota Statutes; or an offense in any
other state, the elements of which are substantially similar to
the elements of any of the foregoing offenses;
(2) regardless of how much time has passed since the
discharge of the sentence imposed for the offense, the
individual was convicted of a violation of any offense listed in
sections 609.185 to 609.195 (murder in the first, second, or
third degree), 609.2661 to 609.2663 (murder of an unborn child
in the first, second, or third degree), a felony offense under
609.377 (malicious punishment of a child), 609.322
(solicitation, inducement, and promotion of prostitution),
609.323 (receiving profit derived from prostitution), 609.342 to
609.345 (criminal sexual conduct in the first, second, third, or
fourth degree), 609.352 (solicitation