Office of the Revisor of Statutes
Minnesota Session Laws - 2002, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 375-S.F.No. 3099
An act relating to human services; modifying
provisions for certain government data; modifying the
Human Services Licensing Act; modifying certain
hearing provisions; modifying provisions for reporting
maltreatment of minors and vulnerable adults;
modifying continuing care provisions; modifying
moratorium provisions on certification of nursing home
beds; modifying eligibility for transition planning
grants; providing for optional registration as housing
with services establishment; modifying case manager
continuing education requirements; modifying
provisions for interstate contracts for mental health
services; modifying commissioner's authority to
administer a supplemental drug rebate program;
designating state agent to carry out responsibilities
under the Ryan White Comprehensive AIDS Resources
Emergency Act; allowing certain nursing homes to elect
to participate in the medical assistance program;
modifying medical assistance provisions; modifying
group residential housing provisions; modifying
MinnesotaCare provisions; modifying prior
appropriations; providing for the use of certain
grants to develop certain housing options; providing
for deaf-blind services; modifying provisions for
funding medical education; providing for special
education; providing for identification of certain
deceased individuals; modifying provisions for rural
hospital capital improvement grants; modifying
provisions for costs associated with patient records;
requiring legislative approval of Clean Indoor Air Act
rules; modifying acupuncture provisions; modifying
provisions for county relief of the poor; requiring
studies, reports, and recommendations; appropriating
money; amending Minnesota Statutes 2000, sections
13.41, subdivision 1; 13.46, subdivision 3; 62J.692,
subdivision 4, as amended; 125A.76, subdivision 5;
144.05, by adding a subdivision; 144.335, subdivision
5; 144.417, subdivision 1; 144D.01, subdivision 4;
147B.02, subdivision 9; 245.462, subdivision 4;
245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5;
245A.02, by adding subdivisions; 245A.035, subdivision
3; 245A.04, by adding a subdivision; 256.01, by adding
a subdivision; 256.9657, subdivision 1, as amended;
256B.0625, subdivisions 26, as amended, 35, by adding
a subdivision; 256B.0915, subdivisions 4, 6, by adding
a subdivision; 256B.19, subdivision 1, as amended;
256B.431, subdivisions 14, 30; 256B.5012, subdivision
2; 256B.69, subdivision 5a, as amended; 256I.04,
subdivision 2a; 256L.12, subdivision 9, as amended;
261.063; 626.557, subdivision 3a; Minnesota Statutes
2001 Supplement, sections 13.46, subdivisions 1, 4;
125A.515; 144.148, subdivision 2; 144A.071,
subdivision 1a; 144A.36, subdivision 1; 149A.90,
subdivision 1; 245A.03, subdivision 2; 245A.04,
subdivisions 3, 3a, 3b; 245A.07, subdivisions 2a, 3;
245A.144; 245A.16, subdivision 1; 256.01, subdivision
2, as amended; 256.045, subdivisions 3b, 4; 256B.0625,
subdivision 13, as amended; 256B.0627, subdivision 10;
256B.0911, subdivisions 4b, 4d; 256B.0913,
subdivisions 4, 5, 8, 10, 12, 14; 256B.0915,
subdivisions 3, 5; 256B.0924, subdivision 6;
256B.0951, subdivisions 7, 8; 256B.431, subdivisions
2e, 33; 256B.437, subdivisions 3, 6; 256B.438,
subdivision 1; 256B.76; 626.556, subdivision 10i;
626.557, subdivision 9d; Laws 2002, chapter 220,
article 17, section 2, subdivision 6; proposing coding
for new law in Minnesota Statutes, chapters 144D;
245A; repealing Minnesota Statutes 2000, section
147B.01, subdivisions 8, 15; Minnesota Statutes 2001
Supplement, section 256B.0621, subdivision 1.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
LICENSING
Section 1. Minnesota Statutes 2000, section 13.41,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] As used in this section
"licensing agency" means any board, department or agency of this
state which is given the statutory authority to issue
professional or other types of licenses, except the various
agencies primarily administered by the commissioner of human
services. Data pertaining to persons or agencies licensed or
registered under authority of the commissioner of human services
shall be administered pursuant to section 13.46, subdivision 4.
Sec. 2. Minnesota Statutes 2001 Supplement, section 13.46,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] As used in this section:
(a) "Individual" means an individual according to section
13.02, subdivision 8, but does not include a vendor of services.
(b) "Program" includes all programs for which authority is
vested in a component of the welfare system according to statute
or federal law, including, but not limited to, the aid to
families with dependent children program formerly codified in
sections 256.72 to 256.87, Minnesota Family Investment Program,
medical assistance, general assistance, general assistance
medical care, and child support collections.
(c) "Welfare system" includes the department of human
services, local social services agencies, county welfare
agencies, private licensing agencies, the public authority
responsible for child support enforcement, human services
boards, community mental health center boards, state hospitals,
state nursing homes, the ombudsman for mental health and mental
retardation, and persons, agencies, institutions, organizations,
and other entities under contract to any of the above agencies
to the extent specified in the contract.
(d) "Mental health data" means data on individual clients
and patients of community mental health centers, established
under section 245.62, mental health divisions of counties and
other providers under contract to deliver mental health
services, or the ombudsman for mental health and mental
retardation.
(e) "Fugitive felon" means a person who has been convicted
of a felony and who has escaped from confinement or violated the
terms of probation or parole for that offense.
(f) "Private licensing agency" means an agency licensed by
the commissioner of human services under chapter 245A to perform
the duties under section 245A.16.
Sec. 3. Minnesota Statutes 2000, section 13.46,
subdivision 3, is amended to read:
Subd. 3. [INVESTIGATIVE DATA.] (a) Data on persons,
including data on vendors of services and data on licensees,
that is collected, maintained, used, or disseminated by the
welfare system in an investigation, authorized by statute and
relating to the enforcement of rules or law, is confidential
data on individuals pursuant to section 13.02, subdivision 3, or
protected nonpublic data not on individuals pursuant to section
13.02, subdivision 13, and shall not be disclosed except:
(a) (1) pursuant to section 13.05;
(b) (2) pursuant to statute or valid court order;
(c) (3) to a party named in a civil or criminal proceeding,
administrative or judicial, for preparation of defense; or
(d) (4) to provide notices required or permitted by statute.
The data referred to in this subdivision shall be
classified as public data upon its submission to an
administrative law judge or court in an administrative or
judicial proceeding. Inactive welfare investigative data shall
be treated as provided in section 13.39, subdivision 3.
(b) Notwithstanding any other provision in law, the
commissioner of human services shall provide all active and
inactive investigative data, including the name of the reporter
of alleged maltreatment under section 626.556 or 626.557, to the
ombudsman for mental health and retardation upon the request of
the ombudsman.
Sec. 4. Minnesota Statutes 2001 Supplement, section 13.46,
subdivision 4, is amended to read:
Subd. 4. [LICENSING DATA.] (a) As used in this subdivision:
(1) "licensing data" means all data collected, maintained,
used, or disseminated by the welfare system pertaining to
persons licensed or registered or who apply for licensure or
registration or who formerly were licensed or registered under
the authority of the commissioner of human services;
(2) "client" means a person who is receiving services from
a licensee or from an applicant for licensure; and
(3) "personal and personal financial data" means social
security numbers, identity of and letters of reference,
insurance information, reports from the bureau of criminal
apprehension, health examination reports, and social/home
studies.
(b)(1) Except as provided in paragraph (c), the following
data on current and former licensees are public: name, address,
telephone number of licensees, date of receipt of a completed
application, dates of licensure, licensed capacity, type of
client preferred, variances granted, type of dwelling, name and
relationship of other family members, previous license history,
class of license, and the existence and status of complaints.
When a correction order or fine has been issued, a license is
suspended, immediately suspended, revoked, denied, or made
conditional, or a complaint is resolved, the following data on
current and former licensees are public: the substance and
investigative findings of the complaint, licensing violation, or
substantiated maltreatment; the record of informal resolution of
a licensing violation; orders of hearing; findings of fact;
conclusions of law; specifications of the final correction
order, fine, suspension, immediate suspension, revocation,
denial, or conditional license contained in the record of
licensing action; and the status of any appeal of these
actions. When an individual licensee is a substantiated
perpetrator of maltreatment, and the substantiated maltreatment
is a reason for the licensing action, the identity of the
licensee as a perpetrator is public data. For purposes of this
clause, a person is a substantiated perpetrator if the
maltreatment determination has been upheld under section
626.556, subdivision 10i, 626.557, subdivision 9d, or 256.045,
or an individual or facility has not timely exercised appeal
rights under these sections.
(2) For applicants who withdraw their application prior to
licensure or denial of a license, the following data are
public: the name of the applicant, the city and county in which
the applicant was seeking licensure, the dates of the
commissioner's receipt of the initial application and completed
application, the type of license sought, and the date of
withdrawal of the application.
(3) For applicants who are denied a license, the following
data are public: the name of the applicant, the city and county
in which the applicant was seeking licensure, the dates of the
commissioner's receipt of the initial application and completed
application, the type of license sought, the date of denial of
the application, the nature of the basis for the denial, and the
status of any appeal of the denial.
(4) The following data on persons subject to
disqualification under section 245A.04 in connection with a
license to provide family day care for children, child care
center services, foster care for children in the provider's
home, or foster care or day care services for adults in the
provider's home, are public: the nature of any disqualification
set aside under section 245A.04, subdivision 3b, and the reasons
for setting aside the disqualification; and the reasons for
granting any variance under section 245A.04, subdivision 9.
(5) When maltreatment is substantiated under section
626.556 or 626.557 and the victim and the substantiated
perpetrator are affiliated with a program licensed under chapter
245A, the commissioner of human services, local social services
agency, or county welfare agency may inform the license holder
where the maltreatment occurred of the identity of the
substantiated perpetrator and the victim.
(c) The following are private data on individuals under
section 13.02, subdivision 12, or nonpublic data under section
13.02, subdivision 9: personal and personal financial data on
family day care program and family foster care program
applicants and licensees and their family members who provide
services under the license.
(d) The following are private data on individuals: the
identity of persons who have made reports concerning licensees
or applicants that appear in inactive investigative data, and
the records of clients or employees of the licensee or applicant
for licensure whose records are received by the licensing agency
for purposes of review or in anticipation of a contested
matter. The names of reporters under sections 626.556 and
626.557 may be disclosed only as provided in section 626.556,
subdivision 11, or 626.557, subdivision 12b.
(e) Data classified as private, confidential, nonpublic, or
protected nonpublic under this subdivision become public data if
submitted to a court or administrative law judge as part of a
disciplinary proceeding in which there is a public hearing
concerning a license which has been suspended, immediately
suspended, revoked, or denied.
(f) Data generated in the course of licensing
investigations that relate to an alleged violation of law are
investigative data under subdivision 3.
(g) Data that are not public data collected, maintained,
used, or disseminated under this subdivision that relate to or
are derived from a report as defined in section 626.556,
subdivision 2, or 626.5572, subdivision 18, are subject to the
destruction provisions of sections 626.556, subdivision 11c, and
626.557, subdivision 12b.
(h) Upon request, not public data collected, maintained,
used, or disseminated under this subdivision that relate to or
are derived from a report of substantiated maltreatment as
defined in section 626.556 or 626.557 may be exchanged with the
department of health for purposes of completing background
studies pursuant to section 144.057 and with the department of
corrections for purposes of completing background studies
pursuant to section 241.021.
(i) Data on individuals collected according to licensing
activities under chapter 245A, and data on individuals collected
by the commissioner of human services according to maltreatment
investigations under sections 626.556 and 626.557, may be shared
with the department of human rights, the department of health,
the department of corrections, the ombudsman for mental health
and retardation, and the individual's professional regulatory
board when there is reason to believe that laws or standards
under the jurisdiction of those agencies may have been violated.
(j) In addition to the notice of determinations required
under section 626.556, subdivision 10f, if the commissioner or
the local social services agency has determined that an
individual is a substantiated perpetrator of maltreatment of a
child based on sexual abuse, as defined in section 626.556,
subdivision 2, and the commissioner or local social services
agency knows that the individual is a person responsible for a
child's care in another facility, the commissioner or local
social services agency shall notify the head of that facility of
this determination. The notification must include an
explanation of the individual's available appeal rights and the
status of any appeal. If a notice is given under this
paragraph, the government entity making the notification shall
provide a copy of the notice to the individual who is the
subject of the notice.
Sec. 5. Minnesota Statutes 2000, section 245A.02, is
amended by adding a subdivision to read:
Subd. 2a. [ADULT DAY CARE.] "Adult day care" means a
program operating less than 24 hours per day that provides
functionally impaired adults with an individualized and
coordinated set of services including health services, social
services, and nutritional services that are directed at
maintaining or improving the participants' capabilities for
self-care. Adult day care does not include programs where
adults gather or congregate primarily for purposes of
socialization, education, supervision, caregiver respite,
religious expression, exercise, or nutritious meals.
Sec. 6. Minnesota Statutes 2000, section 245A.02, is
amended by adding a subdivision to read:
Subd. 2b. [ANNUAL OR ANNUALLY.] "Annual" or "annually"
means prior to or within the same month of the subsequent
calendar year.
Sec. 7. Minnesota Statutes 2001 Supplement, section
245A.03, subdivision 2, is amended to read:
Subd. 2. [EXCLUSION FROM LICENSURE.] (a) This chapter does
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 120A.22, 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
120A.22, 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;
(25) settings registered under chapter 144D which provide
home care services licensed by the commissioner of health to
fewer than seven adults; or
(26) consumer-directed community support service funded
under the Medicaid waiver for persons with mental retardation
and related conditions when the individual who provided the
service is:
(i) the same individual who is the direct payee of these
specific waiver funds or paid by a fiscal agent, fiscal
intermediary, or employer of record; and
(ii) not otherwise under the control of a residential or
nonresidential program that is required to be licensed under
this chapter when providing the service.
(b) For purposes of paragraph (a), 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.
(c) Nothing in this chapter shall be construed to require
licensure for any services provided and funded according to an
approved federal waiver plan where licensure is specifically
identified as not being a condition for the services and funding.
Sec. 8. Minnesota Statutes 2000, section 245A.035,
subdivision 3, is amended to read:
Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an
emergency license may be issued, the following requirements must
be met:
(1) the county agency must conduct an initial inspection of
the premises where the foster care is to be provided to ensure
the health and safety of any child placed in the home. The
county agency shall conduct the inspection using a form
developed by the commissioner;
(2) at the time of the inspection or placement, whichever
is earlier, the relative being considered for an emergency
license shall receive an application form for a child foster
care license; and
(3) whenever possible, prior to placing the child in the
relative's home, the relative being considered for an emergency
license shall provide the information required by section
245A.04, subdivision 3, paragraph (b); and
(4) if the county determines, prior to the issuance of an
emergency license, that anyone requiring a background study may
be disqualified under section 245A.04, and the disqualification
is one which the commissioner cannot set aside, an emergency
license shall not be issued.
Sec. 9. Minnesota Statutes 2001 Supplement, section
245A.04, subdivision 3, is amended to read:
Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.]
(a) Individuals and organizations that are required in statute
to initiate background studies under this section shall comply
with the following requirements:
(1) Applicants for licensure, license holders, and other
entities as provided in this section must submit completed
background study forms to the commissioner before individuals
specified in paragraph (c), clauses (1) to (4), (6), and (7),
begin positions allowing direct contact in any licensed program.
(2) Applicants and license holders under the jurisdiction
of other state agencies who are required in other statutory
sections to initiate background studies under this section must
submit completed background study forms to the commissioner
prior to the background study subject beginning in a position
allowing direct contact in the licensed program, or where
applicable, prior to being employed.
(3) Organizations required to initiate background studies
under section 256B.0627 for individuals described in paragraph
(c), clause (5), must submit a completed background study form
to the commissioner before those individuals begin a position
allowing direct contact with persons served by the
organization. The commissioner shall recover the cost of these
background studies through a fee of no more than $12 per study
charged to the organization responsible for submitting the
background study form. The fees collected under this paragraph
are appropriated to the commissioner for the purpose of
conducting background studies.
Upon receipt of the background study forms from the
entities in clauses (1) to (3), the commissioner shall complete
the background study as specified under this section and provide
notices required in subdivision 3a. Unless otherwise specified,
the subject of a background study may have direct contact with
persons served by a program after the background study form is
mailed or submitted to the commissioner pending notification of
the study results under subdivision 3a. A county agency may
accept a background study completed by the commissioner under
this section in place of the background study required under
section 245A.16, subdivision 3, in programs with joint licensure
as home and community-based services and adult foster care for
people with developmental disabilities when the license holder
does not reside in the foster care residence and the subject of
the study has been continuously affiliated with the license
holder since the date of the commissioner's study.
(b) The definitions in this paragraph apply only to
subdivisions 3 to 3e.
(1) "Background study" means the review of records
conducted by the commissioner to determine whether a subject is
disqualified from direct contact with persons served by a
program, and where specifically provided in statutes, whether a
subject is disqualified from having access to persons served by
a program.
(2) "Continuous, direct supervision" means an individual is
within sight or hearing of the supervising person to the extent
that supervising person is capable at all times of intervening
to protect the health and safety of the persons served by the
program.
(3) "Contractor" means any person, regardless of employer,
who is providing program services for hire under the control of
the provider.
(4) "Direct contact" means providing face-to-face care,
training, supervision, counseling, consultation, or medication
assistance to persons served by the program.
(5) "Reasonable cause" means information or circumstances
exist which provide the commissioner with articulable suspicion
that further pertinent information may exist concerning a
subject. The commissioner has reasonable cause when, but not
limited to, the commissioner has received a report from the
subject, the license holder, or a third party indicating that
the subject has a history that would disqualify the person or
that may pose a risk to the health or safety of persons
receiving services.
(6) "Subject of a background study" means an individual on
whom a background study is required or completed.
(c) The applicant, license holder, registrant under section
144A.71, subdivision 1, bureau of criminal apprehension,
commissioner of health, and county agencies, after written
notice to the individual who is the subject of the study, shall
help with the study by giving the commissioner criminal
conviction data and reports about the maltreatment of adults
substantiated under section 626.557 and the maltreatment of
minors in licensed programs substantiated under section
626.556. If a background study is initiated by an applicant or
license holder and the applicant or license holder receives
information about the possible criminal or maltreatment history
of an individual who is the subject of the background study, the
applicant or license holder must immediately provide the
information to the commissioner. The individuals to be studied
shall include:
(1) the applicant;
(2) persons age 13 and over living in the household where
the licensed program will be provided;
(3) current employees or contractors of the applicant who
will have direct contact with persons served by the facility,
agency, or program;
(4) volunteers or student volunteers who have direct
contact with persons served by the program to provide program
services, if the contact is not directly supervised by the
individuals under the continuous, direct supervision by an
individual listed in clause (1) or (3);
(5) any person required under section 256B.0627 to have a
background study completed under this section;
(6) persons ages 10 to 12 living in the household where the
licensed services will be provided when the commissioner has
reasonable cause; and
(7) persons who, without providing direct contact services
at a licensed program, may have unsupervised access to children
or vulnerable adults receiving services from the program
licensed to provide family child 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 when the
commissioner has reasonable cause.
(d) According to paragraph (c), clauses (2) and (6), the
commissioner shall review records from the juvenile courts. For
persons under paragraph (c), clauses (1), (3), (4), (5), and
(7), who are ages 13 to 17, the commissioner shall review
records from the juvenile courts when the commissioner has
reasonable cause. The juvenile courts shall help with the study
by giving the commissioner existing juvenile court records on
individuals described in paragraph (c), clauses (2), (6), and
(7), relating to delinquency proceedings held within either the
five years immediately preceding the background study or the
five years immediately preceding the individual's 18th birthday,
whichever time period is longer. The commissioner shall destroy
juvenile records obtained pursuant to this subdivision when the
subject of the records reaches age 23.
(e) Beginning August 1, 2001, the commissioner shall
conduct all background studies required under this chapter and
initiated by supplemental nursing services agencies registered
under section 144A.71, subdivision 1. Studies for the agencies
must be initiated annually by each agency. The commissioner
shall conduct the background studies according to this chapter.
The commissioner shall recover the cost of the background
studies through a fee of no more than $8 per study, charged to
the supplemental nursing services agency. The fees collected
under this paragraph are appropriated to the commissioner for
the purpose of conducting background studies.
(f) For purposes of this section, a finding that a
delinquency petition is proven in juvenile court shall be
considered a conviction in state district court.
(g) A study of an individual in paragraph (c), clauses (1)
to (7), shall be conducted at least upon application for initial
license for all license types or registration under section
144A.71, subdivision 1, and at reapplication for a license or
registration for family child care, child foster care, and adult
foster care. The commissioner is not required to conduct a
study of an individual at the time of reapplication for a
license or if the individual has been continuously affiliated
with a foster care provider licensed by the commissioner of
human services and registered under chapter 144D, other than a
family day care or foster care license, if: (i) a study of the
individual was conducted either at the time of initial licensure
or when the individual became affiliated with the license
holder; (ii) the individual has been continuously affiliated
with the license holder since the last study was conducted; and
(iii) the procedure described in paragraph (j) has been
implemented and was in effect continuously since the last study
was conducted. For the purposes of this section, a physician
licensed under chapter 147 is considered to be continuously
affiliated upon the license holder's receipt from the
commissioner of health or human services of the physician's
background study results. For individuals who are required to
have background studies under paragraph (c) and who have been
continuously affiliated with a foster care provider that is
licensed in more than one county, criminal conviction data may
be shared among those counties in which the foster care programs
are licensed. A county agency's receipt of criminal conviction
data from another county agency shall meet the criminal data
background study requirements of this section.
(h) The commissioner may also conduct studies on
individuals specified in paragraph (c), clauses (3) and (4),
when the studies are initiated by:
(i) personnel pool agencies;
(ii) temporary personnel agencies;
(iii) educational programs that train persons by providing
direct contact services in licensed programs; and
(iv) professional services agencies that are not licensed
and which contract with licensed programs to provide direct
contact services or individuals who provide direct contact
services.
(i) Studies on individuals in paragraph (h), items (i) to
(iv), must be initiated annually by these agencies, programs,
and individuals. Except as provided in paragraph (a), clause
(3), no applicant, license holder, or individual who is the
subject of the study shall pay any fees required to conduct the
study.
(1) At the option of the licensed facility, rather than
initiating another background study on an individual required to
be studied who has indicated to the licensed facility that a
background study by the commissioner was previously completed,
the facility may make a request to the commissioner for
documentation of the individual's background study status,
provided that:
(i) the facility makes this request using a form provided
by the commissioner;
(ii) in making the request the facility informs the
commissioner that either:
(A) the individual has been continuously affiliated with a
licensed facility since the individual's previous background
study was completed, or since October 1, 1995, whichever is
shorter; or
(B) the individual is affiliated only with a personnel pool
agency, a temporary personnel agency, an educational program
that trains persons by providing direct contact services in
licensed programs, or a professional services agency that is not
licensed and which contracts with licensed programs to provide
direct contact services or individuals who provide direct
contact services; and
(iii) the facility provides notices to the individual as
required in paragraphs (a) to (j), and that the facility is
requesting written notification of the individual's background
study status from the commissioner.
(2) The commissioner shall respond to each request under
paragraph (1) with a written or electronic notice to the
facility and the study subject. If the commissioner determines
that a background study is necessary, the study shall be
completed without further request from a licensed agency or
notifications to the study subject.
(3) When a background study is being initiated by a
licensed facility or a foster care provider that is also
registered under chapter 144D, a study subject affiliated with
multiple licensed facilities may attach to the background study
form a cover letter indicating the additional facilities' names,
addresses, and background study identification numbers. When
the commissioner receives such notices, each facility identified
by the background study subject shall be notified of the study
results. The background study notice sent to the subsequent
agencies shall satisfy those facilities' responsibilities for
initiating a background study on that individual.
(j) If an individual who is affiliated with a program or
facility regulated by the department of human services or
department of health or who is affiliated with any type of home
care agency or provider of personal care assistance services, is
convicted of a crime constituting a disqualification under
subdivision 3d, the probation officer or corrections agent shall
notify the commissioner of the conviction. For the purpose of
this paragraph, "conviction" has the meaning given it in section
609.02, subdivision 5. The commissioner, in consultation with
the commissioner of corrections, shall develop forms and
information necessary to implement this paragraph and shall
provide the forms and information to the commissioner of
corrections for distribution to local probation officers and
corrections agents. The commissioner shall inform individuals
subject to a background study that criminal convictions for
disqualifying crimes will be reported to the commissioner by the
corrections system. A probation officer, corrections agent, or
corrections agency is not civilly or criminally liable for
disclosing or failing to disclose the information required by
this paragraph. Upon receipt of disqualifying information, the
commissioner shall provide the notifications required in
subdivision 3a, as appropriate to agencies on record as having
initiated a background study or making a request for
documentation of the background study status of the individual.
This paragraph does not apply to family day care and child
foster care programs.
(k) The individual who is the subject of the study must
provide the applicant or license holder with sufficient
information to ensure an accurate study including the
individual's first, middle, and last name and all other names by
which the individual has been known; home address, city, county,
and state of residence for the past five years; zip code; sex;
date of birth; and driver's license number or state
identification number. The applicant or license holder shall
provide this information about an individual in paragraph (c),
clauses (1) to (7), on forms prescribed by the commissioner. By
January 1, 2000, for background studies conducted by the
department of human services, the commissioner shall implement a
system for the electronic transmission of: (1) background study
information to the commissioner; and (2) background study
results to the license holder. The commissioner may request
additional information of the individual, which shall be
optional for the individual to provide, such as the individual's
social security number or race.
(l) For programs directly licensed by the commissioner, a
study must include information related to names of substantiated
perpetrators of maltreatment of vulnerable adults that has been
received by the commissioner as required under section 626.557,
subdivision 9c, paragraph (i), and the commissioner's records
relating to the maltreatment of minors in licensed programs,
information from juvenile courts as required in paragraph (c)
for persons listed in paragraph (c), clauses (2), (6), and (7),
and information from the bureau of criminal apprehension. For
child foster care, adult foster care, and family day care homes,
the study must include information from the county agency's
record of substantiated maltreatment of adults, and the
maltreatment of minors, information from juvenile courts as
required in paragraph (c) for persons listed in paragraph (c),
clauses (2), (6), and (7), and information from the bureau of
criminal apprehension. The commissioner may also review arrest
and investigative information from the bureau of criminal
apprehension, the commissioner of health, a county attorney,
county sheriff, county agency, local chief of police, other
states, the courts, or the Federal Bureau of Investigation if
the commissioner has reasonable cause to believe the information
is pertinent to the disqualification of an individual listed in
paragraph (c), clauses (1) to (7). The commissioner is not
required to conduct more than one review of a subject's records
from the Federal Bureau of Investigation if a review of the
subject's criminal history with the Federal Bureau of
Investigation has already been completed by the commissioner and
there has been no break in the subject's affiliation with the
license holder who initiated the background study.
(m) When the commissioner has reasonable cause to believe
that further pertinent information may exist on the subject, the
subject shall provide a set of classifiable fingerprints
obtained from an authorized law enforcement agency. For
purposes of requiring fingerprints, the commissioner shall be
considered to have reasonable cause under, but not limited to,
the following circumstances:
(1) information from the bureau of criminal apprehension
indicates that the subject is a multistate offender;
(2) information from the bureau of criminal apprehension
indicates that multistate offender status is undetermined; or
(3) the commissioner has received a report from the subject
or a third party indicating that the subject has a criminal
history in a jurisdiction other than Minnesota.
(n) The failure or refusal of an applicant, license holder,
or registrant under section 144A.71, subdivision 1, to cooperate
with the commissioner is reasonable cause to disqualify a
subject, deny a license application or immediately suspend,
suspend, or revoke a license or registration. Failure or
refusal of an individual to cooperate with the study is just
cause for denying or terminating employment of the individual if
the individual's failure or refusal to cooperate could cause the
applicant's application to be denied or the license holder's
license to be immediately suspended, suspended, or revoked.
(o) The commissioner shall not consider an application to
be complete until all of the information required to be provided
under this subdivision has been received.
(p) No person in paragraph (c), clauses (1) to (7), who is
disqualified as a result of this section may be retained by the
agency in a position involving direct contact with persons
served by the program or in a position allowing and no person in
paragraph (c), clauses (2), (6), and (7), or as provided
elsewhere in statute who is disqualified as a result of this
section may be allowed access to persons served by the
program as provided for in statutes, unless the commissioner has
provided written notice to the agency stating that:
(1) the individual may remain in direct contact during the
period in which the individual may request reconsideration as
provided in subdivision 3a, paragraph (b), clause (2) or (3);
(2) the individual's disqualification has been set aside
for that agency as provided in subdivision 3b, paragraph (b); or
(3) the license holder has been granted a variance for the
disqualified individual under subdivision 3e.
(q) Termination of affiliation with persons in paragraph
(c), clauses (1) to (7), made in good faith reliance on a notice
of disqualification provided by the commissioner shall not
subject the applicant or license holder to civil liability.
(r) The commissioner may establish records to fulfill the
requirements of this section.
(s) The commissioner may not disqualify an individual
subject to a study under this section because that person has,
or has had, a mental illness as defined in section 245.462,
subdivision 20.
(t) An individual subject to disqualification under this
subdivision has the applicable rights in subdivision 3a, 3b, or
3c.
(u) For the purposes of background studies completed by
tribal organizations performing licensing activities otherwise
required of the commissioner under this chapter, after obtaining
consent from the background study subject, tribal licensing
agencies shall have access to criminal history data in the same
manner as county licensing agencies and private licensing
agencies under this chapter.
(v) County agencies shall have access to the criminal
history data in the same manner as county licensing agencies
under this chapter for purposes of background studies completed
by county agencies on legal nonlicensed child care providers to
determine eligibility for child care funds under chapter 119B.
Sec. 10. Minnesota Statutes 2001 Supplement, section
245A.04, subdivision 3a, is amended to read:
Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF
STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15
working days, the commissioner shall notify the applicant,
license holder, or registrant under section 144A.71, subdivision
1, and the individual who is the subject of the study, in
writing or by electronic transmission, of the results of the
study or that more time is needed to complete the study. When
the study is completed, a notice that the study was undertaken
and completed shall be maintained in the personnel files of the
program. For studies on individuals pertaining to a license to
provide family day care or group family day care, 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, the
commissioner is not required to provide a separate notice of the
background study results to the individual who is the subject of
the study unless the study results in a disqualification of the
individual.
The commissioner shall notify the individual studied if the
information in the study indicates the individual is
disqualified from direct contact with persons served by the
program. The commissioner shall disclose the information
causing disqualification and instructions on how to request a
reconsideration of the disqualification to the individual
studied. An applicant or license holder who is not the subject
of the study shall be informed that the commissioner has found
information that disqualifies the subject from direct contact
with persons served by the program. However, only the
individual studied must be informed of the information contained
in the subject's background study unless the basis for the
disqualification is failure to cooperate, substantiated
maltreatment under section 626.556 or 626.557, the Data
Practices Act provides for release of the information, or the
individual studied authorizes the release of the information.
When a disqualification is based on the subject's failure to
cooperate with the background study or substantiated
maltreatment under section 626.556 or 626.557, the agency that
initiated the study shall be informed by the commissioner of the
reason for the disqualification.
(b) Except as provided in subdivision 3d, paragraph (b), if
the commissioner determines that the individual studied has a
disqualifying characteristic, the commissioner shall review the
information immediately available and make a determination as to
the subject's immediate risk of harm to persons served by the
program where the individual studied will have direct contact.
The commissioner shall consider all relevant information
available, including the following factors in determining the
immediate risk of harm: the recency of the disqualifying
characteristic; the recency of discharge from probation for the
crimes; the number of disqualifying characteristics; the
intrusiveness or violence of the disqualifying characteristic;
the vulnerability of the victim involved in the disqualifying
characteristic; and the similarity of the victim to the persons
served by the program where the individual studied will have
direct contact. The commissioner may determine that the
evaluation of the information immediately available gives the
commissioner reason to believe one of the following:
(1) The individual poses an imminent risk of harm to
persons served by the program where the individual studied will
have direct contact. If the commissioner determines that an
individual studied poses an imminent risk of harm to persons
served by the program where the individual studied will have
direct contact, the individual and the license holder must be
sent a notice of disqualification. The commissioner shall order
the license holder to immediately remove the individual studied
from direct contact. The notice to the individual studied must
include an explanation of the basis of this determination.
(2) The individual poses a risk of harm requiring
continuous, direct supervision while providing direct contact
services during the period in which the subject may request a
reconsideration. If the commissioner determines that an
individual studied poses a risk of harm that requires
continuous, direct supervision, the individual and the license
holder must be sent a notice of disqualification. The
commissioner shall order the license holder to immediately
remove the individual studied from direct contact services or
assure that the individual studied is within sight or hearing
under the continuous, direct supervision of another staff person
when providing direct contact services during the period in
which the individual may request a reconsideration of the
disqualification. If the individual studied does not submit a
timely request for reconsideration, or the individual submits a
timely request for reconsideration, but the disqualification is
not set aside for that license holder, the license holder will
be notified of the disqualification and ordered to immediately
remove the individual from any position allowing direct contact
with persons receiving services from the license holder.
(3) The individual does not pose an imminent risk of harm
or a risk of harm requiring continuous, direct supervision while
providing direct contact services during the period in which the
subject may request a reconsideration. If the commissioner
determines that an individual studied does not pose a risk of
harm that requires continuous, direct supervision, only the
individual must be sent a notice of disqualification. The
license holder must be sent a notice that more time is needed to
complete the individual's background study. If the individual
studied submits a timely request for reconsideration, and if the
disqualification is set aside for that license holder, the
license holder will receive the same notification received by
license holders in cases where the individual studied has no
disqualifying characteristic. If the individual studied does
not submit a timely request for reconsideration, or the
individual submits a timely request for reconsideration, but the
disqualification is not set aside for that license holder, the
license holder will be notified of the disqualification and
ordered to immediately remove the individual from any position
allowing direct contact with persons receiving services from the
license holder.
(c) County licensing agencies performing duties under this
subdivision may develop an alternative system for determining
the subject's immediate risk of harm to persons served by the
program, providing the notices under paragraph (b), and
documenting the action taken by the county licensing agency.
Each county licensing agency's implementation of the alternative
system is subject to approval by the commissioner.
Notwithstanding this alternative system, county licensing
agencies shall complete the requirements of paragraph (a).
Sec. 11. Minnesota Statutes 2001 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. Upon
showing that the information in clause (1) or (2) cannot be
obtained within 30 days, the disqualified individual may request
additional time, not to exceed 30 days, to obtain that
information. 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. An individual who was determined to
have maltreated a child under section 626.556 or a vulnerable
adult under section 626.557, and who was disqualified under this
section on the basis of serious or recurring maltreatment, may
request reconsideration of both the maltreatment and the
disqualification determinations. The request for
reconsideration of the maltreatment determination and the
disqualification must be submitted within 30 calendar days of
the 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 in
determining that the underlying conduct giving rise to the
disqualification occurred, and for maltreatment, that the
maltreatment was serious or recurring, 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 or 245A.08, subdivision 5, the commissioner's
order is conclusive on the issue of maltreatment. If the
individual did not request reconsideration of the maltreatment
determination, the maltreatment determination is deemed
conclusive; or
(2) the subject of the study does not pose a risk of harm
to any person served by the applicant, license holder, or
registrant under section 144A.71, subdivision 1.
(b) The commissioner shall rescind the disqualification if
the commissioner finds that the information relied on to
disqualify the subject is incorrect. The commissioner may set
aside the disqualification under this section if the
commissioner finds that the individual does not pose a risk of
harm to any person served by the applicant, license holder, or
registrant under section 144A.71, subdivision 1. In determining
that an individual does not pose a risk of harm, the
commissioner shall consider the nature, severity, and
consequences of the event or events that lead to
disqualification, whether there is more than one disqualifying
event, the age and vulnerability of the victim at the time of
the event, the harm suffered by the victim, the similarity
between the victim and persons served by the program, 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, applicant, or registrant under section
144A.71, subdivision 1, over the interests of the license
holder, applicant, or registrant under section 144A.71,
subdivision 1.
(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), a felony level
conviction involving alcohol or drug use, a gross misdemeanor
offense under 609.324, subdivision 1 (other prohibited acts), a
gross misdemeanor offense under 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
involuntary termination of parental rights under section
260C.301 or 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), a
felony offense under 609.324, subdivision 1 (other prohibited
acts), a felony offense under 609.378 (neglect or endangerment
of a child), 609.322 (solicitation, inducement, and promotion of
prostitution), 609.342 to 609.345 (criminal sexual conduct in
the first, second, third, or fourth degree), 609.352
(solicitation of children to engage in sexual conduct), 617.246
(use of minors in a sexual performance), 617.247 (possession of
pictorial representations of a minor), 609.365 (incest), a
felony offense under sections 609.2242 and 609.2243 (domestic
assault), a felony offense of spousal abuse, a felony offense of
child abuse or neglect, a felony offense of a crime against
children, or an attempt or conspiracy to commit any of these
offenses as defined in Minnesota Statutes, or an offense in any
other state, the elements of which are substantially similar to
any of the foregoing offenses;
(3) within the seven years preceding the study, the
individual committed an act that constitutes maltreatment of a
child under section 626.556, subdivision 10e, and that resulted
in substantial bodily harm as defined in section 609.02,
subdivision 7a, or substantial mental or emotional harm as
supported by competent psychological or psychiatric evidence; or
(4) within the seven years preceding the study, the
individual was determined under section 626.557 to be the
perpetrator of a substantiated incident of maltreatment of a
vulnerable adult that resulted in substantial bodily harm as
defined in section 609.02, subdivision 7a, or substantial mental
or emotional harm as supported by competent psychological or
psychiatric evidence.
In the case of any ground for disqualification under
clauses (1) to (4), if the act was committed by an individual
other than the applicant, license holder, or registrant under
section 144A.71, subdivision 1, residing in the applicant's or
license holder's home, or the home of a registrant under section
144A.71, subdivision 1, the applicant, license holder, or
registrant under section 144A.71, subdivision 1, may seek
reconsideration when the individual who committed the act no
longer resides in the home.
The disqualification periods provided under clauses (1),
(3), and (4) are the minimum applicable disqualification
periods. The commissioner may determine that an individual
should continue to be disqualified from licensure or
registration under section 144A.71, subdivision 1, because the
license holder, applicant, or registrant under section 144A.71,
subdivision 1, poses a risk of harm to a person served by that
individual after the minimum disqualification period has passed.
(d) The commissioner shall respond in writing or by
electronic transmission to all reconsideration requests for
which the basis for the request is that the information relied
upon by the commissioner to disqualify is incorrect or
inaccurate within 30 working days of receipt of a request and
all relevant information. If the basis for the request is that
the individual does not pose a risk of harm, the commissioner
shall respond to the request within 15 working days after
receiving the request for reconsideration and all relevant
information. If the request is based on both the correctness or
accuracy of the information relied on to disqualify the
individual and the risk of harm, the commissioner shall respond
to the request within 45 working days after receiving the
request for reconsideration and all relevant information. If
the disqualification is set aside, the commissioner shall notify
the applicant or license holder in writing or by electronic
transmission of the decision.
(e) Except as provided in subdivision 3c, if a
disqualification for which reconsideration was requested is not
set aside or is not rescinded, an individual who was
disqualified on the basis of a preponderance of evidence that
the individual committed an act or acts that meet the definition
of any of the crimes lists listed in subdivision 3d, paragraph
(a), clauses (1) to (4); or for failure to make required reports
under section 626.556, subdivision 3, or 626.557, subdivision 3,
pursuant to subdivision 3d, paragraph (a), clause (4), may
request a fair hearing under section 256.045. Except as
provided under subdivision 3c, the commissioner's final order
for an individual under this paragraph is conclusive on the
issue of maltreatment and disqualification, including for
purposes of subsequent studies conducted under subdivision 3,
and fair hearing is the only administrative appeal of the final
agency determination, specifically, including a challenge to the
accuracy and completeness of data under section 13.04.
(f) Except as provided under subdivision 3c, if an
individual was disqualified on the basis of a determination of
maltreatment under section 626.556 or 626.557, which was serious
or recurring, and the individual has requested reconsideration
of the maltreatment determination under section 626.556,
subdivision 10i, or 626.557, subdivision 9d, and also requested
reconsideration of the disqualification under this subdivision,
reconsideration of the maltreatment determination and
reconsideration of the disqualification shall be consolidated
into a single reconsideration. For maltreatment and
disqualification determinations made by county agencies, the
consolidated reconsideration shall be conducted by the county
agency. If the county agency has disqualified an individual on
multiple bases, one of which is a county maltreatment
determination for which the individual has a right to request
reconsideration, the county shall conduct the reconsideration of
all disqualifications. Except as provided under subdivision 3c,
if an individual who was disqualified on the basis of serious or
recurring maltreatment requests a fair hearing on the
maltreatment determination under section 626.556, subdivision
10i, or 626.557, subdivision 9d, and requests a fair hearing on
the disqualification, which has not been set aside or rescinded
under this subdivision, the scope of the fair hearing under
section 256.045 shall include the maltreatment determination and
the disqualification. Except as provided under subdivision
3c, the commissioner's final order for an individual under this
paragraph is conclusive on the issue of maltreatment and
disqualification, including for purposes of subsequent studies
conducted under subdivision 3, and a fair hearing is the only
administrative appeal of the final agency determination,
specifically, including a challenge to the accuracy and
completeness of data under section 13.04.
Sec. 12. Minnesota Statutes 2000, section 245A.04, is
amended by adding a subdivision to read:
Subd. 3f. [CONCLUSIVE DETERMINATIONS OR DISPOSITIONS.]
Unless otherwise specified in statute, the following
determinations or dispositions are deemed conclusive:
(1) a maltreatment determination or disposition under
section 626.556 or 626.557, if:
(i) the commissioner has issued a final order in an appeal
of that determination or disposition under section 245A.08,
subdivision 5, or 256.045;
(ii) the individual did not request reconsideration of the
maltreatment determination or disposition under section 626.556
or 626.557; or
(iii) the individual did not request a hearing of the
maltreatment determination or disposition under section 256.045;
and
(2) a determination that the information relied upon to
disqualify an individual under subdivision 3d, was correct based
on serious or recurring maltreatment; or
(3) a preponderance of evidence shows that the individual
committed an act or acts that meet the definition of any of the
crimes listed in subdivision 3d, paragraph (a), clauses (1) to
(4); or the individual's failure to make required reports under
section 626.556, subdivision 3, or 626.557, subdivision 3, if:
(i) the commissioner has issued a final order in an appeal
of that determination under section 245A.08, subdivision 5, or
256.045, or a court has issued a final decision;
(ii) the individual did not request reconsideration of the
disqualification under this section; or
(iii) the individual did not request a hearing on the
disqualification under section 256.045.
Sec. 13. Minnesota Statutes 2001 Supplement, section
245A.07, subdivision 2a, is amended to read:
Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a)
Within five working days of receipt of the license holder's
timely appeal, the commissioner shall request assignment of an
administrative law judge. The request must include a proposed
date, time, and place of a hearing. A hearing must be conducted
by an administrative law judge within 30 calendar days of the
request for assignment, unless an extension is requested by
either party and granted by the administrative law judge for
good cause. The commissioner shall issue a notice of hearing by
certified mail at least ten working days before the hearing.
The scope of the hearing shall be limited solely to the issue of
whether the temporary immediate suspension should remain in
effect pending the commissioner's final order under section
245A.08, regarding a licensing sanction issued under subdivision
3 following the immediate suspension. The burden of proof in
expedited hearings under this subdivision shall be limited to
the commissioner's demonstration that reasonable cause exists to
believe that the license holder's actions or failure to comply
with applicable law or rule poses an imminent risk of harm to
the health, safety, or rights of persons served by the program.
(b) The administrative law judge shall issue findings of
fact, conclusions, and a recommendation within ten working days
from the date of hearing. The commissioner's final order shall
be issued within ten working days from receipt of the
recommendation of the administrative law judge. Within 90
calendar days after a final order affirming an immediate
suspension, the commissioner shall make a determination
regarding whether a final licensing sanction shall be issued
under subdivision 3. The license holder shall continue to be
prohibited from operation of the program during this 90-day
period.
(c) When the final order under paragraph (b) affirms an
immediate suspension, and a final licensing sanction is issued
under subdivision 3, and the license holder appeals that
sanction, the license holder continues to be prohibited from
operation of the program pending a final commissioner's order
under section 245A.08, subdivision 5, regarding the final
licensing sanction.
Sec. 14. Minnesota Statutes 2001 Supplement, section
245A.07, subdivision 3, is amended to read:
Subd. 3. [LICENSE SUSPENSION, REVOCATION, OR FINE.] The
commissioner may suspend or revoke a license, or impose a fine
if a license holder fails to comply fully with applicable laws
or rules, or knowingly withholds relevant information from or
gives false or misleading information to the commissioner in
connection with an application for a license, in connection with
the background study status of an individual, or during an
investigation. A license holder who has had a license
suspended, revoked, or has been ordered to pay a fine must be
given notice of the action by certified mail. The notice must
be mailed to the address shown on the application or the last
known address of the license holder. The notice must state the
reasons the license was suspended, revoked, or a fine was
ordered.
(a) If the license was suspended or revoked, the notice
must inform the license holder of the right to a contested case
hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to
1400.8612 and successor rules. The license holder may appeal an
order suspending or revoking a license. The appeal of an order
suspending or revoking a license must be made in writing by
certified mail and must be received by the commissioner within
ten calendar days after the license holder receives notice that
the license has been suspended or revoked. Except as provided
in subdivision 2a, paragraph (c), a timely appeal of an order
suspending or revoking a license shall stay the suspension or
revocation until the commissioner issues a final order.
(b)(1) If the license holder was ordered to pay a fine, the
notice must inform the license holder of the responsibility for
payment of fines and the right to a contested case hearing under
chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and
successor rules. The appeal of an order to pay a fine must be
made in writing by certified mail and must be received by the
commissioner within ten calendar days after the license holder
receives notice that the fine has been ordered.
(2) The license holder shall pay the fines assessed on or
before the payment date specified. If the license holder fails
to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder
complies. If the license holder receives state funds, the
state, county, or municipal agencies or departments responsible
for administering the funds shall withhold payments and recover
any payments made while the license is suspended for failure to
pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.
(3) A license holder shall promptly notify the commissioner
of human services, in writing, when a violation specified in the
order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected
as indicated by the order to forfeit a fine, the commissioner
may issue a second fine. The commissioner shall notify the
license holder by certified mail that a second fine has been
assessed. The license holder may appeal the second fine as
provided under this subdivision.
(4) Fines shall be assessed as follows: the license holder
shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable
adult under section 626.557; the license holder shall forfeit
$200 for each occurrence of a violation of law or rule governing
matters of health, safety, or supervision, including but not
limited to the provision of adequate staff-to-child or adult
ratios, and failure to submit a background study; and the
license holder shall forfeit $100 for each occurrence of a
violation of law or rule other than those subject to a $1,000 or
$200 fine above. For purposes of this section, "occurrence"
means each violation identified in the commissioner's fine order.
(5) When a fine has been assessed, the license holder may
not avoid payment by closing, selling, or otherwise transferring
the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the
case of a corporation, each controlling individual is personally
and jointly liable for payment.
Sec. 15. [245A.085] [CONSOLIDATION OF HEARINGS;
RECONSIDERATION.]
Hearings authorized under this chapter and sections
256.045, 626.556, and 626.557, shall be consolidated if feasible
and in accordance with other applicable statutes and rules.
Reconsideration under sections 245A.04, subdivision 3c; 626.556,
subdivision 10i; and 626.557, subdivision 9d, shall also be
consolidated if feasible.
Sec. 16. Minnesota Statutes 2001 Supplement, section
245A.144, is amended to read:
245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME
IN CHILD CARE PROGRAMS.]
License holders must ensure that before staff persons,
caregivers, and helpers assist in the care of infants, they
receive training on reducing the risk of sudden infant death
syndrome. The training on reducing the risk of sudden infant
death syndrome may be provided as orientation training under
Minnesota Rules, part 9503.0035, subpart 1, as initial training
under Minnesota Rules, part 9502.0385, subpart 2, as in-service
training under Minnesota Rules, part 9503.0035, subpart 4, or as
ongoing training under Minnesota Rules, part 9502.0385, subpart
3. Training required under this section must be at least one
hour in length and must be completed at least once every five
years. At a minimum, the training must address the risk factors
related to sudden infant death syndrome, means of reducing the
risk of sudden infant death syndrome in child care, and license
holder communication with parents regarding reducing the risk of
sudden infant death syndrome. Training for family and group
family child care providers must be approved by the county
licensing agency according to Minnesota Rules, part 9502.0385.
Sec. 17. [245A.151] [FIRE MARSHAL INSPECTION.]
When licensure under this chapter requires an inspection by
a fire marshal to determine compliance with the Minnesota
Uniform Fire Code under section 299F.011, a local fire code
inspector approved by the state fire marshal may conduct the
inspection. If a community does not have a local fire code
inspector or if the local fire code inspector does not perform
the inspection, the state fire marshal must conduct the
inspection. A local fire code inspector or the state fire
marshal may recover the cost of these inspections through a fee
of no more than $50 per inspection charged to the applicant or
license holder. The fees collected by the state fire marshal
under this section are appropriated to the commissioner of
public safety for the purpose of conducting the inspections.
Sec. 18. Minnesota Statutes 2001 Supplement, section
245A.16, subdivision 1, is amended to read:
Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a)
County agencies and private agencies that have been designated
or licensed by the commissioner to perform licensing functions
and activities under section 245A.04, to recommend denial of
applicants under section 245A.05, to issue correction orders, to
issue variances, and recommend a conditional license under
section 245A.06, or to recommend suspending or revoking a
license or issuing a fine under section 245A.07, shall comply
with rules and directives of the commissioner governing those
functions and with this section. The following variances are
excluded from the delegation of variance authority and may be
issued only by the commissioner:
(1) dual licensure of family child care and child foster
care, dual licensure of child and adult foster care, and adult
foster care and family child care;
(2) adult foster care maximum capacity;
(3) adult foster care minimum age requirement;
(4) child foster care maximum age requirement;
(5) variances regarding disqualified individuals except
that county agencies may issue variances under section 245A.04,
subdivision 3e, regarding disqualified individuals when the
county is responsible for conducting a consolidated
reconsideration according to section 245A.04, subdivision 3b,
paragraph (f), of a county maltreatment determination and a
disqualification based on serious or recurring maltreatment; and
(6) the required presence of a caregiver in the adult
foster care residence during normal sleeping hours.
(b) County agencies must report information about
disqualification reconsiderations under section 245A.04,
subdivision 3b, paragraph (f), and variances granted under
paragraph (a), clause (5), to the commissioner at least monthly
in a format prescribed by the commissioner.
(c) For family day care programs, the commissioner may
authorize licensing reviews every two years after a licensee has
had at least one annual review.
Sec. 19. Minnesota Statutes 2001 Supplement, section
256.045, subdivision 3b, is amended to read:
Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND
DISQUALIFICATION HEARINGS.] (a) The state human services referee
shall determine that maltreatment has occurred if a
preponderance of evidence exists to support the final
disposition under sections 626.556 and 626.557. For purposes of
hearings regarding disqualification, the state human services
referee shall affirm the proposed disqualification in an appeal
under subdivision 3, paragraph (a), clause (9), if a
preponderance of the evidence shows the individual has:
(1) committed maltreatment under section 626.556 or
626.557, which is serious or recurring;
(2) committed an act or acts meeting the definition of any
of the crimes listed in section 245A.04, subdivision 3d,
paragraph (a), clauses (1) to (4); or
(3) failed to make required reports under section 626.556
or 626.557, for incidents in which:
(i) the final disposition under section 626.556 or 626.557
was substantiated maltreatment; and
(ii) the maltreatment was recurring or serious; or
substantiated serious or recurring maltreatment of a minor under
section 626.556 or of a vulnerable adult under section 626.557
for which there is a preponderance of evidence that the
maltreatment occurred, and that the subject was responsible for
the maltreatment that was serious or recurring.
(b) If the disqualification is affirmed, the state human
services referee shall determine whether the individual poses a
risk of harm in accordance with the requirements of section
245A.04, subdivision 3b.
(c) The state human services referee shall recommend an
order to the commissioner of health, children, families, and
learning, or human services, as applicable, who shall issue a
final order. The commissioner shall affirm, reverse, or modify
the final disposition. Any order of the commissioner issued in
accordance with this subdivision is conclusive upon the parties
unless appeal is taken in the manner provided in subdivision 7.
Except as provided under section 245A.04, subdivisions 3b,
paragraphs (e) and (f), and 3c, In any licensing appeal under
chapter 245A and sections 144.50 to 144.58 and 144A.02 to
144A.46, the commissioner's determination as to maltreatment is
conclusive, as provided under section 245A.04, subdivision 3f.
Sec. 20. Minnesota Statutes 2001 Supplement, section
256.045, subdivision 4, is amended to read:
Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held
pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted
according to the provisions of the federal Social Security Act
and the regulations implemented in accordance with that act to
enable this state to qualify for federal grants-in-aid, and
according to the rules and written policies of the commissioner
of human services. County agencies shall install equipment
necessary to conduct telephone hearings. A state human services
referee may schedule a telephone conference hearing when the
distance or time required to travel to the county agency offices
will cause a delay in the issuance of an order, or to promote
efficiency, or at the mutual request of the parties. Hearings
may be conducted by telephone conferences unless the applicant,
recipient, former recipient, person, or facility contesting
maltreatment objects. The hearing shall not be held earlier
than five days after filing of the required notice with the
county or state agency. The state human services referee shall
notify all interested persons of the time, date, and location of
the hearing at least five days before the date of the hearing.
Interested persons may be represented by legal counsel or other
representative of their choice, including a provider of therapy
services, at the hearing and may appear personally, testify and
offer evidence, and examine and cross-examine witnesses. The
applicant, recipient, former recipient, person, or facility
contesting maltreatment shall have the opportunity to examine
the contents of the case file and all documents and records to
be used by the county or state agency at the hearing at a
reasonable time before the date of the hearing and during the
hearing. In hearings under subdivision 3, paragraph (a),
clauses (4), (8), and (9), either party may subpoena the private
data relating to the investigation prepared by the agency under
section 626.556 or 626.557 that is not otherwise accessible
under section 13.04, provided the identity of the reporter may
not be disclosed.
(b) The private data obtained by subpoena in a hearing
under subdivision 3, paragraph (a), clause (4), (8), or (9),
must be subject to a protective order which prohibits its
disclosure for any other purpose outside the hearing provided
for in this section without prior order of the district court.
Disclosure without court order is punishable by a sentence of
not more than 90 days imprisonment or a fine of not more than
$700, or both. These restrictions on the use of private data do
not prohibit access to the data under section 13.03, subdivision
6. Except for appeals under subdivision 3, paragraph (a),
clauses (4), (5), (8), and (9), upon request, the county agency
shall provide reimbursement for transportation, child care,
photocopying, medical assessment, witness fee, and other
necessary and reasonable costs incurred by the applicant,
recipient, or former recipient in connection with the appeal.
All evidence, except that privileged by law, commonly accepted
by reasonable people in the conduct of their affairs as having
probative value with respect to the issues shall be submitted at
the hearing and such hearing shall not be "a contested case"
within the meaning of section 14.02, subdivision 3. The agency
must present its evidence prior to or at the hearing, and may
not submit evidence after the hearing except by agreement of the
parties at the hearing, provided the petitioner has the
opportunity to respond.
(c) In hearings under subdivision 3, paragraph (a), clauses
(4), (8), and (9), involving determinations of maltreatment or
disqualification made by more than one county agency, by a
county agency and a state agency, or by more than one state
agency, the hearings may be consolidated into a single fair
hearing upon the consent of all parties and the state human
services referee.
Sec. 21. Minnesota Statutes 2001 Supplement, section
626.556, subdivision 10i, is amended to read:
Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL
DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON
SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as
provided under paragraph (e), an individual or facility that the
commissioner of human services, a local social service agency,
or the commissioner of children, families, and learning
determines has maltreated a child, an interested person acting
on behalf of the child, regardless of the determination, who
contests the investigating agency's final determination
regarding maltreatment, may request the investigating agency to
reconsider its final determination regarding maltreatment. The
request for reconsideration must be submitted in writing to the
investigating agency within 15 calendar days after receipt of
notice of the final determination regarding maltreatment or, if
the request is made by an interested person who is not entitled
to notice, within 15 days after receipt of the notice by the
parent or guardian of the child. Effective January 1, 2002, an
individual who was determined to have maltreated a child under
this section and who was disqualified on the basis of serious or
recurring maltreatment under section 245A.04, subdivision 3d,
may request reconsideration of the maltreatment determination
and the disqualification. The request for reconsideration of
the maltreatment determination and the disqualification must be
submitted within 30 calendar days of the individual's receipt of
the notice of disqualification under section 245A.04,
subdivision 3a.
(b) Except as provided under paragraphs (e) and (f), if the
investigating agency denies the request or fails to act upon the
request within 15 calendar days after receiving the request for
reconsideration, the person or facility entitled to a fair
hearing under section 256.045 may submit to the commissioner of
human services or the commissioner of children, families, and
learning a written request for a hearing under that section.
Section 256.045 also governs hearings requested to contest a
final determination of the commissioner of children, families,
and learning. For reports involving maltreatment of a child in
a facility, an interested person acting on behalf of the child
may request a review by the child maltreatment review panel
under section 256.022 if the investigating agency denies the
request or fails to act upon the request or if the interested
person contests a reconsidered determination. The investigating
agency shall notify persons who request reconsideration of their
rights under this paragraph. The request must be submitted in
writing to the review panel and a copy sent to the investigating
agency within 30 calendar days of receipt of notice of a denial
of a request for reconsideration or of a reconsidered
determination. The request must specifically identify the
aspects of the agency determination with which the person is
dissatisfied.
(c) If, as a result of a reconsideration or review, the
investigating agency changes the final determination of
maltreatment, that agency shall notify the parties specified in
subdivisions 10b, 10d, and 10f.
(d) Except as provided under paragraph (f), if an
individual or facility contests the investigating agency's final
determination regarding maltreatment by requesting a fair
hearing under section 256.045, the commissioner of human
services shall assure that the hearing is conducted and a
decision is reached within 90 days of receipt of the request for
a hearing. The time for action on the decision may be extended
for as many days as the hearing is postponed or the record is
held open for the benefit of either party.
(e) Effective January 1, 2002, if an individual was
disqualified under section 245A.04, subdivision 3d, on the basis
of a determination of maltreatment, which was serious or
recurring, and the individual has requested reconsideration of
the maltreatment determination under paragraph (a) and requested
reconsideration of the disqualification under section 245A.04,
subdivision 3b, reconsideration of the maltreatment
determination and reconsideration of the disqualification shall
be consolidated into a single reconsideration. If
reconsideration of the maltreatment determination is denied or
the disqualification is not set aside or rescinded under section
245A.04, subdivision 3b, the individual may request a fair
hearing under section 256.045. If an individual disqualified on
the basis of a determination of maltreatment, which was serious
or recurring requests a fair hearing under paragraph (b) on the
maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment
determination and the disqualification.
(f) Effective January 1, 2002, if a maltreatment
determination or a disqualification based on serious or
recurring maltreatment is the basis for a denial of a license
under section 245A.05 or a licensing sanction under section
245A.07, the license holder has the right to a contested case
hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to
1400.8612 and successor rules. As provided for under section
245A.08, subdivision 2a, the scope of the contested case hearing
shall include the maltreatment determination, disqualification,
and licensing sanction or denial of a license. In such cases, a
fair hearing regarding the maltreatment determination shall not
be conducted under paragraph (b). If the disqualified subject
is an individual other than the license holder and upon whom a
background study must be conducted under section 245A.04,
subdivision 3, the hearings of all parties may be consolidated
into a single contested case hearing upon consent of all parties
and the administrative law judge.
(g) For purposes of this subdivision, "interested person
acting on behalf of the child" means a parent or legal guardian;
stepparent; grandparent; guardian ad litem; adult stepbrother,
stepsister, or sibling; or adult aunt or uncle; unless the
person has been determined to be the perpetrator of the
maltreatment.
Sec. 22. Minnesota Statutes 2000, section 626.557,
subdivision 3a, is amended to read:
Subd. 3a. [REPORT NOT REQUIRED.] The following events are
not required to be reported under this section:
(a) A circumstance where federal law specifically prohibits
a person from disclosing patient identifying information in
connection with a report of suspected maltreatment, unless the
vulnerable adult, or the vulnerable adult's guardian,
conservator, or legal representative, has consented to
disclosure in a manner which conforms to federal requirements.
Facilities whose patients or residents are covered by such a
federal law shall seek consent to the disclosure of suspected
maltreatment from each patient or resident, or a guardian,
conservator, or legal representative, upon the patient's or
resident's admission to the facility. Persons who are
prohibited by federal law from reporting an incident of
suspected maltreatment shall immediately seek consent to make a
report.
(b) Verbal or physical aggression occurring between
patients, residents, or clients of a facility, or self-abusive
behavior by these persons does not constitute abuse unless the
behavior causes serious harm. The operator of the facility or a
designee shall record incidents of aggression and self-abusive
behavior to facilitate review by licensing agencies and county
and local welfare agencies.
(c) Accidents as defined in section 626.5572, subdivision 3.
(d) Events occurring in a facility that result from an
individual's single mistake error in the provision of
therapeutic conduct to a vulnerable adult, as defined provided
in section 626.5572, subdivision 17, paragraph (c), clause (4).
(e) Nothing in this section shall be construed to require a
report of financial exploitation, as defined in section
626.5572, subdivision 9, solely on the basis of the transfer of
money or property by gift or as compensation for services
rendered.
Sec. 23. Minnesota Statutes 2001 Supplement, section
626.557, subdivision 9d, is amended to read:
Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL
DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON
SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as
provided under paragraph (e), any individual or facility which a
lead agency determines has maltreated a vulnerable adult, or the
vulnerable adult or an interested person acting on behalf of the
vulnerable adult, regardless of the lead agency's determination,
who contests the lead agency's final disposition of an
allegation of maltreatment, may request the lead agency to
reconsider its final disposition. The request for
reconsideration must be submitted in writing to the lead agency
within 15 calendar days after receipt of notice of final
disposition or, if the request is made by an interested person
who is not entitled to notice, within 15 days after receipt of
the notice by the vulnerable adult or the vulnerable adult's
legal guardian. An individual who was determined to have
maltreated a vulnerable adult under this section and who was
disqualified on the basis of serious or recurring maltreatment
under section 245A.04, subdivision 3d, may request
reconsideration of the maltreatment determination and the
disqualification. The request for reconsideration of the
maltreatment determination and the disqualification must be
submitted within 30 calendar days of the individual's receipt of
the notice of disqualification under section 245A.04,
subdivision 3a.
(b) Except as provided under paragraphs (e) and (f), if the
lead agency denies the request or fails to act upon the request
within 15 calendar days after receiving the request for
reconsideration, the person or facility entitled to a fair
hearing under section 256.045, may submit to the commissioner of
human services a written request for a hearing under that
statute. The vulnerable adult, or an interested person acting
on behalf of the vulnerable adult, may request a review by the
vulnerable adult maltreatment review panel under section 256.021
if the lead agency denies the request or fails to act upon the
request, or if the vulnerable adult or interested person
contests a reconsidered disposition. The lead agency shall
notify persons who request reconsideration of their rights under
this paragraph. The request must be submitted in writing to the
review panel and a copy sent to the lead agency within 30
calendar days of receipt of notice of a denial of a request for
reconsideration or of a reconsidered disposition. The request
must specifically identify the aspects of the agency
determination with which the person is dissatisfied.
(c) If, as a result of a reconsideration or review, the
lead agency changes the final disposition, it shall notify the
parties specified in subdivision 9c, paragraph (d).
(d) For purposes of this subdivision, "interested person
acting on behalf of the vulnerable adult" means a person
designated in writing by the vulnerable adult to act on behalf
of the vulnerable adult, or a legal guardian or conservator or
other legal representative, a proxy or health care agent
appointed under chapter 145B or 145C, or an individual who is
related to the vulnerable adult, as defined in section 245A.02,
subdivision 13.
(e) If an individual was disqualified under section
245A.04, subdivision 3d, on the basis of a determination of
maltreatment, which was serious or recurring, and the individual
has requested reconsideration of the maltreatment determination
under paragraph (a) and reconsideration of the disqualification
under section 245A.04, subdivision 3b, reconsideration of the
maltreatment determination and requested reconsideration of the
disqualification shall be consolidated into a single
reconsideration. If reconsideration of the maltreatment
determination is denied or if the disqualification is not set
aside or rescinded under section 245A.04, subdivision 3b, the
individual may request a fair hearing under section 256.045. If
an individual who was disqualified on the basis of serious or
recurring maltreatment requests a fair hearing under paragraph
(b) on the maltreatment determination and the disqualification,
the scope of the fair hearing shall include both the
maltreatment determination and the disqualification.
(f) If a maltreatment determination or a disqualification
based on serious or recurring maltreatment is the basis for a
denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right
to a contested case hearing under chapter 14 and Minnesota
Rules, parts 1400.8510 to 1400.8612 and successor rules. As
provided for under section 245A.08, the scope of the contested
case hearing shall include the maltreatment determination,
disqualification, and licensing sanction or denial of a
license. In such cases, a fair hearing shall not be conducted
under paragraph (b). If the disqualified subject is an
individual other than the license holder and upon whom a
background study must be conducted under section 245A.04,
subdivision 3, the hearings of all parties may be consolidated
into a single contested case hearing upon consent of all parties
and the administrative law judge.
(g) Until August 1, 2002, an individual or facility that
was determined by the commissioner of human services or the
commissioner of health to be responsible for neglect under
section 626.5572, subdivision 17, after October 1, 1995, and
before August 1, 2001, that believes that the finding of neglect
does not meet an amended definition of neglect may request a
reconsideration of the determination of neglect. The
commissioner of human services or the commissioner of health
shall mail a notice to the last known address of individuals who
are eligible to seek this reconsideration. The request for
reconsideration must state how the established findings no
longer meet the elements of the definition of neglect. The
commissioner shall review the request for reconsideration and
make a determination within 15 calendar days. The
commissioner's decision on this reconsideration is the final
agency action.
(1) For purposes of compliance with the data destruction
schedule under subdivision 12b, paragraph (d), when a finding of
substantiated maltreatment has been changed as a result of a
reconsideration under this paragraph, the date of the original
finding of a substantiated maltreatment must be used to
calculate the destruction date.
(2) For purposes of any background studies under section
245A.04, when a determination of substantiated maltreatment has
been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under
section 245A.04 that was based on this determination of
maltreatment shall be rescinded, and for future background
studies under section 245A.04 the commissioner must not use the
previous determination of substantiated maltreatment as a basis
for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing
board under section 245A.04, subdivision 3d, paragraph (b).
ARTICLE 2
CONTINUING CARE AND HEALTH CARE
Section 1. Minnesota Statutes 2001 Supplement, section
144A.071, subdivision 1a, is amended to read:
Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071
to 144A.073, the following terms have the meanings given them:
(a) "Attached fixtures" has the meaning given in Minnesota
Rules, part 9549.0020, subpart 6.
(b) "Buildings" has the meaning given in Minnesota Rules,
part 9549.0020, subpart 7.
(c) "Capital assets" has the meaning given in section
256B.421, subdivision 16.
(d) "Commenced construction" means that all of the
following conditions were met: the final working drawings and
specifications were approved by the commissioner of health; the
construction contracts were let; a timely construction schedule
was developed, stipulating dates for beginning, achieving
various stages, and completing construction; and all zoning and
building permits were applied for.
(e) "Completion date" means the date on which a certificate
of occupancy is issued for a construction project, or if a
certificate of occupancy is not required, the date on which the
construction project is available for facility use.
(f) "Construction" means any erection, building,
alteration, reconstruction, modernization, or improvement
necessary to comply with the nursing home licensure rules.
(g) "Construction project" means:
(1) a capital asset addition to, or replacement of a
nursing home or certified boarding care home that results in new
space or the remodeling of or renovations to existing facility
space;
(2) the remodeling or renovation of existing facility space
the use of which is modified as a result of the project
described in clause (1). This existing space and the project
described in clause (1) must be used for the functions as
designated on the construction plans on completion of the
project described in clause (1) for a period of not less than 24
months; or
(3) capital asset additions or replacements that are
completed within 12 months before or after the completion date
of the project described in clause (1).
(h) "New licensed" or "new certified beds" means:
(1) newly constructed beds in a facility or the
construction of a new facility that would increase the total
number of licensed nursing home beds or certified boarding care
or nursing home beds in the state; or
(2) newly licensed nursing home beds or newly certified
boarding care or nursing home beds that result from remodeling
of the facility that involves relocation of beds but does not
result in an increase in the total number of beds, except when
the project involves the upgrade of boarding care beds to
nursing home beds, as defined in section 144A.073, subdivision
1. "Remodeling" includes any of the type of conversion,
renovation, replacement, or upgrading projects as defined in
section 144A.073, subdivision 1.
(i) "Project construction costs" means the cost of the
facility capital asset additions, replacements, renovations, or
remodeling projects, construction site preparation costs, and
related soft costs. Project construction costs include the cost
of any remodeling or renovation of existing facility space which
is modified as a result of the construction project. Project
construction costs also includes the cost of new technology
implemented as part of the construction project. Project
construction costs also include the cost of new technology
implemented as part of the construction project and depreciable
equipment directly identified to the project. Any new
technology and depreciable equipment included in the project
construction costs shall, at the written election of the
facility, be included in the facility's appraised value for
purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt
incurred for its purchase shall be included as allowable debt
for purposes of Minnesota Rules, part 9549.0060, subpart 5,
items A and C. Any new technology and depreciable equipment
included in the project construction costs that the facility
elects not to include in its appraised value and allowable debt
shall be treated as provided in section 256B.431, subdivision
17, paragraph (b). Written election under this paragraph must
be included in the facility's request for the rate change
related to the project, and this election may not be changed.
(j) "Technology" means information systems or devices that
make documentation, charting, and staff time more efficient or
encourage and allow for care through alternative settings
including, but not limited to, touch screens, monitors,
hand-helds, swipe cards, motion detectors, pagers, telemedicine,
medication dispensers, and equipment to monitor vital signs and
self-injections, and to observe skin and other conditions.
Sec. 2. Minnesota Statutes 2001 Supplement, section
144A.36, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] "Eligible nursing home"
means any nursing home licensed under sections 144A.01 to
144A.155 and or any boarding care facility, certified by the
appropriate authority under United States Code, title 42,
sections 1396-1396p, to participate as a vendor in the medical
assistance program established under chapter 256B.
Sec. 3. Minnesota Statutes 2000, section 144D.01,
subdivision 4, is amended to read:
Subd. 4. [HOUSING WITH SERVICES ESTABLISHMENT OR
ESTABLISHMENT.] (a) "Housing with services establishment" or
"establishment" means:
(1) an establishment providing sleeping accommodations to
one or more adult residents, at least 80 percent of which are 55
years of age or older, and offering or providing, for a fee, one
or more regularly scheduled health-related services or two or
more regularly scheduled supportive services, whether offered or
provided directly by the establishment or by another entity
arranged for by the establishment; or
(2) an establishment that registers under section 144D.025.
(b) Housing with services establishment does not include:
(1) a nursing home licensed under chapter 144A;
(2) a hospital, certified boarding care home, or supervised
living facility licensed under sections 144.50 to 144.56;
(3) a board and lodging establishment licensed under
chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670,
9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to
9530.4450, or under chapter 245B;
(4) a board and lodging establishment which serves as a
shelter for battered women or other similar purpose;
(5) a family adult foster care home licensed by the
department of human services;
(6) private homes in which the residents are related by
kinship, law, or affinity with the providers of services;
(7) residential settings for persons with mental
retardation or related conditions in which the services are
licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or
applicable successor rules or laws;
(8) a home-sharing arrangement such as when an elderly or
disabled person or single-parent family makes lodging in a
private residence available to another person in exchange for
services or rent, or both;
(9) a duly organized condominium, cooperative, common
interest community, or owners' association of the foregoing
where at least 80 percent of the units that comprise the
condominium, cooperative, or common interest community are
occupied by individuals who are the owners, members, or
shareholders of the units; or
(10) services for persons with developmental disabilities
that are provided under a license according to Minnesota Rules,
parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or
under chapter 245B.
Sec. 4. [144D.025] [OPTIONAL REGISTRATION.]
An establishment that meets all the requirements of this
chapter except that fewer than 80 percent of the adult residents
are age 55 or older may, at its option, register as a housing
with services establishment.
Sec. 5. Minnesota Statutes 2000, section 245.462,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case
management service provider" means a case manager or case
manager associate employed by the county or other entity
authorized by the county board to provide case management
services specified in section 245.4711.
(b) A case manager must:
(1) be skilled in the process of identifying and assessing
a wide range of client needs;
(2) be knowledgeable about local community resources and
how to use those resources for the benefit of the client;
(3) have a bachelor's degree in one of the behavioral
sciences or related fields including, but not limited to, social
work, psychology, or nursing from an accredited college or
university or meet the requirements of paragraph (c); and
(4) meet the supervision and continuing education
requirements described in paragraphs (d), (e), and (f), as
applicable.
(c) Case managers without a bachelor's degree must meet one
of the requirements in clauses (1) to (3):
(1) have three or four years of experience as a case
manager associate as defined in this section;
(2) be a registered nurse without a bachelor's degree and
have a combination of specialized training in psychiatry and
work experience consisting of community interaction and
involvement or community discharge planning in a mental health
setting totaling three years; or
(3) be a person who qualified as a case manager under the
1998 department of human service waiver provision and meet the
continuing education and mentoring requirements in this section.
(d) A case manager with at least 2,000 hours of supervised
experience in the delivery of services to adults with mental
illness must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year of which at least one
hour per month must be clinical supervision regarding individual
service delivery with a case management supervisor. The
remaining 26 hours of supervision may be provided by a case
manager with two years of experience. Group supervision may not
constitute more than one-half of the required supervision
hours. Clinical supervision must be documented in the client
record.
(e) A case manager without 2,000 hours of supervised
experience in the delivery of services to adults with mental
illness must:
(1) receive clinical supervision regarding individual
service delivery from a mental health professional at least one
hour per week until the requirement of 2,000 hours of experience
is met; and
(2) complete 40 hours of training approved by the
commissioner in case management skills and the characteristics
and needs of adults with serious and persistent mental illness.
(f) A case manager who is not licensed, registered, or
certified by a health-related licensing board must receive 30
hours of continuing education and training in mental illness and
mental health services annually every two years.
(g) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case
management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent;
and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the
behavioral sciences or human services;
(ii) be a registered nurse without a bachelor's degree;
(iii) within the previous ten years, have three years of
life experience with serious and persistent mental illness as
defined in section 245.462, subdivision 20; or as a child had
severe emotional disturbance as defined in section 245.4871,
subdivision 6; or have three years life experience as a primary
caregiver to an adult with serious and persistent mental illness
within the previous ten years;
(iv) have 6,000 hours work experience as a nondegreed state
hospital technician; or
(v) be a mental health practitioner as defined in section
245.462, subdivision 17, clause (2).
Individuals meeting one of the criteria in items (i) to
(iv), may qualify as a case manager after four years of
supervised work experience as a case manager associate.
Individuals meeting the criteria in item (v), may qualify as a
case manager after three years of supervised experience as a
case manager associate.
(h) A case management associate must meet the following
supervision, mentoring, and continuing education requirements:
(1) have 40 hours of preservice training described under
paragraph (e), clause (2);
(2) receive at least 40 hours of continuing education in
mental illness and mental health services annually; and
(3) receive at least five hours of mentoring per week from
a case management mentor.
A "case management mentor" means a qualified, practicing case
manager or case management supervisor who teaches or advises and
provides intensive training and clinical supervision to one or
more case manager associates. Mentoring may occur while
providing direct services to consumers in the office or in the
field and may be provided to individuals or groups of case
manager associates. At least two mentoring hours per week must
be individual and face-to-face.
(i) A case management supervisor must meet the criteria for
mental health professionals, as specified in section 245.462,
subdivision 18.
(j) An immigrant who does not have the qualifications
specified in this subdivision may provide case management
services to adult immigrants with serious and persistent mental
illness who are members of the same ethnic group as the case
manager if the person:
(1) is currently enrolled in and is actively pursuing
credits toward the completion of a bachelor's degree in one of
the behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing 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 this subdivision are met.
Sec. 6. Minnesota Statutes 2000, section 245.4871,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case
management service provider" means a case manager or case
manager associate 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.
(b) A case manager must:
(1) have experience and training in working with children;
(2) have at least a bachelor's degree in one of the
behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an
accredited college or university or meet the requirements of
paragraph (d);
(3) have experience and training in identifying and
assessing a wide range of children's needs;
(4) be knowledgeable about local community resources and
how to use those resources for the benefit of children and their
families; and
(5) meet the supervision and continuing education
requirements of paragraphs (e), (f), and (g), as applicable.
(c) A 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) A case manager without a bachelor's degree must meet
one of the requirements in clauses (1) to (3):
(1) have three or four years of experience as a case
manager associate;
(2) be a registered nurse without a bachelor's degree who
has a combination of specialized training in psychiatry and work
experience consisting of community interaction and involvement
or community discharge planning in a mental health setting
totaling three years; or
(3) be a person who qualified as a case manager under the
1998 department of human services waiver provision and meets the
continuing education, supervision, and mentoring requirements in
this section.
(e) A case manager with at least 2,000 hours of supervised
experience in the delivery of mental health services to children
must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year, of which at least one
hour per month must be clinical supervision regarding individual
service delivery with a case management supervisor. The other
26 hours of supervision may be provided by a case manager with
two years of experience. Group supervision may not constitute
more than one-half of the required supervision hours.
(f) A case manager 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 one
hour each week until the requirement of 2,000 hours of
experience is met.
(g) A case manager who is not licensed, registered, or
certified by a health-related licensing board must receive 30
hours of continuing education and training in severe emotional
disturbance and mental health services annually every two years.
(h) 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.
(i) 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.
(j) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case
management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent;
and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the
behavioral sciences or human services;
(ii) be a registered nurse without a bachelor's degree;
(iii) have three years of life experience as a primary
caregiver to a child with serious emotional disturbance as
defined in section 245.4871, subdivision 6, within the previous
ten years;
(iv) have 6,000 hours work experience as a nondegreed state
hospital technician; or
(v) be a mental health practitioner as defined in
subdivision 26, clause (2).
Individuals meeting one of the criteria in items (i) to
(iv) may qualify as a case manager after four years of
supervised work experience as a case manager associate.
Individuals meeting the criteria in item (v) may qualify as a
case manager after three years of supervised experience as a
case manager associate.
(k) Case manager associates must meet the following
supervision, mentoring, and continuing education requirements;
(1) have 40 hours of preservice training described under
paragraph (f), clause (1);
(2) receive at least 40 hours of continuing education in
severe emotional disturbance and mental health service annually;
and
(3) receive at least five hours of mentoring per week from
a case management mentor. A "case management mentor" means a
qualified, practicing case manager or case management supervisor
who teaches or advises and provides intensive training and
clinical supervision to one or more case manager associates.
Mentoring may occur while providing direct services to consumers
in the office or in the field and may be provided to individuals
or groups of case manager associates. At least two mentoring
hours per week must be individual and face-to-face.
(l) A case management supervisor must meet the criteria for
a mental health professional as specified in section 245.4871,
subdivision 27.
(m) An immigrant who does not have the qualifications
specified in this subdivision may provide case management
services to child immigrants with severe emotional disturbance
of the same ethnic group as the immigrant if the person:
(1) is currently enrolled in and 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.
Sec. 7. Minnesota Statutes 2000, section 245.50,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them.
(a) "Bordering state" means Iowa, North Dakota, South
Dakota, or Wisconsin.
(b) "Receiving agency or facility" means a public or
private hospital, mental health center, or other person or
organization authorized by a state to provide which provides
mental health services under this section to individuals from a
state other than the state in which the agency is located.
(c) "Receiving state" means the state in which a receiving
agency is located.
(d) "Sending agency" means a state or county agency which
sends an individual to a bordering state for treatment under
this section.
(e) "Sending state" means the state in which the sending
agency is located.
Sec. 8. Minnesota Statutes 2000, section 245.50,
subdivision 2, is amended to read:
Subd. 2. [PURPOSE AND AUTHORITY.] (a) The purpose of this
section is to enable appropriate treatment to be provided to
individuals, across state lines from the individual's state of
residence, in qualified facilities that are closer to the homes
of individuals than are facilities available in the individual's
home state.
(b) Unless prohibited by another law and subject to the
exceptions listed in subdivision 3, a county board or the
commissioner of human services may contract with an agency or
facility in a bordering state for mental health services for
residents of Minnesota, and a Minnesota mental health agency or
facility may contract to provide services to residents of
bordering states. Except as provided in subdivision 5, a person
who receives services in another state under this section is
subject to the laws of the state in which services are
provided. A person who will receive services in another state
under this section must be informed of the consequences of
receiving services in another state, including the implications
of the differences in state laws, to the extent the individual
will be subject to the laws of the receiving state.
Sec. 9. Minnesota Statutes 2000, section 245.50,
subdivision 5, is amended to read:
Subd. 5. [SPECIAL CONTRACTS; WISCONSIN BORDERING
STATES.] The commissioner of the Minnesota department of human
services must enter into negotiations with appropriate personnel
at the Wisconsin department of health and social services and
must develop an agreement that conforms to the requirements of
subdivision 4, to enable the placement in Minnesota of patients
who are on emergency holds or who have been involuntarily
committed as mentally ill or chemically dependent in Wisconsin
and to enable the temporary placement in Wisconsin of patients
who are on emergency holds in Minnesota under section 253B.05,
provided that the Minnesota courts retain jurisdiction over
Minnesota patients, and the state of Wisconsin affords to
Minnesota patients the rights under Minnesota law. Persons
committed by the Wisconsin courts and placed in Minnesota
facilities shall continue to be in the legal custody of
Wisconsin and Wisconsin's laws governing length of commitment,
reexaminations, and extension of commitment shall continue to
apply to these residents. In all other respects, Wisconsin
residents placed in Minnesota facilities are subject to
Minnesota laws. The agreement must specify that responsibility
for payment for the cost of care of Wisconsin residents shall
remain with the state of Wisconsin and the cost of care of
Minnesota residents shall remain with the state of Minnesota.
The commissioner shall be assisted by attorneys from the
Minnesota attorney general's office in negotiating and
finalizing this agreement. The agreement shall be completed so
as to permit placement of Wisconsin residents in Minnesota
facilities and Minnesota residents in Wisconsin facilities
beginning July 1, 1994. (a) An individual who is detained,
committed, or placed on an involuntary basis under chapter 253B
may be confined or treated in a bordering state pursuant to a
contract under this section. An individual who is detained,
committed, or placed on an involuntary basis under the civil law
of a bordering state may be confined or treated in Minnesota
pursuant to a contract under this section. A peace or health
officer who is acting under the authority of the sending state
may transport an individual to a receiving agency that provides
services pursuant to a contract under this section and may
transport the individual back to the sending state under the
laws of the sending state. Court orders valid under the law of
the sending state are granted recognition and reciprocity in the
receiving state for individuals covered by a contract under this
section to the extent that the court orders relate to
confinement for treatment or care of mental illness. Such
treatment or care may address other conditions that may be
co-occurring with the mental illness. These court orders are
not subject to legal challenge in the courts of the receiving
state. Individuals who are detained, committed, or placed under
the law of a sending state and who are transferred to a
receiving state under this section continue to be in the legal
custody of the authority responsible for them under the law of
the sending state. Except in emergencies, those individuals may
not be transferred, removed, or furloughed from a receiving
agency without the specific approval of the authority
responsible for them under the law of the sending state.
(b) While in the receiving state pursuant to a contract
under this section, an individual shall be subject to the
sending state's laws and rules relating to length of
confinement, reexaminations, and extensions of confinement. No
individual may be sent to another state pursuant to a contract
under this section until the receiving state has enacted a law
recognizing the validity and applicability of this section.
(c) If an individual receiving services pursuant to a
contract under this section leaves the receiving agency without
permission and the individual is subject to involuntary
confinement under the law of the sending state, the receiving
agency shall use all reasonable means to return the individual
to the receiving agency. The receiving agency shall immediately
report the absence to the sending agency. The receiving state
has the primary responsibility for, and the authority to direct,
the return of these individuals within its borders and is liable
for the cost of the action to the extent that it would be liable
for costs of its own resident.
(d) Responsibility for payment for the cost of care remains
with the sending agency.
(e) This subdivision also applies to county contracts under
subdivision 2 which include emergency care and treatment
provided to a county resident in a bordering state.
Sec. 10. Minnesota Statutes 2001 Supplement, section
256.01, subdivision 2, as amended by Laws 2002, chapter 220,
article 15, section 4, 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;
(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 or a Minnesota tribal social services
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.
Funds encumbered and obligated under an agreement for a specific
child shall remain available until the terms of the agreement
are fulfilled or the agreement is terminated.
(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 and human services 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 program formerly codified in
sections 256.72 to 256.87, 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 and the AFDC program
formerly codified in sections 256.72 to 256.87, 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 program
formerly codified in sections 256.72 to 256.87, 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 prescription 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. Rebate agreements for prescription drugs
delivered on or after July 1, 2002, must include rebates for
individuals covered under the prescription drug program who are
under 65 years of age. 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.
(22) Have the authority to administer the federal drug
rebate program for drugs purchased under the medical assistance
program as allowed by section 1927 of title XIX of the Social
Security Act and according to the terms and conditions of
section 1927. Rebates shall be collected for all drugs that
have been dispensed or administered in an outpatient setting and
that are from manufacturers who have signed a rebate agreement
with the United States Department of Health and Human Services.
(23) Have the authority to administer a supplemental drug
rebate program for drugs purchased under the medical assistance
program and under the prescription drug program established in
section 256.955. The commissioner may enter into supplemental
rebate contracts with pharmaceutical manufacturers and may
require prior authorization for drugs that are from
manufacturers that have not signed a supplemental rebate
contract. Prior authorization of drugs shall be subject to the
provisions of section 256B.0625, subdivision 13, paragraph (b).
(24) Operate the department's communication systems account
established in Laws 1993, First Special Session chapter 1,
article 1, section 2, subdivision 2, to manage shared
communication costs necessary for the operation of the programs
the commissioner supervises. A communications account may also
be established for each regional treatment center which operates
communications systems. Each account must be used to manage
shared communication costs necessary for the operations of the
programs the commissioner supervises. The commissioner may
distribute the costs of operating and maintaining communication
systems to participants in a manner that reflects actual usage.
Costs may include acquisition, licensing, insurance,
maintenance, repair, staff time and other costs as determined by
the commissioner. Nonprofit organizations and state, county,
and local government agencies involved in the operation of
programs the commissioner supervises may participate in the use
of the department's communications technology and share in the
cost of operation. The commissioner may accept on behalf of the
state any gift, bequest, devise or personal property of any
kind, or money tendered to the state for any lawful purpose
pertaining to the communication activities of the department.
Any money received for this purpose must be deposited in the
department's communication systems accounts. Money collected by
the commissioner for the use of communication systems must be
deposited in the state communication systems account and is
appropriated to the commissioner for purposes of this section.
(25) Receive any federal matching money that is made
available through the medical assistance program for the
consumer satisfaction survey. Any federal money received for
the survey is appropriated to the commissioner for this
purpose. The commissioner may expend the federal money received
for the consumer satisfaction survey in either year of the
biennium.
(26) Incorporate cost reimbursement claims from First Call
Minnesota and Greater Twin Cities United Way into the federal
cost reimbursement claiming processes of the department
according to federal law, rule, and regulations. Any
reimbursement received is appropriated to the commissioner and
shall be disbursed to First Call Minnesota and Greater Twin
Cities United Way according to normal department payment
schedules.
(27) Develop recommended standards for foster care homes
that address the components of specialized therapeutic services
to be provided by foster care homes with those services.
Sec. 11. Minnesota Statutes 2000, section 256.01, is
amended by adding a subdivision to read:
Subd. 20. [RYAN WHITE COMPREHENSIVE AIDS RESOURCES
EMERGENCY ACT.] The commissioner shall act as the designated
state agent for carrying out responsibilities required under
Title II of the federal Ryan White Comprehensive AIDS Resources
Emergency (CARE) Act. These responsibilities include:
(1) coordinating statewide HIV/AIDS needs assessment
activities;
(2) developing the state's plan to meet identified health
and support service needs of people living with HIV/AIDS;
(3) administering federal funds designed to provide
comprehensive health and support services to persons living with
HIV/AIDS;
(4) administering federal funds designated for the AIDS
drug assistance program (ADAP);
(5) collecting rebates from pharmaceutical manufacturers on
drugs purchased with federal ADAP funds; and
(6) utilizing ADAP rebate funds in accordance with
guidelines of the federal Health Resources and Services
Administration.
Rebates collected under this subdivision shall be deposited into
the ADAP account in the special revenue fund and are
appropriated to the commissioner for purposes of this
subdivision.
Sec. 12. Minnesota Statutes 2000, section 256.9657,
subdivision 1, as amended by Laws 2002, chapter 220, article 14,
section 5, is amended to read:
Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a)
Effective July 1, 1993, each non-state-operated nursing home
licensed under chapter 144A shall pay to the commissioner an
annual surcharge according to the schedule in subdivision 4.
The surcharge shall be calculated as $620 per licensed bed. If
the number of licensed beds is reduced, the surcharge shall be
based on the number of remaining licensed beds the second month
following the receipt of timely notice by the commissioner of
human services that beds have been delicensed. The nursing home
must notify the commissioner of health in writing when beds are
delicensed. The commissioner of health must notify the
commissioner of human services within ten working days after
receiving written notification. If the notification is received
by the commissioner of human services by the 15th of the month,
the invoice for the second following month must be reduced to
recognize the delicensing of beds. Beds on layaway status
continue to be subject to the surcharge. The commissioner of
human services must acknowledge a medical care surcharge appeal
within 30 days of receipt of the written appeal from the
provider.
(b) Effective July 1, 1994, the surcharge in paragraph (a)
shall be increased to $625.
(c) Effective August 15, 2003, the surcharge under
paragraph (b) shall be increased by an amount necessary to
ensure a net gain to the general fund of $9,620,000 during
fiscal year 2004 as a result of:
(1) the total transfers anticipated during the fiscal year
ending June 30, 2004, under section 256B.19, subdivision 1d,
paragraph (c);
(2) the county nursing home payment adjustments under
section 256B.431, subdivision 23, paragraph (c);
(3) the surcharges under this paragraph; and
(4) the nursing facility rate increases under section
256B.431, subdivision 37.
The increase under this paragraph shall not exceed $365 per bed.
(d) Effective August 15, 2004, the surcharge under
paragraph (c) shall be equal to an amount necessary to ensure a
net gain to the general fund each fiscal year of $10,228,000 as
a result of:
(1) the total transfers anticipated during the fiscal year
under section 256B.19, subdivision 1d, paragraph (c);
(2) the county nursing home payment adjustments under
section 256B.431, subdivision 23, paragraph (c);
(3) the surcharges under this paragraph; and
(4) the nursing facility rate increases under section
256B.431, subdivision 37.
The surcharge under this paragraph shall not exceed $365 per bed.
(e) Between April 1, 2002, and August 15, 2003, a facility
governed by this subdivision may elect to assume full
participation in the medical assistance program by agreeing to
comply with all of the requirements of the medical assistance
program, including the rate equalization law in section 256B.48,
subdivision 1, paragraph (a), and all other requirements
established in law or rule, and to begin intake of new medical
assistance recipients. Rates will be determined under Minnesota
Rules, parts 9549.0010 to 9549.0080. Notwithstanding section
256B.431, subdivision 27, paragraph (i), rate calculations will
be subject to limits as prescribed in rule and law. Other than
the adjustments in sections 256B.431, subdivisions 30 and 32;
256B.437, subdivision 3, paragraph (b), Minnesota Rules, part
9549.0057, and any other applicable legislation enacted prior to
the finalization of rates, facilities assuming full
participation in medical assistance under this paragraph are not
eligible for any rate adjustments until the July 1 following
their settle-up period.
[EFFECTIVE DATE.] This section is effective April 1, 2002.
Sec. 13. Minnesota Statutes 2001 Supplement, section
256B.0625, subdivision 13, as amended by Laws 2002, chapter 220,
article 15, section 13, is amended to read:
Subd. 13. [DRUGS.] (a) Medical assistance covers drugs,
except for fertility drugs when specifically used to enhance
fertility, if prescribed by a licensed practitioner and
dispensed by a licensed pharmacist, by a physician enrolled in
the medical assistance program as a dispensing physician, or by
a physician or a nurse practitioner employed by or under
contract with a community health board as defined in section
145A.02, subdivision 5, for the purposes of communicable disease
control. The commissioner, after receiving recommendations from
professional medical associations and professional pharmacist
associations, shall designate a formulary committee to advise
the commissioner on the names of drugs for which payment is
made, recommend a system for reimbursing providers on a set fee
or charge basis rather than the present system, and develop
methods encouraging use of generic drugs when they are less
expensive and equally effective as trademark drugs. The
formulary committee shall consist of nine members, four of whom
shall be physicians who are not employed by the department of
human services, and a majority of whose practice is for persons
paying privately or through health insurance, three of whom
shall be pharmacists who are not employed by the department of
human services, and a majority of whose practice is for persons
paying privately or through health insurance, a consumer
representative, and a nursing home representative. Committee
members shall serve three-year terms and shall serve without
compensation. Members may be reappointed once.
(b) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the
requirements of the Administrative Procedure Act, but the
formulary committee shall review and comment on the formulary
contents.
The formulary shall not include:
(i) drugs or products for which there is no federal
funding;
(ii) over-the-counter drugs, except for antacids,
acetaminophen, family planning products, aspirin, insulin,
products for the treatment of lice, vitamins for adults with
documented vitamin deficiencies, vitamins for children under the
age of seven and pregnant or nursing women, and any other
over-the-counter drug identified by the commissioner, in
consultation with the drug formulary committee, as necessary,
appropriate, and cost-effective for the treatment of certain
specified chronic diseases, conditions or disorders, and this
determination shall not be subject to the requirements of
chapter 14;
(iii) anorectics, except that medically necessary
anorectics shall be covered for a recipient previously diagnosed
as having pickwickian syndrome and currently diagnosed as having
diabetes and being morbidly obese;
(iv) drugs for which medical value has not been
established; and
(v) drugs from manufacturers who have not signed a rebate
agreement with the Department of Health and Human Services
pursuant to section 1927 of title XIX of the Social Security Act.
The commissioner shall publish conditions for prohibiting
payment for specific drugs after considering the formulary
committee's recommendations. An honorarium of $100 per meeting
and reimbursement for mileage shall be paid to each committee
member in attendance.
(c) The basis for determining the amount of payment shall
be the lower of the actual acquisition costs of the drugs plus a
fixed dispensing fee; the maximum allowable cost set by the
federal government or by the commissioner plus the fixed
dispensing fee; or the usual and customary price charged to the
public. The pharmacy dispensing fee shall be $3.65, except that
the dispensing fee for intravenous solutions which must be
compounded by the pharmacist shall be $8 per bag, $14 per bag
for cancer chemotherapy products, and $30 per bag for total
parenteral nutritional products dispensed in one liter
quantities, or $44 per bag for total parenteral nutritional
products dispensed in quantities greater than one liter. Actual
acquisition cost includes quantity and other special discounts
except time and cash discounts. The actual acquisition cost of
a drug shall be estimated by the commissioner, at average
wholesale price minus nine percent, except that where a drug has
had its wholesale price reduced as a result of the actions of
the National Association of Medicaid Fraud Control Units, the
estimated actual acquisition cost shall be the reduced average
wholesale price, without the nine percent deduction. The
maximum allowable cost of a multisource drug may be set by the
commissioner and it shall be comparable to, but no higher than,
the maximum amount paid by other third-party payors in this
state who have maximum allowable cost programs. The
commissioner shall set maximum allowable costs for multisource
drugs that are not on the federal upper limit list as described
in United States Code, title 42, chapter 7, section 1396r-8(e),
the Social Security Act, and Code of Federal Regulations, title
42, part 447, section 447.332. Establishment of the amount of
payment for drugs shall not be subject to the requirements of
the Administrative Procedure Act. An additional dispensing fee
of $.30 may be added to the dispensing fee paid to pharmacists
for legend drug prescriptions dispensed to residents of
long-term care facilities when a unit dose blister card system,
approved by the department, is used. Under this type of
dispensing system, the pharmacist must dispense a 30-day supply
of drug. The National Drug Code (NDC) from the drug container
used to fill the blister card must be identified on the claim to
the department. The unit dose blister card containing the drug
must meet the packaging standards set forth in Minnesota Rules,
part 6800.2700, that govern the return of unused drugs to the
pharmacy for reuse. The pharmacy provider will be required to
credit the department for the actual acquisition cost of all
unused drugs that are eligible for reuse. Over-the-counter
medications must be dispensed in the manufacturer's unopened
package. The commissioner may permit the drug clozapine to be
dispensed in a quantity that is less than a 30-day supply.
Whenever a generically equivalent product is available, payment
shall be on the basis of the actual acquisition cost of the
generic drug, unless the prescriber specifically indicates
"dispense as written - brand necessary" on the prescription as
required by section 151.21, subdivision 2.
(d) For purposes of this subdivision, "multisource drugs"
means covered outpatient drugs, excluding innovator multisource
drugs for which there are two or more drug products, which:
(1) are related as therapeutically equivalent under the
Food and Drug Administration's most recent publication of
"Approved Drug Products with Therapeutic Equivalence
Evaluations";
(2) are pharmaceutically equivalent and bioequivalent as
determined by the Food and Drug Administration; and
(3) are sold or marketed in Minnesota.
"Innovator multisource drug" means a multisource drug that was
originally marketed under an original new drug application
approved by the Food and Drug Administration.
(e) The formulary committee shall review and recommend
drugs which require prior authorization. The formulary
committee may recommend drugs for prior authorization directly
to the commissioner, as long as opportunity for public input is
provided. Prior authorization may be requested by the
commissioner based on medical and clinical criteria and on cost
before certain drugs are eligible for payment. Before a drug
may be considered for prior authorization at the request of the
commissioner:
(1) the drug formulary committee must develop criteria to
be used for identifying drugs; the development of these criteria
is not subject to the requirements of chapter 14, but the
formulary committee shall provide opportunity for public input
in developing criteria;
(2) the drug formulary committee must hold a public forum
and receive public comment for an additional 15 days; and
(3) the drug formulary committee must consider data from
the state Medicaid program if such data is available; and
(4) the commissioner must provide information to the
formulary committee on the impact that placing the drug on prior
authorization will have on the quality of patient care and on
program costs, and information regarding whether the drug is
subject to clinical abuse or misuse.
Prior authorization may be required by the commissioner
before certain formulary drugs are eligible for payment. If
prior authorization of a drug is required by the commissioner,
the commissioner must provide a 30-day notice period before
implementing the prior authorization. If a prior authorization
request is denied by the department, the recipient may appeal
the denial in accordance with section 256.045. If an appeal is
filed, the drug must be provided without prior authorization
until a decision is made on the appeal.
(f) The basis for determining the amount of payment for
drugs administered in an outpatient setting shall be the lower
of the usual and customary cost submitted by the provider; the
average wholesale price minus five percent; or the maximum
allowable cost set by the federal government under United States
Code, title 42, chapter 7, section 1396r-8(e), and Code of
Federal Regulations, title 42, section 447.332, or by the
commissioner under paragraph (c).
(g) Prior authorization shall not be required or utilized
for any antipsychotic drug prescribed for the treatment of
mental illness where there is no generically equivalent drug
available unless the commissioner determines that prior
authorization is necessary for patient safety. This paragraph
applies to any supplemental drug rebate program established or
administered by the commissioner.
(h) Prior authorization shall not be required or utilized
for any antihemophilic factor drug prescribed for the treatment
of hemophilia and blood disorders where there is no generically
equivalent drug available unless the commissioner determines
that prior authorization is necessary for patient safety. This
paragraph applies to any supplemental drug rebate program
established or administered by the commissioner. This paragraph
expires July 1, 2003.
Sec. 14. Minnesota Statutes 2000, section 256B.0625,
subdivision 26, as amended by Laws 2002, chapter 294, section 6,
is amended to read:
Subd. 26. [SPECIAL EDUCATION SERVICES.] (a) Medical
assistance covers medical services identified in a recipient's
individualized education plan and covered under the medical
assistance state plan. Covered services include occupational
therapy, physical therapy, speech-language therapy, clinical
psychological services, nursing services, school psychological
services, school social work services, personal care assistants
serving as management aides, assistive technology devices,
transportation services, health assessments, and other services
covered under the medical assistance state plan. Mental health
services eligible for medical assistance reimbursement must be
provided or coordinated through a children's mental health
collaborative where a collaborative exists if the child is
included in the collaborative operational target population.
The provision or coordination of services does not require that
the individual education plan be developed by the collaborative.
The services may be provided by a Minnesota school district
that is enrolled as a medical assistance provider or its
subcontractor, and only if the services meet all the
requirements otherwise applicable if the service had been
provided by a provider other than a school district, in the
following areas: medical necessity, physician's orders,
documentation, personnel qualifications, and prior authorization
requirements. The nonfederal share of costs for services
provided under this subdivision is the responsibility of the
local school district as provided in section 125A.74. Services
listed in a child's individual education plan are eligible for
medical assistance reimbursement only if those services meet
criteria for federal financial participation under the Medicaid
program.
(b) Approval of health-related services for inclusion in
the individual education plan does not require prior
authorization for purposes of reimbursement under this chapter.
The commissioner may require physician review and approval of
the plan not more than once annually or upon any modification of
the individual education plan that reflects a change in
health-related services.
(c) Services of a speech-language pathologist provided
under this section are covered notwithstanding Minnesota Rules,
part 9505.0390, subpart 1, item L, if the person:
(1) holds a masters degree in speech-language pathology;
(2) is licensed by the Minnesota board of teaching as an
educational speech-language pathologist; and
(3) either has a certificate of clinical competence from
the American Speech and Hearing Association, has completed the
equivalent educational requirements and work experience
necessary for the certificate or has completed the academic
program and is acquiring supervised work experience to qualify
for the certificate.
(d) Medical assistance coverage for medically necessary
services provided under other subdivisions in this section may
not be denied solely on the basis that the same or similar
services are covered under this subdivision.
(e) The commissioner shall develop and implement package
rates, bundled rates, or per diem rates for special education
services under which separately covered services are grouped
together and billed as a unit in order to reduce administrative
complexity.
(f) The commissioner shall develop a cost-based payment
structure for payment of these services.
(g) Effective July 1, 2000, medical assistance services
provided under an individual education plan or an individual
family service plan by local school districts shall not count
against medical assistance authorization thresholds for that
child.
(h) Nursing services as defined in section 148.171,
subdivision 15, and provided as an individual education plan
health-related service, are eligible for medical assistance
payment if they are otherwise a covered service in under the
medical assistant assistance program. Medical assistance covers
the administration of prescription medications by a licensed
nurse who is employed by or under contract with a school
district when the administration of medications is identified in
the child's individualized education plan. The simple
administration of medications alone is not covered under medical
assistance when administered by a provider other than a school
district or when it is not identified in the child's
individualized education plan.
[EFFECTIVE DATE.] This section is effective for services
provided on or after April 1, 2002, upon federal approval, if
federal approval is required.
Sec. 15. Minnesota Statutes 2000, section 256B.0625,
subdivision 35, is amended to read:
Subd. 35. [FAMILY COMMUNITY SUPPORT SERVICES.] (a) Medical
assistance covers family community support services as defined
in section 245.4871, subdivision 17. In addition to the
provisions of section 245.4871, and to the extent authorized by
rules promulgated by the state agency, medical assistance covers
the following services as family community support services:
(1) services identified in an individual treatment plan
when provided by a trained mental health behavioral aide under
the direction of a mental health practitioner or mental health
professional;
(2) mental health crisis intervention and crisis
stabilization services provided outside of hospital inpatient
settings; and
(3) the therapeutic components of preschool and therapeutic
camp programs.
(b) Notwithstanding the provisions of Minnesota Rules,
parts 9505.0324, subpart 2, 9505.0326, subpart 2, and 9505.0327,
subpart 2, a provider of family community support services,
home-based mental health services, or therapeutic support of
foster care services under contract with a county may continue
to provide existing services, and may provide new services, to a
child if that child is placed in foster care, or the child and
family relocate, outside the original county of residence.
Sec. 16. Minnesota Statutes 2000, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 44. [TARGETED CASE MANAGEMENT SERVICES.] Medical
assistance covers case management services for vulnerable adults
and adults with developmental disabilities, as provided under
section 256B.0924.
Sec. 17. Minnesota Statutes 2001 Supplement, section
256B.0627, subdivision 10, is amended to read:
Subd. 10. [FISCAL INTERMEDIARY OPTION AVAILABLE FOR
PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may
allow a recipient of personal care assistant services to use a
fiscal intermediary to assist the recipient in paying and
accounting for medically necessary covered personal care
assistant services authorized in subdivision 4 and within the
payment parameters of subdivision 5. Unless otherwise provided
in this subdivision, all other statutory and regulatory
provisions relating to personal care assistant services apply to
a recipient using the fiscal intermediary option.
(b) The recipient or responsible party shall:
(1) recruit, hire, and terminate a qualified professional,
if a qualified professional is requested by the recipient or
responsible party;
(2) verify and document the credentials of the qualified
professional, if a qualified professional is requested by the
recipient or responsible party;
(3) develop a service plan based on physician orders and
public health nurse assessment with the assistance of a
qualified professional, if a qualified professional is requested
by the recipient or responsible party, that addresses the health
and safety of the recipient;
(4) recruit, hire, and terminate the personal care
assistant;
(5) orient and train the personal care assistant with
assistance as needed from the qualified professional;
(6) supervise and evaluate the personal care assistant with
assistance as needed from the recipient's physician or the
qualified professional;
(7) monitor and verify in writing and report to the fiscal
intermediary the number of hours worked by the personal care
assistant and the qualified professional; and
(8) enter into a written agreement, as specified in
paragraph (f).
(c) The duties of the fiscal intermediary shall be to:
(1) bill the medical assistance program for personal care
assistant and qualified professional services;
(2) request and secure background checks on personal care
assistants and qualified professionals according to section
245A.04;
(3) pay the personal care assistant and qualified
professional based on actual hours of services provided;
(4) withhold and pay all applicable federal and state
taxes;
(5) verify and keep records of hours worked by the personal
care assistant and qualified professional;
(6) make the arrangements and pay unemployment insurance,
taxes, workers' compensation, liability insurance, and other
benefits, if any;
(7) enroll in the medical assistance program as a fiscal
intermediary; and
(8) enter into a written agreement as specified in
paragraph (f) before services are provided.
(d) The fiscal intermediary:
(1) may not be related to the recipient, qualified
professional, or the personal care assistant;
(2) must ensure arm's length transactions with the
recipient and personal care assistant; and
(3) shall be considered a joint employer of the personal
care assistant and qualified professional to the extent
specified in this section.
The fiscal intermediary or owners of the entity that
provides fiscal intermediary services under this subdivision
must pass a criminal background check as required in section
256B.0627, subdivision 1, paragraph (e).
(e) If the recipient or responsible party requests a
qualified professional, the qualified professional providing
assistance to the recipient shall meet the qualifications
specified in section 256B.0625, subdivision 19c. The qualified
professional shall assist the recipient in developing and
revising a plan to meet the recipient's needs, as assessed by
the public health nurse. In performing this function, the
qualified professional must visit the recipient in the
recipient's home at least once annually. The qualified
professional must report any suspected abuse, neglect, or
financial exploitation of the recipient to the appropriate
authorities.
(f) The fiscal intermediary, recipient or responsible
party, personal care assistant, and qualified professional shall
enter into a written agreement before services are started. The
agreement shall include:
(1) the duties of the recipient, qualified professional,
personal care assistant, and fiscal agent based on paragraphs
(a) to (e);
(2) the salary and benefits for the personal care assistant
and the qualified professional;
(3) the administrative fee of the fiscal intermediary and
services paid for with that fee, including background check
fees;
(4) procedures to respond to billing or payment complaints;
and
(5) procedures for hiring and terminating the personal care
assistant and the qualified professional.
(g) The rates paid for personal care assistant
services, shared care services, qualified professional services,
and fiscal intermediary services under this subdivision shall be
the same rates paid for personal care assistant services and
qualified professional services under subdivision 2
respectively. Except for the administrative fee of the fiscal
intermediary specified in paragraph (f), the remainder of the
rates paid to the fiscal intermediary must be used to pay for
the salary and benefits for the personal care assistant or the
qualified professional.
(h) As part of the assessment defined in subdivision 1, the
following conditions must be met to use or continue use of a
fiscal intermediary:
(1) the recipient must be able to direct the recipient's
own care, or the responsible party for the recipient must be
readily available to direct the care of the personal care
assistant;
(2) the recipient or responsible party must be
knowledgeable of the health care needs of the recipient and be
able to effectively communicate those needs;
(3) a face-to-face assessment must be conducted by the
local county public health nurse at least annually, or when
there is a significant change in the recipient's condition or
change in the need for personal care assistant services;
(4) the recipient cannot select the shared services option
as specified in subdivision 8 recipients who choose to use the
shared care option as specified in subdivision 8 must utilize
the same fiscal intermediary; and
(5) parties must be in compliance with the written
agreement specified in paragraph (f).
(i) The commissioner shall deny, revoke, or suspend the
authorization to use the fiscal intermediary option if:
(1) it has been determined by the qualified professional or
local county public health nurse that the use of this option
jeopardizes the recipient's health and safety;
(2) the parties have failed to comply with the written
agreement specified in paragraph (f); or
(3) the use of the option has led to abusive or fraudulent
billing for personal care assistant services.
The recipient or responsible party may appeal the
commissioner's action according to section 256.045. The denial,
revocation, or suspension to use the fiscal intermediary option
shall not affect the recipient's authorized level of personal
care assistant services as determined in subdivision 5.
Sec. 18. Minnesota Statutes 2001 Supplement, section
256B.0911, subdivision 4b, is amended to read:
Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a)
Exemptions from the federal screening requirements outlined in
subdivision 4a, paragraphs (b) and (c), are limited to:
(1) a person who, having entered an acute care facility
from a certified nursing facility, is returning to a certified
nursing facility; and
(2) a person transferring from one certified nursing
facility in Minnesota to another certified nursing facility in
Minnesota; and
(3) a person, 21 years of age or older, who satisfies the
following criteria, as specified in Code of Federal Regulations,
title 42, section 483.106(b)(2):
(i) the person is admitted to a nursing facility directly
from a hospital after receiving acute inpatient care at the
hospital;
(ii) the person requires nursing facility services for the
same condition for which care was provided in the hospital; and
(iii) the attending physician has certified before the
nursing facility admission that the person is likely to receive
less than 30 days of nursing facility services.
(b) Persons who are exempt from preadmission screening for
purposes of level of care determination include:
(1) persons described in paragraph (a);
(2) an individual who has a contractual right to have
nursing facility care paid for indefinitely by the veterans'
administration;
(3) an individual enrolled in a demonstration project under
section 256B.69, subdivision 8, at the time of application to a
nursing facility;
(4) an individual currently being served under the
alternative care program or under a home and community-based
services waiver authorized under section 1915(c) of the federal
Social Security Act; and
(5) individuals admitted to a certified nursing facility
for a short-term stay, which is expected to be 14 days or less
in duration based upon a physician's certification, and who have
been assessed and approved for nursing facility admission within
the previous six months. This exemption applies only if the
consultation team member determines at the time of the initial
assessment 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. The payment
limitations in subdivision 7 apply to an individual found at
screening to not meet the level of care criteria for admission
to a certified nursing facility.
(c) Persons admitted to a Medicaid-certified nursing
facility from the community on an emergency basis as described
in paragraph (d) or from an acute care facility on a nonworking
day must be screened the first working day after admission.
(d) Emergency admission to a nursing facility prior to
screening is permitted when all of the following conditions are
met:
(1) a person is admitted from the community to a certified
nursing or certified boarding care facility during county
nonworking hours;
(2) a physician has determined that delaying admission
until preadmission screening is completed would adversely affect
the person's health and safety;
(3) there is a recent precipitating event that precludes
the client from living safely in the community, such as
sustaining an injury, sudden onset of acute illness, or a
caregiver's inability to continue to provide care;
(4) the attending physician has authorized the emergency
placement and has documented the reason that the emergency
placement is recommended; and
(5) the county is contacted on the first working day
following the emergency admission.
Transfer of a patient from an acute care hospital to a nursing
facility is not considered an emergency except for a person who
has received hospital services in the following situations:
hospital admission for observation, care in an emergency room
without hospital admission, or following hospital 24-hour bed
care.
(e) A nursing facility must provide a written notice to
persons who satisfy the criteria in paragraph (a), clause (3),
regarding the person's right to request and receive long-term
care consultation services as defined in subdivision 1a. The
notice must be provided prior to the person's discharge from the
facility and in a format specified by the commissioner.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 19. Minnesota Statutes 2001 Supplement, section
256B.0911, subdivision 4d, is amended to read:
Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65
YEARS OF AGE.] (a) It is the policy of the state of Minnesota to
ensure that individuals with disabilities or chronic illness are
served in the most integrated setting appropriate to their needs
and have the necessary information to make informed choices
about home and community-based service options.
(b) Individuals under 65 years of age who are admitted to a
nursing facility from a hospital must be screened prior to
admission as outlined in subdivisions 4a through 4c.
(c) Individuals under 65 years of age who are admitted to
nursing facilities with only a telephone screening must receive
a face-to-face assessment from the long-term care consultation
team member of the county in which the facility is located or
from the recipient's county case manager within 20 working days
of admission.
(d) Individuals under 65 years of age who are admitted to a
nursing facility without preadmission screening according to the
exemption described in subdivision 4b, paragraph (a), clause
(3), and who remain in the facility longer than 30 days must
receive a face-to-face assessment within 40 days of admission.
(e) At the face-to-face assessment, the long-term care
consultation team member or county case manager must perform the
activities required under subdivision 3b.
(e) (f) For individuals under 21 years of age, a screening
interview which recommends nursing facility admission must be
face-to-face and approved by the commissioner before the
individual is admitted to the nursing facility.
(f) (g) In the event that an individual under 65 years of
age is admitted to a nursing facility on an emergency basis, the
county must be notified of the admission on the next working
day, and a face-to-face assessment as described in paragraph (c)
must be conducted within 20 working days of admission.
(g) (h) At the face-to-face assessment, the long-term care
consultation team member or the case manager must present
information about home and community-based options so the
individual can make informed choices. If the individual chooses
home and community-based services, the long-term care
consultation team member or case manager must complete a written
relocation plan within 20 working days of the visit. The plan
shall describe the services needed to move out of the facility
and a time line for the move which is designed to ensure a
smooth transition to the individual's home and community.
(h) (i) An individual under 65 years of age residing in a
nursing facility shall receive a face-to-face assessment at
least every 12 months to review the person's service choices and
available alternatives unless the individual indicates, in
writing, that annual visits are not desired. In this case, the
individual must receive a face-to-face assessment at least once
every 36 months for the same purposes.
(i) (j) Notwithstanding the provisions of subdivision 6,
the commissioner may pay county agencies directly for
face-to-face assessments for individuals under 65 years of age
who are being considered for placement or residing in a nursing
facility.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 20. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 4, is amended to read:
Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR
NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services
under the alternative care program is available to persons who
meet the following criteria:
(1) the person has been determined by a community
assessment under section 256B.0911 to be a person who would
require the level of care provided in a nursing facility, but
for the provision of services under the alternative care
program;
(2) the person is age 65 or older;
(3) the person would be eligible for medical assistance
within 180 days of admission to a nursing facility;
(4) the person is not ineligible for the medical assistance
program due to an asset transfer penalty;
(5) the person needs services that are not funded through
other state or federal funding; and
(6) the monthly cost of the alternative care services
funded by the program for this person does not exceed 75 percent
of the statewide weighted average monthly nursing facility rate
of the case mix resident class to which the individual
alternative care client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the recipient's maintenance
needs allowance as described in section 256B.0915, subdivision
1d, paragraph (a), until the first day of the state fiscal year
in which the resident assessment system, under section 256B.437,
for nursing home rate determination is implemented. Effective
on the first day of the state fiscal year in which a resident
assessment system, under section 256B.437, for nursing home rate
determination is implemented and the first day of each
subsequent state fiscal year, the monthly cost of alternative
care services for this person shall not exceed the alternative
care monthly cap for the case mix resident class to which the
alternative care client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, which was in effect on the last
day of the previous state fiscal year, and adjusted by the
greater of any legislatively adopted home and community-based
services cost-of-living percentage increase or any legislatively
adopted statewide percent rate increase for nursing facilities.
This monthly limit does not prohibit the alternative care client
from payment for additional services, but in no case may the
cost of additional services purchased under this section exceed
the difference between the client's monthly service limit
defined under section 256B.0915, subdivision 3, and the
alternative care program monthly service limit defined in this
paragraph. If medical supplies and equipment or environmental
modifications are or will be purchased for an alternative care
services recipient, the costs may be prorated on a monthly basis
for up to 12 consecutive months beginning with the month of
purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established
in this paragraph, the annual cost of the alternative care
services shall be determined. In this event, the annual cost of
alternative care services shall not exceed 12 times the monthly
limit described in this paragraph.
(b) Alternative care funding under this subdivision is not
available for a person who is a medical assistance recipient or
who would be eligible for medical assistance without a spenddown
or waiver obligation. A person whose initial application for
medical assistance is being processed may be served under the
alternative care program for a period up to 60 days. If the
individual is found to be eligible for medical assistance,
medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the
date the individual was found eligible for the federally
approved elderly waiver plan. Notwithstanding this provision,
upon federal approval, alternative care funds may not be used to
pay for any service the cost of which is payable by medical
assistance or which is used by a recipient to meet a medical
assistance income spenddown or waiver obligation.
(c) Alternative care funding is not available for a person
who resides in a licensed nursing home, certified boarding care
home, hospital, or intermediate care facility, except for case
management services which are provided in support of the
discharge planning process to a nursing home resident or
certified boarding care home resident who is ineligible for case
management funded by medical assistance.
Sec. 21. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 5, is amended to read:
Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a)
Alternative care funding may be used for payment of costs of:
(1) adult foster care;
(2) adult day care;
(3) home health aide;
(4) homemaker services;
(5) personal care;
(6) case management;
(7) respite care;
(8) assisted living;
(9) residential care services;
(10) care-related supplies and equipment;
(11) meals delivered to the home;
(12) transportation;
(13) skilled nursing services;
(14) chore services;
(15) companion services;
(16) nutrition services;
(17) training for direct informal caregivers;
(18) telemedicine telehome care devices to monitor
recipients in their own homes as an alternative to hospital
care, nursing home care, or home visits;
(19) other services which includes discretionary funds and
direct cash payments to clients, following approval by the
commissioner, subject to the provisions of paragraph (j). Total
annual payments for "other services" for all clients within a
county may not exceed either ten 25 percent of that county's
annual alternative care program base allocation or $5,000,
whichever is greater. In no case shall this amount exceed the
county's total annual alternative care program base allocation;
and
(20) environmental modifications.
(b) The county agency must ensure that the funds are not
used to supplant services available through other public
assistance or services programs.
(c) Unless specified in statute, the services, service
definitions, and standards for alternative care services shall
be the same as the services, service definitions, and standards
specified in the federally approved elderly waiver plan. Except
for the county agencies' approval of direct cash payments to
clients as described in paragraph (j) or for a provider of
supplies and equipment when the monthly cost of the supplies and
equipment is less than $250, persons or agencies must be
employed by or under a contract with the county agency or the
public health nursing agency of the local board of health in
order to receive funding under the alternative care program.
Supplies and equipment may be purchased from a vendor not
certified to participate in the Medicaid program if the cost for
the item is less than that of a Medicaid vendor.
(d) The adult foster care rate shall be considered a
difficulty of care payment and shall not include room and
board. The adult foster care rate shall be negotiated between
the county agency and the foster care provider. The alternative
care payment for the foster care service in combination with the
payment for other alternative care services, including case
management, must not exceed the limit specified in subdivision
4, paragraph (a), clause (6).
(e) Personal care services must meet the service standards
defined in the federally approved elderly waiver plan, except
that a county agency may contract with a client's relative who
meets the relative hardship waiver requirement as defined in
section 256B.0627, subdivision 4, paragraph (b), clause (10), to
provide personal care services if the county agency ensures
supervision of this service by a registered nurse or mental
health practitioner qualified professional as defined in section
256B.0625, subdivision 19c.
(f) For purposes of this section, residential care services
are services which are provided to individuals living in
residential care homes. Residential care homes are currently
licensed as board and lodging establishments and are registered
with the department of health as providing special services
under section 157.17 and are not subject to registration under
chapter 144D. Residential care services are defined as
"supportive services" and "health-related services."
"Supportive services" means the provision of up to 24-hour
supervision and oversight. Supportive services includes: (1)
transportation, when provided by the residential care home only;
(2) socialization, when socialization is part of the plan of
care, has specific goals and outcomes established, and is not
diversional or recreational in nature; (3) assisting clients in
setting up meetings and appointments; (4) assisting clients in
setting up medical and social services; (5) providing assistance
with personal laundry, such as carrying the client's laundry to
the laundry room. Assistance with personal laundry does not
include any laundry, such as bed linen, that is included in the
room and board rate. "Health-related services" are limited to
minimal assistance with dressing, grooming, and bathing and
providing reminders to residents to take medications that are
self-administered or providing storage for medications, if
requested. Individuals receiving residential care services
cannot receive homemaking services funded under this section.
(g) For the purposes of this section, "assisted living"
refers to supportive services provided by a single vendor to
clients who reside in the same apartment building of three or
more units which are not subject to registration under chapter
144D and are licensed by the department of health as a class A
home care provider or a class E home care provider. Assisted
living services are defined as up to 24-hour supervision, and
oversight, supportive services as defined in clause (1),
individualized home care aide tasks as defined in clause (2),
and individualized home management tasks as defined in clause
(3) provided to residents of a residential center living in
their units or apartments with a full kitchen and bathroom. A
full kitchen includes a stove, oven, refrigerator, food
preparation counter space, and a kitchen utensil storage
compartment. Assisted living services must be provided by the
management of the residential center or by providers under
contract with the management or with the county.
(1) Supportive services include:
(i) socialization, when socialization is part of the plan
of care, has specific goals and outcomes established, and is not
diversional or recreational in nature;
(ii) assisting clients in setting up meetings and
appointments; and
(iii) providing transportation, when provided by the
residential center only.
(2) Home care aide tasks means:
(i) preparing modified diets, such as diabetic or low
sodium diets;
(ii) reminding residents to take regularly scheduled
medications or to perform exercises;
(iii) household chores in the presence of technically
sophisticated medical equipment or episodes of acute illness or
infectious disease;
(iv) household chores when the resident's care requires the
prevention of exposure to infectious disease or containment of
infectious disease; and
(v) assisting with dressing, oral hygiene, hair care,
grooming, and bathing, if the resident is ambulatory, and if the
resident has no serious acute illness or infectious disease.
Oral hygiene means care of teeth, gums, and oral prosthetic
devices.
(3) Home management tasks means:
(i) housekeeping;
(ii) laundry;
(iii) preparation of regular snacks and meals; and
(iv) shopping.
Individuals receiving assisted living services shall not
receive both assisted living services and homemaking services.
Individualized means services are chosen and designed
specifically for each resident's needs, rather than provided or
offered to all residents regardless of their illnesses,
disabilities, or physical conditions. Assisted living services
as defined in this section shall not be authorized in boarding
and lodging establishments licensed according to sections
157.011 and 157.15 to 157.22.
(h) For establishments registered under chapter 144D,
assisted living services under this section means either the
services described in paragraph (g) and delivered by a class E
home care provider licensed by the department of health or the
services described under section 144A.4605 and delivered by an
assisted living home care provider or a class A home care
provider licensed by the commissioner of health.
(i) Payment for assisted living services and residential
care services shall be a monthly rate negotiated and authorized
by the county agency based on an individualized service plan for
each resident and may not cover direct rent or food costs.
(1) The individualized monthly negotiated payment for
assisted living services as described in paragraph (g) or (h),
and residential care services as described in paragraph (f),
shall not exceed the nonfederal share in effect on July 1 of the
state fiscal year for which the rate limit is being calculated
of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility payment rate
of the case mix resident class to which the alternative care
eligible client would be assigned under Minnesota Rules, parts
9549.0050 to 9549.0059, less the maintenance needs allowance as
described in section 256B.0915, subdivision 1d, paragraph (a),
until the first day of the state fiscal year in which a resident
assessment system, under section 256B.437, of nursing home rate
determination is implemented. Effective on the first day of the
state fiscal year in which a resident assessment system, under
section 256B.437, of nursing home rate determination is
implemented and the first day of each subsequent state fiscal
year, the individualized monthly negotiated payment for the
services described in this clause shall not exceed the limit
described in this clause which was in effect on the last day of
the previous state fiscal year and which has been adjusted by
the greater of any legislatively adopted home and
community-based services cost-of-living percentage increase or
any legislatively adopted statewide percent rate increase for
nursing facilities.
(2) The individualized monthly negotiated payment for
assisted living services described under section 144A.4605 and
delivered by a provider licensed by the department of health as
a class A home care provider or an assisted living home care
provider and provided in a building that is registered as a
housing with services establishment under chapter 144D and that
provides 24-hour supervision in combination with the payment for
other alternative care services, including case management, must
not exceed the limit specified in subdivision 4, paragraph (a),
clause (6).
(j) A county agency may make payment from their alternative
care program allocation for "other services" which include use
of "discretionary funds" for services that are not otherwise
defined in this section and direct cash payments to the client
for the purpose of purchasing the services. The following
provisions apply to payments under this paragraph:
(1) a cash payment to a client under this provision cannot
exceed 80 percent of the monthly payment limit for that client
as specified in subdivision 4, paragraph (a), clause (6);
(2) a county may not approve any cash payment for a client
who meets either of the following:
(i) has been assessed as having a dependency in
orientation, unless the client has an authorized
representative. An "authorized representative" means an
individual who is at least 18 years of age and is designated by
the person or the person's legal representative to act on the
person's behalf. This individual may be a family member,
guardian, representative payee, or other individual designated
by the person or the person's legal representative, if any, to
assist in purchasing and arranging for supports; or
(ii) is concurrently receiving adult foster care,
residential care, or assisted living services;
(3) cash payments to a person or a person's family will be
provided through a monthly payment and be in the form of cash,
voucher, or direct county payment to a vendor. Fees or premiums
assessed to the person for eligibility for health and human
services are not reimbursable through this service option.
Services and goods purchased through cash payments must be
identified in the person's individualized care plan and must
meet all of the following criteria:
(i) they must be over and above the normal cost of caring
for the person if the person did not have functional
limitations;
(ii) they must be directly attributable to the person's
functional limitations;
(iii) they must have the potential to be effective at
meeting the goals of the program;
(iv) they must be consistent with the needs identified in
the individualized service plan. The service plan shall specify
the needs of the person and family, the form and amount of
payment, the items and services to be reimbursed, and the
arrangements for management of the individual grant; and
(v) the person, the person's family, or the legal
representative shall be provided sufficient information to
ensure an informed choice of alternatives. The local agency
shall document this information in the person's care plan,
including the type and level of expenditures to be reimbursed;
(4) the state of Minnesota, county, lead agency under
contract, or tribal government under contract to administer the
alternative care program shall not be liable for damages,
injuries, or liabilities sustained through the purchase of
direct supports or goods by the person, the person's family, or
the authorized representative with funds received through the
cash payments under this section. Liabilities include, but are
not limited to, workers' compensation, the Federal Insurance
Contributions Act (FICA), or the Federal Unemployment Tax Act
(FUTA);
(5) persons receiving grants under this section shall have
the following responsibilities:
(i) spend the grant money in a manner consistent with their
individualized service plan with the local agency;
(ii) notify the local agency of any necessary changes in
the grant expenditures;
(iii) arrange and pay for supports; and
(iv) inform the local agency of areas where they have
experienced difficulty securing or maintaining supports; and
(6) the county shall report client outcomes, services, and
costs under this paragraph in a manner prescribed by the
commissioner.
(k) Upon implementation of direct cash payments to clients
under this section, any person determined eligible for the
alternative care program who chooses a cash payment approved by
the county agency shall receive the cash payment under this
section and not under section 256.476 unless the person was
receiving a consumer support grant under section 256.476 before
implementation of direct cash payments under this section.
Sec. 22. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 8, is amended to read:
Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The
case manager shall implement the plan of care for each
alternative care client and ensure that a client's service needs
and eligibility are reassessed at least every 12 months. The
plan shall include any services prescribed by the individual's
attending physician as necessary to allow the individual to
remain in a community setting. In developing the individual's
care plan, the case manager should include the use of volunteers
from families and neighbors, religious organizations, social
clubs, and civic and service organizations to support the formal
home care services. The county shall be held harmless for
damages or injuries sustained through the use of volunteers
under this subdivision including workers' compensation
liability. The lead agency shall provide documentation in each
individual's plan of care and, if requested, to the commissioner
that the most cost-effective alternatives available have been
offered to the individual and that the individual was free to
choose among available qualified providers, both public and
private. The case manager must give the individual a ten-day
written notice of any decrease in or denial, termination, or
reduction of alternative care services.
(b) If the county administering alternative care services
is different than the county of financial responsibility, the
care plan may be implemented without the approval of the county
of financial responsibility.
Sec. 23. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 10, is amended to read:
Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care
appropriation for fiscal years 1992 and beyond shall cover only
alternative care eligible clients. Prior to By July 1 of each
year, the commissioner shall allocate to county agencies the
state funds available for alternative care for persons eligible
under subdivision 2.
(b) The adjusted base for each county is the county's
current fiscal year base allocation plus any targeted funds
approved during the current fiscal year. Calculations for
paragraphs (c) and (d) are to be made as follows: for each
county, the determination of alternative care program
expenditures shall be based on payments for services rendered
from April 1 through March 31 in the base year, to the extent
that claims have been submitted and paid by June 1 of that year.
(c) If the alternative care program expenditures as defined
in paragraph (b) are 95 percent or more of the county's adjusted
base allocation, the allocation for the next fiscal year is 100
percent of the adjusted base, plus inflation to the extent that
inflation is included in the state budget.
(d) If the alternative care program expenditures as defined
in paragraph (b) are less than 95 percent of the county's
adjusted base allocation, the allocation for the next fiscal
year is the adjusted base allocation less the amount of unspent
funds below the 95 percent level.
(e) If the annual legislative appropriation for the
alternative care program is inadequate to fund the combined
county allocations for a biennium, the commissioner shall
distribute to each county the entire annual appropriation as
that county's percentage of the computed base as calculated in
paragraphs (c) and (d).
Sec. 24. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 12, is amended to read:
Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for
all alternative care eligible clients to help pay for the cost
of participating in the program. The amount of the premium for
the alternative care client shall be determined as follows:
(1) when the alternative care client's income less
recurring and predictable medical expenses is greater than the
recipient's maintenance needs allowance as defined in section
256B.0915, subdivision 1d, paragraph (a), but less than 150
percent of the federal poverty guideline effective on July 1 of
the state fiscal year in which the premium is being computed,
and total assets are less than $10,000, the fee is zero;
(2) when the alternative care client's income less
recurring and predictable medical expenses is greater than 150
percent of the federal poverty guideline effective on July 1 of
the state fiscal year in which the premium is being computed,
and total assets are less than $10,000, the fee is 25 percent of
the cost of alternative care services or the difference between
150 percent of the federal poverty guideline effective on July 1
of the state fiscal year in which the premium is being computed
and the client's income less recurring and predictable medical
expenses, whichever is less; and
(3) when the alternative care client's total assets are
greater than $10,000, the fee is 25 percent of the cost of
alternative care services.
For married persons, total assets are defined as the total
marital assets less the estimated community spouse asset
allowance, under section 256B.059, if applicable. For married
persons, total income is defined as the client's income less the
monthly spousal allotment, under section 256B.058.
All alternative care services except case management shall
be included in the estimated costs for the purpose of
determining 25 percent of the costs.
The monthly premium shall be calculated based on the cost
of the first full month of alternative care services and shall
continue unaltered until the next reassessment is completed or
at the end of 12 months, whichever comes first. Premiums are
due and payable each month alternative care services are
received unless the actual cost of the services is less than the
premium.
(b) The fee shall be waived by the commissioner when:
(1) a person who is residing in a nursing facility is
receiving case management only;
(2) a person is applying for medical assistance;
(3) a married couple is requesting an asset assessment
under the spousal impoverishment provisions;
(4) a person is found eligible for alternative care, but is
not yet receiving alternative care services; or
(5) a person's fee under paragraph (a) is less than $25.
(c) The county agency must record in the state's receivable
system the client's assessed premium amount or the reason the
premium has been waived. The commissioner will bill and collect
the premium from the client. Money collected must be deposited
in the general fund and is appropriated to the commissioner for
the alternative care program. The client must supply the county
with the client's social security number at the time of
application. The county shall supply the commissioner with the
client's social security number and other information the
commissioner requires to collect the premium from the client.
The commissioner shall collect unpaid premiums using the Revenue
Recapture Act in chapter 270A and other methods available to the
commissioner. The commissioner may require counties to inform
clients of the collection procedures that may be used by the
state if a premium is not paid. This paragraph does not apply
to alternative care pilot projects authorized in Laws 1993,
First Special Session chapter 1, article 5, section 133, if a
county operating under the pilot project reports the following
dollar amounts to the commissioner quarterly:
(1) total premiums billed to clients;
(2) total collections of premiums billed; and
(3) balance of premiums owed by clients.
If a county does not adhere to these reporting requirements, the
commissioner may terminate the billing, collecting, and
remitting portions of the pilot project and require the county
involved to operate under the procedures set forth in this
paragraph.
(d) The commissioner shall begin to adopt emergency or
permanent rules governing client premiums within 30 days after
July 1, 1991, including criteria for determining when services
to a client must be terminated due to failure to pay a premium.
Sec. 25. Minnesota Statutes 2001 Supplement, section
256B.0913, subdivision 14, is amended to read:
Subd. 14. [PROVIDER REQUIREMENTS, PAYMENT, AND RATE
ADJUSTMENTS.] (a) Unless otherwise specified in statute,
providers must be enrolled as Minnesota health care program
providers and abide by the requirements for provider
participation according to Minnesota Rules, part 9505.0195.
(b) Payment for provided alternative care services as
approved by the client's case manager shall be occur through the
invoice processing procedures of the department's Medicaid
Management Information System (MMIS). To receive payment, 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) (c) The county shall negotiate individual rates with
vendors and may authorize service payment for actual costs up to
the county's current approved rate. 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. To improve
access to community services and eliminate payment disparities
between the alternative care program and the elderly waiver
program, the commissioner shall establish statewide maximum
service rate limits and eliminate county-specific service rate
limits.
(1) Effective July 1, 2001, for service rate limits, except
those in subdivision 5, paragraphs (d) and (i), the rate limit
for each service shall be the greater of the alternative care
statewide maximum rate or the elderly waiver statewide maximum
rate.
(2) Counties may negotiate individual service rates with
vendors for actual costs up to the statewide maximum service
rate limit.
Sec. 26. Minnesota Statutes 2001 Supplement, section
256B.0915, subdivision 3, is amended to read:
Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, 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 elderly waiver client shall be the weighted
average monthly nursing facility rate of the case mix resident
class to which the elderly waiver client would be assigned under
Minnesota Rules, parts 9549.0050 to 9549.0059, less the
recipient's maintenance needs allowance as described in
subdivision 1d, paragraph (a), until the first day of the state
fiscal year in which the resident assessment system as described
in section 256B.437 for nursing home rate determination is
implemented. Effective on the first day of the state fiscal
year in which the resident assessment system as described in
section 256B.437 for nursing home rate determination is
implemented and the first day of each subsequent state fiscal
year, the monthly limit for the cost of waivered services to an
individual elderly waiver client shall be the rate of the case
mix resident class to which the waiver client would be assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect
on the last day of the previous state fiscal year, adjusted by
the greater of any legislatively adopted home and
community-based services cost-of-living percentage increase or
any legislatively adopted statewide percent rate increase for
nursing facilities.
(c) If extended medical supplies and equipment or
environmental modifications are or will be purchased for an
elderly waiver client, the costs may be prorated for up to 12
consecutive months beginning with the month of purchase. If the
monthly cost of a recipient's waivered services exceeds the
monthly limit established in paragraph (b), the annual cost of
all waivered services shall be determined. In this event, the
annual cost of all waivered services shall not exceed 12 times
the monthly limit of waivered services as described in paragraph
(b).
(d) For a person who is a nursing facility resident at the
time of requesting a determination of eligibility for elderly
waivered services, a monthly conversion limit for the cost of
elderly waivered services may be requested. The monthly
conversion limit for the cost of elderly waiver services shall
be 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 until July 1 of
the state fiscal year in which the resident assessment system as
described in section 256B.437 for nursing home rate
determination is implemented. Effective on July 1 of the state
fiscal year in which the resident assessment system as described
in section 256B.437 for nursing home rate determination is
implemented, the monthly conversion limit for the cost of
elderly waiver services shall be the per diem nursing facility
rate as determined by the resident assessment system as
described in section 256B.437 for that resident in the nursing
facility where the resident currently resides multiplied by 365
and divided by 12, less the recipient's maintenance needs
allowance as described in subdivision 1d. The initially
approved conversion rate may be adjusted by the greater of any
subsequent legislatively adopted home and community-based
services cost-of-living percentage increase or any subsequent
legislatively adopted statewide percentage rate increase for
nursing facilities. The limit under this clause only applies to
persons discharged from a nursing facility after a minimum
30-day stay 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 environmental modifications;
and
(2) cost of skilled nursing, home health aide, and personal
care services reimbursable by medical assistance.
(e) 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.
(f) 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.
(g) The adult foster care rate shall be considered a
difficulty of care payment and shall not include room and
board. The adult foster care service rate shall be negotiated
between the county agency and the foster care provider. The
elderly waiver payment for the foster care service in
combination with the payment for all other elderly waiver
services, including case management, must not exceed the limit
specified in paragraph (b).
(h) Payment for assisted living service shall be a monthly
rate negotiated and authorized by the county agency based on an
individualized service plan for each resident and may not cover
direct rent or food costs.
(1) The individualized monthly negotiated payment for
assisted living services as described in section 256B.0913,
subdivision 5, paragraph (g) or (h), and residential care
services as described in section 256B.0913, subdivision 5,
paragraph (f), shall not exceed the nonfederal share, in effect
on July 1 of the state fiscal year for which the rate limit is
being calculated, of the greater of either the statewide or any
of the geographic groups' weighted average monthly nursing
facility rate of the case mix resident class to which the
elderly waiver eligible client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, less the maintenance needs
allowance as described in subdivision 1d, paragraph (a), until
the July 1 of the state fiscal year in which the resident
assessment system as described in section 256B.437 for nursing
home rate determination is implemented. Effective on July 1 of
the state fiscal year in which the resident assessment system as
described in section 256B.437 for nursing home rate
determination is implemented and July 1 of each subsequent state
fiscal year, the individualized monthly negotiated payment for
the services described in this clause shall not exceed the limit
described in this clause which was in effect on June 30 of the
previous state fiscal year and which has been adjusted by the
greater of any legislatively adopted home and community-based
services cost-of-living percentage increase or any legislatively
adopted statewide percent rate increase for nursing facilities.
(2) The individualized monthly negotiated payment for
assisted living services described in section 144A.4605 and
delivered by a provider licensed by the department of health as
a class A home care provider or an assisted living home care
provider and provided in a building that is registered as a
housing with services establishment under chapter 144D and that
provides 24-hour supervision in combination with the payment for
other elderly waiver services, including case management, must
not exceed the limit specified in paragraph (b).
(i) The county shall negotiate individual service rates
with vendors and may authorize payment for actual costs up to
the county's current approved rate. Persons or agencies must be
employed by or under a contract with the county agency or the
public health nursing agency of the local board of health in
order to receive funding under the elderly waiver program,
except as a provider of supplies and equipment when the monthly
cost of the supplies and equipment is less than $250.
(j) Reimbursement for the medical assistance recipients
under the approved waiver shall be made from the medical
assistance account through the invoice processing procedures of
the department's Medicaid Management Information System (MMIS),
only with the approval of the client's case manager. The budget
for the state share of the Medicaid expenditures shall be
forecasted with the medical assistance budget, and shall be
consistent with the approved waiver.
(k) To improve access to community services and eliminate
payment disparities between the alternative care program and the
elderly waiver, the commissioner shall establish statewide
maximum service rate limits and eliminate county-specific
service rate limits.
(1) Effective July 1, 2001, for service rate limits, except
those described or defined in paragraphs (g) and (h), the rate
limit for each service shall be the greater of the alternative
care statewide maximum rate or the elderly waiver statewide
maximum rate.
(2) Counties may negotiate individual service rates with
vendors for actual costs up to the statewide maximum service
rate limit.
(l) Beginning July 1, 1991, the state shall reimburse
counties according to the payment schedule in section 256.025
for the county share of costs incurred under this subdivision on
or after January 1, 1991, for individuals who are receiving
medical assistance.
Sec. 27. Minnesota Statutes 2000, section 256B.0915,
subdivision 4, is amended to read:
Subd. 4. [TERMINATION NOTICE.] The case manager must give
the individual a ten-day written notice of any decrease in
denial, reduction, or termination of waivered services.
Sec. 28. Minnesota Statutes 2001 Supplement, section
256B.0915, subdivision 5, is amended to read:
Subd. 5. [ASSESSMENTS AND REASSESSMENTS FOR WAIVER
CLIENTS.] Each client shall receive an initial assessment of
strengths, informal supports, and need for services in
accordance with section 256B.0911, subdivisions 3, 3a, and 3b.
A reassessment of a client served under the elderly waiver must
be conducted at least every 12 months and at other times when
the case manager determines that there has been significant
change in the client's functioning. This may include instances
where the client is discharged from the hospital.
Sec. 29. Minnesota Statutes 2000, section 256B.0915,
subdivision 6, is amended to read:
Subd. 6. [IMPLEMENTATION OF CARE PLAN.] Each elderly
waiver client shall be provided a copy of a written care plan
that meets the requirements outlined in section 256B.0913,
subdivision 8. If the county administering waivered services is
different than the county of financial responsibility, the care
plan may be implemented without the approval of the county of
financial responsibility.
Sec. 30. Minnesota Statutes 2000, section 256B.0915, is
amended by adding a subdivision to read:
Subd. 8. [SERVICES AND SUPPORTS.] (a) Services and
supports shall meet the requirements set out in United States
Code, title 42, section 1396n.
(b) Services and supports shall promote consumer choice and
be arranged and provided consistent with individualized, written
care plans.
(c) The state of Minnesota, county, or tribal government
under contract to administer the elderly waiver shall not be
liable for damages, injuries, or liabilities sustained through
the purchase of direct supports or goods by the person, the
person's family, or the authorized representatives with funds
received through consumer-directed community support services
under the federally approved waiver plan. Liabilities include,
but are not limited to, workers' compensation liability, the
Federal Insurance Contributions Act (FICA), or the Federal
Unemployment Tax Act (FUTA).
Sec. 31. Minnesota Statutes 2001 Supplement, section
256B.0924, subdivision 6, is amended to read:
Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a)
Medical assistance and MinnesotaCare payment for targeted case
management shall be made on a monthly basis. In order to
receive payment for an eligible adult, the provider must
document at least one contact per month and not more than two
consecutive months without a face-to-face contact with the adult
or the adult's legal representative, family, primary caregiver,
or other relevant persons identified as necessary to the
development or implementation of the goals of the personal
service plan.
(b) Payment for targeted case management provided by county
staff under this subdivision shall be based on the monthly rate
methodology under section 256B.094, subdivision 6, paragraph
(b), calculated as one combined average rate together with adult
mental health case management under section 256B.0625,
subdivision 20, except for calendar year 2002. In calendar year
2002, the rate for case management under this section shall be
the same as the rate for adult mental health case management in
effect as of December 31, 2001. Billing and payment must
identify the recipient's primary population group to allow
tracking of revenues.
(c) Payment for targeted 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.
(d) If the service is provided by a team that includes
contracted vendors and county staff, the costs for county staff
participation on 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 targeted case management and
a description of the different roles of the team members.
(e) Notwithstanding section 256B.19, subdivision 1, the
nonfederal share of costs for targeted 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.
(f) The commissioner may suspend, reduce, or terminate
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.
(g) The commissioner shall set aside five percent of the
federal funds received under this section for use in reimbursing
the state for costs of developing and implementing this section.
(h) Notwithstanding section 256.025, subdivision 2,
payments to counties for targeted 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.
(i) Notwithstanding section 256B.041, county payments for
the cost of case management services provided by county staff
shall not be made to the state treasurer. For the purposes of
targeted case management services provided by county 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.
(j) 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
targeted case management services under this subdivision is
limited to the last 180 days of the recipient's residency in
that facility and may not exceed more than six months in a
calendar year.
(k) Payment for targeted case management services under
this subdivision shall not duplicate payments made under other
program authorities for the same purpose.
(l) Any growth in targeted case management services and
cost increases under this section shall be the responsibility of
the counties.
Sec. 32. Minnesota Statutes 2001 Supplement, section
256B.0951, subdivision 7, is amended to read:
Subd. 7. [WAIVER OF RULES.] If a federal waiver is
approved under subdivision 8, the commissioner of health may
exempt residents of intermediate care facilities for persons
with mental retardation (ICFs/MR) who participate in the
three-year alternative 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.
Sec. 33. Minnesota Statutes 2001 Supplement, section
256B.0951, subdivision 8, is amended to read:
Subd. 8. [FEDERAL WAIVER.] The commissioner of human
services shall seek federal authority to waive provisions of
intermediate care facilities for persons with mental retardation
(ICFs/MR) regulations to enable the demonstration and evaluation
of the alternative quality assurance system for ICFs/MR under
the project. The commissioner of human services shall apply for
any necessary waivers as soon as practicable. a federal waiver
to allow intermediate care facilities for persons with mental
retardation (ICFs/MR) in region 10 of Minnesota to participate
in the alternative licensing system. If it is necessary for
purposes of participation in this alternative licensing system
for a facility to be decertified as an ICF/MR facility according
to the terms of the federal waiver, when the facility seeks
recertification under the provisions of ICF/MR regulations at
the end of the demonstration project, it will not be considered
a new ICF/MR as defined under section 252.291 provided the
licensed capacity of the facility did not increase during its
participation in the alternative licensing system. The
provisions of sections 252.82, 252.292, and 256B.5011 to
256B.5015 will remain applicable for counties in region 10 of
Minnesota and the ICFs/MR located within those counties
notwithstanding a county's participation in the alternative
licensing system.
Sec. 34. Minnesota Statutes 2000, section 256B.19,
subdivision 1, as amended by Laws 2002, chapter 220, article 14,
section 7, is amended to read:
Subdivision 1. [DIVISION OF COST.] The state and county
share of medical assistance costs not paid by federal funds
shall be as follows:
(1) ninety 90 percent state funds and ten percent county
funds, unless otherwise provided below;
(2) beginning January 1, 1992, 50 percent state funds and
50 percent county funds for the cost of placement of severely
emotionally disturbed children in regional treatment centers;
and
(3) beginning January 1, 2003, 80 percent state funds and
20 percent county funds for the costs of nursing facility
placements of persons with disabilities under the age of 65 that
have exceeded 90 days. This clause shall be subject to chapter
256G and shall not apply to placements in facilities not
certified to participate in medical assistance.
For counties that participate in a Medicaid demonstration
project under sections 256B.69 and 256B.71, the division of the
nonfederal share of medical assistance expenses for payments
made to prepaid health plans or for payments made to health
maintenance organizations in the form of prepaid capitation
payments, this division of medical assistance expenses shall be
95 percent by the state and five percent by the county of
financial responsibility.
In counties where prepaid health plans are under contract
to the commissioner to provide services to medical assistance
recipients, the cost of court ordered treatment ordered without
consulting the prepaid health plan that does not include
diagnostic evaluation, recommendation, and referral for
treatment by the prepaid health plan is the responsibility of
the county of financial responsibility.
Sec. 35. Minnesota Statutes 2001 Supplement, section
256B.431, subdivision 2e, is amended to read:
Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT
PERSONS.] The commissioner may contract negotiate with a nursing
facility eligible to receive medical assistance payments to
provide services to a ventilator-dependent person identified by
the commissioner according to criteria developed by the
commissioner, including:
(1) nursing facility care has been recommended for the
person by a preadmission screening team;
(2) the person has been hospitalized and no longer requires
inpatient acute care hospital services; and
(3) the commissioner has determined that necessary services
for the person cannot be provided under existing nursing
facility rates.
The commissioner may issue a request for proposals to
provide services to a ventilator-dependent person to nursing
facilities eligible to receive medical assistance payments and
shall select nursing facilities from among respondents according
to criteria developed by the commissioner, including:
(1) the cost-effectiveness and appropriateness of services;
(2) the nursing facility's compliance with federal and
state licensing and certification standards; and
(3) the proximity of the nursing facility to a
ventilator-dependent person identified by the commissioner who
requires nursing facility placement.
The commissioner may negotiate an adjustment to the
operating cost payment rate for a nursing facility selected by
the commissioner from among respondents to the request for
proposals with a resident who is ventilator-dependent, for that
resident. The negotiated adjustment must reflect only the
actual additional cost of meeting the specialized care needs of
a ventilator-dependent person identified by the commissioner for
whom necessary services cannot be provided under existing
nursing facility rates and which are not otherwise covered under
Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to
9505.0475. For persons who are initially admitted to a nursing
facility before July 1, 2001, and have their payment rate under
this subdivision negotiated after July 1, 2001, the negotiated
payment rate must not exceed 200 percent of the highest multiple
bedroom payment rate for the facility, as initially established
by the commissioner for the rate year for case mix
classification K; or, upon implementation of the RUGs-based case
mix system, 200 percent of the highest RUGs rate. For persons
initially admitted to a nursing facility on or after July 1,
2001, the negotiated payment rate must not exceed 300 percent of
the facility's multiple bedroom payment rate for case mix
classification K; or, upon implementation of the RUGs-based case
mix system, 300 percent of the highest RUGs rate. The
negotiated adjustment shall not affect the payment rate charged
to private paying residents under the provisions of section
256B.48, subdivision 1.
Sec. 36. Minnesota Statutes 2000, section 256B.431,
subdivision 14, is amended to read:
Subd. 14. [LIMITATIONS ON SALES OF NURSING FACILITIES.]
(a) For rate periods beginning on October 1, 1992, and for rate
years beginning after June 30, 1993, a nursing facility's
property-related payment rate as established under subdivision
13 shall be adjusted by either paragraph (b) or (c) for the sale
of the nursing facility, including sales occurring after June
30, 1992, as provided in this subdivision.
(b) If the nursing facility's property-related payment rate
under subdivision 13 prior to sale is greater than the nursing
facility's rental rate under Minnesota Rules, parts 9549.0010 to
9549.0080, and this section prior to sale, the nursing
facility's property-related payment rate after sale shall be the
greater of its property-related payment rate under subdivision
13 prior to sale or its rental rate under Minnesota Rules, parts
9549.0010 to 9549.0080, and this section calculated after sale.
(c) If the nursing facility's property-related payment rate
under subdivision 13 prior to sale is equal to or less than the
nursing facility's rental rate under Minnesota Rules, parts
9549.0010 to 9549.0080, and this section prior to sale, the
nursing facility's property-related payment rate after sale
shall be the nursing facility's property-related payment rate
under subdivision 13 plus the difference between its rental rate
calculated under Minnesota Rules, parts 9549.0010 to 9549.0080,
and this section prior to sale and its rental rate calculated
under Minnesota Rules, parts 9549.0010 to 9549.0080, and this
section calculated after sale.
(d) For purposes of this subdivision, "sale" means the
purchase of a nursing facility's capital assets with cash or
debt. The term sale does not include a stock purchase of a
nursing facility or any of the following transactions:
(1) a sale and leaseback to the same licensee that does not
constitute a change in facility license;
(2) a transfer of an interest to a trust;
(3) gifts or other transfers for no consideration;
(4) a merger of two or more related organizations;
(5) a change in the legal form of doing business, other
than a publicly held organization that becomes privately held or
vice versa;
(6) the addition of a new partner, owner, or shareholder
who owns less than 20 percent of the nursing facility or the
issuance of stock; and
(7) a sale, merger, reorganization, or any other transfer
of interest between related organizations other than those
permitted in this section.
(e) For purposes of this subdivision, "sale" includes the
sale or transfer of a nursing facility to a close relative as
defined in Minnesota Rules, part 9549.0020, subpart 38, item C,
upon the death of an owner, due to serious illness or
disability, as defined under the Social Security Act, under
United States Code, title 42, section 423(d)(1)(A), or upon
retirement of an owner from the business of owning or operating
a nursing home at 62 years of age or older. For sales to a
close relative allowed under this paragraph, otherwise
nonallowable debt resulting from seller financing of all or a
portion of the debt resulting from the sale shall be allowed and
shall not be subject to Minnesota Rules, part 9549.0060, subpart
5, item E, provided that in addition to existing requirements
for allowance of debt and interest, the debt is subject to
repayment through annual principal payments and the interest
rate on the related organization debt does not exceed three
percentage points above the posted yield for standard
conventional fixed rate mortgages of the Federal Home Loan
Mortgage Corporation for delivery in 60 days in effect on the
day of sale. If at any time, the seller forgives the related
organization debt allowed under this paragraph for other than
equal amount of payment on that debt, then the buyer shall pay
to the state the total revenue received by the nursing facility
after the sale attributable to the amount of allowable debt
which has been forgiven. Any assignment, sale, or transfer of
the debt instrument entered into by the close relatives, either
directly or indirectly, which grants to the close relative buyer
the right to receive all or a portion of the payments under the
debt instrument shall, effective on the date of the transfer,
result in the prospective reduction in the corresponding portion
of the allowable debt and interest expense. Upon the death of
the close relative seller, any remaining balance of the close
relative debt must be refinanced and such refinancing shall be
subject to the provisions of Minnesota Rules, part 9549.0060,
subpart 7, item G. This paragraph shall not apply to sales
occurring on or after June 30, 1997.
(f) For purposes of this subdivision, "effective date of
sale" means the later of either the date on which legal title to
the capital assets is transferred or the date on which closing
for the sale occurred.
(g) The effective day for the property-related payment rate
determined under this subdivision shall be the first day of the
month following the month in which the effective date of sale
occurs or October 1, 1992, whichever is later, provided that the
notice requirements under section 256B.47, subdivision 2, have
been met.
(h) Notwithstanding Minnesota Rules, part 9549.0060,
subparts 5, item A, subitems (3) and (4), and 7, items E and F,
the commissioner shall limit the total allowable debt and
related interest for sales occurring after June 30, 1992, to the
sum of clauses (1) to (3):
(1) the historical cost of capital assets, as of the
nursing facility's most recent previous effective date of sale
or, if there has been no previous sale, the nursing facility's
initial historical cost of constructing capital assets;
(2) the average annual capital asset additions after
deduction for capital asset deletions, not including
depreciations; and
(3) one-half of the allowed inflation on the nursing
facility's capital assets. The commissioner shall compute the
allowed inflation as described in paragraph (h) (i).
(i) For purposes of computing the amount of allowed
inflation, the commissioner must apply the following principles:
(1) the lesser of the Consumer Price Index for all urban
consumers or the Dodge Construction Systems Costs for Nursing
Homes for any time periods during which both are available must
be used. If the Dodge Construction Systems Costs for Nursing
Homes becomes unavailable, the commissioner shall substitute the
index in subdivision 3f, or such other index as the secretary of
the health care financing administration may designate;
(2) the amount of allowed inflation to be applied to the
capital assets in paragraph (g), clauses (1) and (2), must be
computed separately;
(3) the amount of allowed inflation must be determined on
an annual basis, prorated on a monthly basis for partial years
and if the initial month of use is not determinable for a
capital asset, then one-half of that calendar year shall be used
for purposes of prorating;
(4) the amount of allowed inflation to be applied to the
capital assets in paragraph (g), clauses (1) and (2), must not
exceed 300 percent of the total capital assets in any one of
those clauses; and
(5) the allowed inflation must be computed starting with
the month following the nursing facility's most recent previous
effective date of sale or, if there has been no previous sale,
the month following the date of the nursing facility's initial
occupancy, and ending with the month preceding the effective
date of sale.
(j) If the historical cost of a capital asset is not
readily available for the date of the nursing facility's most
recent previous sale or if there has been no previous sale for
the date of the nursing facility's initial occupancy, then the
commissioner shall limit the total allowable debt and related
interest after sale to the extent recognized by the Medicare
intermediary after the sale. For a nursing facility that has no
historical capital asset cost data available and does not have
allowable debt and interest calculated by the Medicare
intermediary, the commissioner shall use the historical cost of
capital asset data from the point in time for which capital
asset data is recorded in the nursing facility's audited
financial statements.
(k) The limitations in this subdivision apply only to debt
resulting from a sale of a nursing facility occurring after June
30, 1992, including debt assumed by the purchaser of the nursing
facility.
Sec. 37. Minnesota Statutes 2000, section 256B.431,
subdivision 30, is amended to read:
Subd. 30. [BED LAYAWAY AND DELICENSURE.] (a) For rate
years beginning on or after July 1, 2000, a nursing facility
reimbursed under this section which has placed beds on layaway
shall, for purposes of application of the downsizing incentive
in subdivision 3a, paragraph (d) (c), and calculation of the
rental per diem, have those beds given the same effect as if the
beds had been delicensed so long as the beds remain on layaway.
At the time of a layaway, a facility may change its single bed
election for use in calculating capacity days under Minnesota
Rules, part 9549.0060, subpart 11. The property payment rate
increase shall be effective the first day of the month following
the month in which the layaway of the beds becomes effective
under section 144A.071, subdivision 4b.
(b) For rate years beginning on or after July 1, 2000,
notwithstanding any provision to the contrary under section
256B.434, a nursing facility reimbursed under that section which
has placed beds on layaway shall, for so long as the beds remain
on layaway, be allowed to:
(1) aggregate the applicable investment per bed limits
based on the number of beds licensed immediately prior to
entering the alternative payment system;
(2) retain or change the facility's single bed election for
use in calculating capacity days under Minnesota Rules, part
9549.0060, subpart 11; and
(3) establish capacity days based on the number of beds
immediately prior to the layaway and the number of beds after
the layaway.
The commissioner shall increase the facility's property payment
rate by the incremental increase in the rental per diem
resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the layaway of
beds and clauses (1), (2), and (3). If a facility reimbursed
under section 256B.434 completes a moratorium exception project
after its base year, the base year property rate shall be the
moratorium project property rate. The base year rate shall be
inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be
effective the first day of the month following the month in
which the layaway of the beds becomes effective.
(c) If a nursing facility removes a bed from layaway status
in accordance with section 144A.071, subdivision 4b, the
commissioner shall establish capacity days based on the number
of licensed and certified beds in the facility not on layaway
and shall reduce the nursing facility's property payment rate in
accordance with paragraph (b).
(d) For the rate years beginning on or after July 1, 2000,
notwithstanding any provision to the contrary under section
256B.434, a nursing facility reimbursed under that section,
which has delicensed beds after July 1, 2000, by giving notice
of the delicensure to the commissioner of health according to
the notice requirements in section 144A.071, subdivision 4b,
shall be allowed to:
(1) aggregate the applicable investment per bed limits
based on the number of beds licensed immediately prior to
entering the alternative payment system;
(2) retain or change the facility's single bed election for
use in calculating capacity days under Minnesota Rules, part
9549.0060, subpart 11; and
(3) establish capacity days based on the number of beds
immediately prior to the delicensure and the number of beds
after the delicensure.
The commissioner shall increase the facility's property payment
rate by the incremental increase in the rental per diem
resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the delicensure of
beds and clauses (1), (2), and (3). If a facility reimbursed
under section 256B.434 completes a moratorium exception project
after its base year, the base year property rate shall be the
moratorium project property rate. The base year rate shall be
inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be
effective the first day of the month following the month in
which the delicensure of the beds becomes effective.
(e) For nursing facilities reimbursed under this section or
section 256B.434, any beds placed on layaway shall not be
included in calculating facility occupancy as it pertains to
leave days defined in Minnesota Rules, part 9505.0415.
(f) For nursing facilities reimbursed under this section or
section 256B.434, the rental rate calculated after placing beds
on layaway may not be less than the rental rate prior to placing
beds on layaway.
(g) A nursing facility receiving a rate adjustment as a
result of this section shall comply with section 256B.47,
subdivision 2.
(h) A facility that does not utilize the space made
available as a result of bed layaway or delicensure under this
subdivision to reduce the number of beds per room or provide
more common space for nursing facility uses or perform other
activities related to the operation of the nursing facility
shall have its property rate increase calculated under this
subdivision reduced by the ratio of the square footage made
available that is not used for these purposes to the total
square footage made available as a result of bed layaway or
delicensure.
Sec. 38. Minnesota Statutes 2001 Supplement, section
256B.431, subdivision 33, is amended to read:
Subd. 33. [STAGED REDUCTION IN RATE DISPARITIES.] (a) For
the rate years beginning July 1, 2001, and July 1, 2002, the
commissioner shall adjust the operating payment rates for
low-rate nursing facilities reimbursed under this section or
section 256B.434.
(b) For the rate year beginning July 1, 2001, for each case
mix level, if the amount computed under subdivision 32 31 is
less than the amount in clause (1), the commissioner shall make
available the lesser of the amount in clause (1) or an increase
of ten percent over the rate in effect on June 30, 2001, as an
adjustment to the operating payment rate. For the rate year
beginning July 1, 2002, for each case mix level, if the amount
computed under subdivision 32 31 is less than the amount in
clause (2), the commissioner shall make available the lesser of
the amount in clause (2) or an increase of ten percent over the
rate in effect on June 30, 2002, as an adjustment to the
operating payment rate. For purposes of this subdivision,
nursing facilities shall be considered to be metro if they are
located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey,
Scott, or Washington counties; or in the cities of Moorhead or
Breckenridge; or in St. Louis county, north of Toivola and south
of Cook; or in Itasca county, east of a north south line two
miles west of Grand Rapids:
(1) Operating Payment Rate Target Level for July 1, 2001:
Case Mix Classification Metro Nonmetro
A $ 76.00 $ 68.13
B $ 83.40 $ 74.46
C $ 91.67 $ 81.63
D $ 99.51 $ 88.04
E $107.46 $ 94.87
F $107.96 $ 95.29
G $114.67 $100.98
H $126.99 $111.31
I $131.42 $115.06
J $138.34 $120.85
K $152.26 $133.10
(2) Operating Payment Rate Target Level for July 1, 2002:
Case Mix Classification Metro Nonmetro
A $ 78.28 $ 70.51
B $ 85.91 $ 77.16
C $ 94.42 $ 84.62
D $102.50 $ 91.42
E $110.68 $ 98.40
F $111.20 $ 98.84
G $118.11 $104.77
H $130.80 $115.64
I $135.38 $119.50
J $142.49 $125.38
K $156.85 $137.77
Sec. 39. Minnesota Statutes 2001 Supplement, section
256B.437, subdivision 3, is amended to read:
Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING
FACILITIES.] (a) By August 15, 2001, the commissioner of human
services shall implement and announce a program for closure or
partial closure of nursing facilities. Names and identifying
information provided in response to the announcement shall
remain private unless approved, according to the timelines
established in the plan. The announcement must specify:
(1) the criteria in subdivision 4 that will be used by the
commissioner to approve or reject applications;
(2) a requirement for the submission of a letter of intent
before the submission of an application;
(3) the information that must accompany an application; and
(4) (3) that applications may combine planned closure rate
adjustments with moratorium exception funding, in which case a
single application may serve both purposes.
Between August 1, 2001, and June 30, 2003, the commissioner may
approve planned closures of up to 5,140 nursing facility beds,
less the number of licensed beds delicensed in facilities that
close during the same time period without approved closure plans
or that have notified the commissioner of health of their intent
to close without an approved closure plan.
(b) A facility or facilities reimbursed under section
256B.431 or 256B.434 with a closure plan approved by the
commissioner under subdivision 5 may assign a planned closure
rate adjustment to another facility or facilities that are not
closing or in the case of a partial closure, to the facility
undertaking the partial closure. A facility may also elect to
have a planned closure rate adjustment shared equally by the
five nursing facilities with the lowest total operating payment
rates in the state development region designated under section
462.385, in which the facility that is closing is located. The
planned closure rate adjustment must be calculated under
subdivision 6. Facilities that close delicense beds without a
closure plan, or whose closure plan is not approved by the
commissioner, are not eligible to assign a planned closure rate
adjustment under subdivision 6., unless they are delicensing
five or fewer beds, or less than six percent of their total
licensed bed capacity, whichever is greater, are located in a
county in the top three quartiles of beds per 1,000 persons aged
65 or older, and have not delicensed beds in the prior three
months. Facilities meeting these criteria are eligible to
assign the amount calculated under subdivision 6 to themselves.
If a facility is delicensing the greater of six or more beds, or
six percent or more of its total licensed bed capacity, and does
not have an approved closure plan or is not eligible for the
adjustment under subdivision 6, the commissioner shall calculate
the amount the facility would have been eligible to assign under
subdivision 6, and shall use this amount to provide equal rate
adjustments to the five nursing facilities with the lowest total
operating payment rates in the state development region
designated under section 462.385, in which the facility
that closed delicensed beds is located.
(c) To be considered for approval, an application must
include:
(1) a description of the proposed closure plan, which must
include identification of the facility or facilities to receive
a planned closure rate adjustment and the amount and timing of a
planned closure rate adjustment proposed for each facility;
(2) the proposed timetable for any proposed closure,
including the proposed dates for announcement to residents,
commencement of closure, and completion of closure;
(3) if available, the proposed relocation plan for current
residents of any facility designated for closure. The proposed
If a relocation plan is not available, the application must
include a statement agreeing to develop a relocation plan must
be designed to comply with all applicable state and federal
statutes and regulations, including, but not limited to, section
144A.161;
(4) a description of the relationship between the nursing
facility that is proposed for closure and the nursing facility
or facilities proposed to receive the planned closure rate
adjustment. If these facilities are not under common ownership,
copies of any contracts, purchase agreements, or other documents
establishing a relationship or proposed relationship must be
provided;
(5) documentation, in a format approved by the
commissioner, that all the nursing facilities receiving a
planned closure rate adjustment under the plan have accepted
joint and several liability for recovery of overpayments under
section 256B.0641, subdivision 2, for the facilities designated
for closure under the plan; and
(6) an explanation of how the application coordinates with
planning efforts under subdivision 2. If the planning group
does not support a level of nursing facility closures that the
commissioner considers to be reasonable, the commissioner may
approve a planned closure proposal without its support.
(d) The application must address the criteria listed in
subdivision 4.
Sec. 40. Minnesota Statutes 2001 Supplement, section
256B.437, subdivision 6, is amended to read:
Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The
commissioner of human services shall calculate the amount of the
planned closure rate adjustment available under subdivision 3,
paragraph (b), for up to 5,140 beds according to clauses (1) to
(4):
(1) the amount available is the net reduction of nursing
facility beds multiplied by $2,080;
(2) the total number of beds in the nursing facility or
facilities receiving the planned closure rate adjustment must be
identified;
(3) capacity days are determined by multiplying the number
determined under clause (2) by 365; and
(4) the planned closure rate adjustment is the amount
available in clause (1), divided by capacity days determined
under clause (3).
(b) A planned closure rate adjustment under this section is
effective on the first day of the month following completion of
closure of the facility designated for closure in the
application and becomes part of the nursing facility's total
operating payment rate.
(c) Applicants may use the planned closure rate adjustment
to allow for a property payment for a new nursing facility or an
addition to an existing nursing facility or as an operating
payment rate adjustment. Applications approved under this
subdivision are exempt from other requirements for moratorium
exceptions under section 144A.073, subdivisions 2 and 3.
(d) Upon the request of a closing facility, the
commissioner must allow the facility a closure rate adjustment
as provided under section 144A.161, subdivision 10.
(e) A facility that has received a planned closure rate
adjustment may reassign it to another facility that is under the
same ownership at any time within three years of its effective
date. The amount of the adjustment shall be computed according
to paragraph (a).
(f) If the per bed dollar amount specified in paragraph
(a), clause (1), is increased, the commissioner shall
recalculate planned closure rate adjustments for facilities that
delicense beds under this section on or after July 1, 2001, to
reflect the increase in the per bed dollar amount. The
recalculated planned closure rate adjustment shall be effective
from the date the per bed dollar amount is increased.
Sec. 41. Minnesota Statutes 2001 Supplement, section
256B.438, subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] This section establishes the
method and criteria used to determine resident reimbursement
classifications based upon the assessments of residents of
nursing homes and boarding care homes whose payment rates are
established under section 256B.431, 256B.434, or 256B.435.
Resident reimbursement classifications shall be established
according to the 34 group, resource utilization groups, version
III or RUG-III model as described in section 144.0724.
Reimbursement classifications established under this section
shall be implemented after June 30, 2002, but no later than
January 1, 2003. Reimbursement classifications established
under this section shall be implemented no earlier than six
weeks after the commissioner mails notices of payment rates to
the facilities.
Sec. 42. Minnesota Statutes 2000, section 256B.5012,
subdivision 2, is amended to read:
Subd. 2. [OPERATING PAYMENT RATE.] (a) The operating
payment rate equals the facility's total payment rate in effect
on September 30, 2000, minus the property rate. The operating
payment rate includes the special operating rate and the
efficiency incentive in effect as of September 30, 2000. Within
the limits of appropriations specifically for this purpose, the
operating payment shall be increased for each rate year by the
annual percentage change in the Employment Cost Index for
Private Industry Workers - Total Compensation, as forecasted by
the commissioner of finance's economic consultant, in the second
quarter of the calendar year preceding the start of each rate
year. In the case of the initial rate year beginning October 1,
2000, and continuing through December 31, 2001, the percentage
change shall be based on the percentage change in the Employment
Cost Index for Private Industry Workers - Total Compensation for
the 15-month period beginning October 1, 2000, as forecast by
Data Resources, Inc., in the first quarter of 2000.
(b) Effective October 1, 2000, the operating payment rate
shall be adjusted to reflect an occupancy rate equal to 100
percent of the facility's capacity days as of September 30, 2000.
(c) Effective July 1, 2001, the operating payment rate
shall be adjusted for the increases in the department of health
licensing fees that were authorized in Laws 2001, First Special
Session chapter 9, article 1, section 30.
Sec. 43. Minnesota Statutes 2000, section 256B.69,
subdivision 5a, as amended by Laws 2002, chapter 220, article
15, section 15, is amended to read:
Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care
contracts under this section and sections 256L.12 and 256D.03,
shall be entered into or renewed on a calendar year basis
beginning January 1, 1996. Managed care contracts which were in
effect on June 30, 1995, and set to renew on July 1, 1995, shall
be renewed for the period July 1, 1995 through December 31, 1995
at the same terms that were in effect on June 30, 1995.
(b) A prepaid health plan providing covered health services
for eligible persons pursuant to chapters 256B, 256D, and 256L,
is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care
programs under chapters 256B, 256D, and 256L, established after
the effective date of a contract with the commissioner take
effect when the contract is next issued or renewed.
(c) Effective for services rendered on or after January 1,
2003, the commissioner shall withhold five percent of managed
care plan payments under this section for the prepaid medical
assistance and general assistance medical care programs pending
completion of performance targets. The withheld funds will must
be returned no sooner than July of the following year if
performance targets in the contract are achieved. The
commissioner may exclude special demonstration projects under
subdivision 23. A managed care plan may include as admitted
assets under section 62D.044 any amount withheld under this
paragraph that is reasonably expected to be returned.
Sec. 44. Minnesota Statutes 2001 Supplement, section
256B.76, is amended to read:
256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.]
(a) Effective for services rendered on or after October 1,
1992, the commissioner shall make payments for physician
services as follows:
(1) payment for level one Health Care Finance
Administration's common procedural coding system (HCPCS) codes
titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum,
and postpartum care," "critical care," cesarean delivery and
pharmacologic management provided to psychiatric patients, and
HCPCS level three codes for enhanced services for prenatal high
risk, shall be paid at the lower of (i) submitted charges, or
(ii) 25 percent above the rate in effect on June 30, 1992. If
the rate on any procedure code within these categories is
different than the rate that would have been paid under the
methodology in section 256B.74, subdivision 2, then the larger
rate shall be paid;
(2) payments for all other services shall be paid at the
lower of (i) submitted charges, or (ii) 15.4 percent above the
rate in effect on June 30, 1992;
(3) all physician rates shall be converted from the 50th
percentile of 1982 to the 50th percentile of 1989, less the
percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall
be the rates in effect on September 30, 1992;
(4) effective for services rendered on or after January 1,
2000, payment rates for physician and professional services
shall be increased by three percent over the rates in effect on
December 31, 1999, except for home health agency and family
planning agency services; and
(5) the increases in clause (4) shall be implemented
January 1, 2000, for managed care.
(b) Effective for services rendered on or after October 1,
1992, the commissioner shall make payments for dental services
as follows:
(1) dental services shall be paid at the lower of (i)
submitted charges, or (ii) 25 percent above the rate in effect
on June 30, 1992;
(2) dental rates shall be converted from the 50th
percentile of 1982 to the 50th percentile of 1989, less the
percent in aggregate necessary to equal the above increases;
(3) effective for services rendered on or after January 1,
2000, payment rates for dental services shall be increased by
three percent over the rates in effect on December 31, 1999;
(4) the commissioner shall award grants to community
clinics or other nonprofit community organizations, political
subdivisions, professional associations, or other organizations
that demonstrate the ability to provide dental services
effectively to public program recipients. Grants may be used to
fund the costs related to coordinating access for recipients,
developing and implementing patient care criteria, upgrading or
establishing new facilities, acquiring furnishings or equipment,
recruiting new providers, or other development costs that will
improve access to dental care in a region. In awarding grants,
the commissioner shall give priority to applicants that plan to
serve areas of the state in which the number of dental providers
is not currently sufficient to meet the needs of recipients of
public programs or uninsured individuals. The commissioner
shall consider the following in awarding the grants:
(i) potential to successfully increase access to an
underserved population;
(ii) the ability to raise matching funds;
(iii) the long-term viability of the project to improve
access beyond the period of initial funding;
(iv) the efficiency in the use of the funding; and
(v) the experience of the proposers in providing services
to the target population.
The commissioner shall monitor the grants and may terminate
a grant if the grantee does not increase dental access for
public program recipients. The commissioner shall consider
grants for the following:
(i) implementation of new programs or continued expansion
of current access programs that have demonstrated success in
providing dental services in underserved areas;
(ii) a pilot program for utilizing hygienists outside of a
traditional dental office to provide dental hygiene services;
and
(iii) a program that organizes a network of volunteer
dentists, establishes a system to refer eligible individuals to
volunteer dentists, and through that network provides donated
dental care services to public program recipients or uninsured
individuals;
(5) beginning October 1, 1999, the payment for tooth
sealants and fluoride treatments shall be the lower of (i)
submitted charge, or (ii) 80 percent of median 1997 charges;
(6) the increases listed in clauses (3) and (5) shall be
implemented January 1, 2000, for managed care; and
(7) effective for services provided on or after January 1,
2002, payment for diagnostic examinations and dental x-rays
provided to children under age 21 shall be the lower of (i) the
submitted charge, or (ii) 85 percent of median 1999 charges.
(c) Effective for dental services rendered on or after
January 1, 2002, the commissioner may, within the limits of
available appropriation, increase reimbursements to dentists and
dental clinics deemed by the commissioner to be critical access
dental providers. Reimbursement to a critical access dental
provider may be increased by not more than 50 percent above the
reimbursement rate that would otherwise be paid to the
provider. Payments to health plan companies shall be adjusted
to reflect increased reimbursements to critical access dental
providers as approved by the commissioner. In determining which
dentists and dental clinics shall be deemed critical access
dental providers, the commissioner shall review:
(1) the utilization rate in the service area in which the
dentist or dental clinic operates for dental services to
patients covered by medical assistance, general assistance
medical care, or MinnesotaCare as their primary source of
coverage;
(2) the level of services provided by the dentist or dental
clinic to patients covered by medical assistance, general
assistance medical care, or MinnesotaCare as their primary
source of coverage; and
(3) whether the level of services provided by the dentist
or dental clinic is critical to maintaining adequate levels of
patient access within the service area.
In the absence of a critical access dental provider in a service
area, the commissioner may designate a dentist or dental clinic
as a critical access dental provider if the dentist or dental
clinic is willing to provide care to patients covered by medical
assistance, general assistance medical care, or MinnesotaCare at
a level which significantly increases access to dental care in
the service area.
(d) Effective July 1, 2001, the medical assistance rates
for outpatient mental health services provided by an entity that
operates:
(1) a Medicare-certified comprehensive outpatient
rehabilitation facility; and
(2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation
services in the most recent calendar year who are medical
assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient
rehabilitation facility and provided to residents of nursing
facilities owned by the entity.
(e) An entity that operates both a Medicare certified
comprehensive outpatient rehabilitation facility and a facility
which was certified prior to January 1, 1993, that is licensed
under Minnesota Rules, parts 9570.2000 to 9570.3600, and for
whom at least 33 percent of the clients receiving rehabilitation
services in the most recent calendar year are medical assistance
recipients, shall be reimbursed by the commissioner for
rehabilitation services at rates that are 38 percent greater
than the maximum reimbursement rate allowed under paragraph (a),
clause (2), when those services are (1) provided within the
comprehensive outpatient rehabilitation facility and (2)
provided to residents of nursing facilities owned by the entity.
Sec. 45. Minnesota Statutes 2000, section 256I.04,
subdivision 2a, is amended to read:
Subd. 2a. [LICENSE REQUIRED.] A county agency may not
enter into an agreement with an establishment to provide group
residential housing unless:
(1) the establishment is licensed by the department of
health as a hotel and restaurant; a board and lodging
establishment; a residential care home; a boarding care home
before March 1, 1985; or a supervised living facility, and the
service provider for residents of the facility is licensed under
chapter 245A. However, an establishment licensed by the
department of health to provide lodging need not also be
licensed to provide board if meals are being supplied to
residents under a contract with a food vendor who is licensed by
the department of health;
(2) the residence is licensed by the commissioner of human
services under Minnesota Rules, parts 9555.5050 to 9555.6265, or
certified by a county human services agency prior to July 1,
1992, using the standards under Minnesota Rules, parts 9555.5050
to 9555.6265; or
(3) the establishment is registered under chapter 144D and
provides three meals a day, except that an establishment
registered under section 144D.025 is not eligible for an
agreement to provide group residential housing.
The requirements under clauses (1), (2), and (3) do not
apply to establishments exempt from state licensure because they
are located on Indian reservations and subject to tribal health
and safety requirements.
Sec. 46. Minnesota Statutes 2000, section 256L.12,
subdivision 9, as amended by Laws 2002, chapter 220, article 15,
section 23, is amended to read:
Subd. 9. [RATE SETTING.] (a) Rates will be prospective,
per capita, where possible. The commissioner may allow health
plans to arrange for inpatient hospital services on a risk or
nonrisk basis. The commissioner shall consult with an
independent actuary to determine appropriate rates.
(b) For services rendered on or after January 1, 2003, the
commissioner shall withhold .5 percent of managed care plan
payments under this section pending completion of performance
targets. The withheld funds will must be returned no sooner
than July 1 and no later than July 31 of the following year if
performance targets in the contract are achieved. A managed
care plan may include as admitted assets under section 62D.044
any amount withheld under this paragraph that is reasonably
expected to be returned.
Sec. 47. Laws 2002, chapter 220, article 17, section 2,
subdivision 6, is amended to read:
Subd. 6. Continuing Care
Grants
General (8,907,000) (26,227,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Aging Adult Service
Grants
General -0- (2,638,000)
[PLANNING AND SERVICE DEVELOPMENT.] The
planning and service development grant
from Laws 2001, First Special Session
chapter 9, article 17, section 2,
subdivision 9, is eliminated for fiscal
year 2003. Base funding for the
2004-2005 biennium shall be $550,000
each year. Notwithstanding Laws 2001,
First Special Session chapter 9,
article 17, section 2, subdivision 9,
beginning in fiscal year 2004, the
commissioner shall annually distribute
$5,000 to each county. Counties with
more than 10,000 persons over age 65
shall receive a distribution of an
additional 25 cents for each person
over age 65. The amount distributed to
each area agency on aging shall be
$2,500.
[COMMUNITY SERVICES DEVELOPMENT
GRANTS.] For fiscal year 2003, base
level funding for community services
development grants under Minnesota
Statutes, section 256.9754, is reduced
by $1,478,000. For fiscal year 2004,
base level funding for these grants is
reduced by $768,000. For fiscal year
2005, base level funding shall be
$3,000,000, and this amount shall be
the base funding level for these grants
for the biennium beginning July 1,
2005. Notwithstanding section 5, this
provision shall not expire.
(b) Medical Assistance
Long-Term Care Waivers and
Home Care Grants
General 18,471,000 12,833,000
(c) Medical Assistance
Long-Term Care Facilities
Grants
General (27,382,000) (31,922,000)
(d) Group Residential
Housing Grants
General 4,000 574,000
[FEDERAL FUNDING FOR GROUP RESIDENTIAL
HOUSING COSTS.] The commissioner shall
seek federal funding to offset costs
for group residential housing services
under Minnesota Statutes, chapter 256I.
Any federal funding received shall be
distributed to counties on a pro rata
basis according to county spending
under Minnesota Statutes, section
256B.19, subdivision 1, clause (3), for
the costs of nursing facility
placements of persons with disabilities
under the age of 65 that have exceeded
90 days. The commissioner shall report
to the legislature by January 15, 2003,
on the status of additional federal
funding for group residential housing
costs.
(e) Chemical Dependency
Entitlement Grants
General -0- (84,000)
[CONSOLIDATED CHEMICAL DEPENDENCY
TREATMENT FUND RESERVE TRANSFER.] In
fiscal year 2003, $8,544,000 of funds
available in the consolidated chemical
dependency treatment fund general
reserve account is transferred to the
general fund.
(f) Community Social Services
Block Grants
General -0- (4,990,000)
[CSSA TRADITIONAL APPROPRIATION
REDUCTION.] For fiscal year 2003, base
level funding for community social
service aids under Minnesota Statutes,
section 256E.06, subdivisions 1 and 2,
is reduced by $4,700,000. This
reduction shall become part of base
level funding for the biennium
beginning July 1, 2003.
Notwithstanding section 5, this
provision shall not expire.
[CSSA GRANTS FOR FORMER GRH
RECIPIENTS.] For fiscal year 2003, base
level funding for community social
service aids under Minnesota Statutes,
section 256E.06, subdivision 2b, is
reduced by $290,000. This reduction
shall become part of base level funding
for the biennium beginning July 1,
2003. These reductions shall be made
on a pro rata basis to each affected
county. Notwithstanding section 5,
this provision shall not expire.
Sec. 48. [CASE MANAGEMENT STUDY.]
The commissioner of human services shall study case
management services for persons with disabilities, in
consultation with consumers, providers, consumer advocates, and
local social service and public health agencies. The
commissioner shall report to the chairs and ranking minority
members of the house and senate committees having jurisdiction
over health and human services policy and funding, by January
15, 2003, on strategies that:
(1) streamline administration;
(2) improve case management service availability across the
state;
(3) enhance consumer access to needed services and
supports;
(4) improve accountability and the use of performance
measures;
(5) provide for consumer choice of vendor; and
(6) improve the financing of case management services.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 49. [MENTAL HEALTH SERVICES RATE INCREASE
PASS-THROUGH.]
Prepaid health plans must pass through to service providers
the rate increases provided under Minnesota Statutes, section
256B.761.
Sec. 50. [COMMUNITY SERVICES DEVELOPMENT GRANTS USAGE.]
For fiscal year 2003, the commissioner of human services
may make grants under the community services development grants
program in Minnesota Statutes, section 256.9754, for the
development of housing options for persons under age 65 residing
in nursing facilities.
Sec. 51. [ACCESS TO AFFORDABLE HOUSING.]
The commissioners of human services and the Minnesota
housing finance agency shall make recommendations to the
long-term care task force by January 15, 2003, on ways to
increase the ability of persons with disabilities to access
affordable housing. The recommendations shall include:
(1) income supplement or housing subsidy options that
support efforts to relocate persons under the age of 65 from
nursing facilities or to divert them from a nursing facility
placement;
(2) an analysis of the impacts of the state using a fixed
amount attributable to room and board costs for home and
community-based waiver recipients in group residential settings;
(3) options to maximize federal funding that result in no
additional costs to the state. These options may include the
transfer of state funds between income maintenance programs and
the Medicaid program. These options may be implemented prior to
the report to the task force. Any additional funds made
available through implementation of these options and not
utilized to support persons relocating from nursing facilities
shall be used to reduce the county share enacted in Laws 2002,
chapter 220, article 14, section 8; and
(4) alternatives that provide additional incentives to
county agencies that successfully discharge persons with
disabilities under the age of 65 from nursing facilities.
Sec. 52. [PRIOR AUTHORIZATION REPORT.]
The commissioner of human services shall review prior
authorization of prescription drugs in the fee-for-service
medical assistance program in terms of the cost effectiveness
achieved through prior authorization on prescription drug costs
and on other medical assistance costs and evaluate the effect
that placing a drug on prior authorization has had on the
quality of patient care. The commissioner shall submit the
results to the chairs and ranking minority members of the senate
and house of representatives committees having jurisdiction over
human services funding by January 15, 2004.
Sec. 53. [PILOT PROGRAM FOR DEAF-BLIND SERVICES.]
(a) The commissioners of human services; children,
families, and learning; and state services for the blind shall
meet with deaf-blind citizens, parents of deaf-blind children,
and the Minnesota commission serving deaf and hard-of-hearing
individuals to determine which agency can most efficiently and
effectively develop and administer a pilot program for
consumer-directed services to provide needed services to
deaf-blind adults, children, and families.
(b) The planning for this pilot program must proceed using
current appropriations. The agency that develops the pilot
program described in paragraph (a) shall provide a report to the
senate and house of representatives policy and fiscal committees
having jurisdiction over human services issues by January 1,
2003, that addresses future funding for the program. The report
shall include the program proposal, recommendations, and a
fiscal note.
Sec. 54. [SERVICES FOR DEAF-BLIND PERSONS.]
(a) Effective for fiscal years beginning on or after July
1, 2003, the commissioner of human services shall combine the
existing $1,000,000 biennial base level funding for deaf-blind
services into a single grant program. Within the limits of the
appropriation for this purpose, each biennium at least $350,000
shall be awarded for services to deaf-blind children and their
families and at least $250,000 shall be awarded for services to
deaf-blind adults.
(b) The commissioner may make grants:
(1) for services provided by organizations; and
(2) to develop and administer consumer-directed services.
(c) Any entity that is able to satisfy the grant criteria
is eligible to receive a grant under paragraph (a).
(d) Deaf-blind service providers are not required to, but
may, provide intervenor services as part of the service package
provided with grant funds under this section.
Sec. 55. [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE
EXPANSION TO COVER DEAF-BLIND SERVICES.]
(a) The commissioner of human services shall study and
report to the legislature by January 15, 2003, with a
feasibility assessment of the costs and policy implications,
including the necessity of federal waivers, to expand benefits
covered under medical assistance and under medical assistance
waiver programs to include the following services for deaf-blind
persons:
(1) sign language interpreters;
(2) intervenors;
(3) support service persons;
(4) orientation and mobility services; and
(5) rehabilitation teaching services.
(b) Notwithstanding Laws 2001, First Special Session
chapter 9, article 17, section 10, subdivision 3, the
commissioner may transfer $20,000 of deaf and hard-of-hearing
grants to operations for purposes of paragraph (a). The study
and report under paragraph (a) is exempt from the consulting
contract moratorium in Laws 2002, chapter 220, article 10,
section 37.
Sec. 56. [REPEALER; TARGETED CASE MANAGEMENT.]
Minnesota Statutes 2001 Supplement, section 256B.0621,
subdivision 1, is repealed.
ARTICLE 3
MISCELLANEOUS
Section 1. Minnesota Statutes 2000, section 62J.692,
subdivision 4, as amended by Laws 2002, chapter 220, article 15,
section 1, is amended to read:
Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner
shall annually distribute medical education funds to all
qualifying applicants based on the following criteria:
(1) total medical education funds available for
distribution;
(2) total number of eligible trainee FTEs in each clinical
medical education program; and
(3) the statewide average cost per trainee as determined by
the application information provided in the first year of the
biennium, by type of trainee, in each clinical medical education
program.
(b) Funds distributed shall not be used to displace current
funding appropriations from federal or state sources.
(c) Funds shall be distributed to the sponsoring
institutions indicating the amount to be distributed to each of
the sponsor's clinical medical education programs based on the
criteria in this subdivision and in accordance with the
commissioner's approval letter. Each clinical medical education
program must distribute funds to the training sites as specified
in the commissioner's approval letter. Sponsoring institutions,
which are accredited through an organization recognized by the
department of education or the health care financing
administration, may contract directly with training sites to
provide clinical training. To ensure the quality of clinical
training, those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations,
and outcomes of the clinical training conducted at sites; and
(2) take necessary action if the contract requirements are
not met. Action may include the withholding of payments under
this section or the removal of students from the site.
(d) Any funds not distributed in accordance with the
commissioner's approval letter must be returned to the medical
education and research fund within 30 days of receiving notice
from the commissioner. The commissioner shall distribute
returned funds to the appropriate training sites in accordance
with the commissioner's approval letter.
(e) The commissioner shall distribute no later than by June
30 of each year an amount equal to the funds transferred under
section 62J.694, subdivision 2a, paragraph (b), plus five
percent interest at a rate equal to the average earnings paid
under section 62J.694, subdivision 2a, to the University of
Minnesota board of regents for the costs of the academic health
center as specified under section 62J.694, subdivision 2a,
paragraph (a).
Sec. 2. Minnesota Statutes 2001 Supplement, section
125A.515, is amended to read:
125A.515 [PLACEMENT OF CHILDREN WITHOUT DISABILITIES
STUDENTS; APPROVAL OF EDUCATION PROGRAM.]
Subdivision 1. [APPROVAL OF EDUCATION PROGRAMS.] The
commissioner shall approve education programs in care and
treatment facilities for placement of children without
disabilities and youth in care and treatment facilities
including detention centers, before being licensed by the
department of human services under Minnesota Rules, parts
9545.0905 to 9545.1125 and 9545.1400 to 9545.1480, or the
department of corrections under Minnesota Rules, chapters 2925,
2930, 2935, and 2950. For the purposes of this section, care
and treatment facilities includes adult facilities that admit
children and provide an education program specifically designed
for children who are residents of the facility including
chemical dependency and other substance abuse programs, shelter
care facilities, hospitals, correctional facilities, mental
health programs, and detention facilities. Education programs
in these facilities shall conform to state and federal education
laws including the Individuals with Disabilities Education Act
(IDEA).
Subd. 2. [DEFINITION OF CARE AND TREATMENT
PLACEMENT.] Students placed in the following public or private
facilities are considered to be placed for care and treatment:
(1) group foster home, department of corrections;
(2) secure juvenile detention facilities, department of
corrections;
(3) juvenile residential facilities, department of
corrections;
(4) temporary holdover - eight day, department of
corrections;
(5) group homes, department of human services;
(6) residential academies, department of human services;
(7) transitional programs, department of human services;
(8) shelter care, department of human services and
department of corrections;
(9) shelter for homeless, department of human services;
(10) adult facilities that admit persons under the age of
22; and
(11) residential treatment programs.
Subd. 3. [RESPONSIBILITIES FOR PROVIDING EDUCATION.] (a)
The district in which the facility is located must provide
education services, including special education if eligible, to
all students placed in a facility for care and treatment.
(b) For education programs operated by the department of
corrections, the providing district shall be the department of
corrections. For students remanded to the commissioner of
corrections, the providing and resident district shall be the
department of corrections.
(c) Placement for care and treatment does not automatically
make a student eligible for special education. A student placed
in a care and treatment facility is eligible for special
education under state and federal law including the Individuals
with Disabilities Education Act under United States Code, title
20, chapter 33.
Subd. 4. [EDUCATION SERVICES REQUIRED.] (a) Education
services must be provided to a student beginning within three
business days after the student enters the care and treatment
facility. The first four days of the student's placement may be
used to screen the student for educational and safety issues.
(b) If the student does not meet the eligibility criteria
for special education, regular education services must be
provided to that student.
Subd. 5. [EDUCATION PROGRAMS FOR STUDENTS PLACED IN
FACILITIES FOR CARE AND TREATMENT.] (a) When a student is placed
in a care and treatment facility that has an on-site education
program, the providing district, upon notice from the care and
treatment facility, must contact the resident district within
one business day to determine if a student has been identified
as having a disability, and to request at least the student's
transcript, and for students with disabilities, the most recent
individualized education plan (IEP) and evaluation report, and
to determine if the student has been identified as a student
with a disability. The resident district must send a facsimile
copy to the providing district within two business days of
receiving the request.
(b) If a student placed for care and treatment has been
identified as having a disability and has an individual
education plan in the resident district:
(1) the providing agency must conduct an individualized
education plan meeting to reach an agreement about continuing or
modifying special education services in accordance with the
current individualized education plan goals and objectives and
to determine if additional evaluations are necessary; and
(2) at least the following people shall receive written
notice or documented phone call to be followed with written
notice to attend the individualized education plan meeting:
(i) the person or agency placing the student;
(ii) the resident district;
(iii) the appropriate teachers and related services staff
from the providing district;
(iv) appropriate staff from the care and treatment
facility;
(v) the parents or legal guardians of the student; and
(vi) when appropriate, the student.
(c) For a student who has not been identified as a student
with a disability, a screening must be conducted by the
providing districts as soon as possible to determine the
student's educational and behavioral needs and must include a
review of the student's educational records.
Subd. 6. [EXIT REPORT SUMMARIZING EDUCATIONAL
PROGRESS.] If a student has been placed in a care and treatment
facility for 15 or more business days, the providing district
must prepare an exit report summarizing the regular education,
special education, evaluation, educational progress, and service
information and must send the report to the resident district
and the next providing district if different, the parent or
legal guardian, and any appropriate social service agency. For
students with disabilities, this report must include the
student's IEP.
Subd. 7. [MINIMUM EDUCATIONAL SERVICES REQUIRED.] At a
minimum, the providing district is responsible for:
(1) the education necessary, including summer school
services, for a student who is not performing at grade level as
indicated in the education record or IEP; and
(2) a school day, of the same length as the school day of
the providing district, unless the unique needs of the student,
as documented through the IEP or education record in
consultation with treatment providers, requires an alteration in
the length of the school day.
Subd. 8. [PLACEMENT, SERVICES, AND DUE PROCESS.] When a
student's treatment and educational needs allow, education shall
be provided in a regular educational setting. The determination
of the amount and site of integrated services must be a joint
decision between the student's parents or legal guardians and
the treatment and education staff. When applicable, educational
placement decisions must be made by the IEP team of the
providing district. Educational services shall be provided in
conformance with the least restrictive environment principle of
the Individuals with Disabilities Education Act. The providing
district and care and treatment facility shall cooperatively
develop discipline and behavior management procedures to be used
in emergency situations that comply with the Minnesota Pupil
Fair Dismissal Act and other relevant state and federal laws and
regulations.
Subd. 9. [REIMBURSEMENT FOR EDUCATION SERVICES.] (a)
Education services provided to students who have been placed for
care and treatment are reimbursable in accordance with special
education and general education statutes.
(b) Indirect or consultative services provided in
conjunction with regular education prereferral interventions and
assessment provided to regular education students suspected of
being disabled and who have demonstrated learning or behavioral
problems in a screening are reimbursable with special education
categorical aids.
(c) Regular education, including screening, provided to
students with or without disabilities is not reimbursable with
special education categorical aids.
Subd. 10. [STUDENTS UNABLE TO ATTEND SCHOOL BUT NOT PLACED
IN CARE AND TREATMENT FACILITIES.] Students who are absent from,
or predicted to be absent from, school for 15 consecutive or
intermittent days, at home or in facilities not licensed by the
departments of corrections or human services are not students
placed for care and treatment. These students include students
with and without disabilities who are home due to accident or
illness, in a hospital or other medical facility, or in a day
treatment center. These students are entitled to education
services through their district of residence.
Sec. 3. Minnesota Statutes 2000, section 125A.76,
subdivision 5, is amended to read:
Subd. 5. [SCHOOL DISTRICT SPECIAL EDUCATION AID.] (a) A
school district's special education aid for fiscal year 2000 and
later equals the state total special education aid, minus the
amount determined under paragraphs (b) and (c), times the ratio
of the district's adjusted special education base revenue to the
state total adjusted special education base revenue. If the
commissioner of children, families, and learning modifies its
rules for special education in a manner that increases a
district's special education obligations or service
requirements, the commissioner shall annually increase each
district's special education aid by the amount necessary to
compensate for the increased service requirements. The
additional aid equals the cost in the current year attributable
to rule changes not reflected in the computation of special
education base revenue, multiplied by the appropriate
percentages from subdivision 2.
(b) Notwithstanding paragraph (a), if the special education
base revenue for a district equals zero, the special education
aid equals the amount computed according to subdivision 2 using
current year data.
(c) Notwithstanding paragraphs (a) and (b), if the special
education base revenue for a district is greater than zero, and
the base year amount for the district under subdivision 2,
paragraph (a), clause (7), equals zero, the special education
aid equals the sum of the amount computed according to paragraph
(a), plus the amount computed according to subdivision 2,
paragraph (a), clause (7), using current year data.
(d) A charter school under section 124D.10 shall generate
state special education aid based on current year expenditures
for its first four years of operation and only in its fifth and
later years shall paragraphs (a), (b), and (c) apply.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 4. Minnesota Statutes 2000, section 144.05, is
amended by adding a subdivision to read:
Subd. 4. [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon
receiving notice under section 149A.90, subdivision 1, of the
death of an individual who cannot be identified, the
commissioner must post on the department's Web site information
regarding the individual for purposes of obtaining information
that may aid in identifying the individual and for purposes of
notifying relatives who may be seeking the individual. The
information must remain on the Web site continuously until the
person's identity is determined.
Sec. 5. Minnesota Statutes 2001 Supplement, section
144.148, subdivision 2, is amended to read:
Subd. 2. [PROGRAM.] (a) The commissioner of health shall
award rural hospital capital improvement grants to eligible
rural hospitals. Except as provided in paragraph (b), a grant
shall not exceed $500,000 per hospital. Prior to the receipt of
any grant, the hospital must certify to the commissioner that at
least one-quarter of the grant amount, which may include in-kind
services, is available for the same purposes from nonstate
resources. Notwithstanding any law to the contrary, funds
awarded to grantees in a grant agreement do not lapse until
expended by the grantee.
(b) A grant shall not exceed $1,500,000 per eligible rural
hospital that also satisfies the following criteria:
(1) is the only hospital in a county;
(2) has 25 or fewer licensed hospital beds with a net
hospital operating margin not greater than an average of two
percent over the three fiscal years prior to application;
(3) is located in a medically underserved community (MUC)
or a health professional shortage area (HPSA);
(4) is located near a migrant worker employment site and
regularly treats significant numbers of migrant workers and
their families; and
(5) has not previously received a grant under this section
prior to July 1, 1999.
Sec. 6. Minnesota Statutes 2000, section 144.335,
subdivision 5, is amended to read:
Subd. 5. [COSTS.] (a) When a patient requests a copy of
the patient's record for purposes of reviewing current medical
care, the provider must not charge a fee.
(b) When a provider or its representative makes copies of
patient records upon a patient's request under this section, the
provider or its representative may charge the patient or the
patient's representative no more than 75 cents per page, plus
$10 for time spent retrieving and copying the records, unless
other law or a rule or contract provide for a lower maximum
charge. This limitation does not apply to x-rays. The provider
may charge a patient no more than the actual cost of reproducing
X-rays, plus no more than $10 for the time spent retrieving and
copying the x-rays.
(c) The respective maximum charges of 75 cents per page and
$10 for time provided in this subdivision are in effect for
calendar year 1992 and may be adjusted annually each calendar
year as provided in this subdivision. The permissible maximum
charges shall change each year by an amount that reflects the
change, as compared to the previous year, in the consumer price
index for all urban consumers, Minneapolis-St. Paul (CPI-U),
published by the department of labor.
(d) A provider or its representative must not charge a fee
to provide copies of records requested by a patient or the
patient's authorized representative if the request for copies of
records is for purposes of appealing a denial of social security
disability income or social security disability benefits under
title II or title XVI of the Social Security Act. For the
purpose of further appeals, a patient may receive no more than
two medical record updates without charge, but only for medical
record information previously not provided. For purposes of
this paragraph, a patient's authorized representative does not
include units of state government engaged in the adjudication of
social security disability claims.
Sec. 7. Minnesota Statutes 2000, section 144.417,
subdivision 1, is amended to read:
Subdivision 1. [RULES.] (a) The state commissioner of
health shall adopt rules necessary and reasonable to implement
the provisions of sections 144.411 to 144.417, except as
provided for in section 144.414.
(b) Rules implementing sections 144.411 to 144.417 adopted
after January 1, 2002, may not take effect until approved by a
law enacted after January 1, 2002. This paragraph does not
apply to a rule or severable portion of a rule governing smoking
in office buildings, factories, warehouses, or similar places of
work, or in health care facilities. This paragraph does not
apply to a rule changing the definition of "restaurant" to make
it the same as the definition in section 157.15, subdivision 12.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 8. Minnesota Statutes 2000, section 147B.02,
subdivision 9, is amended to read:
Subd. 9. [RENEWAL.] (a) To renew a license an applicant
must:
(1) annually, or as determined by the board, complete a
renewal application on a form provided by the board;
(2) submit the renewal fee;
(3) provide evidence annually of one hour of continuing
education in the subject of infection control, including blood
borne pathogen diseases;
(4) provide documentation of current and active NCCAOM
certification; or
(5) (4) if licensed under subdivision 5 or 6, meet the same
NCCAOM professional development activity requirements as those
licensed under subdivision 7.
(b) An applicant shall submit any additional information
requested by the board to clarify information presented in the
renewal application. The information must be submitted within
30 days after the board's request, or the renewal request is
nullified.
Sec. 9. Minnesota Statutes 2001 Supplement, section
149A.90, subdivision 1, is amended to read:
Subdivision 1. [DEATH RECORD.] (a) Except as provided in
this section, a death record must be completed and filed for
every known death by the mortician, funeral director, or other
person lawfully in charge of the disposition of the body.
(b) If the body is that of an individual whose identity is
unknown, the person in charge of the disposition of the body
must notify the commissioner for purposes of compliance with
section 144.05, subdivision 4.
Sec. 10. Minnesota Statutes 2000, section 261.063, is
amended to read:
261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY;
PENALTY.]
(a) The board of county commissioners of each county shall
annually levy taxes and fix a rate sufficient to produce the
full amount required for poor relief, general assistance,
Minnesota family investment program, county share of county and
state supplemental aid to supplemental security income
applicants or recipients, and any other social security measures
wherein there is now or may hereafter be county participation,
sufficient to produce the full amount necessary for each such
item, including administrative expenses, for the ensuing year,
within the time fixed by law in addition to all other tax levies
and tax rates, however fixed or determined, and any commissioner
who shall fail to comply herewith shall be guilty of a gross
misdemeanor and shall be immediately removed from office by the
governor. For the purposes of this paragraph, "poor relief"
means county services provided under sections 261.035, 261.04,
and 261.21 to 261.231.
(b) Nothing within the provisions of this section shall be
construed as requiring a county agency to provide income support
or cash assistance to needy persons when they are no longer
eligible for assistance under general assistance, the Minnesota
family investment program, or Minnesota supplemental aid.
Sec. 11. [REPEALER.]
Minnesota Statutes 2000, section 147B.01, subdivisions 8
and 15, are repealed.
Presented to the governor May 16, 2002
Signed by the governor May 18, 2002, 7:10 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes