Office of the Revisor of Statutes
Minnesota Session Laws - 2003, 1st Special Session
Key: (1) language to be deleted (2) new language
CHAPTER 14-H.F.No. 6
An act relating to state government; making changes to
public assistance programs, long-term care, continuing
care for persons with disabilities, children's
services, occupational licenses, human services
licensing, county initiatives, local public health
grants, child care provisions, child support
provisions, and health care; establishing the
Community Services Act; establishing alternative care
liens; modifying petroleum product specifications;
conveying land in Cass county; making forecast
adjustments; appropriating money; amending Minnesota
Statutes 2002, sections 13.69, subdivision 1; 41A.09,
subdivision 2a; 61A.072, subdivision 6; 62A.31,
subdivisions 1f, 1u, by adding a subdivision; 62A.315;
62A.316; 62A.48, by adding a subdivision; 62A.49, by
adding a subdivision; 62A.65, subdivision 7; 62D.095,
subdivision 2, by adding a subdivision; 62E.06,
subdivision 1; 62J.17, subdivision 2; 62J.23, by
adding a subdivision; 62J.52, subdivisions 1, 2;
62J.692, subdivisions 3, 4, 5, 7, 8; 62J.694, by
adding a subdivision; 62L.05, subdivision 4; 62Q.19,
subdivisions 1, 2; 62S.22, subdivision 1; 69.021,
subdivision 11; 119B.011, subdivisions 5, 6, 15, 19,
20, 21, by adding a subdivision; 119B.02, subdivision
1; 119B.03, subdivisions 4, 9; 119B.05, subdivision 1;
119B.08, subdivision 3; 119B.09, subdivisions 1, 2, 7,
by adding subdivisions; 119B.11, subdivision 2a;
119B.12, subdivision 2; 119B.13, subdivisions 1, 6, by
adding a subdivision; 119B.16, subdivision 2, by
adding subdivisions; 119B.19, subdivision 7; 119B.21,
subdivision 11; 119B.23, subdivision 3; 124D.23,
subdivision 1; 144.1222, by adding a subdivision;
144.125; 144.128; 144.1481, subdivision 1; 144.1483;
144.1488, subdivision 4; 144.1491, subdivision 1;
144.1502, subdivision 4; 144.396, subdivisions 1, 5,
7, 10, 11, 12; 144.414, subdivision 3; 144.551,
subdivision 1; 144A.04, subdivision 3, by adding a
subdivision; 144A.071, subdivision 4c, as added;
144A.10, by adding a subdivision; 144A.4605,
subdivision 4; 144E.11, subdivision 6; 144E.50,
subdivision 5; 145.88; 145.881, subdivisions 1, 2;
145.882, subdivisions 1, 2, 3, 7, by adding a
subdivision; 145.883, subdivisions 1, 9; 145A.02,
subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09,
subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by
adding a subdivision; 145A.11, subdivisions 2, 4;
145A.12, subdivisions 1, 2, by adding a subdivision;
145A.13, by adding a subdivision; 145A.14, subdivision
2, by adding a subdivision; 147A.08; 148.5194,
subdivisions 1, 2, 3, by adding a subdivision;
148.6445, subdivision 7; 148C.01, subdivisions 2, 12,
by adding subdivisions; 148C.03, subdivision 1;
148C.0351, subdivision 1, by adding a subdivision;
148C.04; 148C.05, subdivision 1, by adding
subdivisions; 148C.07; 148C.10, subdivisions 1, 2;
148C.11; 153A.17; 171.06, subdivision 3; 171.07, by
adding a subdivision; 174.30, subdivision 1; 239.761,
subdivisions 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13;
239.792; 245.0312; 245.4874; 245.493, subdivision 1a;
245A.035, subdivision 3; 245A.04, subdivisions 3, 3b,
3d; 245A.09, subdivision 7; 245A.10; 245A.11,
subdivisions 2a, 2b, by adding a subdivision; 245B.03,
subdivision 2, by adding a subdivision; 245B.04,
subdivision 2; 245B.06, subdivisions 2, 5, 8; 245B.07,
subdivisions 6, 9, 11; 245B.08, subdivision 1;
246.014; 246.015, subdivision 3; 246.018, subdivisions
2, 3, 4; 246.13; 246.15; 246.16; 246.54; 246.57,
subdivisions 1, 4, 6; 246.71, subdivisions 4, 5;
246B.02; 246B.03; 246B.04; 252.025, subdivision 7;
252.06; 252.27, subdivision 2a; 252.32, subdivisions
1, 1a, 3, 3c; 252.41, subdivision 3; 252.46,
subdivision 1; 253.015, subdivision 1; 253.017;
253.20; 253.26; 253B.02, subdivision 18a; 253B.04,
subdivision 1; 253B.05, subdivision 3; 253B.09,
subdivision 1; 256.01, subdivision 2; 256.012;
256.046, subdivision 1; 256.0471, subdivision 1;
256.476, subdivisions 1, 3, 4, 5, 11; 256.482,
subdivision 8; 256.955, subdivisions 2a, 3, by adding
a subdivision; 256.9657, subdivisions 1, 4, by adding
a subdivision; 256.969, subdivisions 2b, 3a, by adding
a subdivision; 256.975, by adding a subdivision;
256.98, subdivisions 3, 4, 8; 256.984, subdivision 1;
256B.055, by adding a subdivision; 256B.056,
subdivisions 1a, 1c, 3c, 6; 256B.057, subdivisions 1,
2, 3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding
subdivisions; 256B.06, subdivision 4; 256B.061;
256B.0621, subdivisions 4, 7; 256B.0623, subdivisions
2, 4, 5, 6, 8; 256B.0625, subdivisions 5a, 9, 13, 17,
19c, 23, by adding subdivisions; 256B.0627,
subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2;
256B.064, subdivision 2; 256B.0911, subdivision 4d;
256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12;
256B.0915, subdivision 3, by adding a subdivision;
256B.092, subdivisions 1a, 5, by adding a subdivision;
256B.0945, subdivisions 2, 4; 256B.095; 256B.0951,
subdivisions 1, 2, 3, 5, 7, 9; 256B.0952, subdivision
1; 256B.0953, subdivision 2; 256B.0955; 256B.15,
subdivisions 1, 1a, 2, 3, 4, by adding subdivisions;
256B.19, subdivision 1; 256B.195, subdivisions 3, 5;
256B.32, subdivision 1; 256B.431, subdivisions 2r, 32,
36, by adding subdivisions; 256B.434, subdivisions 4,
10; 256B.47, subdivision 2; 256B.49, subdivision 15;
256B.501, subdivision 1, by adding a subdivision;
256B.5012, by adding a subdivision; 256B.5013, by
adding a subdivision; 256B.5015; 256B.69, subdivisions
2, 4, 5, 5a, 5c, 6a, 6b, 8, by adding subdivisions;
256B.75; 256B.76; 256B.761; 256B.82; 256D.03,
subdivisions 3, 3a, 4; 256D.06, subdivision 2;
256D.44, subdivision 5; 256D.46, subdivisions 1, 3;
256D.48, subdivision 1; 256G.05, subdivision 2;
256I.02; 256I.04, subdivision 3; 256I.05, subdivisions
1, 1a, 7c; 256J.01, subdivision 5; 256J.02,
subdivision 2; 256J.021; 256J.08, subdivisions 35, 65,
82, 85, by adding subdivisions; 256J.09, subdivisions
2, 3, 3a, 3b, 8, 10; 256J.14; 256J.20, subdivision 3;
256J.21, subdivisions 1, 2; 256J.24, subdivisions 3,
5, 6, 7, 10; 256J.30, subdivision 9; 256J.32,
subdivisions 2, 4, 5a, by adding a subdivision;
256J.37, subdivision 9, by adding subdivisions;
256J.38, subdivisions 3, 4; 256J.40; 256J.42,
subdivisions 4, 5, 6; 256J.425, subdivisions 1, 1a, 2,
3, 4, 6, 7; 256J.45, subdivision 2; 256J.46,
subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9,
13, by adding subdivisions; 256J.50, subdivisions 1,
9, 10; 256J.51, subdivisions 1, 2, 3, 4; 256J.53,
subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3,
5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57;
256J.62, subdivision 9; 256J.645, subdivision 3;
256J.66, subdivision 2; 256J.69, subdivision 2;
256J.75, subdivision 3; 256J.751, subdivisions 1, 2,
5; 256L.03, subdivision 1; 256L.04, subdivisions 1,
10; 256L.05, subdivisions 3a, 4; 256L.06, subdivision
3; 256L.07, subdivisions 1, 3; 256L.12, subdivisions
6, 9, by adding a subdivision; 256L.15, subdivisions
1, 2, 3; 256L.17, subdivision 2; 257.05; 257.0769;
259.21, subdivision 6; 259.67, subdivisions 4, 7;
260B.157, subdivision 1; 260B.176, subdivision 2;
260B.178, subdivision 1; 260B.193, subdivision 2;
260B.235, subdivision 6; 260C.141, subdivision 2;
261.063; 295.53, subdivision 1; 295.55, subdivision 2;
296A.01, subdivisions 2, 7, 8, 14, 19, 20, 22, 23, 24,
25, 26, 28, by adding a subdivision; 297I.15,
subdivisions 1, 4; 326.42; 393.07, subdivisions 1, 5,
10; 471.59, subdivision 1; 514.981, subdivision 6;
518.167, subdivision 1; 518.551, subdivisions 7, 12,
13; 518.6111, subdivisions 2, 3, 4, 16; 524.3-805;
626.559, subdivision 5; 641.15, subdivision 2; Laws
1997, chapter 203, article 9, section 21, as amended;
Laws 1997, chapter 245, article 2, section 11; 2003
S.F. No. 1019, sections 2, 3, 7, if enacted; proposing
coding for new law in Minnesota Statutes, chapters
62J; 62Q; 62S; 97A; 119B; 144; 144A; 145; 145A; 148C;
245; 246; 256; 256B; 256I; 256J; 256L; 514; proposing
coding for new law as Minnesota Statutes, chapter
256M; repealing Minnesota Statutes 2002, sections
62J.15; 62J.152; 62J.451; 62J.452; 62J.66; 62J.68;
119B.061; 119B.13, subdivision 2; 144.126; 144.1484;
144.1494; 144.1495; 144.1496; 144.1497; 144.401;
144A.071, subdivision 5; 144A.35; 144A.36; 144A.38;
145.882, subdivisions 4, 5, 6, 8; 145.883,
subdivisions 4, 7; 145.884; 145.885; 145.886; 145.888;
145.889; 145.890; 145A.02, subdivisions 9, 10, 11, 12,
13, 14; 145A.09, subdivision 6; 145A.10, subdivisions
5, 6, 8; 145A.11, subdivision 3; 145A.12, subdivisions
3, 4, 5; 145A.14, subdivisions 3, 4; 145A.17,
subdivision 2; 148.5194, subdivision 3a; 148.6445,
subdivision 9; 148C.0351, subdivision 2; 148C.05,
subdivisions 2, 3, 4; 148C.06; 148C.10, subdivision
1a; 245.478; 245.4886; 245.4888; 245.496; 246.017,
subdivision 2; 246.022; 246.06; 246.07; 246.08;
246.11; 246.19; 246.42; 252.025, subdivisions 1, 2, 4,
5, 6; 252.032; 252.10; 252.32, subdivision 2; 253.015,
subdivisions 2, 3; 253.10; 253.19; 253.201; 253.202;
253.25; 253.27; 254A.17; 256.05; 256.06; 256.08;
256.09; 256.10; 256.955, subdivision 8; 256.973;
256.9772; 256B.055, subdivision 10a; 256B.057,
subdivision 1b; 256B.0625, subdivisions 35, 36;
256B.0945, subdivision 10; 256B.437, subdivision 2;
256B.5013, subdivision 4; 256E.01; 256E.02; 256E.03;
256E.04; 256E.05; 256E.06; 256E.07; 256E.08; 256E.081;
256E.09; 256E.10; 256E.11; 256E.115; 256E.13; 256E.14;
256E.15; 256F.01; 256F.02; 256F.03; 256F.04; 256F.05;
256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 256F.14;
256J.02, subdivision 3; 256J.08, subdivisions 28, 70;
256J.24, subdivision 8; 256J.30, subdivision 10;
256J.462; 256J.47; 256J.48; 256J.49, subdivisions 1a,
2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7;
256J.52; 256J.55, subdivision 5; 256J.62, subdivisions
1, 2a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74,
subdivision 3; 256J.751, subdivisions 3, 4; 256J.76;
256K.30; 257.075; 257.81; 260.152; 268A.08; 626.562;
Laws 1998, chapter 407, article 4, section 63; Laws
2000, chapter 488, article 10, section 29; Laws 2000,
chapter 489, article 1, section 36; Laws 2001, First
Special Session chapter 3, article 1, section 16; Laws
2001, First Special Session chapter 9, article 13,
section 24; Laws 2002, chapter 374, article 9, section
8; Laws 2003, chapter 55, sections 1, 4; Minnesota
Rules, parts 4705.0100; 4705.0200; 4705.0300;
4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800;
4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300;
4705.1400; 4705.1500; 4705.1600; 4736.0010; 4736.0020;
4736.0030; 4736.0040; 4736.0050; 4736.0060; 4736.0070;
4736.0080; 4736.0090; 4736.0120; 4736.0130; 4747.0030,
subparts 25, 28, 30; 4747.0040, subpart 3, item A;
4747.0060, subpart 1, items A, B, D; 4747.0070,
subparts 4, 5; 4747.0080; 4747.0090; 4747.0100;
4747.0300; 4747.0400, subparts 2, 3; 4747.0500;
4747.0600; 4747.1000; 4747.1100, subpart 3; 4747.1600;
4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140;
4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190;
4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240;
4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295;
4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045;
9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070;
9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100;
9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120;
9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140;
9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010;
9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020;
9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070;
9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
WELFARE REFORM
Section 1. Minnesota Statutes 2002, section 119B.03,
subdivision 4, is amended to read:
Subd. 4. [FUNDING PRIORITY.] (a) First priority for child
care assistance under the basic sliding fee program must be
given to eligible non-MFIP families who do not have a high
school or general equivalency diploma or who need remedial and
basic skill courses in order to pursue employment or to pursue
education leading to employment and who need child care
assistance to participate in the education program. Within this
priority, the following subpriorities must be used:
(1) child care needs of minor parents;
(2) child care needs of parents under 21 years of age; and
(3) child care needs of other parents within the priority
group described in this paragraph.
(b) Second priority must be given to parents who have
completed their MFIP or work first transition year, or parents
who are no longer receiving or eligible for diversionary work
program supports.
(c) Third priority must be given to families who are
eligible for portable basic sliding fee assistance through the
portability pool under subdivision 9.
Sec. 2. Minnesota Statutes 2002, section 256.984,
subdivision 1, is amended to read:
Subdivision 1. [DECLARATION.] Every application for public
assistance under this chapter and/or or chapters 256B, 256D,
256K, MFIP program 256J, and food stamps or food support under
chapter 393 shall be in writing or reduced to writing as
prescribed by the state agency and shall contain the following
declaration which shall be signed by the applicant:
"I declare under the penalties of perjury that this
application has been examined by me and to the best of my
knowledge is a true and correct statement of every material
point. I understand that a person convicted of perjury may
be sentenced to imprisonment of not more than five years or
to payment of a fine of not more than $10,000, or both."
Sec. 3. Minnesota Statutes 2002, section 256D.06,
subdivision 2, is amended to read:
Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions
of subdivision 1, a grant of emergency general assistance shall,
to the extent funds are available, be made to an eligible single
adult, married couple, or family for an emergency need, as
defined in rules promulgated by the commissioner, where the
recipient requests temporary assistance not exceeding 30 days if
an emergency situation appears to exist and (a) until March 31,
1998, the individual is ineligible for the program of emergency
assistance under aid to families with dependent children and is
not a recipient of aid to families with dependent children at
the time of application; or (b) the individual or family is (i)
ineligible for MFIP or DWP or is not a participant of MFIP; and
(ii) is ineligible for emergency assistance under section
256J.48 or DWP. If an applicant or recipient relates facts to
the county agency which may be sufficient to constitute an
emergency situation, the county agency shall, to the extent
funds are available, advise the person of the procedure for
applying for assistance according to this subdivision. An
emergency general assistance grant is available to a recipient
not more than once in any 12-month period. Funding for an
emergency general assistance program is limited to the
appropriation. Each fiscal year, the commissioner shall
allocate to counties the money appropriated for emergency
general assistance grants based on each county agency's average
share of state's emergency general expenditures for the
immediate past three fiscal years as determined by the
commissioner, and may reallocate any unspent amounts to other
counties. Any emergency general assistance expenditures by a
county above the amount of the commissioner's allocation to the
county must be made from county funds.
Sec. 4. Minnesota Statutes 2002, section 256D.44,
subdivision 5, is amended to read:
Subd. 5. [SPECIAL NEEDS.] In addition to the state
standards of assistance established in subdivisions 1 to 4,
payments are allowed for the following special needs of
recipients of Minnesota supplemental aid who are not residents
of a nursing home, a regional treatment center, or a group
residential housing facility.
(a) The county agency shall pay a monthly allowance for
medically prescribed diets payable under the Minnesota family
investment program if the cost of those additional dietary needs
cannot be met through some other maintenance benefit. The need
for special diets or dietary items must be prescribed by a
licensed physician. Costs for special diets shall be determined
as percentages of the allotment for a one-person household under
the thrifty food plan as defined by the United States Department
of Agriculture. The types of diets and the percentages of the
thrifty food plan that are covered are as follows:
(1) high protein diet, at least 80 grams daily, 25 percent
of thrifty food plan;
(2) controlled protein diet, 40 to 60 grams and requires
special products, 100 percent of thrifty food plan;
(3) controlled protein diet, less than 40 grams and
requires special products, 125 percent of thrifty food plan;
(4) low cholesterol diet, 25 percent of thrifty food plan;
(5) high residue diet, 20 percent of thrifty food plan;
(6) pregnancy and lactation diet, 35 percent of thrifty
food plan;
(7) gluten-free diet, 25 percent of thrifty food plan;
(8) lactose-free diet, 25 percent of thrifty food plan;
(9) antidumping diet, 15 percent of thrifty food plan;
(10) hypoglycemic diet, 15 percent of thrifty food plan; or
(11) ketogenic diet, 25 percent of thrifty food plan.
(b) Payment for nonrecurring special needs must be allowed
for necessary home repairs or necessary repairs or replacement
of household furniture and appliances using the payment standard
of the AFDC program in effect on July 16, 1996, for these
expenses, as long as other funding sources are not available.
(c) A fee for guardian or conservator service is allowed at
a reasonable rate negotiated by the county or approved by the
court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100
per month. If the guardian or conservator is a member of the
county agency staff, no fee is allowed.
(d) The county agency shall continue to pay a monthly
allowance of $68 for restaurant meals for a person who was
receiving a restaurant meal allowance on June 1, 1990, and who
eats two or more meals in a restaurant daily. The allowance
must continue until the person has not received Minnesota
supplemental aid for one full calendar month or until the
person's living arrangement changes and the person no longer
meets the criteria for the restaurant meal allowance, whichever
occurs first.
(e) A fee of ten percent of the recipient's gross income or
$25, whichever is less, is allowed for representative payee
services provided by an agency that meets the requirements under
SSI regulations to charge a fee for representative payee
services. This special need is available to all recipients of
Minnesota supplemental aid regardless of their living
arrangement.
(f) Notwithstanding the language in this subdivision, an
amount equal to the maximum allotment authorized by the federal
Food Stamp Program for a single individual which is in effect on
the first day of January of the previous year will be added to
the standards of assistance established in subdivisions 1 to 4
for individuals under the age of 65 who are relocating from an
institution and who are shelter needy. An eligible individual
who receives this benefit prior to age 65 may continue to
receive the benefit after the age of 65.
"Shelter needy" means that the assistance unit incurs
monthly shelter costs that exceed 40 percent of the assistance
unit's gross income before the application of this special needs
standard. "Gross income" for the purposes of this section is
the applicant's or recipient's income as defined in section
256D.35, subdivision 10, or the standard specified in
subdivision 3, whichever is greater. A recipient of a federal
or state housing subsidy, that limits shelter costs to a
percentage of gross income, shall not be considered shelter
needy for purposes of this paragraph.
Sec. 5. Minnesota Statutes 2002, section 256D.46,
subdivision 1, is amended to read:
Subdivision 1. [ELIGIBILITY.] A county agency must grant
emergency Minnesota supplemental aid must be granted, to the
extent funds are available, if the recipient is without adequate
resources to resolve an emergency that, if unresolved, will
threaten the health or safety of the recipient. For the
purposes of this section, the term "recipient" includes persons
for whom a group residential housing benefit is being paid under
sections 256I.01 to 256I.06.
Sec. 6. Minnesota Statutes 2002, section 256D.46,
subdivision 3, is amended to read:
Subd. 3. [PAYMENT AMOUNT.] The amount of assistance
granted under emergency Minnesota supplemental aid is limited to
the amount necessary to resolve the emergency. An emergency
Minnesota supplemental aid grant is available to a recipient no
more than once in any 12-month period. Funding for emergency
Minnesota supplemental aid is limited to the appropriation.
Each fiscal year, the commissioner shall allocate to counties
the money appropriated for emergency Minnesota supplemental aid
grants based on each county agency's average share of state's
emergency Minnesota supplemental aid expenditures for the
immediate past three fiscal years as determined by the
commissioner, and may reallocate any unspent amounts to other
counties. Any emergency Minnesota supplemental aid expenditures
by a county above the amount of the commissioner's allocation to
the county must be made from county funds.
Sec. 7. Minnesota Statutes 2002, section 256D.48,
subdivision 1, is amended to read:
Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county
agency shall determine whether a recipient needs a protective
payee when a physical or mental condition renders the recipient
unable to manage funds and when payments to the recipient would
be contrary to the recipient's welfare. Protective payments
must be issued when there is evidence of: (1) repeated
inability to plan the use of income to meet necessary
expenditures; (2) repeated observation that the recipient is not
properly fed or clothed; (3) repeated failure to meet
obligations for rent, utilities, food, and other essentials; (4)
evictions or a repeated incurrence of debts; or (5) lost or
stolen checks; or (6) use of emergency Minnesota supplemental
aid more than twice in a calendar year. The determination of
representative payment by the Social Security Administration for
the recipient is sufficient reason for protective payment of
Minnesota supplemental aid payments.
Sec. 8. Minnesota Statutes 2002, section 256J.01,
subdivision 5, is amended to read:
Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall
administer a compliance system for the state's temporary
assistance for needy families (TANF) program, the food stamp
program, emergency assistance, general assistance, medical
assistance, general assistance medical care, emergency general
assistance, Minnesota supplemental aid, preadmission screening,
child support program, and alternative care grants under the
powers and authorities named in section 256.01, subdivision 2.
The purpose of the compliance system is to permit the
commissioner to supervise the administration of public
assistance programs and to enforce timely and accurate
distribution of benefits, completeness of service and efficient
and effective program management and operations, to increase
uniformity and consistency in the administration and delivery of
public assistance programs throughout the state, and to reduce
the possibility of sanction and fiscal disallowances for
noncompliance with federal regulations and state statutes.
Sec. 9. Minnesota Statutes 2002, section 256J.02,
subdivision 2, is amended to read:
Subd. 2. [USE OF MONEY.] State money appropriated for
purposes of this section and TANF block grant money must be used
for:
(1) financial assistance to or on behalf of any minor child
who is a resident of this state under section 256J.12;
(2) employment and training services under this chapter or
chapter 256K;
(3) emergency financial assistance and services under
section 256J.48;
(4) diversionary assistance under section 256J.47;
(5) the health care and human services training and
retention program under chapter 116L, for costs associated with
families with children with incomes below 200 percent of the
federal poverty guidelines;
(6) (3) the pathways program under section 116L.04,
subdivision 1a;
(7) welfare-to-work extended employment services for MFIP
participants with severe impairment to employment as defined in
section 268A.15, subdivision 1a;
(8) the family homeless prevention and assistance program
under section 462A.204;
(9) the rent assistance for family stabilization
demonstration project under section 462A.205;
(10) (4) welfare to work transportation authorized under
Public Law Number 105-178;
(11) (5) reimbursements for the federal share of child
support collections passed through to the custodial parent;
(12) (6) reimbursements for the working family credit under
section 290.0671;
(13) intensive ESL grants under Laws 2000, chapter 489,
article 1;
(14) transitional housing programs under section 119A.43;
(15) programs and pilot projects under chapter 256K; and
(16) (7) program administration under this chapter;
(8) the diversionary work program under section 256J.95;
(9) the MFIP consolidated fund under section 256J.626; and
(10) the Minnesota department of health consolidated fund
under Laws 2001, First Special Session chapter 9, article 17,
section 3, subdivision 2.
Sec. 10. Minnesota Statutes 2002, section 256J.021, is
amended to read:
256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.]
Beginning October 1, 2001, and each year thereafter, the
commissioner of human services must treat financial assistance
MFIP expenditures made to or on behalf of any minor child under
section 256J.02, subdivision 2, clause (1), who is a resident of
this state under section 256J.12, and who is part of a
two-parent eligible household as expenditures under a separately
funded state program and report those expenditures to the
federal Department of Health and Human Services as separate
state program expenditures under Code of Federal Regulations,
title 45, section 263.5.
Sec. 11. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a
case that would be part of the child only TANF program under
section 256J.88.
Sec. 12. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.]
"Diversionary work program" or "DWP" has the meaning given in
section 256J.95.
Sec. 13. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 28b. [EMPLOYABLE.] "Employable" means a person is
capable of performing existing positions in the local labor
market, regardless of the current availability of openings for
those positions.
Sec. 14. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means
the following, if committed against a family or household member
by a family or household member:
(1) physical harm, bodily injury, or assault;
(2) the infliction of fear of imminent physical harm,
bodily injury, or assault; or
(3) terroristic threats, within the meaning of section
609.713, subdivision 1; criminal sexual conduct, within the
meaning of section 609.342, 609.343, 609.344, 609.345, or
609.3451; or interference with an emergency call within the
meaning of section 609.78, subdivision 2.
(b) For the purposes of family violence, "family or
household member" means:
(1) spouses and former spouses;
(2) parents and children;
(3) persons related by blood;
(4) persons who are residing together or who have resided
together in the past;
(5) persons who have a child in common regardless of
whether they have been married or have lived together at any
time;
(6) a man and woman if the woman is pregnant and the man is
alleged to be the father, regardless of whether they have been
married or have lived together at anytime; and
(7) persons involved in a current or past significant
romantic or sexual relationship.
Sec. 15. Minnesota Statutes, section 256J.08, is amended
by adding a subdivision to read:
Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence
waiver" means a waiver of the 60-month time limit for victims of
family violence who meet the criteria in section 256J.545 and
are complying with an employment plan in section 256J.521,
subdivision 3.
Sec. 16. Minnesota Statutes 2002, section 256J.08,
subdivision 35, is amended to read:
Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means
110 percent of the transitional standard as specified in section
256J.24, subdivision 7.
Sec. 17. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for
purposes of an extension to the 60-month time limit under
section 256J.425, subdivision 3, clause (3), means the person
has a disorder in one or more of the psychological processes
involved in perceiving, understanding, or using concepts through
verbal language or nonverbal means. Learning disabled does not
include learning problems that are primarily the result of
visual, hearing, or motor handicaps, mental retardation,
emotional disturbance, or due to environmental, cultural, or
economic disadvantage.
Sec. 18. Minnesota Statutes 2002, section 256J.08,
subdivision 65, is amended to read:
Subd. 65. [PARTICIPANT.] "Participant" means a person who
is currently receiving cash assistance or the food portion
available through MFIP as funded by TANF and the food stamp
program. A person who fails to withdraw or access
electronically any portion of the person's cash and food
assistance payment by the end of the payment month, who makes a
written request for closure before the first of a payment month
and repays cash and food assistance electronically issued for
that payment month within that payment month, or who returns any
uncashed assistance check and food coupons and withdraws from
the program is not a participant. A person who withdraws a cash
or food assistance payment by electronic transfer or receives
and cashes an MFIP assistance check or food coupons and is
subsequently determined to be ineligible for assistance for that
period of time is a participant, regardless whether that
assistance is repaid. The term "participant" includes the
caregiver relative and the minor child whose needs are included
in the assistance payment. A person in an assistance unit who
does not receive a cash and food assistance payment because the
person case has been suspended from MFIP is a participant. A
person who receives cash payments under the diversionary work
program under section 256J.95 is a participant.
Sec. 19. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 65a. [PARTICIPATION REQUIREMENTS OF
TANF.] "Participation requirements of TANF" means activities and
hourly requirements allowed under title IV-A of the federal
Social Security Act.
Sec. 20. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical
illness, injury, or incapacity, a "qualified professional" means
a licensed physician, a physician's assistant, a nurse
practitioner, or a licensed chiropractor.
(b) For mental retardation and intelligence testing, a
"qualified professional" means an individual qualified by
training and experience to administer the tests necessary to
make determinations, such as tests of intellectual functioning,
assessments of adaptive behavior, adaptive skills, and
developmental functioning. These professionals include licensed
psychologists, certified school psychologists, or certified
psychometrists working under the supervision of a licensed
psychologist.
(c) For learning disabilities, a "qualified professional"
means a licensed psychologist or school psychologist with
experience determining learning disabilities.
(d) For mental health, a "qualified professional" means a
licensed physician or a qualified mental health professional. A
"qualified mental health professional" means:
(1) for children, in psychiatric nursing, a registered
nurse who is licensed under sections 148.171 to 148.285, and who
is certified as a clinical specialist in child and adolescent
psychiatric or mental health nursing by a national nurse
certification organization or who has a master's degree in
nursing or one of the behavioral sciences or related fields from
an accredited college or university or its equivalent, with at
least 4,000 hours of post-master's supervised experience in the
delivery of clinical services in the treatment of mental
illness;
(2) for adults, in psychiatric nursing, a registered nurse
who is licensed under sections 148.171 to 148.285, and who is
certified as a clinical specialist in adult psychiatric and
mental health nursing by a national nurse certification
organization or who has a master's degree in nursing or one of
the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000
hours of post-master's supervised experience in the delivery of
clinical services in the treatment of mental illness;
(3) in clinical social work, a person licensed as an
independent clinical social worker under section 148B.21,
subdivision 6, or a person with a master's degree in social work
from an accredited college or university, with at least 4,000
hours of post-master's supervised experience in the delivery of
clinical services in the treatment of mental illness;
(4) in psychology, an individual licensed by the board of
psychology under sections 148.88 to 148.98, who has stated to
the board of psychology competencies in the diagnosis and
treatment of mental illness;
(5) in psychiatry, a physician licensed under chapter 147
and certified by the American Board of Psychiatry and Neurology
or eligible for board certification in psychiatry; and
(6) in marriage and family therapy, the mental health
professional must be a marriage and family therapist licensed
under sections 148B.29 to 148B.39, with at least two years of
post-master's supervised experience in the delivery of clinical
services in the treatment of mental illness.
Sec. 21. Minnesota Statutes 2002, section 256J.08,
subdivision 82, is amended to read:
Subd. 82. [SANCTION.] "Sanction" means the reduction of a
family's assistance payment by a specified percentage of the
MFIP standard of need because: a nonexempt participant fails to
comply with the requirements of sections 256J.52 256J.515 to
256J.55 256J.57; a parental caregiver fails without good cause
to cooperate with the child support enforcement requirements; or
a participant fails to comply with the insurance, tort
liability, or other requirements of this chapter.
Sec. 22. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person
who receives at least $1 in SSI benefits, or who is not
receiving an SSI benefit due to recoupment or a one month
suspension by the Social Security Administration due to excess
income.
Sec. 23. Minnesota Statutes 2002, section 256J.08,
subdivision 85, is amended to read:
Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard"
means the basic standard for a family with no other income or a
nonworking family without earned income and is a combination of
the cash assistance needs portion and food assistance needs for
a family of that size portion as specified in section 256J.24,
subdivision 5.
Sec. 24. Minnesota Statutes 2002, section 256J.08, is
amended by adding a subdivision to read:
Subd. 90. [SEVERE FORMS OF TRAFFICKING IN
PERSONS.] "Severe forms of trafficking in persons" means: (1)
sex trafficking in which a commercial sex act is induced by
force, fraud, or coercion, or in which the person induced to
perform the act has not attained 18 years of age; or (2) the
recruitment, harboring, transportation, provision, or obtaining
of a person for labor or services through the use of force,
fraud, or coercion for the purposes of subjection to involuntary
servitude, peonage, debt bondage, or slavery.
Sec. 25. Minnesota Statutes 2002, section 256J.09,
subdivision 2, is amended to read:
Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE
INFORMATION.] When a person inquires about assistance, a county
agency must:
(1) explain the eligibility requirements of, and how to
apply for, diversionary assistance as provided in section
256J.47; emergency assistance as provided in section 256J.48;
MFIP as provided in section 256J.10; or any other assistance for
which the person may be eligible; and
(2) offer the person brochures developed or approved by the
commissioner that describe how to apply for assistance.
Sec. 26. Minnesota Statutes 2002, section 256J.09,
subdivision 3, is amended to read:
Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county
agency must offer, in person or by mail, the application forms
prescribed by the commissioner as soon as a person makes a
written or oral inquiry. At that time, the county agency must:
(1) inform the person that assistance begins with the date
the signed application is received by the county agency or the
date all eligibility criteria are met, whichever is later;
(2) inform the person that any delay in submitting the
application will reduce the amount of assistance paid for the
month of application;
(3) inform a person that the person may submit the
application before an interview;
(4) explain the information that will be verified during
the application process by the county agency as provided in
section 256J.32;
(5) inform a person about the county agency's average
application processing time and explain how the application will
be processed under subdivision 5;
(6) explain how to contact the county agency if a person's
application information changes and how to withdraw the
application;
(7) inform a person that the next step in the application
process is an interview and what a person must do if the
application is approved including, but not limited to, attending
orientation under section 256J.45 and complying with employment
and training services requirements in sections 256J.52 256J.515
to 256J.55 256J.57;
(8) explain the child care and transportation services that
are available under paragraph (c) to enable caregivers to attend
the interview, screening, and orientation; and
(9) identify any language barriers and arrange for
translation assistance during appointments, including, but not
limited to, screening under subdivision 3a, orientation under
section 256J.45, and the initial assessment under section
256J.52 256J.521.
(b) Upon receipt of a signed application, the county agency
must stamp the date of receipt on the face of the application.
The county agency must process the application within the time
period required under subdivision 5. An applicant may withdraw
the application at any time by giving written or oral notice to
the county agency. The county agency must issue a written
notice confirming the withdrawal. The notice must inform the
applicant of the county agency's understanding that the
applicant has withdrawn the application and no longer wants to
pursue it. When, within ten days of the date of the agency's
notice, an applicant informs a county agency, in writing, that
the applicant does not wish to withdraw the application, the
county agency must reinstate the application and finish
processing the application.
(c) Upon a participant's request, the county agency must
arrange for transportation and child care or reimburse the
participant for transportation and child care expenses necessary
to enable participants to attend the screening under subdivision
3a and orientation under section 256J.45.
Sec. 27. Minnesota Statutes 2002, section 256J.09,
subdivision 3a, is amended to read:
Subd. 3a. [SCREENING.] The county agency, or at county
option, the county's employment and training service provider as
defined in section 256J.49, must screen each applicant to
determine immediate needs and to determine if the applicant may
be eligible for:
(1) another program that is not partially funded through
the federal temporary assistance to needy families block grant
under Title I of Public Law Number 104-193, including the
expedited issuance of food stamps under section 256J.28,
subdivision 1. If the applicant may be eligible for another
program, a county caseworker must provide the appropriate
referral to the program;
(2) the diversionary assistance program under section
256J.47; or
(3) the emergency assistance program under section
256J.48. If the applicant appears eligible for another program,
including any program funded by the MFIP consolidated fund, the
county must make a referral to the appropriate program.
Sec. 28. Minnesota Statutes 2002, section 256J.09,
subdivision 3b, is amended to read:
Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.]
If the applicant is not diverted from applying for MFIP, and if
the applicant meets the MFIP eligibility requirements, then a
county agency must:
(1) identify an applicant who is under the age of
20 without a high school diploma or its equivalent and explain
to the applicant the assessment procedures and employment plan
requirements for minor parents under section 256J.54;
(2) explain to the applicant the eligibility criteria in
section 256J.545 for an exemption under the family violence
provisions in section 256J.52, subdivision 6 waiver, and explain
what an applicant should do to develop an alternative employment
plan;
(3) determine if an applicant qualifies for an exemption
under section 256J.56 from employment and training services
requirements, explain how a person should report to the county
agency any status changes, and explain that an applicant who is
exempt may volunteer to participate in employment and training
services;
(4) for applicants who are not exempt from the requirement
to attend orientation, arrange for an orientation under section
256J.45 and an initial assessment under section 256J.52
256J.521;
(5) inform an applicant who is not exempt from the
requirement to attend orientation that failure to attend the
orientation is considered an occurrence of noncompliance with
program requirements and will result in an imposition of a
sanction under section 256J.46; and
(6) explain how to contact the county agency if an
applicant has questions about compliance with program
requirements.
Sec. 29. Minnesota Statutes 2002, section 256J.09,
subdivision 8, is amended to read:
Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency
issues notice of approval or denial, additional applications
submitted by an applicant are void. However, an application for
monthly assistance or other benefits funded under section
256J.626 and an application for emergency assistance or
emergency general assistance may exist concurrently. More than
one application for monthly assistance, emergency assistance, or
emergency general assistance may exist concurrently when the
county agency decisions on one or more earlier applications have
been appealed to the commissioner, and the applicant asserts
that a change in circumstances has occurred that would allow
eligibility. A county agency must require additional
application forms or supplemental forms as prescribed by the
commissioner when a payee's name changes, or when a caregiver
requests the addition of another person to the assistance unit.
Sec. 30. Minnesota Statutes 2002, section 256J.09,
subdivision 10, is amended to read:
Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY
REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an
applicant is not eligible for MFIP or the diversionary work
program under section 256J.95 because the applicant does not
meet eligibility requirements, the county agency must determine
whether the applicant is eligible for food stamps, medical
assistance, diversionary assistance, or has a need for emergency
assistance when the applicant meets the eligibility requirements
for those programs or health care programs. The county must
also inform applicants about resources available through the
county or other agencies to meet short-term emergency needs.
Sec. 31. Minnesota Statutes 2002, section 256J.14, is
amended to read:
256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.]
(a) The definitions in this paragraph only apply to this
subdivision.
(1) "Household of a parent, legal guardian, or other adult
relative" means the place of residence of:
(i) a natural or adoptive parent;
(ii) a legal guardian according to appointment or
acceptance under section 260C.325, 525.615, or 525.6165, and
related laws;
(iii) a caregiver as defined in section 256J.08,
subdivision 11; or
(iv) an appropriate adult relative designated by a county
agency.
(2) "Adult-supervised supportive living arrangement" means
a private family setting which assumes responsibility for the
care and control of the minor parent and minor child, or other
living arrangement, not including a public institution, licensed
by the commissioner of human services which ensures that the
minor parent receives adult supervision and supportive services,
such as counseling, guidance, independent living skills
training, or supervision.
(b) A minor parent and the minor child who is in the care
of the minor parent must reside in the household of a parent,
legal guardian, other adult relative, or in an adult-supervised
supportive living arrangement in order to receive MFIP unless:
(1) the minor parent has no living parent, other adult
relative, or legal guardian whose whereabouts is known;
(2) no living parent, other adult relative, or legal
guardian of the minor parent allows the minor parent to live in
the parent's, other adult relative's, or legal guardian's home;
(3) the minor parent lived apart from the minor parent's
own parent or legal guardian for a period of at least one year
before either the birth of the minor child or the minor parent's
application for MFIP;
(4) the physical or emotional health or safety of the minor
parent or minor child would be jeopardized if the minor parent
and the minor child resided in the same residence with the minor
parent's parent, other adult relative, or legal guardian; or
(5) an adult supervised supportive living arrangement is
not available for the minor parent and child in the county in
which the minor parent and child currently reside. If an adult
supervised supportive living arrangement becomes available
within the county, the minor parent and child must reside in
that arrangement.
(c) The county agency shall inform minor applicants both
orally and in writing about the eligibility requirements, their
rights and obligations under the MFIP program, and any other
applicable orientation information. The county must advise the
minor of the possible exemptions under section 256J.54,
subdivision 5, and specifically ask whether one or more of these
exemptions is applicable. If the minor alleges one or more of
these exemptions, then the county must assist the minor in
obtaining the necessary verifications to determine whether or
not these exemptions apply.
(d) If the county worker has reason to suspect that the
physical or emotional health or safety of the minor parent or
minor child would be jeopardized if they resided with the minor
parent's parent, other adult relative, or legal guardian, then
the county worker must make a referral to child protective
services to determine if paragraph (b), clause (4), applies. A
new determination by the county worker is not necessary if one
has been made within the last six months, unless there has been
a significant change in circumstances which justifies a new
referral and determination.
(e) If a minor parent is not living with a parent, legal
guardian, or other adult relative due to paragraph (b), clause
(1), (2), or (4), the minor parent must reside, when possible,
in a living arrangement that meets the standards of paragraph
(a), clause (2).
(f) Regardless of living arrangement, MFIP must be paid,
when possible, in the form of a protective payment on behalf of
the minor parent and minor child according to section 256J.39,
subdivisions 2 to 4.
Sec. 32. Minnesota Statutes 2002, section 256J.20,
subdivision 3, is amended to read:
Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for
MFIP, the equity value of all nonexcluded real and personal
property of the assistance unit must not exceed $2,000 for
applicants and $5,000 for ongoing participants. The value of
assets in clauses (1) to (19) must be excluded when determining
the equity value of real and personal property:
(1) a licensed vehicle up to a loan value of less than or
equal to $7,500. The county agency shall apply any excess loan
value as if it were equity value to the asset limit described in
this section. If the assistance unit owns more than one
licensed vehicle, the county agency shall determine the vehicle
with the highest loan value and count only the loan value over
$7,500, excluding: (i) the value of one vehicle per physically
disabled person when the vehicle is needed to transport the
disabled unit member; this exclusion does not apply to mentally
disabled people; (ii) the value of special equipment for a
handicapped member of the assistance unit; and (iii) any vehicle
used for long-distance travel, other than daily commuting, for
the employment of a unit member.
The county agency shall count the loan value of all other
vehicles and apply this amount as if it were equity value to the
asset limit described in this section. To establish the loan
value of vehicles, a county agency must use the N.A.D.A.
Official Used Car Guide, Midwest Edition, for newer model cars.
When a vehicle is not listed in the guidebook, or when the
applicant or participant disputes the loan value listed in the
guidebook as unreasonable given the condition of the particular
vehicle, the county agency may require the applicant or
participant document the loan value by securing a written
statement from a motor vehicle dealer licensed under section
168.27, stating the amount that the dealer would pay to purchase
the vehicle. The county agency shall reimburse the applicant or
participant for the cost of a written statement that documents a
lower loan value;
(2) the value of life insurance policies for members of the
assistance unit;
(3) one burial plot per member of an assistance unit;
(4) the value of personal property needed to produce earned
income, including tools, implements, farm animals, inventory,
business loans, business checking and savings accounts used at
least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if at least 50
percent of the vehicle's use is to produce income and if the
vehicles are essential for the self-employment business;
(5) the value of personal property not otherwise specified
which is commonly used by household members in day-to-day living
such as clothing, necessary household furniture, equipment, and
other basic maintenance items essential for daily living;
(6) the value of real and personal property owned by a
recipient of Supplemental Security Income or Minnesota
supplemental aid;
(7) the value of corrective payments, but only for the
month in which the payment is received and for the following
month;
(8) a mobile home or other vehicle used by an applicant or
participant as the applicant's or participant's home;
(9) money in a separate escrow account that is needed to
pay real estate taxes or insurance and that is used for this
purpose;
(10) money held in escrow to cover employee FICA, employee
tax withholding, sales tax withholding, employee worker
compensation, business insurance, property rental, property
taxes, and other costs that are paid at least annually, but less
often than monthly;
(11) monthly assistance, emergency assistance, and
diversionary payments for the current month's needs or
short-term emergency needs under section 256J.626, subdivision
2;
(12) the value of school loans, grants, or scholarships for
the period they are intended to cover;
(13) payments listed in section 256J.21, subdivision 2,
clause (9), which are held in escrow for a period not to exceed
three months to replace or repair personal or real property;
(14) income received in a budget month through the end of
the payment month;
(15) savings from earned income of a minor child or a minor
parent that are set aside in a separate account designated
specifically for future education or employment costs;
(16) the federal earned income credit, Minnesota working
family credit, state and federal income tax refunds, state
homeowners and renters credits under chapter 290A, property tax
rebates and other federal or state tax rebates in the month
received and the following month;
(17) payments excluded under federal law as long as those
payments are held in a separate account from any nonexcluded
funds;
(18) the assets of children ineligible to receive MFIP
benefits because foster care or adoption assistance payments are
made on their behalf; and
(19) the assets of persons whose income is excluded under
section 256J.21, subdivision 2, clause (43).
Sec. 33. Minnesota Statutes 2002, section 256J.21,
subdivision 1, is amended to read:
Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP
eligibility, the county agency must evaluate income received by
members of an assistance unit, or by other persons whose income
is considered available to the assistance unit, and only count
income that is available to the member of the assistance unit.
Income is available if the individual has legal access to the
income. All payments, unless specifically excluded in
subdivision 2, must be counted as income. The county agency
shall verify the income of all MFIP recipients and applicants.
Sec. 34. Minnesota Statutes 2002, section 256J.21,
subdivision 2, is amended to read:
Subd. 2. [INCOME EXCLUSIONS.] The following must be
excluded in determining a family's available income:
(1) payments for basic care, difficulty of care, and
clothing allowances received for providing family foster care to
children or adults under Minnesota Rules, parts 9545.0010 to
9545.0260 and 9555.5050 to 9555.6265, and payments received and
used for care and maintenance of a third-party beneficiary who
is not a household member;
(2) reimbursements for employment training received through
the Job Training Partnership Workforce Investment Act 1998,
United States Code, title 29 20, chapter 19 73, sections 1501
to 1792b section 9201;
(3) reimbursement for out-of-pocket expenses incurred while
performing volunteer services, jury duty, employment, or
informal carpooling arrangements directly related to employment;
(4) all educational assistance, except the county agency
must count graduate student teaching assistantships,
fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary
educational expenses, shall count scholarships or grants awarded
to graduate students that do not require teaching or research as
unearned income;
(5) loans, regardless of purpose, from public or private
lending institutions, governmental lending institutions, or
governmental agencies;
(6) loans from private individuals, regardless of purpose,
provided an applicant or participant documents that the lender
expects repayment;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter
290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or
rebate of personal or real property when these payments are made
by public agencies, awarded by a court, solicited through public
appeal, or made as a grant by a federal agency, state or local
government, or disaster assistance organizations, subsequent to
a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to
pay medical, funeral, and burial expenses, or to repair or
replace insured property;
(11) reimbursements for medical expenses that cannot be
paid by medical assistance;
(12) payments by a vocational rehabilitation program
administered by the state under chapter 268A, except those
payments that are for current living expenses;
(13) in-kind income, including any payments directly made
by a third party to a provider of goods and services;
(14) assistance payments to correct underpayments, but only
for the month in which the payment is received;
(15) emergency assistance payments for short-term emergency
needs under section 256J.626, subdivision 2;
(16) funeral and cemetery payments as provided by section
256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding
$30 per participant in a calendar month;
(18) any form of energy assistance payment made through
Public Law Number 97-35, Low-Income Home Energy Assistance Act
of 1981, payments made directly to energy providers by other
public and private agencies, and any form of credit or rebate
payment issued by energy providers;
(19) Supplemental Security Income (SSI), including
retroactive SSI payments and other income of an SSI recipient,
except as described in section 256J.37, subdivision 3b;
(20) Minnesota supplemental aid, including retroactive
payments;
(21) proceeds from the sale of real or personal property;
(22) adoption assistance payments under section 259.67;
(23) state-funded family subsidy program payments made
under section 252.32 to help families care for children with
mental retardation or related conditions, consumer support grant
funds under section 256.476, and resources and services for a
disabled household member under one of the home and
community-based waiver services programs under chapter 256B;
(24) interest payments and dividends from property that is
not excluded from and that does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver, minor child
through age 6, or a minor child who is at least a half-time
student in an approved elementary or secondary education
program;
(27) income earned by a caregiver under age 20 who is at
least a half-time student in an approved elementary or secondary
education program;
(28) MFIP child care payments under section 119B.05;
(29) all other payments made through MFIP to support a
caregiver's pursuit of greater self-support economic stability;
(30) income a participant receives related to shared living
expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966,
United States Code, title 42, chapter 13A, sections 1771 to
1790;
(33) benefits provided by the women, infants, and children
(WIC) nutrition program, United States Code, title 42, chapter
13A, section 1786;
(34) benefits from the National School Lunch Act, United
States Code, title 42, chapter 13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the
Uniform Relocation Assistance and Real Property Acquisition
Policies Act of 1970, United States Code, title 42, chapter 61,
subchapter II, section 4636, or the National Housing Act, United
States Code, title 12, chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States
Code, title 19, chapter 12, part 2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and
Aleuts under United States Code, title 50, sections 1989 to
1989d;
(38) payments to veterans or their dependents as a result
of legal settlements regarding Agent Orange or other chemical
exposure under Public Law Number 101-239, section 10405,
paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from
MFIP consideration in federal law, state law, or federal
regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under
Public Law Numbers Laws 98-123, 98-124, and 99-377 to the
Mississippi Band Chippewa Indians of White Earth, Leech Lake,
and Mille Lacs reservations and payments to members of the White
Earth Band, under United States Code, title 25, chapter 9,
section 331, and chapter 16, section 1407;
(42) all income of the minor parent's parents and
stepparents when determining the grant for the minor parent in
households that include a minor parent living with parents or
stepparents on MFIP with other children;
(43) income of the minor parent's parents and stepparents
equal to 200 percent of the federal poverty guideline for a
family size not including the minor parent and the minor
parent's child in households that include a minor parent living
with parents or stepparents not on MFIP when determining the
grant for the minor parent. The remainder of income is deemed
as specified in section 256J.37, subdivision 1b;
(44) payments made to children eligible for relative
custody assistance under section 257.85;
(45) vendor payments for goods and services made on behalf
of a client unless the client has the option of receiving the
payment in cash; and
(46) the principal portion of a contract for deed payment.
Sec. 35. Minnesota Statutes 2002, section 256J.24,
subdivision 3, is amended to read:
Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN
ASSISTANCE UNIT.] (a) The following individuals who are part of
the assistance unit determined under subdivision 2 are
ineligible to receive MFIP:
(1) individuals receiving who are recipients of
Supplemental Security Income or Minnesota supplemental aid;
(2) individuals disqualified from the food stamp program or
MFIP, until the disqualification ends;
(3) children on whose behalf federal, state or local foster
care payments are made, except as provided in sections 256J.13,
subdivision 2, and 256J.74, subdivision 2; and
(4) children receiving ongoing monthly adoption assistance
payments under section 259.67.
(b) The exclusion of a person under this subdivision does
not alter the mandatory assistance unit composition.
Sec. 36. Minnesota Statutes 2002, section 256J.24,
subdivision 5, is amended to read:
Subd. 5. [MFIP TRANSITIONAL STANDARD.] The following table
represents the MFIP transitional standard table when all members
of is based on the number of persons in the assistance unit are
eligible for both food and cash assistance unless the
restrictions in subdivision 6 on the birth of a child apply.
The following table represents the transitional standards
effective October 1, 2002.
Number of Transitional Cash Food
Eligible People Standard Portion Portion
1 $351 $370: $250 $120
2 $609 $658: $437 $221
3 $763 $844: $532 $312
4 $903 $998: $621 $377
5 $1,025 $1,135: $697 $438
6 $1,165 $1,296: $773 $523
7 $1,273 $1,414: $850 $564
8 $1,403 $1,558: $916 $642
9 $1,530 $1,700: $980 $720
10 $1,653 $1,836: $1,035 $801
over 10 add $121 $136: $53 $83
per additional member.
The commissioner shall annually publish in the State
Register the transitional standard for an assistance unit sizes
1 to 10 including a breakdown of the cash and food portions.
Sec. 37. Minnesota Statutes 2002, section 256J.24,
subdivision 6, is amended to read:
Subd. 6. [APPLICATION OF ASSISTANCE STANDARDS FAMILY CAP.]
The standards apply to the number of eligible persons in the
assistance unit. (a) MFIP assistance units shall not receive an
increase in the cash portion of the transitional standard as a
result of the birth of a child, unless one of the conditions
under paragraph (b) is met. The child shall be considered a
member of the assistance unit according to subdivisions 1 to 3,
but shall be excluded in determining family size for purposes of
determining the amount of the cash portion of the transitional
standard under subdivision 5. The child shall be included in
determining family size for purposes of determining the food
portion of the transitional standard. The transitional standard
under this subdivision shall be the total of the cash and food
portions as specified in this paragraph. The family wage level
under this subdivision shall be based on the family size used to
determine the food portion of the transitional standard.
(b) A child shall be included in determining family size
for purposes of determining the amount of the cash portion of
the MFIP transitional standard when at least one of the
following conditions is met:
(1) for families receiving MFIP assistance on July 1, 2003,
the child is born to the adult parent before May 1, 2004;
(2) for families who apply for the diversionary work
program under section 256J.95 or MFIP assistance on or after
July 1, 2003, the child is born to the adult parent within ten
months of the date the family is eligible for assistance;
(3) the child was conceived as a result of a sexual assault
or incest, provided that the incident has been reported to a law
enforcement agency;
(4) the child's mother is a minor caregiver as defined in
section 256J.08, subdivision 59, and the child, or multiple
children, are the mother's first birth; or
(5) any child previously excluded in determining family
size under paragraph (a) shall be included if the adult parent
or parents have not received benefits from the diversionary work
program under section 256J.95 or MFIP assistance in the previous
ten months. An adult parent or parents who reapply and have
received benefits from the diversionary work program or MFIP
assistance in the past ten months shall be under the ten-month
grace period of their previous application under clause (2).
(c) Income and resources of a child excluded under this
subdivision, except child support received or distributed on
behalf of this child, must be considered using the same policies
as for other children when determining the grant amount of the
assistance unit.
(d) The caregiver must assign support and cooperate with
the child support enforcement agency to establish paternity and
collect child support on behalf of the excluded child. Failure
to cooperate results in the sanction specified in section
256J.46, subdivisions 2 and 2a. Current support paid on behalf
of the excluded child shall be distributed according to section
256.741, subdivision 15.
(e) County agencies must inform applicants of the
provisions under this subdivision at the time of each
application and at recertification.
(f) Children excluded under this provision shall be deemed
MFIP recipients for purposes of child care under chapter 119B.
Sec. 38. Minnesota Statutes 2002, section 256J.24,
subdivision 7, is amended to read:
Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage
level standard is 110 percent of the transitional standard under
subdivision 5 or 6, when applicable, and is the standard used
when there is earned income in the assistance unit. As
specified in section 256J.21, earned income is subtracted from
the family wage level to determine the amount of the assistance
payment. Not including The family wage level standard,
assistance payments payment may not exceed the MFIP standard of
need transitional standard under subdivision 5 or 6, or the
shared household standard under subdivision 9, whichever is
applicable, for the assistance unit.
Sec. 39. Minnesota Statutes 2002, section 256J.24,
subdivision 10, is amended to read:
Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust
the MFIP earned income disregard to ensure that most
participants do not lose eligibility for MFIP until their income
reaches at least 120 115 percent of the federal poverty
guidelines in effect in October of each fiscal year. The
adjustment to the disregard shall be based on a household size
of three, and the resulting earned income disregard percentage
must be applied to all household sizes. The adjustment under
this subdivision must be implemented at the same time as the
October food stamp cost-of-living adjustment is reflected in the
food portion of MFIP transitional standard as required under
subdivision 5a.
Sec. 40. Minnesota Statutes 2002, section 256J.30,
subdivision 9, is amended to read:
Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must
report the changes or anticipated changes specified in clauses
(1) to (17) (16) within ten days of the date they occur, at the
time of the periodic recertification of eligibility under
section 256J.32, subdivision 6, or within eight calendar days of
a reporting period as in subdivision 5 or 6, whichever occurs
first. A caregiver must report other changes at the time of the
periodic recertification of eligibility under section 256J.32,
subdivision 6, or at the end of a reporting period under
subdivision 5 or 6, as applicable. A caregiver must make these
reports in writing to the county agency. When a county agency
could have reduced or terminated assistance for one or more
payment months if a delay in reporting a change specified under
clauses (1) to (16) (15) had not occurred, the county agency
must determine whether a timely notice under section 256J.31,
subdivision 4, could have been issued on the day that the change
occurred. When a timely notice could have been issued, each
month's overpayment subsequent to that notice must be considered
a client error overpayment under section 256J.38. Calculation
of overpayments for late reporting under clause (17) (16) is
specified in section 256J.09, subdivision 9. Changes in
circumstances which must be reported within ten days must also
be reported on the MFIP household report form for the reporting
period in which those changes occurred. Within ten days, a
caregiver must report:
(1) a change in initial employment;
(2) a change in initial receipt of unearned income;
(3) a recurring change in unearned income;
(4) a nonrecurring change of unearned income that exceeds
$30;
(5) the receipt of a lump sum;
(6) an increase in assets that may cause the assistance
unit to exceed asset limits;
(7) a change in the physical or mental status of an
incapacitated member of the assistance unit if the physical or
mental status is the basis of exemption from an MFIP employment
services program under section 256J.56, or as the basis for
reducing the hourly participation requirements under section
256J.55, subdivision 1, or the type of activities included in an
employment plan under section 256J.521, subdivision 2;
(8) a change in employment status;
(9) information affecting an exception under section
256J.24, subdivision 9;
(10) a change in health insurance coverage;
(11) the marriage or divorce of an assistance unit member;
(12) (11) the death of a parent, minor child, or
financially responsible person;
(13) (12) a change in address or living quarters of the
assistance unit;
(14) (13) the sale, purchase, or other transfer of
property;
(15) (14) a change in school attendance of a custodial
parent caregiver under age 20 or an employed child;
(16) (15) filing a lawsuit, a workers' compensation claim,
or a monetary claim against a third party; and
(17) (16) a change in household composition, including
births, returns to and departures from the home of assistance
unit members and financially responsible persons, or a change in
the custody of a minor child.
Sec. 41. Minnesota Statutes 2002, section 256J.32,
subdivision 2, is amended to read:
Subd. 2. [DOCUMENTATION.] The applicant or participant
must document the information required under subdivisions 4 to 6
or authorize the county agency to verify the information. The
applicant or participant has the burden of providing documentary
evidence to verify eligibility. The county agency shall assist
the applicant or participant in obtaining required documents
when the applicant or participant is unable to do so. When an
applicant or participant and the county agency are unable to
obtain documents needed to verify information, the county agency
may accept an affidavit from an applicant or participant as
sufficient documentation. The county agency may accept an
affidavit only for factors specified under subdivision 8.
Sec. 42. Minnesota Statutes 2002, section 256J.32,
subdivision 4, is amended to read:
Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall
verify the following at application:
(1) identity of adults;
(2) presence of the minor child in the home, if
questionable;
(3) relationship of a minor child to caregivers in the
assistance unit;
(4) age, if necessary to determine MFIP eligibility;
(5) immigration status;
(6) social security number according to the requirements of
section 256J.30, subdivision 12;
(7) income;
(8) self-employment expenses used as a deduction;
(9) source and purpose of deposits and withdrawals from
business accounts;
(10) spousal support and child support payments made to
persons outside the household;
(11) real property;
(12) vehicles;
(13) checking and savings accounts;
(14) savings certificates, savings bonds, stocks, and
individual retirement accounts;
(15) pregnancy, if related to eligibility;
(16) inconsistent information, if related to eligibility;
(17) medical insurance;
(18) burial accounts;
(19) (18) school attendance, if related to eligibility;
(20) (19) residence;
(21) (20) a claim of family violence if used as a basis for
a to qualify for the family violence waiver from the 60-month
time limit in section 256J.42 and regular employment and
training services requirements in section 256J.56;
(22) (21) disability if used as the basis for an exemption
from employment and training services requirements under section
256J.56 or as the basis for reducing the hourly participation
requirements under section 256J.55, subdivision 1, or the type
of activity included in an employment plan under section
256J.521, subdivision 2; and
(23) (22) information needed to establish an exception
under section 256J.24, subdivision 9.
Sec. 43. Minnesota Statutes 2002, section 256J.32,
subdivision 5a, is amended to read:
Subd. 5a. [INCONSISTENT INFORMATION.] When the county
agency verifies inconsistent information under subdivision 4,
clause (16), or 6, clause (4) (5), the reason for verifying the
information must be documented in the financial case record.
Sec. 44. Minnesota Statutes 2002, section 256J.32, is
amended by adding a subdivision to read:
Subd. 8. [AFFIDAVIT.] The county agency may accept an
affidavit from the applicant or recipient as sufficient
documentation at the time of application or recertification only
for the following factors:
(1) a claim of family violence if used as a basis to
qualify for the family violence waiver;
(2) information needed to establish an exception under
section 256J.24, subdivision 9;
(3) relationship of a minor child to caregivers in the
assistance unit; and
(4) citizenship status from a noncitizen who reports to be,
or is identified as, a victim of severe forms of trafficking in
persons, if the noncitizen reports that the noncitizen's
immigration documents are being held by an individual or group
of individuals against the noncitizen's will. The noncitizen
must follow up with the Office of Refugee Resettlement (ORR) to
pursue certification. If verification that certification is
being pursued is not received within 30 days, the MFIP case must
be closed and the agency shall pursue overpayments. The ORR
documents certifying the noncitizen's status as a victim of
severe forms of trafficking in persons, or the reason for the
delay in processing, must be received within 90 days, or the
MFIP case must be closed and the agency shall pursue
overpayments.
Sec. 45. Minnesota Statutes 2002, section 256J.37, is
amended by adding a subdivision to read:
Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a)
Effective July 1, 2003, the county agency shall count $50 of the
value of public and assisted rental subsidies provided through
the Department of Housing and Urban Development (HUD) as
unearned income to the cash portion of the MFIP grant. The full
amount of the subsidy must be counted as unearned income when
the subsidy is less than $50. The income from this subsidy
shall be budgeted according to section 256J.34.
(b) The provisions of this subdivision shall not apply to
an MFIP assistance unit which includes a participant who is:
(1) age 60 or older;
(2) a caregiver who is suffering from an illness, injury,
or incapacity that has been certified by a qualified
professional when the illness, injury, or incapacity is expected
to continue for more than 30 days and prevents the person from
obtaining or retaining employment; or
(3) a caregiver whose presence in the home is required due
to the illness or incapacity of another member in the assistance
unit, a relative in the household, or a foster child in the
household when the illness or incapacity and the need for the
participant's presence in the home has been certified by a
qualified professional and is expected to continue for more than
30 days.
(c) The provisions of this subdivision shall not apply to
an MFIP assistance unit where the parental caregiver is an SSI
recipient.
(d) Prior to implementing this provision, the commissioner
must identify the MFIP participants subject to this provision
and provide written notice to these participants at least 30
days before the first grant reduction. The notice must inform
the participant of the basis for the potential grant reduction,
the exceptions to the provision, if any, and inform the
participant of the steps necessary to claim an exception. A
person who is found not to meet one of the exceptions to the
provision must be notified and informed of the right to a fair
hearing under section 256J.40. The notice must also inform the
participant that the participant may be eligible for a rent
reduction resulting from a reduction in the MFIP grant, and
encourage the participant to contact the local housing authority.
Sec. 46. Minnesota Statutes 2002, section 256J.37, is
amended by adding a subdivision to read:
Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY
INCOME.] Effective July 1, 2003, the county shall reduce the
cash portion of the MFIP grant by $125 per SSI recipient who
resides in the household, and who would otherwise be included in
the MFIP assistance unit under section 256J.24, subdivision 2,
but is excluded solely due to the SSI recipient status under
section 256J.24, subdivision 3, paragraph (a), clause (1). If
the SSI recipient receives less than $125 of SSI, only the
amount received shall be used in calculating the MFIP cash
assistance payment. This provision does not apply to relative
caregivers who could elect to be included in the MFIP assistance
unit under section 256J.24, subdivision 4, unless the
caregiver's children or stepchildren are included in the MFIP
assistance unit.
Sec. 47. Minnesota Statutes 2002, section 256J.37,
subdivision 9, is amended to read:
Subd. 9. [UNEARNED INCOME.] (a) The county agency must
apply unearned income to the MFIP standard of need. When
determining the amount of unearned income, the county agency
must deduct the costs necessary to secure payments of unearned
income. These costs include legal fees, medical fees, and
mandatory deductions such as federal and state income taxes.
(b) Effective July 1, 2003, the county agency shall count
$100 of the value of public and assisted rental subsidies
provided through the Department of Housing and Urban Development
(HUD) as unearned income. The full amount of the subsidy must
be counted as unearned income when the subsidy is less than $100.
(c) The provisions of paragraph (b) shall not apply to MFIP
participants who are exempt from the employment and training
services component because they are:
(i) individuals who are age 60 or older;
(ii) individuals who are suffering from a professionally
certified permanent or temporary illness, injury, or incapacity
which is expected to continue for more than 30 days and which
prevents the person from obtaining or retaining employment; or
(iii) caregivers whose presence in the home is required
because of the professionally certified illness or incapacity of
another member in the assistance unit, a relative in the
household, or a foster child in the household.
(d) The provisions of paragraph (b) shall not apply to an
MFIP assistance unit where the parental caregiver receives
supplemental security income.
Sec. 48. Minnesota Statutes 2002, section 256J.38,
subdivision 3, is amended to read:
Subd. 3. [RECOVERING OVERPAYMENTS FROM FORMER
PARTICIPANTS.] A county agency must initiate efforts to recover
overpayments paid to a former participant or caregiver. Adults
Caregivers, both parental and nonparental, and minor caregivers
of an assistance unit at the time an overpayment occurs, whether
receiving assistance or not, are jointly and individually liable
for repayment of the overpayment. The county agency must
request repayment from the former participants and caregivers.
When an agreement for repayment is not completed within six
months of the date of discovery or when there is a default on an
agreement for repayment after six months, the county agency must
initiate recovery consistent with chapter 270A, or section
541.05. When a person has been convicted of fraud under section
256.98, recovery must be sought regardless of the amount of
overpayment. When an overpayment is less than $35, and is not
the result of a fraud conviction under section 256.98, the
county agency must not seek recovery under this subdivision.
The county agency must retain information about all overpayments
regardless of the amount. When an adult, adult caregiver, or
minor caregiver reapplies for assistance, the overpayment must
be recouped under subdivision 4.
Sec. 49. Minnesota Statutes 2002, section 256J.38,
subdivision 4, is amended to read:
Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A
participant may voluntarily repay, in part or in full, an
overpayment even if assistance is reduced under this
subdivision, until the total amount of the overpayment is
repaid. When an overpayment occurs due to fraud, the county
agency must recover from the overpaid assistance unit, including
child only cases, ten percent of the applicable standard or the
amount of the monthly assistance payment, whichever is less.
When a nonfraud overpayment occurs, the county agency must
recover from the overpaid assistance unit, including child only
cases, three percent of the MFIP standard of need or the amount
of the monthly assistance payment, whichever is less.
Sec. 50. Minnesota Statutes 2002, section 256J.40, is
amended to read:
256J.40 [FAIR HEARINGS.]
Caregivers receiving a notice of intent to sanction or a
notice of adverse action that includes a sanction, reduction in
benefits, suspension of benefits, denial of benefits, or
termination of benefits may request a fair hearing. A request
for a fair hearing must be submitted in writing to the county
agency or to the commissioner and must be mailed within 30 days
after a participant or former participant receives written
notice of the agency's action or within 90 days when a
participant or former participant shows good cause for not
submitting the request within 30 days. A former participant who
receives a notice of adverse action due to an overpayment may
appeal the adverse action according to the requirements in this
section. Issues that may be appealed are:
(1) the amount of the assistance payment;
(2) a suspension, reduction, denial, or termination of
assistance;
(3) the basis for an overpayment, the calculated amount of
an overpayment, and the level of recoupment;
(4) the eligibility for an assistance payment; and
(5) the use of protective or vendor payments under section
256J.39, subdivision 2, clauses (1) to (3).
Except for benefits issued under section 256J.95, a county
agency must not reduce, suspend, or terminate payment when an
aggrieved participant requests a fair hearing prior to the
effective date of the adverse action or within ten days of the
mailing of the notice of adverse action, whichever is later,
unless the participant requests in writing not to receive
continued assistance pending a hearing decision. An appeal
request cannot extend benefits for the diversionary work program
under section 256J.95 beyond the four-month time limit.
Assistance issued pending a fair hearing is subject to recovery
under section 256J.38 when as a result of the fair hearing
decision the participant is determined ineligible for assistance
or the amount of the assistance received. A county agency may
increase or reduce an assistance payment while an appeal is
pending when the circumstances of the participant change and are
not related to the issue on appeal. The commissioner's order is
binding on a county agency. No additional notice is required to
enforce the commissioner's order.
A county agency shall reimburse appellants for reasonable
and necessary expenses of attendance at the hearing, such as
child care and transportation costs and for the transportation
expenses of the appellant's witnesses and representatives to and
from the hearing. Reasonable and necessary expenses do not
include legal fees. Fair hearings must be conducted at a
reasonable time and date by an impartial referee employed by the
department. The hearing may be conducted by telephone or at a
site that is readily accessible to persons with disabilities.
The appellant may introduce new or additional evidence
relevant to the issues on appeal. Recommendations of the
appeals referee and decisions of the commissioner must be based
on evidence in the hearing record and are not limited to a
review of the county agency action.
Sec. 51. Minnesota Statutes 2002, section 256J.42,
subdivision 4, is amended to read:
Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance
received by an assistance unit in a month when a caregiver
complied with a safety plan, an alternative employment plan, or
an employment plan or after October 1, 2001, complied or is
complying with an alternative employment plan under section
256J.49 256J.521, subdivision 1a 3, does not count toward the
60-month limitation on assistance.
Sec. 52. Minnesota Statutes 2002, section 256J.42,
subdivision 5, is amended to read:
Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash
assistance received by an assistance unit does not count toward
the 60-month limit on assistance during a month in which the
caregiver is in the category in age 60 or older, including
months during which the caregiver was exempt under section
256J.56, paragraph (a), clause (1).
(b) From July 1, 1997, until the date MFIP is operative in
the caregiver's county of financial responsibility, any cash
assistance received by a caregiver who is complying with
Minnesota Statutes 1996, section 256.73, subdivision 5a, and
Minnesota Statutes 1998, section 256.736, if applicable, does
not count toward the 60-month limit on assistance. Thereafter,
any cash assistance received by a minor caregiver who is
complying with the requirements of sections 256J.14 and 256J.54,
if applicable, does not count towards the 60-month limit on
assistance.
(c) Any diversionary assistance or emergency assistance
received prior to July 1, 2003, does not count toward the
60-month limit.
(d) Any cash assistance received by an 18- or 19-year-old
caregiver who is complying with the requirements of an
employment plan that includes an education option under section
256J.54 does not count toward the 60-month limit.
(e) Payments provided to meet short-term emergency needs
under section 256J.626 and diversionary work program benefits
provided under section 256J.95 do not count toward the 60-month
time limit.
Sec. 53. Minnesota Statutes 2002, section 256J.42,
subdivision 6, is amended to read:
Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less
than 60 days, before the end of the participant's 60th month on
assistance, the county agency or job counselor must review the
participant's case to determine if the employment plan is still
appropriate or if the participant is exempt under section
256J.56 from the employment and training services component, and
attempt to meet with the participant face-to-face.
(b) During the face-to-face meeting, a county agency or the
job counselor must:
(1) inform the participant how many months of counted
assistance the participant has accrued and when the participant
is expected to reach the 60th month;
(2) explain the hardship extension criteria under section
256J.425 and what the participant should do if the participant
thinks a hardship extension applies;
(3) identify other resources that may be available to the
participant to meet the needs of the family; and
(4) inform the participant of the right to appeal the case
closure under section 256J.40.
(c) If a face-to-face meeting is not possible, the county
agency must send the participant a notice of adverse action as
provided in section 256J.31, subdivisions 4 and 5.
(d) Before a participant's case is closed under this
section, the county must ensure that:
(1) the case has been reviewed by the job counselor's
supervisor or the review team designated in by the county's
approved local service unit plan county to determine if the
criteria for a hardship extension, if requested, were applied
appropriately; and
(2) the county agency or the job counselor attempted to
meet with the participant face-to-face.
Sec. 54. Minnesota Statutes 2002, section 256J.425,
subdivision 1, is amended to read:
Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a
hardship extension, a participant in an assistance unit subject
to the time limit under section 256J.42, subdivision 1, in which
any participant has received 60 counted months of assistance,
must be in compliance in the participant's 60th counted month
the participant is applying for the extension. For purposes of
determining eligibility for a hardship extension, a participant
is in compliance in any month that the participant has not been
sanctioned.
(b) If one participant in a two-parent assistance unit is
determined to be ineligible for a hardship extension, the county
shall give the assistance unit the option of disqualifying the
ineligible participant from MFIP. In that case, the assistance
unit shall be treated as a one-parent assistance unit and the
assistance unit's MFIP grant shall be calculated using the
shared household standard under section 256J.08, subdivision 82a.
Sec. 55. Minnesota Statutes 2002, section 256J.425,
subdivision 1a, is amended to read:
Subd. 1a. [REVIEW.] If a county grants a hardship
extension under this section, a county agency shall review the
case every six or 12 months, whichever is appropriate based on
the participant's circumstances and the extension
category. More frequent reviews shall be required if
eligibility for an extension is based on a condition that is
subject to change in less than six months.
Sec. 56. Minnesota Statutes 2002, section 256J.425,
subdivision 2, is amended to read:
Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit
subject to the time limit in section 256J.42, subdivision 1, in
which any participant has received 60 counted months of
assistance, is eligible to receive months of assistance under a
hardship extension if the participant who reached the time limit
belongs to any of the following groups:
(1) participants who are suffering from a professionally
certified an illness, injury, or incapacity which has been
certified by a qualified professional when the illness, injury,
or incapacity is expected to continue for more than 30 days
and which prevents the person from obtaining or retaining
employment and who are following. These participants must
follow the treatment recommendations of the health care provider
qualified professional certifying the illness, injury, or
incapacity;
(2) participants whose presence in the home is required as
a caregiver because of a professionally certified the illness,
injury, or incapacity of another member in the assistance unit,
a relative in the household, or a foster child in the
household and when the illness or incapacity and the need for a
person to provide assistance in the home has been certified by a
qualified professional and is expected to continue for more than
30 days; or
(3) caregivers with a child or an adult in the household
who meets the disability or medical criteria for home care
services under section 256B.0627, subdivision 1, paragraph
(c) (f), or a home and community-based waiver services program
under chapter 256B, or meets the criteria for severe emotional
disturbance under section 245.4871, subdivision 6, or for
serious and persistent mental illness under section 245.462,
subdivision 20, paragraph (c). Caregivers in this category are
presumed to be prevented from obtaining or retaining employment.
(b) An assistance unit receiving assistance under a
hardship extension under this subdivision may continue to
receive assistance as long as the participant meets the criteria
in paragraph (a), clause (1), (2), or (3).
Sec. 57. Minnesota Statutes 2002, section 256J.425,
subdivision 3, is amended to read:
Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit
subject to the time limit in section 256J.42, subdivision 1, in
which any participant has received 60 counted months of
assistance, is eligible to receive months of assistance under a
hardship extension if the participant who reached the time limit
belongs to any of the following groups:
(1) a person who is diagnosed by a licensed physician,
psychological practitioner, or other qualified professional, as
mentally retarded or mentally ill, and that condition prevents
the person from obtaining or retaining unsubsidized employment;
(2) a person who:
(i) has been assessed by a vocational specialist or the
county agency to be unemployable for purposes of this
subdivision; or
(ii) has an IQ below 80 who has been assessed by a
vocational specialist or a county agency to be employable, but
not at a level that makes the participant eligible for an
extension under subdivision 4 or,. The determination of IQ
level must be made by a qualified professional. In the case of
a non-English-speaking person for whom it is not possible to
provide a determination due to language barriers or absence of
culturally appropriate assessment tools, is determined by a
qualified professional to have an IQ below 80. A person is
considered employable if positions of employment in the local
labor market exist, regardless of the current availability of
openings for those positions, that the person is capable of
performing: (A) the determination must be made by a qualified
professional with experience conducting culturally appropriate
assessments, whenever possible; (B) the county may accept
reports that identify an IQ range as opposed to a specific
score; (C) these reports must include a statement of confidence
in the results;
(3) a person who is determined by the county agency a
qualified professional to be learning disabled or, and the
disability severely limits the person's ability to obtain,
perform, or maintain suitable employment. For purposes of the
initial approval of a learning disability extension, the
determination must have been made or confirmed within the
previous 12 months. In the case of a non-English-speaking
person for whom it is not possible to provide a medical
diagnosis due to language barriers or absence of culturally
appropriate assessment tools, is determined by a qualified
professional to have a learning disability. If a rehabilitation
plan for the person is developed or approved by the county
agency, the plan must be incorporated into the employment plan.
However, a rehabilitation plan does not replace the requirement
to develop and comply with an employment plan under section
256J.52. For purposes of this section, "learning disabled"
means the applicant or recipient has a disorder in one or more
of the psychological processes involved in perceiving,
understanding, or using concepts through verbal language or
nonverbal means. The disability must severely limit the
applicant or recipient in obtaining, performing, or maintaining
suitable employment. Learning disabled does not include
learning problems that are primarily the result of visual,
hearing, or motor handicaps; mental retardation; emotional
disturbance; or due to environmental, cultural, or economic
disadvantage: (i) the determination must be made by a qualified
professional with experience conducting culturally appropriate
assessments, whenever possible; and (ii) these reports must
include a statement of confidence in the results. If a
rehabilitation plan for a participant extended as learning
disabled is developed or approved by the county agency, the plan
must be incorporated into the employment plan. However, a
rehabilitation plan does not replace the requirement to develop
and comply with an employment plan under section 256J.521; or
(4) a person who is a victim of has been granted a family
violence as defined in section 256J.49, subdivision 2 waiver,
and who is participating in complying with an alternative
employment plan under section 256J.49 256J.521, subdivision 1a
3.
Sec. 58. Minnesota Statutes 2002, section 256J.425,
subdivision 4, is amended to read:
Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit
subject to the time limit under section 256J.42, subdivision 1,
in which any participant has received 60 months of assistance,
is eligible to receive assistance under a hardship extension if
the participant who reached the time limit belongs to:
(1) a one-parent assistance unit in which the participant
is participating in work activities for at least 30 hours per
week, of which an average of at least 25 hours per week every
month are spent participating in employment;
(2) a two-parent assistance unit in which the participants
are participating in work activities for at least 55 hours per
week, of which an average of at least 45 hours per week every
month are spent participating in employment; or
(3) an assistance unit in which a participant is
participating in employment for fewer hours than those specified
in clause (1), and the participant submits verification from a
health care provider qualified professional, in a form
acceptable to the commissioner, stating that the number of hours
the participant may work is limited due to illness or
disability, as long as the participant is participating in
employment for at least the number of hours specified by
the health care provider qualified professional. The
participant must be following the treatment recommendations of
the health care provider qualified professional providing the
verification. The commissioner shall develop a form to be
completed and signed by the health care provider qualified
professional, documenting the diagnosis and any additional
information necessary to document the functional limitations of
the participant that limit work hours. If the participant is
part of a two-parent assistance unit, the other parent must be
treated as a one-parent assistance unit for purposes of meeting
the work requirements under this subdivision.
(b) For purposes of this section, employment means:
(1) unsubsidized employment under section 256J.49,
subdivision 13, clause (1);
(2) subsidized employment under section 256J.49,
subdivision 13, clause (2);
(3) on-the-job training under section 256J.49, subdivision
13, clause (4) (2);
(4) an apprenticeship under section 256J.49, subdivision
13, clause (19) (1);
(5) supported work. For purposes of this section,
"supported work" means services supporting a participant on the
job which include, but are not limited to, supervision, job
coaching, and subsidized wages under section 256J.49,
subdivision 13, clause (2);
(6) a combination of clauses (1) to (5); or
(7) child care under section 256J.49, subdivision 13,
clause (25) (7), if it is in combination with paid employment.
(c) If a participant is complying with a child protection
plan under chapter 260C, the number of hours required under the
child protection plan count toward the number of hours required
under this subdivision.
(d) The county shall provide the opportunity for subsidized
employment to participants needing that type of employment
within available appropriations.
(e) To be eligible for a hardship extension for employed
participants under this subdivision, a participant in a
one-parent assistance unit or both parents in a two-parent
assistance unit must be in compliance for at least ten out of
the 12 months immediately preceding the participant's 61st month
on assistance. If only one parent in a two-parent assistance
unit fails to be in compliance ten out of the 12 months
immediately preceding the participant's 61st month, the county
shall give the assistance unit the option of disqualifying the
noncompliant parent. If the noncompliant participant is
disqualified, the assistance unit must be treated as a
one-parent assistance unit for the purposes of meeting the work
requirements under this subdivision and the assistance unit's
MFIP grant shall be calculated using the shared household
standard under section 256J.08, subdivision 82a.
(f) The employment plan developed under section 256J.52
256J.521, subdivision 5 2, for participants under this
subdivision must contain the number of hours specified in
paragraph (a) related to employment and work activities. The
job counselor and the participant must sign the employment plan
to indicate agreement between the job counselor and the
participant on the contents of the plan.
(g) Participants who fail to meet the requirements in
paragraph (a), without good cause under section 256J.57, shall
be sanctioned or permanently disqualified under subdivision 6.
Good cause may only be granted for that portion of the month for
which the good cause reason applies. Participants must meet all
remaining requirements in the approved employment plan or be
subject to sanction or permanent disqualification.
(h) If the noncompliance with an employment plan is due to
the involuntary loss of employment, the participant is exempt
from the hourly employment requirement under this subdivision
for one month. Participants must meet all remaining
requirements in the approved employment plan or be subject to
sanction or permanent disqualification. This exemption is
available to one-parent assistance units a participant two times
in a 12-month period, and two-parent assistance units, two times
per parent in a 12-month period.
(i) This subdivision expires on June 30, 2004.
Sec. 59. Minnesota Statutes 2002, section 256J.425,
subdivision 6, is amended to read:
Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or
both participants in an assistance unit receiving assistance
under subdivision 3 or 4 are not in compliance with the
employment and training service requirements in sections 256J.52
256J.521 to 256J.55 256J.57, the sanctions under this
subdivision apply. For a first occurrence of noncompliance, an
assistance unit must be sanctioned under section 256J.46,
subdivision 1, paragraph (d) (c), clause (1). For a second or
third occurrence of noncompliance, the assistance unit must be
sanctioned under section 256J.46, subdivision 1,
paragraph (d) (c), clause (2). For a fourth occurrence of
noncompliance, the assistance unit is disqualified from MFIP.
If a participant is determined to be out of compliance, the
participant may claim a good cause exception under section
256J.57, however, the participant may not claim an exemption
under section 256J.56.
(b) If both participants in a two-parent assistance unit
are out of compliance at the same time, it is considered one
occurrence of noncompliance.
Sec. 60. Minnesota Statutes 2002, section 256J.425,
subdivision 7, is amended to read:
Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An
assistance unit that is disqualified under subdivision 6,
paragraph (a), may be approved for MFIP if the participant
complies with MFIP program requirements and demonstrates
compliance for up to one month. No assistance shall be paid
during this period.
(b) An assistance unit that is disqualified under
subdivision 6, paragraph (a), and that reapplies under paragraph
(a) is subject to sanction under section 256J.46, subdivision 1,
paragraph (d) (c), clause (1), for a first occurrence of
noncompliance. A subsequent occurrence of noncompliance results
in a permanent disqualification.
(c) If one participant in a two-parent assistance unit
receiving assistance under a hardship extension under
subdivision 3 or 4 is determined to be out of compliance with
the employment and training services requirements under sections
256J.52 256J.521 to 256J.55 256J.57, the county shall give the
assistance unit the option of disqualifying the noncompliant
participant from MFIP. In that case, the assistance unit shall
be treated as a one-parent assistance unit for the purposes of
meeting the work requirements under subdivision 4 and the
assistance unit's MFIP grant shall be calculated using the
shared household standard under section 256J.08, subdivision
82a. An applicant who is disqualified from receiving assistance
under this paragraph may reapply under paragraph (a). If a
participant is disqualified from MFIP under this subdivision a
second time, the participant is permanently disqualified from
MFIP.
(d) Prior to a disqualification under this subdivision, a
county agency must review the participant's case to determine if
the employment plan is still appropriate and attempt to meet
with the participant face-to-face. If a face-to-face meeting is
not conducted, the county agency must send the participant a
notice of adverse action as provided in section 256J.31. During
the face-to-face meeting, the county agency must:
(1) determine whether the continued noncompliance can be
explained and mitigated by providing a needed preemployment
activity, as defined in section 256J.49, subdivision 13, clause
(16), or services under a local intervention grant for
self-sufficiency under section 256J.625 (9);
(2) determine whether the participant qualifies for a good
cause exception under section 256J.57;
(3) inform the participant of the family violence waiver
criteria and make appropriate referrals if the waiver is
requested;
(4) inform the participant of the participant's sanction
status and explain the consequences of continuing noncompliance;
(4) (5) identify other resources that may be available to
the participant to meet the needs of the family; and
(5) (6) inform the participant of the right to appeal under
section 256J.40.
Sec. 61. Minnesota Statutes 2002, section 256J.45,
subdivision 2, is amended to read:
Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must
consist of a presentation that informs caregivers of:
(1) the necessity to obtain immediate employment;
(2) the work incentives under MFIP, including the
availability of the federal earned income tax credit and the
Minnesota working family tax credit;
(3) the requirement to comply with the employment plan and
other requirements of the employment and training services
component of MFIP, including a description of the range of work
and training activities that are allowable under MFIP to meet
the individual needs of participants;
(4) the consequences for failing to comply with the
employment plan and other program requirements, and that the
county agency may not impose a sanction when failure to comply
is due to the unavailability of child care or other
circumstances where the participant has good cause under
subdivision 3;
(5) the rights, responsibilities, and obligations of
participants;
(6) the types and locations of child care services
available through the county agency;
(7) the availability and the benefits of the early
childhood health and developmental screening under sections
121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;
(8) the caregiver's eligibility for transition year child
care assistance under section 119B.05;
(9) the caregiver's eligibility for extended medical
assistance when the caregiver loses eligibility for MFIP due to
increased earnings or increased child or spousal support the
availability of all health care programs, including transitional
medical assistance;
(10) the caregiver's option to choose an employment and
training provider and information about each provider, including
but not limited to, services offered, program components, job
placement rates, job placement wages, and job retention rates;
(11) the caregiver's option to request approval of an
education and training plan according to section 256J.52
256J.53;
(12) the work study programs available under the higher
education system; and
(13) effective October 1, 2001, information about the
60-month time limit exemption and waivers of regular employment
and training requirements for family violence victims exemptions
under the family violence waiver and referral information about
shelters and programs for victims of family violence.
Sec. 62. Minnesota Statutes 2002, section 256J.46,
subdivision 1, is amended to read:
Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM
REQUIREMENTS.] (a) A participant who fails without good
cause under section 256J.57 to comply with the requirements of
this chapter, and who is not subject to a sanction under
subdivision 2, shall be subject to a sanction as provided in
this subdivision. Prior to the imposition of a sanction, a
county agency shall provide a notice of intent to sanction under
section 256J.57, subdivision 2, and, when applicable, a notice
of adverse action as provided in section 256J.31.
(b) A participant who fails to comply with an alternative
employment plan must have the plan reviewed by a person trained
in domestic violence and a job counselor or the county agency to
determine if components of the alternative employment plan are
still appropriate. If the activities are no longer appropriate,
the plan must be revised with a person trained in domestic
violence and approved by a job counselor or the county agency.
A participant who fails to comply with a plan that is determined
not to need revision will lose their exemption and be required
to comply with regular employment services activities.
(c) A sanction under this subdivision becomes effective the
month following the month in which a required notice is given.
A sanction must not be imposed when a participant comes into
compliance with the requirements for orientation under section
256J.45 or third-party liability for medical services under
section 256J.30, subdivision 10, prior to the effective date of
the sanction. A sanction must not be imposed when a participant
comes into compliance with the requirements for employment and
training services under sections 256J.49 256J.515 to
256J.55 256J.57 ten days prior to the effective date of the
sanction. For purposes of this subdivision, each month that a
participant fails to comply with a requirement of this chapter
shall be considered a separate occurrence of noncompliance. A
participant who has had one or more sanctions imposed must
remain in compliance with the provisions of this chapter for six
months in order for a subsequent occurrence of noncompliance to
be considered a first occurrence. If both participants in a
two-parent assistance unit are out of compliance at the same
time, it is considered one occurrence of noncompliance.
(d) (c) Sanctions for noncompliance shall be imposed as
follows:
(1) For the first occurrence of noncompliance by a
participant in an assistance unit, the assistance unit's grant
shall be reduced by ten percent of the MFIP standard of need for
an assistance unit of the same size with the residual grant paid
to the participant. The reduction in the grant amount must be
in effect for a minimum of one month and shall be removed in the
month following the month that the participant returns to
compliance.
(2) For a second or subsequent, third, fourth, fifth, or
sixth occurrence of noncompliance by a participant in an
assistance unit, or when each of the participants in a
two-parent assistance unit have a first occurrence of
noncompliance at the same time, the assistance unit's shelter
costs shall be vendor paid up to the amount of the cash portion
of the MFIP grant for which the assistance unit is eligible. At
county option, the assistance unit's utilities may also be
vendor paid up to the amount of the cash portion of the MFIP
grant remaining after vendor payment of the assistance unit's
shelter costs. The residual amount of the grant after vendor
payment, if any, must be reduced by an amount equal to 30
percent of the MFIP standard of need for an assistance unit of
the same size before the residual grant is paid to the
assistance unit. The reduction in the grant amount must be in
effect for a minimum of one month and shall be removed in the
month following the month that the participant in a one-parent
assistance unit returns to compliance. In a two-parent
assistance unit, the grant reduction must be in effect for a
minimum of one month and shall be removed in the month following
the month both participants return to compliance. The vendor
payment of shelter costs and, if applicable, utilities shall be
removed six months after the month in which the participant or
participants return to compliance. If an assistance unit is
sanctioned under this clause, the participant's case file must
be reviewed as required under paragraph (e) to determine if the
employment plan is still appropriate.
(e) When a sanction under paragraph (d), clause (2), is in
effect (d) For a seventh occurrence of noncompliance by a
participant in an assistance unit, or when the participants in a
two-parent assistance unit have a total of seven occurrences of
noncompliance, the county agency shall close the MFIP assistance
unit's financial assistance case, both the cash and food
portions. The case must remain closed for a minimum of one full
month. Closure under this paragraph does not make a participant
automatically ineligible for food support, if otherwise eligible.
Before the case is closed, the county agency must review the
participant's case to determine if the employment plan is still
appropriate and attempt to meet with the participant
face-to-face. The participant may bring an advocate to the
face-to-face meeting. If a face-to-face meeting is not
conducted, the county agency must send the participant a written
notice that includes the information required under clause (1).
(1) During the face-to-face meeting, the county agency must:
(i) determine whether the continued noncompliance can be
explained and mitigated by providing a needed preemployment
activity, as defined in section 256J.49, subdivision 13, clause
(16), or services under a local intervention grant for
self-sufficiency under section 256J.625 (9);
(ii) determine whether the participant qualifies for a good
cause exception under section 256J.57, or if the sanction is for
noncooperation with child support requirements, determine if the
participant qualifies for a good cause exemption under section
256.741, subdivision 10;
(iii) determine whether the participant qualifies for an
exemption under section 256J.56 or the work activities in the
employment plan are appropriate based on the criteria in section
256J.521, subdivision 2 or 3;
(iv) determine whether the participant qualifies for an
exemption from regular employment services requirements for
victims of family violence under section 256J.52, subdivision
6 determine whether the participant qualifies for the family
violence waiver;
(v) inform the participant of the participant's sanction
status and explain the consequences of continuing noncompliance;
(vi) identify other resources that may be available to the
participant to meet the needs of the family; and
(vii) inform the participant of the right to appeal under
section 256J.40.
(2) If the lack of an identified activity or service can
explain the noncompliance, the county must work with the
participant to provide the identified activity, and the county
must restore the participant's grant amount to the full amount
for which the assistance unit is eligible. The grant must be
restored retroactively to the first day of the month in which
the participant was found to lack preemployment activities or to
qualify for an exemption under section 256J.56, a good cause
exception under section 256J.57, or an exemption for victims of
family violence under section 256J.52, subdivision 6.
(3) If the participant is found to qualify for a good cause
exception or an exemption, the county must restore the
participant's grant to the full amount for which the assistance
unit is eligible. The grant must be restored to the full amount
for which the assistance unit is eligible retroactively to the
first day of the month in which the participant was found to
lack preemployment activities or to qualify for an exemption
under section 256J.56, a family violence waiver, or for a good
cause exemption under section 256.741, subdivision 10, or
256J.57.
(e) For the purpose of applying sanctions under this
section, only occurrences of noncompliance that occur after the
effective date of this section shall be considered. If the
participant is in 30 percent sanction in the month this section
takes effect, that month counts as the first occurrence for
purposes of applying the sanctions under this section, but the
sanction shall remain at 30 percent for that month.
(f) An assistance unit whose case is closed under paragraph
(d) or (g), or under an approved county option sanction plan
under section 256J.462 in effect June 30, 2003, or a county
pilot project under Laws 2000, chapter 488, article 10, section
29, in effect June 30, 2003, may reapply for MFIP and shall be
eligible if the participant complies with MFIP program
requirements and demonstrates compliance for up to one month.
No assistance shall be paid during this period.
(g) An assistance unit whose case has been closed for
noncompliance, that reapplies under paragraph (f) is subject to
sanction under paragraph (c), clause (2), for a first occurrence
of noncompliance. Any subsequent occurrence of noncompliance
shall result in case closure under paragraph (d).
Sec. 63. Minnesota Statutes 2002, section 256J.46,
subdivision 2, is amended to read:
Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT
REQUIREMENTS.] The grant of an MFIP caregiver who refuses to
cooperate, as determined by the child support enforcement
agency, with support requirements under section 256.741, shall
be subject to sanction as specified in this subdivision and
subdivision 1. For a first occurrence of noncooperation, the
assistance unit's grant must be reduced by 25 30 percent of the
applicable MFIP standard of need. Subsequent occurrences of
noncooperation shall be subject to sanction under subdivision 1,
paragraphs (c), clause (2), and (d). The residual amount of the
grant, if any, must be paid to the caregiver. A sanction under
this subdivision becomes effective the first month following the
month in which a required notice is given. A sanction must not
be imposed when a caregiver comes into compliance with the
requirements under section 256.741 prior to the effective date
of the sanction. The sanction shall be removed in the month
following the month that the caregiver cooperates with the
support requirements. Each month that an MFIP caregiver fails
to comply with the requirements of section 256.741 must be
considered a separate occurrence of noncompliance for the
purpose of applying sanctions under subdivision 1, paragraphs
(c), clause (2), and (d). An MFIP caregiver who has had one or
more sanctions imposed must remain in compliance with the
requirements of section 256.741 for six months in order for a
subsequent sanction to be considered a first occurrence.
Sec. 64. Minnesota Statutes 2002, section 256J.46,
subdivision 2a, is amended to read:
Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the
provisions of subdivisions 1 and 2, for a participant subject to
a sanction for refusal to comply with child support requirements
under subdivision 2 and subject to a concurrent sanction for
refusal to cooperate with other program requirements under
subdivision 1, sanctions shall be imposed in the manner
prescribed in this subdivision.
A participant who has had one or more sanctions imposed
under this subdivision must remain in compliance with the
provisions of this chapter for six months in order for a
subsequent occurrence of noncompliance to be considered a first
occurrence. Any vendor payment of shelter costs or utilities
under this subdivision must remain in effect for six months
after the month in which the participant is no longer subject to
sanction under subdivision 1.
(b) If the participant was subject to sanction for:
(i) noncompliance under subdivision 1 before being subject
to sanction for noncooperation under subdivision 2; or
(ii) noncooperation under subdivision 2 before being
subject to sanction for noncompliance under subdivision 1, the
participant is considered to have a second occurrence of
noncompliance and shall be sanctioned as provided in subdivision
1, paragraph (d) (c), clause (2). Each subsequent occurrence of
noncompliance shall be considered one additional occurrence and
shall be subject to the applicable level of sanction under
subdivision 1, paragraph (d), or section 256J.462. The
requirement that the county conduct a review as specified in
subdivision 1, paragraph (e) (d), remains in effect.
(c) A participant who first becomes subject to sanction
under both subdivisions 1 and 2 in the same month is subject to
sanction as follows:
(i) in the first month of noncompliance and noncooperation,
the participant's grant must be reduced by 25 30 percent of the
applicable MFIP standard of need, with any residual amount paid
to the participant;
(ii) in the second and subsequent months of noncompliance
and noncooperation, the participant shall be subject to the
applicable level of sanction under subdivision 1, paragraph (d),
or section 256J.462.
The requirement that the county conduct a review as
specified in subdivision 1, paragraph (e) (d), remains in effect.
(d) A participant remains subject to sanction under
subdivision 2 if the participant:
(i) returns to compliance and is no longer subject to
sanction under subdivision 1 or section 256J.462 for
noncompliance with section 256J.45 or sections 256J.515 to
256J.57; or
(ii) has the sanction under subdivision 1, paragraph (d),
or section 256J.462 for noncompliance with section 256J.45 or
sections 256J.515 to 256J.57 removed upon completion of the
review under subdivision 1, paragraph (e).
A participant remains subject to the applicable level of
sanction under subdivision 1, paragraph (d), or section 256J.462
if the participant cooperates and is no longer subject to
sanction under subdivision 2.
Sec. 65. Minnesota Statutes 2002, section 256J.49,
subdivision 4, is amended to read:
Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.]
"Employment and training service provider" means:
(1) a public, private, or nonprofit employment and training
agency certified by the commissioner of economic security under
sections 268.0122, subdivision 3, and 268.871, subdivision 1, or
is approved under section 256J.51 and is included in the county
plan service agreement submitted under section 256J.50 256J.626,
subdivision 7 4;
(2) a public, private, or nonprofit agency that is not
certified by the commissioner under clause (1), but with which a
county has contracted to provide employment and training
services and which is included in the county's plan service
agreement submitted under section 256J.50 256J.626,
subdivision 7 4; or
(3) a county agency, if the county has opted to provide
employment and training services and the county has indicated
that fact in the plan service agreement submitted under section
256J.50 256J.626, subdivision 7 4.
Notwithstanding section 268.871, an employment and training
services provider meeting this definition may deliver employment
and training services under this chapter.
Sec. 66. Minnesota Statutes 2002, section 256J.49,
subdivision 5, is amended to read:
Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan
developed by the job counselor and the participant which
identifies the participant's most direct path to unsubsidized
employment, lists the specific steps that the caregiver will
take on that path, and includes a timetable for the completion
of each step. The plan should also identify any subsequent
steps that support long-term economic stability. For
participants who request and qualify for a family violence
waiver, an employment plan must be developed by the job
counselor and the participant, and in consultation with a person
trained in domestic violence and follow the employment plan
provisions in section 256J.521, subdivision 3.
Sec. 67. Minnesota Statutes 2002, section 256J.49, is
amended by adding a subdivision to read:
Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work
literacy" means an intensive English as a second language
program that is work focused and offers at least 20 hours of
class time per week.
Sec. 68. Minnesota Statutes 2002, section 256J.49,
subdivision 9, is amended to read:
Subd. 9. [PARTICIPANT.] "Participant" means a recipient of
MFIP assistance who participates or is required to participate
in employment and training services under sections 256J.515 to
256J.57 and 256J.95.
Sec. 69. Minnesota Statutes 2002, section 256J.49, is
amended by adding a subdivision to read:
Subd. 12a. [SUPPORTED WORK.] "Supported work" means a
subsidized or unsubsidized work experience placement with a
public or private sector employer, which may include services
such as individualized supervision and job coaching to support
the participant on the job.
Sec. 70. Minnesota Statutes 2002, section 256J.49,
subdivision 13, is amended to read:
Subd. 13. [WORK ACTIVITY.] "Work activity" means any
activity in a participant's approved employment plan that is
tied to the participant's leads to employment goal. For
purposes of the MFIP program, any activity that is included in a
participant's approved employment plan meets this includes
activities that meet the definition of work activity as counted
under the federal participation standards requirements of TANF.
Work activity includes, but is not limited to:
(1) unsubsidized employment, including work study and paid
apprenticeships or internships;
(2) subsidized private sector or public sector employment,
including grant diversion as specified in section 256J.69,
on-the-job training as specified in section 256J.66, the
self-employment investment demonstration program (SEID) as
specified in section 256J.65, paid work experience, and
supported work when a wage subsidy is provided;
(3) unpaid work experience, including CWEP community
service, volunteer work, the community work experience program
as specified in section 256J.67, unpaid apprenticeships or
internships, and including work associated with the refurbishing
of publicly assisted housing if sufficient private sector
employment is not available supported work when a wage subsidy
is not provided;
(4) on-the-job training as specified in section 256J.66 job
search including job readiness assistance, job clubs, job
placement, job-related counseling, and job retention services;
(5) job search, either supervised or unsupervised;
(6) job readiness assistance;
(7) job clubs, including job search workshops;
(8) job placement;
(9) job development;
(10) job-related counseling;
(11) job coaching;
(12) job retention services;
(13) job-specific training or education;
(14) job skills training directly related to employment;
(15) the self-employment investment demonstration (SEID),
as specified in section 256J.65;
(16) preemployment activities, based on availability and
resources, such as volunteer work, literacy programs and related
activities, citizenship classes, English as a second language
(ESL) classes as limited by the provisions of section 256J.52,
subdivisions 3, paragraph (d), and 5, paragraph (c), or
participation in dislocated worker services, chemical dependency
treatment, mental health services, peer group networks,
displaced homemaker programs, strength-based resiliency
training, parenting education, or other programs designed to
help families reach their employment goals and enhance their
ability to care for their children;
(17) community service programs;
(18) vocational educational training or educational
programs that can reasonably be expected to lead to employment,
as limited by the provisions of section 256J.53;
(19) apprenticeships;
(20) satisfactory attendance in general educational
development diploma classes or an adult diploma program;
(21) satisfactory attendance at secondary school, if the
participant has not received a high school diploma;
(22) adult basic education classes;
(23) internships;
(24) bilingual employment and training services;
(25) providing child care services to a participant who is
working in a community service program; and
(26) activities included in an alternative employment plan
that is developed under section 256J.52, subdivision 6.
(5) job readiness education, including English as a second
language (ESL) or functional work literacy classes as limited by
the provisions of section 256J.531, subdivision 2, general
educational development (GED) course work, high school
completion, and adult basic education as limited by the
provisions of section 256J.531, subdivision 1;
(6) job skills training directly related to employment,
including education and training that can reasonably be expected
to lead to employment, as limited by the provisions of section
256J.53;
(7) providing child care services to a participant who is
working in a community service program;
(8) activities included in the employment plan that is
developed under section 256J.521, subdivision 3; and
(9) preemployment activities including chemical and mental
health assessments, treatment, and services; learning
disabilities services; child protective services; family
stabilization services; or other programs designed to enhance
employability.
Sec. 71. Minnesota Statutes 2002, section 256J.50,
subdivision 1, is amended to read:
Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT
OF MFIP.] (a) By January 1, 1998, Each county must develop and
implement provide an employment and training services component
of MFIP which is designed to put participants on the most direct
path to unsubsidized employment. Participation in these
services is mandatory for all MFIP caregivers, unless the
caregiver is exempt under section 256J.56.
(b) A county must provide employment and training services
under sections 256J.515 to 256J.74 within 30 days after
the caregiver's participation becomes mandatory under
subdivision 5 or within 30 days of receipt of a request for
services from a caregiver who under section 256J.42 is no longer
eligible to receive MFIP but whose income is below 120 percent
of the federal poverty guidelines for a family of the same
size. The request must be made within 12 months of the date the
caregivers' MFIP case was closed caregiver is determined
eligible for MFIP, or within ten days when the caregiver
participated in the diversionary work program under section
256J.95 within the past 12 months.
Sec. 72. Minnesota Statutes 2002, section 256J.50,
subdivision 9, is amended to read:
Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding
subdivision 8, a county that explains in the plan service
agreement required under section 256J.626, subdivision 7 4, that
the provision of alternative employment and training service
providers would result in financial hardship for the county is
not required to make available more than one employment and
training provider.
Sec. 73. Minnesota Statutes 2002, section 256J.50,
subdivision 10, is amended to read:
Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY
VIOLENCE.] (a) County agencies and their contractors must
provide universal notification to all applicants and recipients
of MFIP that:
(1) referrals to counseling and supportive services are
available for victims of family violence;
(2) nonpermanent resident battered individuals married to
United States citizens or permanent residents may be eligible to
petition for permanent residency under the federal Violence
Against Women Act, and that referrals to appropriate legal
services are available;
(3) victims of family violence are exempt from the 60-month
limit on assistance while the individual is if they are
complying with an approved safety plan or, after October 1,
2001, an alternative employment plan, as defined in under
section 256J.49 256J.521, subdivision 1a 3; and
(4) victims of family violence may choose to have regular
work requirements waived while the individual is complying with
an alternative employment plan as defined in under section
256J.49 256J.521, subdivision 1a 3.
(b) If an alternative employment plan under section
256J.521, subdivision 3, is denied, the county or a job
counselor must provide reasons why the plan is not approved and
document how the denial of the plan does not interfere with the
safety of the participant or children.
Notification must be in writing and orally at the time of
application and recertification, when the individual is referred
to the title IV-D child support agency, and at the beginning of
any job training or work placement assistance program.
Sec. 74. Minnesota Statutes 2002, section 256J.51,
subdivision 1, is amended to read:
Subdivision 1. [PROVIDER APPLICATION.] An employment and
training service provider that is not included in a county's
plan service agreement under section 256J.50 256J.626,
subdivision 7 4, because the county has demonstrated financial
hardship under section 256J.50, subdivision 9 of that section,
may appeal its exclusion to the commissioner of economic
security under this section.
Sec. 75. Minnesota Statutes 2002, section 256J.51,
subdivision 2, is amended to read:
Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment
and training service provider that is not included by a county
agency in the plan service agreement under section
256J.50 256J.626, subdivision 7 4, and that meets the criteria
in paragraph (b), may appeal its exclusion to the commissioner
of economic security, and may request alternative approval by
the commissioner of economic security to provide services in the
county.
(b) An employment and training services provider that is
requesting alternative approval must demonstrate to the
commissioner that the provider meets the standards specified in
section 268.871, subdivision 1, paragraph (b), except that the
provider's past experience may be in services and programs
similar to those specified in section 268.871, subdivision 1,
paragraph (b).
Sec. 76. Minnesota Statutes 2002, section 256J.51,
subdivision 3, is amended to read:
Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner
must act on a request for alternative approval under this
section within 30 days of the receipt of the request. If after
reviewing the provider's request, and the county's plan service
agreement submitted under section 256J.50 256J.626,
subdivision 7 4, the commissioner determines that the provider
meets the criteria under subdivision 2, paragraph (b), and that
approval of the provider would not cause financial hardship to
the county, the county must submit a revised plan service
agreement under subdivision 4 that includes the approved
provider.
(b) If the commissioner determines that the approval of the
provider would cause financial hardship to the county, the
commissioner must notify the provider and the county of this
determination. The alternate approval process under this
section shall be closed to other requests for alternate approval
to provide employment and training services in the county for up
to 12 months from the date that the commissioner makes a
determination under this paragraph.
Sec. 77. Minnesota Statutes 2002, section 256J.51,
subdivision 4, is amended to read:
Subd. 4. [REVISED PLAN SERVICE AGREEMENT REQUIRED.] The
commissioner of economic security must notify the county agency
when the commissioner grants an alternative approval to an
employment and training service provider under subdivision 2.
Upon receipt of the notice, the county agency must submit a
revised plan service agreement under section 256J.50 256J.626,
subdivision 7 4, that includes the approved provider. The
county has 90 days from the receipt of the commissioner's notice
to submit the revised plan service agreement.
Sec. 78. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.]
Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP
employment services, assessment is a continuing process of
gathering information related to employability for the purpose
of identifying both participant's strengths and strategies for
coping with issues that interfere with employment. The job
counselor must use information from the assessment process to
develop and update the employment plan under subdivision 2.
(b) The scope of assessment must cover at least the
following areas:
(1) basic information about the participant's ability to
obtain and retain employment, including: a review of the
participant's education level; interests, skills, and abilities;
prior employment or work experience; transferable work skills;
child care and transportation needs;
(2) identification of personal and family circumstances
that impact the participant's ability to obtain and retain
employment, including: any special needs of the children, the
level of English proficiency, family violence issues, and any
involvement with social services or the legal system;
(3) the results of a mental and chemical health screening
tool designed by the commissioner and results of the brief
screening tool for special learning needs. Screening tools for
mental and chemical health and special learning needs must be
approved by the commissioner and may only be administered by job
counselors or county staff trained in using such screening
tools. The commissioner shall work with county agencies to
develop protocols for referrals and follow-up actions after
screens are administered to participants, including guidance on
how employment plans may be modified based upon outcomes of
certain screens. Participants must be told of the purpose of
the screens and how the information will be used to assist the
participant in identifying and overcoming barriers to
employment. Screening for mental and chemical health and
special learning needs must be completed by participants who are
unable to find suitable employment after six weeks of job search
under subdivision 2, paragraph (b), and participants who are
determined to have barriers to employment under subdivision 2,
paragraph (d). Failure to complete the screens will result in
sanction under section 256J.46; and
(4) a comprehensive review of participation and progress
for participants who have received MFIP assistance and have not
worked in unsubsidized employment during the past 12 months.
The purpose of the review is to determine the need for
additional services and supports, including placement in
subsidized employment or unpaid work experience under section
256J.49, subdivision 13.
(c) Information gathered during a caregiver's participation
in the diversionary work program under section 256J.95 must be
incorporated into the assessment process.
(d) The job counselor may require the participant to
complete a professional chemical use assessment to be performed
according to the rules adopted under section 254A.03,
subdivision 3, including provisions in the administrative rules
which recognize the cultural background of the participant, or a
professional psychological assessment as a component of the
assessment process, when the job counselor has a reasonable
belief, based on objective evidence, that a participant's
ability to obtain and retain suitable employment is impaired by
a medical condition. The job counselor may assist the
participant with arranging services, including child care
assistance and transportation, necessary to meet needs
identified by the assessment. Data gathered as part of a
professional assessment must be classified and disclosed
according to the provisions in section 13.46.
Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the
assessment under subdivision 1, the job counselor and the
participant must develop an employment plan that includes
participation in activities and hours that meet the requirements
of section 256J.55, subdivision 1. The purpose of the
employment plan is to identify for each participant the most
direct path to unsubsidized employment and any subsequent steps
that support long-term economic stability. The employment plan
should be developed using the highest level of activity
appropriate for the participant. Activities must be chosen from
clauses (1) to (6), which are listed in order of preference.
The employment plan must also list the specific steps the
participant will take to obtain employment, including steps
necessary for the participant to progress from one level of
activity to another, and a timetable for completion of each
step. Levels of activity include:
(1) unsubsidized employment;
(2) job search;
(3) subsidized employment or unpaid work experience;
(4) unsubsidized employment and job readiness education or
job skills training;
(5) unsubsidized employment or unpaid work experience, and
activities related to a family violence waiver or preemployment
needs; and
(6) activities related to a family violence waiver or
preemployment needs.
(b) Participants who are determined to possess sufficient
skills such that the participant is likely to succeed in
obtaining unsubsidized employment must job search at least 30
hours per week for up to six weeks, and accept any offer of
suitable employment. The remaining hours necessary to meet the
requirements of section 256J.55, subdivision 1, may be met
through participation in other work activities under section
256J.49, subdivision 13. The participant's employment plan must
specify, at a minimum: (1) whether the job search is supervised
or unsupervised; (2) support services that will be provided; and
(3) how frequently the participant must report to the job
counselor. Participants who are unable to find suitable
employment after six weeks must meet with the job counselor to
determine whether other activities in paragraph (a) should be
incorporated into the employment plan. Job search activities
which are continued after six weeks must be structured and
supervised.
(c) Beginning July 1, 2004, activities and hourly
requirements in the employment plan may be adjusted as necessary
to accommodate the personal and family circumstances of
participants identified under section 256J.561, subdivision 2,
paragraph (d). Participants who no longer meet the provisions
of section 256J.561, subdivision 2, paragraph (d), must meet
with the job counselor within ten days of the determination to
revise the employment plan.
(d) Participants who are determined to have barriers to
obtaining or retaining employment that will not be overcome
during six weeks of job search under paragraph (b) must work
with the job counselor to develop an employment plan that
addresses those barriers by incorporating appropriate activities
from paragraph (a), clauses (1) to (6). The employment plan
must include enough hours to meet the participation requirements
in section 256J.55, subdivision 1, unless a compelling reason to
require fewer hours is noted in the participant's file.
(e) The job counselor and the participant must sign the
employment plan to indicate agreement on the contents. Failure
to develop or comply with activities in the plan, or voluntarily
quitting suitable employment without good cause, will result in
the imposition of a sanction under section 256J.46.
(f) Employment plans must be reviewed at least every three
months to determine whether activities and hourly requirements
should be revised.
Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A
participant who requests and qualifies for a family violence
waiver shall develop or revise the employment plan as specified
in this subdivision with a job counselor or county, and a person
trained in domestic violence. The revised or new employment
plan must be approved by the county or the job counselor. The
plan may address safety, legal, or emotional issues, and other
demands on the family as a result of the family violence.
Information in section 256J.515, clauses (1) to (8), must be
included as part of the development of the plan.
(b) The primary goal of an employment plan developed under
this subdivision is to ensure the safety of the caregiver and
children. To the extent it is consistent with ensuring safety,
the plan shall also include activities that are designed to lead
to economic stability. An activity is inconsistent with
ensuring safety if, in the opinion of a person trained in
domestic violence, the activity would endanger the safety of the
participant or children. A plan under this subdivision may not
automatically include a provision that requires a participant to
obtain an order for protection or to attend counseling.
(c) If at any time there is a disagreement over whether the
activities in the plan are appropriate or the participant is not
complying with activities in the plan under this subdivision,
the participant must receive the assistance of a person trained
in domestic violence to help resolve the disagreement or
noncompliance with the county or job counselor. If the person
trained in domestic violence recommends that the activities are
still appropriate, the county or a job counselor must approve
the activities in the plan or provide written reasons why
activities in the plan are not approved and document how denial
of the activities do not endanger the safety of the participant
or children.
Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities
may be included in an employment plan contingent on the
development of a business plan which establishes a timetable and
earning goals that will result in the participant exiting MFIP
assistance. Business plans must be developed with assistance
from an individual or organization with expertise in small
business as approved by the job counselor.
(b) Participants with an approved plan that includes
self-employment must meet the participation requirements in
section 256J.55, subdivision 1. Only hours where the
participant earns at least minimum wage shall be counted toward
the requirement. Additional activities and hours necessary to
meet the participation requirements in section 256J.55,
subdivision 1, must be included in the employment plan.
(c) Employment plans which include self-employment
activities must be reviewed every three months. Participants
who fail, without good cause, to make satisfactory progress as
established in the business plan must revise the employment plan
to replace the self-employment with other approved work
activities.
(d) The requirements of this subdivision may be waived for
participants who are enrolled in the self-employment investment
demonstration program (SEID) under section 256J.65, and who make
satisfactory progress as determined by the job counselor and the
SEID provider.
Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK
PROGRAM.] Participants who become eligible for MFIP assistance
after completing the diversionary work program under section
256J.95 must comply with all requirements of subdivisions 1 and
2. Participants who become eligible for MFIP assistance after
being determined unable to benefit from the diversionary work
program must comply with the requirements of subdivisions 1 and
2, with the exception of subdivision 2, paragraph (b).
Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid
off, quit with good cause, or are terminated from employment
through no fault of their own must meet with the job counselor
within ten working days to ascertain the reason for the job loss
and to revise the employment plan as necessary to address the
problem.
Sec. 79. Minnesota Statutes 2002, section 256J.53,
subdivision 1, is amended to read:
Subdivision 1. [LENGTH OF PROGRAM.] In order for a
post-secondary education or training program to be an approved
work activity as defined in section 256J.49, subdivision 13,
clause (18) (6), it must be a program lasting 24 months or less,
and the participant must meet the requirements of subdivisions 2
and, 3, and 5.
Sec. 80. Minnesota Statutes 2002, section 256J.53,
subdivision 2, is amended to read:
Subd. 2. [DOCUMENTATION SUPPORTING PROGRAM APPROVAL OF
POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a
post-secondary education or training program to be an approved
activity in a participant's an employment plan, the participant
or the employment and training service provider must provide
documentation that: be working in unsubsidized employment at
least 20 hours per week.
(b) Participants seeking approval of a postsecondary
education or training plan must provide documentation that:
(1) the participant's employment plan identifies specific
goals that goal can only be met with the additional education or
training;
(2) there are suitable employment opportunities that
require the specific education or training in the area in which
the participant resides or is willing to reside;
(3) the education or training will result in significantly
higher wages for the participant than the participant could earn
without the education or training;
(4) the participant can meet the requirements for admission
into the program; and
(5) there is a reasonable expectation that the participant
will complete the training program based on such factors as the
participant's MFIP assessment, previous education, training, and
work history; current motivation; and changes in previous
circumstances.
(c) The hourly unsubsidized employment requirement may be
reduced for intensive education or training programs lasting 12
weeks or less when full-time attendance is required.
(d) Participants with an approved employment plan in place
on July 1, 2003, which includes more than 12 months of
postsecondary education or training shall be allowed to complete
that plan provided that hourly requirements in section 256J.55,
subdivision 1, and conditions specified in paragraph (b), and
subdivisions 3 and 5 are met.
Sec. 81. Minnesota Statutes 2002, section 256J.53,
subdivision 5, is amended to read:
Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY
REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.] If a
participant's employment plan includes a post-secondary
educational or training program, the plan must include an
anticipated completion date for those activities. At the time
the education or training is completed, the participant must
participate in job search. If, after three months of job
search, the participant does not find a job that is consistent
with the participant's employment goal, the participant must
accept any offer of suitable employment. Upon completion of an
approved education or training program, a participant who does
not meet the participation requirements in section 256J.55,
subdivision 1, through unsubsidized employment must participate
in job search. If, after six weeks of job search, the
participant does not find a full-time job consistent with the
employment goal, the participant must accept any offer of
full-time suitable employment, or meet with the job counselor to
revise the employment plan to include additional work activities
necessary to meet hourly requirements.
Sec. 82. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND
LANGUAGE.]
Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With
the exception of classes related to obtaining a general
educational development credential (GED), a participant must
have reading or mathematics proficiency below a ninth grade
level in order for adult basic education classes to be an
approved work activity. The employment plan must also specify
that the participant fulfill no more than one-half of the
participation requirements in section 256J.55, subdivision 1,
through attending adult basic education or general educational
development classes.
Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In
order for English as a second language (ESL) classes to be an
approved work activity in an employment plan, a participant must
be below a spoken language proficiency level of SPL6 or its
equivalent, as measured by a nationally recognized test. In
approving ESL as a work activity, the job counselor must give
preference to enrollment in a functional work literacy program,
if one is available, over a regular ESL program. A participant
may not be approved for more than a combined total of 24 months
of ESL classes while participating in the diversionary work
program and the employment and training services component of
MFIP. The employment plan must also specify that the
participant fulfill no more than one-half of the participation
requirements in section 256J.55, subdivision 1, through
attending ESL classes. For participants enrolled in functional
work literacy classes, no more than two-thirds of the
participation requirements in section 256J.55, subdivision 1,
may be met through attending functional work literacy classes.
Sec. 83. Minnesota Statutes 2002, section 256J.54,
subdivision 1, is amended to read:
Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND
NEEDS.] (a) The county agency must document the educational
level of each MFIP caregiver who is under the age of 20 and
determine if the caregiver has obtained a high school diploma or
its equivalent. If the caregiver has not obtained a high school
diploma or its equivalent, and is not exempt from the
requirement to attend school under subdivision 5, the county
agency must complete an individual assessment for the
caregiver unless the caregiver is exempt from the requirement to
attend school under subdivision 5 or has chosen to have an
employment plan under section 256J.521, subdivision 2, as
allowed in paragraph (b). The assessment must be performed as
soon as possible but within 30 days of determining MFIP
eligibility for the caregiver. The assessment must provide an
initial examination of the caregiver's educational progress and
needs, literacy level, child care and supportive service needs,
family circumstances, skills, and work experience. In the case
of a caregiver under the age of 18, the assessment must also
consider the results of either the caregiver's or the
caregiver's minor child's child and teen checkup under Minnesota
Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available,
and the effect of a child's development and educational needs on
the caregiver's ability to participate in the program. The
county agency must advise the caregiver that the caregiver's
first goal must be to complete an appropriate educational
education option if one is identified for the caregiver through
the assessment and, in consultation with educational agencies,
must review the various school completion options with the
caregiver and assist in selecting the most appropriate option.
(b) The county agency must give a caregiver, who is age 18
or 19 and has not obtained a high school diploma or its
equivalent, the option to choose an employment plan with an
education option under subdivision 3 or an employment plan under
section 256J.521, subdivision 2.
Sec. 84. Minnesota Statutes 2002, section 256J.54,
subdivision 2, is amended to read:
Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT
PLAN.] For caregivers who are under age 18 without a high school
diploma or its equivalent, the assessment under subdivision 1
and the employment plan under subdivision 3 must be completed by
the social services agency under section 257.33. For caregivers
who are age 18 or 19 without a high school diploma or its
equivalent who choose to have an employment plan with an
education option under subdivision 3, the assessment under
subdivision 1 and the employment plan under subdivision 3 must
be completed by the job counselor or, at county option, by the
social services agency under section 257.33. Upon reaching age
18 or 19 a caregiver who received social services under section
257.33 and is without a high school diploma or its equivalent
has the option to choose whether to continue receiving services
under the caregiver's plan from the social services agency or to
utilize an MFIP employment and training service provider. The
social services agency or the job counselor shall consult with
representatives of educational agencies that are required to
assist in developing educational plans under section 124D.331.
Sec. 85. Minnesota Statutes 2002, section 256J.54,
subdivision 3, is amended to read:
Subd. 3. [EDUCATIONAL EDUCATION OPTION DEVELOPED.] If the
job counselor or county social services agency identifies an
appropriate educational education option for a minor caregiver
under the age of 20 without a high school diploma or its
equivalent, or a caregiver age 18 or 19 without a high school
diploma or its equivalent who chooses an employment plan with an
education option, the job counselor or agency must develop an
employment plan which reflects the identified option. The plan
must specify that participation in an educational activity is
required, what school or educational program is most
appropriate, the services that will be provided, the activities
the caregiver will take part in, including child care and
supportive services, the consequences to the caregiver for
failing to participate or comply with the specified
requirements, and the right to appeal any adverse action. The
employment plan must, to the extent possible, reflect the
preferences of the caregiver.
Sec. 86. Minnesota Statutes 2002, section 256J.54,
subdivision 5, is amended to read:
Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding
the provisions of section 256J.56, minor parents, or 18- or
19-year-old parents without a high school diploma or its
equivalent who chooses an employment plan with an education
option must attend school unless:
(1) transportation services needed to enable the caregiver
to attend school are not available;
(2) appropriate child care services needed to enable the
caregiver to attend school are not available;
(3) the caregiver is ill or incapacitated seriously enough
to prevent attendance at school; or
(4) the caregiver is needed in the home because of the
illness or incapacity of another member of the household. This
includes a caregiver of a child who is younger than six weeks of
age.
(b) The caregiver must be enrolled in a secondary school
and meeting the school's attendance requirements. The county,
social service agency, or job counselor must verify at least
once per quarter that the caregiver is meeting the school's
attendance requirements. An enrolled caregiver is considered to
be meeting the attendance requirements when the school is not in
regular session, including during holiday and summer breaks.
Sec. 87. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.]
(a) In order to qualify for a family violence waiver, an
individual must provide documentation of past or current family
violence which may prevent the individual from participating in
certain employment activities. A claim of family violence must
be documented by the applicant or participant providing a sworn
statement which is supported by collateral documentation.
(b) Collateral documentation may consist of:
(1) police, government agency, or court records;
(2) a statement from a battered women's shelter staff with
knowledge of the circumstances or credible evidence that
supports the sworn statement;
(3) a statement from a sexual assault or domestic violence
advocate with knowledge of the circumstances or credible
evidence that supports the sworn statement;
(4) a statement from professionals from whom the applicant
or recipient has sought assistance for the abuse; or
(5) a sworn statement from any other individual with
knowledge of circumstances or credible evidence that supports
the sworn statement.
Sec. 88. Minnesota Statutes 2002, section 256J.55,
subdivision 1, is amended to read:
Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT
PLAN; SUITABLE EMPLOYMENT PARTICIPATION REQUIREMENTS.] (a) Each
MFIP participant must comply with the terms of the participant's
job search support plan or employment plan. When the
participant has completed the steps listed in the employment
plan, the participant must comply with section 256J.53,
subdivision 5, if applicable, and then the participant must not
refuse any offer of suitable employment. The participant may
choose to accept an offer of suitable employment before the
participant has completed the steps of the employment plan.
(b) For a participant under the age of 20 who is without a
high school diploma or general educational development diploma,
the requirement to comply with the terms of the employment plan
means the participant must meet the requirements of section
256J.54.
(c) Failure to develop or comply with a job search support
plan or an employment plan, or quitting suitable employment
without good cause, shall result in the imposition of a sanction
as specified in sections 256J.46 and 256J.57.
(a) All caregivers must participate in employment services
under sections 256J.515 to 256J.57 concurrent with receipt of
MFIP assistance.
(b) Until July 1, 2004, participants who meet the
requirements of section 256J.56 are exempt from participation
requirements.
(c) Participants under paragraph (a) must develop and
comply with an employment plan under section 256J.521, or
section 256J.54 in the case of a participant under the age of 20
who has not obtained a high school diploma or its equivalent.
(d) With the exception of participants under the age of 20
who must meet the education requirements of section 256J.54, all
participants must meet the hourly participation requirements of
TANF or the hourly requirements listed in clauses (1) to (3),
whichever is higher.
(1) In single-parent families with no children under six
years of age, the job counselor and the caregiver must develop
an employment plan that includes 30 to 35 hours per week of work
activities.
(2) In single-parent families with a child under six years
of age, the job counselor and the caregiver must develop an
employment plan that includes 20 to 35 hours per week of work
activities.
(3) In two-parent families, the job counselor and the
caregivers must develop employment plans which result in a
combined total of at least 55 hours per week of work activities.
(e) Failure to participate in employment services,
including the requirement to develop and comply with an
employment plan, including hourly requirements, without good
cause under section 256J.57, shall result in the imposition of a
sanction under section 256J.46.
Sec. 89. Minnesota Statutes 2002, section 256J.55,
subdivision 2, is amended to read:
Subd. 2. [DUTY TO REPORT.] The participant must inform the
job counselor within three ten working days regarding any
changes related to the participant's employment status.
Sec. 90. Minnesota Statutes 2002, section 256J.56, is
amended to read:
256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT;
EXEMPTIONS.]
(a) An MFIP participant is exempt from the requirements of
sections 256J.52 256J.515 to 256J.55 256J.57 if the participant
belongs to any of the following groups:
(1) participants who are age 60 or older;
(2) participants who are suffering from a professionally
certified permanent or temporary illness, injury, or incapacity
which has been certified by a qualified professional when the
illness, injury, or incapacity is expected to continue for more
than 30 days and which prevents the person from obtaining or
retaining employment. Persons in this category with a temporary
illness, injury, or incapacity must be reevaluated at least
quarterly;
(3) participants whose presence in the home is required as
a caregiver because of a professionally certified the illness,
injury, or incapacity of another member in the assistance unit,
a relative in the household, or a foster child in the
household and when the illness or incapacity and the need for a
person to provide assistance in the home has been certified by a
qualified professional and is expected to continue for more than
30 days;
(4) women who are pregnant, if the pregnancy has resulted
in a professionally certified an incapacity that prevents the
woman from obtaining or retaining employment, and the incapacity
has been certified by a qualified professional;
(5) caregivers of a child under the age of one year who
personally provide full-time care for the child. This exemption
may be used for only 12 months in a lifetime. In two-parent
households, only one parent or other relative may qualify for
this exemption;
(6) participants experiencing a personal or family crisis
that makes them incapable of participating in the program, as
determined by the county agency. If the participant does not
agree with the county agency's determination, the participant
may seek professional certification from a qualified
professional, as defined in section 256J.08, that the
participant is incapable of participating in the program.
Persons in this exemption category must be reevaluated
every 60 days. A personal or family crisis related to family
violence, as determined by the county or a job counselor with
the assistance of a person trained in domestic violence, should
not result in an exemption, but should be addressed through the
development or revision of an alternative employment plan under
section 256J.52 256J.521, subdivision 6 3; or
(7) caregivers with a child or an adult in the household
who meets the disability or medical criteria for home care
services under section 256B.0627, subdivision 1,
paragraph (c) (f), or a home and community-based waiver services
program under chapter 256B, or meets the criteria for severe
emotional disturbance under section 245.4871, subdivision 6, or
for serious and persistent mental illness under section 245.462,
subdivision 20, paragraph (c). Caregivers in this exemption
category are presumed to be prevented from obtaining or
retaining employment.
A caregiver who is exempt under clause (5) must enroll in
and attend an early childhood and family education class, a
parenting class, or some similar activity, if available, during
the period of time the caregiver is exempt under this section.
Notwithstanding section 256J.46, failure to attend the required
activity shall not result in the imposition of a sanction.
(b) The county agency must provide employment and training
services to MFIP participants who are exempt under this section,
but who volunteer to participate. Exempt volunteers may request
approval for any work activity under section 256J.49,
subdivision 13. The hourly participation requirements for
nonexempt participants under section 256J.50 256J.55,
subdivision 5 1, do not apply to exempt participants who
volunteer to participate.
(c) This section expires on June 30, 2004.
Sec. 91. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.]
Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION
REQUIREMENTS.] (a) All caregivers whose applications were
received July 1, 2004, or after, are immediately subject to the
requirements in subdivision 2.
(b) For all MFIP participants who were exempt from
participating in employment services under section 256J.56 as of
June 30, 2004, between July 1, 2004, and June 30, 2005, the
county, as part of the participant's recertification under
section 256J.32, subdivision 6, shall determine whether a new
employment plan is required to meet the requirements in
subdivision 2. Counties shall notify each participant who is in
need of an employment plan that the participant must meet with a
job counselor within ten days to develop an employment plan.
Until a participant's employment plan is developed, the
participant shall be considered in compliance with the
participation requirements in this section if the participant
continues to meet the criteria for an exemption under section
256J.56 as in effect on June 30, 2004, and is cooperating in the
development of the new plan.
Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP
caregivers, except caregivers who meet the criteria in
subdivision 3, must participate in employment services. Except
as specified in paragraphs (b) to (d), the employment plan must
meet the requirements of section 256J.521, subdivision 2,
contain allowable work activities, as defined in section
256J.49, subdivision 13, and, include at a minimum, the number
of participation hours required under section 256J.55,
subdivision 1.
(b) Minor caregivers and caregivers who are less than age
20 who have not completed high school or obtained a GED are
required to comply with section 256J.54.
(c) A participant who has a family violence waiver shall
develop and comply with an employment plan under section
256J.521, subdivision 3.
(d) As specified in section 256J.521, subdivision 2,
paragraph (c), a participant who meets any one of the following
criteria may work with the job counselor to develop an
employment plan that contains less than the number of
participation hours under section 256J.55, subdivision 1.
Employment plans for participants covered under this paragraph
must be tailored to recognize the special circumstances of
caregivers and families including limitations due to illness or
disability and caregiving needs:
(1) a participant who is age 60 or older;
(2) a participant who has been diagnosed by a qualified
professional as suffering from an illness or incapacity that is
expected to last for 30 days or more, including a pregnant
participant who is determined to be unable to obtain or retain
employment due to the pregnancy; or
(3) a participant who is determined by a qualified
professional as being needed in the home to care for an ill or
incapacitated family member, including caregivers with a child
or an adult in the household who meets the disability or medical
criteria for home care services under section 256B.0627,
subdivision 1, paragraph (f), or a home and community-based
waiver services program under chapter 256B, or meets the
criteria for severe emotional disturbance under section
245.4871, subdivision 6, or for serious and persistent mental
illness under section 245.462, subdivision 20, paragraph (c).
(e) For participants covered under paragraphs (c) and (d),
the county shall review the participant's employment services
status every three months to determine whether conditions have
changed. When it is determined that the participant's status is
no longer covered under paragraph (c) or (d), the county shall
notify the participant that a new or revised employment plan is
needed. The participant and job counselor shall meet within ten
days of the determination to revise the employment plan.
Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant
who has a natural born child who is less than 12 weeks of age
who meets the criteria in clauses (1) and (2) is not required to
participate in employment services until the child reaches 12
weeks of age. To be eligible for this provision, the following
conditions must be met:
(1) the child must have been born within ten months of the
caregiver's application for the diversionary work program or
MFIP; and
(2) the assistance unit must not have already used this
provision or the previously allowed child under age one
exemption. However, an assistance unit that has an approved
child under age one exemption at the time this provision becomes
effective may continue to use that exemption until the child
reaches one year of age.
(b) The provision in paragraph (a) ends the first full
month after the child reaches 12 weeks of age. This provision
is available only once in a caregiver's lifetime. In a
two-parent household, only one parent shall be allowed to use
this provision. The participant and job counselor must meet
within ten days after the child reaches 12 weeks of age to
revise the participant's employment plan.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 92. Minnesota Statutes 2002, section 256J.57, is
amended to read:
256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE;
CONCILIATION CONFERENCE.]
Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The
county agency shall not impose the sanction under section
256J.46 if it determines that the participant has good cause for
failing to comply with the requirements of sections 256J.52
256J.515 to 256J.55 256J.57. Good cause exists when:
(1) appropriate child care is not available;
(2) the job does not meet the definition of suitable
employment;
(3) the participant is ill or injured;
(4) a member of the assistance unit, a relative in the
household, or a foster child in the household is ill and needs
care by the participant that prevents the participant from
complying with the job search support plan or employment plan;
(5) the parental caregiver is unable to secure necessary
transportation;
(6) the parental caregiver is in an emergency situation
that prevents compliance with the job search support plan or
employment plan;
(7) the schedule of compliance with the job search support
plan or employment plan conflicts with judicial proceedings;
(8) a mandatory MFIP meeting is scheduled during a time
that conflicts with a judicial proceeding or a meeting related
to a juvenile court matter, or a participant's work schedule;
(9) the parental caregiver is already participating in
acceptable work activities;
(10) the employment plan requires an educational program
for a caregiver under age 20, but the educational program is not
available;
(11) activities identified in the job search support plan
or employment plan are not available;
(12) the parental caregiver is willing to accept suitable
employment, but suitable employment is not available; or
(13) the parental caregiver documents other verifiable
impediments to compliance with the job search support plan or
employment plan beyond the parental caregiver's control.
The job counselor shall work with the participant to
reschedule mandatory meetings for individuals who fall under
clauses (1), (3), (4), (5), (6), (7), and (8).
Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a
participant fails without good cause to comply with the
requirements of sections 256J.52 256J.515 to 256J.55 256J.57,
the job counselor or the county agency must provide a notice of
intent to sanction to the participant specifying the program
requirements that were not complied with, informing the
participant that the county agency will impose the sanctions
specified in section 256J.46, and informing the participant of
the opportunity to request a conciliation conference as
specified in paragraph (b). The notice must also state that the
participant's continuing noncompliance with the specified
requirements will result in additional sanctions under section
256J.46, without the need for additional notices or conciliation
conferences under this subdivision. The notice, written in
English, must include the department of human services language
block, and must be sent to every applicable participant. If the
participant does not request a conciliation conference within
ten calendar days of the mailing of the notice of intent to
sanction, the job counselor must notify the county agency that
the assistance payment should be reduced. The county must then
send a notice of adverse action to the participant informing the
participant of the sanction that will be imposed, the reasons
for the sanction, the effective date of the sanction, and the
participant's right to have a fair hearing under section 256J.40.
(b) The participant may request a conciliation conference
by sending a written request, by making a telephone request, or
by making an in-person request. The request must be received
within ten calendar days of the date the county agency mailed
the ten-day notice of intent to sanction. If a timely request
for a conciliation is received, the county agency's service
provider must conduct the conference within five days of the
request. The job counselor's supervisor, or a designee of the
supervisor, must review the outcome of the conciliation
conference. If the conciliation conference resolves the
noncompliance, the job counselor must promptly inform the county
agency and request withdrawal of the sanction notice.
(c) Upon receiving a sanction notice, the participant may
request a fair hearing under section 256J.40, without exercising
the option of a conciliation conference. In such cases, the
county agency shall not require the participant to engage in a
conciliation conference prior to the fair hearing.
(d) If the participant requests a fair hearing or a
conciliation conference, sanctions will not be imposed until
there is a determination of noncompliance. Sanctions must be
imposed as provided in section 256J.46.
Sec. 93. Minnesota Statutes 2002, section 256J.62,
subdivision 9, is amended to read:
Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if
services were approved as part of an employment plan prior to
June 30, 2003, at the request of the participant, the county may
continue to provide case management, counseling, or other
support services to a participant:
(a) (1) who has achieved the employment goal; or
(b) (2) who under section 256J.42 is no longer eligible to
receive MFIP but whose income is below 115 percent of the
federal poverty guidelines for a family of the same size.
These services may be provided for up to 12 months
following termination of the participant's eligibility for MFIP.
Sec. 94. [256J.626] [MFIP CONSOLIDATED FUND.]
Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund
is established to support counties and tribes in meeting their
duties under this chapter. Counties and tribes must use funds
from the consolidated fund to develop programs and services that
are designed to improve participant outcomes as measured in
section 256J.751, subdivision 2. Counties may use the funds for
any allowable expenditures under subdivision 2. Tribes may use
the funds for any allowable expenditures under subdivision 2,
except those in clauses (1) and (6).
Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner
must restrict expenditures under the consolidated fund to
benefits and services allowed under title IV-A of the federal
Social Security Act. Allowable expenditures under the
consolidated fund may include, but are not limited to:
(1) short-term, nonrecurring shelter and utility needs that
are excluded from the definition of assistance under Code of
Federal Regulations, title 45, section 260.31, for families who
meet the residency requirement in section 256J.12, subdivisions
1 and 1a. Payments under this subdivision are not considered
TANF cash assistance and are not counted towards the 60-month
time limit;
(2) transportation needed to obtain or retain employment or
to participate in other approved work activities;
(3) direct and administrative costs of staff to deliver
employment services for MFIP or the diversionary work program,
to administer financial assistance, and to provide specialized
services intended to assist hard-to-employ participants to
transition to work;
(4) costs of education and training including functional
work literacy and English as a second language;
(5) cost of work supports including tools, clothing, boots,
and other work-related expenses;
(6) county administrative expenses as defined in Code of
Federal Regulations, title 45, section 260(b);
(7) services to parenting and pregnant teens;
(8) supported work;
(9) wage subsidies;
(10) child care needed for MFIP or diversionary work
program participants to participate in social services;
(11) child care to ensure that families leaving MFIP or
diversionary work program will continue to receive child care
assistance from the time the family no longer qualifies for
transition year child care until an opening occurs under the
basic sliding fee child care program; and
(12) services to help noncustodial parents who live in
Minnesota and have minor children receiving MFIP or DWP
assistance, but do not live in the same household as the child,
obtain or retain employment.
(b) Administrative costs that are not matched with county
funds as provided in subdivision 8 may not exceed 7.5 percent of
a county's or 15 percent of a tribe's reimbursement under this
section. The commissioner shall define administrative costs for
purposes of this subdivision.
Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor
child, a pregnant woman, or a noncustodial parent of a minor
child receiving assistance, with incomes below 200 percent of
the federal poverty guideline for a family of the applicable
size, are eligible for services funded under the consolidated
fund. Counties and tribes must give priority to families
currently receiving MFIP or diversionary work program, and
families at risk of receiving MFIP or diversionary work program.
Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE
AGREEMENTS.] (a) Effective January 1, 2004, and each two-year
period thereafter, each county and tribe must have in place an
approved biennial service agreement related to the services and
programs in this chapter. In counties with a city of the first
class with a population over 300,000, the county must consider a
service agreement that includes a jointly developed plan for the
delivery of employment services with the city. Counties may
collaborate to develop multicounty, multitribal, or regional
service agreements.
(b) The service agreements will be completed in a form
prescribed by the commissioner. The agreement must include:
(1) a statement of the needs of the service population and
strengths and resources in the community;
(2) numerical goals for participant outcomes measures to be
accomplished during the biennial period. The commissioner may
identify outcomes from section 256J.751, subdivision 2, as core
outcomes for all counties and tribes;
(3) strategies the county or tribe will pursue to achieve
the outcome targets. Strategies must include specification of
how funds under this section will be used and may include
community partnerships that will be established or strengthened;
and
(4) other items prescribed by the commissioner in
consultation with counties and tribes.
(c) The commissioner shall provide each county and tribe
with information needed to complete an agreement, including:
(1) information on MFIP cases in the county or tribe; (2)
comparisons with the rest of the state; (3) baseline performance
on outcome measures; and (4) promising program practices.
(d) The service agreement must be submitted to the
commissioner by October 15, 2003, and October 15 of each second
year thereafter. The county or tribe must allow a period of not
less than 30 days prior to the submission of the agreement to
solicit comments from the public on the contents of the
agreement.
(e) The commissioner must, within 60 days of receiving each
county or tribal service agreement, inform the county or tribe
if the service agreement is approved. If the service agreement
is not approved, the commissioner must inform the county or
tribe of any revisions needed prior to approval.
(f) The service agreement in this subdivision supersedes
the plan requirements of section 268.88.
Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005,
no more than $3,000,000 of the funds annually appropriated to
the commissioner for use in the consolidated fund shall be
available to the commissioner for projects testing innovative
approaches to improving outcomes for MFIP participants, and
persons at risk of receiving MFIP as detailed in subdivision 3.
Projects shall be targeted to geographic areas with poor
outcomes as specified in section 256J.751, subdivision 5, or to
subgroups within the MFIP case load who are experiencing poor
outcomes.
Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For
purposes of this section, the following terms have the meanings
given them:
(1) "2002 historic spending base" means the commissioner's
determination of the sum of the reimbursement related to fiscal
year 2002 of county or tribal agency expenditures for the base
programs listed in clause (4), items (i) through (iv), and
earnings related to calendar year 2002 in the base program
listed in clause (4), item (v), and the amount of spending in
fiscal year 2002 in the base program listed in clause (4), item
(vi), issued to or on behalf of persons residing in the county
or tribal service delivery area.
(2) "Initial allocation" means the amount potentially
available to each county or tribe based on the formula in
paragraphs (b) through (d).
(3) "Final allocation" means the amount available to each
county or tribe based on the formula in paragraphs (b) through
(d), after adjustment by subdivision 7.
(4) "Base programs" means the:
(i) MFIP employment and training services under section
256J.62, subdivision 1, in effect June 30, 2002;
(ii) bilingual employment and training services to refugees
under section 256J.62, subdivision 6, in effect June 30, 2002;
(iii) work literacy language programs under section
256J.62, subdivision 7, in effect June 30, 2002;
(iv) supported work program authorized in Laws 2001, First
Special Session chapter 9, article 17, section 2, in effect June
30, 2002;
(v) administrative aid program under section 256J.76 in
effect December 31, 2002; and
(vi) emergency assistance program under section 256J.48 in
effect June 30, 2002.
(b)(1) Beginning July 1, 2003, the commissioner shall
determine the initial allocation of funds available under this
section according to clause (2).
(2) All of the funds available for the period beginning
July 1, 2003, and ending December 31, 2004, shall be allocated
to each county or tribe in proportion to the county's or tribe's
share of the statewide 2002 historic spending base.
(c) For calendar year 2005, the commissioner shall
determine the initial allocation of funds to be made available
under this section in proportion to the county or tribe's
initial allocation for the period of July 1, 2003 to December
31, 2004.
(d) The formula under this subdivision sunsets December 31,
2005.
(e) Before November 30, 2003, a county or tribe may ask for
a review of the commissioner's determination of the historic
base spending when the county or tribe believes the 2002
information was inaccurate or incomplete. By January 1, 2004,
the commissioner must adjust that county's or tribe's base when
the commissioner has determined that inaccurate or incomplete
information was used to develop that base. The commissioner
shall adjust each county's or tribe's initial allocation under
paragraph (c) and final allocation under subdivision 7 to
reflect the base change.
(f) Effective January 1, 2005, counties and tribes will
have their final allocations adjusted based on the performance
provisions of subdivision 7.
Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Each county and
tribe will be allocated 95 percent of their initial calendar
year 2005 allocation. Counties and tribes will be allocated
additional funds based on performance as follows:
(1) a county or tribe that achieves a 50 percent rate or
higher on the MFIP participation rate under section 256J.751,
subdivision 2, clause (8), as averaged across the four quarterly
measurements for the most recent year for which the measurements
are available, will receive an additional allocation equal to
2.5 percent of its initial allocation; and
(2) a county or tribe that performs above the top of its
range of expected performance on the three-year self-support
index under section 256J.751, subdivision 2, clause (7), in both
measurements in the preceding year will receive an additional
allocation equal to five percent of its initial allocation; or
(3) a county or tribe that performs within its range of
expected performance on the three-year self-support index under
section 256J.751, subdivision 2, clause (7), in both
measurements in the preceding year, or above the top of its
range of expected performance in one measurement and within its
expected range of performance in the other measurement, will
receive an additional allocation equal to 2.5 percent of its
initial allocation.
(b) Funds remaining unallocated after the performance-based
allocations in paragraph (a) are available to the commissioner
for innovation projects under subdivision 5.
(c)(1) If available funds are insufficient to meet county
and tribal allocations under paragraph (a), the commissioner may
make available for allocation funds that are unobligated and
available from the innovation projects through the end of the
current biennium.
(2) If after the application of clause (1) funds remain
insufficient to meet county and tribal allocations under
paragraph (a), the commissioner must proportionally reduce the
allocation of each county and tribe with respect to their
maximum allocation available under paragraph (a).
Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a)
The commissioner shall specify requirements for reporting
according to section 256.01, subdivision 2, clause (17). Each
county or tribe shall be reimbursed for eligible expenditures up
to the limit of its allocation and subject to availability of
funds.
(b) Reimbursements for county administrative-related
expenditures determined through the income maintenance random
moment time study shall be reimbursed at a rate of 50 percent of
eligible expenditures.
(c) The commissioner of human services shall review county
and tribal agency expenditures of the MFIP consolidated fund as
appropriate and may reallocate unencumbered or unexpended money
appropriated under this section to those county and tribal
agencies that can demonstrate a need for additional money.
Subd. 9. [REPORT.] The commissioner shall, in consultation
with counties and tribes:
(1) determine how performance-based allocations under
subdivision 7, paragraph (a), clauses (2) and (3), will be
allocated to groupings of counties and tribes when groupings are
used to measure expected performance ranges for the self-support
index under section 256J.751, subdivision 2, clause (7); and
(2) determine how performance-based allocations under
subdivision 7, paragraph (a), clauses (2) and (3), will be
allocated to tribes.
The commissioner shall report to the legislature on the formulas
developed in clauses (1) and (2) by January 1, 2004.
Sec. 95. Minnesota Statutes 2002, section 256J.645,
subdivision 3, is amended to read:
Subd. 3. [FUNDING.] If the commissioner and an Indian
tribe are parties to an agreement under this subdivision, the
agreement shall annually provide to the Indian tribe the funding
allocated in section 256J.62, subdivisions 1 and 2a 256J.626.
Sec. 96. Minnesota Statutes 2002, section 256J.66,
subdivision 2, is amended to read:
Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies
shall limit the length of training based on the complexity of
the job and the caregiver's previous experience and training.
Placement in an on-the-job training position with an employer is
for the purpose of training and employment with the same
employer who has agreed to retain the person upon satisfactory
completion of training.
(b) Placement of any participant in an on-the-job training
position must be compatible with the participant's assessment
and employment plan under section 256J.52 256J.521.
Sec. 97. Minnesota Statutes 2002, section 256J.69,
subdivision 2, is amended to read:
Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies
shall limit the length of training to nine months. Placement in
a grant diversion training position with an employer is for the
purpose of training and employment with the same employer who
has agreed to retain the person upon satisfactory completion of
training.
(b) Placement of any participant in a grant diversion
subsidized training position must be compatible with the
assessment and employment plan or employability development plan
established for the recipient under section 256J.52 or 256K.03,
subdivision 8 256J.521.
Sec. 98. Minnesota Statutes 2002, section 256J.75,
subdivision 3, is amended to read:
Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE
PAYMENTS.] A county of residence, when different from the county
of financial responsibility, will be charged by the commissioner
for the value of incorrect assistance payments and medical
assistance paid to or on behalf of a person who was not eligible
to receive that amount. Incorrect payments include payments to
an ineligible person or family resulting from decisions,
failures to act, miscalculations, or overdue recertification.
However, financial responsibility does not accrue for a county
when the recertification is overdue at the time the referral is
received by the county of residence or when the county of
financial responsibility does not act on the recommendation of
the county of residence. When federal or state law requires
that medical assistance continue after assistance ends, this
subdivision also governs financial responsibility for the
extended medical assistance.
Sec. 99. Minnesota Statutes 2002, section 256J.751,
subdivision 1, is amended to read:
Subdivision 1. [QUARTERLY MONTHLY COUNTY CASELOAD REPORT.]
The commissioner shall report quarterly monthly to each county
on the county's performance on the following measures following
caseload information:
(1) number of cases receiving only the food portion of
assistance;
(2) number of child-only cases;
(3) number of minor caregivers;
(4) number of cases that are exempt from the 60-month time
limit by the exemption category under section 256J.42;
(5) number of participants who are exempt from employment
and training services requirements by the exemption category
under section 256J.56;
(6) number of assistance units receiving assistance under a
hardship extension under section 256J.425;
(7) number of participants and number of months spent in
each level of sanction under section 256J.46, subdivision 1;
(8) number of MFIP cases that have left assistance;
(9) federal participation requirements as specified in
title 1 of Public Law Number 104-193;
(10) median placement wage rate; and
(11) of each county's total MFIP caseload less the number
of cases in clauses (1) to (6):
(i) number of one-parent cases;
(ii) number of two-parent cases;
(iii) percent of one-parent cases that are working more
than 20 hours per week;
(iv) percent of two-parent cases that are working more than
20 hours per week; and
(v) percent of cases that have received more than 36 months
of assistance.
(1) total number of cases receiving MFIP, and subtotals of
cases with one eligible parent, two eligible parents, and an
eligible caregiver who is not a parent;
(2) total number of child only assistance cases;
(3) total number of eligible adults and children receiving
an MFIP grant, and subtotals for cases with one eligible parent,
two eligible parents, an eligible caregiver who is not a parent,
and child only cases;
(4) number of cases with an exemption from the 60-month
time limit based on a family violence waiver;
(5) number of MFIP cases with work hours, and subtotals for
cases with one eligible parent, two eligible parents, and an
eligible caregiver who is not a parent;
(6) number of employed MFIP cases, and subtotals for cases
with one eligible parent, two eligible parents, and an eligible
caregiver who is not a parent;
(7) average monthly gross earnings, and averages for
subgroups of cases with one eligible parent, two eligible
parents, and an eligible caregiver who is not a parent;
(8) number of employed cases receiving only the food
portion of assistance;
(9) number of parents or caregivers exempt from work
activity requirements, with subtotals for each exemption type;
and
(10) number of cases with a sanction, with subtotals by
level of sanction for cases with one eligible parent, two
eligible parents, and an eligible caregiver who is not a parent.
Sec. 100. Minnesota Statutes 2002, section 256J.751,
subdivision 2, is amended to read:
Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner
shall report quarterly to all counties on each county's
performance on the following measures:
(1) percent of MFIP caseload working in paid employment;
(2) percent of MFIP caseload receiving only the food
portion of assistance;
(3) number of MFIP cases that have left assistance;
(4) federal participation requirements as specified in
Title 1 of Public Law Number 104-193;
(5) median placement wage rate; and
(6) caseload by months of TANF assistance;
(7) percent of MFIP cases off cash assistance or working 30
or more hours per week at one-year, two-year, and three-year
follow-up points from a base line quarter. This measure is
called the self-support index. Twice annually, the commissioner
shall report an expected range of performance for each county,
county grouping, and tribe on the self-support index. The
expected range shall be derived by a statistical methodology
developed by the commissioner in consultation with the counties
and tribes. The statistical methodology shall control
differences across counties in economic conditions and
demographics of the MFIP case load; and
(8) the MFIP work participation rate, defined as the
participation requirements specified in title 1 of Public Law
104-193 applied to all MFIP cases except child only cases and
cases exempt under section 256J.56.
Sec. 101. Minnesota Statutes 2002, section 256J.751,
subdivision 5, is amended to read:
Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.]
(a) If sanctions occur for failure to meet the performance
standards specified in title 1 of Public Law Number 104-193 of
the Personal Responsibility and Work Opportunity Act of 1996,
the state shall pay 88 percent of the sanction. The remaining
12 percent of the sanction will be paid by the counties. The
county portion of the sanction will be distributed across all
counties in proportion to each county's percentage of the MFIP
average monthly caseload during the period for which the
sanction was applied.
(b) If a county fails to meet the performance standards
specified in title 1 of Public Law Number 104-193 of the
Personal Responsibility and Work Opportunity Act of 1996 for any
year, the commissioner shall work with counties to organize a
joint state-county technical assistance team to work with the
county. The commissioner shall coordinate any technical
assistance with other departments and agencies including the
departments of economic security and children, families, and
learning as necessary to achieve the purpose of this paragraph.
(c) For state performance measures, a low-performing county
is one that:
(1) performs below the bottom of their expected range for
the measure in subdivision 2, clause (7), in both measurements
during the year; or
(2) performs below 40 percent for the measure in
subdivision 2, clause (8), as averaged across the four quarterly
measurements for the year, or the ten counties with the lowest
rates if more than ten are below 40 percent.
(d) Low-performing counties under paragraph (c) must engage
in corrective action planning as defined by the commissioner.
The commissioner may coordinate technical assistance as
specified in paragraph (b) for low-performing counties under
paragraph (c).
Sec. 102. [256J.95] [DIVERSIONARY WORK PROGRAM.]
Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM
(DWP).] (a) The Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, Public Law 104-193, establishes
block grants to states for temporary assistance for needy
families (TANF). TANF provisions allow states to use TANF
dollars for nonrecurrent, short-term diversionary benefits. The
diversionary work program established on July 1, 2003, is
Minnesota's TANF program to provide short-term diversionary
benefits to eligible recipients of the diversionary work program.
(b) The goal of the diversionary work program is to provide
short-term, necessary services and supports to families which
will lead to unsubsidized employment, increase economic
stability, and reduce the risk of those families needing longer
term assistance, under the Minnesota family investment program
(MFIP).
(c) When a family unit meets the eligibility criteria in
this section, the family must receive a diversionary work
program grant and is not eligible for MFIP.
(d) A family unit is eligible for the diversionary work
program for a maximum of four months only once in a 12-month
period. The 12-month period begins at the date of application
or the date eligibility is met, whichever is later. During the
four-month period, family maintenance needs as defined in
subdivision 2, shall be vendor paid, up to the cash portion of
the MFIP standard of need for the same size household. To the
extent there is a balance available between the amount paid for
family maintenance needs and the cash portion of the
transitional standard, a personal needs allowance of up to $70
per DWP recipient in the family unit shall be issued. The
personal needs allowance payment plus the family maintenance
needs shall not exceed the cash portion of the MFIP standard of
need. Counties may provide supportive and other allowable
services funded by the MFIP consolidated fund under section
256J.626 to eligible participants during the four-month
diversionary period.
Subd. 2. [DEFINITIONS.] The terms used in this section
have the following meanings.
(a) "Diversionary Work Program (DWP)" means the program
established under this section.
(b) "Employment plan" means a plan developed by the job
counselor and the participant which identifies the participant's
most direct path to unsubsidized employment, lists the specific
steps that the caregiver will take on that path, and includes a
timetable for the completion of each step. For participants who
request and qualify for a family violence waiver in section
256J.521, subdivision 3, an employment plan must be developed by
the job counselor, the participant and a person trained in
domestic violence and follow the employment plan provisions in
section 256J.521, subdivision 3. Employment plans under this
section shall be written for a period of time not to exceed four
months.
(c) "Employment services" means programs, activities, and
services in this section that are designed to assist
participants in obtaining and retaining employment.
(d) "Family maintenance needs" means current housing costs
including rent, manufactured home lot rental costs, or monthly
principal, interest, insurance premiums, and property taxes due
for mortgages or contracts for deed, association fees required
for homeownership, utility costs for current month expenses of
gas and electric, garbage, water and sewer, and a flat rate of
$35 for telephone services.
(e) "Family unit" means a group of people applying for or
receiving DWP benefits together. For the purposes of
determining eligibility for this program, the unit includes the
relationships in section 256J.24, subdivisions 2 and 4.
(f) "Minnesota family investment program (MFIP)" means the
assistance program as defined in section 256J.08, subdivision 57.
(g) "Personal needs allowance" means an allowance of up to
$70 per month per DWP unit member to pay for expenses such as
household products and personal products.
(h) "Work activities" means allowable work activities as
defined in section 256J.49, subdivision 13.
Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a)
Except for the categories of family units listed below, all
family units who apply for cash benefits and who meet MFIP
eligibility as required in sections 256J.11 to 256J.15 are
eligible and must participate in the diversionary work program.
Family units that are not eligible for the diversionary work
program include:
(1) child only cases;
(2) a single-parent family unit that includes a child under
12 weeks of age. A parent is eligible for this exception once
in a parent's lifetime and is not eligible if the parent has
already used the previously allowed child under age one
exemption from MFIP employment services;
(3) a minor parent without a high school diploma or its
equivalent;
(4) a caregiver 18 or 19 years of age without a high school
diploma or its equivalent who chooses to have an employment plan
with an education option;
(5) a caregiver age 60 or over;
(6) family units with a parent who received DWP benefits
within a 12-month period as defined in subdivision 1, paragraph
(d); and
(7) family units with a parent who received MFIP within the
past 12 months.
(b) A two-parent family must participate in DWP unless both
parents meet the criteria for an exception under paragraph (a),
clauses (1) through (5), or the family unit includes a parent
who meets the criteria in paragraph (a), clause (6) or (7).
Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To
be eligible for DWP, an applicant must comply with the
requirements of paragraphs (b) to (d).
(b) Applicants and participants must cooperate with the
requirements of the child support enforcement program, but will
not be charged a fee under section 518.551, subdivision 7.
(c) The applicant must provide each member of the family
unit's social security number to the county agency. This
requirement is satisfied when each member of the family unit
cooperates with the procedures for verification of numbers,
issuance of duplicate cards, and issuance of new numbers which
have been established jointly between the Social Security
Administration and the commissioner.
(d) Before DWP benefits can be issued to a family unit, the
caregiver must, in conjunction with a job counselor, develop and
sign an employment plan. In two-parent family units, both
parents must develop and sign employment plans before benefits
can be issued. Food support and health care benefits are not
contingent on the requirement for a signed employment plan.
Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility
date for the diversionary work program begins with the date the
signed combined application form (CAF) is received by the county
agency or the date diversionary work program eligibility
criteria are met, whichever is later. The county agency must
inform the applicant that any delay in submitting the
application will reduce the benefits paid for the month of
application. The county agency must inform a person that an
application may be submitted before the person has an interview
appointment. Upon receipt of a signed application, the county
agency must stamp the date of receipt on the face of the
application. The applicant may withdraw the application at any
time prior to approval by giving written or oral notice to the
county agency. The county agency must follow the notice
requirements in section 256J.09, subdivision 3, when issuing a
notice confirming the withdrawal.
Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt
of the application, the county agency must determine if the
applicant may be eligible for other benefits as required in
sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1
and 5. The county must also follow the provisions in section
256J.09, subdivision 3b, clause (2).
Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The
interview to determine financial eligibility for the
diversionary work program must be conducted within five working
days of the receipt of the cash application form. During the
intake interview the financial worker must discuss:
(1) the goals, requirements, and services of the
diversionary work program;
(2) the availability of child care assistance. If child
care is needed, the worker must obtain a completed application
for child care from the applicant before the interview is
terminated. The same day the application for child care is
received, the application must be forwarded to the appropriate
child care worker. For purposes of eligibility for child care
assistance under chapter 119B, DWP participants shall be
eligible for the same benefits as MFIP recipients; and
(3) if the applicant has not requested food support and
health care assistance on the application, the county agency
shall, during the interview process, talk with the applicant
about the availability of these benefits.
(b) The county shall follow section 256J.74, subdivision 2,
paragraph (b), clauses (1) and (2), when an applicant or a
recipient of DWP has a person who is a member of more than one
assistance unit in a given payment month.
(c) If within 30 days the county agency cannot determine
eligibility for the diversionary work program, the county must
deny the application and inform the applicant of the decision
according to the notice provisions in section 256J.31. A family
unit is eligible for a fair hearing under section 256J.40.
Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency
must only require verification of information necessary to
determine DWP eligibility and the amount of the payment. The
applicant or participant must document the information required
or authorize the county agency to verify the information. The
applicant or participant has the burden of providing documentary
evidence to verify eligibility. The county agency shall assist
the applicant or participant in obtaining required documents
when the applicant or participant is unable to do so.
(b) A county agency must not request information about an
applicant or participant that is not a matter of public record
from a source other than county agencies, the department of
human services, or the United States Department of Health and
Human Services without the person's prior written consent. An
applicant's signature on an application form constitutes consent
for contact with the sources specified on the application. A
county agency may use a single consent form to contact a group
of similar sources, but the sources to be contacted must be
identified by the county agency prior to requesting an
applicant's consent.
(c) Factors to be verified shall follow section 256J.32,
subdivision 4. Except for personal needs, family maintenance
needs must be verified before the expense can be allowed in the
calculation of the DWP grant.
Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset
limits and exclusions in section 256J.20, apply to applicants
and recipients of DWP. All payments, unless excluded in section
256J.21, must be counted as income to determine eligibility for
the diversionary work program. The county shall treat income as
outlined in section 256J.37, except for subdivision 3a. The
initial income test and the disregards in section 256J.21,
subdivision 3, shall be followed for determining eligibility for
the diversionary work program.
Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The
amount of cash benefits that a family unit is eligible for under
the diversionary work program is based on the number of persons
in the family unit, the family maintenance needs, personal needs
allowance, and countable income. The county agency shall
evaluate the income of the family unit that is requesting
payments under the diversionary work program. Countable income
means gross earned and unearned income not excluded or
disregarded under MFIP. The same disregards for earned income
that are allowed under MFIP are allowed for the diversionary
work program.
(b) The DWP grant is based on the family maintenance needs
for which the DWP family unit is responsible plus a personal
needs allowance. Housing and utilities, except for telephone
service, shall be vendor paid. Unless otherwise stated in this
section, actual housing and utility expenses shall be used when
determining the amount of the DWP grant.
(c) The maximum monthly benefit amount available under the
diversionary work program is the difference between the family
unit's needs under paragraph (b) and the family unit's countable
income not to exceed the cash portion of the MFIP standard of
need as defined in section 256J.08, subdivision 55a, for the
family unit's size.
(d) Once the county has determined a grant amount, the DWP
grant amount will not be decreased if the determination is based
on the best information available at the time of approval and
shall not be decreased because of any additional income to the
family unit. The grant must be increased if a participant later
verifies an increase in family maintenance needs or family unit
size. The minimum cash benefit amount, if income and asset
tests are met, is $10. Benefits of $10 shall not be vendor paid.
(e) When all criteria are met, including the development of
an employment plan as described in subdivision 14 and
eligibility exists for the month of application, the amount of
benefits for the diversionary work program retroactive to the
date of application is as specified in section 256J.35,
paragraph (a).
(f) Any month during the four-month DWP period that a
person receives a DWP benefit directly or through a vendor
payment made on the person's behalf, that person is ineligible
for MFIP or any other TANF cash assistance program except for
benefits defined in section 256J.626, subdivision 2, clause (1).
If during the four-month period a family unit that receives
DWP benefits moves to a county that has not established a
diversionary work program, the family unit may be eligible for
MFIP the month following the last month of the issuance of the
DWP benefit.
Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP
caregivers, except caregivers who meet the criteria in paragraph
(d), are required to participate in DWP employment services.
Except as specified in paragraphs (b) and (c), employment plans
under DWP must, at a minimum, meet the requirements in section
256J.55, subdivision 1.
(b) A caregiver who is a member of a two-parent family that
is required to participate in DWP who would otherwise be
ineligible for DWP under subdivision 3 may be allowed to develop
an employment plan under section 256J.521, subdivision 2,
paragraph (c), that may contain alternate activities and reduced
hours.
(c) A participant who has a family violence waiver shall be
allowed to develop an employment plan under section 256J.521,
subdivision 3.
(d) One parent in a two-parent family unit that has a
natural born child under 12 weeks of age is not required to have
an employment plan until the child reaches 12 weeks of age
unless the family unit has already used the exclusion under
section 256J.561, subdivision 2, or the previously allowed child
under age one exemption under section 256J.56, paragraph (a),
clause (5).
(e) The provision in paragraph (d) ends the first full
month after the child reaches 12 weeks of age. This provision
is allowable only once in a caregiver's lifetime. In a
two-parent household, only one parent shall be allowed to use
this category.
(f) The participant and job counselor must meet within ten
working days after the child reaches 12 weeks of age to revise
the participant's employment plan. The employment plan for a
family unit that has a child under 12 weeks of age that has
already used the exclusion in section 256J.561 or the previously
allowed child under age one exemption under section 256J.56,
paragraph (a), clause (5), must be tailored to recognize the
caregiving needs of the parent.
Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any
time during the DWP application process or during the four-month
DWP eligibility period, it is determined that a participant is
unlikely to benefit from the diversionary work program, the
county shall convert or refer the participant to MFIP as
specified in paragraph (d). Participants who are determined to
be unlikely to benefit from the diversionary work program must
develop and sign an employment plan. Participants who meet any
one of the criteria in paragraph (b) shall be considered to be
unlikely to benefit from DWP, provided the necessary
documentation is available to support the determination.
(b) A participant who:
(1) has been determined by a qualified professional as
being unable to obtain or retain employment due to an illness,
injury, or incapacity that is expected to last at least 60 days;
(2) is required in the home as a caregiver because of the
illness, injury, or incapacity, of a family member, or a
relative in the household, or a foster child, and the illness,
injury, or incapacity and the need for a person to provide
assistance in the home has been certified by a qualified
professional and is expected to continue more than 60 days;
(3) is determined by a qualified professional as being
needed in the home to care for a child meeting the special
medical criteria in section 256J.425, subdivision 2, clause (3);
(4) is pregnant and is determined by a qualified
professional as being unable to obtain or retain employment due
to the pregnancy; or
(5) has applied for SSI or RSDI.
(c) In a two-parent family unit, both parents must be
determined to be unlikely to benefit from the diversionary work
program before the family unit can be converted or referred to
MFIP.
(d) A participant who is determined to be unlikely to
benefit from the diversionary work program shall be converted to
MFIP and, if the determination was made within 30 days of the
initial application for benefits, no additional application form
is required. A participant who is determined to be unlikely to
benefit from the diversionary work program shall be referred to
MFIP and, if the determination is made more than 30 days after
the initial application, the participant must submit a program
change request form. The county agency shall process the
program change request form by the first of the following month
to ensure that no gap in benefits is due to delayed action by
the county agency. In processing the program change request
form, the county must follow section 256J.32, subdivision 1,
except that the county agency shall not require additional
verification of the information in the case file from the DWP
application unless the information in the case file is
inaccurate, questionable, or no longer current.
(e) The county shall not request a combined application
form for a participant who has exhausted the four months of the
diversionary work program, has continued need for cash and food
assistance, and has completed, signed, and submitted a program
change request form within 30 days of the fourth month of the
diversionary work program. The county must process the program
change request according to section 256J.32, subdivision 1,
except that the county agency shall not require additional
verification of information in the case file unless the
information is inaccurate, questionable, or no longer current.
When a participant does not request MFIP within 30 days of the
diversionary work program benefits being exhausted, a new
combined application form must be completed for any subsequent
request for MFIP.
Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.]
Within one working day of determination that the applicant is
eligible for the diversionary work program, but before benefits
are issued to or on behalf of the family unit, the county shall
refer all caregivers to employment services. The referral to
the DWP employment services must be in writing and must contain
the following information:
(1) notification that, as part of the application process,
applicants are required to develop an employment plan or the DWP
application will be denied;
(2) the employment services provider name and phone number;
(3) the date, time, and location of the scheduled
employment services interview;
(4) the immediate availability of supportive services,
including, but not limited to, child care, transportation, and
other work-related aid; and
(5) the rights, responsibilities, and obligations of
participants in the program, including, but not limited to, the
grounds for good cause, the consequences of refusing or failing
to participate fully with program requirements, and the appeal
process.
Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] As soon as
possible, but no later than ten working days of being notified
that a participant is financially eligible for the diversionary
work program, the employment services provider shall provide the
participant with an opportunity to meet to develop an initial
employment plan. Once the initial employment plan has been
developed and signed by the participant and the job counselor,
the employment services provider shall notify the county within
one working day that the employment plan has been signed. The
county shall issue DWP benefits within one working day after
receiving notice that the employment plan has been signed.
Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a)
Except as specified in paragraphs (b) to (d), employment
activities listed in section 256J.49, subdivision 13, are
allowable under the diversionary work program.
(b) Work activities under section 256J.49, subdivision 13,
clause (5), shall be allowable only when in combination with
approved work activities under section 256J.49, subdivision 13,
clauses (1) to (4), and shall be limited to no more than
one-half of the hours required in the employment plan.
(c) In order for an English as a second language (ESL)
class to be an approved work activity, a participant must:
(1) be below a spoken language proficiency level of SPL6 or
its equivalent, as measured by a nationally recognized test; and
(2) not have been enrolled in ESL for more than 24 months
while previously participating in MFIP or DWP. A participant
who has been enrolled in ESL for 20 or more months may be
approved for ESL until the participant has received 24 total
months.
(d) Work activities under section 256J.49, subdivision 13,
clause (6), shall be allowable only when the training or
education program will be completed within the four-month DWP
period. Training or education programs that will not be
completed within the four-month DWP period shall not be approved.
Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family
unit that includes a participant who fails to comply with DWP
employment service or child support enforcement requirements,
without good cause as defined in sections 256.741 and 256J.57,
shall be disqualified from the diversionary work program. The
county shall provide written notice as specified in section
256J.31 to the participant prior to disqualifying the family
unit due to noncompliance with employment service or child
support. The disqualification does not apply to food support or
health care benefits.
Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH
REQUIREMENTS.] A participant who fails to comply with the
requirements of the diversionary work program may claim good
cause for reasons listed in sections 256.741 and 256J.57,
subdivision 1, clauses (1) to (13). The county shall not impose
a disqualification if good cause exists.
Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A
participant who has been disqualified from the diversionary work
program due to noncompliance with employment services may regain
eligibility for the diversionary work program by complying with
program requirements. A participant who has been disqualified
from the diversionary work program due to noncooperation with
child support enforcement requirements may regain eligibility by
complying with child support requirements under section
256.741. Once a participant has been reinstated, the county
shall issue prorated benefits for the remaining portion of the
month. A family unit that has been disqualified from the
diversionary work program due to noncompliance shall not be
eligible for MFIP or any other TANF cash program during the
period of time the participant remains noncompliant. In a
two-parent family, both parents must be in compliance before the
family unit can regain eligibility for benefits.
Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment
or an ATM error is determined, the overpayment shall be recouped
or recovered as specified in section 256J.38.
Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish
a diversionary work program according to this section any time
on or after July 1, 2003. Prior to establishing a diversionary
work program, the county must notify the commissioner. All
counties must implement the provisions of this section no later
than July 1, 2004.
Sec. 103. Minnesota Statutes 2002, 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, diversionary work 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 chapter 256J, or Minnesota
supplemental aid.
Sec. 104. Minnesota Statutes 2002, section 393.07,
subdivision 10, is amended to read:
Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND
CHILD NUTRITION ACT.] (a) The local social services agency shall
establish and administer the food stamp or support program
according to rules of the commissioner of human services, the
supervision of the commissioner as specified in section 256.01,
and all federal laws and regulations. The commissioner of human
services shall monitor food stamp or support program delivery on
an ongoing basis to ensure that each county complies with
federal laws and regulations. Program requirements to be
monitored include, but are not limited to, number of
applications, number of approvals, number of cases pending,
length of time required to process each application and deliver
benefits, number of applicants eligible for expedited issuance,
length of time required to process and deliver expedited
issuance, number of terminations and reasons for terminations,
client profiles by age, household composition and income level
and sources, and the use of phone certification and home
visits. The commissioner shall determine the county-by-county
and statewide participation rate.
(b) On July 1 of each year, the commissioner of human
services shall determine a statewide and county-by-county food
stamp program participation rate. The commissioner may
designate a different agency to administer the food stamp
program in a county if the agency administering the program
fails to increase the food stamp program participation rate
among families or eligible individuals, or comply with all
federal laws and regulations governing the food stamp program.
The commissioner shall review agency performance annually to
determine compliance with this paragraph.
(c) A person who commits any of the following acts has
violated section 256.98 or 609.821, or both, and is subject to
both the criminal and civil penalties provided under those
sections:
(1) obtains or attempts to obtain, or aids or abets any
person to obtain by means of a willful statement or
misrepresentation, or intentional concealment of a material
fact, food stamps or vouchers issued according to sections
145.891 to 145.897 to which the person is not entitled or in an
amount greater than that to which that person is entitled or
which specify nutritional supplements to which that person is
not entitled; or
(2) presents or causes to be presented, coupons or vouchers
issued according to sections 145.891 to 145.897 for payment or
redemption knowing them to have been received, transferred or
used in a manner contrary to existing state or federal law; or
(3) willfully uses, possesses, or transfers food stamp
coupons, authorization to purchase cards or vouchers issued
according to sections 145.891 to 145.897 in any manner contrary
to existing state or federal law, rules, or regulations; or
(4) buys or sells food stamp coupons, authorization to
purchase cards, other assistance transaction devices, vouchers
issued according to sections 145.891 to 145.897, or any food
obtained through the redemption of vouchers issued according to
sections 145.891 to 145.897 for cash or consideration other than
eligible food.
(d) A peace officer or welfare fraud investigator may
confiscate food stamps, authorization to purchase cards, or
other assistance transaction devices found in the possession of
any person who is neither a recipient of the food stamp program
nor otherwise authorized to possess and use such materials.
Confiscated property shall be disposed of as the commissioner
may direct and consistent with state and federal food stamp
law. The confiscated property must be retained for a period of
not less than 30 days to allow any affected person to appeal the
confiscation under section 256.045.
(e) Food stamp overpayment claims which are due in whole or
in part to client error shall be established by the county
agency for a period of six years from the date of any resultant
overpayment.
(f) With regard to the federal tax revenue offset program
only, recovery incentives authorized by the federal food and
consumer service shall be retained at the rate of 50 percent by
the state agency and 50 percent by the certifying county agency.
(g) A peace officer, welfare fraud investigator, federal
law enforcement official, or the commissioner of health may
confiscate vouchers found in the possession of any person who is
neither issued vouchers under sections 145.891 to 145.897, nor
otherwise authorized to possess and use such vouchers.
Confiscated property shall be disposed of as the commissioner of
health may direct and consistent with state and federal law.
The confiscated property must be retained for a period of not
less than 30 days.
(h) The commissioner of human services may seek a waiver
from the United States Department of Agriculture to allow the
state to specify foods that may and may not be purchased in
Minnesota with benefits funded by the federal Food Stamp
Program. The commissioner shall consult with the members of the
house of representatives and senate policy committees having
jurisdiction over food support issues in developing the waiver.
The commissioner, in consultation with the commissioners of
health and education, shall develop a broad public health policy
related to improved nutrition and health status. The
commissioner must seek legislative approval prior to
implementing the waiver.
Sec. 105. Laws 1997, chapter 203, article 9, section 21,
as amended by Laws 1998, chapter 407, article 6, section 111,
Laws 2000, chapter 488, article 10, section 28, and Laws 2001,
First Special Session chapter 9, article 10, section 62, is
amended to read:
Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.]
(a) Effective on the date specified, the following
persons Beginning July 1, 2007, legal noncitizens ineligible for
federally funded cash or food benefits due to 1996 changes in
federal law and subsequent relevant enactments, who are eligible
for state-funded MFIP cash or food assistance, will be
ineligible for general assistance and general assistance medical
care under Minnesota Statutes, chapter 256D, group residential
housing under Minnesota Statutes, chapter 256I, and state-funded
MFIP assistance under Minnesota Statutes, chapter 256J, funded
with state money:.
(1) Beginning July 1, 2002, persons who are terminated from
or denied Supplemental Security Income due to the 1996 changes
in the federal law making persons whose alcohol or drug
addiction is a material factor contributing to the person's
disability ineligible for Supplemental Security Income, and are
eligible for general assistance under Minnesota Statutes,
section 256D.05, subdivision 1, paragraph (a), clause (15),
general assistance medical care under Minnesota Statutes,
chapter 256D, or group residential housing under Minnesota
Statutes, chapter 256I; and
(2) Beginning July 1, 2002, legal noncitizens who are
ineligible for Supplemental Security Income due to the 1996
changes in federal law making certain noncitizens ineligible for
these programs due to their noncitizen status; and
(3) beginning July 1, 2003, legal noncitizens who are
eligible for MFIP assistance, either the cash assistance portion
or the food assistance portion, funded entirely with state money.
(b) State money that remains unspent due to changes in
federal law enacted after May 12, 1997, that reduce state
spending for legal noncitizens or for persons whose alcohol or
drug addiction is a material factor contributing to the person's
disability, or enacted after February 1, 1998, that reduce state
spending for food benefits for legal noncitizens shall not
cancel and shall be deposited in the TANF reserve account.
Sec. 106. [REVISOR'S INSTRUCTION.]
(a) In the next publication of Minnesota Statutes, the
revisor of statutes shall codify section 108 of this act.
(b) Wherever "food stamp" or "food stamps" appears in
Minnesota Statutes and Rules, the revisor of statutes shall
insert "food support" or "or food support" except for instances
where federal code or federal law is referenced.
(c) For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 107. [REPEALER.]
(a) Minnesota Statutes 2002, sections 256J.02, subdivision
3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8;
256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49,
subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5,
and 7; 256J.52; 256J.55, subdivision 5; 256J.62, subdivisions 1,
2a, 4, 6, 7, and 8; 256J.625; 256J.655; 256J.74, subdivision 3;
256J.751, subdivisions 3 and 4; 256J.76; and 256K.30, are
repealed.
(b) Laws 2000, chapter 488, article 10, section 29, is
repealed.
ARTICLE 2
LONG-TERM CARE
Section 1. Minnesota Statutes 2002, section 61A.072,
subdivision 6, is amended to read:
Subd. 6. [ACCELERATED BENEFITS.] (a) "Accelerated
benefits" covered under this section are benefits payable under
the life insurance contract:
(1) to a policyholder or certificate holder, during the
lifetime of the insured, in anticipation of death upon the
occurrence of a specified life-threatening or catastrophic
condition as defined by the policy or rider;
(2) that reduce the death benefit otherwise payable under
the life insurance contract; and
(3) that are payable upon the occurrence of a single
qualifying event that results in the payment of a benefit amount
fixed at the time of acceleration.
(b) "Qualifying event" means one or more of the following:
(1) a medical condition that would result in a drastically
limited life span as specified in the contract;
(2) a medical condition that has required or requires
extraordinary medical intervention, such as, but not limited to,
major organ transplant or continuous artificial life support
without which the insured would die; or
(3) a condition that requires continuous confinement in an
eligible institution as defined in the contract if the insured
is expected to remain there for the rest of the insured's life;
(4) a long-term care illness or physical condition that
results in cognitive impairment or the inability to perform the
activities of daily life or the substantial and material duties
of any occupation; or
(5) other qualifying events that the commissioner approves
for a particular filing.
[EFFECTIVE DATE.] This section is effective the day
following final enactment and applies to policies issued on or
after that date.
Sec. 2. Minnesota Statutes 2002, section 62A.315, is
amended to read:
62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN;
COVERAGE.]
The extended basic Medicare supplement plan must have a
level of coverage so that it will be certified as a qualified
plan pursuant to section 62E.07, and will provide:
(1) coverage for all of the Medicare part A inpatient
hospital deductible and coinsurance amounts, and 100 percent of
all Medicare part A eligible expenses for hospitalization not
covered by Medicare;
(2) coverage for the daily copayment amount of Medicare
part A eligible expenses for the calendar year incurred for
skilled nursing facility care;
(3) coverage for the copayment amount of Medicare eligible
expenses under Medicare part B regardless of hospital
confinement, and the Medicare part B deductible amount;
(4) 80 percent of the usual and customary hospital and
medical expenses and supplies described in section 62E.06,
subdivision 1, not to exceed any charge limitation established
by the Medicare program or state law, the usual and customary
hospital and medical expenses and supplies, described in section
62E.06, subdivision 1, while in a foreign country, and
prescription drug expenses, not covered by Medicare;
(5) coverage for the reasonable cost of the first three
pints of blood, or equivalent quantities of packed red blood
cells as defined under federal regulations under Medicare parts
A and B, unless replaced in accordance with federal regulations;
(6) 100 percent of the cost of immunizations and routine
screening procedures for cancer, including mammograms and pap
smears;
(7) preventive medical care benefit: coverage for the
following preventive health services:
(i) an annual clinical preventive medical history and
physical examination that may include tests and services from
clause (ii) and patient education to address preventive health
care measures;
(ii) any one or a combination of the following preventive
screening tests or preventive services, the frequency of which
is considered medically appropriate:
(A) fecal occult blood test and/or digital rectal
examination;
(B) dipstick urinalysis for hematuria, bacteriuria, and
proteinuria;
(C) pure tone (air only) hearing screening test
administered or ordered by a physician;
(D) serum cholesterol screening every five years;
(E) thyroid function test;
(F) diabetes screening;
(iii) any other tests or preventive measures determined
appropriate by the attending physician.
Reimbursement shall be for the actual charges up to 100
percent of the Medicare-approved amount for each service as if
Medicare were to cover the service as identified in American
Medical Association current procedural terminology (AMA CPT)
codes to a maximum of $120 annually under this benefit. This
benefit shall not include payment for any procedure covered by
Medicare;
(8) at-home recovery benefit: coverage for services to
provide short-term at-home assistance with activities of daily
living for those recovering from an illness, injury, or surgery:
(i) for purposes of this benefit, the following definitions
shall apply:
(A) "activities of daily living" include, but are not
limited to, bathing, dressing, personal hygiene, transferring,
eating, ambulating, assistance with drugs that are normally
self-administered, and changing bandages or other dressings;
(B) "care provider" means a duly qualified or licensed home
health aide/homemaker, personal care aide, or nurse provided
through a licensed home health care agency or referred by a
licensed referral agency or licensed nurses registry;
(C) "home" means a place used by the insured as a place of
residence, provided that the place would qualify as a residence
for home health care services covered by Medicare. A hospital
or skilled nursing facility shall not be considered the
insured's place of residence;
(D) "at-home recovery visit" means the period of a visit
required to provide at-home recovery care, without limit on the
duration of the visit, except each consecutive four hours in a
24-hour period of services provided by a care provider is one
visit;
(ii) coverage requirements and limitations:
(A) at-home recovery services provided must be primarily
services that assist in activities of daily living;
(B) the insured's attending physician must certify that the
specific type and frequency of at-home recovery services are
necessary because of a condition for which a home care plan of
treatment was approved by Medicare;
(C) coverage is limited to:
(I) no more than the number and type of at-home recovery
visits certified as medically necessary by the insured's
attending physician. The total number of at-home recovery
visits shall not exceed the number of Medicare-approved home
health care visits under a Medicare-approved home care plan of
treatment;
(II) the actual charges for each visit up to a maximum
reimbursement of $40 $100 per visit;
(III) $1,600 $4,000 per calendar year;
(IV) seven visits in any one week;
(V) care furnished on a visiting basis in the insured's
home;
(VI) services provided by a care provider as defined in
this section;
(VII) at-home recovery visits while the insured is covered
under the policy or certificate and not otherwise excluded;
(VIII) at-home recovery visits received during the period
the insured is receiving Medicare-approved home care services or
no more than eight weeks after the service date of the last
Medicare-approved home health care visit;
(iii) coverage is excluded for:
(A) home care visits paid for by Medicare or other
government programs; and
(B) care provided by family members, unpaid volunteers, or
providers who are not care providers.
[EFFECTIVE DATE.] This section is effective January 1,
2004, and applies to policies issued on or after that date.
Sec. 3. Minnesota Statutes 2002, section 62A.48, is
amended by adding a subdivision to read:
Subd. 12. [REGULATORY FLEXIBILITY.] The commissioner may
upon written request issue an order to modify or suspend a
specific provision or provisions of sections 62A.46 to 62A.56
with respect to a specific long-term care insurance policy or
certificate upon a written finding that:
(1) the modification or suspension is in the best interest
of the insureds;
(2) the purpose to be achieved could not be effectively or
efficiently achieved without the modifications or suspension;
and
(3)(i) the modification or suspension is necessary to the
development of an innovative and reasonable approach for
insuring long-term care;
(ii) the policy or certificate is to be issued to residents
of a life care or continuing care retirement community or some
other residential community for the elderly and the modification
or suspension is reasonably related to the special needs or
nature of such a community; or
(iii) the modification or suspension is necessary to permit
long-term care insurance to be sold as part of, or in
conjunction with, another insurance product.
[EFFECTIVE DATE.] This section is effective January 1,
2004, and applies to policies issued on or after that date.
Sec. 4. Minnesota Statutes 2002, section 62A.49, is
amended by adding a subdivision to read:
Subd. 3. [PROHIBITED LIMITATIONS.] A long-term care
insurance policy or certificate shall not, if it provides
benefits for home health care or community care services, limit
or exclude benefits by:
(1) requiring that the insured would need care in a skilled
nursing facility if home health care services were not provided;
(2) requiring that the insured first or simultaneously
receive nursing or therapeutic services in a home, community, or
institutional setting before home health care services are
covered;
(3) limiting eligible services to services provided by a
registered nurse or licensed practical nurse;
(4) requiring that a nurse or therapist provide services
covered by the policy that can be provided by a home health aide
or other licensed or certified home care worker acting within
the scope of licensure or certification;
(5) excluding coverage for personal care services provided
by a home health aide;
(6) requiring that the provision of home health care
services be at a level of certification or licensure greater
than that required by the eligible service;
(7) requiring that the insured have an acute condition
before home health care services are covered;
(8) limiting benefits to services provided by
Medicare-certified agencies or providers;
(9) excluding coverage for adult day care services; or
(10) excluding coverage based upon location or type of
residence in which the home health care services would be
provided.
[EFFECTIVE DATE.] This section is effective January 1,
2004, and applies to policies issued on or after that date.
Sec. 5. Minnesota Statutes 2002, section 62S.22,
subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED LIMITATIONS.] A long-term care
insurance policy or certificate shall not, if it provides
benefits for home health care or community care services, limit
or exclude benefits by:
(1) requiring that the insured would need care in a skilled
nursing facility if home health care services were not provided;
(2) requiring that the insured first or simultaneously
receive nursing or therapeutic services in a home, community, or
institutional setting before home health care services are
covered;
(3) limiting eligible services to services provided by a
registered nurse or licensed practical nurse;
(4) requiring that a nurse or therapist provide services
covered by the policy that can be provided by a home health aide
or other licensed or certified home care worker acting within
the scope of licensure or certification;
(5) excluding coverage for personal care services provided
by a home health aide;
(6) requiring that the provision of home health care
services be at a level of certification or licensure greater
than that required by the eligible service;
(7) requiring that the insured have an acute condition
before home health care services are covered;
(8) limiting benefits to services provided by
Medicare-certified agencies or providers; or
(9) excluding coverage for adult day care services; or
(10) excluding coverage based upon location or type of
residence in which the home health care services would be
provided.
[EFFECTIVE DATE.] This section is effective January 1,
2004, and applies to policies issued on or after that date.
Sec. 6. [62S.34] [REGULATORY FLEXIBILITY.]
The commissioner may upon written request issue an order to
modify or suspend a specific provision or provisions of this
chapter with respect to a specific long-term care insurance
policy or certificate upon a written finding that:
(1) the modification or suspension is in the best interest
of the insureds;
(2) the purpose to be achieved could not be effectively or
efficiently achieved without the modifications or suspension;
and
(3)(i) the modification or suspension is necessary to the
development of an innovative and reasonable approach for
insuring long-term care;
(ii) the policy or certificate is to be issued to residents
of a life care or continuing care retirement community or some
other residential community for the elderly and the modification
or suspension is reasonably related to the special needs or
nature of such a community; or
(iii) the modification or suspension is necessary to permit
long-term care insurance to be sold as part of, or in
conjunction with, another insurance product.
[EFFECTIVE DATE.] This section is effective January 1,
2004, and applies to policies issued on or after that date.
Sec. 7. Minnesota Statutes 2002, section 144A.04,
subdivision 3, is amended to read:
Subd. 3. [STANDARDS.] (a) The facility must meet the
minimum health, sanitation, safety and comfort standards
prescribed by the rules of the commissioner of health with
respect to the construction, equipment, maintenance and
operation of a nursing home. The commissioner of health may
temporarily waive compliance with one or more of the standards
if the commissioner determines that:
(a) (1) temporary noncompliance with the standard will not
create an imminent risk of harm to a nursing home resident; and
(b) (2) a controlling person on behalf of all other
controlling persons:
(1) (i) has entered into a contract to obtain the materials
or labor necessary to meet the standard set by the commissioner
of health, but the supplier or other contractor has failed to
perform the terms of the contract and the inability of the
nursing home to meet the standard is due solely to that failure;
or
(2) (ii) is otherwise making a diligent good faith effort
to meet the standard.
The commissioner shall make available to other nursing
homes information on facility-specific waivers related to
technology or physical plant that are granted. The commissioner
shall, upon the request of a facility, extend a waiver granted
to a specific facility related to technology or physical plant
to the facility making the request, if the commissioner
determines that the facility also satisfies clauses (1) and (2)
and any other terms and conditions of the waiver.
The commissioner of health shall allow, by rule, a nursing
home to provide fewer hours of nursing care to intermediate care
residents of a nursing home than required by the present rules
of the commissioner if the commissioner determines that the
needs of the residents of the home will be adequately met by a
lesser amount of nursing care.
(b) A facility is not required to seek a waiver for room
furniture or equipment under paragraph (a) when responding to
resident-specific requests, if the facility has discussed health
and safety concerns with the resident and the resident request
and discussion of health and safety concerns are documented in
the resident's patient record.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 8. Minnesota Statutes 2002, section 144A.04, is
amended by adding a subdivision to read:
Subd. 11. [INCONTINENT RESIDENTS.] Notwithstanding
Minnesota Rules, part 4658.0520, an incontinent resident must be
checked according to a specific time interval written in the
resident's care plan. The resident's attending physician must
authorize in writing any interval longer than two hours unless
the resident, if competent, or a family member or legally
appointed conservator, guardian, or health care agent of a
resident who is not competent, agrees in writing to waive
physician involvement in determining this interval, and this
waiver is documented in the resident's care plan.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 9. Minnesota Statutes 2002, section 144A.071,
subdivision 4c, as added by Laws 2003, chapter 16, section 1, is
amended to read:
Subd. 4c. [EXCEPTIONS FOR REPLACEMENT BEDS AFTER JUNE 30,
2003.] (a) The commissioner of health, in coordination with the
commissioner of human services, may approve the renovation,
replacement, upgrading, or relocation of a nursing home or
boarding care home, under the following conditions:
(1) to license and certify an 80-bed city-owned facility in
Nicollet county to be constructed on the site of a new
city-owned hospital to replace an existing 85-bed facility
attached to a hospital that is also being replaced. The
threshold allowed for this project under section 144A.073 shall
be the maximum amount available to pay the additional medical
assistance costs of the new facility; and
(2) to license and certify 29 beds to be added to an
existing 69-bed facility in St. Louis county, provided that the
29 beds must be transferred from active or layaway status at an
existing facility in St. Louis county that had 235 beds on April
1, 2003.
The licensed capacity at the 235-bed facility must be reduced to
206 beds, but the payment rate at that facility shall not be
adjusted as a result of this transfer. The operating payment
rate of the facility adding beds after completion of this
project shall be the same as it was on the day prior to the day
the beds are licensed and certified. This project shall not
proceed unless it is approved and financed under the provisions
of section 144A.073.
(b) Projects approved under this subdivision shall be
treated in a manner equivalent to projects approved under
subdivision 4a.
Sec. 10. Minnesota Statutes 2002, section 144A.10, is
amended by adding a subdivision to read:
Subd. 16. [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a)
Notwithstanding subdivision 15, a facility certified under the
federal Medicare or Medicaid programs may request from the
commissioner, in writing, an independent informal dispute
resolution process regarding any deficiency citation issued to
the facility. The facility must specify in its written request
each deficiency citation that it disputes. The commissioner
shall provide a hearing under sections 14.57 to 14.62. Upon the
written request of the facility, the parties must submit the
issues raised to arbitration by an administrative law judge.
(b) Upon receipt of a written request for an arbitration
proceeding, the commissioner shall file with the office of
administrative hearings a request for the appointment of an
arbitrator and simultaneously serve the facility with notice of
the request. The arbitrator for the dispute shall be an
administrative law judge appointed by the office of
administrative hearings. The disclosure provisions of section
572.10 and the notice provisions of section 572.12 apply. The
facility and the commissioner have the right to be represented
by an attorney.
(c) The commissioner and the facility may present written
evidence, depositions, and oral statements and arguments at the
arbitration proceeding. Oral statements and arguments may be
made by telephone.
(d) Within ten working days of the close of the arbitration
proceeding, the administrative law judge shall issue findings
regarding each of the deficiencies in dispute. The findings
shall be one or more of the following:
(1) Supported in full. The citation is supported in full,
with no deletion of findings and no change in the scope or
severity assigned to the deficiency citation.
(2) Supported in substance. The citation is supported, but
one or more findings are deleted without any change in the scope
or severity assigned to the deficiency.
(3) Deficient practice cited under wrong requirement of
participation. The citation is amended by moving it to the
correct requirement of participation.
(4) Scope not supported. The citation is amended through a
change in the scope assigned to the citation.
(5) Severity not supported. The citation is amended
through a change in the severity assigned to the citation.
(6) No deficient practice. The citation is deleted because
the findings did not support the citation or the negative
resident outcome was unavoidable. The findings of the
arbitrator are not binding on the commissioner.
(e) The commissioner shall reimburse the office of
administrative hearings for the costs incurred by that office
for the arbitration proceeding. The facility shall reimburse
the commissioner for the proportion of the costs that represent
the sum of deficiency citations supported in full under
paragraph (d), clause (1), or in substance under paragraph (d),
clause (2), divided by the total number of deficiencies
disputed. A deficiency citation for which the administrative
law judge's sole finding is that the deficient practice was
cited under the wrong requirements of participation shall not be
counted in the numerator or denominator in the calculation of
the proportion of costs.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 11. [144A.351] [BALANCING LONG-TERM CARE: REPORT
REQUIRED.]
The commissioners of health and human services, with the
cooperation of counties and regional entities, shall prepare a
report to the legislature by January 15, 2004, and biennially
thereafter, regarding the status of the full range of long-term
care services for the elderly in Minnesota. The report shall
address:
(1) demographics and need for long-term care in Minnesota;
(2) summary of county and regional reports on long-term
care gaps, surpluses, imbalances, and corrective action plans;
(3) status of long-term care services by county and region
including:
(i) changes in availability of the range of long-term care
services and housing options;
(ii) access problems regarding long-term care; and
(iii) comparative measures of long-term care availability
and progress over time; and
(4) recommendations regarding goals for the future of
long-term care services, policy changes, and resource needs.
Sec. 12. Minnesota Statutes 2002, section 144A.4605,
subdivision 4, is amended to read:
Subd. 4. [LICENSE REQUIRED.] (a) A housing with services
establishment registered under chapter 144D that is required to
obtain a home care license must obtain an assisted living home
care license according to this section or a class A or class E
license according to rule. A housing with services
establishment that obtains a class E license under this
subdivision remains subject to the payment limitations in
sections 256B.0913, subdivision 5 5f, paragraph (h) (b), and
256B.0915, subdivision 3, paragraph (g) 3d.
(b) A board and lodging establishment registered for
special services as of December 31, 1996, and also registered as
a housing with services establishment under chapter 144D, must
deliver home care services according to sections 144A.43 to
144A.47, and may apply for a waiver from requirements under
Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a
licensed agency under the standards of section 157.17. Such
waivers as may be granted by the department will expire upon
promulgation of home care rules implementing section 144A.4605.
(c) An adult foster care provider licensed by the
department of human services and registered under chapter 144D
may continue to provide health-related services under its foster
care license until the promulgation of home care rules
implementing this section.
(d) An assisted living home care provider licensed under
this section must comply with the disclosure provisions of
section 325F.72 to the extent they are applicable.
Sec. 13. Minnesota Statutes 2002, section 256.9657,
subdivision 1, 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, 2002, the surcharge under
paragraph (b) shall be increased to $990.
(d) Effective July 15, 2003, the surcharge under paragraph
(c) shall be increased to $2,815.
(e) The commissioner may reduce, and may subsequently
restore, the surcharge under paragraph (d) based on the
commissioner's determination of a permissible surcharge.
(f) Between April 1, 2002, and August 15, 2003 2004, 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 June 30, 2003.
Sec. 14. Minnesota Statutes 2002, section 256.9657, is
amended by adding a subdivision to read:
Subd. 3a. [ICF/MR LICENSE SURCHARGE.] Effective July 1,
2003, each nonstate-operated facility as defined under section
256B.501, subdivision 1, shall pay to the commissioner an annual
surcharge according to the schedule in subdivision 4, paragraph
(d). The annual surcharge shall be $1,040 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 facility
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. The commissioner may reduce,
and may subsequently restore, the surcharge under this
subdivision based on the commissioner's determination of a
permissible surcharge.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 15. Minnesota Statutes 2002, section 256.9657,
subdivision 4, is amended to read:
Subd. 4. [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the
commissioner under subdivisions 1 to 3 must be paid in monthly
installments due on the 15th of the month beginning October 15,
1992. The monthly payment must be equal to the annual surcharge
divided by 12. Payments to the commissioner under subdivisions
2 and 3 for fiscal year 1993 must be based on calendar year 1990
revenues. Effective July 1 of each year, beginning in 1993,
payments under subdivisions 2 and 3 must be based on revenues
earned in the second previous calendar year.
(b) Effective October 1, 1995, and each October 1
thereafter, the payments in subdivisions 2 and 3 must be based
on revenues earned in the previous calendar year.
(c) If the commissioner of health does not provide by
August 15 of any year data needed to update the base year for
the hospital and health maintenance organization surcharges, the
commissioner of human services may estimate base year revenue
and use that estimate for the purposes of this section until
actual data is provided by the commissioner of health.
(d) Payments to the commissioner under subdivision 3a must
be paid in monthly installments due on the 15th of the month
beginning July 15, 2003. The monthly payment must be equal to
the annual surcharge divided by 12.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 16. Minnesota Statutes 2002, section 256B.056,
subdivision 6, is amended to read:
Subd. 6. [ASSIGNMENT OF BENEFITS.] To be eligible for
medical assistance a person must have applied or must agree to
apply all proceeds received or receivable by the person or the
person's spouse legal representative from any third person party
liable for the costs of medical care for the person, the spouse,
and children. The state agency shall require from any applicant
or recipient of medical assistance the assignment of any rights
to medical support and third party payments. By accepting or
receiving assistance, the person is deemed to have assigned the
person's rights to medical support and third party payments as
required by Title 19 of the Social Security Act. Persons must
cooperate with the state in establishing paternity and obtaining
third party payments. By signing an application for accepting
medical assistance, a person assigns to the department of human
services all rights the person may have to medical support or
payments for medical expenses from any other person or entity on
their own or their dependent's behalf and agrees to cooperate
with the state in establishing paternity and obtaining third
party payments. Any rights or amounts so assigned shall be
applied against the cost of medical care paid for under this
chapter. Any assignment takes effect upon the determination
that the applicant is eligible for medical assistance and up to
three months prior to the date of application if the applicant
is determined eligible for and receives medical assistance
benefits. The application must contain a statement explaining
this assignment. Any assignment shall not be effective as to
benefits paid or provided under automobile accident coverage and
private health care coverage prior to notification of the
assignment by the person or organization providing the
benefits. For the purposes of this section, "the department of
human services or the state" includes prepaid health plans under
contract with the commissioner according to sections 256B.031,
256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12;
children's mental health collaboratives under section 245.493;
demonstration projects for persons with disabilities under
section 256B.77; nursing facilities under the alternative
payment demonstration project under section 256B.434; and the
county-based purchasing entities under section 256B.692.
Sec. 17. Minnesota Statutes 2002, section 256B.064,
subdivision 2, is amended to read:
Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.]
(a) The commissioner shall determine any monetary amounts to be
recovered and sanctions to be imposed upon a vendor of medical
care under this section. Except as provided in
paragraph paragraphs (b) and (d), neither a monetary recovery
nor a sanction will be imposed by the commissioner without prior
notice and an opportunity for a hearing, according to chapter
14, on the commissioner's proposed action, provided that the
commissioner may suspend or reduce payment to a vendor of
medical care, except a nursing home or convalescent care
facility, after notice and prior to the hearing if in the
commissioner's opinion that action is necessary to protect the
public welfare and the interests of the program.
(b) Except for a nursing home or convalescent care
facility, the commissioner may withhold or reduce payments to a
vendor of medical care without providing advance notice of such
withholding or reduction if either of the following occurs:
(1) the vendor is convicted of a crime involving the
conduct described in subdivision 1a; or
(2) the commissioner receives reliable evidence of fraud or
willful misrepresentation by the vendor.
(c) The commissioner must send notice of the withholding or
reduction of payments under paragraph (b) within five days of
taking such action. The notice must:
(1) state that payments are being withheld according to
paragraph (b);
(2) except in the case of a conviction for conduct
described in subdivision 1a, state that the withholding is for a
temporary period and cite the circumstances under which
withholding will be terminated;
(3) identify the types of claims to which the withholding
applies; and
(4) inform the vendor of the right to submit written
evidence for consideration by the commissioner.
The withholding or reduction of payments will not continue
after the commissioner determines there is insufficient evidence
of fraud or willful misrepresentation by the vendor, or after
legal proceedings relating to the alleged fraud or willful
misrepresentation are completed, unless the commissioner has
sent notice of intention to impose monetary recovery or
sanctions under paragraph (a).
(d) The commissioner may suspend or terminate a vendor's
participation in the program without providing advance notice
and an opportunity for a hearing when the suspension or
termination is required because of the vendor's exclusion from
participation in Medicare. Within five days of taking such
action, the commissioner must send notice of the suspension or
termination. The notice must:
(1) state that suspension or termination is the result of
the vendor's exclusion from Medicare;
(2) identify the effective date of the suspension or
termination;
(3) inform the vendor of the need to be reinstated to
Medicare before reapplying for participation in the program; and
(4) inform the vendor of the right to submit written
evidence for consideration by the commissioner.
(e) Upon receipt of a notice under paragraph (a) that a
monetary recovery or sanction is to be imposed, a vendor may
request a contested case, as defined in section 14.02,
subdivision 3, by filing with the commissioner a written request
of appeal. The appeal request must be received by the
commissioner no later than 30 days after the date the
notification of monetary recovery or sanction was mailed to the
vendor. The appeal request must specify:
(1) each disputed item, the reason for the dispute, and an
estimate of the dollar amount involved for each disputed item;
(2) the computation that the vendor believes is correct;
(3) the authority in statute or rule upon which the vendor
relies for each disputed item;
(4) the name and address of the person or entity with whom
contacts may be made regarding the appeal; and
(5) other information required by the commissioner.
Sec. 18. Minnesota Statutes 2002, section 256B.0913,
subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care
services are available to Minnesotans age 65 or older who are
not eligible for medical assistance without a spenddown or
waiver obligation but who would be eligible for medical
assistance within 180 days of admission to a nursing facility
and subject to subdivisions 4 to 13.
Sec. 19. Minnesota Statutes 2002, 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 monthly limit described under section 256B.0915,
subdivision 3a. 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.;
and
(7) the person is making timely payments of the assessed
monthly fee.
A person is ineligible if payment of the fee is over 60 days
past due, unless the person agrees to:
(i) the appointment of a representative payee;
(ii) automatic payment from a financial account;
(iii) the establishment of greater family involvement in
the financial management of payments; or
(iv) another method acceptable to the county to ensure
prompt fee payments.
The county shall extend the client's eligibility as
necessary while making arrangements to facilitate payment of
past-due amounts and future premium payments. Following
disenrollment due to nonpayment of a monthly fee, eligibility
shall not be reinstated for a period of 30 days.
(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 and the elderly waiver program 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: (i) is payable by medical assistance or
which; (ii) is used by a recipient to meet a medical assistance
income spenddown or waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program
under the special income standard provision.
(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 for a nursing home resident or
certified boarding care home resident to assist with a
relocation process to a community-based setting.
(d) Alternative care funding is not available for a person
whose income is greater than the maintenance needs allowance
under section 256B.0915, subdivision 1d, but equal to or less
than 120 percent of the federal poverty guideline effective July
1, in the year for which alternative care eligibility is
determined, who would be eligible for the elderly waiver with a
waiver obligation.
Sec. 20. Minnesota Statutes 2002, 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) nursing services;
(14) chore services;
(15) companion services;
(16) nutrition services;
(17) training for direct informal caregivers;
(18) telehome care devices to monitor recipients provide
services in their own homes as an alternative to hospital care,
nursing home care, or home in conjunction with in-home visits;
(19) other services which includes discretionary funds and
direct cash payments to clients, services, for which counties
may make payment from their alternative care program allocation
or services not otherwise defined in this section or section
256B.0625, 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
25 percent of that county's annual alternative care program base
allocation; and
(20) environmental modifications.; and
(21) direct cash payments for which counties may make
payment from their alternative care program allocation to
clients for the purpose of purchasing services, following
approval by the commissioner, and subject to the provisions of
subdivision 5h, until approval and implementation of
consumer-directed services through the federally approved
elderly waiver plan. Upon implementation, consumer-directed
services under the alternative care program are available
statewide and limited to the average monthly expenditures
representative of all alternative care program participants for
the same case mix resident class assigned in the most recent
fiscal year for which complete expenditure data is available.
Total annual payments for discretionary services and direct
cash payments, until the federally approved consumer-directed
service option is implemented statewide, for all clients within
a county may not exceed 25 percent of that county's annual
alternative care program base allocation. Thereafter,
discretionary services are limited to 25 percent of the county's
annual alternative care program base allocation.
Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE
STANDARDS.] (a) 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 transitional support services.
(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.
(c) 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 requirements or a relative
who meets the criteria and is also the responsible party under
an individual service plan that ensures the client's health and
safety and supervision of the personal care services by a
qualified professional as defined in section 256B.0625,
subdivision 19c. Relative hardship is established by the county
when the client's care causes a relative caregiver to do any of
the following: resign from a paying job, reduce work hours
resulting in lost wages, obtain a leave of absence resulting in
lost wages, incur substantial client-related expenses, provide
services to address authorized, unstaffed direct care time, or
meet special needs of the client unmet in the formal service
plan.
(d) Subd. 5b. [ADULT FOSTER CARE RATE.] 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 qualified professional as
defined in section 256B.0625, subdivision 19c.
(f) Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE
SERVICES; HEALTH-RELATED SERVICES.] 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 under section 157.16, and are registered
with the department of health as providing special services
under section 157.17 and are not subject to registration except
settings that are currently registered 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
services as defined in section 157.17, subdivision 1, paragraph
(a). "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 means services covered in section 157.17, subdivision
1, paragraph (b). Individuals receiving residential care
services cannot receive homemaking services funded under this
section.
(g) Subd. 5d. [ASSISTED LIVING SERVICES.] 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, and supportive
services as defined in clause (1) section 157.17, subdivision 1,
paragraph (a), individualized home care aide tasks as defined in
clause (2) Minnesota Rules, part 4668.0110, and individualized
home management tasks as defined in clause (3) Minnesota Rules,
part 4668.0120 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.
Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a)
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) (b) For establishments registered under chapter 144D,
assisted living services under this section means either the
services described in paragraph (g) subdivision 5d 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) Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES
AND RESIDENTIAL CARE.] (a) 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) (b) The individualized monthly negotiated payment for
assisted living services as described in paragraph
(g) subdivision 5d or (h) 5e, paragraph (b), and residential
care services as described in paragraph (f) subdivision 5c,
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 groups according to subdivision 4, paragraph
(a), clause (6).
(2) (c) 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) Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.]
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 subdivision:
(1) a cash payment to a client under this provision cannot
exceed the monthly payment limit for that client as specified in
subdivision 4, paragraph (a), clause (6); and
(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) Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) 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) (1) they must be over and above the normal cost of
caring for the person if the person did not have functional
limitations;
(ii) (2) they must be directly attributable to the person's
functional limitations;
(iii) (3) they must have the potential to be effective at
meeting the goals of the program; and
(iv) (4) 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) (b) 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;.
(c) Persons receiving grants under this section shall have
the following responsibilities:
(1) spend the grant money in a manner consistent with their
individualized service plan with the local agency;
(2) notify the local agency of any necessary changes in the
grant expenditures;
(3) arrange and pay for supports; and
(4) inform the local agency of areas where they have
experienced difficulty securing or maintaining supports.
(d) The county shall report client outcomes, services, and
costs under this paragraph in a manner prescribed by the
commissioner.
(4) Subd. 5i. [IMMUNITY.] 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.
Sec. 21. Minnesota Statutes 2002, section 256B.0913,
subdivision 6, is amended to read:
Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a)
The alternative care program is administered by the county
agency. This agency is the lead agency responsible for the
local administration of the alternative care program as
described in this section. However, it may contract with the
public health nursing service to be the lead agency. The
commissioner may contract with federally recognized Indian
tribes with a reservation in Minnesota to serve as the lead
agency responsible for the local administration of the
alternative care program as described in the contract.
(b) Alternative care pilot projects operate according to
this section and the provisions of Laws 1993, First Special
Session chapter 1, article 5, section 133, under agreement with
the commissioner. Each pilot project agreement period shall
begin no later than the first payment cycle of the state fiscal
year and continue through the last payment cycle of the state
fiscal year.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 22. Minnesota Statutes 2002, section 256B.0913,
subdivision 7, is amended to read:
Subd. 7. [CASE MANAGEMENT.] Providers of case management
services for persons receiving services funded by the
alternative care program must meet the qualification
requirements and standards specified in section 256B.0915,
subdivision 1b. The case manager must not approve alternative
care funding for a client in any setting in which the case
manager cannot reasonably ensure the client's health and
safety. The case manager is responsible for the
cost-effectiveness of the alternative care individual care plan
and must not approve any care plan in which the cost of services
funded by alternative care and client contributions exceeds the
limit specified in section 256B.0915, subdivision 3, paragraph
(b). The county may allow a case manager employed by the county
to delegate certain aspects of the case management activity to
another individual employed by the county provided there is
oversight of the individual by the case manager. The case
manager may not delegate those aspects which require
professional judgment including assessments, reassessments, and
care plan development.
Sec. 23. Minnesota Statutes 2002, 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, including qualified case management or service
coordination providers other than those employed by the lead
agency when the lead agency maintains responsibility for prior
authorizing services in accordance with statutory and
administrative requirements. The case manager must give the
individual a ten-day written notice of any 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.
[EFFECTIVE DATE.] This section is effective July 1, 2005.
Sec. 24. Minnesota Statutes 2002, 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. 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).
(f) On agreement between the commissioner and the lead
agency, the commissioner may have discretion to reallocate
alternative care base allocations distributed to lead agencies
in which the base amount exceeds program expenditures.
Sec. 25. Minnesota Statutes 2002, section 256B.0913,
subdivision 12, is amended to read:
Subd. 12. [CLIENT PREMIUMS FEES.] (a) A premium fee is
required for all alternative care eligible clients to help pay
for the cost of participating in the program. The amount of the
premium fee 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 150 100
percent of the federal poverty guideline effective on July 1 of
the state fiscal year in which the premium fee 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 equal to or
greater than 100 percent but less than 150 percent of the
federal poverty guideline effective on July 1 of the state
fiscal year in which the premium fee is being computed, and
total assets are less than $10,000, the fee is 25 five 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 income less recurring and predictable medical expenses
is equal to or greater than 150 percent but less than 200
percent of the federal poverty guidelines effective on July 1 of
the state fiscal year in which the fee is being computed and
assets are less than $10,000, the fee is 25 15 percent of the
cost of alternative care services;
(4) when the alternative care client's income less
recurring and predictable medical expenses is equal to or
greater than 200 percent of the federal poverty guidelines
effective on July 1 of the state fiscal year in which the fee is
being computed and assets are less than $10,000, the fee is 30
percent of the cost of alternative care services; and
(5) when the alternative care client's assets are equal to
or greater than $10,000, the fee is 30 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 fee.
Premiums Fees are due and payable each month alternative
care services are received unless the actual cost of the
services is less than the premium fee, in which case the fee is
the lesser amount.
(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) (3) 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
(4) a person has chosen to participate in a
consumer-directed service plan for which the cost is no greater
than the total cost of the person's alternative care service
plan less the monthly fee amount that would otherwise be
assessed.
(c) The county agency must record in the state's receivable
system the client's assessed premium fee amount or the reason
the premium fee has been waived. The commissioner will bill and
collect the premium fee 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 fee
from the client. The commissioner shall collect unpaid premiums
fees 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 fee 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 fees billed to clients;
(2) total collections of premiums fees billed; and
(3) balance of premiums fees 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.
Sec. 26. Minnesota Statutes 2002, 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) Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) 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) (b) 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) (a), 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) (a).
(d) Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS
WHO RESIDE IN A NURSING FACILITY.] (a) 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 subdivision 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.
(b) 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) Subd. 3c. [SERVICE APPROVAL AND CONTRACTING
PROVISIONS.] (a) 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) (b) A county is not required to contract with a
provider of supplies and equipment if the monthly cost of the
supplies and equipment is less than $250.
(g) Subd. 3d. [ADULT FOSTER CARE RATE.] 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 subdivision 3a, paragraph (b) (a).
(h) Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) 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) (b) The individualized monthly negotiated payment for
assisted living services as described in section 256B.0913,
subdivision 5, paragraph (g) or (h) subdivisions 5d to 5f, and
residential care services as described in section 256B.0913,
subdivision 5, paragraph (f) 5c, 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) (c) 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) subdivision 3a.
(i) Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE
FORECASTS.] (a) 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) (b) 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) Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF
COSTS.] (a) 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) (b) Effective July 1, 2001, for service rate limits,
except those described or defined in paragraphs (g) and
(h) subdivisions 3d and 3e, 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) (c) Counties may negotiate individual service rates
with vendors for actual costs up to the statewide maximum
service rate limit.
Sec. 27. Minnesota Statutes 2002, section 256B.15,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] For purposes of this section,
"medical assistance" includes the medical assistance program
under this chapter and the general assistance medical care
program under chapter 256D, but does not include the alternative
care program for nonmedical assistance recipients under section
256B.0913, subdivision 4 and alternative care for nonmedical
assistance recipients under section 256B.0913.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for decedents dying on or after that date.
Sec. 28. Minnesota Statutes 2002, section 256B.15,
subdivision 1a, is amended to read:
Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person
receives any medical assistance hereunder, on the person's
death, if single, or on the death of the survivor of a married
couple, either or both of whom received medical assistance, or
as otherwise provided for in this section, the total amount paid
for medical assistance rendered for the person and spouse shall
be filed as a claim against the estate of the person or the
estate of the surviving spouse in the court having jurisdiction
to probate the estate or to issue a decree of descent according
to sections 525.31 to 525.313.
A claim shall be filed if medical assistance was rendered
for either or both persons under one of the following
circumstances:
(a) the person was over 55 years of age, and received
services under this chapter, excluding alternative care;
(b) the person resided in a medical institution for six
months or longer, received services under this chapter excluding
alternative care, and, at the time of institutionalization or
application for medical assistance, whichever is later, the
person could not have reasonably been expected to be discharged
and returned home, as certified in writing by the person's
treating physician. For purposes of this section only, a
"medical institution" means a skilled nursing facility,
intermediate care facility, intermediate care facility for
persons with mental retardation, nursing facility, or inpatient
hospital; or
(c) the person received general assistance medical care
services under chapter 256D.
The claim shall be considered an expense of the last
illness of the decedent for the purpose of section 524.3-805.
Any statute of limitations that purports to limit any county
agency or the state agency, or both, to recover for medical
assistance granted hereunder shall not apply to any claim made
hereunder for reimbursement for any medical assistance granted
hereunder. Notice of the claim shall be given to all heirs and
devisees of the decedent whose identity can be ascertained with
reasonable diligence. The notice must include procedures and
instructions for making an application for a hardship waiver
under subdivision 5; time frames for submitting an application
and determination; and information regarding appeal rights and
procedures. Counties are entitled to one-half of the nonfederal
share of medical assistance collections from estates that are
directly attributable to county effort. Counties are entitled
to ten percent of the collections for alternative care directly
attributable to county effort.
[EFFECTIVE DATE.] The amendments in this section relating
to the alternative care program are effective July 1, 2003, and
apply to the estates of decedents who die on or after that
date. The remaining amendments in this section are effective
August 1, 2003, and apply to the estates of decedents who die on
and after that date.
Sec. 29. Minnesota Statutes 2002, section 256B.15,
subdivision 2, is amended to read:
Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include
only the total amount of medical assistance rendered after age
55 or during a period of institutionalization described in
subdivision 1a, clause (b), and the total amount of general
assistance medical care rendered, and shall not include
interest. Claims that have been allowed but not paid shall bear
interest according to section 524.3-806, paragraph (d). A claim
against the estate of a surviving spouse who did not receive
medical assistance, for medical assistance rendered for the
predeceased spouse, is limited to the value of the assets of the
estate that were marital property or jointly owned property at
any time during the marriage. Claims for alternative care shall
be net of all premiums paid under section 256B.0913, subdivision
12, on or after July 1, 2003, and shall be limited to services
provided on or after July 1, 2003.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for decedents dying on or after that date.
Sec. 30. Minnesota Statutes 2002, section 256B.431,
subdivision 2r, is amended to read:
Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective
July 1, 1993, the commissioner shall limit payment for leave
days in a nursing facility to 79 percent of that nursing
facility's total payment rate for the involved resident. For
services rendered on or after July 1, 2003, for facilities
reimbursed under this section or section 256B.434, the
commissioner shall limit payment for leave days in a nursing
facility to 60 percent of that nursing facility's total payment
rate for the involved resident.
Sec. 31. Minnesota Statutes 2002, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2t. [PAYMENT LIMITATION.] For services rendered on
or after July 1, 2003, for facilities reimbursed under this
section or section 256B.434, the Medicaid program shall only pay
a co-payment during a Medicare-covered skilled nursing facility
stay if the Medicare rate less the resident's co-payment
responsibility is less than the Medicaid RUG-III case-mix
payment rate. The amount that shall be paid by the Medicaid
program is equal to the amount by which the Medicaid RUG-III
case-mix payment rate exceeds the Medicare rate less the
co-payment responsibility. Health plans paying for nursing home
services under section 256B.69, subdivision 6a, may limit
payments as allowed under this subdivision.
Sec. 32. Minnesota Statutes 2002, section 256B.431,
subdivision 32, is amended to read:
Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate
years beginning on or after July 1, 2001, the total payment rate
for a facility reimbursed under this section, section 256B.434,
or any other section for the first 90 paid days after admission
shall be:
(1) for the first 30 paid days, the rate shall be 120
percent of the facility's medical assistance rate for each case
mix class; and
(2) for the next 60 paid days after the first 30 paid days,
the rate shall be 110 percent of the facility's medical
assistance rate for each case mix class.;
(b) (3) beginning with the 91st paid day after admission,
the payment rate shall be the rate otherwise determined under
this section, section 256B.434, or any other section.; and
(c) (4) payments under this subdivision applies paragraph
apply to admissions occurring on or after July 1, 2001, and
before July 1, 2003, and to resident days occurring before July
30, 2003.
(b) For rate years beginning on or after July 1, 2003, the
total payment rate for a facility reimbursed under this section,
section 256B.434, or any other section shall be:
(1) for the first 30 calendar days after admission, the
rate shall be 120 percent of the facility's medical assistance
rate for each RUG class;
(2) beginning with the 31st calendar day after admission,
the payment rate shall be the rate otherwise determined under
this section, section 256B.434, or any other section; and
(3) payments under this paragraph apply to admissions
occurring on or after July 1, 2003.
(c) Effective January 1, 2004, the enhanced rates under
this subdivision shall not be allowed if a resident has resided
during the previous 30 calendar days in:
(1) the same nursing facility;
(2) a nursing facility owned or operated by a related
party; or
(3) a nursing facility or part of a facility that closed.
Sec. 33. Minnesota Statutes 2002, section 256B.431,
subdivision 36, is amended to read:
Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN
ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July
1, 2001, and June 30, 2003, the commissioner shall provide to
each nursing facility reimbursed under this section, section
256B.434, or any other section, a scholarship per diem of 25
cents to the total operating payment rate to be used:
(1) for employee scholarships that satisfy the following
requirements:
(i) scholarships are available to all employees who work an
average of at least 20 hours per week at the facility except the
administrator, department supervisors, and registered nurses;
and
(ii) the course of study is expected to lead to career
advancement with the facility or in long-term care, including
medical care interpreter services and social work; and
(2) to provide job-related training in English as a second
language.
(b) A facility receiving a rate adjustment under this
subdivision may submit to the commissioner on a schedule
determined by the commissioner and on a form supplied by the
commissioner a calculation of the scholarship per diem,
including: the amount received from this rate adjustment; the
amount used for training in English as a second language; the
number of persons receiving the training; the name of the person
or entity providing the training; and for each scholarship
recipient, the name of the recipient, the amount awarded, the
educational institution attended, the nature of the educational
program, the program completion date, and a determination of the
per diem amount of these costs based on actual resident days.
(c) On July 1, 2003, the commissioner shall remove the 25
cent scholarship per diem from the total operating payment rate
of each facility.
(d) For rate years beginning after June 30, 2003, the
commissioner shall provide to each facility the scholarship per
diem determined in paragraph (b). In calculating the per diem
under paragraph (b), the commissioner shall allow only costs
related to tuition and direct educational expenses.
Sec. 34. Minnesota Statutes 2002, section 256B.431, is
amended by adding a subdivision to read:
Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL
YEAR 2003.] Effective June 1, 2003, the commissioner shall
provide to each nursing home reimbursed under this section or
section 256B.434, an increase in each case mix payment rate
equal to the increase in the per-bed surcharge paid under
section 256.9657, subdivision 1, paragraph (d), divided by 365
and further divided by .90. The increase shall not be subject
to any annual percentage increase. The 30-day advance notice
requirement in section 256B.47, subdivision 2, shall not apply
to rate increases resulting from this section. The commissioner
shall not adjust the rate increase under this subdivision unless
the adjustment is greater than 1.5 percent of the monthly
surcharge payment amount under section 256.9657, subdivision 4.
[EFFECTIVE DATE.] This section is effective May 31, 2003.
Sec. 35. Minnesota Statutes 2002, section 256B.431, is
amended by adding a subdivision to read:
Subd. 39. [FACILITY RATES BEGINNING ON OR AFTER JULY 1,
2003.] For rate years beginning on or after July 1, 2003,
nursing facilities reimbursed under this section shall have
their July 1 operating payment rate be equal to their operating
payment rate in effect on the prior June 30th.
Sec. 36. Minnesota Statutes 2002, section 256B.434,
subdivision 4, is amended to read:
Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For
nursing facilities which have their payment rates determined
under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The
nursing facility must enter into a written contract with the
commissioner.
(b) A nursing facility's case mix payment rate for the
first rate year of a facility's contract under this section is
the payment rate the facility would have received under section
256B.431.
(c) A nursing facility's case mix payment rates for the
second and subsequent years of a facility's contract under this
section are the previous rate year's contract payment rates plus
an inflation adjustment and, for facilities reimbursed under
this section or section 256B.431, an adjustment to include the
cost of any increase in health department licensing fees for the
facility taking effect on or after July 1, 2001. The index for
the inflation adjustment must be based on the change in the
Consumer Price Index-All Items (United States City average)
(CPI-U) forecasted by Data Resources, Inc. the commissioner of
finance's national economic consultant, as forecasted in the
fourth quarter of the calendar year preceding the rate year.
The inflation adjustment must be based on the 12-month period
from the midpoint of the previous rate year to the midpoint of
the rate year for which the rate is being determined. For the
rate years beginning on July 1, 1999, July 1, 2000, July 1,
2001, and July 1, 2002, July 1, 2003, and July 1, 2004, this
paragraph shall apply only to the property-related payment rate,
except that adjustments to include the cost of any increase in
health department licensing fees taking effect on or after July
1, 2001, shall be provided. In determining the amount of the
property-related payment rate adjustment under this paragraph,
the commissioner shall determine the proportion of the
facility's rates that are property-related based on the
facility's most recent cost report.
(d) The commissioner shall develop additional
incentive-based payments of up to five percent above the
standard contract rate for achieving outcomes specified in each
contract. The specified facility-specific outcomes must be
measurable and approved by the commissioner. The commissioner
may establish, for each contract, various levels of achievement
within an outcome. After the outcomes have been specified the
commissioner shall assign various levels of payment associated
with achieving the outcome. Any incentive-based payment cancels
if there is a termination of the contract. In establishing the
specified outcomes and related criteria the commissioner shall
consider the following state policy objectives:
(1) improved cost effectiveness and quality of life as
measured by improved clinical outcomes;
(2) successful diversion or discharge to community
alternatives;
(3) decreased acute care costs;
(4) improved consumer satisfaction;
(5) the achievement of quality; or
(6) any additional outcomes proposed by a nursing facility
that the commissioner finds desirable.
Sec. 37. Minnesota Statutes 2002, section 256B.434,
subdivision 10, is amended to read:
Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by
federal law, (1) a facility that has entered into a contract
under this section is not required to file a cost report, as
defined in Minnesota Rules, part 9549.0020, subpart 13, for any
year after the base year that is the basis for the calculation
of the contract payment rate for the first rate year of the
alternative payment demonstration project contract; and (2) a
facility under contract is not subject to audits of historical
costs or revenues, or paybacks or retroactive adjustments based
on these costs or revenues, except audits, paybacks, or
adjustments relating to the cost report that is the basis for
calculation of the first rate year under the contract.
(b) A facility that is under contract with the commissioner
under this section is not subject to the moratorium on licensure
or certification of new nursing home beds in section 144A.071,
unless the project results in a net increase in bed capacity or
involves relocation of beds from one site to another. Contract
payment rates must not be adjusted to reflect any additional
costs that a nursing facility incurs as a result of a
construction project undertaken under this paragraph. In
addition, as a condition of entering into a contract under this
section, a nursing facility must agree that any future medical
assistance payments for nursing facility services will not
reflect any additional costs attributable to the sale of a
nursing facility under this section and to construction
undertaken under this paragraph that otherwise would not be
authorized under the moratorium in section 144A.073. Nothing in
this section prevents a nursing facility participating in the
alternative payment demonstration project under this section
from seeking approval of an exception to the moratorium through
the process established in section 144A.073, and if approved the
facility's rates shall be adjusted to reflect the cost of the
project. Nothing in this section prevents a nursing facility
participating in the alternative payment demonstration project
from seeking legislative approval of an exception to the
moratorium under section 144A.071, and, if enacted, the
facility's rates shall be adjusted to reflect the cost of the
project.
(c) Notwithstanding section 256B.48, subdivision 6,
paragraphs (c), (d), and (e), and pursuant to any terms and
conditions contained in the facility's contract, a nursing
facility that is under contract with the commissioner under this
section is in compliance with section 256B.48, subdivision 6,
paragraph (b), if the facility is Medicare certified.
(d) Notwithstanding paragraph (a), if by April 1, 1996, the
health care financing administration has not approved a required
waiver, or the Centers for Medicare and Medicaid Services
otherwise requires cost reports to be filed prior to the
waiver's approval, the commissioner shall require a cost report
for the rate year.
(e) A facility that is under contract with the commissioner
under this section shall be allowed to change therapy
arrangements from an unrelated vendor to a related vendor during
the term of the contract. The commissioner may develop
reasonable requirements designed to prevent an increase in
therapy utilization for residents enrolled in the medical
assistance program.
(f) Nursing facilities participating in the alternative
payment system demonstration project must either participate in
the alternative payment system quality improvement program
established by the commissioner or submit information on their
own quality improvement process to the commissioner for
approval. Nursing facilities that have had their own quality
improvement process approved by the commissioner must report
results for at least one key area of quality improvement
annually to the commissioner.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 38. Minnesota Statutes 2002, section 256B.5012, is
amended by adding a subdivision to read:
Subd. 5. [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate
periods beginning on or after June 1, 2003, the commissioner
shall increase the total operating payment rate for each
facility reimbursed under this section by $3 per day. The
increase shall not be subject to any annual percentage increase.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 39. Minnesota Statutes 2002, 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 Centers for Medicare and Medicaid
Services' common procedural coding system 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 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. 40. Minnesota Statutes 2002, section 256B.761, is
amended to read:
256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.]
(a) Effective for services rendered on or after July 1,
2001, payment for medication management provided to psychiatric
patients, outpatient mental health services, day treatment
services, home-based mental health services, and family
community support services shall be paid at the lower of (1)
submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.
(b) 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.
Sec. 41. Minnesota Statutes 2002, section 256D.03,
subdivision 3a, is amended to read:
Subd. 3a. [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be
filed pursuant to section 256D.16. General assistance medical
care applicants and recipients must apply or agree to apply
third party health and accident benefits to the costs of medical
care. They must cooperate with the state in establishing
paternity and obtaining third party payments. By signing an
application for accepting general assistance, a person assigns
to the department of human services all rights to medical
support or payments for medical expenses from another person or
entity on their own or their dependent's behalf and agrees to
cooperate with the state in establishing paternity and obtaining
third party payments. The application shall contain a statement
explaining the assignment. Any rights or amounts assigned shall
be applied against the cost of medical care paid for under this
chapter. An assignment is effective on the date general
assistance medical care eligibility takes effect. The
assignment shall not affect benefits paid or provided under
automobile accident coverage and private health care coverage
until the person or organization providing the benefits has
received notice of the assignment.
Sec. 42. Minnesota Statutes 2002, section 256I.02, is
amended to read:
256I.02 [PURPOSE.]
The Group Residential Housing Act establishes a
comprehensive system of rates and payments for persons who
reside in a group residence the community and who meet the
eligibility criteria under section 256I.04, subdivision 1.
Sec. 43. Minnesota Statutes 2002, section 256I.04,
subdivision 3, is amended to read:
Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP
RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter
into agreements for new group residential housing beds with
total rates in excess of the MSA equivalent rate except: (1)
for group residential housing establishments meeting the
requirements of subdivision 2a, clause (2) with department
approval; (2) for group residential housing establishments
licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
provided the facility is needed to meet the census reduction
targets for persons with mental retardation or related
conditions at regional treatment centers; (3) (2) to ensure
compliance with the federal Omnibus Budget Reconciliation Act
alternative disposition plan requirements for inappropriately
placed persons with mental retardation or related conditions or
mental illness; (4) (3) up to 80 beds in a single, specialized
facility located in Hennepin county that will provide housing
for chronic inebriates who are repetitive users of
detoxification centers and are refused placement in emergency
shelters because of their state of intoxication, and planning
for the specialized facility must have been initiated before
July 1, 1991, in anticipation of receiving a grant from the
housing finance agency under section 462A.05, subdivision 20a,
paragraph (b); (5) (4) notwithstanding the provisions of
subdivision 2a, for up to 190 supportive housing units in Anoka,
Dakota, Hennepin, or Ramsey county for homeless adults with a
mental illness, a history of substance abuse, or human
immunodeficiency virus or acquired immunodeficiency syndrome.
For purposes of this section, "homeless adult" means a person
who is living on the street or in a shelter or discharged from a
regional treatment center, community hospital, or residential
treatment program and has no appropriate housing available and
lacks the resources and support necessary to access appropriate
housing. At least 70 percent of the supportive housing units
must serve homeless adults with mental illness, substance abuse
problems, or human immunodeficiency virus or acquired
immunodeficiency syndrome who are about to be or, within the
previous six months, has been discharged from a regional
treatment center, or a state-contracted psychiatric bed in a
community hospital, or a residential mental health or chemical
dependency treatment program. If a person meets the
requirements of subdivision 1, paragraph (a), and receives a
federal or state housing subsidy, the group residential housing
rate for that person is limited to the supplementary rate under
section 256I.05, subdivision 1a, and is determined by
subtracting the amount of the person's countable income that
exceeds the MSA equivalent rate from the group residential
housing supplementary rate. A resident in a demonstration
project site who no longer participates in the demonstration
program shall retain eligibility for a group residential housing
payment in an amount determined under section 256I.06,
subdivision 8, using the MSA equivalent rate. Service funding
under section 256I.05, subdivision 1a, will end June 30, 1997,
if federal matching funds are available and the services can be
provided through a managed care entity. If federal matching
funds are not available, then service funding will continue
under section 256I.05, subdivision 1a; or (6) for group
residential housing beds in settings meeting the requirements of
subdivision 2a, clauses (1) and (3), which are used exclusively
for recipients receiving home and community-based waiver
services under sections 256B.0915, 256B.092, subdivision 5,
256B.093, and 256B.49, and who resided in a nursing facility for
the six months immediately prior to the month of entry into the
group residential housing setting. The group residential
housing rate for these beds must be set so that the monthly
group residential housing payment for an individual occupying
the bed when combined with the nonfederal share of services
delivered under the waiver for that person does not exceed the
nonfederal share of the monthly medical assistance payment made
for the person to the nursing facility in which the person
resided prior to entry into the group residential housing
establishment. The rate may not exceed the MSA equivalent rate
plus $426.37 for any case.
(b) A county agency may enter into a group residential
housing agreement for beds with rates in excess of the MSA
equivalent rate in addition to those currently covered under a
group residential housing agreement if the additional beds are
only a replacement of beds with rates in excess of the MSA
equivalent rate which have been made available due to closure of
a setting, a change of licensure or certification which removes
the beds from group residential housing payment, or as a result
of the downsizing of a group residential housing setting. The
transfer of available beds from one county to another can only
occur by the agreement of both counties.
Sec. 44. Minnesota Statutes 2002, section 256I.05,
subdivision 1, is amended to read:
Subdivision 1. [MAXIMUM RATES.] (a) Monthly room and board
rates negotiated by a county agency for a recipient living in
group residential housing must not exceed the MSA equivalent
rate specified under section 256I.03, subdivision 5,. with the
exception that a county agency may negotiate a supplementary
room and board rate that exceeds the MSA equivalent rate for
recipients of waiver services under title XIX of the Social
Security Act. This exception is subject to the following
conditions:
(1) the setting is licensed by the commissioner of human
services under Minnesota Rules, parts 9555.5050 to 9555.6265;
(2) the setting is not the primary residence of the license
holder and in which the license holder is not the primary
caregiver; and
(3) the average supplementary room and board rate in a
county for a calendar year may not exceed the average
supplementary room and board rate for that county in effect on
January 1, 2000. For calendar years beginning on or after
January 1, 2002, within the limits of appropriations
specifically for this purpose, the commissioner shall increase
each county's supplemental room and board rate average on an
annual basis by a factor consisting of the percentage change in
the Consumer Price Index-All items, United States city average
(CPI-U) for that calendar year compared to the preceding
calendar year as forecasted by Data Resources, Inc., in the
third quarter of the preceding calendar year. If a county has
not negotiated supplementary room and board rates for any
facilities located in the county as of January 1, 2000, or has
an average supplemental room and board rate under $100 per
person as of January 1, 2000, it may submit a supplementary room
and board rate request with budget information for a facility to
the commissioner for approval.
The county agency may at any time negotiate a higher or lower
room and board rate than the average supplementary room and
board rate.
(b) Notwithstanding paragraph (a), clause (3), county
agencies may negotiate a supplementary room and board rate that
exceeds the MSA equivalent rate by up to $426.37 for up to five
facilities, serving not more than 20 individuals in total, that
were established to replace an intermediate care facility for
persons with mental retardation and related conditions located
in the city of Roseau that became uninhabitable due to flood
damage in June 2002.
[EFFECTIVE DATE.] This section is effective July 1, 2004,
or upon receipt of federal approval of waiver amendment,
whichever is later.
Sec. 45. Minnesota Statutes 2002, section 256I.05,
subdivision 1a, is amended to read:
Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to
the provisions of section 256I.04, subdivision 3, in addition to
the room and board rate specified in subdivision 1, the county
agency may negotiate a payment not to exceed $426.37 for other
services necessary to provide room and board provided by the
group residence if the residence is licensed by or registered by
the department of health, or licensed by the department of human
services to provide services in addition to room and board, and
if the provider of services is not also concurrently receiving
funding for services for a recipient under a home and
community-based waiver under title XIX of the Social Security
Act; or funding from the medical assistance program under
section 256B.0627, subdivision 4, for personal care services for
residents in the setting; or residing in a setting which
receives funding under Minnesota Rules, parts 9535.2000 to
9535.3000. If funding is available for other necessary services
through a home and community-based waiver, or personal care
services under section 256B.0627, subdivision 4, then the GRH
rate is limited to the rate set in subdivision 1. Unless
otherwise provided in law, in no case may the supplementary
service rate plus the supplementary room and board rate exceed
$426.37. The registration and licensure requirement does not
apply to establishments which are exempt from state licensure
because they are located on Indian reservations and for which
the tribe has prescribed health and safety requirements.
Service payments under this section may be prohibited under
rules to prevent the supplanting of federal funds with state
funds. The commissioner shall pursue the feasibility of
obtaining the approval of the Secretary of Health and Human
Services to provide home and community-based waiver services
under title XIX of the Social Security Act for residents who are
not eligible for an existing home and community-based waiver due
to a primary diagnosis of mental illness or chemical dependency
and shall apply for a waiver if it is determined to be
cost-effective.
(b) The commissioner is authorized to make cost-neutral
transfers from the GRH fund for beds under this section to other
funding programs administered by the department after
consultation with the county or counties in which the affected
beds are located. The commissioner may also make cost-neutral
transfers from the GRH fund to county human service agencies for
beds permanently removed from the GRH census under a plan
submitted by the county agency and approved by the
commissioner. The commissioner shall report the amount of any
transfers under this provision annually to the legislature.
(c) The provisions of paragraph (b) do not apply to a
facility that has its reimbursement rate established under
section 256B.431, subdivision 4, paragraph (c).
Sec. 46. Minnesota Statutes 2002, section 256I.05,
subdivision 7c, is amended to read:
Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is
authorized to pursue a demonstration project under federal food
stamp regulation for the purpose of gaining federal
reimbursement of food and nutritional costs currently paid by
the state group residential housing program. The commissioner
shall seek approval no later than January 1, 2004. Any
reimbursement received is nondedicated revenue to the general
fund.
Sec. 47. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to sections 514.991 to 514.995.
Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR
DEPARTMENT.] "Alternative care agency," "agency," or "department"
means the department of human services when it pays for or
provides alternative care benefits for a nonmedical assistance
recipient directly or through a county social services agency
under chapter 256B according to section 256B.0913.
Subd. 3. [ALTERNATIVE CARE BENEFIT OR
BENEFITS.] "Alternative care benefit" or "benefits" means a
benefit provided to a nonmedical assistance recipient under
chapter 256B according to section 256B.0913.
Subd. 4. [ALTERNATIVE CARE RECIPIENT OR
RECIPIENT.] "Alternative care recipient" or "recipient" means a
person who receives alternative care grant benefits.
Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative
care lien" or "lien" means a lien filed under sections 514.992
to 514.995.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for services for persons first enrolling in the alternative care
program on or after that date and on the first day of the first
eligibility renewal period for persons enrolled in the
alternative care program prior to July 1, 2003.
Sec. 48. [514.992] [ALTERNATIVE CARE LIEN.]
Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a)
Subject to sections 514.991 to 514.995, payments made by an
alternative care agency to provide benefits to a recipient or to
the recipient's spouse who owns property in this state
constitute a lien in favor of the agency on all real property
the recipient owns at and after the time the benefits are first
paid.
(b) The amount of the lien is limited to benefits paid for
services provided to recipients over 55 years of age and
provided on and after July 1, 2003.
Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes
enforceable against specific real property as of the date when
all of the following conditions are met:
(1) the agency has paid benefits for a recipient;
(2) the recipient has been given notice and an opportunity
for a hearing under paragraph (b);
(3) the lien has been filed as provided for in section
514.993 or memorialized on the certificate of title for the
property it describes; and
(4) all restrictions against enforcement have ceased to
apply.
(b) An agency may not file a lien until it has sent the
recipient, their authorized representative, or their legal
representative written notice of its lien rights by certified
mail, return receipt requested, or registered mail and there has
been an opportunity for a hearing under section 256.045. No
person other than the recipient shall have a right to a hearing
under section 256.045 prior to the time the lien is filed. The
hearing shall be limited to whether the agency has met all of
the prerequisites for filing the lien and whether any of the
exceptions in this section apply.
(c) An agency may not file a lien against the recipient's
homestead when any of the following exceptions apply:
(1) while the recipient's spouse is also physically present
and lawfully and continuously residing in the homestead;
(2) a child of the recipient who is under age 21 or who is
blind or totally and permanently disabled according to
supplemental security income criteria is also physically present
on the property and lawfully and continuously residing on the
property from and after the date the recipient first receives
benefits;
(3) a child of the recipient who has also lawfully and
continuously resided on the property for a period beginning at
least two years before the first day of the month in which the
recipient began receiving alternative care, and who provided
uncompensated care to the recipient which enabled the recipient
to live without alternative care services for the two-year
period;
(4) a sibling of the recipient who has an ownership
interest in the property of record in the office of the county
recorder or registrar of titles for the county in which the real
property is located and who has also continuously occupied the
homestead for a period of at least one year immediately prior to
the first day of the first month in which the recipient received
benefits and continuously since that date.
(d) A lien only applies to the real property it describes.
Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective
from the time it is filed until it is paid, satisfied,
discharged, or becomes unenforceable under sections 514.991 to
514.995.
Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to
the real property it describes is subject to the rights of
anyone else whose interest in the real property is perfected of
record before the lien has been recorded or filed under section
514.993, including:
(1) an owner, other than the recipient or the recipient's
spouse;
(2) a good faith purchaser for value without notice of the
lien;
(3) a holder of a mortgage or security interest; or
(4) a judgment lien creditor whose judgment lien has
attached to the recipient's interest in the real property.
(b) The rights of the other person have the same
protections against an alternative care lien as are afforded
against a judgment lien that arises out of an unsecured
obligation and arises as of the time of the filing of an
alternative care grant lien under section 514.993. The lien
shall be inferior to a lien for property taxes and special
assessments and shall be superior to all other matters first
appearing of record after the time and date the lien is filed or
recorded.
Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An
agency may, with absolute discretion, settle or subordinate the
lien to any other lien or encumbrance of record upon the terms
and conditions it deems appropriate.
(b) The agency filing the lien shall release and discharge
the lien:
(1) if it has been paid, discharged, or satisfied;
(2) if it has received reimbursement for the amounts
secured by the lien, has entered into a binding and legally
enforceable agreement under which it is reimbursed for the
amount of the lien, or receives other collateral sufficient to
secure payment of the lien;
(3) against some, but not all, of the property it describes
upon the terms, conditions, and circumstances the agency deems
appropriate;
(4) to the extent it cannot be lawfully enforced against
the property it describes because of an error, omission, or
other material defect in the legal description contained in the
lien or a necessary prerequisite to enforcement of the lien; and
(5) if, in its discretion, it determines the filing or
enforcement of the lien is contrary to the public interest.
(c) The agency executing the lien shall execute and file
the release as provided for in section 514.993, subdivision 2.
Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on
the real property it describes for a period of ten years from
the date it attaches according to subdivision 2, paragraph (a),
except as otherwise provided for in sections 514.992 to
514.995. The agency filing the lien may renew the lien for one
additional ten-year period from the date it would otherwise
expire by recording or filing a certificate of renewal before
the lien expires. The certificate of renewal shall be recorded
or filed in the office of the county recorder or registrar of
titles for the county in which the lien is recorded or filed.
The certificate must refer to the recording or filing data for
the lien it renews. The certificate need not be attested,
certified, or acknowledged as a condition for recording or
filing. The recorder or registrar of titles shall record, file,
index, and return the certificate of renewal in the same manner
provided for liens in section 514.993, subdivision 2.
(b) An alternative care lien is not enforceable against the
real property of an estate to the extent there is a
determination by a court of competent jurisdiction, or by an
officer of the court designated for that purpose, that there are
insufficient assets in the estate to satisfy the lien in whole
or in part because of the homestead exemption under section
256B.15, subdivision 4, the rights of a surviving spouse or a
minor child under section 524.2-403, paragraphs (a) and (b), or
claims with a priority under section 524.3-805, paragraph (a),
clauses (1) to (4). For purposes of this section, the rights of
the decedent's adult children to exempt property under section
524.2-403, paragraph (b), shall not be considered costs of
administration under section 524.3-805, paragraph (a), clause
(1).
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for services for persons first enrolling in the alternative care
program on or after that date and on the first day of the first
eligibility renewal period for persons enrolled in the
alternative care program prior to July 1, 2003.
Sec. 49. [514.993] [LIEN; CONTENTS AND FILING.]
Subdivision 1. [CONTENTS.] A lien shall be dated and must
contain:
(1) the recipient's full name, last known address, and
social security number;
(2) a statement that benefits have been paid to or for the
recipient's benefit;
(3) a statement that all of the recipient's interests in
the real property described in the lien may be subject to or
affected by the agency's right to reimbursement for benefits;
(4) a legal description of the real property subject to the
lien and whether it is registered or abstract property; and
(5) such other contents, if any, as the agency deems
appropriate.
Subd. 2. [FILING.] Any lien, release, or other document
required or permitted to be filed under sections 514.991 to
514.995 must be recorded or filed in the office of the county
recorder or registrar of titles, as appropriate, in the county
where the real property is located. Notwithstanding section
386.77, the agency shall pay the applicable filing fee for any
documents filed under sections 514.991 to 514.995. An
attestation, certification, or acknowledgment is not required as
a condition of filing. If the property described in the lien is
registered property, the registrar of titles shall record it on
the certificate of title for each parcel of property described
in the lien. If the property described in the lien is abstract
property, the recorder shall file the lien in the county's
grantor-grantee indexes and any tract indexes the county
maintains for each parcel of property described in the lien.
The recorder or registrar shall return the recorded or filed
lien to the agency at no cost. If the agency provides a
duplicate copy of the lien, the recorder or registrar of titles
shall show the recording or filing data on the copy and return
it to the agency at no cost. The agency is responsible for
filing any lien, release, or other documents under sections
514.991 to 514.995.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for services for persons first enrolling in the alternative care
program on or after that date and on the first day of the first
eligibility renewal period for persons enrolled in the
alternative care program prior to July 1, 2003.
Sec. 50. [514.994] [ENFORCEMENT; OTHER REMEDIES.]
Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The
agency may enforce or foreclose a lien filed under sections
514.991 to 514.995 in the manner provided for by law for
enforcement of judgment liens against real estate or by a
foreclosure by action under chapter 581. The lien shall remain
enforceable as provided for in sections 514.991 to 514.995
notwithstanding any laws limiting the enforceability of
judgments.
Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be
enforced against the homestead property of the recipient or the
spouse while they physically occupy it as their lawful residence.
Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to
514.995 do not limit the agency's right to file a claim against
the recipient's estate or the estate of the recipient's spouse,
do not limit any other claims for reimbursement the agency may
have, and do not limit the availability of any other remedy to
the agency.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for services for persons first enrolling in the alternative care
program on or after that date and on the first day of the first
eligibility renewal period for persons enrolled in the
alternative care program prior to July 1, 2003.
Sec. 51. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.]
Amounts the agency receives to satisfy the lien must be
deposited in the state treasury and credited to the fund from
which the benefits were paid.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for services for persons first enrolling in the alternative care
program on or after that date and on the first day of the first
eligibility renewal period for persons enrolled in the
alternative care program prior to July 1, 2003.
Sec. 52. Minnesota Statutes 2002, section 524.3-805, is
amended to read:
524.3-805 [CLASSIFICATION OF CLAIMS.]
(a) If the applicable assets of the estate are insufficient
to pay all claims in full, the personal representative shall
make payment in the following order:
(1) costs and expenses of administration;
(2) reasonable funeral expenses;
(3) debts and taxes with preference under federal law;
(4) reasonable and necessary medical, hospital, or nursing
home expenses of the last illness of the decedent, including
compensation of persons attending the decedent, a claim filed
under section 256B.15 for recovery of expenditures for
alternative care for nonmedical assistance recipients under
section 256B.0913, and including a claim filed pursuant to
section 256B.15;
(5) reasonable and necessary medical, hospital, and nursing
home expenses for the care of the decedent during the year
immediately preceding death;
(6) debts with preference under other laws of this state,
and state taxes;
(7) all other claims.
(b) No preference shall be given in the payment of any
claim over any other claim of the same class, and a claim due
and payable shall not be entitled to a preference over claims
not due, except that if claims for expenses of the last illness
involve only claims filed under section 256B.15 for recovery of
expenditures for alternative care for nonmedical assistance
recipients under section 256B.0913, section 246.53 for costs of
state hospital care and claims filed under section 256B.15,
claims filed to recover expenditures for alternative care for
nonmedical assistance recipients under section 256B.0913 shall
have preference over claims filed under both sections 246.53 and
other claims filed under section 256B.15, and claims filed under
section 246.53 have preference over claims filed under section
256B.15 for recovery of amounts other than those for
expenditures for alternative care for nonmedical assistance
recipients under section 256B.0913.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
for decedents dying on or after that date.
Sec. 53. [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.]
The commissioner of health shall seek changes in the
federal policy that mandates the imposition of federal sanctions
without providing an opportunity for a nursing facility to
correct deficiencies, solely as the result of previous
deficiencies issued to the nursing facility.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 54. [REPORT ON LONG-TERM CARE.]
The report on long-term care services required under
Minnesota Statutes, section 144A.351, that is presented to the
legislature by January 15, 2004, must also address the
feasibility of offering government or private sector loans or
lines of credit to individuals age 65 and over, for the purchase
of long-term care services.
Sec. 55. [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN
LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.]
The commissioner of human services shall report to the
legislature by January 15, 2005, on long-term care financing
reform. The report must include a new mix of public and private
approaches to the financing of long-term care. The report shall
examine strategies and financing options that will increase the
availability and use of nongovernment resources to pay for
long-term care, including new ways of using limited government
funds for long-term care. The report shall examine the
feasibility of:
(1) initiating a long-term care insurance partnership
program, similar to those adopted in other states, under which
the state would encourage the purchase of private long-term care
insurance by permitting the insured to retain assets in excess
of those otherwise permitted for medical assistance eligibility,
if the insured later exhausts the private long-term care
insurance benefits. The report must include the feasibility of
obtaining any necessary federal waiver;
(2) using state medical assistance funds to subsidize the
purchase of private long-term care insurance by individuals who
would be unlikely to purchase it without a subsidy, in order to
generate long-term medical assistance savings; and
(3) adding a nursing facility benefit to Medicare-related
coverage, as defined in Minnesota Statutes, section 62Q.01,
subdivision 6. The report must quantify the costs or savings
resulting from adding a nursing facility benefit.
The report must comply with Minnesota Statutes, sections
3.195 and 3.197.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 56. [REVISOR'S INSTRUCTION.]
For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 57. [REPEALER.]
(a) Minnesota Statutes 2002, sections 256.973; 256.9772;
and 256B.437, subdivision 2, are repealed effective July 1, 2003.
(b) Minnesota Statutes 2002, sections 62J.66; 62J.68;
144A.071, subdivision 5; and 144A.35, are repealed.
(c) Laws 1998, chapter 407, article 4, section 63, is
repealed.
(d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055;
9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080;
9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107;
9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130;
9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and
9505.3700, are repealed effective July 1, 2003.
(e) Laws 2003, chapter 55, sections 1 and 4, are repealed
effective the day following final enactment.
ARTICLE 3
CONTINUING CARE FOR PERSONS WITH DISABILITIES
Section 1. Minnesota Statutes 2002, section 174.30,
subdivision 1, is amended to read:
Subdivision 1. [APPLICABILITY.] (a) The operating
standards for special transportation service adopted under this
section do not apply to special transportation provided by:
(1) a common carrier operating on fixed routes and
schedules;
(2) a volunteer driver using a private automobile;
(3) a school bus as defined in section 169.01, subdivision
6; or
(4) an emergency ambulance regulated under chapter 144.
(b) The operating standards adopted under this section only
apply to providers of special transportation service who receive
grants or other financial assistance from either the state or
the federal government, or both, to provide or assist in
providing that service; except that the operating standards
adopted under this section do not apply to any nursing home
licensed under section 144A.02, to any board and care facility
licensed under section 144.50, or to any day training and
habilitation services, day care, or group home facility licensed
under sections 245A.01 to 245A.19 unless the facility or program
provides transportation to nonresidents on a regular basis and
the facility receives reimbursement, other than per diem
payments, for that service under rules promulgated by the
commissioner of human services.
(c) Notwithstanding paragraph (b), the operating standards
adopted under this section do not apply to any vendor of
services licensed under chapter 245B that provides
transportation services to consumers or residents of other
vendors licensed under chapter 245B and transports 15 or fewer
persons, including consumers or residents and the driver.
Sec. 2. Minnesota Statutes 2002, section 245B.06,
subdivision 8, is amended to read:
Subd. 8. [LEAVING THE RESIDENCE.] As specified in each
consumer's individual service plan, Each consumer requiring a
24-hour plan of care must leave the residence to participate in
regular education, employment, or community activities shall
receive services during the day outside the residence unless
otherwise specified in the individual's service plan. License
holders, providing services to consumers living in a licensed
site, shall ensure that they are prepared to care for consumers
whenever they are at the residence during the day because of
illness, work schedules, or other reasons.
Sec. 3. Minnesota Statutes 2002, section 245B.07,
subdivision 11, is amended to read:
Subd. 11. [TRAVEL TIME TO AND FROM A DAY TRAINING AND
HABILITATION SITE.] Except in unusual circumstances, the license
holder must not transport a consumer receiving services for
longer than one hour 90 minutes per one-way trip. Nothing in
this subdivision relieves the provider of the obligation to
provide the number of program hours as identified in the
individualized service plan.
Sec. 4. Minnesota Statutes 2002, section 246.54, is
amended to read:
246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.]
Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except
for chemical dependency services provided under sections 254B.01
to 254B.09, the client's county shall pay to the state of
Minnesota a portion of the cost of care provided in a regional
treatment center or a state nursing facility to a client legally
settled in that county. A county's payment shall be made from
the county's own sources of revenue and payments shall be paid
as follows: payments to the state from the county shall
equal ten 20 percent of the cost of care, as determined by the
commissioner, for each day, or the portion thereof, that the
client spends at a regional treatment center or a state nursing
facility. If payments received by the state under sections
246.50 to 246.53 exceed 90 80 percent of the cost of care, the
county shall be responsible for paying the state only the
remaining amount. The county shall not be entitled to
reimbursement from the client, the client's estate, or from the
client's relatives, except as provided in section 246.53. No
such payments shall be made for any client who was last
committed prior to July 1, 1947.
Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to
services provided at the Minnesota security hospital, the
Minnesota sex offender program, or the Minnesota extended
treatment options program. For services at these facilities, a
county's payment shall be made from the county's own sources of
revenue and payments shall be paid as follows: payments to the
state from the county shall equal ten percent of the cost of
care, as determined by the commissioner, for each day, or the
portion thereof, that the client spends at the facility. If
payments received by the state under sections 246.50 to 246.53
exceed 90 percent of the cost of care, the county shall be
responsible for paying the state only the remaining amount. The
county shall not be entitled to reimbursement from the client,
the client's estate, or from the client's relatives, except as
provided in section 246.53.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 5. Minnesota Statutes 2002, section 252.32,
subdivision 1, is amended to read:
Subdivision 1. [PROGRAM ESTABLISHED.] In accordance with
state policy established in section 256F.01 that all children
are entitled to live in families that offer safe, nurturing,
permanent relationships, and that public services be directed
toward preventing the unnecessary separation of children from
their families, and because many families who have children with
mental retardation or related conditions disabilities have
special needs and expenses that other families do not have, the
commissioner of human services shall establish a program to
assist families who have dependents dependent children with
mental retardation or related conditions disabilities living in
their home. The program shall make support grants available to
the families.
Sec. 6. Minnesota Statutes 2002, section 252.32,
subdivision 1a, is amended to read:
Subd. 1a. [SUPPORT GRANTS.] (a) Provision of support
grants must be limited to families who require support and whose
dependents are under the age of 22 and who have mental
retardation or who have a related condition 21 and who have been
determined by a screening team established certified disabled
under section 256B.092 to be at risk of
institutionalization 256B.055, subdivision 12, paragraphs (a),
(b), (c), (d), and (e). Families who are receiving home and
community-based waivered services for persons with mental
retardation or related conditions are not eligible for support
grants.
Families receiving grants who will be receiving home and
community-based waiver services for persons with mental
retardation or a related condition for their family member
within the grant year, and who have ongoing payments for
environmental or vehicle modifications which have been approved
by the county as a grant expense and would have qualified for
payment under this waiver may receive a onetime grant payment
from the commissioner to reduce or eliminate the principal of
the remaining debt for the modifications, not to exceed the
maximum amount allowable for the remaining years of eligibility
for a family support grant. The commissioner is authorized to
use up to $20,000 annually from the grant appropriation for this
purpose. Any amount unexpended at the end of the grant year
shall be allocated by the commissioner in accordance with
subdivision 3a, paragraph (b), clause (2). Families whose
annual adjusted gross income is $60,000 or more are not eligible
for support grants except in cases where extreme hardship is
demonstrated. Beginning in state fiscal year 1994, the
commissioner shall adjust the income ceiling annually to reflect
the projected change in the average value in the United States
Department of Labor Bureau of Labor Statistics consumer price
index (all urban) for that year.
(b) Support grants may be made available as monthly subsidy
grants and lump sum grants.
(c) Support grants may be issued in the form of cash,
voucher, and direct county payment to a vendor.
(d) Applications for the support grant shall be made by the
legal guardian to the county social service agency. The
application shall specify the needs of the families, the form of
the grant requested by the families, and that the families have
agreed to use the support grant for items and services within
the designated reimbursable expense categories and
recommendations of the county to be reimbursed.
(e) Families who were receiving subsidies on the date of
implementation of the $60,000 income limit in paragraph (a)
continue to be eligible for a family support grant until
December 31, 1991, if all other eligibility criteria are met.
After December 31, 1991, these families are eligible for a grant
in the amount of one-half the grant they would otherwise
receive, for as long as they remain eligible under other
eligibility criteria.
Sec. 7. Minnesota Statutes 2002, section 252.32,
subdivision 3, is amended to read:
Subd. 3. [AMOUNT OF SUPPORT GRANT; USE.] Support grant
amounts shall be determined by the county social service
agency. Each service Services and item items purchased with a
support grant must:
(1) be over and above the normal costs of caring for the
dependent if the dependent did not have a disability;
(2) be directly attributable to the dependent's disabling
condition; and
(3) enable the family to delay or prevent the out-of-home
placement of the dependent.
The design and delivery of services and items purchased
under this section must suit the dependent's chronological age
and be provided in the least restrictive environment possible,
consistent with the needs identified in the individual service
plan.
Items and services purchased with support grants must be
those for which there are no other public or private funds
available to the family. Fees assessed to parents for health or
human services that are funded by federal, state, or county
dollars are not reimbursable through this program.
In approving or denying applications, the county shall
consider the following factors:
(1) the extent and areas of the functional limitations of
the disabled child;
(2) the degree of need in the home environment for
additional support; and
(3) the potential effectiveness of the grant to maintain
and support the person in the family environment.
The maximum monthly grant amount shall be $250 per eligible
dependent, or $3,000 per eligible dependent per state fiscal
year, within the limits of available funds. The county social
service agency may consider the dependent's supplemental
security income in determining the amount of the support grant.
The county social service agency may exceed $3,000 per state
fiscal year per eligible dependent for emergency circumstances
in cases where exceptional resources of the family are required
to meet the health, welfare-safety needs of the child.
County social service agencies shall continue to provide
funds to families receiving state grants on June 30, 1997, if
eligibility criteria continue to be met. Any adjustments to
their monthly grant amount must be based on the needs of the
family and funding availability.
Sec. 8. Minnesota Statutes 2002, section 252.32,
subdivision 3c, is amended to read:
Subd. 3c. [COUNTY BOARD RESPONSIBILITIES.] County boards
receiving funds under this section shall:
(1) determine the needs of families for services in
accordance with section 256B.092 or 256E.08 and any rules
adopted under those sections; submit a plan to the department
for the management of the family support grant program. The
plan must include the projected number of families the county
will serve and policies and procedures for:
(i) identifying potential families for the program;
(ii) grant distribution;
(iii) waiting list procedures; and
(iv) prioritization of families to receive grants;
(2) determine the eligibility of all persons proposed for
program participation;
(3) approve a plan for items and services to be reimbursed
and inform families of the county's approval decision;
(4) issue support grants directly to, or on behalf of,
eligible families;
(5) inform recipients of their right to appeal under
subdivision 3e;
(6) submit quarterly financial reports under subdivision 3b
and indicate on the screening documents the annual grant level
for each family, the families denied grants, and the families
eligible but waiting for funding; and
(7) coordinate services with other programs offered by the
county.
Sec. 9. Minnesota Statutes 2002, section 252.41,
subdivision 3, is amended to read:
Subd. 3. [DAY TRAINING AND HABILITATION SERVICES FOR
ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day
training and habilitation services for adults with mental
retardation and related conditions" means services that:
(1) include supervision, training, assistance, and
supported employment, work-related activities, or other
community-integrated activities designed and implemented in
accordance with the individual service and individual
habilitation plans required under Minnesota Rules, parts
9525.0015 to 9525.0165, to help an adult reach and maintain the
highest possible level of independence, productivity, and
integration into the community; and
(2) are provided under contract with the county where the
services are delivered by a vendor licensed under sections
245A.01 to 245A.16 and 252.28, subdivision 2, to provide day
training and habilitation services; and
(3) are regularly provided to one or more adults with
mental retardation or related conditions in a place other than
the adult's own home or residence unless medically
contraindicated.
Day training and habilitation services reimbursable under
this section do not include special education and related
services as defined in the Education of the Handicapped Act,
United States Code, title 20, chapter 33, section 1401, clauses
(6) and (17), or vocational services funded under section 110 of
the Rehabilitation Act of 1973, United States Code, title 29,
section 720, as amended.
Sec. 10. Minnesota Statutes 2002, section 252.46,
subdivision 1, is amended to read:
Subdivision 1. [RATES.] (a) Payment rates to vendors,
except regional centers, for county-funded day training and
habilitation services and transportation provided to persons
receiving day training and habilitation services established by
a county board are governed by subdivisions 2 to 19. The
commissioner shall approve the following three payment rates for
services provided by a vendor:
(1) a full-day service rate for persons who receive at
least six service hours a day, including the time it takes to
transport the person to and from the service site;
(2) a partial-day service rate that must not exceed 75
percent of the full-day service rate for persons who receive
less than a full day of service; and
(3) a transportation rate for providing, or arranging and
paying for, transportation of a person to and from the person's
residence to the service site.
(b) The commissioner may also approve an hourly job-coach,
follow-along rate for services provided by one employee at or en
route to or from community locations to supervise, support, and
assist one person receiving the vendor's services to learn
job-related skills necessary to obtain or retain employment when
and where no other persons receiving services are present and
when all the following criteria are met:
(1) the vendor requests and the county recommends the
optional rate;
(2) the service is prior authorized by the county on the
Medicaid Management Information System for no more than 414
hours in a 12-month period and the daily per person charge to
medical assistance does not exceed the vendor's approved full
day plus transportation rates;
(3) separate full day, partial day, and transportation
rates are not billed for the same person on the same day;
(4) the approved hourly rate does not exceed the sum of the
vendor's current average hourly direct service wage, including
fringe benefits and taxes, plus a component equal to the
vendor's average hourly nondirect service wage expenses; and
(5) the actual revenue received for provision of hourly
job-coach, follow-along services is subtracted from the vendor's
total expenses for the same time period and those adjusted
expenses are used for determining recommended full day and
transportation payment rates under subdivision 5 in accordance
with the limitations in subdivision 3.
(b) Notwithstanding any law or rule to the contrary, the
commissioner may authorize county participation in a voluntary
individualized payment rate structure for day training and
habilitation services to allow a county the flexibility to
change, after consulting with providers, from a site-based
payment rate structure to an individual payment rate structure
for the providers of day training and habilitation services in
the county. The commissioner shall seek input from providers
and consumers in establishing procedures for determining the
structure of voluntary individualized payment rates to ensure
that there is no additional cost to the state or counties and
that the rate structure is cost-neutral to providers of day
training and habilitation services, on July 1, 2004, or on day
one of the individual rate structure, whichever is later.
(c) Medical assistance rates for home and community-based
service provided under section 256B.501, subdivision 4, by
licensed vendors of day training and habilitation services must
not be greater than the rates for the same services established
by counties under sections 252.40 to 252.46. For very dependent
persons with special needs the commissioner may approve an
exception to the approved payment rate under section 256B.501,
subdivision 4 or 8.
Sec. 11. Minnesota Statutes 2002, section 256.476,
subdivision 1, is amended to read:
Subdivision 1. [PURPOSE AND GOALS.] The commissioner of
human services shall establish a consumer support grant program
for individuals with functional limitations and their families
who wish to purchase and secure their own supports. The
commissioner and local agencies shall jointly develop an
implementation plan which must include a way to resolve the
issues related to county liability. The program shall:
(1) make support grants or exception grants described in
subdivision 11 available to individuals or families as an
effective alternative to existing programs and services, such as
the developmental disability family support program, personal
care attendant services, home health aide services, and private
duty nursing services;
(2) provide consumers more control, flexibility, and
responsibility over their services and supports;
(3) promote local program management and decision making;
and
(4) encourage the use of informal and typical community
supports.
[EFFECTIVE DATE.] This section is effective January 1, 2004.
Sec. 12. Minnesota Statutes 2002, section 256.476,
subdivision 3, is amended to read:
Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person
is eligible to apply for a consumer support grant if the person
meets all of the following criteria:
(1) the person is eligible for and has been approved to
receive services under medical assistance as determined under
sections 256B.055 and 256B.056 or the person has been approved
to receive a grant under the developmental disability family
support program under section 252.32;
(2) the person is able to direct and purchase the person's
own care and supports, or the person has a family member, legal
representative, or other authorized representative who can
purchase and arrange supports on the person's behalf;
(3) the person has functional limitations, requires ongoing
supports to live in the community, and is at risk of or would
continue institutionalization without such supports; and
(4) the person will live in a home. For the purpose of
this section, "home" means the person's own home or home of a
person's family member. These homes are natural home settings
and are not licensed by the department of health or human
services.
(b) Persons may not concurrently receive a consumer support
grant if they are:
(1) receiving home and community-based services under
United States Code, title 42, section 1396h(c); personal care
attendant and home health aide services, or private duty nursing
under section 256B.0625; a developmental disability family
support grant; or alternative care services under section
256B.0913; or
(2) residing in an institutional or congregate care setting.
(c) A person or person's family receiving a consumer
support grant shall not be charged a fee or premium by a local
agency for participating in the program.
(d) The commissioner may limit the participation of
recipients of services from federal waiver programs in the
consumer support grant program if the participation of these
individuals will result in an increase in the cost to the
state. Individuals receiving home and community-based waivers
under United States Code, title 42, section 1396h(c), are not
eligible for the consumer support grant, except for individuals
receiving consumer support grants before July 1, 2003, as long
as other eligibility criteria are met.
(e) The commissioner shall establish a budgeted
appropriation each fiscal year for the consumer support grant
program. The number of individuals participating in the program
will be adjusted so the total amount allocated to counties does
not exceed the amount of the budgeted appropriation. The
budgeted appropriation will be adjusted annually to accommodate
changes in demand for the consumer support grants.
Sec. 13. Minnesota Statutes 2002, section 256.476,
subdivision 4, is amended to read:
Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A
county board may choose to participate in the consumer support
grant program. If a county has not chosen to participate by
July 1, 2002, the commissioner shall contract with another
county or other entity to provide access to residents of the
nonparticipating county who choose the consumer support grant
option. The commissioner shall notify the county board in a
county that has declined to participate of the commissioner's
intent to enter into a contract with another county or other
entity at least 30 days in advance of entering into the
contract. The local agency shall establish written procedures
and criteria to determine the amount and use of support grants.
These procedures must include, at least, the availability of
respite care, assistance with daily living, and adaptive aids.
The local agency may establish monthly or annual maximum amounts
for grants and procedures where exceptional resources may be
required to meet the health and safety needs of the person on a
time-limited basis, however, the total amount awarded to each
individual may not exceed the limits established in subdivision
11.
(b) Support grants to a person or a person's family will be
provided through a monthly subsidy payment and be in the form of
cash, voucher, or direct county payment to vendor. Support
grant amounts must be determined by the local agency. Each
service and item purchased with a support grant must meet all of
the following criteria:
(1) it must be over and above the normal cost of caring for
the person if the person did not have functional limitations;
(2) it must be directly attributable to the person's
functional limitations;
(3) it must enable the person or the person's family to
delay or prevent out-of-home placement of the person; and
(4) it must be consistent with the needs identified in the
service plan agreement, when applicable.
(c) Items and services purchased with support grants must
be those for which there are no other public or private funds
available to the person or the person's family. Fees assessed
to the person or the person's family for health and human
services are not reimbursable through the grant.
(d) In approving or denying applications, the local agency
shall consider the following factors:
(1) the extent and areas of the person's functional
limitations;
(2) the degree of need in the home environment for
additional support; and
(3) the potential effectiveness of the grant to maintain
and support the person in the family environment or the person's
own home.
(e) At the time of application to the program or screening
for other services, the person or the person's family shall be
provided sufficient information to ensure an informed choice of
alternatives by the person, the person's legal representative,
if any, or the person's family. The application shall be made
to the local agency and shall specify the needs of the person
and family, the form and amount of grant requested, the items
and services to be reimbursed, and evidence of eligibility for
medical assistance.
(f) Upon approval of an application by the local agency and
agreement on a support plan for the person or person's family,
the local agency shall make grants to the person or the person's
family. The grant shall be in an amount for the direct costs of
the services or supports outlined in the service agreement.
(g) Reimbursable costs shall not include costs for
resources already available, such as special education classes,
day training and habilitation, case management, other services
to which the person is entitled, medical costs covered by
insurance or other health programs, or other resources usually
available at no cost to the person or the person's family.
(h) The state of Minnesota, the county boards participating
in the consumer support grant program, or the agencies acting on
behalf of the county boards in the implementation and
administration of the consumer support grant program shall not
be liable for damages, injuries, or liabilities sustained
through the purchase of support by the individual, the
individual's family, or the authorized representative under this
section with funds received through the consumer support grant
program. Liabilities include but are not limited to: workers'
compensation liability, the Federal Insurance Contributions Act
(FICA), or the Federal Unemployment Tax Act (FUTA). For
purposes of this section, participating county boards and
agencies acting on behalf of county boards are exempt from the
provisions of section 268.04.
Sec. 14. Minnesota Statutes 2002, section 256.476,
subdivision 5, is amended to read:
Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a)
For the purpose of transferring persons to the consumer support
grant program from specific programs or services, such as the
developmental disability family support program and personal
care assistant services, home health aide services, or private
duty nursing services, the amount of funds transferred by the
commissioner between the developmental disability family support
program account, the medical assistance account, or the consumer
support grant account shall be based on each county's
participation in transferring persons to the consumer support
grant program from those programs and services.
(b) At the beginning of each fiscal year, county
allocations for consumer support grants shall be based on:
(1) the number of persons to whom the county board expects
to provide consumer supports grants;
(2) their eligibility for current program and services;
(3) the amount of nonfederal dollars allowed under
subdivision 11; and
(4) projected dates when persons will start receiving
grants. County allocations shall be adjusted periodically by
the commissioner based on the actual transfer of persons or
service openings, and the nonfederal dollars associated with
those persons or service openings, to the consumer support grant
program.
(c) The amount of funds transferred by the commissioner
from the medical assistance account for an individual may be
changed if it is determined by the county or its agent that the
individual's need for support has changed.
(d) The authority to utilize funds transferred to the
consumer support grant account for the purposes of implementing
and administering the consumer support grant program will not be
limited or constrained by the spending authority provided to the
program of origination.
(e) The commissioner may use up to five percent of each
county's allocation, as adjusted, for payments for
administrative expenses, to be paid as a proportionate addition
to reported direct service expenditures.
(f) The county allocation for each individual or
individual's family cannot exceed the amount allowed under
subdivision 11.
(g) The commissioner may recover, suspend, or withhold
payments if the county board, local agency, or grantee does not
comply with the requirements of this section.
(h) Grant funds unexpended by consumers shall return to the
state once a year. The annual return of unexpended grant funds
shall occur in the quarter following the end of the state fiscal
year.
Sec. 15. Minnesota Statutes 2002, section 256.476,
subdivision 11, is amended to read:
Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1,
2001.] (a) Effective July 1, 2001, the commissioner shall
allocate consumer support grant resources to serve additional
individuals based on a review of Medicaid authorization and
payment information of persons eligible for a consumer support
grant from the most recent fiscal year. The commissioner shall
use the following methodology to calculate maximum allowable
monthly consumer support grant levels:
(1) For individuals whose program of origination is medical
assistance home care under section 256B.0627, the maximum
allowable monthly grant levels are calculated by:
(i) determining the nonfederal share of the average service
authorization for each home care rating;
(ii) calculating the overall ratio of actual payments to
service authorizations by program;
(iii) applying the overall ratio to the average service
authorization level of each home care rating;
(iv) adjusting the result for any authorized rate increases
provided by the legislature; and
(v) adjusting the result for the average monthly
utilization per recipient; and.
(2) for persons with programs of origination other than the
program described in clause (1), the maximum grant level for an
individual shall not exceed the total of the nonfederal dollars
expended on the individual by the program of origination The
commissioner may review and evaluate the methodology to reflect
changes in the home care programs overall ratio of actual
payments to service authorizations.
(b) Effective January 1, 2004, persons previously receiving
consumer support exception grants prior to July 1, 2001, may
continue to receive the grant amount established prior to July
1, 2001 will have their grants calculated using the methodology
in paragraph (a), clause (1). If a person currently receiving
an exception grant wishes to have their home care rating
reevaluated, they may request an assessment as defined in
section 256B.0627, subdivision 1, paragraph (b).
(c) The commissioner may provide up to 200 exception
grants, including grants in use under paragraph (b). Eligible
persons shall be provided an exception grant in priority order
based upon the date of the commissioner's receipt of the county
request. The maximum allowable grant level for an exception
grant shall be based upon the nonfederal share of the average
service authorization from the most recent fiscal year for each
home care rating category. The amount of each exception grant
shall be based upon the commissioner's determination of the
nonfederal dollars that would have been expended if services had
been available for an individual who is unable to obtain the
support needed from the program of origination due to the
unavailability of qualified service providers at the time or the
location where the supports are needed.
Sec. 16. Minnesota Statutes 2002, section 256.482,
subdivision 8, is amended to read:
Subd. 8. [SUNSET.] Notwithstanding section 15.059,
subdivision 5, the council on disability shall not sunset until
June 30, 2003 2007.
[EFFECTIVE DATE.] This section is effective May 30, 2003.
Sec. 17. Minnesota Statutes 2002, section 256B.0621,
subdivision 4, is amended to read:
Subd. 4. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER
QUALIFICATIONS.] The following qualifications and certification
standards must be met by providers of relocation targeted case
management:
(a) The commissioner must certify each provider of
relocation targeted case management before enrollment. The
certification process shall examine the provider's ability to
meet the requirements in this subdivision and other federal and
state requirements of this service. A certified relocation
targeted case management provider may subcontract with another
provider to deliver relocation targeted case management
services. Subcontracted providers must demonstrate the ability
to provide the services outlined in subdivision 6.
(b) (a) A relocation targeted case management provider is
an enrolled medical assistance provider who is determined by the
commissioner to have all of the following characteristics:
(1) the legal authority to provide public welfare under
sections 393.01, subdivision 7; and 393.07; or a federally
recognized Indian tribe;
(2) the demonstrated capacity and experience to provide the
components of case management to coordinate and link community
resources needed by the eligible population;
(3) the administrative capacity and experience to serve the
target population for whom it will provide services and ensure
quality of services under state and federal requirements;
(4) the legal authority to provide complete investigative
and protective services under section 626.556, subdivision 10;
and child welfare and foster care services under section 393.07,
subdivisions 1 and 2; or a federally recognized Indian tribe;
(5) a financial management system that provides accurate
documentation of services and costs under state and federal
requirements; and
(6) the capacity to document and maintain individual case
records under state and federal requirements.
(b) A provider of targeted case management under section
256B.0625, subdivision 20, may be deemed a certified provider of
relocation targeted case management.
(c) A relocation targeted case management provider may
subcontract with another provider to deliver relocation targeted
case management services. Subcontracted providers must
demonstrate the ability to provide the services outlined in
subdivision 6, and have a procedure in place that notifies the
recipient and the recipient's legal representative of any
conflict of interest if the contracted targeted case management
provider also provides, or will provide, the recipient's
services and supports. Contracted providers must provide
information on all conflicts of interest and obtain the
recipient's informed consent or provide the recipient with
alternatives.
Sec. 18. Minnesota Statutes 2002, section 256B.0621,
subdivision 7, is amended to read:
Subd. 7. [TIME LINES.] The following time lines must be
met for assigning a case manager:
(1) (a) For relocation targeted case management, an
eligible recipient must be assigned a case manager who visits
the person within 20 working days of requesting a case manager
from their county of financial responsibility as determined
under chapter 256G.
(1) If a county agency, its contractor, or federally
recognized tribe does not provide case management services as
required, the recipient may, after written notice to the county
agency, obtain targeted relocation case management services from
a home care targeted case management provider, as defined in
subdivision 5; and an alternative provider of targeted case
management services enrolled by the commissioner.
(2) The commissioner may waive the provider requirements in
subdivision 4, paragraph (a), clauses (1) and (4), to ensure
recipient access to the assistance necessary to move from an
institution to the community. The recipient or the recipient's
legal guardian shall provide written notice to the county or
tribe of the decision to obtain services from an alternative
provider.
(3) Providers of relocation targeted case management
enrolled under this subdivision shall:
(i) meet the provider requirements under subdivision 4 that
are not waived by the commissioner;
(ii) be qualified to provide the services specified in
subdivision 6;
(iii) coordinate efforts with local social service agencies
and tribes; and
(iv) comply with the conflict of interest provisions
established under subdivision 4, paragraph (c).
(4) Local social service agencies and federally recognized
tribes shall cooperate with providers certified by the
commissioner under this subdivision to facilitate the
recipient's successful relocation from an institution to the
community.
(b) For home care targeted case management, an eligible
recipient must be assigned a case manager within 20 working days
of requesting a case manager from a home care targeted case
management provider, as defined in subdivision 5.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 19. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL
HEALTH SERVICES.]
Subdivision 1. [SCOPE.] Subject to federal approval,
medical assistance covers medically necessary, intensive
nonresidential and residential rehabilitative mental health
services as defined in subdivision 2, for recipients as defined
in subdivision 3, when the services are provided by an entity
meeting the standards in this section.
Subd. 2. [DEFINITIONS.] For purposes of this section, the
following terms have the meanings given them.
(a) "Intensive nonresidential rehabilitative mental health
services" means adult rehabilitative mental health services as
defined in section 256B.0623, subdivision 2, paragraph (a),
except that these services are provided by a multidisciplinary
staff using a total team approach consistent with assertive
community treatment, the Fairweather Lodge treatment model, and
other evidence-based practices, and directed to recipients with
a serious mental illness who require intensive services.
(b) "Intensive residential rehabilitative mental health
services" means short-term, time-limited services provided in a
residential setting to recipients who are in need of more
restrictive settings and are at risk of significant functional
deterioration if they do not receive these services. Services
are designed to develop and enhance psychiatric stability,
personal and emotional adjustment, self-sufficiency, and skills
to live in a more independent setting. Services must be
directed toward a targeted discharge date with specified client
outcomes and must be consistent with evidence-based practices.
(c) "Evidence-based practices" are nationally recognized
mental health services that are proven by substantial research
to be effective in helping individuals with serious mental
illness obtain specific treatment goals.
(d) "Overnight staff" means a member of the intensive
residential rehabilitative mental health treatment team who is
responsible during hours when recipients are typically asleep.
(e) "Treatment team" means all staff who provide services
under this section to recipients. At a minimum, this includes
the clinical supervisor, mental health professionals, mental
health practitioners, and mental health rehabilitation workers.
Subd. 3. [ELIGIBILITY.] An eligible recipient is an
individual who:
(1) is age 18 or older;
(2) is eligible for medical assistance;
(3) is diagnosed with a mental illness;
(4) because of a mental illness, has substantial disability
and functional impairment in three or more of the areas listed
in section 245.462, subdivision 11a, so that self-sufficiency is
markedly reduced;
(5) has one or more of the following: a history of two or
more inpatient hospitalizations in the past year, significant
independent living instability, homelessness, or very frequent
use of mental health and related services yielding poor
outcomes; and
(6) in the written opinion of a licensed mental health
professional, has the need for mental health services that
cannot be met with other available community-based services, or
is likely to experience a mental health crisis or require a more
restrictive setting if intensive rehabilitative mental health
services are not provided.
Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT
REQUIREMENTS.] (a) The intensive nonresidential rehabilitative
mental health services provider must:
(1) have a contract with the host county to provide
intensive adult rehabilitative mental health services; and
(2) be certified by the commissioner as being in compliance
with this section and section 256B.0623.
(b) The intensive residential rehabilitative mental health
services provider must:
(1) be licensed under Minnesota Rules, parts 9520.0500 to
9520.0670;
(2) not exceed 16 beds per site;
(3) comply with the additional standards in this section;
and
(4) have a contract with the host county to provide these
services.
(c) The commissioner shall develop procedures for counties
and providers to submit contracts and other documentation as
needed to allow the commissioner to determine whether the
standards in this section are met.
Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND
RESIDENTIAL PROVIDERS.] (a) Services must be provided by
qualified staff as defined in section 256B.0623, subdivision 5,
who are trained and supervised according to section 256B.0623,
subdivision 6, except that mental health rehabilitation workers
acting as overnight staff are not required to comply with
section 256B.0623, subdivision 5, clause (3)(iv).
(b) The clinical supervisor must be an active member of the
treatment team. The treatment team must meet with the clinical
supervisor at least weekly to discuss recipients' progress and
make rapid adjustments to meet recipients' needs. The team
meeting shall include recipient-specific case reviews and
general treatment discussions among team members.
Recipient-specific case reviews and planning must be documented
in the individual recipient's treatment record.
(c) Treatment staff must have prompt access in person or by
telephone to a mental health practitioner or mental health
professional. The provider must have the capacity to promptly
and appropriately respond to emergent needs and make any
necessary staffing adjustments to assure the health and safety
of recipients.
(d) The initial functional assessment must be completed
within ten days of intake and updated at least every three
months or prior to discharge from the service, whichever comes
first.
(e) The initial individual treatment plan must be completed
within ten days of intake and reviewed and updated at least
monthly with the recipient.
Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO
INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH
SERVICES.] (a) The provider of intensive residential services
must have sufficient staff to provide 24 hour per day coverage
to deliver the rehabilitative services described in the
treatment plan and to safely supervise and direct the activities
of recipients given the recipient's level of behavioral and
psychiatric stability, cultural needs, and vulnerability. The
provider must have the capacity within the facility to provide
integrated services for chemical dependency, illness management
services, and family education when appropriate.
(b) At a minimum:
(1) staff must be available and provide direction and
supervision whenever recipients are present in the facility;
(2) staff must remain awake during all work hours;
(3) there must be a staffing ratio of at least one to nine
recipients for each day and evening shift. If more than nine
recipients are present at the residential site, there must be a
minimum of two staff during day and evening shifts, one of whom
must be a mental health practitioner or mental health
professional;
(4) if services are provided to recipients who need the
services of a medical professional, the provider shall assure
that these services are provided either by the provider's own
medical staff or through referral to a medical professional; and
(5) the provider must assure the timely availability of a
licensed registered nurse, either directly employed or under
contract, who is responsible for ensuring the effectiveness and
safety of medication administration in the facility and
assessing patients for medication side effects and drug
interactions.
Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL
SERVICES.] The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.
(1) The treatment team must use team treatment, not an
individual treatment model.
(2) The clinical supervisor must function as a practicing
clinician at least on a part-time basis.
(3) The staffing ratio must not exceed ten recipients to
one full-time equivalent treatment team position.
(4) Services must be available at times that meet client
needs.
(5) The treatment team must actively and assertively engage
and reach out to the recipient's family members and significant
others, after obtaining the recipient's permission.
(6) The treatment team must establish ongoing communication
and collaboration between the team, family, and significant
others and educate the family and significant others about
mental illness, symptom management, and the family's role in
treatment.
(7) The treatment team must provide interventions to
promote positive interpersonal relationships.
Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE
REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for
residential and nonresidential services in this section shall be
based on one daily rate per provider inclusive of the following
services received by an eligible recipient in a given calendar
day: all rehabilitative services under this section and crisis
stabilization services under section 256B.0624.
(b) Except as indicated in paragraph (c), payment will not
be made to more than one entity for each recipient for services
provided under this section on a given day. If services under
this section are provided by a team that includes staff from
more than one entity, the team must determine how to distribute
the payment among the members.
(c) The host county shall recommend to the commissioner one
rate for each entity that will bill medical assistance for
residential services under this section and two rates for each
nonresidential provider. The first nonresidential rate is for
recipients who are not receiving residential services. The
second nonresidential rate is for recipients who are temporarily
receiving residential services and need continued contact with
the nonresidential team to assure timely discharge from
residential services. In developing these rates, the host
county shall consider and document:
(1) the cost for similar services in the local trade area;
(2) actual costs incurred by entities providing the
services;
(3) the intensity and frequency of services to be provided
to each recipient;
(4) the degree to which recipients will receive services
other than services under this section;
(5) the costs of other services, such as case management,
that will be separately reimbursed; and
(6) input from the local planning process authorized by the
adult mental health initiative under section 245.4661, regarding
recipients' service needs.
(d) The rate for intensive rehabilitative mental health
services must exclude room and board, as defined in section
256I.03, subdivision 6, and services not covered under this
section, such as case management, partial hospitalization, home
care, and inpatient services. Physician services that are not
separately billed may be included in the rate to the extent that
a psychiatrist is a member of the treatment team. The county's
recommendation shall specify the period for which the rate will
be applicable, not to exceed two years.
(e) When services under this section are provided by an
assertive community team, case management functions must be an
integral part of the team. The county must allocate costs which
are reimbursable under this section versus costs which are
reimbursable through case management or other reimbursement, so
that payment is not duplicated.
(f) The rate for a provider must not exceed the rate
charged by that provider for the same service to other payors.
(g) The commissioner shall approve or reject the county's
rate recommendation, based on the commissioner's own analysis of
the criteria in paragraph (c).
Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR
COUNTY-OPERATED ENTITIES.] Counties that employ their own staff
to provide services under this section shall apply directly to
the commissioner for enrollment and rate setting. In this case,
a county contract is not required and the commissioner shall
perform the program review and rate setting duties which would
otherwise be required of counties under this section.
Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR
SPECIALIZED PROGRAM.] A provider proposing to serve a
subpopulation of eligible recipients may bypass the county
approval procedures in this section and receive approval for
provider enrollment and rate setting directly from the
commissioner under the following circumstances:
(1) the provider demonstrates that the subpopulation to be
served requires a specialized program which is not available
from county-approved entities; and
(2) the subpopulation to be served is of such a low
incidence that it is not feasible to develop a program serving a
single county or regional group of counties.
For providers meeting the criteria in clauses (1) and (2),
the commissioner shall perform the program review and rate
setting duties which would otherwise be required of counties
under this section.
Sec. 20. Minnesota Statutes 2002, section 256B.0623,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For purposes of this section, the
following terms have the meanings given them.
(a) "Adult rehabilitative mental health services" means
mental health services which are rehabilitative and enable the
recipient to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, and independent
living and community skills, when these abilities are impaired
by the symptoms of mental illness. Adult rehabilitative mental
health services are also appropriate when provided to enable a
recipient to retain stability and functioning, if the recipient
would be at risk of significant functional decompensation or
more restrictive service settings without these services.
(1) Adult rehabilitative mental health services instruct,
assist, and support the recipient in areas such as:
interpersonal communication skills, community resource
utilization and integration skills, crisis assistance, relapse
prevention skills, health care directives, budgeting and
shopping skills, healthy lifestyle skills and practices, cooking
and nutrition skills, transportation skills, medication
education and monitoring, mental illness symptom management
skills, household management skills, employment-related skills,
and transition to community living services.
(2) These services shall be provided to the recipient on a
one-to-one basis in the recipient's home or another community
setting or in groups.
(b) "Medication education services" means services provided
individually or in groups which focus on educating the recipient
about mental illness and symptoms; the role and effects of
medications in treating symptoms of mental illness; and the side
effects of medications. Medication education is coordinated
with medication management services and does not duplicate it.
Medication education services are provided by physicians,
pharmacists, physician's assistants, or registered nurses.
(c) "Transition to community living services" means
services which maintain continuity of contact between the
rehabilitation services provider and the recipient and which
facilitate discharge from a hospital, residential treatment
program under Minnesota Rules, chapter 9505, board and lodging
facility, or nursing home. Transition to community living
services are not intended to provide other areas of adult
rehabilitative mental health services.
Sec. 21. Minnesota Statutes 2002, section 256B.0623,
subdivision 4, is amended to read:
Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider
entity must be:
(1) a county operated entity certified by the state; or
(2) a noncounty entity certified by the entity's host
county certified by the state following the certification
process and procedures developed by the commissioner.
(b) The certification process is a determination as to
whether the entity meets the standards in this subdivision. The
certification must specify which adult rehabilitative mental
health services the entity is qualified to provide.
(c) If an entity seeks to provide services outside its host
county, it A noncounty provider entity must obtain additional
certification from each county in which it will provide
services. The additional certification must be based on the
adequacy of the entity's knowledge of that county's local health
and human service system, and the ability of the entity to
coordinate its services with the other services available in
that county. A county-operated entity must obtain this
additional certification from any other county in which it will
provide services.
(d) Recertification must occur at least every two three
years.
(e) The commissioner may intervene at any time and
decertify providers with cause. The decertification is subject
to appeal to the state. A county board may recommend that the
state decertify a provider for cause.
(f) The adult rehabilitative mental health services
provider entity must meet the following standards:
(1) have capacity to recruit, hire, manage, and train
mental health professionals, mental health practitioners, and
mental health rehabilitation workers;
(2) have adequate administrative ability to ensure
availability of services;
(3) ensure adequate preservice and inservice and ongoing
training for staff;
(4) ensure that mental health professionals, mental health
practitioners, and mental health rehabilitation workers are
skilled in the delivery of the specific adult rehabilitative
mental health services provided to the individual eligible
recipient;
(5) ensure that staff is capable of implementing culturally
specific services that are culturally competent and appropriate
as determined by the recipient's culture, beliefs, values, and
language as identified in the individual treatment plan;
(6) ensure enough flexibility in service delivery to
respond to the changing and intermittent care needs of a
recipient as identified by the recipient and the individual
treatment plan;
(7) ensure that the mental health professional or mental
health practitioner, who is under the clinical supervision of a
mental health professional, involved in a recipient's services
participates in the development of the individual treatment
plan;
(8) assist the recipient in arranging needed crisis
assessment, intervention, and stabilization services;
(9) ensure that services are coordinated with other
recipient mental health services providers and the county mental
health authority and the federally recognized American Indian
authority and necessary others after obtaining the consent of
the recipient. Services must also be coordinated with the
recipient's case manager or care coordinator if the recipient is
receiving case management or care coordination services;
(10) develop and maintain recipient files, individual
treatment plans, and contact charting;
(11) develop and maintain staff training and personnel
files;
(12) submit information as required by the state;
(13) establish and maintain a quality assurance plan to
evaluate the outcome of services provided;
(14) keep all necessary records required by law;
(15) deliver services as required by section 245.461;
(16) comply with all applicable laws;
(17) be an enrolled Medicaid provider;
(18) maintain a quality assurance plan to determine
specific service outcomes and the recipient's satisfaction with
services; and
(19) develop and maintain written policies and procedures
regarding service provision and administration of the provider
entity.
(g) The commissioner shall develop statewide procedures for
provider certification, including timelines for counties to
certify qualified providers.
Sec. 22. Minnesota Statutes 2002, section 256B.0623,
subdivision 5, is amended to read:
Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult
rehabilitative mental health services must be provided by
qualified individual provider staff of a certified provider
entity. Individual provider staff must be qualified under one
of the following criteria:
(1) a mental health professional as defined in section
245.462, subdivision 18, clauses (1) to (5). If the recipient
has a current diagnostic assessment by a licensed mental health
professional as defined in section 245.462, subdivision 18,
clauses (1) to (5), recommending receipt of adult mental health
rehabilitative services, the definition of mental health
professional for purposes of this section includes a person who
is qualified under section 245.462, subdivision 18, clause (6),
and who holds a current and valid national certification as a
certified rehabilitation counselor or certified psychosocial
rehabilitation practitioner;
(2) a mental health practitioner as defined in section
245.462, subdivision 17. The mental health practitioner must
work under the clinical supervision of a mental health
professional; or
(3) a mental health rehabilitation worker. A mental health
rehabilitation worker means a staff person working under the
direction of a mental health practitioner or mental health
professional and under the clinical supervision of a mental
health professional in the implementation of rehabilitative
mental health services as identified in the recipient's
individual treatment plan who:
(i) is at least 21 years of age;
(ii) has a high school diploma or equivalent;
(iii) has successfully completed 30 hours of training
during the past two years in all of the following areas:
recipient rights, recipient-centered individual treatment
planning, behavioral terminology, mental illness, co-occurring
mental illness and substance abuse, psychotropic medications and
side effects, functional assessment, local community resources,
adult vulnerability, recipient confidentiality; and
(iv) meets the qualifications in subitem (A) or (B):
(A) has an associate of arts degree in one of the
behavioral sciences or human services, or is a registered nurse
without a bachelor's degree, or who within the previous ten
years has:
(1) three years of personal life experience with serious
and persistent mental illness;
(2) three years of life experience as a primary caregiver
to an adult with a serious mental illness or traumatic brain
injury; or
(3) 4,000 hours of supervised paid work experience in the
delivery of mental health services to adults with a serious
mental illness or traumatic brain injury; or
(B)(1) is fluent in the non-English language or competent
in the culture of the ethnic group to which at least 50 20
percent of the mental health rehabilitation worker's clients
belong;
(2) receives during the first 2,000 hours of work, monthly
documented individual clinical supervision by a mental health
professional;
(3) has 18 hours of documented field supervision by a
mental health professional or practitioner during the first 160
hours of contact work with recipients, and at least six hours of
field supervision quarterly during the following year;
(4) has review and cosignature of charting of recipient
contacts during field supervision by a mental health
professional or practitioner; and
(5) has 40 hours of additional continuing education on
mental health topics during the first year of employment.
Sec. 23. Minnesota Statutes 2002, section 256B.0623,
subdivision 6, is amended to read:
Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental
health rehabilitation workers must receive ongoing continuing
education training of at least 30 hours every two years in areas
of mental illness and mental health services and other areas
specific to the population being served. Mental health
rehabilitation workers must also be subject to the ongoing
direction and clinical supervision standards in paragraphs (c)
and (d).
(b) Mental health practitioners must receive ongoing
continuing education training as required by their professional
license; or if the practitioner is not licensed, the
practitioner must receive ongoing continuing education training
of at least 30 hours every two years in areas of mental illness
and mental health services. Mental health practitioners must
meet the ongoing clinical supervision standards in paragraph (c).
(c) Clinical supervision may be provided by a full- or
part-time qualified professional employed by or under contract
with the provider entity. Clinical supervision may be provided
by interactive videoconferencing according to procedures
developed by the commissioner. A mental health professional
providing clinical supervision of staff delivering adult
rehabilitative mental health services must provide the following
guidance:
(1) review the information in the recipient's file;
(2) review and approve initial and updates of individual
treatment plans;
(3) meet with mental health rehabilitation workers and
practitioners, individually or in small groups, at least monthly
to discuss treatment topics of interest to the workers and
practitioners;
(4) meet with mental health rehabilitation workers and
practitioners, individually or in small groups, at least monthly
to discuss treatment plans of recipients, and approve by
signature and document in the recipient's file any resulting
plan updates;
(5) meet at least twice a month monthly with the directing
mental health practitioner, if there is one, to review needs of
the adult rehabilitative mental health services program, review
staff on-site observations and evaluate mental health
rehabilitation workers, plan staff training, review program
evaluation and development, and consult with the directing
practitioner; and
(6) be available for urgent consultation as the individual
recipient needs or the situation necessitates; and
(7) provide clinical supervision by full- or part-time
mental health professionals employed by or under contract with
the provider entity.
(d) An adult rehabilitative mental health services provider
entity must have a treatment director who is a mental health
practitioner or mental health professional. The treatment
director must ensure the following:
(1) while delivering direct services to recipients, a newly
hired mental health rehabilitation worker must be directly
observed delivering services to recipients by the a mental
health practitioner or mental health professional for at least
six hours per 40 hours worked during the first 160 hours that
the mental health rehabilitation worker works;
(2) the mental health rehabilitation worker must receive
ongoing on-site direct service observation by a mental health
professional or mental health practitioner for at least six
hours for every six months of employment;
(3) progress notes are reviewed from on-site service
observation prepared by the mental health rehabilitation worker
and mental health practitioner for accuracy and consistency with
actual recipient contact and the individual treatment plan and
goals;
(4) immediate availability by phone or in person for
consultation by a mental health professional or a mental health
practitioner to the mental health rehabilitation services worker
during service provision;
(5) oversee the identification of changes in individual
recipient treatment strategies, revise the plan, and communicate
treatment instructions and methodologies as appropriate to
ensure that treatment is implemented correctly;
(6) model service practices which: respect the recipient,
include the recipient in planning and implementation of the
individual treatment plan, recognize the recipient's strengths,
collaborate and coordinate with other involved parties and
providers;
(7) ensure that mental health practitioners and mental
health rehabilitation workers are able to effectively
communicate with the recipients, significant others, and
providers; and
(8) oversee the record of the results of on-site
observation and charting evaluation and corrective actions taken
to modify the work of the mental health practitioners and mental
health rehabilitation workers.
(e) A mental health practitioner who is providing treatment
direction for a provider entity must receive supervision at
least monthly from a mental health professional to:
(1) identify and plan for general needs of the recipient
population served;
(2) identify and plan to address provider entity program
needs and effectiveness;
(3) identify and plan provider entity staff training and
personnel needs and issues; and
(4) plan, implement, and evaluate provider entity quality
improvement programs.
Sec. 24. Minnesota Statutes 2002, section 256B.0623,
subdivision 8, is amended to read:
Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult
rehabilitative mental health services must complete a diagnostic
assessment as defined in section 245.462, subdivision 9, within
five days after the recipient's second visit or within 30 days
after intake, whichever occurs first. In cases where a
diagnostic assessment is available that reflects the recipient's
current status, and has been completed within 180 days preceding
admission, an update must be completed. An update shall include
a written summary by a mental health professional of the
recipient's current mental health status and service needs. If
the recipient's mental health status has changed significantly
since the adult's most recent diagnostic assessment, a new
diagnostic assessment is required. For initial implementation
of adult rehabilitative mental health services, until June 30,
2005, a diagnostic assessment that reflects the recipient's
current status and has been completed within the past three
years preceding admission is acceptable.
Sec. 25. Minnesota Statutes 2002, section 256B.0625,
subdivision 19c, is amended to read:
Subd. 19c. [PERSONAL CARE.] Medical assistance covers
personal care assistant services provided by an individual who
is qualified to provide the services according to subdivision
19a and section 256B.0627, where the services are prescribed by
a physician in accordance with a plan of treatment and are
supervised by the recipient or a qualified professional.
"Qualified professional" means a mental health professional as
defined in section 245.462, subdivision 18, or 245.4871,
subdivision 27; or a registered nurse as defined in sections
148.171 to 148.285, or a licensed social worker as defined in
section 148B.21. As part of the assessment, the county public
health nurse will assist the recipient or responsible party to
identify the most appropriate person to provide supervision of
the personal care assistant. The qualified professional shall
perform the duties described in Minnesota Rules, part 9505.0335,
subpart 4.
Sec. 26. Minnesota Statutes 2002, section 256B.0627,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] (a) "Activities of daily
living" includes eating, toileting, grooming, dressing, bathing,
transferring, mobility, and positioning.
(b) "Assessment" means a review and evaluation of a
recipient's need for home care services conducted in person.
Assessments for private duty nursing shall be conducted by a
registered private duty nurse. Assessments for home health
agency services shall be conducted by a home health agency
nurse. Assessments for personal care assistant services shall
be conducted by the county public health nurse or a certified
public health nurse under contract with the county. A
face-to-face assessment must include: documentation of health
status, determination of need, evaluation of service
effectiveness, identification of appropriate services, service
plan development or modification, coordination of services,
referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of
service authorization, and consumer education. Once the need
for personal care assistant services is determined under this
section, the county public health nurse or certified public
health nurse under contract with the county is responsible for
communicating this recommendation to the commissioner and the
recipient. A face-to-face assessment for personal care
assistant services is conducted on those recipients who have
never had a county public health nurse assessment. A
face-to-face assessment must occur at least annually or when
there is a significant change in the recipient's condition or
when there is a change in the need for personal care assistant
services. A service update may substitute for the annual
face-to-face assessment when there is not a significant change
in recipient condition or a change in the need for personal care
assistant service. A service update or review for temporary
increase includes a review of initial baseline data, evaluation
of service effectiveness, redetermination of service need,
modification of service plan and appropriate referrals, update
of initial forms, obtaining service authorization, and on going
consumer education. Assessments for medical assistance home
care services for mental retardation or related conditions and
alternative care services for developmentally disabled home and
community-based waivered recipients may be conducted by the
county public health nurse to ensure coordination and avoid
duplication. Assessments must be completed on forms provided by
the commissioner within 30 days of a request for home care
services by a recipient or responsible party.
(c) "Care plan" means a written description of personal
care assistant services developed by the qualified professional
or the recipient's physician with the recipient or responsible
party to be used by the personal care assistant with a copy
provided to the recipient or responsible party.
(d) "Complex and regular private duty nursing care" means:
(1) complex care is private duty nursing provided to
recipients who are ventilator dependent or for whom a physician
has certified that were it not for private duty nursing the
recipient would meet the criteria for inpatient hospital
intensive care unit (ICU) level of care; and
(2) regular care is private duty nursing provided to all
other recipients.
(e) "Health-related functions" means functions that can be
delegated or assigned by a licensed health care professional
under state law to be performed by a personal care attendant.
(f) "Home care services" means a health service, determined
by the commissioner as medically necessary, that is ordered by a
physician and documented in a service plan that is reviewed by
the physician at least once every 60 days for the provision of
home health services, or private duty nursing, or at least once
every 365 days for personal care. Home care services are
provided to the recipient at the recipient's residence that is a
place other than a hospital or long-term care facility or as
specified in section 256B.0625.
(g) "Instrumental activities of daily living" includes meal
planning and preparation, managing finances, shopping for food,
clothing, and other essential items, performing essential
household chores, communication by telephone and other media,
and getting around and participating in the community.
(h) "Medically necessary" has the meaning given in
Minnesota Rules, parts 9505.0170 to 9505.0475.
(i) "Personal care assistant" means a person who:
(1) is at least 18 years old, except for persons 16 to 18
years of age who participated in a related school-based job
training program or have completed a certified home health aide
competency evaluation;
(2) is able to effectively communicate with the recipient
and personal care provider organization;
(3) effective July 1, 1996, has completed one of the
training requirements as specified in Minnesota Rules, part
9505.0335, subpart 3, items A to D;
(4) has the ability to, and provides covered personal care
assistant services according to the recipient's care plan,
responds appropriately to recipient needs, and reports changes
in the recipient's condition to the supervising qualified
professional or physician;
(5) is not a consumer of personal care assistant services;
and
(6) is subject to criminal background checks and procedures
specified in section 245A.04.
(j) "Personal care provider organization" means an
organization enrolled to provide personal care assistant
services under the medical assistance program that complies with
the following: (1) owners who have a five percent interest or
more, and managerial officials are subject to a background study
as provided in section 245A.04. This applies to currently
enrolled personal care provider organizations and those agencies
seeking enrollment as a personal care provider organization. An
organization will be barred from enrollment if an owner or
managerial official of the organization has been convicted of a
crime specified in section 245A.04, or a comparable crime in
another jurisdiction, unless the owner or managerial official
meets the reconsideration criteria specified in section 245A.04;
(2) the organization must maintain a surety bond and liability
insurance throughout the duration of enrollment and provides
proof thereof. The insurer must notify the department of human
services of the cancellation or lapse of policy; and (3) the
organization must maintain documentation of services as
specified in Minnesota Rules, part 9505.2175, subpart 7, as well
as evidence of compliance with personal care assistant training
requirements.
(k) "Responsible party" means an individual residing with a
recipient of personal care assistant services who is capable of
providing the supportive care support necessary to assist the
recipient to live in the community, is at least 18 years
old, actively participates in planning and directing of personal
care assistant services, and is not a the personal care
assistant. The responsible party must be accessible to the
recipient and the personal care assistant when personal care
services are being provided and monitor the services at least
weekly according to the plan of care. The responsible party
must be identified at the time of assessment and listed on the
recipient's service agreement and care plan. Responsible
parties who are parents of minors or guardians of minors or
incapacitated persons may delegate the responsibility to another
adult during a temporary absence of at least 24 hours but not
more than six months. The person delegated as a responsible
party must be able to meet the definition of responsible party,
except that the delegated responsible party is required to
reside with the recipient only while serving as the responsible
party who is not the personal care assistant. The responsible
party must assure that the delegate performs the functions of
the responsible party, is identified at the time of the
assessment, and is listed on the service agreement and the care
plan. Foster care license holders may be designated the
responsible party for residents of the foster care home if case
management is provided as required in section 256B.0625,
subdivision 19a. For persons who, as of April 1, 1992, are
sharing personal care assistant services in order to obtain the
availability of 24-hour coverage, an employee of the personal
care provider organization may be designated as the responsible
party if case management is provided as required in section
256B.0625, subdivision 19a.
(l) "Service plan" means a written description of the
services needed based on the assessment developed by the nurse
who conducts the assessment together with the recipient or
responsible party. The service plan shall include a description
of the covered home care services, frequency and duration of
services, and expected outcomes and goals. The recipient and
the provider chosen by the recipient or responsible party must
be given a copy of the completed service plan within 30 calendar
days of the request for home care services by the recipient or
responsible party.
(m) "Skilled nurse visits" are provided in a recipient's
residence under a plan of care or service plan that specifies a
level of care which the nurse is qualified to provide. These
services are:
(1) nursing services according to the written plan of care
or service plan and accepted standards of medical and nursing
practice in accordance with chapter 148;
(2) services which due to the recipient's medical condition
may only be safely and effectively provided by a registered
nurse or a licensed practical nurse;
(3) assessments performed only by a registered nurse; and
(4) teaching and training the recipient, the recipient's
family, or other caregivers requiring the skills of a registered
nurse or licensed practical nurse.
(n) "Telehomecare" means the use of telecommunications
technology by a home health care professional to deliver home
health care services, within the professional's scope of
practice, to a patient located at a site other than the site
where the practitioner is located.
Sec. 27. Minnesota Statutes 2002, section 256B.0627,
subdivision 4, is amended to read:
Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The
personal care assistant services that are eligible for payment
are services and supports furnished to an individual, as needed,
to assist in accomplishing activities of daily living;
instrumental activities of daily living; health-related
functions through hands-on assistance, supervision, and cuing;
and redirection and intervention for behavior including
observation and monitoring.
(b) Payment for services will be made within the limits
approved using the prior authorized process established in
subdivision 5.
(c) The amount and type of services authorized shall be
based on an assessment of the recipient's needs in these areas:
(1) bowel and bladder care;
(2) skin care to maintain the health of the skin;
(3) repetitive maintenance range of motion, muscle
strengthening exercises, and other tasks specific to maintaining
a recipient's optimal level of function;
(4) respiratory assistance;
(5) transfers and ambulation;
(6) bathing, grooming, and hairwashing necessary for
personal hygiene;
(7) turning and positioning;
(8) assistance with furnishing medication that is
self-administered;
(9) application and maintenance of prosthetics and
orthotics;
(10) cleaning medical equipment;
(11) dressing or undressing;
(12) assistance with eating and meal preparation and
necessary grocery shopping;
(13) accompanying a recipient to obtain medical diagnosis
or treatment;
(14) assisting, monitoring, or prompting the recipient to
complete the services in clauses (1) to (13);
(15) redirection, monitoring, and observation that are
medically necessary and an integral part of completing the
personal care assistant services described in clauses (1) to
(14);
(16) redirection and intervention for behavior, including
observation and monitoring;
(17) interventions for seizure disorders, including
monitoring and observation if the recipient has had a seizure
that requires intervention within the past three months;
(18) tracheostomy suctioning using a clean procedure if the
procedure is properly delegated by a registered nurse. Before
this procedure can be delegated to a personal care assistant, a
registered nurse must determine that the tracheostomy suctioning
can be accomplished utilizing a clean rather than a sterile
procedure and must ensure that the personal care assistant has
been taught the proper procedure; and
(19) incidental household services that are an integral
part of a personal care service described in clauses (1) to (18).
For purposes of this subdivision, monitoring and observation
means watching for outward visible signs that are likely to
occur and for which there is a covered personal care service or
an appropriate personal care intervention. For purposes of this
subdivision, a clean procedure refers to a procedure that
reduces the numbers of microorganisms or prevents or reduces the
transmission of microorganisms from one person or place to
another. A clean procedure may be used beginning 14 days after
insertion.
(d) The personal care assistant services that are not
eligible for payment are the following:
(1) services not ordered by the physician;
(2) assessments by personal care assistant provider
organizations or by independently enrolled registered nurses;
(3) services that are not in the service plan;
(4) services provided by the recipient's spouse, legal
guardian for an adult or child recipient, or parent of a
recipient under age 18;
(5) services provided by a foster care provider of a
recipient who cannot direct the recipient's own care, unless
monitored by a county or state case manager under section
256B.0625, subdivision 19a;
(6) services provided by the residential or program license
holder in a residence for more than four persons;
(7) services that are the responsibility of a residential
or program license holder under the terms of a service agreement
and administrative rules;
(8) sterile procedures;
(9) injections of fluids into veins, muscles, or skin;
(10) services provided by parents of adult recipients,
adult children, or siblings of the recipient, unless these
relatives meet one of the following hardship criteria and the
commissioner waives this requirement:
(i) the relative resigns from a part-time or full-time job
to provide personal care for the recipient;
(ii) the relative goes from a full-time to a part-time job
with less compensation to provide personal care for the
recipient;
(iii) the relative takes a leave of absence without pay to
provide personal care for the recipient;
(iv) the relative incurs substantial expenses by providing
personal care for the recipient; or
(v) because of labor conditions, special language needs, or
intermittent hours of care needed, the relative is needed in
order to provide an adequate number of qualified personal care
assistants to meet the medical needs of the recipient;
(11) homemaker services that are not an integral part of a
personal care assistant services;
(12) (11) home maintenance, or chore services;
(13) (12) services not specified under paragraph (a); and
(14) (13) services not authorized by the commissioner or
the commissioner's designee.
(e) The recipient or responsible party may choose to
supervise the personal care assistant or to have a qualified
professional, as defined in section 256B.0625, subdivision 19c,
provide the supervision. As required under section 256B.0625,
subdivision 19c, the county public health nurse, as a part of
the assessment, will assist the recipient or responsible party
to identify the most appropriate person to provide supervision
of the personal care assistant. Health-related delegated tasks
performed by the personal care assistant will be under the
supervision of a qualified professional or the direction of the
recipient's physician. If the recipient has a qualified
professional, Minnesota Rules, part 9505.0335, subpart 4,
applies.
Sec. 28. Minnesota Statutes 2002, section 256B.0627,
subdivision 9, is amended to read:
Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.]
(a) The commissioner may allow for the flexible use of personal
care assistant hours. "Flexible use" means the scheduled use of
authorized hours of personal care assistant services, which vary
within the length of the service authorization in order to more
effectively meet the needs and schedule of the recipient.
Recipients may use their approved hours flexibly within the
service authorization period for medically necessary covered
services specified in the assessment required in subdivision 1.
The flexible use of authorized hours does not increase the total
amount of authorized hours available to a recipient as
determined under subdivision 5. The commissioner shall not
authorize additional personal care assistant services to
supplement a service authorization that is exhausted before the
end date under a flexible service use plan, unless the county
public health nurse determines a change in condition and a need
for increased services is established.
(b) The recipient or responsible party, together with the
county public health nurse, shall determine whether flexible use
is an appropriate option based on the needs and preferences of
the recipient or responsible party, and, if appropriate, must
ensure that the allocation of hours covers the ongoing needs of
the recipient over the entire service authorization period. As
part of the assessment and service planning process, the
recipient or responsible party must work with the county public
health nurse to develop a written month-to-month plan of the
projected use of personal care assistant services that is part
of the service plan and ensures that the:
(1) health and safety needs of the recipient will be met;
(2) total annual authorization will not exceed before the
end date; and
(3) how actual use of hours will be monitored.
(c) If the actual use of personal care assistant service
varies significantly from the use projected in the plan, the
written plan must be promptly updated by the recipient or
responsible party and the county public health nurse.
(d) The recipient or responsible party, together with the
provider, must work to monitor and document the use of
authorized hours and ensure that a recipient is able to manage
services effectively throughout the authorized period. The
provider must ensure that the month-to-month plan is
incorporated into the care plan. Upon request of the recipient
or responsible party, the provider must furnish regular updates
to the recipient or responsible party on the amount of personal
care assistant services used.
(e) The recipient or responsible party may revoke the
authorization for flexible use of hours by notifying the
provider and county public health nurse in writing.
(f) If the requirements in paragraphs (a) to (e) have not
substantially been met, the commissioner shall deny, revoke, or
suspend the authorization to use authorized hours flexibly. The
recipient or responsible party may appeal the commissioner's
action according to section 256.045. The denial, revocation, or
suspension to use the flexible hours option shall not affect the
recipient's authorized level of personal care assistant services
as determined under subdivision 5.
Sec. 29. Minnesota Statutes 2002, 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 40
calendar 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.
(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.
(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 40 calendar days of
admission.
(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.
(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.
(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.
Sec. 30. Minnesota Statutes 2002, section 256B.0915, is
amended by adding a subdivision to read:
Subd. 9. [TRIBAL MANAGEMENT OF ELDERLY WAIVER.]
Notwithstanding contrary provisions of this section, or those in
other state laws or rules, the commissioner and White Earth
reservation may develop a model for tribal management of the
elderly waiver program and implement this model through a
contract between the state and White Earth reservation. The
model shall include the provision of tribal waiver case
management, assessment for personal care assistance, and
administrative requirements otherwise carried out by counties
but shall not include tribal financial eligibility determination
for medical assistance.
Sec. 31. Minnesota Statutes 2002, section 256B.092,
subdivision 1a, is amended to read:
Subd. 1a. [CASE MANAGEMENT ADMINISTRATION AND SERVICES.]
(a) The administrative functions of case management provided to
or arranged for a person include:
(1) intake review of eligibility for services;
(2) diagnosis screening;
(3) screening intake;
(4) service authorization diagnosis;
(5) review of eligibility for services the review and
authorization of services based upon an individualized service
plan; and
(6) responding to requests for conciliation conferences and
appeals according to section 256.045 made by the person, the
person's legal guardian or conservator, or the parent if the
person is a minor.
(b) Case management service activities provided to or
arranged for a person include:
(1) development of the individual service plan;
(2) informing the individual or the individual's legal
guardian or conservator, or parent if the person is a minor, of
service options;
(3) consulting with relevant medical experts or service
providers;
(3) (4) assisting the person in the identification of
potential providers;
(4) (5) assisting the person to access services;
(5) (6) coordination of services, if coordination is not
provided by another service provider;
(6) (7) evaluation and monitoring of the services
identified in the plan; and
(7) (8) annual reviews of service plans and services
provided.
(c) Case management administration and service activities
that are provided to the person with mental retardation or a
related condition shall be provided directly by county agencies
or under contract.
(d) Case managers are responsible for the administrative
duties and service provisions listed in paragraphs (a) and (b).
Case managers shall collaborate with consumers, families, legal
representatives, and relevant medical experts and service
providers in the development and annual review of the
individualized service and habilitation plans.
(e) The department of human services shall offer ongoing
education in case management to case managers. Case managers
shall receive no less than ten hours of case management
education and disability-related training each year.
Sec. 32. Minnesota Statutes 2002, section 256B.092,
subdivision 5, is amended to read:
Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall
apply for any federal waivers necessary to secure, to the extent
allowed by law, federal financial participation under United
States Code, title 42, sections 1396 et seq., as amended, for
the provision of services to persons who, in the absence of the
services, would need the level of care provided in a regional
treatment center or a community intermediate care facility for
persons with mental retardation or related conditions. The
commissioner may seek amendments to the waivers or apply for
additional waivers under United States Code, title 42, sections
1396 et seq., as amended, to contain costs. The commissioner
shall ensure that payment for the cost of providing home and
community-based alternative services under the federal waiver
plan shall not exceed the cost of intermediate care services
including day training and habilitation services that would have
been provided without the waivered services.
(b) The commissioner, in administering home and
community-based waivers for persons with mental retardation and
related conditions, shall ensure that day services for eligible
persons are not provided by the person's residential service
provider, unless the person or the person's legal representative
is offered a choice of providers and agrees in writing to
provision of day services by the residential service provider.
The individual service plan for individuals who choose to have
their residential service provider provide their day services
must describe how health, safety, and protection, and
habilitation needs will be met by, including how frequent and
regular contact with persons other than the residential service
provider will occur. The individualized service plan must
address the provision of services during the day outside the
residence on weekdays.
(c) When a county is evaluating denials, reductions, or
terminations of home and community-based services under section
256B.0916 for an individual, the case manager shall offer to
meet with the individual or the individual's guardian in order
to discuss the prioritization of service needs within the
individualized service plan. The reduction in the authorized
services for an individual due to changes in funding for
waivered services may not exceed the amount needed to ensure
medically necessary services to meet the individual's health,
safety, and welfare.
Sec. 33. Minnesota Statutes 2002, section 256B.095, is
amended to read:
256B.095 [QUALITY ASSURANCE PROJECT SYSTEM ESTABLISHED.]
(a) Effective July 1, 1998, an alternative a quality
assurance licensing system project for persons with
developmental disabilities, which includes an alternative
quality assurance licensing system for programs for persons with
developmental disabilities, is established in Dodge, Fillmore,
Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele,
Wabasha, and Winona counties for the purpose of improving the
quality of services provided to persons with developmental
disabilities. A county, at its option, may choose to have all
programs for persons with developmental disabilities located
within the county licensed under chapter 245A using standards
determined under the alternative quality assurance licensing
system project or may continue regulation of these programs
under the licensing system operated by the commissioner. The
project expires on June 30, 2005 2007.
(b) Effective July 1, 2003, a county not listed in
paragraph (a) may apply to participate in the quality assurance
system established under paragraph (a). The commission
established under section 256B.0951 may, at its option, allow
additional counties to participate in the system.
(c) Effective July 1, 2003, any county or group of counties
not listed in paragraph (a) may establish a quality assurance
system under this section. A new system established under this
section shall have the same rights and duties as the system
established under paragraph (a). A new system shall be governed
by a commission under section 256B.0951. The commissioner shall
appoint the initial commission members based on recommendations
from advocates, families, service providers, and counties in the
geographic area included in the new system. Counties that
choose to participate in a new system shall have the duties
assigned under section 256B.0952. The new system shall
establish a quality assurance process under section 256B.0953.
The provisions of section 256B.0954 shall apply to a new system
established under this paragraph. The commissioner shall
delegate authority to a new system established under this
paragraph according to section 256B.0955.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 34. Minnesota Statutes 2002, section 256B.0951,
subdivision 1, is amended to read:
Subdivision 1. [MEMBERSHIP.] The region 10 quality
assurance commission is established. The commission consists of
at least 14 but not more than 21 members as follows: at least
three but not more than five members representing advocacy
organizations; at least three but not more than five members
representing consumers, families, and their legal
representatives; at least three but not more than five members
representing service providers; at least three but not more than
five members representing counties; and the commissioner of
human services or the commissioner's designee. Initial
membership of the commission shall be recruited and approved by
the region 10 stakeholders group. Prior to approving the
commission's membership, the stakeholders group shall provide to
the commissioner a list of the membership in the stakeholders
group, as of February 1, 1997, a brief summary of meetings held
by the group since July 1, 1996, and copies of any materials
prepared by the group for public distribution. The first
commission shall establish membership guidelines for the
transition and recruitment of membership for the commission's
ongoing existence. Members of the commission who do not receive
a salary or wages from an employer for time spent on commission
duties may receive a per diem payment when performing commission
duties and functions. All members may be reimbursed for
expenses related to commission activities. Notwithstanding the
provisions of section 15.059, subdivision 5, the commission
expires on June 30, 2005 2007.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 35. Minnesota Statutes 2002, section 256B.0951,
subdivision 2, is amended to read:
Subd. 2. [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE
TECHNICAL ASSISTANCE.] (a) The commission may hire staff to
perform the duties assigned in this section.
(b) The commission may charge fees for its services.
(c) The commission may provide technical assistance to
other counties, families, providers, and advocates interested in
participating in a quality assurance system under section
256B.095, paragraph (b) or (c).
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 36. Minnesota Statutes 2002, section 256B.0951,
subdivision 3, is amended to read:
Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the
commission, in cooperation with the commissioners of human
services and health, shall do the following: (1) approve an
alternative quality assurance licensing system based on the
evaluation of outcomes; (2) approve measurable outcomes in the
areas of health and safety, consumer evaluation, education and
training, providers, and systems that shall be evaluated during
the alternative licensing process; and (3) establish variable
licensure periods not to exceed three years based on outcomes
achieved. For purposes of this subdivision, "outcome" means the
behavior, action, or status of a person that can be observed or
measured and can be reliably and validly determined.
(b) By January 15, 1998, the commission shall approve, in
cooperation with the commissioner of human services, a training
program for members of the quality assurance teams established
under section 256B.0952, subdivision 4.
(c) The commission and the commissioner shall establish an
ongoing review process for the alternative quality assurance
licensing system. The review shall take into account the
comprehensive nature of the alternative system, which is
designed to evaluate the broad spectrum of licensed and
unlicensed entities that provide services to clients, as
compared to the current licensing system.
(d) The commission shall contract with an independent
entity to conduct a financial review of the alternative quality
assurance project. The review shall take into account the
comprehensive nature of the alternative system, which is
designed to evaluate the broad spectrum of licensed and
unlicensed entities that provide services to clients, as
compared to the current licensing system. The review shall
include an evaluation of possible budgetary savings within the
department of human services as a result of implementation of
the alternative quality assurance project. If a federal waiver
is approved under subdivision 7, the financial review shall also
evaluate possible savings within the department of health. This
review must be completed by December 15, 2000.
(e) The commission shall submit a report to the legislature
by January 15, 2001, on the results of the review process for
the alternative quality assurance project, a summary of the
results of the independent financial review, and a
recommendation on whether the project should be extended beyond
June 30, 2001.
(f) The commissioner commission, in consultation with
the commission commissioner, shall examine the feasibility of
expanding work cooperatively with other populations to expand
the project system to other those populations or geographic
areas and identify barriers to expansion. The commissioner
shall report findings and recommendations to the legislature by
December 15, 2004.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 37. Minnesota Statutes 2002, section 256B.0951,
subdivision 5, is amended to read:
Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The
safety standards, rights, or procedural protections under
sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a,
3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2)
and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092,
subdivisions 1b, clause (7), and 10; 626.556; 626.557, and
procedures for the monitoring of psychotropic medications shall
not be varied under the alternative licensing quality assurance
licensing system project. The commission may make
recommendations to the commissioners of human services and
health or to the legislature regarding alternatives to or
modifications of the rules and procedures referenced in this
subdivision.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 38. Minnesota Statutes 2002, 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
alternative quality assurance project system established in
section 256B.095 from the requirements of Minnesota Rules,
chapter 4665.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 39. Minnesota Statutes 2002, section 256B.0951,
subdivision 9, is amended to read:
Subd. 9. [EVALUATION.] The commission, in consultation
with the commissioner of human services, shall conduct an
evaluation of the alternative quality assurance system, and
present a report to the commissioner by June 30, 2004.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 40. Minnesota Statutes 2002, section 256B.0952,
subdivision 1, is amended to read:
Subdivision 1. [NOTIFICATION.] For each year of the
project, region 10 Counties shall give notice to the commission
and commissioners of human services and health by March 15 of
intent to join the quality assurance alternative quality
assurance licensing system, effective July 1 of that year. A
county choosing to participate in the alternative quality
assurance licensing system commits to participate until June 30,
2005. Counties participating in the quality assurance
alternative licensing system as of January 1, 2001, shall notify
the commission and the commissioners of human services and
health by March 15, 2001, of intent to continue participation.
Counties that elect to continue participation must participate
in the alternative licensing system until June 30, 2005 for
three years.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 41. Minnesota Statutes 2002, section 256B.0953,
subdivision 2, is amended to read:
Subd. 2. [LICENSURE PERIODS.] (a) In order to be licensed
under the alternative quality assurance process licensing
system, a facility, program, or service must satisfy the health
and safety outcomes approved for the pilot project alternative
quality assurance licensing system.
(b) Licensure shall be approved for periods of one to three
years for a facility, program, or service that satisfies the
requirements of paragraph (a) and achieves the outcome
measurements in the categories of consumer evaluation, education
and training, providers, and systems.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 42. Minnesota Statutes 2002, section 256B.0955, is
amended to read:
256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.]
(a) Effective July 1, 1998, the commissioner of human
services shall delegate authority to perform licensing functions
and activities, in accordance with section 245A.16, to counties
participating in the alternative quality assurance licensing
system. The commissioner shall not license or reimburse a
facility, program, or service for persons with developmental
disabilities in a county that participates in the
alternative quality assurance licensing system if the
commissioner has received from the appropriate county
notification that the facility, program, or service has been
reviewed by a quality assurance team and has failed to qualify
for licensure.
(b) The commissioner may conduct random licensing
inspections based on outcomes adopted under section 256B.0951 at
facilities, programs, and services governed by the alternative
quality assurance licensing system. The role of such random
inspections shall be to verify that the alternative quality
assurance licensing system protects the safety and well-being of
consumers and maintains the availability of high-quality
services for persons with developmental disabilities.
(c) The commissioner shall provide technical assistance and
support or training to the alternative licensing system pilot
project.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 43. Minnesota Statutes 2002, section 256B.19,
subdivision 1, 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) 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
(2) 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.;
(3) beginning July 1, 2004, 80 percent state funds and 20
percent county funds for the costs of placements that have
exceeded 90 days in intermediate care facilities for persons
with mental retardation or a related condition that have seven
or more beds. This provision includes pass-through payments
made under section 256B.5015; and
(4) beginning July 1, 2004, when state funds are used to
pay for a nursing facility placement due to the facility's
status as an institution for mental diseases (IMD), the county
shall pay 20 percent of the nonfederal share of costs that have
exceeded 90 days. This clause is subject to chapter 256G.
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. 44. Minnesota Statutes 2002, section 256B.47,
subdivision 2, is amended to read:
Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing
facility rates for private paying residents shall be effective
unless the nursing facility notifies the resident or person
responsible for payment of the increase in writing 30 days
before the increase takes effect.
A nursing facility may adjust its rates without giving the
notice required by this subdivision when the purpose of the rate
adjustment is to reflect a necessary change in the level of care
provided to a case-mix classification of the resident. If the
state fails to set rates as required by section
256B.431, subdivision 1, the time required for giving notice is
decreased by the number of days by which the state was late in
setting the rates.
(b) If the state does not set rates by the date required in
section 256B.431, subdivision 1, nursing facilities shall meet
the requirement for advance notice by informing the resident or
person responsible for payments, on or before the effective date
of the increase, that a rate increase will be effective on that
date. If the exact amount has not yet been determined, the
nursing facility may raise the rates by the amount anticipated
to be allowed. Any amounts collected from private pay residents
in excess of the allowable rate must be repaid to private pay
residents with interest at the rate used by the commissioner of
revenue for the late payment of taxes and in effect on the date
the rate increase is effective.
Sec. 45. Minnesota Statutes 2002, section 256B.47,
subdivision 2, is amended to read:
Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing
facility rates for private paying residents shall be effective
unless the nursing facility notifies the resident or person
responsible for payment of the increase in writing 30 days
before the increase takes effect.
A nursing facility may adjust its rates without giving the
notice required by this subdivision when the purpose of the rate
adjustment is to reflect a necessary change in the level of care
provided to a case-mix classification of the resident. If the
state fails to set rates as required by section
256B.431, subdivision 1, the time required for giving notice is
decreased by the number of days by which the state was late in
setting the rates.
(b) If the state does not set rates by the date required in
section 256B.431, subdivision 1, nursing facilities shall meet
the requirement for advance notice by informing the resident or
person responsible for payments, on or before the effective date
of the increase, that a rate increase will be effective on that
date. If the exact amount has not yet been determined, the
nursing facility may raise the rates by the amount anticipated
to be allowed. Any amounts collected from private pay residents
in excess of the allowable rate must be repaid to private pay
residents with interest at the rate used by the commissioner of
revenue for the late payment of taxes and in effect on the date
the rate increase is effective.
Sec. 46. Minnesota Statutes 2002, section 256B.49,
subdivision 15, is amended to read:
Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] (a) Each
recipient of home and community-based waivered services shall be
provided a copy of the written service plan which:
(1) is developed and signed by the recipient within ten
working days of the completion of the assessment;
(2) meets the assessed needs of the recipient;
(3) reasonably ensures the health and safety of the
recipient;
(4) promotes independence;
(5) allows for services to be provided in the most
integrated settings; and
(6) provides for an informed choice, as defined in section
256B.77, subdivision 2, paragraph (p), of service and support
providers.
(b) When a county is evaluating denials, reductions, or
terminations of home and community-based services under section
256B.49 for an individual, the case manager shall offer to meet
with the individual or the individual's guardian in order to
discuss the prioritization of service needs within the
individualized service plan. The reduction in the authorized
services for an individual due to changes in funding for
waivered services may not exceed the amount needed to ensure
medically necessary services to meet the individual's health,
safety, and welfare.
Sec. 47. Minnesota Statutes 2002, section 256B.501,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For the purposes of this
section, the following terms have the meaning given them.
(a) "Commissioner" means the commissioner of human services.
(b) "Facility" means a facility licensed as a mental
retardation residential facility under section 252.28, licensed
as a supervised living facility under chapter 144, and certified
as an intermediate care facility for persons with mental
retardation or related conditions. The term does not include a
state regional treatment center.
(c) "Habilitation services" means health and social
services directed toward increasing and maintaining the
physical, intellectual, emotional, and social functioning of
persons with mental retardation or related conditions.
Habilitation services include therapeutic activities,
assistance, training, supervision, and monitoring in the areas
of self-care, sensory and motor development, interpersonal
skills, communication, socialization, reduction or elimination
of maladaptive behavior, community living and mobility, health
care, leisure and recreation, money management, and household
chores.
(d) "Services during the day" means services or supports
provided to a person that enables the person to be fully
integrated into the community. Services during the day must
include habilitation services, and may include a variety of
supports to enable the person to exercise choices for community
integration and inclusion activities. Services during the day
may include, but are not limited to: supported work, support
during community activities, community volunteer opportunities,
adult day care, recreational activities, and other
individualized integrated supports.
(e) "Waivered service" means home or community-based
service authorized under United States Code, title 42, section
1396n(c), as amended through December 31, 1987, and defined in
the Minnesota state plan for the provision of medical assistance
services. Waivered services include, at a minimum, case
management, family training and support, developmental training
homes, supervised living arrangements, semi-independent living
services, respite care, and training and habilitation services.
Sec. 48. Minnesota Statutes 2002, section 256B.501, is
amended by adding a subdivision to read:
Subd. 3m. [SERVICES DURING THE DAY.] When establishing a
rate for services during the day, the commissioner shall ensure
that these services comply with active treatment requirements
for persons residing in an ICF/MR as defined under federal
regulations and shall ensure that services during the day for
eligible persons are not provided by the person's residential
service provider, unless the person or the person's legal
representative is offered a choice of providers and agrees in
writing to provision of services during the day by the
residential service provider, consistent with the individual
service plan. The individual service plan for individuals who
choose to have their residential service provider provide their
services during the day must describe how health, safety,
protection, and habilitation needs will be met, including how
frequent and regular contact with persons other than the
residential service provider will occur. The individualized
service plan must address the provision of services during the
day outside the residence.
Sec. 49. Minnesota Statutes 2002, section 256B.5013, is
amended by adding a subdivision to read:
Subd. 7. [RATE ADJUSTMENTS FOR SHORT-TERM ADMISSIONS FOR
CRISIS OR SPECIALIZED MEDICAL CARE.] Beginning July 1, 2003, the
commissioner may designate up to 25 beds in ICF/MR facilities
statewide for short-term admissions due to crisis care needs or
care for medically fragile individuals. The commissioner shall
adjust the monthly facility rate to provide payment for
vacancies in designated short-term beds by an amount equal to
the rate for each recipient residing in a designated bed for up
to 15 days per bed per month. The commissioner may designate
short-term beds in ICF/MR facilities based on the short-term
care needs of a region or county as provided in section 252.28.
Nothing in this section shall be construed as limiting payments
for short-term admissions of eligible recipients to an ICF/MR
that is not designated for short-term admissions for crisis or
specialized medical care under this subdivision and does not
receive a temporary rate adjustment.
Sec. 50. Minnesota Statutes 2002, section 256B.5015, is
amended to read:
256B.5015 [PASS-THROUGH OF TRAINING AND HABILITATION OTHER
SERVICES COSTS.]
Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.]
Day training and habilitation services costs shall be paid as a
pass-through payment at the lowest rate paid for the comparable
services at that site under sections 252.40 to 252.46. The
pass-through payments for training and habilitation services
shall be paid separately by the commissioner and shall not be
included in the computation of the ICF/MR facility total payment
rate.
Subd. 2. [SERVICES DURING THE DAY.] Services during the
day, as defined in section 256B.501, but excluding day training
and habilitation services, shall be paid as a pass-through
payment no later than January 1, 2004. The commissioner shall
establish rates for these services, other than day training and
habilitation services, at levels that do not exceed 75 percent
of a recipient's day training and habilitation service costs
prior to the service change.
When establishing a rate for these services, the
commissioner shall also consider an individual recipient's needs
as identified in the individualized service plan and the
person's need for active treatment as defined under federal
regulations. The pass-through payments for services during the
day shall be paid separately by the commissioner and shall not
be included in the computation of the ICF/MR facility total
payment rate.
Sec. 51. Minnesota Statutes 2002, section 256B.82, is
amended to read:
256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE
SERVICES.]
Medical assistance and MinnesotaCare prepaid health plans
may include coverage for adult mental health rehabilitative
services under section 256B.0623, intensive rehabilitative
services under section 256B.0622, and adult mental health crisis
response services under section 256B.0624, beginning January 1,
2004 2005.
By January 15, 2003 2004, the commissioner shall report to
the legislature how these services should be included in prepaid
plans. The commissioner shall consult with mental health
advocates, health plans, and counties in developing this
report. The report recommendations must include a plan to
ensure coordination of these services between health plans and
counties, assure recipient access to essential community
providers, and monitor the health plans' delivery of services
through utilization review and quality standards.
Sec. 52. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING
FACILITY STAYS.]
Beginning July 1, 2004, if group residential housing is
used to pay for a nursing facility placement due to the
facility's status as an Institution for Mental Diseases, the
county is liable for 20 percent of the nonfederal share of costs
for persons under the age of 65 that have exceeded 90 days.
Sec. 53. [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING
COMMUNITY-BASED SERVICES.]
When a person requests services authorized under Minnesota
Statutes, section 256B.0621, 256B.092, or 256B.49, subdivision
13, the county must determine whether the person qualifies,
begin the screening process, begin individualized service plan
development, and provide mandated case management services or
relocation service coordination to those eligible within a
reasonable time. If a county is unable to provide case
management services within the required time period under
Minnesota Statutes, sections 256B.0621, subdivision 7; 256B.49,
subdivision 13; and Minnesota Rules, parts 9525.0004 to
9525.0036, the county shall contract for case management
services to meet the obligation.
Sec. 54. [CASE MANAGEMENT SERVICES REDESIGN.]
The commissioner shall report to the legislature on the
redesign of case management services. In preparing the report,
the commissioner shall consult with representatives for
consumers, consumer advocates, counties, and service providers.
The report shall include draft legislation for case management
changes that will (1) streamline administration, (2) improve
consumer access to case management services, (3) address the use
of a comprehensive universal assessment protocol for persons
seeking community supports, (4) establish case management
performance measures, (5) provide for consumer choice of the
case management service vendor, and (6) provide a method of
payment for case management services that is cost-effective and
best supports the draft legislation in clauses (1) to (5). The
proposed legislation shall be provided to the legislative
committees with jurisdiction over health and human services
issues by January 15, 2005.
Sec. 55. [VACANCY LISTINGS.]
The commissioner of human services shall work with
interested stakeholders on how provider and industry specific
Web sites can provide useful information to consumers on bed
vacancies for group residential housing providers and
intermediate care facilities for persons with mental retardation
and related conditions. Providers and industry trade
organizations are responsible for all costs related to
maintaining Web sites listing bed vacancies.
Sec. 56. [HOMELESS SERVICES; STATE CONTRACTS.]
The commissioner of human services may contract directly
with nonprofit organizations providing homeless services in two
or more counties.
Sec. 57. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY,
OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL
ON DISABILITIES.]
The governor's council on developmental disability under
Minnesota Statutes, section 16B.053, the ombudsman for mental
health and mental retardation under Minnesota Statutes, section
245.92, the centers for independent living, and the council on
disability under Minnesota Statutes, section 256.482, must study
the feasibility of reducing costs and increasing effectiveness
through (1) space coordination, (2) shared use of technology,
(3) coordination of resource priorities, and (4) consolidation
and make recommendations to the house and senate committees with
jurisdiction over these entities by January 15, 2004.
Sec. 58. [LICENSING CHANGE.]
Notwithstanding Minnesota Statutes, sections 245A.11 and
252.291, the commissioner of human services shall allow an
existing intermediate care facility for persons with mental
retardation or related conditions located in Goodhue county
serving 39 children to be converted to four separately licensed
or certified cottages serving up to six children each.
Sec. 59. [REVISOR'S INSTRUCTION.]
For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 60. [REPEALER.]
(a) Minnesota Statutes 2002, sections 252.32, subdivision
2; and 256B.5013, subdivision 4, are repealed July 1, 2003.
(b) Laws 2001, First Special Session chapter 9, article 13,
section 24, is repealed July 1, 2003.
ARTICLE 4
CHILDREN'S SERVICES
Section 1. Minnesota Statutes 2002, section 124D.23,
subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT.] (a) In order to qualify as
a family services collaborative, a minimum of one school
district, one county, one public health entity, one community
action agency as defined in section 119A.375, and one Head Start
grantee if the community action agency is not the designated
federal grantee for the Head Start program must agree in writing
to provide coordinated family services and commit resources to
an integrated fund. Collaboratives are expected to have broad
community representation, which may include other local
providers, including additional school districts, counties, and
public health entities, other municipalities, public libraries,
existing culturally specific community organizations, tribal
entities, local health organizations, private and nonprofit
service providers, child care providers, local foundations,
community-based service groups, businesses, local transit
authorities or other transportation providers, community action
agencies under section 119A.375, senior citizen volunteer
organizations, parent organizations, parents, and sectarian
organizations that provide nonsectarian services.
(b) Members of the governing bodies of political
subdivisions involved in the establishment of a family services
collaborative shall select representatives of the
nongovernmental entities listed in paragraph (a) to serve on the
governing board of a collaborative. The governing body members
of the political subdivisions shall select one or more
representatives of the nongovernmental entities within the
family service collaborative.
(c) Two or more family services collaboratives or
children's mental health collaboratives may consolidate
decision-making, pool resources, and collectively act on behalf
of the individual collaboratives, based on a written agreement
among the participating collaboratives.
Sec. 2. Minnesota Statutes 2002, section 245.4874, is
amended to read:
245.4874 [DUTIES OF COUNTY BOARD.]
The county board in each county shall use its share of
mental health and Community Social Services Act funds allocated
by the commissioner according to a biennial children's mental
health component of the community social services plan required
under section 245.4888, and approved by the commissioner. The
county board must:
(1) develop a system of affordable and locally available
children's mental health services according to sections 245.487
to 245.4888;
(2) establish a mechanism providing for interagency
coordination as specified in section 245.4875, subdivision 6;
(3) develop a biennial children's mental health component
of the community social services plan required under section
256E.09 which considers the assessment of unmet needs in the
county as reported by the local children's mental health
advisory council under section 245.4875, subdivision 5,
paragraph (b), clause (3). The county shall provide, upon
request of the local children's mental health advisory council,
readily available data to assist in the determination of unmet
needs;
(4) assure that parents and providers in the county receive
information about how to gain access to services provided
according to sections 245.487 to 245.4888;
(5) coordinate the delivery of children's mental health
services with services provided by social services, education,
corrections, health, and vocational agencies to improve the
availability of mental health services to children and the
cost-effectiveness of their delivery;
(6) assure that mental health services delivered according
to sections 245.487 to 245.4888 are delivered expeditiously and
are appropriate to the child's diagnostic assessment and
individual treatment plan;
(7) provide the community with information about predictors
and symptoms of emotional disturbances and how to access
children's mental health services according to sections 245.4877
and 245.4878;
(8) provide for case management services to each child with
severe emotional disturbance according to sections 245.486;
245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3,
and 5;
(9) provide for screening of each child under section
245.4885 upon admission to a residential treatment facility,
acute care hospital inpatient treatment, or informal admission
to a regional treatment center;
(10) prudently administer grants and purchase-of-service
contracts that the county board determines are necessary to
fulfill its responsibilities under sections 245.487 to 245.4888;
(11) assure that mental health professionals, mental health
practitioners, and case managers employed by or under contract
to the county to provide mental health services are qualified
under section 245.4871;
(12) assure that children's mental health services are
coordinated with adult mental health services specified in
sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness,
regardless of the person's age; and
(13) assure that culturally informed mental health
consultants are used as necessary to assist the county board in
assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and
(14) arrange for or provide a children's mental health
screening to a child receiving child protective services or a
child in out-of-home placement, a child for whom parental rights
have been terminated, a child found to be delinquent, and a
child found to have committed a juvenile petty offense for the
third or subsequent time, unless a screening has been performed
within the previous 180 days, or the child is currently under
the care of a mental health professional. The court or county
agency must notify a parent or guardian whose parental rights
have not been terminated of the potential mental health
screening and the option to prevent the screening by notifying
the court or county agency in writing. The screening shall be
conducted with a screening instrument approved by the
commissioner of human services according to criteria that are
updated and issued annually to ensure that approved screening
instruments are valid and useful for child welfare and juvenile
justice populations, and shall be conducted by a mental health
practitioner as defined in section 245.4871, subdivision 26, or
a probation officer or local social services agency staff person
who is trained in the use of the screening instrument. Training
in the use of the instrument shall include training in the
administration of the instrument, the interpretation of its
validity given the child's current circumstances, the state and
federal data practices laws and confidentiality standards, the
parental consent requirement, and providing respect for families
and cultural values. If the screen indicates a need for
assessment, the child's family, or if the family lacks mental
health insurance, the local social services agency, in
consultation with the child's family, shall have conducted a
diagnostic assessment, including a functional assessment, as
defined in section 245.4871. The administration of the
screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota
Government Data Practices Act, chapter 13, and the federal
Health Insurance Portability and Accountability Act of 1996,
Public Law 104-191. Screening results shall be considered
private data and the commissioner shall not collect individual
screening results.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 3. Minnesota Statutes 2002, section 245.493,
subdivision 1a, is amended to read:
Subd. 1a. [DUTIES OF CERTAIN COORDINATING BODIES.] (a) By
mutual agreement of the collaborative and a coordinating body
listed in this subdivision, a children's mental health
collaborative or a collaborative established by the merger of a
children's mental health collaborative and a family services
collaborative under section 124D.23, may assume the duties of a
community transition interagency committee established under
section 125A.22; an interagency early intervention committee
established under section 125A.30; a local advisory council
established under section 245.4875, subdivision 5; or a local
coordinating council established under section 245.4875,
subdivision 6.
(b) Two or more family services collaboratives or
children's mental health collaboratives may consolidate
decision-making, pool resources, and collectively act on behalf
of the individual collaboratives, based on a written agreement
among the participating collaboratives.
Sec. 4. Minnesota Statutes 2002, section 256B.0625,
subdivision 23, is amended to read:
Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance
covers day treatment services as specified in sections 245.462,
subdivision 8, and 245.4871, subdivision 10, that are provided
under contract with the county board. Notwithstanding Minnesota
Rules, part 9505.0323, subpart 15, the commissioner may set
authorization thresholds for day treatment for adults according
to section 256B.0625, subdivision 25. Effective July 1, 2004,
medical assistance covers day treatment services for children as
specified under section 256B.0943.
Sec. 5. Minnesota Statutes 2002, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE
SERVICES.] Medical assistance covers children's mental health
crisis response services according to section 256B.0944.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 6. Minnesota Statutes 2002, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.]
Medical assistance covers children's therapeutic services and
supports according to section 256B.0943.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 7. Minnesota Statutes 2002, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21
YEARS OF AGE.] Medical assistance covers subacute psychiatric
care for person under 21 years of age when:
(1) the services meet the requirements of Code of Federal
Regulations, title 42, section 440.160;
(2) the facility is accredited as a psychiatric treatment
facility by the joint commission on accreditation of healthcare
organizations, the commission on accreditation of rehabilitation
facilities, or the council on accreditation; and
(3) the facility is licensed by the commissioner of health
under section 144.50.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 8. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND
SUPPORTS.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them.
(a) "Children's therapeutic services and supports" means
the flexible package of mental health services for children who
require varying therapeutic and rehabilitative levels of
intervention. The services are time-limited interventions that
are delivered using various treatment modalities and
combinations of services designed to reach treatment outcomes
identified in the individual treatment plan.
(b) "Clinical supervision" means the overall responsibility
of the mental health professional for the control and direction
of individualized treatment planning, service delivery, and
treatment review for each client. A mental health professional
who is an enrolled Minnesota health care program provider
accepts full professional responsibility for a supervisee's
actions and decisions, instructs the supervisee in the
supervisee's work, and oversees or directs the supervisee's work.
(c) "County board" means the county board of commissioners
or board established under sections 402.01 to 402.10 or 471.59.
(d) "Crisis assistance" has the meaning given in section
245.4871, subdivision 9a.
(e) "Culturally competent provider" means a provider who
understands and can utilize to a client's benefit the client's
culture when providing services to the client. A provider may
be culturally competent because the provider is of the same
cultural or ethnic group as the client or the provider has
developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.
(f) "Day treatment program" for children means a site-based
structured program consisting of group psychotherapy for more
than three individuals and other intensive therapeutic services
provided by a multidisciplinary team, under the clinical
supervision of a mental health professional.
(g) "Diagnostic assessment" has the meaning given in
section 245.4871, subdivision 11.
(h) "Direct service time" means the time that a mental
health professional, mental health practitioner, or mental
health behavioral aide spends face-to-face with a client and the
client's family. Direct service time includes time in which the
provider obtains a client's history or provides service
components of children's therapeutic services and supports.
Direct service time does not include time doing work before and
after providing direct services, including scheduling,
maintaining clinical records, consulting with others about the
client's mental health status, preparing reports, receiving
clinical supervision directly related to the client's
psychotherapy session, and revising the client's individual
treatment plan.
(i) "Direction of mental health behavioral aide" means the
activities of a mental health professional or mental health
practitioner in guiding the mental health behavioral aide in
providing services to a client. The direction of a mental
health behavioral aide must be based on the client's
individualized treatment plan and meet the requirements in
subdivision 6, paragraph (b), clause (5).
(j) "Emotional disturbance" has the meaning given in
section 245.4871, subdivision 15. For persons at least age 18
but under age 21, mental illness has the meaning given in
section 245.462, subdivision 20, paragraph (a).
(k) "Individual behavioral plan" means a plan of
intervention, treatment, and services for a child written by a
mental health professional or mental health practitioner, under
the clinical supervision of a mental health professional, to
guide the work of the mental health behavioral aide.
(l) "Individual treatment plan" has the meaning given in
section 245.4871, subdivision 21.
(m) "Mental health professional" means an individual as
defined in section 245.4871, subdivision 27, clauses (1) to (5),
or tribal vendor as defined in section 256B.02, subdivision 7,
paragraph (b).
(n) "Preschool program" means a day program licensed under
Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a
children's therapeutic services and supports provider to provide
a structured treatment program to a child who is at least 33
months old but who has not yet attended the first day of
kindergarten.
(o) "Skills training" means individual, family, or group
training designed to improve the basic functioning of the child
with emotional disturbance and the child's family in the
activities of daily living and community living, and to improve
the social functioning of the child and the child's family in
areas important to the child's maintaining or reestablishing
residency in the community. Individual, family, and group
skills training must:
(1) consist of activities designed to promote skill
development of the child and the child's family in the use of
age-appropriate daily living skills, interpersonal and family
relationships, and leisure and recreational services;
(2) consist of activities that will assist the family's
understanding of normal child development and to use parenting
skills that will help the child with emotional disturbance
achieve the goals outlined in the child's individual treatment
plan; and
(3) promote family preservation and unification, promote
the family's integration with the community, and reduce the use
of unnecessary out-of-home placement or institutionalization of
children with emotional disturbance.
Subd. 2. [COVERED SERVICE COMPONENTS OF CHILDREN'S
THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal
approval, medical assistance covers medically necessary
children's therapeutic services and supports as defined in this
section that an eligible provider entity under subdivisions 4
and 5 provides to a client eligible under subdivision 3.
(b) The service components of children's therapeutic
services and supports are:
(1) individual, family, and group psychotherapy;
(2) individual, family, or group skills training provided
by a mental health professional or mental health practitioner;
(3) crisis assistance;
(4) mental health behavioral aide services; and
(5) direction of a mental health behavioral aide.
(c) Service components may be combined to constitute
therapeutic programs, including day treatment programs and
preschool programs. Although day treatment and preschool
programs have specific client and provider eligibility
requirements, medical assistance only pays for the service
components listed in paragraph (b).
Subd. 3. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's
eligibility to receive children's therapeutic services and
supports under this section shall be determined based on a
diagnostic assessment by a mental health professional that is
performed within 180 days of the initial start of service. The
diagnostic assessment must:
(1) include current diagnoses on all five axes of the
client's current mental health status;
(2) determine whether a child under age 18 has a diagnosis
of emotional disturbance or, if the person is between the ages
of 18 and 21, whether the person has a mental illness;
(3) document children's therapeutic services and supports
as medically necessary to address an identified disability,
functional impairment, and the individual client's needs and
goals;
(4) be used in the development of the individualized
treatment plan; and
(5) be completed annually until age 18. For individuals
between age 18 and 21, unless a client's mental health condition
has changed markedly since the client's most recent diagnostic
assessment, annual updating is necessary. For the purpose of
this section, "updating" means a written summary, including
current diagnoses on all five axes, by a mental health
professional of the client's current mental health status and
service needs.
Subd. 4. [PROVIDER ENTITY CERTIFICATION.] (a) Effective
July 1, 2003, the commissioner shall establish an initial
provider entity application and certification process and
recertification process to determine whether a provider entity
has an administrative and clinical infrastructure that meets the
requirements in subdivisions 5 and 6. The commissioner shall
recertify a provider entity at least every three years. The
commissioner shall establish a process for decertification of a
provider entity that no longer meets the requirements in this
section. The county, tribe, and the commissioner shall be
mutually responsible and accountable for the county's, tribe's,
and state's part of the certification, recertification, and
decertification processes.
(b) For purposes of this section, a provider entity must be:
(1) an Indian health services facility or a facility owned
and operated by a tribe or tribal organization operating as a
638 facility under Public Law 93-368 certified by the state;
(2) a county-operated entity certified by the state; or
(3) a noncounty entity recommended for certification by the
provider's host county and certified by the state.
Subd. 5. [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE
REQUIREMENTS.] (a) To be an eligible provider entity under this
section, a provider entity must have an administrative
infrastructure that establishes authority and accountability for
decision making and oversight of functions, including finance,
personnel, system management, clinical practice, and performance
measurement. The provider must have written policies and
procedures that it reviews and updates every three years and
distributes to staff initially and upon each subsequent update.
(b) The administrative infrastructure written policies and
procedures must include:
(1) personnel procedures, including a process for: (i)
recruiting, hiring, training, and retention of culturally and
linguistically competent providers; (ii) conducting a criminal
background check on all direct service providers and volunteers;
(iii) investigating, reporting, and acting on violations of
ethical conduct standards; (iv) investigating, reporting, and
acting on violations of data privacy policies that are compliant
with federal and state laws; (v) utilizing volunteers, including
screening applicants, training and supervising volunteers, and
providing liability coverage for volunteers; and (vi)
documenting that a mental health professional, mental health
practitioner, or mental health behavioral aide meets the
applicable provider qualification criteria, training criteria
under subdivision 8, and clinical supervision or direction of a
mental health behavioral aide requirements under subdivision 6;
(2) fiscal procedures, including internal fiscal control
practices and a process for collecting revenue that is compliant
with federal and state laws;
(3) if a client is receiving services from a case manager
or other provider entity, a service coordination process that
ensures services are provided in the most appropriate manner to
achieve maximum benefit to the client. The provider entity must
ensure coordination and nonduplication of services consistent
with county board coordination procedures established under
section 245.4881, subdivision 5;
(4) a performance measurement system, including monitoring
to determine cultural appropriateness of services identified in
the individual treatment plan, as determined by the client's
culture, beliefs, values, and language, and family-driven
services; and
(5) a process to establish and maintain individual client
records. The client's records must include: (i) the client's
personal information; (ii) forms applicable to data privacy;
(iii) the client's diagnostic assessment, updates, tests,
individual treatment plan, and individual behavior plan, if
necessary; (iv) documentation of service delivery as specified
under subdivision 6; (v) telephone contacts; (vi) discharge
plan; and (vii) if applicable, insurance information.
Subd. 6. [PROVIDER ENTITY CLINICAL INFRASTRUCTURE
REQUIREMENTS.] (a) To be an eligible provider entity under this
section, a provider entity must have a clinical infrastructure
that utilizes diagnostic assessment, an individualized treatment
plan, service delivery, and individual treatment plan review
that are culturally competent, child-centered, and family-driven
to achieve maximum benefit for the client. The provider entity
must review and update the clinical policies and procedures
every three years and must distribute the policies and
procedures to staff initially and upon each subsequent update.
(b) The clinical infrastructure written policies and
procedures must include policies and procedures for:
(1) providing or obtaining a client's diagnostic assessment
that identifies acute and chronic clinical disorders,
co-occurring medical conditions, sources of psychological and
environmental problems, and a functional assessment. The
functional assessment must clearly summarize the client's
individual strengths and needs;
(2) developing an individual treatment plan that is: (i)
based on the information in the client's diagnostic assessment;
(ii) developed no later than the end of the first psychotherapy
session after the completion of the client's diagnostic
assessment by the mental health professional who provides the
client's psychotherapy; (iii) developed through a
child-centered, family-driven planning process that identifies
service needs and individualized, planned, and culturally
appropriate interventions that contain specific treatment goals
and objectives for the client and the client's family or foster
family; (iv) reviewed at least once every 90 days and revised,
if necessary; and (v) signed by the client or, if appropriate,
by the client's parent or other person authorized by statute to
consent to mental health services for the client;
(3) developing an individual behavior plan that documents
services to be provided by the mental health behavioral aide.
The individual behavior plan must include: (i) detailed
instructions on the service to be provided; (ii) time allocated
to each service; (iii) methods of documenting the child's
behavior; (iv) methods of monitoring the child's progress in
reaching objectives; and (v) goals to increase or decrease
targeted behavior as identified in the individual treatment
plan;
(4) clinical supervision of the mental health practitioner
and mental health behavioral aide. A mental health professional
must document the clinical supervision the professional provides
by cosigning individual treatment plans and making entries in
the client's record on supervisory activities. Clinical
supervision does not include the authority to make or terminate
court-ordered placements of the child. A clinical supervisor
must be available for urgent consultation as required by the
individual client's needs or the situation. Clinical
supervision may occur individually or in a small group to
discuss treatment and review progress toward goals. The focus
of clinical supervision must be the client's treatment needs and
progress and the mental health practitioner's or behavioral
aide's ability to provide services;
(5) providing direction to a mental health behavioral
aide. For entities that employ mental health behavioral aides,
the clinical supervisor must be employed by the provider entity
to ensure necessary and appropriate oversight for the client's
treatment and continuity of care. The mental health
professional or mental health practitioner giving direction must
begin with the goals on the individualized treatment plan, and
instruct the mental health behavioral aide on how to construct
therapeutic activities and interventions that will lead to goal
attainment. The professional or practitioner giving direction
must also instruct the mental health behavioral aide about the
client's diagnosis, functional status, and other characteristics
that are likely to affect service delivery. Direction must also
include determining that the mental health behavioral aide has
the skills to interact with the client and the client's family
in ways that convey personal and cultural respect and that the
aide actively solicits information relevant to treatment from
the family. The aide must be able to clearly explain the
activities the aide is doing with the client and the activities'
relationship to treatment goals. Direction is more didactic
than is supervision and requires the professional or
practitioner providing it to continuously evaluate the mental
health behavioral aide's ability to carry out the activities of
the individualized treatment plan and the individualized
behavior plan. When providing direction, the professional or
practitioner must: (i) review progress notes prepared by the
mental health behavioral aide for accuracy and consistency with
diagnostic assessment, treatment plan, and behavior goals and
the professional or practitioner must approve and sign the
progress notes; (ii) identify changes in treatment strategies,
revise the individual behavior plan, and communicate treatment
instructions and methodologies as appropriate to ensure that
treatment is implemented correctly; (iii) demonstrate
family-friendly behaviors that support healthy collaboration
among the child, the child's family, and providers as treatment
is planned and implemented; (iv) ensure that the mental health
behavioral aide is able to effectively communicate with the
child, the child's family, and the provider; and (v) record the
results of any evaluation and corrective actions taken to modify
the work of the mental health behavioral aide;
(6) providing service delivery that implements the
individual treatment plan and meets the requirements under
subdivision 9; and
(7) individual treatment plan review. The review must
determine the extent to which the services have met the goals
and objectives in the previous treatment plan. The review must
assess the client's progress and ensure that services and
treatment goals continue to be necessary and appropriate to the
client and the client's family or foster family. Revision of
the individual treatment plan does not require a new diagnostic
assessment unless the client's mental health status has changed
markedly. The updated treatment plan must be signed by the
client, if appropriate, and by the client's parent or other
person authorized by statute to give consent to the mental
health services for the child.
Subd. 7. [QUALIFICATIONS OF INDIVIDUAL AND TEAM
PROVIDERS.] (a) An individual or team provider working within
the scope of the provider's practice or qualifications may
provide service components of children's therapeutic services
and supports that are identified as medically necessary in a
client's individual treatment plan.
(b) An individual provider and multidisciplinary team
include:
(1) a mental health professional as defined in subdivision
1, paragraph (m);
(2) a mental health practitioner as defined in section
245.4871, subdivision 26. The mental health practitioner must
work under the clinical supervision of a mental health
professional;
(3) a mental health behavioral aide working under the
direction of a mental health professional to implement the
rehabilitative mental health services identified in the client's
individual treatment plan. A level I mental health behavioral
aide must: (i) be at least 18 years old; (ii) have a high
school diploma or general equivalency diploma (GED) or two years
of experience as a primary caregiver to a child with severe
emotional disturbance within the previous ten years; and (iii)
meet preservices and continuing education requirements under
subdivision 8. A level II mental health behavioral aide must:
(i) be at least 18 years old; (ii) have an associate or
bachelor's degree or 4,000 hours of experience in delivering
clinical services in the treatment of mental illness concerning
children or adolescents; and (iii) meet preservice and
continuing education requirements in subdivision 8;
(4) a preschool program multidisciplinary team that
includes at least one mental health professional and one or more
of the following individuals under the clinical supervision of a
mental health professional: (i) a mental health practitioner;
or (ii) a program person, including a teacher, assistant
teacher, or aide, who meets the qualifications and training
standards of a level I mental health behavioral aide; or
(5) a day treatment multidisciplinary team that includes at
least one mental health professional and one mental health
practitioner.
Subd. 8. [REQUIRED PRESERVICE AND CONTINUING
EDUCATION.] (a) A provider entity shall establish a plan to
provide preservice and continuing education for staff. The plan
must clearly describe the type of training necessary to maintain
current skills and obtain new skills, and that relates to the
provider entity's goals and objectives for services offered.
(b) A provider that employs a mental health behavioral aide
under this section must require the mental health behavioral
aide to complete 30 hours of preservice training. The
preservice training must include topics specified in Minnesota
Rules, part 9535.4068, subparts 1 and 2, and parent team
training. The preservice training must include 15 hours of
in-person training of a mental health behavioral aide in mental
health services delivery and eight hours of parent team
training. Components of parent team training include:
(1) partnering with parents;
(2) fundamentals of family support;
(3) fundamentals of policy and decision making;
(4) defining equal partnership;
(5) complexities of the parent and service provider
partnership in multiple service delivery systems due to system
strengths and weaknesses;
(6) sibling impacts;
(7) support networks; and
(8) community resources.
(c) A provider entity that employs a mental health
practitioner and a mental health behavioral aide to provide
children's therapeutic services and supports under this section
must require the mental health practitioner and mental health
behavioral aide to complete 20 hours of continuing education
every two calendar years. The continuing education must be
related to serving the needs of a child with emotional
disturbance in the child's home environment and the child's
family. The topics covered in orientation and training must
conform to Minnesota Rules, part 9535.4068.
(d) The provider entity must document the mental health
practitioner's or mental health behavioral aide's annual
completion of the required continuing education. The
documentation must include the date, subject, and number of
hours of the continuing education, and attendance records, as
verified by the staff member's signature, job title, and the
instructor's name. The provider entity must keep documentation
for each employee, including records of attendance at
professional workshops and conferences, at a central location
and in the employee's personnel file.
Subd. 9. [SERVICE DELIVERY CRITERIA.] (a) In delivering
services under this section, a certified provider entity must
ensure that:
(1) each individual provider's caseload size permits the
provider to deliver services to both clients with severe,
complex needs and clients with less intensive needs. The
provider's caseload size should reasonably enable the provider
to play an active role in service planning, monitoring, and
delivering services to meet the client's and client's family's
needs, as specified in each client's individual treatment plan;
(2) site-based programs, including day treatment and
preschool programs, provide staffing and facilities to ensure
the client's health, safety, and protection of rights, and that
the programs are able to implement each client's individual
treatment plan;
(3) a day treatment program is provided to a group of
clients by a multidisciplinary staff under the clinical
supervision of a mental health professional. The day treatment
program must be provided in and by: (i) an outpatient hospital
accredited by the joint commission on accreditation of health
organizations and licensed under sections 144.50 to 144.55; (ii)
a community mental health center under section 245.62; and (iii)
an entity that is under contract with the county board to
operate a program that meets the requirements of sections
245.4712, subdivision 2, and 245.4884, subdivision 2, and
Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
program must stabilize the client's mental health status while
developing and improving the client's independent living and
socialization skills. The goal of the day treatment program
must be to reduce or relieve the effects of mental illness and
provide training to enable the client to live in the community.
The program must be available at least one day a week for a
minimum three-hour time block. The three-hour time block must
include at least one hour, but no more than two hours, of
individual or group psychotherapy. The remainder of the
three-hour time block may include recreation therapy,
socialization therapy, or independent living skills therapy, but
only if the therapies are included in the client's individual
treatment plan. Day treatment programs are not part of
inpatient or residential treatment services; and
(4) a preschool program is a structured treatment program
offered to a child who is at least 33 months old, but who has
not yet reached the first day of kindergarten, by a preschool
multidisciplinary team in a day program licensed under Minnesota
Rules, parts 9503.0005 to 9503.0175. The program must be
available at least one day a week for a minimum two-hour time
block. The structured treatment program may include individual
or group psychotherapy and recreation therapy, socialization
therapy, or independent living skills therapy, if included in
the client's individual treatment plan.
(b) A provider entity must delivery the service components
of children's therapeutic services and supports in compliance
with the following requirements:
(1) individual, family, and group psychotherapy must be
delivered as specified in Minnesota Rules, parts 9505.0523;
(2) individual, family, or group skills training must be
provided by a mental health professional or a mental health
practitioner who has a consulting relationship with a mental
health professional who accepts full professional responsibility
for the training;
(3) crisis assistance must be an intense, time-limited, and
designed to resolve or stabilize crisis through arrangements for
direct intervention and support services to the child and the
child's family. Crisis assistance must utilize resources
designed to address abrupt or substantial changes in the
functioning of the child or the child's family as evidenced by a
sudden change in behavior with negative consequences for well
being, a loss of usual coping mechanisms, or the presentation of
danger to self or others;
(4) medically necessary services that are provided by a
mental health behavioral aide must be designed to improve the
functioning of the child and support the family in activities of
daily and community living. A mental health behavioral aide
must document the delivery of services in written progress
notes. The mental health behavioral aide must implement goals
in the treatment plan for the child's emotional disturbance that
allow the child to acquire developmentally and therapeutically
appropriate daily living skills, social skills, and leisure and
recreational skills through targeted activities. These
activities may include:
(i) assisting a child as needed with skills development in
dressing, eating, and toileting;
(ii) assisting, monitoring, and guiding the child to
complete tasks, including facilitating the child's participation
in medical appointments;
(iii) observing the child and intervening to redirect the
child's inappropriate behavior;
(iv) assisting the child in using age-appropriate
self-management skills as related to the child's emotional
disorder or mental illness, including problem solving, decision
making, communication, conflict resolution, anger management,
social skills, and recreational skills;
(v) implementing deescalation techniques as recommended by
the mental health professional;
(vi) implementing any other mental health service that the
mental health professional has approved as being within the
scope of the behavioral aide's duties; or
(vii) assisting the parents to develop and use parenting
skills that help the child achieve the goals outlined in the
child's individual treatment plan or individual behavioral
plan. Parenting skills must be directed exclusively to the
child's treatment; and
(5) direction of a mental health behavioral aide must
include the following:
(i) a total of one hour of on-site observation by a mental
health professional during the first 12 hours of service
provided to a child;
(ii) ongoing on-site observation by a mental health
professional or mental health practitioner for at least a total
of one hour during every 40 hours of service provided to a
child; and
(iii) immediate accessibility of the mental health
professional or mental health practitioner to the mental health
behavioral aide during service provision.
Subd. 10. [SERVICE AUTHORIZATION.] The commissioner shall
publish in the State Register a list of health services that
require prior authorization, as well as the criteria and
standards used to select health services on the list. The list
and the criteria and standards used to formulate the list are
not subject to the requirements of sections 14.001 to 14.69.
The commissioner's decision on whether prior authorization is
required for a health service is not subject to administrative
appeal.
Subd. 11. [DOCUMENTATION AND BILLING.] (a) A provider
entity must document the services it provides under this
section. The provider entity must ensure that the entity's
documentation standards meet the requirements of federal and
state laws. Services billed under this section that are not
documented according to this subdivision shall be subject to
monetary recovery by the commissioner.
(b) An individual mental health provider must promptly
document the following in a client's record after providing
services to the client:
(1) each occurrence of the client's mental health service,
including the date, type, length, and scope of the service;
(2) the name of the person who gave the service;
(3) contact made with other persons interested in the
client, including representatives of the courts, corrections
systems, or schools. The provider must document the name and
date of each contact;
(4) any contact made with the client's other mental health
providers, case manager, family members, primary caregiver,
legal representative, or the reason the provider did not contact
the client's family members, primary caregiver, or legal
representative, if applicable; and
(5) required clinical supervision, as appropriate.
Subd. 12. [EXCLUDED SERVICES.] The following services are
not eligible for medical assistance payment as children's
therapeutic services and supports:
(1) service components of children's therapeutic services
and supports simultaneously provided by more than one provider
entity unless prior authorization is obtained;
(2) children's therapeutic services and supports provided
in violation of medical assistance policy in Minnesota Rules,
part 9505.0220;
(3) mental health behavioral aide services provided by a
personal care assistant who is not qualified as a mental health
behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;
(4) services that are the responsibility of a residential
or program license holder, including foster care providers under
the terms of a service agreement or administrative rules
governing licensure;
(5) up to 15 hours of children's therapeutic services and
supports provided within a six-month period to a child with
severe emotional disturbance who is residing in a hospital, a
group home as defined in Minnesota Rules, part 9560.0520,
subpart 4, a residential treatment facility licensed under
Minnesota Rules, parts 9545.0900 to 9545.1090, a regional
treatment center, or other institutional group setting or who is
participating in a program of partial hospitalization are
eligible for medical assistance payment if part of the discharge
plan; and
(6) adjunctive activities that may be offered by a provider
entity but are not otherwise covered by medical assistance,
including:
(i) a service that is primarily recreation oriented or that
is provided in a setting that is not medically supervised. This
includes sports activities, exercise groups, activities such as
craft hours, leisure time, social hours, meal or snack time,
trips to community activities, and tours;
(ii) a social or educational service that does not have or
cannot reasonably be expected to have a therapeutic outcome
related to the client's emotional disturbance;
(iii) consultation with other providers or service agency
staff about the care or progress of a client;
(iv) prevention or education programs provided to the
community; and
(v) treatment for clients with primary diagnoses of alcohol
or other drug abuse.
[EFFECTIVE DATE.] Unless otherwise specified, this section
is effective July 1, 2004.
Sec. 9. [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL
HEALTH CRISIS RESPONSE SERVICES.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them.
(a) "Mental health crisis" means a child's behavioral,
emotional, or psychiatric situation that, but for the provision
of crisis response services to the child, would likely result in
significantly reduced levels of functioning in primary
activities of daily living, an emergency situation, or the
child's placement in a more restrictive setting, including, but
not limited to, inpatient hospitalization.
(b) "Mental health emergency" means a child's behavioral,
emotional, or psychiatric situation that causes an immediate
need for mental health services and is consistent with section
62Q.55. A physician, mental health professional, or crisis
mental health practitioner determines a mental health crisis or
emergency for medical assistance reimbursement with input from
the client and the client's family, if possible.
(c) "Mental health crisis assessment" means an immediate
face-to-face assessment by a physician, mental health
professional, or mental health practitioner under the clinical
supervision of a mental health professional, following a
screening that suggests the child may be experiencing a mental
health crisis or mental health emergency situation.
(d) "Mental health mobile crisis intervention services"
means face-to-face, short-term intensive mental health services
initiated during a mental health crisis or mental health
emergency. Mental health mobile crisis services must help the
recipient cope with immediate stressors, identify and utilize
available resources and strengths, and begin to return to the
recipient's baseline level of functioning. Mental health mobile
services must be provided on-site by a mobile crisis
intervention team outside of an emergency room, urgent care, or
an inpatient hospital setting.
(e) "Mental health crisis stabilization services" means
individualized mental health services provided to a recipient
following crisis intervention services that are designed to
restore the recipient to the recipient's prior functional
level. The individual treatment plan recommending mental health
crisis stabilization must be completed by the intervention team
or by staff after an inpatient or urgent care visit. Mental
health crisis stabilization services may be provided in the
recipient's home, the home of a family member or friend of the
recipient, schools, another community setting, or a short-term
supervised, licensed residential program if the service is not
included in the facility's cost pool or per diem. Mental health
crisis stabilization is not reimbursable when provided as part
of a partial hospitalization or day treatment program.
Subd. 2. [MEDICAL ASSISTANCE COVERAGE.] Medical assistance
covers medically necessary children's mental health crisis
response services, subject to federal approval, if provided to
an eligible recipient under subdivision 3, by a qualified
provider entity under subdivision 4 or a qualified individual
provider working within the provider's scope of practice, and
identified in the recipient's individual crisis treatment plan
under subdivision 8.
Subd. 3. [ELIGIBILITY.] An eligible recipient is an
individual who:
(1) is eligible for medical assistance;
(2) is under age 18 or between the ages of 18 and 21;
(3) is screened as possibly experiencing a mental health
crisis or mental health emergency where a mental health crisis
assessment is needed;
(4) is assessed as experiencing a mental health crisis or
mental health emergency, and mental health mobile crisis
intervention or mental health crisis stabilization services are
determined to be medically necessary; and
(5) meets the criteria for emotional disturbance or mental
illness.
Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A crisis
intervention and crisis stabilization provider entity must meet
the administrative and clinical standards specified in section
256B.0943, subdivisions 5 and 6, meet the standards listed in
paragraph (b), and be:
(1) an Indian health service facility or facility owned and
operated by a tribe or a tribal organization operating under
Public Law 93-638 as a 638 facility;
(2) a county board-operated entity; or
(3) a provider entity that is under contract with the
county board in the county where the potential crisis or
emergency is occurring.
(b) The children's mental health crisis response services
provider entity must:
(1) ensure that mental health crisis assessment and mobile
crisis intervention services are available 24 hours a day, seven
days a week;
(2) directly provide the services or, if services are
subcontracted, the provider entity must maintain clinical
responsibility for services and billing;
(3) ensure that crisis intervention services are provided
in a manner consistent with sections 245.487 to 245.4888; and
(4) develop and maintain written policies and procedures
regarding service provision that include safety of staff and
recipients in high-risk situations.
Subd. 5. [MOBILE CRISIS INTERVENTION STAFF
QUALIFICATIONS.] (a) To provide children's mental health mobile
crisis intervention services, a mobile crisis intervention team
must include:
(1) at least two mental health professionals as defined in
section 256B.0943, subdivision 1, paragraph (m); or
(2) a combination of at least one mental health
professional and one mental health practitioner as defined in
section 245.4871, subdivision 26, with the required mental
health crisis training and under the clinical supervision of a
mental health professional on the team.
(b) The team must have at least two people with at least
one member providing on-site crisis intervention services when
needed. Team members must be experienced in mental health
assessment, crisis intervention techniques, and clinical
decision making under emergency conditions and have knowledge of
local services and resources. The team must recommend and
coordinate the team's services with appropriate local resources,
including as the county social services agency, mental health
service providers, and local law enforcement, if necessary.
Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE
INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile
crisis intervention services, a screening of the potential
crisis situation must be conducted. The screening may use the
resources of crisis assistance and emergency services as defined
in sections 245.4871, subdivision 14, and 245.4879, subdivisions
1 and 2. The screening must gather information, determine
whether a crisis situation exists, identify the parties
involved, and determine an appropriate response.
(b) If a crisis exists, a crisis assessment must be
completed. A crisis assessment must evaluate any immediate
needs for which emergency services are needed and, as time
permits, the recipient's current life situation, sources of
stress, mental health problems and symptoms, strengths, cultural
considerations, support network, vulnerabilities, and current
functioning.
(c) If the crisis assessment determines mobile crisis
intervention services are needed, the intervention services must
be provided promptly. As the opportunity presents itself during
the intervention, at least two members of the mobile crisis
intervention team must confer directly or by telephone about the
assessment, treatment plan, and actions taken and needed. At
least one of the team members must be on site providing crisis
intervention services. If providing on-site crisis intervention
services, a mental health practitioner must seek clinical
supervision as required under subdivision 9.
(d) The mobile crisis intervention team must develop an
initial, brief crisis treatment plan as soon as appropriate but
no later than 24 hours after the initial face-to-face
intervention. The plan must address the needs and problems
noted in the crisis assessment and include measurable short-term
goals, cultural considerations, and frequency and type of
services to be provided to achieve the goals and reduce or
eliminate the crisis. The crisis treatment plan must be updated
as needed to reflect current goals and services. The team must
involve the client and the client's family in developing and
implementing the plan.
(e) The team must document in progress notes which
short-term goals have been met and when no further crisis
intervention services are required.
(f) If the client's crisis is stabilized, but the client
needs a referral for mental health crisis stabilization services
or to other services, the team must provide a referral to these
services. If the recipient has a case manager, planning for
other services must be coordinated with the case manager.
Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis
stabilization services must be provided by a mental health
professional or a mental health practitioner who works under the
clinical supervision of a mental health professional and for a
crisis stabilization services provider entity, and must meet the
following standards:
(1) a crisis stabilization treatment plan must be developed
which meets the criteria in subdivision 8;
(2) services must be delivered according to the treatment
plan and include face-to-face contact with the recipient by
qualified staff for further assessment, help with referrals,
updating the crisis stabilization treatment plan, supportive
counseling, skills training, and collaboration with other
service providers in the community; and
(3) mental health practitioners must have completed at
least 30 hours of training in crisis intervention and
stabilization during the past two years.
Subd. 8. [TREATMENT PLAN.] (a) The individual crisis
stabilization treatment plan must include, at a minimum:
(1) a list of problems identified in the assessment;
(2) a list of the recipient's strengths and resources;
(3) concrete, measurable short-term goals and tasks to be
achieved, including time frames for achievement of the goals;
(4) specific objectives directed toward the achievement of
each goal;
(5) documentation of the participants involved in the
service planning;
(6) planned frequency and type of services initiated;
(7) a crisis response action plan if a crisis should occur;
and
(8) clear progress notes on the outcome of goals.
(b) The client, if clinically appropriate, must be a
participant in the development of the crisis stabilization
treatment plan. The client or the client's legal guardian must
sign the service plan or documentation must be provided why this
was not possible. A copy of the plan must be given to the
client and the client's legal guardian. The plan should include
services arranged, including specific providers where applicable.
(c) A treatment plan must be developed by a mental health
professional or mental health practitioner under the clinical
supervision of a mental health professional. A written plan
must be completed within 24 hours of beginning services with the
client.
Subd. 9. [SUPERVISION.] (a) A mental health practitioner
may provide crisis assessment and mobile crisis intervention
services if the following clinical supervision requirements are
met:
(1) the mental health provider entity must accept full
responsibility for the services provided;
(2) the mental health professional of the provider entity,
who is an employee or under contract with the provider entity,
must be immediately available by telephone or in person for
clinical supervision;
(3) the mental health professional is consulted, in person
or by telephone, during the first three hours when a mental
health practitioner provides on-site service; and
(4) the mental health professional must review and approve
the tentative crisis assessment and crisis treatment plan,
document the consultation, and sign the crisis assessment and
treatment plan within the next business day.
(b) If the mobile crisis intervention services continue
into a second calendar day, a mental health professional must
contact the client face-to-face on the second day to provide
services and update the crisis treatment plan. The on-site
observation must be documented in the client's record and signed
by the mental health professional.
Subd. 10. [CLIENT RECORD.] The provider must maintain a
file for each client that complies with the requirements under
section 256B.0943, subdivision 11, and contains the following
information:
(1) individual crisis treatment plans signed by the
recipient, mental health professional, and mental health
practitioner who developed the crisis treatment plan, or if the
recipient refused to sign the plan, the date and reason stated
by the recipient for not signing the plan;
(2) signed release of information forms;
(3) recipient health information and current medications;
(4) emergency contacts for the recipient;
(5) case records that document the date of service, place
of service delivery, signature of the person providing the
service, and the nature, extent, and units of service. Direct
or telephone contact with the recipient's family or others
should be documented;
(6) required clinical supervision by mental health
professionals;
(7) summary of the recipient's case reviews by staff; and
(8) any written information by the recipient that the
recipient wants in the file.
Subd. 11. [EXCLUDED SERVICES.] The following services are
excluded from reimbursement under this section:
(1) room and board services;
(2) services delivered to a recipient while admitted to an
inpatient hospital;
(3) transportation services under children's mental health
crisis response service;
(4) services provided and billed by a provider who is not
enrolled under medical assistance to provide children's mental
health crisis response services;
(5) crisis response services provided by a residential
treatment center to clients in their facility;
(6) services performed by volunteers;
(7) direct billing of time spent "on call" when not
delivering services to a recipient;
(8) provider service time included in case management
reimbursement;
(9) outreach services to potential recipients; and
(10) a mental health service that is not medically
necessary.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 10. Minnesota Statutes 2002, section 256B.0945,
subdivision 2, is amended to read:
Subd. 2. [COVERED SERVICES.] All services must be included
in a child's individualized treatment or multiagency plan of
care as defined in chapter 245.
(a) For facilities that are institutions for mental
diseases according to statute and regulation or are not
institutions for mental diseases but are approved by the
commissioner to provide services under this paragraph, medical
assistance covers the full contract rate, including room and
board if the services meet the requirements of Code of Federal
Regulations, title 42, section 440.160.
(b) For facilities that are not institutions for mental
diseases according to federal statute and regulation and are not
providing services under paragraph (a), medical assistance
covers mental health related services that are required to be
provided by a residential facility under section 245.4882 and
administrative rules promulgated thereunder, except for room and
board.
Sec. 11. Minnesota Statutes 2002, section 256B.0945,
subdivision 4, is amended to read:
Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections
256B.19 and 256B.041, payments to counties for residential
services provided by a residential facility shall only be made
of federal earnings for services provided under this section,
and the nonfederal share of costs for services provided under
this section shall be paid by the county from sources other than
federal funds or funds used to match other federal funds.
Payment to counties for services provided according to
subdivision 2, paragraph (a), shall be the federal share of the
contract rate. Payment to counties for services provided
according to subdivision 2, paragraph (b), this section shall be
a proportion of the per day contract rate that relates to
rehabilitative mental health services and shall not include
payment for costs or services that are billed to the IV-E
program as room and board.
(b) The commissioner shall set aside a portion not to
exceed five percent of the federal funds earned under this
section to cover the state costs of administering this section.
Any unexpended funds from the set-aside shall be distributed to
the counties in proportion to their earnings under this section.
Sec. 12. Minnesota Statutes 2002, section 257.05, is
amended to read:
257.05 [IMPORTATION.]
Subdivision 1. [NOTIFICATION AND DUTIES OF COMMISSIONER.]
No person, except as provided by subdivision subdivisions 2 and
3, shall bring or send into the state any child for the purpose
of placing the child out or procuring the child's adoption
without first obtaining the consent of the commissioner of human
services, and such person shall conform to all rules of the
commissioner of human services and laws of the state of
Minnesota relating to protection of children in foster care.
Before any child shall be brought or sent into the state for the
purpose of being placed in foster care, the person bringing or
sending the child into the state shall first notify the
commissioner of human services of the person's intention, and
shall obtain from the commissioner of human services a
certificate stating that the home in which the child is to be
placed is, in the opinion of the commissioner of human services,
a suitable adoptive home for the child if legal adoption is
contemplated or that the home meets the commissioner's
requirements for licensing of foster homes if legal adoption is
not contemplated. The commissioner is responsible for
protecting the child's interests so long as the child remains
within the state and until the child reaches the age of 18 or is
legally adopted. Notice to the commissioner shall state the
name, age, and personal description of the child, and the name
and address of the person with whom the child is to be placed,
and such other information about the child and the foster home
as may be required by the commissioner.
Subd. 2. [EXEMPT RELATIVES.] A parent, stepparent,
grandparent, brother, sister and aunt or uncle in the first
degree of the minor child who bring a child into the state for
placement within their own home shall be exempt from the
provisions of subdivision 1. This relationship may be by blood
or marriage.
Subd. 3. [INTERNATIONAL ADOPTIONS.] Subject to state and
federal laws and rules, adoption agencies licensed under chapter
245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and
county social services agencies are authorized to certify that
the prospective adoptive home of a child brought into the state
from another country for the purpose of adoption is a suitable
home, or that the home meets the commissioner's requirements for
licensing of foster homes if legal adoption is not contemplated.
Sec. 13. Minnesota Statutes 2002, section 259.67,
subdivision 4, is amended to read:
Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency
shall use the AFDC requirements as specified in federal law as
of July 16, 1996, when determining the child's eligibility for
adoption assistance under title IV-E of the Social Security
Act. If the child does not qualify, the placing agency shall
certify a child as eligible for state funded adoption assistance
only if the following criteria are met:
(1) Due to the child's characteristics or circumstances it
would be difficult to provide the child an adoptive home without
adoption assistance.
(2)(i) A placement agency has made reasonable efforts to
place the child for adoption without adoption assistance, but
has been unsuccessful; or
(ii) the child's licensed foster parents desire to adopt
the child and it is determined by the placing agency that the
adoption is in the best interest of the child.
(3) The child has been a ward of the commissioner or, a
Minnesota-licensed child-placing agency, or a tribal social
service agency of Minnesota recognized by the Secretary of the
Interior.
(b) For purposes of this subdivision, the characteristics
or circumstances that may be considered in determining whether a
child is a child with special needs under United States Code,
title 42, chapter 7, subchapter IV, part E, or meets the
requirements of paragraph (a), clause (1), are the following:
(1) The child is a member of a sibling group to be placed
as one unit in which at least one sibling is older than 15
months of age or is described in clause (2) or (3).
(2) The child has documented physical, mental, emotional,
or behavioral disabilities.
(3) The child has a high risk of developing physical,
mental, emotional, or behavioral disabilities.
(4) The child is adopted according to tribal law without a
termination of parental rights or relinquishment, provided that
the tribe has documented the valid reason why the child cannot
or should not be returned to the home of the child's parent.
(c) When a child's eligibility for adoption assistance is
based upon the high risk of developing physical, mental,
emotional, or behavioral disabilities, payments shall not be
made under the adoption assistance agreement unless and until
the potential disability manifests itself as documented by an
appropriate health care professional.
Sec. 14. Minnesota Statutes 2002, section 260B.157,
subdivision 1, is amended to read:
Subdivision 1. [INVESTIGATION.] Upon request of the court
the local social services agency or probation officer shall
investigate the personal and family history and environment of
any minor coming within the jurisdiction of the court under
section 260B.101 and shall report its findings to the court.
The court may order any minor coming within its jurisdiction to
be examined by a duly qualified physician, psychiatrist, or
psychologist appointed by the court.
The court shall have a chemical use assessment conducted
when a child is (1) found to be delinquent for violating a
provision of chapter 152, or for committing a felony-level
violation of a provision of chapter 609 if the probation officer
determines that alcohol or drug use was a contributing factor in
the commission of the offense, or (2) alleged to be delinquent
for violating a provision of chapter 152, if the child is being
held in custody under a detention order. The assessor's
qualifications and the assessment criteria shall comply with
Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under
chapter 254B are to be used to pay for the recommended
treatment, the assessment and placement must comply with all
provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and
9530.7000 to 9530.7030. The commissioner of human services
shall reimburse the court for the cost of the chemical use
assessment, up to a maximum of $100.
The court shall have a children's mental health screening
conducted when a child is found to be delinquent. The screening
shall be conducted with a screening instrument approved by the
commissioner of human services and shall be conducted by a
mental health practitioner as defined in section 245.4871,
subdivision 26, or a probation officer who is trained in the use
of the screening instrument. If the screening indicates a need
for assessment, the local social services agency, in
consultation with the child's family, shall have a diagnostic
assessment conducted, including a functional assessment, as
defined in section 245.4871.
With the consent of the commissioner of corrections and
agreement of the county to pay the costs thereof, the court may,
by order, place a minor coming within its jurisdiction in an
institution maintained by the commissioner for the detention,
diagnosis, custody and treatment of persons adjudicated to be
delinquent, in order that the condition of the minor be given
due consideration in the disposition of the case. Any funds
received under the provisions of this subdivision shall not
cancel until the end of the fiscal year immediately following
the fiscal year in which the funds were received. The funds are
available for use by the commissioner of corrections during that
period and are hereby appropriated annually to the commissioner
of corrections as reimbursement of the costs of providing these
services to the juvenile courts.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 15. Minnesota Statutes 2002, section 260B.176,
subdivision 2, is amended to read:
Subd. 2. [REASONS FOR DETENTION.] (a) If the child is not
released as provided in subdivision 1, the person taking the
child into custody shall notify the court as soon as possible of
the detention of the child and the reasons for detention.
(b) No child may be detained in a juvenile secure detention
facility or shelter care facility longer than 36 hours,
excluding Saturdays, Sundays, and holidays, after being taken
into custody for a delinquent act as defined in section
260B.007, subdivision 6, unless a petition has been filed and
the judge or referee determines pursuant to section 260B.178
that the child shall remain in detention.
(c) No child may be detained in an adult jail or municipal
lockup longer than 24 hours, excluding Saturdays, Sundays, and
holidays, or longer than six hours in an adult jail or municipal
lockup in a standard metropolitan statistical area, after being
taken into custody for a delinquent act as defined in section
260B.007, subdivision 6, unless:
(1) a petition has been filed under section 260B.141; and
(2) a judge or referee has determined under section
260B.178 that the child shall remain in detention.
After August 1, 1991, no child described in this paragraph
may be detained in an adult jail or municipal lockup longer than
24 hours, excluding Saturdays, Sundays, and holidays, or longer
than six hours in an adult jail or municipal lockup in a
standard metropolitan statistical area, unless the requirements
of this paragraph have been met and, in addition, a motion to
refer the child for adult prosecution has been made under
section 260B.125. Notwithstanding this paragraph, continued
detention of a child in an adult detention facility outside of a
standard metropolitan statistical area county is permissible if:
(i) the facility in which the child is detained is located
where conditions of distance to be traveled or other ground
transportation do not allow for court appearances within 24
hours. A delay not to exceed 48 hours may be made under this
clause; or
(ii) the facility is located where conditions of safety
exist. Time for an appearance may be delayed until 24 hours
after the time that conditions allow for reasonably safe
travel. "Conditions of safety" include adverse life-threatening
weather conditions that do not allow for reasonably safe travel.
The continued detention of a child under clause (i) or (ii)
must be reported to the commissioner of corrections.
(d) If a child described in paragraph (c) is to be detained
in a jail beyond 24 hours, excluding Saturdays, Sundays, and
holidays, the judge or referee, in accordance with rules and
procedures established by the commissioner of corrections, shall
notify the commissioner of the place of the detention and the
reasons therefor. The commissioner shall thereupon assist the
court in the relocation of the child in an appropriate juvenile
secure detention facility or approved jail within the county or
elsewhere in the state, or in determining suitable
alternatives. The commissioner shall direct that a child
detained in a jail be detained after eight days from and
including the date of the original detention order in an
approved juvenile secure detention facility with the approval of
the administrative authority of the facility. If the court
refers the matter to the prosecuting authority pursuant to
section 260B.125, notice to the commissioner shall not be
required.
(e) When a child is detained for an alleged delinquent act
in a state licensed juvenile facility or program, or when a
child is detained in an adult jail or municipal lockup as
provided in paragraph (c), the supervisor of the facility shall,
if the child's parent or legal guardian consents, have a
children's mental health screening conducted with a screening
instrument approved by the commissioner of human services,
unless a screening has been performed within the previous 180
days or the child is currently under the care of a mental health
professional. The screening shall be conducted by a mental
health practitioner as defined in section 245.4871, subdivision
26, or a probation officer who is trained in the use of the
screening instrument. The screening shall be conducted after
the initial detention hearing has been held and the court has
ordered the child continued in detention. The results of the
screening may only be presented to the court at the
dispositional phase of the court proceedings on the matter
unless the parent or legal guardian consents to presentation at
a different time. If the screening indicates a need for
assessment, the local social services agency or probation
officer, with the approval of the child's parent or legal
guardian, shall have a diagnostic assessment conducted,
including a functional assessment, as defined in section
245.4871.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 16. Minnesota Statutes 2002, section 260B.178,
subdivision 1, is amended to read:
Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) The
court shall hold a detention hearing:
(1) within 36 hours of the time the child was taken into
custody, excluding Saturdays, Sundays, and holidays, if the
child is being held at a juvenile secure detention facility or
shelter care facility; or
(2) within 24 hours of the time the child was taken into
custody, excluding Saturdays, Sundays, and holidays, if the
child is being held at an adult jail or municipal lockup.
(b) Unless there is reason to believe that the child would
endanger self or others, not return for a court hearing, run
away from the child's parent, guardian, or custodian or
otherwise not remain in the care or control of the person to
whose lawful custody the child is released, or that the child's
health or welfare would be immediately endangered, the child
shall be released to the custody of a parent, guardian,
custodian, or other suitable person, subject to reasonable
conditions of release including, but not limited to, a
requirement that the child undergo a chemical use assessment as
provided in section 260B.157, subdivision 1, and a children's
mental health screening as provided in section 260B.176,
subdivision 2, paragraph (e). In determining whether the
child's health or welfare would be immediately endangered, the
court shall consider whether the child would reside with a
perpetrator of domestic child abuse.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 17. Minnesota Statutes 2002, section 260B.193,
subdivision 2, is amended to read:
Subd. 2. [CONSIDERATION OF REPORTS.] Before making a
disposition in a case, or appointing a guardian for a child, the
court may consider any report or recommendation made by the
local social services agency, probation officer, licensed
child-placing agency, foster parent, guardian ad litem, tribal
representative, or other authorized advocate for the child or
child's family, a school district concerning the effect on
student transportation of placing a child in a school district
in which the child is not a resident, or any other information
deemed material by the court. In addition, the court may
consider the results of the children's mental health screening
provided in section 260B.157, subdivision 1.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 18. Minnesota Statutes 2002, section 260B.235,
subdivision 6, is amended to read:
Subd. 6. [ALTERNATIVE DISPOSITION.] In addition to
dispositional alternatives authorized by subdivision 3 4, in the
case of a third or subsequent finding by the court pursuant to
an admission in court or after trial that a child has committed
a juvenile alcohol or controlled substance offense, the juvenile
court shall order a chemical dependency evaluation of the child
and if warranted by the evaluation, the court may order
participation by the child in an inpatient or outpatient
chemical dependency treatment program, or any other treatment
deemed appropriate by the court. In the case of a third or
subsequent finding that a child has committed any juvenile petty
offense, the court shall order a children's mental health
screening be conducted as provided in section 260B.157,
subdivision 1, and if indicated by the screening, to undergo a
diagnostic assessment, including a functional assessment, as
defined in section 245.4871.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 19. Minnesota Statutes 2002, section 260C.141,
subdivision 2, is amended to read:
Subd. 2. [REVIEW OF FOSTER CARE STATUS.] The social
services agency responsible for the placement of a child in a
residential facility, as defined in section 260C.212,
subdivision 1, pursuant to a voluntary release by the child's
parent or parents must proceed in juvenile court to review the
foster care status of the child in the manner provided in this
section.
(a) Except for a child in placement due solely to the
child's developmental disability or emotional disturbance, when
a child continues in voluntary placement according to section
260C.212, subdivision 8, a petition shall be filed alleging the
child to be in need of protection or services or seeking
termination of parental rights or other permanent placement of
the child away from the parent within 90 days of the date of the
voluntary placement agreement. The petition shall state the
reasons why the child is in placement, the progress on the
out-of-home placement plan required under section 260C.212,
subdivision 1, and the statutory basis for the petition under
section 260C.007, subdivision 6, 260C.201, subdivision 11, or
260C.301.
(1) In the case of a petition alleging the child to be in
need of protection or services filed under this paragraph, if
all parties agree and the court finds it is in the best
interests of the child, the court may find the petition states a
prima facie case that:
(i) the child's needs are being met;
(ii) the placement of the child in foster care is in the
best interests of the child;
(iii) reasonable efforts to reunify the child and the
parent or guardian are being made; and
(iv) the child will be returned home in the next three
months.
(2) If the court makes findings under paragraph (1), the
court shall approve the voluntary arrangement and continue the
matter for up to three more months to ensure the child returns
to the parents' home. The responsible social services agency
shall:
(i) report to the court when the child returns home and the
progress made by the parent on the out-of-home placement plan
required under section 260C.212, in which case the court shall
dismiss jurisdiction;
(ii) report to the court that the child has not returned
home, in which case the matter shall be returned to the court
for further proceedings under section 260C.163; or
(iii) if any party does not agree to continue the matter
under paragraph (1) and this paragraph, the matter shall proceed
under section 260C.163.
(b) In the case of a child in voluntary placement due
solely to the child's developmental disability or emotional
disturbance according to section 260C.212, subdivision 9, the
following procedures apply:
(1) [REPORT TO COURT.] (i) Unless the county attorney
determines that a petition under subdivision 1 is appropriate,
without filing a petition, a written report shall be forwarded
to the court within 165 days of the date of the voluntary
placement agreement. The written report shall contain necessary
identifying information for the court to proceed, a copy of the
out-of-home placement plan required under section 260C.212,
subdivision 1, a written summary of the proceedings of any
administrative review required under section 260C.212,
subdivision 7, and any other information the responsible social
services agency, parent or guardian, the child or the foster
parent or other residential facility wants the court to consider.
(ii) The responsible social services agency, where
appropriate, must advise the child, parent or guardian, the
foster parent, or representative of the residential facility of
the requirements of this section and of their right to submit
information to the court. If the child, parent or guardian,
foster parent, or representative of the residential facility
wants to send information to the court, the responsible social
services agency shall advise those persons of the reporting date
and the identifying information necessary for the court
administrator to accept the information and submit it to a judge
with the agency's report. The responsible social services
agency must also notify those persons that they have the right
to be heard in person by the court and how to exercise that
right. The responsible social services agency must also provide
notice that an in-court hearing will not be held unless
requested by a parent or guardian, foster parent, or the child.
(iii) After receiving the required report, the court has
jurisdiction to make the following determinations and must do so
within ten days of receiving the forwarded report: (A) whether
or not the placement of the child is in the child's best
interests; and (B) whether the parent and agency are
appropriately planning for the child. Unless requested by a
parent or guardian, foster parent, or child, no in-court hearing
need be held in order for the court to make findings and issue
an order under this paragraph.
(iv) If the court finds the placement is in the child's
best interests and that the agency and parent are appropriately
planning for the child, the court shall issue an order
containing explicit, individualized findings to support its
determination. The court shall send a copy of the order to the
county attorney, the responsible social services agency, the
parent or guardian, the child, and the foster parents. The
court shall also send the parent or guardian, the child, and the
foster parent notice of the required review under clause (2).
(v) If the court finds continuing the placement not to be
in the child's best interests or that the agency or the parent
or guardian is not appropriately planning for the child, the
court shall notify the county attorney, the responsible social
services agency, the parent or guardian, the foster parent, the
child, and the county attorney of the court's determinations and
the basis for the court's determinations.
(2) [PERMANENCY REVIEW BY PETITION.] If a child with a
developmental disability or an emotional disturbance continues
in out-of-home placement for 13 months from the date of a
voluntary placement, a petition alleging the child to be in need
of protection or services, for termination of parental rights,
or for permanent placement of the child away from the parent
under section 260C.201 shall be filed. The court shall conduct
a permanency hearing on the petition no later than 14 months
after the date of the voluntary placement. At the permanency
hearing, the court shall determine the need for an order
permanently placing the child away from the parent or determine
whether there are compelling reasons that continued voluntary
placement is in the child's best interests. A petition alleging
the child to be in need of protection or services shall state
the date of the voluntary placement agreement, the nature of the
child's developmental disability or emotional disturbance, the
plan for the ongoing care of the child, the parents'
participation in the plan, the responsible social services
agency's efforts to finalize a plan for the permanent placement
of the child, and the statutory basis for the petition.
(i) If a petition alleging the child to be in need of
protection or services is filed under this paragraph, the court
may find, based on the contents of the sworn petition, and the
agreement of all parties, including the child, where
appropriate, that there are compelling reasons that the
voluntary arrangement is in the best interests of the child and
that the responsible social services agency has made reasonable
efforts to finalize a plan for the permanent placement of the
child, approve the continued voluntary placement, and continue
the matter under the court's jurisdiction for the purpose of
reviewing the child's placement as a continued voluntary
arrangement every 12 months as long as the child continues in
out-of-home placement. The matter must be returned to the court
for further review every 12 months as long as the child remains
in placement. The court shall give notice to the parent or
guardian of the continued review requirements under this
section. Nothing in this paragraph shall be construed to mean
the court must order permanent placement for the child under
section 260C.201, subdivision 11, as long as the court finds
compelling reasons at the first review required under this
section.
(ii) If a petition for termination of parental rights, for
transfer of permanent legal and physical custody to a relative,
for long-term foster care, or for foster care for a specified
period of time is filed, the court must proceed under section
260C.201, subdivision 11.
(3) If any party, including the child, disagrees with the
voluntary arrangement, the court shall proceed under section
260C.163.
Sec. 20. Minnesota Statutes 2002, section 626.559,
subdivision 5, is amended to read:
Subd. 5. [REVENUE.] The commissioner of human services
shall add the following funds to the funds appropriated under
section 626.5591, subdivision 2, to develop and support training:
(a) The commissioner of human services shall submit claims
for federal reimbursement earned through the activities and
services supported through department of human services child
protection or child welfare training funds. Federal revenue
earned must be used to improve and expand training services by
the department. The department expenditures eligible for
federal reimbursement under this section must not be made from
federal funds or funds used to match other federal funds.
(b) Each year, the commissioner of human services shall
withhold from funds distributed to each county under Minnesota
Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5
percent of each county's annual title XX allocation under
section 256E.07 256M.50. The commissioner must use these funds
to ensure decentralization of training.
(c) The federal revenue under this subdivision is available
for these purposes until the funds are expended.
Sec. 21. [MEDICAL ASSISTANCE FOR MENTAL HEALTH SERVICES
PROVIDED IN OUT-OF-HOME PLACEMENT SETTINGS.]
The commissioner of human services shall develop a plan in
conjunction with the commissioner of corrections and
representatives from counties, provider groups, and other
stakeholders, to secure medical assistance funding for mental
health-related services provided in out-of-home placement
settings, including treatment foster care, group homes, and
residential programs licensed under Minnesota Statutes, chapters
241 and 245A. The plan must include proposed legislation,
fiscal implications, and other pertinent information.
Treatment foster care services must be provided by a child
placing agency licensed under Minnesota Rules, parts 9543.0010
to 9543.0150 or 9545.0755 to 9545.0845.
The commissioner shall report to the legislature by January
15, 2004.
Sec. 22. [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES
AND SUPPORTS.]
Beginning July 1, 2003, the commissioner shall use the
provider certification process under Minnesota Statutes, section
256B.0943, instead of the provider certification process
required in Minnesota Rules, parts 9505.0324; 9505.0326; and
9505.0327.
Sec. 23. [REVISOR'S INSTRUCTION.]
For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 24. [REPEALER.]
(a) Minnesota Statutes 2002, sections 256B.0945,
subdivision 10, is repealed.
(b) Minnesota Statutes 2002, section 256B.0625,
subdivisions 35 and 36, are repealed effective July 1, 2004.
(c) Minnesota Rules, parts 9505.0324; 9505.0326; and
9505.0327, are repealed effective July 1, 2004.
ARTICLE 5
OCCUPATIONAL LICENSES
Section 1. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 1a. [ACCREDITING ASSOCIATION.] "Accrediting
association" means an organization recognized by the
commissioner that evaluates schools and education programs of
alcohol and drug counseling or is listed in Nationally
Recognized Accrediting Agencies and Associations, Criteria and
Procedures for Listing by the U.S. Secretary of Education and
Current List (1996), which is incorporated by reference.
Sec. 2. Minnesota Statutes 2002, section 148C.01,
subdivision 2, is amended to read:
Subd. 2. [ALCOHOL AND DRUG COUNSELOR.] "Alcohol and drug
counselor" or "counselor" means a person who:
(1) uses, as a representation to the public, any title,
initials, or description of services incorporating the words
"alcohol and drug counselor";
(2) offers to render professional alcohol and drug
counseling services relative to the abuse of or the dependency
on alcohol or other drugs to the general public or groups,
organizations, corporations, institutions, or government
agencies for compensation, implying that the person is licensed
and trained, experienced or expert in alcohol and drug
counseling;
(3) holds a valid license issued under sections 148C.01 to
148C.11 this chapter to engage in the practice of alcohol and
drug counseling; or
(4) is an applicant for an alcohol and drug counseling
license.
Sec. 3. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2a. [ALCOHOL AND DRUG COUNSELOR ACADEMIC COURSE
WORK.] "Alcohol and drug counselor academic course work" means
classroom education, which is directly related to alcohol and
drug counseling and meets the requirements of section 148C.04,
subdivision 5a, and is taken through an accredited school or
educational program.
Sec. 4. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2b. [ALCOHOL AND DRUG COUNSELOR CONTINUING EDUCATION
ACTIVITY.] "Alcohol and drug counselor continuing education
activity" means clock hours that meet the requirements of
section 148C.075 and Minnesota Rules, part 4747.1100, and are
obtained by a licensee at educational programs of annual
conferences, lectures, panel discussions, workshops, seminars,
symposiums, employer-sponsored inservices, or courses taken
through accredited schools or education programs, including home
study courses. A home study course need not be provided by an
accredited school or education program to meet continuing
education requirements.
Sec. 5. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2c. [ALCOHOL AND DRUG COUNSELOR
TECHNICIAN.] "Alcohol and drug counselor technician" means a
person not licensed as an alcohol and drug counselor who is
performing acts authorized under section 148C.045.
Sec. 6. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2d. [ALCOHOL AND DRUG COUNSELOR TRAINING.] "Alcohol
and drug counselor training" means clock hours obtained by an
applicant at educational programs of annual conferences,
lectures, panel discussions, workshops, seminars, symposiums,
employer-sponsored inservices, or courses taken through
accredited schools or education programs, including home study
courses. Clock hours obtained from accredited schools or
education programs must be measured under Minnesota Rules, part
4747.1100, subpart 5.
Sec. 7. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2f. [CLOCK HOUR.] "Clock hour" means an
instructional session of 50 consecutive minutes, excluding
coffee breaks, registration, meals without a speaker, and social
activities.
Sec. 8. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 2g. [CREDENTIAL.] "Credential" means a license,
permit, certification, registration, or other evidence of
qualification or authorization to engage in the practice of an
occupation.
Sec. 9. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 4a. [LICENSEE.] "Licensee" means a person who holds
a valid license under this chapter.
Sec. 10. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 11a. [STUDENT.] "Student" means a person enrolled in
an alcohol and drug counselor education program at an accredited
school or educational program and earning a minimum of nine
semester credits per calendar year towards completion of an
associate's, bachelor's, master's, or doctorate degree
requirements that include an additional 18 semester credits or
270 clock hours of alcohol and drug counseling specific course
work and 440 clock hours of practicum.
Sec. 11. Minnesota Statutes 2002, section 148C.01,
subdivision 12, is amended to read:
Subd. 12. [SUPERVISED ALCOHOL AND DRUG COUNSELING
EXPERIENCE COUNSELOR.] Except during the transition period,
"Supervised alcohol and drug counseling experience counselor"
means practical experience gained by a student, volunteer, or
either before, during, or after the student completes a program
from an accredited school or educational program of alcohol and
drug counseling, an intern, and or a person issued a temporary
permit under section 148C.04, subdivision 4, and who is
supervised by a person either licensed under this chapter or
exempt under its provisions; either before, during, or after the
student completes a program from an accredited school or
educational program of alcohol and drug counseling.
Sec. 12. Minnesota Statutes 2002, section 148C.01, is
amended by adding a subdivision to read:
Subd. 12a. [SUPERVISOR.] "Supervisor" means a licensed
alcohol and drug counselor licensed under this chapter or other
licensed professional practicing alcohol and drug counseling
under section 148C.11 who monitors activities of and accepts
legal liability for the person practicing under supervision. A
supervisor shall supervise no more than three trainees
practicing under section 148C.04, subdivision 6.
Sec. 13. Minnesota Statutes 2002, section 148C.03,
subdivision 1, is amended to read:
Subdivision 1. [GENERAL.] The commissioner shall, after
consultation with the advisory council or a committee
established by rule:
(a) adopt and enforce rules for licensure of alcohol and
drug counselors, including establishing standards and methods of
determining whether applicants and licensees are qualified under
section 148C.04. The rules must provide for examinations and
establish standards for the regulation of professional conduct.
The rules must be designed to protect the public;
(b) develop and, at least twice a year, administer an
examination to assess applicants' knowledge and skills. The
commissioner may contract for the administration of an
examination with an entity designated by the commissioner. The
examinations must be psychometrically valid and reliable; must
be written and oral, with the oral examination based on a
written case presentation; must minimize cultural bias; and must
be balanced in various theories relative to the practice of
alcohol and drug counseling;
(c) issue licenses to individuals qualified under sections
148C.01 to 148C.11;
(d) issue copies of the rules for licensure to all
applicants;
(e) adopt rules to establish and implement procedures,
including a standard disciplinary process and rules of
professional conduct;
(f) carry out disciplinary actions against licensees;
(g) establish, with the advice and recommendations of the
advisory council, written internal operating procedures for
receiving and investigating complaints and for taking
disciplinary actions as appropriate;
(h) educate the public about the existence and content of
the rules for alcohol and drug counselor licensing to enable
consumers to file complaints against licensees who may have
violated the rules;
(i) evaluate the rules in order to refine and improve the
methods used to enforce the commissioner's standards; and
(j) set, collect, and adjust license fees for alcohol and
drug counselors so that the total fees collected will as closely
as possible equal anticipated expenditures during the biennium,
as provided in section 16A.1285; fees for initial and renewal
application and examinations; late fees for counselors who
submit license renewal applications after the renewal deadline;
and a surcharge fee. The surcharge fee must include an amount
necessary to recover, over a five-year period, the
commissioner's direct expenditures for the adoption of the rules
providing for the licensure of alcohol and drug counselors. All
fees received shall be deposited in the state treasury and
credited to the special revenue fund.
Sec. 14. Minnesota Statutes 2002, section 148C.0351,
subdivision 1, is amended to read:
Subdivision 1. [APPLICATION FORMS.] Unless exempted under
section 148C.11, a person who practices alcohol and drug
counseling in Minnesota must:
(1) apply to the commissioner for a license to practice
alcohol and drug counseling on forms provided by the
commissioner;
(2) include with the application a statement that the
statements in the application are true and correct to the best
of the applicant's knowledge and belief;
(3) include with the application a nonrefundable
application fee specified by the commissioner in section
148C.12;
(4) include with the application information describing the
applicant's experience, including the number of years and months
the applicant has practiced alcohol and drug counseling as
defined in section 148C.01;
(5) include with the application the applicant's business
address and telephone number, or home address and telephone
number if the applicant conducts business out of the home, and
if applicable, the name of the applicant's supervisor, manager,
and employer;
(6) include with the application a written and signed
authorization for the commissioner to make inquiries to
appropriate state regulatory agencies and private credentialing
organizations in this or any other state where the applicant has
practiced alcohol and drug counseling; and
(7) complete the application in sufficient detail for the
commissioner to determine whether the applicant meets the
requirements for filing. The commissioner may ask the applicant
to provide additional information necessary to clarify
incomplete or ambiguous information submitted in the application.
Sec. 15. Minnesota Statutes 2002, section 148C.0351, is
amended by adding a subdivision to read:
Subd. 4. [INITIAL LICENSE; TERM.] (a) An initial license
is effective on the date the commissioner indicates on the
license certificate, with the license number, sent to the
applicant upon approval of the application.
(b) An initial license is valid for a period beginning with
the effective date in paragraph (a) and ending on the date
specified by the commissioner on the license certificate placing
the applicant in an existing two-year renewal cycle, as
established under section 148C.05, subdivision 1.
Sec. 16. [148C.0355] [COMMISSIONER ACTION ON APPLICATIONS
FOR LICENSURE.]
The commissioner shall act on each application for
licensure within 90 days from the date the completed application
and all required information is received by the commissioner.
The commissioner shall determine if the applicant meets the
requirements for licensure and whether there are grounds for
denial of licensure under this chapter. If the commissioner
denies an application on grounds other than the applicant's
failure of an examination, the commissioner shall:
(1) notify the applicant, in writing, of the denial and the
reason for the denial and provide the applicant 30 days from the
date of the letter informing the applicant of the denial in
which the applicant may provide additional information to
address the reasons for the denial. If the applicant does not
respond in writing to the commissioner within the 30-day period,
the denial is final. If the commissioner receives additional
information, the commissioner shall review it and make a final
determination thereafter;
(2) notify the applicant that an application submitted
following denial is a new application and must be accompanied by
the appropriate fee as specified in section 148C.12; and
(3) notify the applicant of the right to request a hearing
under chapter 14.
Sec. 17. Minnesota Statutes 2002, section 148C.04, is
amended to read:
148C.04 [REQUIREMENTS FOR LICENSURE.]
Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner
shall issue licenses to the individuals qualified under sections
148C.01 to 148C.11 this chapter to practice alcohol and drug
counseling.
Subd. 2. [FEE.] Each applicant shall pay a nonrefundable
fee set by the commissioner pursuant to section 148C.03 as
specified in section 148C.12. Fees paid to the commissioner
shall be deposited in the special revenue fund.
Subd. 3. [LICENSING REQUIREMENTS FOR THE FIRST FIVE
YEARS LICENSURE BEFORE JULY 1, 2008.] For five years after the
effective date of the rules authorized in section 148C.03,
the An applicant, unless qualified under section 148C.06 during
the 25-month period authorized therein, under section 148C.07,
or under subdivision 4, for a license must furnish evidence
satisfactory to the commissioner that the applicant has met all
the requirements in clauses (1) to (3). The applicant must have:
(1) received an associate degree, or an equivalent number
of credit hours, and a certificate in alcohol and drug
counseling, including 18 semester credits or 270 clock hours of
alcohol and drug counseling classroom education academic course
work in accordance with subdivision 5a, paragraph (a), from an
accredited school or educational program and 880 clock hours of
supervised alcohol and drug counseling practicum;
(2) completed a written case presentation and
satisfactorily passed an oral examination established by the
commissioner that demonstrates competence in the core functions;
and
(3) satisfactorily passed a written examination as
established by the commissioner.
Subd. 4. [LICENSING REQUIREMENTS AFTER FIVE YEARS FOR
LICENSURE AFTER JULY 1, 2008.] Beginning five years after the
effective date of the rules authorized in section 148C.03,
subdivision 1 , An applicant for licensure a license must submit
evidence to the commissioner that the applicant has met one of
the following requirements:
(1) the applicant must have:
(i) received a bachelor's degree from an accredited school
or educational program, including 480 18 semester credits or 270
clock hours of alcohol and drug counseling education academic
course work in accordance with subdivision 5a, paragraph (a),
from an accredited school or educational program and 880 clock
hours of supervised alcohol and drug counseling practicum;
(ii) completed a written case presentation and
satisfactorily passed an oral examination established by the
commissioner that demonstrates competence in the core functions;
and
(iii) satisfactorily passed a written examination as
established by the commissioner; or
(2) the applicant must meet the requirements of section
148C.07.
Subd. 5a. [ACADEMIC COURSE WORK.] (a) Minimum academic
course work requirements for licensure as referred to under
subdivision 3, clause (1), and subdivision 4, clause (1), item
(i), must be in the following areas:
(1) overview of alcohol and drug counseling focusing on the
transdisciplinary foundations of alcohol and drug counseling and
providing an understanding of theories of chemical dependency,
the continuum of care, and the process of change;
(2) pharmacology of substance abuse disorders and the
dynamics of addiction;
(3) screening, intake, assessment, and treatment planning;
(4) counseling theory and practice, crisis intervention,
orientation, and client education;
(5) case management, consultation, referral, treatment
planning, reporting, record keeping, and professional and
ethical responsibilities; and
(6) multicultural aspects of chemical dependency to include
awareness of learning outcomes described in Minnesota Rules,
part 4747.1100, subpart 2, and the ability to know when
consultation is needed.
(b) Advanced academic course work includes, at a minimum,
the course work required in paragraph (a) and additional course
work in the following areas:
(1) advanced study in the areas listed in paragraph (a);
(2) chemical dependency and the family;
(3) treating substance abuse disorders in culturally
diverse and identified populations;
(4) dual diagnoses/co-occurring disorders with substance
abuse disorders; and
(5) ethics and chemical dependency.
Subd. 6. [TEMPORARY PRACTICE PERMIT REQUIREMENTS.] (a) A
person may temporarily The commissioner shall issue a temporary
permit to practice alcohol and drug counseling prior to being
licensed under this chapter if the person:
(1) either:
(i) meets the associate degree education and practicum
requirements of subdivision 3, clause (1);
(ii) meets the bachelor's degree education and practicum
requirements of subdivision 4, clause (1), item (i); or
(iii) submits verification of a current and unrestricted
credential for the practice of alcohol and drug counseling from
a national certification body or a certification or licensing
body from another state, United States territory, or federally
recognized tribal authority;
(ii) submits verification of the completion of at least 64
semester credits, including 270 clock hours or 18 semester
credits of formal classroom education in alcohol and drug
counseling and at least 880 clock hours of alcohol and drug
counseling practicum from an accredited school or educational
program; or
(iii) meets the requirements of section 148C.11,
subdivision 6, clauses (1), (2), and (5);
(2) requests applies, in writing, temporary practice status
with the commissioner on an application form according to
section 148C.0351 provided by the commissioner, which includes
the nonrefundable license temporary permit fee as specified in
section 148C.12 and an affirmation by the person's supervisor,
as defined in paragraph (b) (c), clause (1), and which is signed
and dated by the person and the person's supervisor; and
(3) has not been disqualified to practice temporarily on
the basis of a background investigation under section 148C.09,
subdivision 1a; and.
(4) has been notified (b) The commissioner must notify the
person in writing within 90 days from the date the completed
application and all required information is received by the
commissioner that whether the person is qualified to practice
under this subdivision.
(b) (c) A person practicing under this subdivision:
(1) may practice only in a program licensed by the
department of human services and under tribal jurisdiction or
under the direct, on-site supervision of a person who is
licensed under this chapter and employed in that licensed
program;
(2) is subject to the rules of professional conduct set by
rule; and
(3) is not subject to the continuing education requirements
of section 148C.05 148C.075.
(c) (d) A person practicing under this subdivision may not
must use with the public any the title or description stating or
implying that the person is licensed to engage a trainee engaged
in the practice of alcohol and drug counseling.
(d) (e) The temporary status of A person applying for
temporary practice practicing under this subdivision expires on
the date the commissioner grants or denies licensing must
annually submit a renewal application on forms provided by the
commissioner with the renewal fee required in section 148C.12,
subdivision 3, and the commissioner may renew the temporary
permit if the trainee meets the requirements of this
subdivision. A trainee may renew a practice permit no more than
five times.
(e) (f) A temporary permit expires if not renewed, upon a
change of employment of the trainee or upon a change in
supervision, or upon the granting or denial by the commissioner
of a license.
Subd. 7. [EFFECT AND SUSPENSION OF TEMPORARY PRACTICE
PERMIT.] Approval of a person's application for
temporary practice permit creates no rights to or expectation of
approval from the commissioner for licensure as an alcohol and
drug counselor. The commissioner may suspend or restrict a
person's temporary practice permit status according to section
148C.09.
[EFFECTIVE DATE.] Subdivisions 1, 2, 3, 4, and 5a are
effective January 28, 2003. Subdivision 6 is effective July 1,
2003.
Sec. 18. [148C.045] [ALCOHOL AND DRUG COUNSELOR
TECHNICIAN.]
An alcohol and drug counselor technician may perform the
services described in section 148C.01, subdivision 9, paragraphs
(1), (2), and (3), while under the direct supervision of a
licensed alcohol and drug counselor.
Sec. 19. Minnesota Statutes 2002, section 148C.05,
subdivision 1, is amended to read:
Subdivision 1. [BIENNIAL RENEWAL REQUIREMENTS.] To renew a
license, an applicant must:
(1) complete a renewal application every two years on a
form provided by the commissioner and submit the biennial
renewal fee by the deadline; and
(2) submit additional information if requested by the
commissioner to clarify information presented in the renewal
application. This information must be submitted within 30 days
of the commissioner's request. A license must be renewed every
two years.
Sec. 20. Minnesota Statutes 2002, section 148C.05, is
amended by adding a subdivision to read:
Subd. 1a. [RENEWAL REQUIREMENTS.] To renew a license, an
applicant must submit to the commissioner:
(1) a completed and signed application for license renewal,
including a signed consent authorizing the commissioner to
obtain information about the applicant from third parties,
including, but not limited to, employers, former employers, and
law enforcement agencies;
(2) the renewal fee required under section 148C.12; and
(3) additional information as requested by the commissioner
to clarify information presented in the renewal application.
The licensee must submit information within 30 days of the date
of the commissioner's request.
Sec. 21. Minnesota Statutes 2002, section 148C.05, is
amended by adding a subdivision to read:
Subd. 5. [LICENSE RENEWAL NOTICE.] At least 60 calendar
days before the renewal deadline date in subdivision 6, the
commissioner shall mail a renewal notice to the licensee's last
known address on file with the commissioner. The notice must
include an application for license renewal, the renewal
deadline, and notice of fees required for renewal. The
licensee's failure to receive notice does not relieve the
licensee of the obligation to meet the renewal deadline and
other requirements for license renewal.
Sec. 22. Minnesota Statutes 2002, section 148C.05, is
amended by adding a subdivision to read:
Subd. 6. [RENEWAL DEADLINE AND LAPSE OF LICENSURE.] (a)
Licensees must comply with paragraphs (b) to (d).
(b) Each license certificate must state an expiration
date. An application for license renewal must be received by
the commissioner or postmarked at least 30 calendar days before
the expiration date. If the postmark is illegible, the
application must be considered timely if received at least 21
calendar days before the expiration date.
(c) An application for license renewal not received within
the time required under paragraph (b) must be accompanied by a
late fee in addition to the renewal fee required in section
148C.12.
(d) A licensee's license lapses if the licensee fails to
submit to the commissioner a license renewal application by the
licensure expiration date. A licensee shall not engage in the
practice of alcohol and drug counseling while the license is
lapsed. A licensee whose license has lapsed may renew the
license by complying with section 148C.055.
Sec. 23. [148C.055] [INACTIVE OR LAPSED LICENSE.]
Subdivision 1. [INACTIVE LICENSE STATUS.] Unless a
complaint is pending against the licensee, a licensee whose
license is in good standing may request, in writing, that the
license be placed on the inactive list. If a complaint is
pending against a licensee, a license may not be placed on the
inactive list until action relating to the complaint is
concluded. The commissioner must receive the request for
inactive status before expiration of the license. A request for
inactive status received after the license expiration date must
be denied. A licensee may renew a license that is inactive
under this subdivision by meeting the renewal requirements of
subdivision 2, except that payment of a late renewal fee is not
required. A licensee must not practice alcohol and drug
counseling while the license is inactive.
Subd. 2. [RENEWAL OF INACTIVE LICENSE.] A licensee whose
license is inactive shall renew the inactive status by the
inactive status expiration date determined by the commissioner
or the license will lapse. An application for renewal of
inactive status must include evidence satisfactory to the
commissioner that the licensee has completed 40 clock hours of
continuing professional education required in section 148C.075,
and be received by the commissioner at least 30 calendar days
before the expiration date. If the postmark is illegible, the
application must be considered timely if received at least 21
calendar days before the expiration date. Late renewal of
inactive status must be accompanied by a late fee as required in
section 148C.12.
Subd. 3. [RENEWAL OF LAPSED LICENSE.] An individual whose
license has lapsed for less than two years may renew the license
by submitting:
(1) a completed and signed license renewal application;
(2) the inactive license renewal fee or the renewal fee and
the late fee as required under section 148C.12; and
(3) proof of having met the continuing education
requirements in section 148C.075 since the individual's initial
licensure or last license renewal. The license issued is then
effective for the remainder of the next two-year license cycle.
Subd. 4. [LICENSE RENEWAL FOR TWO YEARS OR MORE AFTER
LICENSE EXPIRATION DATE.] An individual who submitted a license
renewal two years or more after the license expiration date must
submit the following:
(1) a completed and signed application for licensure, as
required by section 148C.0351;
(2) the initial license fee as required in section 148C.12;
and
(3) verified documentation of having achieved a passing
score within the past year on an examination required by the
commissioner.
Sec. 24. Minnesota Statutes 2002, section 148C.07, is
amended to read:
148C.07 [RECIPROCITY.]
The commissioner shall issue an appropriate license to (a)
An individual who holds a current license or other credential to
engage in alcohol and drug counseling national certification as
an alcohol and drug counselor from another jurisdiction if the
commissioner finds that the requirements for that credential are
substantially similar to the requirements in sections 148C.01 to
148C.11 must file with the commissioner a completed application
for licensure by reciprocity containing the information required
under this section.
(b) The applicant must request the credentialing authority
of the jurisdiction in which the credential is held to send
directly to the commissioner a statement that the credential is
current and in good standing, the applicant's qualifications
that entitled the applicant to the credential, and a copy of the
jurisdiction's credentialing laws and rules that were in effect
at the time the applicant obtained the credential.
(c) The commissioner shall issue a license if the
commissioner finds that the requirements, which the applicant
had to meet to obtain the credential from the other jurisdiction
were substantially similar to the current requirements for
licensure in this chapter, and the applicant is not otherwise
disqualified under section 148C.09.
Sec. 25. [148C.075] [CONTINUING EDUCATION REQUIREMENTS.]
Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner
shall establish a two-year continuing education reporting
schedule requiring licensees to report completion of the
requirements of this section. Licensees must document
completion of a minimum of 40 clock hours of continuing
education activities each reporting period. A licensee may be
given credit only for activities that directly relate to the
practice of alcohol and drug counseling, the core functions, or
the rules of professional conduct in Minnesota Rules, part
4747.1400. The continuing education reporting form must require
reporting of the following information:
(1) the continuing education activity title;
(2) a brief description of the continuing education
activity;
(3) the sponsor, presenter, or author;
(4) the location and attendance dates;
(5) the number of clock hours; and
(6) a statement that the information is true and correct to
the best knowledge of the licensee.
Only continuing education obtained during the previous
two-year reporting period may be considered at the time of
reporting. Clock hours must be earned and reported in
increments of one-half clock hour with a minimum of one clock
hour for each continuing education activity.
Subd. 2. [CONTINUING EDUCATION REQUIREMENTS FOR LICENSEE'S
FIRST FOUR YEARS.] A licensee must, as part of meeting the clock
hour requirement of this section, obtain and document 18 hours
of cultural diversity training within the first four years after
the licensee's initial license effective date according to the
commissioner's reporting schedule.
Subd. 3. [CONTINUING EDUCATION REQUIREMENTS AFTER
LICENSEE'S INITIAL FOUR YEARS.] Beginning four years following a
licensee's initial license effective date and according to the
board's reporting schedule, a licensee must document completion
of a minimum of six clock hours each reporting period of
cultural diversity training. Licensees must also document
completion of six clock hours in courses directly related to the
rules of professional conduct in Minnesota Rules, part 4747.1400.
Subd. 4. [STANDARDS FOR APPROVAL.] In order to obtain
clock hour credit for a continuing education activity, the
activity must:
(1) constitute an organized program of learning;
(2) reasonably be expected to advance the knowledge and
skills of the alcohol and drug counselor;
(3) pertain to subjects that directly relate to the
practice of alcohol and drug counseling and the core functions
of an alcohol and drug counselor, or the rules of professional
conduct in Minnesota Rules, part 4747.1400;
(4) be conducted by individuals who have education,
training, and experience and are knowledgeable about the subject
matter; and
(5) be presented by a sponsor who has a system to verify
participation and maintains attendance records for three years,
unless the sponsor provides dated evidence to each participant
with the number of clock hours awarded.
Sec. 26. Minnesota Statutes 2002, section 148C.10,
subdivision 1, is amended to read:
Subdivision 1. [PRACTICE.] After the commissioner adopts
rules, No individual person, other than those individuals
exempted under section 148C.11, or 148C.045, shall engage in
alcohol and drug counseling practice unless that individual
holds a valid license without first being licensed under this
chapter as an alcohol and drug counselor. For purposes of this
chapter, an individual engages in the practice of alcohol and
drug counseling if the individual performs or offers to perform
alcohol and drug counseling services as defined in section
148C.01, subdivision 10, or if the individual is held out as
able to perform those services.
Sec. 27. Minnesota Statutes 2002, section 148C.10,
subdivision 2, is amended to read:
Subd. 2. [USE OF TITLES.] After the commissioner adopts
rules, No individual person shall present themselves or any
other individual to the public by any title incorporating the
words "licensed alcohol and drug counselor" or otherwise hold
themselves out to the public by any title or description stating
or implying that they are licensed or otherwise qualified to
practice alcohol and drug counseling unless that individual
holds a valid license. City, county, and state agency alcohol
and drug counselors who are not licensed under sections 148C.01
to 148C.11 may use the title "city agency alcohol and drug
counselor," "county agency alcohol and drug counselor," or
"state agency alcohol and drug counselor." Hospital alcohol and
drug counselors who are not licensed under sections 148C.01 to
148C.11 may use the title "hospital alcohol and drug counselor"
while acting within the scope of their employment Persons issued
a temporary permit must use titles consistent with section
148C.04, subdivision 6, paragraph (c).
Sec. 28. Minnesota Statutes 2002, section 148C.11, is
amended to read:
148C.11 [EXCEPTIONS TO LICENSE REQUIREMENT.]
Subdivision 1. [OTHER PROFESSIONALS.] (a) Nothing in
sections 148C.01 to 148C.10 shall prevent this chapter prevents
members of other professions or occupations from performing
functions for which they are qualified or licensed. This
exception includes, but is not limited to, licensed physicians,
registered nurses, licensed practical nurses, licensed
psychological practitioners, members of the clergy, American
Indian medicine men and women, licensed attorneys, probation
officers, licensed marriage and family therapists, licensed
social workers, licensed professional counselors, licensed
school counselors, and registered occupational therapists or
occupational therapy assistants.
(b) Nothing in this chapter prohibits technicians and
resident managers in programs licensed by the department of
human services from discharging their duties as provided in
Minnesota Rules, chapter 9530.
(c) Any person who is exempt under this section but who
elects to obtain a license under this chapter is subject to this
chapter to the same extent as other licensees.
(d) These persons must not, however, use a title
incorporating the words "alcohol and drug counselor" or
"licensed alcohol and drug counselor" or otherwise hold
themselves out to the public by any title or description stating
or implying that they are engaged in the practice of alcohol and
drug counseling, or that they are licensed to engage in the
practice of alcohol and drug counseling. Persons engaged in the
practice of alcohol and drug counseling are not exempt from the
commissioner's jurisdiction solely by the use of one of the
above titles.
Subd. 2. [STUDENTS.] Nothing in sections 148C.01 to
148C.10 shall prevent students enrolled in an accredited school
of alcohol and drug counseling from engaging in the practice of
alcohol and drug counseling while under qualified supervision in
an accredited school of alcohol and drug counseling.
Subd. 3. [FEDERALLY RECOGNIZED TRIBES; ETHNIC MINORITIES.]
(a) Alcohol and drug counselors licensed to practice practicing
alcohol and drug counseling according to standards established
by federally recognized tribes, while practicing under tribal
jurisdiction, are exempt from the requirements of this chapter.
In practicing alcohol and drug counseling under tribal
jurisdiction, individuals licensed practicing under that
authority shall be afforded the same rights, responsibilities,
and recognition as persons licensed pursuant to this chapter.
(b) The commissioner shall develop special licensing
criteria for issuance of a license to alcohol and drug
counselors who: (1) practice alcohol and drug counseling with a
member of an ethnic minority population or with a person with a
disability as defined by rule; or (2) are employed by agencies
whose primary agency service focus addresses ethnic minority
populations or persons with a disability as defined by rule.
These licensing criteria may differ from the licensing
criteria requirements specified in section 148C.04. To develop,
implement, and evaluate the effect of these criteria, the
commissioner shall establish a committee comprised of, but not
limited to, representatives from the Minnesota commission
serving deaf and hard-of-hearing people, the council on affairs
of Chicano/Latino people, the council on Asian-Pacific
Minnesotans, the council on Black Minnesotans, the council on
disability, and the Indian affairs council. The committee does
not expire.
(c) The commissioner shall issue a license to an applicant
who (1) is an alcohol and drug counselor who is exempt under
paragraph (a) from the requirements of this chapter; (2) has at
least 2,000 hours of alcohol and drug counselor experience as
defined by the core functions; and (3) meets the licensing
requirements that are in effect on the date of application under
section 148C.04, subdivision 3 or 4, except the written case
presentation and oral examination component under section
148C.04, subdivision 3, clause (2), or 4, clause (1), item
(ii). When applying for a license under this paragraph, an
applicant must follow the procedures for admission to licensure
specified under section 148C.0351. A person who receives a
license under this paragraph must complete the written case
presentation and satisfactorily pass the oral examination
component under section 148C.04, subdivision 3, clause (2), or
4, clause (1), item (ii), at the earliest available opportunity
after the commissioner begins administering oral examinations.
The commissioner may suspend or restrict a person's license
according to section 148C.09 if the person fails to complete the
written case presentation and satisfactorily pass the oral
examination. This paragraph expires July 1, 2004.
Subd. 4. [HOSPITAL ALCOHOL AND DRUG COUNSELORS.] The
licensing of hospital alcohol and drug counselors shall be
voluntary, while the counselor is employed by the hospital.
Effective January 1, 2006, hospitals employing alcohol and drug
counselors shall not be required to employ licensed alcohol and
drug counselors, nor shall they require their alcohol and drug
counselors to be licensed, however, nothing in this chapter will
prohibit hospitals from requiring their counselors to be
eligible for licensure. An alcohol or drug counselor employed
by a hospital must be licensed as an alcohol and drug counselor
in accordance with this chapter.
Subd. 5. [CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG
COUNSELORS.] The licensing of city, county, and state agency
alcohol and drug counselors shall be voluntary, while the
counselor is employed by the city, county, or state agency.
Effective January 1, 2006, city, county, and state agencies
employing alcohol and drug counselors shall not be required to
employ licensed alcohol and drug counselors, nor shall they
require their drug and alcohol counselors to be licensed. An
alcohol and drug counselor employed by a city, county, or state
agency must be licensed as an alcohol and drug counselor in
accordance with this chapter.
Subd. 6. [TRANSITION PERIOD FOR HOSPITAL AND CITY, COUNTY,
AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] For the period
between July 1, 2003, and January 1, 2006, the commissioner
shall grant a license to an individual who is employed as an
alcohol and drug counselor at a Minnesota hospital or a city,
county, or state agency in Minnesota if the individual:
(1) was employed as an alcohol and drug counselor at a
hospital or a city, county, or state agency before August 1,
2002;
(2) has 8,000 hours of alcohol and drug counselor work
experience;
(3) has completed a written case presentation and
satisfactorily passed an oral examination established by the
commissioner;
(4) has satisfactorily passed a written examination as
established by the commissioner; and
(5) meets the requirements in section 148C.0351.
Sec. 29. [148C.12] [FEES.]
Subdivision 1. [APPLICATION FEE.] The application fee is
$295.
Subd. 2. [BIENNIAL RENEWAL FEE.] The license renewal fee
is $295. If the commissioner changes the renewal schedule and
the expiration date is less than two years, the fee must be
prorated.
Subd. 3. [TEMPORARY PERMIT FEE.] The initial fee for
applicants under section 148C.04, subdivision 6, paragraph (a),
is $100. The fee for annual renewal of a temporary permit is
$100.
Subd. 4. [EXAMINATION FEE.] The examination fee for the
written examination is $95 and for the oral examination is $200.
Subd. 5. [INACTIVE RENEWAL FEE.] The inactive renewal fee
is $150.
Subd. 6. [LATE FEE.] The late fee is 25 percent of the
biennial renewal fee, the inactive renewal fee, or the annual
fee for renewal of temporary practice status.
Subd. 7. [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The
fee for renewal of a license that has expired for less than two
years is the total of the biennial renewal fee, the late fee,
and a fee of $100 for review and approval of the continuing
education report.
Subd. 8. [FEE FOR LICENSE VERIFICATIONS.] The fee for
license verification to institutions and other jurisdictions is
$25.
Subd. 9. [SURCHARGE FEE.] Notwithstanding section
16A.1285, subdivision 2, a surcharge of $99 shall be paid at the
time of initial application for or renewal of an alcohol and
drug counselor license until June 30, 2013.
Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable.
Sec. 30. [REPEALER.]
(a) Minnesota Statutes 2002, sections 148C.0351,
subdivision 2; 148C.05, subdivisions 2, 3, and 4; 148C.06; and
148C.10, subdivision 1a, are repealed.
(b) Minnesota Rules, parts 4747.0030, subparts 25, 28, and
30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A,
B, and D; 4747.0070, subparts 4 and 5; 4747.0080; 4747.0090;
4747.0100; 4747.0300; 4747.0400, subparts 2 and 3; 4747.0500;
4747.0600; 4747.1000; 4747.1100, subpart 3; and 4747.1600, are
repealed.
ARTICLE 6
HUMAN SERVICES LICENSING, COUNTY INITIATIVES,
AND MISCELLANEOUS
Section 1. Minnesota Statutes 2002, section 69.021,
subdivision 11, is amended to read:
Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a)
The excess police state-aid holding account is established in
the general fund. The excess police state-aid holding account
must be administered by the commissioner.
(b) Excess police state aid determined according to
subdivision 10, must be deposited in the excess police state-aid
holding account.
(c) From the balance in the excess police state-aid holding
account, $1,000,000 $900,000 is appropriated to and must be
transferred annually to the ambulance service personnel
longevity award and incentive suspense account established by
section 144E.42, subdivision 2.
(d) If a police officer stress reduction program is created
by law and money is appropriated for that program, an amount
equal to that appropriation must be transferred from the balance
in the excess police state-aid holding account.
(e) On October 1, 1997, and annually on each subsequent
October 1, one-half of the balance of the excess police
state-aid holding account remaining after the deductions under
paragraphs (c) and (d) is appropriated for additional
amortization aid under section 423A.02, subdivision 1b.
(f) Annually, the remaining balance in the excess police
state-aid holding account, after the deductions under paragraphs
(c), (d), and (e), cancels to the general fund.
Sec. 2. Minnesota Statutes 2002, section 245.0312, is
amended to read:
245.0312 [DESIGNATING SPECIAL UNITS AND REGIONAL CENTERS.]
Notwithstanding any provision of law to the contrary,
during the biennium, the commissioner of human services, upon
the approval of the governor after consulting with the
legislative advisory commission, may designate portions of
hospitals for the mentally ill state-operated services
facilities under the commissioner's control as special care
units for mentally retarded or inebriate persons, or as nursing
homes for persons over the age of 65, and may designate portions
of the hospitals designated in Minnesota Statutes 1969, section
252.025, subdivision 1, as special care units for mentally ill
or inebriate persons, and may plan to develop all hospitals for
mentally ill, mentally retarded, or inebriate persons under the
commissioner's control as multipurpose regional centers for
programs related to all of the said problems.
If approved by the governor, the commissioner may rename
the state hospital as a state regional center and appoint the
hospital administrator as administrator of the center, in
accordance with section 246.0251.
The directors of the separate program units of regional
centers shall be responsible directly to the commissioner at the
discretion of the commissioner.
Sec. 3. [245.945] [REIMBURSEMENT TO OMBUDSMAN FOR MENTAL
HEALTH AND MENTAL RETARDATION.]
The commissioner shall obtain federal financial
participation for eligible activity by the ombudsman for mental
health and mental retardation. The ombudsman shall maintain and
transmit to the department of human services documentation that
is necessary in order to obtain federal funds.
Sec. 4. Minnesota Statutes 2002, 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;
(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) (k); 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 5. Minnesota Statutes 2002, 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 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 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, a facility serving children or youth
licensed by the department of corrections, 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. For any background study completed under
this section, 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) For any background study completed under this section,
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 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, 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 6. Minnesota Statutes 2002, 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
(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. If the commissioner sets aside a
disqualification under this section, the disqualified individual
remains disqualified, but may hold a license and have direct
contact with or access to persons receiving services. The
commissioner's set aside of a disqualification is limited solely
to the licensed program, applicant, or agency specified in the
set aside notice, unless otherwise specified in the notice. The
commissioner may rescind a previous set aside of a
disqualification under this section based on new information
that indicates the individual may pose a risk of harm to persons
served by the applicant, license holder, or registrant. If the
commissioner rescinds a set aside of a disqualification under
this paragraph, the appeal rights under paragraphs (a) and (e)
shall apply.
(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
609.165 (felon ineligible to possess firearm), criminal
vehicular homicide under 609.21 (criminal vehicular homicide and
injury), 609.215 (aiding suicide or aiding attempted suicide),
felony violations under 609.223 or 609.2231 (assault in the
third or fourth degree), 609.713 (terroristic threats), 609.235
(use of drugs to injure or to facilitate crime), 609.24 (simple
robbery), 609.255 (false imprisonment), 609.562 (arson in the
second degree), 609.71 (riot), 609.498, subdivision 1 or 1a 1b
(aggravated first degree or first degree tampering with a
witness), 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,
subdivision 2 (gross misdemeanor 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), 609.23 (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), 609.20 (manslaughter in the
first degree), 609.205 (manslaughter in the second degree),
609.245 (aggravated robbery), 609.25 (kidnapping), 609.561
(arson in the first degree), 609.749, subdivision 3, 4, or 5
(felony-level harassment; stalking), 609.228 (great bodily harm
caused by distribution of drugs), 609.221 or 609.222 (assault in
the first or second degree), 609.66, subdivision 1e (drive-by
shooting), 609.855, subdivision 5 (shooting in or at a public
transit vehicle or facility), 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 listed in subdivision 3d, paragraph (a),
clauses (1) to (4); for a determination under section 626.556 or
626.557 of substantiated maltreatment that was serious or
recurring under subdivision 3d, paragraph (a), clause (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 fair hearing is the only administrative
appeal of the final agency determination for purposes of appeal
by the disqualified individual, specifically, including a
challenge to the accuracy and completeness of data under section
13.04. If the individual was disqualified based on a conviction
or admission to any crimes listed in subdivision 3d, paragraph
(a), clauses (1) to (4), the reconsideration decision under this
subdivision is the final agency determination for purposes of
appeal by the disqualified individual and is not subject to a
hearing under section 256.045.
(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,
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.
(g) In the notice from the commissioner that a
disqualification has been set aside, the license holder must be
informed that information about the nature of the
disqualification and which factors under paragraph (b) were the
bases of the decision to set aside the disqualification is
available to the license holder upon request without consent of
the background study subject. With the written consent of a
background study subject, the commissioner may release to the
license holder copies of all information related to the
background study subject's disqualification and the
commissioner's decision to set aside the disqualification as
specified in the written consent.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 7. Minnesota Statutes 2002, section 245A.04,
subdivision 3d, is amended to read:
Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of
information showing, or when a background study completed under
subdivision 3 shows any of the following: a conviction of one
or more crimes listed in clauses (1) to (4); the individual has
admitted to or a preponderance of the evidence indicates the
individual has committed an act or acts that meet the definition
of any of the crimes listed in clauses (1) to (4); or an
investigation results in an administrative determination listed
under clause (4), the individual shall be disqualified from any
position allowing direct contact with persons receiving services
from the license holder, entity identified in subdivision 3,
paragraph (a), or registrant under section 144A.71, subdivision
1, and for individuals studied under section 245A.04,
subdivision 3, paragraph (c), clauses (2), (6), and (7), the
individual shall also be disqualified from access to a person
receiving services from the license holder:
(1) 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, and unless otherwise specified, regardless of the level
of the conviction, the individual was convicted of any of the
following offenses: sections 609.185 (murder in the first
degree); 609.19 (murder in the second degree); 609.195 (murder
in the third degree); 609.2661 (murder of an unborn child in the
first degree); 609.2662 (murder of an unborn child in the second
degree); 609.2663 (murder of an unborn child in the third
degree); 609.20 (manslaughter in the first degree); 609.205
(manslaughter in the second degree); 609.221 or 609.222 (assault
in the first or second degree); 609.228 (great bodily harm
caused by distribution of drugs); 609.245 (aggravated robbery);
609.25 (kidnapping); 609.561 (arson in the first degree);
609.749, subdivision 3, 4, or 5 (felony-level harassment;
stalking); 609.66, subdivision 1e (drive-by shooting); 609.855,
subdivision 5 (shooting at or in a public transit vehicle or
facility); 609.322 (solicitation, inducement, and promotion of
prostitution); 609.342 (criminal sexual conduct in the first
degree); 609.343 (criminal sexual conduct in the second degree);
609.344 (criminal sexual conduct in the third degree); 609.345
(criminal sexual conduct in the fourth degree); 609.352
(solicitation of children to engage in sexual conduct); 609.365
(incest); felony offense under 609.377 (malicious punishment of
a child); a felony offense under 609.378 (neglect or
endangerment of a child); a felony offense under 609.324,
subdivision 1 (other prohibited acts); 617.246 (use of minors in
sexual performance prohibited); 617.247 (possession of pictorial
representations of minors); 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 attempt or
conspiracy to commit any of these offenses as defined in
Minnesota Statutes, or an offense in any other state or country,
where the elements are substantially similar to any of the
offenses listed in this clause;
(2) if less than 15 years have passed since the discharge
of the sentence imposed for the offense; and the individual has
received a felony conviction for a violation of any of these
offenses: sections 609.21 (criminal vehicular homicide and
injury); 609.165 (felon ineligible to possess firearm); 609.215
(suicide); 609.223 or 609.2231 (assault in the third or fourth
degree); repeat offenses under 609.224 (assault in the fifth
degree); repeat offenses under 609.3451 (criminal sexual conduct
in the fifth degree); 609.498, subdivision 1 or 1a
1b (aggravated first degree or first degree tampering with a
witness); 609.713 (terroristic threats); 609.235 (use of drugs
to injure or facilitate crime); 609.24 (simple robbery); 609.255
(false imprisonment); 609.562 (arson in the second degree);
609.563 (arson in the third degree); repeat offenses under
617.23 (indecent exposure; penalties); repeat offenses under
617.241 (obscene materials and performances; distribution and
exhibition prohibited; penalty); 609.71 (riot); 609.66
(dangerous weapons); 609.67 (machine guns and short-barreled
shotguns); 609.2325 (criminal abuse of a vulnerable adult);
609.2664 (manslaughter of an unborn child in the first degree);
609.2665 (manslaughter of an unborn child in the second degree);
609.267 (assault of an unborn child in the first degree);
609.2671 (assault of an unborn child in the second degree);
609.268 (injury or death of an unborn child in the commission of
a crime); 609.52 (theft); 609.2335 (financial exploitation of a
vulnerable adult); 609.521 (possession of shoplifting gear);
609.582 (burglary); 609.625 (aggravated forgery); 609.63
(forgery); 609.631 (check forgery; offering a forged check);
609.635 (obtaining signature by false pretense); 609.27
(coercion); 609.275 (attempt to coerce); 609.687 (adulteration);
260C.301 (grounds for termination of parental rights); chapter
152 (drugs; controlled substance); and a felony level conviction
involving alcohol or drug use. 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
or country, the elements of which are substantially similar to
the elements of the offenses in this clause. If the individual
studied is convicted of one of the felonies listed in this
clause, but the sentence is a gross misdemeanor or misdemeanor
disposition, the lookback period for the conviction is the
period applicable to the disposition, that is the period for
gross misdemeanors or misdemeanors;
(3) if less than ten years have passed since the discharge
of the sentence imposed for the offense; and the individual has
received a gross misdemeanor conviction for a violation of any
of the following offenses: sections 609.224 (assault in the
fifth degree); 609.2242 and 609.2243 (domestic assault);
violation of an order for protection under 518B.01, subdivision
14; 609.3451 (criminal sexual conduct in the fifth degree);
repeat offenses under 609.746 (interference with privacy);
repeat offenses under 617.23 (indecent exposure); 617.241
(obscene materials and performances); 617.243 (indecent
literature, distribution); 617.293 (harmful materials;
dissemination and display to minors prohibited); 609.71 (riot);
609.66 (dangerous weapons); 609.749, subdivision 2 (harassment;
stalking); 609.224, subdivision 2, paragraph (c) (assault in the
fifth degree by a caregiver against a vulnerable adult); 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 maltreatment of a vulnerable adult); 609.72,
subdivision 3 (disorderly conduct against a vulnerable adult);
609.265 (abduction); 609.378 (neglect or endangerment of a
child); 609.377 (malicious punishment of a child); 609.324,
subdivision 1a (other prohibited acts; minor engaged in
prostitution); 609.33 (disorderly house); 609.52 (theft);
609.582 (burglary); 609.631 (check forgery; offering a forged
check); 609.275 (attempt to coerce); 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
or country, the elements of which are substantially similar to
the elements of any of the offenses listed in this clause. If
the defendant is convicted of one of the gross misdemeanors
listed in this clause, but the sentence is a misdemeanor
disposition, the lookback period for the conviction is the
period applicable to misdemeanors; or
(4) if less than seven years have passed since the
discharge of the sentence imposed for the offense; and the
individual has received a misdemeanor conviction for a violation
of any of the following offenses: sections 609.224 (assault in
the fifth degree); 609.2242 (domestic assault); violation of an
order for protection under 518B.01 (Domestic Abuse Act);
violation of an order for protection under 609.3232 (protective
order authorized; procedures; penalties); 609.746 (interference
with privacy); 609.79 (obscene or harassing phone calls);
609.795 (letter, telegram, or package; opening; harassment);
617.23 (indecent exposure; penalties); 609.2672 (assault of an
unborn child in the third degree); 617.293 (harmful materials;
dissemination and display to minors prohibited); 609.66
(dangerous weapons); 609.665 (spring guns); 609.2335 (financial
exploitation of a vulnerable adult); 609.234 (failure to report
maltreatment of a vulnerable adult); 609.52 (theft); 609.27
(coercion); 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 or country, the
elements of which are substantially similar to the elements of
any of the offenses listed in this clause; a determination or
disposition of failure to make required reports under section
626.556, subdivision 3, or 626.557, subdivision 3, 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 a determination or
disposition of 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.
For the purposes of this section, "serious maltreatment"
means sexual abuse; maltreatment resulting in death; or
maltreatment resulting in serious injury which reasonably
requires the care of a physician whether or not the care of a
physician was sought; or abuse resulting in serious injury. For
purposes of this section, "abuse resulting in serious injury"
means: bruises, bites, skin laceration or tissue damage;
fractures; dislocations; evidence of internal injuries; head
injuries with loss of consciousness; extensive second-degree or
third-degree burns and other burns for which complications are
present; extensive second-degree or third-degree frostbite, and
others for which complications are present; irreversible
mobility or avulsion of teeth; injuries to the eyeball;
ingestion of foreign substances and objects that are harmful;
near drowning; and heat exhaustion or sunstroke. For purposes
of this section, "care of a physician" is treatment received or
ordered by a physician, but does not include diagnostic testing,
assessment, or observation. For the purposes of this section,
"recurring maltreatment" means more than one incident of
maltreatment for which there is a preponderance of evidence that
the maltreatment occurred, and that the subject was responsible
for the maltreatment. For purposes of this section, "access"
means physical access to an individual receiving services or the
individual's personal property without continuous, direct
supervision as defined in section 245A.04, subdivision 3.
(b) Except for background studies related to child foster
care, adult foster care, or family child care licensure, when
the subject of a background study is regulated by a
health-related licensing board as defined in chapter 214, and
the regulated person has been determined to have been
responsible for substantiated maltreatment under section 626.556
or 626.557, instead of the commissioner making a decision
regarding disqualification, the board shall make a determination
whether to impose disciplinary or corrective action under
chapter 214.
(1) The commissioner shall notify the health-related
licensing board:
(i) upon completion of a background study that produces a
record showing that the individual was determined to have been
responsible for substantiated maltreatment;
(ii) upon the commissioner's completion of an investigation
that determined the individual was responsible for substantiated
maltreatment; or
(iii) upon receipt from another agency of a finding of
substantiated maltreatment for which the individual was
responsible.
(2) The commissioner's notice shall indicate whether the
individual would have been disqualified by the commissioner for
the substantiated maltreatment if the individual were not
regulated by the board. The commissioner shall concurrently
send this notice to the individual.
(3) Notwithstanding the exclusion from this subdivision for
individuals who provide child foster care, adult foster care, or
family child care, when the commissioner or a local agency has
reason to believe that the direct contact services provided by
the individual may fall within the jurisdiction of a
health-related licensing board, a referral shall be made to the
board as provided in this section.
(4) If, upon review of the information provided by the
commissioner, a health-related licensing board informs the
commissioner that the board does not have jurisdiction to take
disciplinary or corrective action, the commissioner shall make
the appropriate disqualification decision regarding the
individual as otherwise provided in this chapter.
(5) The commissioner has the authority to monitor the
facility's compliance with any requirements that the
health-related licensing board places on regulated persons
practicing in a facility either during the period pending a
final decision on a disciplinary or corrective action or as a
result of a disciplinary or corrective action. The commissioner
has the authority to order the immediate removal of a regulated
person from direct contact or access when a board issues an
order of temporary suspension based on a determination that the
regulated person poses an immediate risk of harm to persons
receiving services in a licensed facility.
(6) A facility that allows a regulated person to provide
direct contact services while not complying with the
requirements imposed by the health-related licensing board is
subject to action by the commissioner as specified under
sections 245A.06 and 245A.07.
(7) The commissioner shall notify a health-related
licensing board immediately upon receipt of knowledge of
noncompliance with requirements placed on a facility or upon a
person regulated by the board.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 8. Minnesota Statutes 2002, section 245A.09,
subdivision 7, is amended to read:
Subd. 7. [REGULATORY METHODS.] (a) Where appropriate and
feasible the commissioner shall identify and implement
alternative methods of regulation and enforcement to the extent
authorized in this subdivision. These methods shall include:
(1) expansion of the types and categories of licenses that
may be granted;
(2) when the standards of another state or federal
governmental agency or an independent accreditation body have
been shown to predict compliance with the rules require the same
standards, methods, or alternative methods to achieve
substantially the same intended outcomes as the licensing
standards, the commissioner shall consider compliance with the
governmental or accreditation standards to be equivalent to
partial compliance with the rules licensing standards; and
(3) use of an abbreviated inspection that employs key
standards that have been shown to predict full compliance with
the rules.
(b) If the commissioner accepts accreditation as
documentation of compliance with a licensing standard under
paragraph (a), the commissioner shall continue to investigate
complaints related to noncompliance with all licensing standards.
The commissioner may take a licensing action for noncompliance
under this chapter and shall recognize all existing appeal
rights regarding any licensing actions taken under this chapter.
(c) The commissioner shall work with the commissioners of
health, public safety, administration, and children, families,
and learning in consolidating duplicative licensing and
certification rules and standards if the commissioner determines
that consolidation is administratively feasible, would
significantly reduce the cost of licensing, and would not reduce
the protection given to persons receiving services in licensed
programs. Where administratively feasible and appropriate, the
commissioner shall work with the commissioners of health, public
safety, administration, and children, families, and learning in
conducting joint agency inspections of programs.
(c) (d) The commissioner shall work with the commissioners
of health, public safety, administration, and children,
families, and learning in establishing a single point of
application for applicants who are required to obtain concurrent
licensure from more than one of the commissioners listed in this
clause.
(d) (e) Unless otherwise specified in statute, the
commissioner may specify in rule periods of licensure up to two
years conduct routine inspections biennially.
Sec. 9. Minnesota Statutes 2002, section 245A.10, is
amended to read:
245A.10 [FEES.]
Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED,
PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph
(b), the commissioner shall charge a fee for evaluation of
applications and inspection of programs, other than family day
care and foster care, which are licensed under this chapter.
The commissioner may charge a fee for the licensing of school
age child care programs, in an amount sufficient to cover the
cost to the state agency of processing the license.
(b) Except as provided under subdivision 2, no application
or license fee shall be charged for child foster care, adult
foster care, family and group family child care or
state-operated programs, unless the state-operated program is an
intermediate care facility for persons with mental retardation
or related conditions (ICF/MR).
Subd. 2. [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING
INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For
purposes of family and group family child care licensing under
this chapter, a county agency may charge a fee to an applicant
or license holder to recover the actual cost of background
studies, but in any case not to exceed $100 annually. A county
agency may also charge a fee to an applicant or license holder
to recover the actual cost of licensing inspections, but in any
case not to exceed $150 annually.
(b) A county agency may charge a fee to a legal nonlicensed
child care provider or applicant for authorization to recover
the actual cost of background studies completed under section
119B.125, but in any case not to exceed $100 annually.
(c) Counties may elect to reduce or waive the fees in
paragraph (a) or (b):
(1) in cases of financial hardship;
(2) if the county has a shortage of providers in the
county's area;
(3) for new providers; or
(4) for providers who have attained at least 16 hours of
training before seeking initial licensure.
(d) Counties may allow providers to pay the applicant fees
in paragraph (a) or (b) on an installment basis for up to one
year. If the provider is receiving child care assistance
payments from the state, the provider may have the fees under
paragraph (a) or (b) deducted from the child care assistance
payments for up to one year and the state shall reimburse the
county for the county fees collected in this manner.
Subd. 3. [APPLICATION FEE FOR INITIAL LICENSE OR
CERTIFICATION.] (a) For fees required under subdivision 1, an
applicant for an initial license or certification issued by the
commissioner shall submit a $500 application fee with each new
application required under this subdivision. The application
fee shall not be prorated, is nonrefundable, and is in lieu of
the annual license or certification fee that expires on December
31. The commissioner shall not process an application until the
application fee is paid.
(b) Except as provided in clauses (1) to (3), an applicant
shall apply for a license to provide services at a specific
location.
(1) For a license to provide waivered services to persons
with developmental disabilities or related conditions, an
applicant shall submit an application for each county in which
the waivered services will be provided.
(2) For a license to provide semi-independent living
services to persons with developmental disabilities or related
conditions, an applicant shall submit a single application to
provide services statewide.
(3) For a license to provide independent living assistance
for youth under section 245A.22, an applicant shall submit a
single application to provide services statewide.
Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS
WITH LICENSED CAPACITY.] (a) Child care centers and programs
with a licensed capacity shall pay an annual nonrefundable
license or certification fee based on the following schedule:
Licensed Capacity Child Care Other
Center Program
License Fee License Fee
1 to 24 persons $300 $400
25 to 49 persons $450 $600
50 to 74 persons $600 $800
75 to 99 persons $750 $1,000
100 to 124 persons $900 $1,200
125 to 149 persons $1,200 $1,400
150 to 174 persons $1,400 $1,600
175 to 199 persons $1,600 $1,800
200 to 224 persons $1,800 $2,000
225 or more persons $2,000 $2,500
(b) A day training and habilitation program serving persons
with developmental disabilities or related conditions shall be
assessed a license fee based on the schedule in paragraph (a)
unless the license holder serves more than 50 percent of the
same persons at two or more locations in the community. When a
day training and habilitation program serves more than 50
percent of the same persons in two or more locations in a
community, the day training and habilitation program shall pay a
license fee based on the licensed capacity of the largest
facility and the other facility or facilities shall be charged a
license fee based on a licensed capacity of a residential
program serving one to 24 persons.
Subd. 5. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS
WITHOUT A LICENSED CAPACITY.] (a) Except as provided in
paragraph (b), a program without a stated licensed capacity
shall pay a license or certification fee of $400.
(b) A mental health center or mental health clinic
requesting certification for purposes of insurance and
subscriber contract reimbursement under Minnesota Rules, parts
9520.0750 to 9520.0870 shall pay a certification fee of $1,000
per year. If the mental health center or mental health clinic
provides services at a primary location with satellite
facilities, the satellite facilities shall be certified with the
primary location without an additional charge.
Subd. 6. [LICENSE NOT ISSUED UNTIL LICENSE OR
CERTIFICATION FEE IS PAID.] The commissioner shall not issue a
license or certification until the license or certification fee
is paid. The commissioner shall send a bill for the license or
certification fee to the billing address identified by the
license holder. If the license holder does not submit the
license or certification fee payment by the due date, the
commissioner shall send the license holder a past due notice.
If the license holder fails to pay the license or certification
fee by the due date on the past due notice, the commissioner
shall send a final notice to the license holder informing the
license holder that the program license will expire on December
31 unless the license fee is paid before December 31. If a
license expires, the program is no longer licensed and, unless
exempt from licensure under section 245A.03, subdivision 2, must
not operate after the expiration date. After a license expires,
if the former license holder wishes to provide licensed
services, the former license holder must submit a new license
application and application fee under subdivision 3.
Sec. 10. Minnesota Statutes 2002, section 245A.11,
subdivision 2a, is amended to read:
Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An
adult foster care license holder may have a maximum license
capacity of five if all persons in care are age 55 or over and
do not have a serious and persistent mental illness or a
developmental disability.
(b) The commissioner may grant variances to paragraph (a)
to allow a foster care provider with a licensed capacity of five
persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and
approval of the variance is recommended by the county in which
the licensed foster care provider is located.
(c) The commissioner may grant variances to paragraph (a)
to allow the use of a fifth bed for emergency crisis services
for a person with serious and persistent mental illness or a
developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of
the variance is recommended by the county in which the licensed
foster care provider is located.
(d) Notwithstanding paragraph (a), the commissioner may
issue an adult foster care license with a capacity of five
adults when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the
recommendation verifies that:
(1) the facility meets the physical environment
requirements in the adult foster care licensing rule;
(2) the five-bed living arrangement is specified for each
resident in the resident's:
(i) individualized plan of care;
(ii) individual service plan under section 256B.092,
subdivision 1b, if required; or
(iii) individual resident placement agreement under
Minnesota Rules, part 9555.5105, subpart 19, if required;
(3) the license holder obtains written and signed informed
consent from each resident or resident's legal representative
documenting the resident's informed choice to living in the home
and that the resident's refusal to consent would not have
resulted in service termination; and
(4) the facility was licensed for adult foster care before
March 1, 2003.
(e) The commissioner shall not issue a new adult foster
care license under paragraph (d) after June 30, 2005. The
commissioner shall allow a facility with an adult foster care
license issued under paragraph (d) before June 30, 2005, to
continue with a capacity of five or six adults if the license
holder continues to comply with the requirements in paragraph
(d).
Sec. 11. Minnesota Statutes 2002, section 245A.11,
subdivision 2b, is amended to read:
Subd. 2b. [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An
adult foster care license holder licensed under the conditions
in subdivision 2a may also provide family adult day care for
adults age 55 or over if no persons in the adult foster or adult
family day care program have a serious and persistent mental
illness or a developmental disability. The maximum combined
capacity for adult foster care and family adult day care is five
adults, except that the commissioner may grant a variance for a
family adult day care provider to admit up to seven individuals
for day care services and one individual for respite care
services, if all of the following requirements are met: (1) the
variance complies with section 245A.04, subdivision 9; (2) a
second caregiver is present whenever six or more clients are
being served; and (3) the variance is recommended by the county
social service agency in the county where the provider is
located. A separate license is not required to provide family
adult day care under this subdivision. Adult foster care homes
providing services to five adults under this section shall not
be subject to licensure by the commissioner of health under the
provisions of chapter 144, 144A, 157, or any other law requiring
facility licensure by the commissioner of health.
Sec. 12. Minnesota Statutes 2002, section 245A.11, is
amended by adding a subdivision to read:
Subd. 7. [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE
OVERNIGHT SUPERVISION.] (a) The commissioner may grant a
variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home
during normal sleeping hours to allow for alternative methods of
overnight supervision. The commissioner may grant the variance
if the local county licensing agency recommends the variance and
the county recommendation includes documentation verifying that:
(1) the county has approved the license holder's plan for
alternative methods of providing overnight supervision and
determined the plan protects the residents' health, safety, and
rights;
(2) the license holder has obtained written and signed
informed consent from each resident or each resident's legal
representative documenting the resident's or legal
representative's agreement with the alternative method of
overnight supervision; and
(3) the alternative method of providing overnight
supervision is specified for each resident in the resident's:
(i) individualized plan of care; (ii) individual service plan
under section 256B.092, subdivision 1b, if required; or (iii)
individual resident placement agreement under Minnesota Rules,
part 9555.5105, subpart 19, if required.
(b) To be eligible for a variance under paragraph (a), the
adult foster care license holder must not have had a licensing
action under section 245A.06 or 245A.07 during the prior 24
months based on failure to provide adequate supervision, health
care services, or resident safety in the adult foster care home.
Sec. 13. Minnesota Statutes 2002, section 245B.03,
subdivision 2, is amended to read:
Subd. 2. [RELATIONSHIP TO OTHER STANDARDS GOVERNING
SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED
CONDITIONS.] (a) ICFs/MR are exempt from:
(1) section 245B.04;
(2) section 245B.06, subdivisions 4 and 6; and
(3) section 245B.07, subdivisions 4, paragraphs (b) and
(c); 7; and 8, paragraphs (1), clause (iv), and (2).
(b) License holders also licensed under chapter 144 as a
supervised living facility are exempt from section 245B.04.
(c) Residential service sites controlled by license holders
licensed under chapter 245B for home and community-based
waivered services for four or fewer adults are exempt from
compliance with Minnesota Rules, parts 9543.0040, subpart 2,
item C; 9555.5505; 9555.5515, items B and G; 9555.5605;
9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to
6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and
9555.6265; and as provided under section 245B.06, subdivision 2,
the license holder is exempt from the program abuse prevention
plans and individual abuse prevention plans otherwise required
under sections 245A.65, subdivision 2, and 626.557, subdivision
14. The commissioner may approve alternative methods of
providing overnight supervision using the process and criteria
for granting a variance in section 245A.04, subdivision 9. This
chapter does not apply to foster care homes that do not provide
residential habilitation services funded under the home and
community-based waiver programs defined in section 256B.092.
(d) Residential service sites controlled by license holders
licensed under this chapter for home and community-based
waivered services for four or fewer children are exempt from
compliance with Minnesota Rules, parts 9545.0130; 9545.0140;
9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I,
and 3; and 9545.0230.
(e) The commissioner may exempt license holders from
applicable standards of this chapter when the license holder
meets the standards under section 245A.09, subdivision 7.
License holders that are accredited by an independent
accreditation body shall continue to be licensed under this
chapter.
(e) (f) License holders governed by sections 245B.02 to
245B.07 must also meet the licensure requirements in chapter
245A.
(f) (g) Nothing in this chapter prohibits license holders
from concurrently serving consumers with and without mental
retardation or related conditions provided this chapter's
standards are met as well as other relevant standards.
(g) (h) The documentation that sections 245B.02 to 245B.07
require of the license holder meets the individual program plan
required in section 256B.092 or successor provisions.
Sec. 14. Minnesota Statutes 2002, section 245B.03, is
amended by adding a subdivision to read:
Subd. 3. [CONTINUITY OF CARE.] (a) When a consumer changes
service to the same type of service provided under a different
license held by the same license holder and the policies and
procedures under section 245B.07, subdivision 8, are
substantially similar, the license holder is exempt from the
requirements in sections 245B.06, subdivisions 2, paragraphs (e)
and (f), and 4; and 245B.07, subdivision 9, clause (2).
(b) When a direct service staff person begins providing
direct service under one or more licenses other than the license
for which the staff person initially received the staff
orientation requirements under section 245B.07, subdivision 5,
the license holder is exempt from all staff orientation
requirements under section 245B.07, subdivision 5, except that:
(1) if the service provision location changes, the staff
person must receive orientation regarding any policies or
procedures under section 245B.07, subdivision 8, that are
specific to the service provision location; and
(2) if the staff person provides direct service to one or
more consumers for whom the staff person has not previously
provided direct service, the staff person must review each
consumer's: (i) service plans and risk management plan in
accordance with section 245B.07, subdivision 5, paragraph (b),
clause (1); and (ii) medication administration in accordance
with section 245B.07, subdivision 5, paragraph (b), clause (6).
Sec. 15. Minnesota Statutes 2002, section 245B.04,
subdivision 2, is amended to read:
Subd. 2. [SERVICE-RELATED RIGHTS.] A consumer's
service-related rights include the right to:
(1) refuse or terminate services and be informed of the
consequences of refusing or terminating services;
(2) know, in advance, limits to the services available from
the license holder;
(3) know conditions and terms governing the provision of
services, including those related to initiation and termination;
(4) know what the charges are for services, regardless of
who will be paying for the services, and be notified upon
request of changes in those charges;
(5) know, in advance, whether services are covered by
insurance, government funding, or other sources, and be told of
any charges the consumer or other private party may have to pay;
and
(6) receive licensed services from individuals who are
competent and trained, who have professional certification or
licensure, as required, and who meet additional qualifications
identified in the individual service plan.
Sec. 16. Minnesota Statutes 2002, section 245B.06,
subdivision 2, is amended to read:
Subd. 2. [RISK MANAGEMENT PLAN.] (a) The license holder
must develop and, document in writing, and implement a risk
management plan that incorporates the individual abuse
prevention plan as required in section 245A.65 meets the
requirements of this subdivision. License holders licensed
under this chapter are exempt from sections 245A.65, subdivision
2, and 626.557, subdivision 14, if the requirements of this
subdivision are met.
(b) The risk management plan must identify areas in which
the consumer is vulnerable, based on an assessment, at a
minimum, of the following areas:
(1) an adult consumer's susceptibility to physical,
emotional, and sexual abuse as defined in section 626.5572,
subdivision 2, and financial exploitation as defined in section
626.5572, subdivision 9; a minor consumer's susceptibility to
sexual and physical abuse as defined in section 626.556,
subdivision 2; and a consumer's susceptibility to self-abuse,
regardless of age;
(2) the consumer's health needs, considering the consumer's
physical disabilities; allergies; sensory impairments; seizures;
diet; need for medications; and ability to obtain medical
treatment;
(3) the consumer's safety needs, considering the consumer's
ability to take reasonable safety precautions; community
survival skills; water survival skills; ability to seek
assistance or provide medical care; and access to toxic
substances or dangerous items;
(4) environmental issues, considering the program's
location in a particular neighborhood or community; the type of
grounds and terrain surrounding the building; and the consumer's
ability to respond to weather-related conditions, open locked
doors, and remain alone in any environment; and
(5) the consumer's behavior, including behaviors that may
increase the likelihood of physical aggression between consumers
or sexual activity between consumers involving force or
coercion, as defined under section 245B.02, subdivision 10,
clauses (6) and (7).
(c) When assessing a consumer's vulnerability, the license
holder must consider only the consumer's skills and abilities,
independent of staffing patterns, supervision plans, the
environment, or other situational elements.
(d) License holders jointly providing services to a
consumer shall coordinate and use the resulting assessment of
risk areas for the development of this each license holder's
risk management or the shared risk management plan. Upon
initiation of services, the license holder will have in place an
initial risk management plan that identifies areas in which the
consumer is vulnerable, including health, safety, and
environmental issues and the supports the provider will have in
place to protect the consumer and to minimize these risks. The
plan must be changed based on the needs of the individual
consumer and reviewed at least annually. The license holder's
plan must include the specific actions a staff person will take
to protect the consumer and minimize risks for the identified
vulnerability areas. The specific actions must include the
proactive measures being taken, training being provided, or a
detailed description of actions a staff person will take when
intervention is needed.
(e) Prior to or upon initiating services, a license holder
must develop an initial risk management plan that is, at a
minimum, verbally approved by the consumer or consumer's legal
representative and case manager. The license holder must
document the date the license holder receives the consumer's or
consumer's legal representative's and case manager's verbal
approval of the initial plan.
(f) As part of the meeting held within 45 days of
initiating service, as required under section 245B.06,
subdivision 4, the license holder must review the initial risk
management plan for accuracy and revise the plan if necessary.
The license holder must give the consumer or consumer's legal
representative and case manager an opportunity to participate in
this plan review. If the license holder revises the plan, or if
the consumer or consumer's legal representative and case manager
have not previously signed and dated the plan, the license
holder must obtain dated signatures to document the plan's
approval.
(g) After plan approval, the license holder must review the
plan at least annually and update the plan based on the
individual consumer's needs and changes to the environment. The
license holder must give the consumer or consumer's legal
representative and case manager an opportunity to participate in
the ongoing plan development. The license holder shall obtain
dated signatures from the consumer or consumer's legal
representative and case manager to document completion of the
annual review and approval of plan changes.
Sec. 17. Minnesota Statutes 2002, section 245B.06,
subdivision 5, is amended to read:
Subd. 5. [PROGRESS REVIEWS.] The license holder must
participate in progress review meetings following stated time
lines established in the consumer's individual service plan or
as requested in writing by the consumer, the consumer's legal
representative, or the case manager, at a minimum of once a
year. The license holder must summarize the progress toward
achieving the desired outcomes and make recommendations in a
written report sent to the consumer or the consumer's legal
representative and case manager prior to the review meeting.
For consumers under public guardianship, the license holder is
required to provide quarterly written progress review reports to
the consumer, designated family member, and case manager.
Sec. 18. Minnesota Statutes 2002, section 245B.07,
subdivision 6, is amended to read:
Subd. 6. [STAFF TRAINING.] (a) The A license holder
providing semi-independent living services shall ensure that
direct service staff annually complete hours of training equal
to two one percent of the number of hours the staff person
worked or one percent for license holders providing
semi-independent living services. All other license holders
shall ensure that direct service staff annually complete hours
of training as follows:
(1) if the direct services staff have been employed for one
to 24 months and:
(i) the average number of work hours scheduled per week is
30 to 40 hours, the staff must annually complete 40 training
hours;
(ii) the average number of work hours scheduled per week is
20 to 29 hours, the staff must annually complete 30 training
hours; and
(iii) the average number of work hours scheduled per week
is one to 19 hours, the staff must annually complete 20 training
hours; or
(2) if the direct services staff have been employed for
more than 24 months and:
(i) the average number of work hours scheduled per week is
30 to 40 hours, the staff must annually complete 20 training
hours;
(ii) the average number of work hours scheduled per week is
20 to 29 hours, the staff must annually complete 15 training
hours; and
(iii) the average number of work hours scheduled per week
is one to 19 hours, the staff must annually complete 12 training
hours.
If direct service staff has received training from a
license holder licensed under a program rule identified in this
chapter or completed course work regarding disability-related
issues from a post-secondary educational institute, that
training may also count toward training requirements for other
services and for other license holders.
(b) The license holder must document the training completed
by each employee.
(c) Training shall address staff competencies necessary to
address the consumer needs as identified in the consumer's
individual service plan and ensure consumer health, safety, and
protection of rights. Training may also include other areas
identified by the license holder.
(d) For consumers requiring a 24-hour plan of care, the
license holder shall provide training in cardiopulmonary
resuscitation, from a qualified source determined by the
commissioner, if the consumer's health needs as determined by
the consumer's physician indicate trained staff would be
necessary to the consumer.
Sec. 19. Minnesota Statutes 2002, section 245B.07,
subdivision 9, is amended to read:
Subd. 9. [AVAILABILITY OF CURRENT WRITTEN POLICIES AND
PROCEDURES.] The license holder shall:
(1) review and update, as needed, the written policies and
procedures in this chapter and inform all consumers or the
consumer's legal representatives, case managers, and employees
of the revised policies and procedures when they affect the
service provision;
(2) inform consumers or the consumer's legal
representatives of the written policies and procedures in this
chapter upon service initiation. Copies must be available to
consumers or the consumer's legal representatives, case
managers, the county where services are located, and the
commissioner upon request; and
(3) provide all consumers or the consumers' legal
representatives and case managers a copy and explanation of
revisions to policies and procedures that affect consumers'
service-related or protection-related rights under section
245B.04. Unless there is reasonable cause, the license holder
must provide this notice at least 30 days before implementing
the revised policy and procedure. The license holder must
document the reason for not providing the notice at least 30
days before implementing the revisions;
(4) annually notify all consumers or the consumers' legal
representatives and case managers of any revised policies and
procedures under this chapter, other than those in clause (3).
Upon request, the license holder must provide the consumer or
consumer's legal representative and case manager copies of the
revised policies and procedures;
(5) before implementing revisions to policies and
procedures under this chapter, inform all employees of the
revised policies and procedures; and
(6) document and maintain relevant information related to
the policies and procedures in this chapter.
Sec. 20. Minnesota Statutes 2002, section 245B.08,
subdivision 1, is amended to read:
Subdivision 1. [ALTERNATIVE METHODS OF DETERMINING
COMPLIANCE.] (a) In addition to methods specified in chapter
245A, the commissioner may use alternative methods and new
regulatory strategies to determine compliance with this
section. The commissioner may use sampling techniques to ensure
compliance with this section. Notwithstanding section 245A.09,
subdivision 7, paragraph (d) (e), the commissioner may also
extend periods of licensure, not to exceed five years, for
license holders who have demonstrated substantial and consistent
compliance with sections 245B.02 to 245B.07 and have
consistently maintained the health and safety of consumers and
have demonstrated by alternative methods in paragraph (b) that
they meet or exceed the requirements of this section. For
purposes of this section, "substantial and consistent
compliance" means that during the current licensing period:
(1) the license holder's license has not been made
conditional, suspended, or revoked;
(2) there have been no substantiated allegations of
maltreatment against the license holder;
(3) there have been no program deficiencies that have been
identified that would jeopardize the health or safety of
consumers being served; and
(4) the license holder is in substantial compliance with
the other requirements of chapter 245A and other applicable laws
and rules.
(b) To determine the length of a license, the commissioner
shall consider:
(1) information from affected consumers, and the license
holder's responsiveness to consumers' concerns and
recommendations;
(2) self assessments and peer reviews of the standards of
this section, corrective actions taken by the license holder,
and sharing the results of the inspections with consumers, the
consumers' families, and others, as requested;
(3) length of accreditation by an independent accreditation
body, if applicable;
(4) information from the county where the license holder is
located; and
(5) information from the license holder demonstrating
performance that meets or exceeds the minimum standards of this
chapter.
(c) The commissioner may reduce the length of the license
if the license holder fails to meet the criteria in paragraph
(a) and the conditions specified in paragraph (b).
Sec. 21. Minnesota Statutes 2002, section 246.014, is
amended to read:
246.014 [SERVICES.]
The measure of services established and prescribed by
section 246.012, are:
(a) The commissioner of human services shall develop and
maintain state-operated services in a manner consistent with
sections 245.461, 245.487, and 253.28, and chapters 252A, 254A,
and 254B. State-operated services shall be provided in
coordination with counties and other vendors. State-operated
services shall include regional treatment centers, specialized
inpatient or outpatient treatment programs, enterprise services,
community-based services and programs, community preparation
services, consultative services, and other services consistent
with the mission of the department of human services. These
services shall include crisis beds, waivered homes, intermediate
care facilities, and day training and habilitation facilities.
The administrative structure of state-operated services must be
statewide in character. The state-operated services staff may
deliver services at any location throughout the state.
(b) The commissioner of human services shall create and
maintain forensic services programs. Forensic services shall be
provided in coordination with counties and other vendors.
Forensic services shall include specialized inpatient programs
at secure treatment facilities as defined in section 253B.02,
subdivision 18a, consultative services, aftercare services,
community-based services and programs, transition services, or
other services consistent with the mission of the department of
human services.
(c) Community preparation services as identified in
paragraphs (a) and (b) are defined as specialized inpatient or
outpatient services or programs operated outside of a secure
environment but are administered by a secured treatment facility.
(d) The commissioner of human services may establish
policies and procedures which govern the operation of the
services and programs under the direct administrative authority
of the commissioner.
(1) There shall be served in state hospitals a single
standard of food for patients and employees alike, which is
nutritious and palatable together with special diets as
prescribed by the medical staff thereof. There shall be a chief
dietitian in the department of human services and at least one
dietitian at each state hospital. There shall be adequate staff
and equipment for processing, preparation, distribution and
serving of food.
(2) There shall be a staff of persons, professional and
lay, sufficient in number, trained in the diagnosis, care and
treatment of persons with mental illness, physical illness, and
including religious and spiritual counsel through qualified
chaplains (who shall be in the unclassified service) adequate to
take advantage of and put into practice modern methods of
psychiatry, medicine and related field.
(3) There shall be a staff and facilities to provide
occupational and recreational therapy, entertainment and other
creative activities as are consistent with modern methods of
treatment and well being.
(4) There shall be in each state hospital for the care and
treatment of persons with mental illness facilities for the
segregation and treatment of patients and residents who have
communicable disease.
(5) The commissioner of human services shall provide modern
and adequate psychiatric social case work service.
(6) The commissioner of human services shall make every
effort to improve the accommodations for patients and residents
so that the same shall be comfortable and attractive with
adequate furnishings, clothing, and supplies.
(7) The commissioner of human services shall establish
training programs for the training of personnel and may require
the participation of personnel in such programs. Within the
limits of the appropriations available the commissioner may
establish professional training programs in the forms of
educational stipends for positions for which there is a scarcity
of applicants.
(8) The standards herein established shall be adapted and
applied to the diagnosis, care and treatment of persons with
chemical dependency or mental retardation who come within those
terms as defined in the laws relating to the hospitalization and
commitment of such persons, and of persons who have sexual
psychopathic personalities or are sexually dangerous persons as
defined in chapter 253B.
(9) The commissioner of human services shall establish a
program of detection, diagnosis and treatment of persons with
mental illness and persons described in clause (8), and within
the limits of appropriations may establish clinics and staff the
same with persons specially trained in psychiatry and related
fields.
(10) The commissioner of employee relations may reclassify
employees of the state hospitals from time to time, and assign
classifications to such salary brackets as will adequately
compensate personnel and reasonably assure a continuity of
adequate staff.
(11) In addition to the chaplaincy services, provided in
clause (2), the commissioner of human services shall open said
state hospitals to members of the clergy and other spiritual
leaders to the end that religious and spiritual counsel and
services are made available to the patients and residents
therein, and shall cooperate with all members of the clergy and
other spiritual leaders in making said patients and residents
available for religious and spiritual counsel, and shall provide
such members of the clergy and other spiritual leaders with
meals and accommodations.
(12) Within the limits of the appropriations therefor, the
commissioner of human services shall establish and provide
facilities and equipment for research and study in the field of
modern hospital management, the causes of mental and related
illness and the treatment, diagnosis and care of persons with
mental illness and funds provided therefor may be used to make
available services, abilities and advice of leaders in these and
related fields, and may provide them with meals and
accommodations and compensate them for traveling expenses and
services.
Sec. 22. Minnesota Statutes 2002, section 246.015,
subdivision 3, is amended to read:
Subd. 3. Within the limits of the appropriations
available, The commissioner of human services may authorize
state-operated services to provide consultative services for
courts, and state welfare agencies, and supervise the placement
and aftercare of patients, on a fee-for-service basis as defined
in section 246.50, provisionally or otherwise discharged from
a state hospital or institution, state-operated services
facility. State-operated services may also promote and conduct
programs of education for the people of the state relating to
the problem of mental health and mental hygiene. The
commissioner shall administer, expend, and distribute federal
funds which may be made available to the state and other funds
other than those not appropriated by the legislature, which may
be made available to the state for mental health and mental
hygiene purposes.
Sec. 23. Minnesota Statutes 2002, section 246.018,
subdivision 2, is amended to read:
Subd. 2. [MEDICAL DIRECTOR.] The commissioner of human
services shall appoint a medical director, and unless otherwise
established by law, set the salary of a licensed physician to
serve as medical director to assist in establishing and
maintaining the medical policies of the department of human
services. The commissioner may place the medical director's
position in the unclassified service if the position meets the
criteria of section 43A.08, subdivision 1a. The medical
director must be a psychiatrist certified by the board of
psychiatry.
Sec. 24. Minnesota Statutes 2002, section 246.018,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The medical director shall:
(1) oversee the clinical provision of inpatient mental
health services provided in the state's regional treatment
centers;
(2) recruit and retain psychiatrists to serve on the state
medical staff established in subdivision 4;
(3) consult with the commissioner of human services, the
assistant commissioner of mental health, community mental health
center directors, and the regional treatment center governing
bodies state-operated services governing body to develop
standards for treatment and care of patients in regional
treatment centers and outpatient state-operated service
programs;
(4) develop and oversee a continuing education program for
members of the regional treatment center medical staff; and
(5) consult with the commissioner on the appointment of the
chief executive officers for regional treatment centers; and
(6) participate and cooperate in the development and
maintenance of a quality assurance program for regional
treatment centers state-operated services that assures that
residents receive quality inpatient care and continuous quality
care once they are discharged or transferred to an outpatient
setting.
Sec. 25. Minnesota Statutes 2002, section 246.018,
subdivision 4, is amended to read:
Subd. 4. [REGIONAL TREATMENT CENTER STATE-OPERATED
SERVICES MEDICAL STAFF.] (a) The commissioner of human services
medical director shall establish a regional treatment center
state-operated service medical staff which shall be under the
clinical direction of the office of medical director.
(b) The medical director, in conjunction with the regional
treatment center medical staff, shall:
(1) establish standards and define qualifications for
physicians who care for residents in regional treatment
centers state-operated services;
(2) monitor the performance of physicians who care for
residents in regional treatment centers state-operated services;
and
(3) recommend to the commissioner changes in procedures for
operating regional treatment centers state-operated service
facilities that are needed to improve the provision of medical
care in those facilities.
Sec. 26. Minnesota Statutes 2002, section 246.13, is
amended to read:
246.13 [RECORD OF PATIENTS AND RESIDENTS; DEPARTMENT OF
HUMAN IN STATE-OPERATED SERVICES.]
The commissioner of human services' office shall have,
accessible only by consent of the commissioner or on the order
of a judge or court of record, a record showing the residence,
sex, age, nativity, occupation, civil condition, and date of
entrance or commitment of every person, in the state hospitals
state-operated services facilities as defined under section
246.014 under exclusive control of the commissioner,; the date
of discharge and whether such discharge was final,; the
condition of such the person when the person left the state
hospital, state-operated services facility; and the date and
cause of all deaths. The record shall state every transfer from
one state hospital state-operated services facility to another,
naming each state-operated services facility. This information
shall be furnished to the commissioner of human services by each
public and private agency, along with such other obtainable
facts as the commissioner may from time to time require. The
chief executive officer of each such state hospital, within ten
days after the commitment or entrance thereto of a patient or
resident, shall cause a true copy of an entrance record to be
forwarded to the commissioner of human services. When a patient
or resident leaves, in a state-operated services facility is
discharged or, transferred, or dies in any state hospital,
the chief executive officer, or other person in charge head of
the state-operated services facility or designee shall inform
the commissioner of human services of these events within ten
days thereafter on forms furnished by the commissioner.
The commissioner of human services may authorize the chief
executive officer of any state hospital for persons with mental
illness or mental retardation, to release to public or private
medical personnel, hospitals, clinics, local social services
agencies or other specifically designated interested persons or
agencies any information regarding any patient or resident
thereat, if, in the opinion of the commissioner, it will be for
the benefit of the patient or resident.
Sec. 27. Minnesota Statutes 2002, section 246.15, is
amended to read:
246.15 [MONEY OF INMATES OF PUBLIC WELFARE INSTITUTIONS
PATIENTS OR RESIDENTS.]
Subdivision 1. [RECORD KEEPING OF MONEY.] The chief
executive officer of each institution head of the state-operated
services facility or designee under the jurisdiction of the
commissioner of human services shall may have the care and
custody of all money belonging to inmates thereof patients or
residents which may come into the chief executive officer's head
of the state-operated services facility or designee's hands,.
The head of the state-operated services facility or designee
shall keep accurate accounts thereof of the money, and pay them
out under rules prescribed by law or by the commissioner of
human services, taking vouchers therefor for the money.
All such money received by any officer or employee shall be paid
to the chief executive officer forthwith head of the
state-operated services facility or designee immediately. Every
such executive officer head of the state-operated services
facility or designee, at the close of each month, or oftener
earlier if required by the commissioner, shall forward to the
commissioner a statement of the amount of all money so received
and the names of the inmates patients or residents from whom
received, accompanied by a check for the amount, payable to the
state treasurer. On receipt of such the statement, the
commissioner shall transmit the same statement along with a
check to the commissioner of finance, together with such check,
who shall deliver the same statement and check to the state
treasurer. Upon the payment of such the check, the amount shall
be credited to a fund to be known as "Inmates Client Fund," for
the institution from which the same check was received. All
such funds shall be paid out by the state treasurer upon
vouchers duly approved by the commissioner of human services as
in other cases. The commissioner may permit a contingent fund
to remain in the hands of the executive officer head of the
state-operated services facility or designee of any such the
institution from which necessary expenditure expenditures may
from time to time be made.
Subd. 2. [CORRECTIONAL INMATES FUND.] Any money in the
inmates fund provided for in this section, belonging to inmates
of state institutions under the jurisdiction of the commissioner
of corrections shall forthwith be immediately transferred by the
commissioner of human services to the correctional inmates
inmates' fund created by section 241.08.
Sec. 28. Minnesota Statutes 2002, section 246.16, is
amended to read:
246.16 [UNCLAIMED MONEY OR PERSONAL PROPERTY OF
INMATES PATIENTS OR RESIDENTS.]
Subdivision 1. [UNCLAIMED MONEY.] When there money has
heretofore accumulated or shall hereafter accumulate in the
hands of the superintendent of any state institution head of the
state-operated services facility or designee under the
jurisdiction of the commissioner of human services money
belonging to inmates patients or residents of such the
institution who have died therein there, or
disappeared therefrom from there, and for which money there is
no claimant or person entitled thereto to the money known to the
superintendent, such head of the state-operated services
facility or designee the money may, at the discretion of such
superintendent the head of the state-operated services facility
or designee, to be expended under the direction of the
superintendent head of the state-operated services facility or
designee for the amusement, entertainment, and general benefit
of the inmates patients or residents of such the institution.
No money shall be so used until it shall have has remained
unclaimed for at least five years. If, at any time after the
expiration of the five years, the legal heirs of the inmate
shall patients or residents appear and make proper proof of such
heirship, they shall be entitled to receive from the state
treasurer such the sum of money as shall have been expended by
the superintendent head of the state-operated services facility
or designee belonging to the inmate patient or resident.
Subd. 2. [UNCLAIMED PERSONAL PROPERTY.] When any
inmate patient or resident of a state institution state-operated
services facility under the jurisdiction of the commissioner of
human services has died or disappeared therefrom, or hereafter
shall die or disappear therefrom dies or disappears from the
state-operated services facility, leaving personal property
exclusive of money in the custody of the superintendent thereof
personal property, exclusive of money, which head of the
state-operated services facility or designee and the property
remains unclaimed for a period of two years, and there is with
no person entitled thereto to the property known to the
superintendent head of the state-operated services or designee,
the superintendent or an agent head of the state-operated
services facility or designee may sell such the property at
public auction. Notice of such the sale shall be published for
two consecutive weeks in a legal newspaper in the county wherein
where the institution state-operated services facility is
located and shall state the time and place of such the sale.
The proceeds of the sale, after deduction of the costs of
publication and auction, may be expended, at the discretion of
the superintendent head of the state-operated services facility
or designee, for the entertainment and benefit of the inmates
patients or residents of such institution the state-operated
services facility. Any inmate patient or resident, or heir or
representative of the inmate patient or resident, may file with,
and make proof of ownership to, the superintendent head of the
state-operated services facility or designee of the institution
state-operated services facility disposing of such the personal
property within four years after such the sale, and, upon proof
satisfactory proof to such superintendent the head of the
state-operated services or designee, shall certify for payment
to the state treasurer the amount received by the sale of such
the property. No suit shall be brought for damages consequent
to the disposal of personal property or use of money in
accordance with this section against the state or any official,
employee, or agent thereof.
Sec. 29. Minnesota Statutes 2002, section 246.57,
subdivision 1, is amended to read:
Subdivision 1. [AUTHORIZED.] The commissioner of human
services may authorize any state state-operated services
facility operated under the authority of the commissioner to
enter into agreement with other governmental entities and both
nonprofit and for-profit organizations for participation in
shared service agreements that would be of mutual benefit to the
state, other governmental entities and organizations involved,
and the public. Notwithstanding section 16C.05, subdivision 2,
the commissioner of human services may delegate the execution of
shared services contracts to the chief executive officers of the
regional centers or state operated nursing homes. No additional
employees shall be added to the legislatively approved
complement for any regional center or state nursing home as a
result of entering into any shared service agreement. However,
Positions funded by a shared service agreement may be are
authorized by the commissioner of finance for the duration of
the shared service agreement. The charges for the services
shall be on an actual cost basis. All receipts for shared
services may be retained by the regional treatment center or
state-operated nursing home service that provided the services,
in addition to other funding the regional treatment center or
state-operated nursing home receives.
Sec. 30. Minnesota Statutes 2002, section 246.57,
subdivision 4, is amended to read:
Subd. 4. [SHARED STAFF OR SERVICES.] The commissioner of
human services may authorize a regional treatment center
state-operated services to provide staff or services to Camp
Confidence in return for services to, or use of the camp's
facilities by, residents of the treatment center facility who
have mental retardation or a related condition.
Sec. 31. Minnesota Statutes 2002, section 246.57,
subdivision 6, is amended to read:
Subd. 6. [DENTAL SERVICES.] The commissioner of human
services shall authorize any regional treatment center or
state-operated nursing home services facility under the
commissioner's authority to provide dental services to disabled
persons who are eligible for medical assistance and are not
residing at the regional treatment center or state-operated
nursing home, provided that the reimbursement received for these
services is sufficient to cover actual costs. To provide these
services, regional treatment centers and state-operated nursing
homes may participate under contract with health networks in
their service area. Notwithstanding section 16C.05, subdivision
2, the commissioner of human services may delegate the execution
of these dental services contracts to the chief executive
officers of the regional centers or state-operated nursing
homes. All receipts for these dental services shall be retained
by the regional treatment center or state-operated nursing home
that provides the services and shall be in addition to other
funding the regional treatment center or state-operated nursing
home receives.
Sec. 32. Minnesota Statutes 2002, section 246.71,
subdivision 4, is amended to read:
Subd. 4. [EMPLOYEE OF A SECURE TREATMENT FACILITY OR
EMPLOYEE.] "Employee of a secure treatment facility" or
"employee" means an employee of the Minnesota security hospital
or a secure treatment facility operated by the Minnesota sexual
psychopathic personality treatment center sex offender program.
Sec. 33. Minnesota Statutes 2002, section 246.71,
subdivision 5, is amended to read:
Subd. 5. [SECURE TREATMENT FACILITY.] "Secure treatment
facility" means the Minnesota security hospital or the Minnesota
sexual psychopathic personality treatment center and the
Minnesota sex offender program facility in Moose Lake and any
portion of the Minnesota sex offender program operated by the
Minnesota sex offender program at the Minnesota security
hospital.
Sec. 34. Minnesota Statutes 2002, section 246B.02, is
amended to read:
246B.02 [ESTABLISHMENT OF MINNESOTA SEXUAL PSYCHOPATHIC
PERSONALITY TREATMENT CENTER SEX OFFENDER PROGRAM.]
The commissioner of human services shall establish and
maintain a secure facility located in Moose Lake. The facility
shall be known as shall be operated by the Minnesota Sexual
Psychopathic Personality Treatment Center sex offender program.
The facility program shall provide care and treatment in secure
treatment facilities to 100 persons committed by the courts as
sexual psychopathic personalities or sexually dangerous persons,
or persons admitted there with the consent of the commissioner
of human services.
Sec. 35. Minnesota Statutes 2002, section 246B.03, is
amended to read:
246B.03 [LICENSURE.]
The commissioner of human services shall apply to the
commissioner of health to license the secure treatment
facilities operated by the Minnesota Sexual Psychopathic
Personality Treatment Center sex offender program as a
supervised living facility facilities with applicable program
licensing standards.
Sec. 36. Minnesota Statutes 2002, section 246B.04, is
amended to read:
246B.04 [RULES; EVALUATION.]
The commissioner of human services shall adopt rules to
govern the operation, maintenance, and licensure of the secure
treatment facilities operated by the Minnesota sex offender
program established at the Minnesota Sexual Psychopathic
Personality Treatment Center, or at any other facility operated
by the commissioner, for persons committed as a sexual
psychopathic personality or sexually dangerous person. The
commissioner shall establish an evaluation process to measure
outcomes and behavioral changes as a result of treatment
compared with incarceration without treatment, to determine the
value, if any, of treatment in protecting the public.
Sec. 37. Minnesota Statutes 2002, section 252.025,
subdivision 7, is amended to read:
Subd. 7. [MINNESOTA EXTENDED TREATMENT OPTIONS.] The
commissioner shall develop by July 1, 1997, the Minnesota
extended treatment options to serve Minnesotans who have mental
retardation and exhibit severe behaviors which present a risk to
public safety. This program must provide specialized
residential services on the Cambridge campus in Cambridge and an
array of community support services statewide.
Sec. 38. Minnesota Statutes 2002, section 252.06, is
amended to read:
252.06 [SHERIFF TO TRANSPORT PERSONS WITH MENTAL
RETARDATION.]
It shall be the duty of the sheriff of any county, upon the
request of the commissioner of human services, to take charge of
and, transport, and deliver any person with mental retardation
who has been committed by the district court of any county to
the care and custody of the commissioner of human services
to such state hospital a state-operated services facility as may
be designated by the commissioner of human services and there
deliver such person to the chief executive officer of the state
hospital.
Sec. 39. Minnesota Statutes 2002, section 252.27,
subdivision 2a, is amended to read:
Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or
adoptive parents of a minor child, including a child determined
eligible for medical assistance without consideration of
parental income, must contribute monthly to the cost of
services, unless the child is married or has been married,
parental rights have been terminated, or the child's adoption is
subsidized according to section 259.67 or through title IV-E of
the Social Security Act.
(b) For households with adjusted gross income equal to or
greater than 100 percent of federal poverty guidelines, the
parental contribution shall be the greater of a minimum monthly
fee of $25 for households with adjusted gross income of $30,000
and over, or an amount to be computed by applying the following
schedule of rates to the adjusted gross income of the natural or
adoptive parents that exceeds 150 percent of the federal poverty
guidelines for the applicable household size, the following
schedule of rates:
(1) on the amount of adjusted gross income over 150 percent
of poverty, but not over $50,000, ten percent if the adjusted
gross income is equal to or greater than 100 percent of federal
poverty guidelines and less than 175 percent of federal poverty
guidelines, the parental contribution is $4 per month;
(2) on if the amount of adjusted gross income over 150
percent of poverty and over $50,000 but not over $60,000, 12
percent is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 375 percent of
federal poverty guidelines, the parental contribution shall be
determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of
adjusted gross income at 175 percent of federal poverty
guidelines and increases to 7.5 percent of adjusted gross income
for those with adjusted gross income up to 375 percent of
federal poverty guidelines;
(3) on if the amount of adjusted gross income over 150 is
greater than 375 percent of federal poverty, and over $60,000
but not over $75,000, 14 percent guidelines and less than 675
percent of federal poverty guidelines, the parental contribution
shall be 7.5 percent of adjusted gross income; and
(4) on all if the adjusted gross income amounts over 150 is
equal to or greater than 675 percent of federal poverty, and
over $75,000, 15 percent guidelines and less than 975 percent of
federal poverty guidelines, the parental contribution shall be
ten percent of adjusted gross income; and
(5) if the adjusted gross income is equal to or greater
than 975 percent of federal poverty guidelines, the parental
contribution shall be 12.5 percent of adjusted gross income.
If the child lives with the parent, the parental
contribution annual adjusted gross income is reduced by $200,
except that the parent must pay the minimum monthly $25 fee
under this paragraph $2,400 prior to calculating the parental
contribution. If the child resides in an institution specified
in section 256B.35, the parent is responsible for the personal
needs allowance specified under that section in addition to the
parental contribution determined under this section. The
parental contribution is reduced by any amount required to be
paid directly to the child pursuant to a court order, but only
if actually paid.
(c) The household size to be used in determining the amount
of contribution under paragraph (b) includes natural and
adoptive parents and their dependents under age 21, including
the child receiving services. Adjustments in the contribution
amount due to annual changes in the federal poverty guidelines
shall be implemented on the first day of July following
publication of the changes.
(d) For purposes of paragraph (b), "income" means the
adjusted gross income of the natural or adoptive parents
determined according to the previous year's federal tax form.
(e) The contribution shall be explained in writing to the
parents at the time eligibility for services is being
determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives
services. Annually upon redetermination or at termination of
eligibility, if the contribution exceeded the cost of services
provided, the local agency or the state shall reimburse that
excess amount to the parents, either by direct reimbursement if
the parent is no longer required to pay a contribution, or by a
reduction in or waiver of parental fees until the excess amount
is exhausted.
(f) The monthly contribution amount must be reviewed at
least every 12 months; when there is a change in household size;
and when there is a loss of or gain in income from one month to
another in excess of ten percent. The local agency shall mail a
written notice 30 days in advance of the effective date of a
change in the contribution amount. A decrease in the
contribution amount is effective in the month that the parent
verifies a reduction in income or change in household size.
(g) Parents of a minor child who do not live with each
other shall each pay the contribution required under paragraph
(a), except that a. An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child
receiving services shall be deducted from the contribution
adjusted gross income of the parent making the payment prior to
calculating the parental contribution under paragraph (b).
(h) The contribution under paragraph (b) shall be increased
by an additional five percent if the local agency determines
that insurance coverage is available but not obtained for the
child. For purposes of this section, "available" means the
insurance is a benefit of employment for a family member at an
annual cost of no more than five percent of the family's annual
income. For purposes of this section, "insurance" means health
and accident insurance coverage, enrollment in a nonprofit
health service plan, health maintenance organization,
self-insured plan, or preferred provider organization.
Parents who have more than one child receiving services
shall not be required to pay more than the amount for the child
with the highest expenditures. There shall be no resource
contribution from the parents. The parent shall not be required
to pay a contribution in excess of the cost of the services
provided to the child, not counting payments made to school
districts for education-related services. Notice of an increase
in fee payment must be given at least 30 days before the
increased fee is due.
(i) The contribution under paragraph (b) shall be reduced
by $300 per fiscal year if, in the 12 months prior to July 1:
(1) the parent applied for insurance for the child;
(2) the insurer denied insurance;
(3) the parents submitted a complaint or appeal, in writing
to the insurer, submitted a complaint or appeal, in writing, to
the commissioner of health or the commissioner of commerce, or
litigated the complaint or appeal; and
(4) as a result of the dispute, the insurer reversed its
decision and granted insurance.
For purposes of this section, "insurance" has the meaning
given in paragraph (h).
A parent who has requested a reduction in the contribution
amount under this paragraph shall submit proof in the form and
manner prescribed by the commissioner or county agency,
including, but not limited to, the insurer's denial of
insurance, the written letter or complaint of the parents, court
documents, and the written response of the insurer approving
insurance. The determinations of the commissioner or county
agency under this paragraph are not rules subject to chapter 14.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 40. Minnesota Statutes 2002, section 253.015,
subdivision 1, is amended to read:
Subdivision 1. [STATE HOSPITALS STATE-OPERATED SERVICES
FOR PERSONS WITH MENTAL ILLNESS.] The state hospitals
state-operated services facilities located at Anoka, Brainerd,
Fergus Falls, St. Peter, and Willmar, and Moose Lake until June
30, 1995, shall constitute the state hospitals state-operated
services facilities for persons with mental illness, and shall
be maintained under the general management of the commissioner
of human services. The commissioner of human services shall
determine to what state hospital state-operated services
facility persons with mental illness shall be committed from
each county and notify the judge exercising probate jurisdiction
thereof, and of changes made from time to time. The chief
executive officer of each hospital for persons with mental
illness shall be known as the chief executive officer.
Sec. 41. Minnesota Statutes 2002, section 253.017, is
amended to read:
253.017 [TREATMENT PROVIDED BY REGIONAL TREATMENT CENTERS
STATE-OPERATED SERVICES.]
Subdivision 1. [ACTIVE PSYCHIATRIC TREATMENT.] The
regional treatment centers state-operated services shall provide
active psychiatric treatment according to contemporary
professional standards. Treatment must be designed to:
(1) stabilize the individual and the symptoms that required
hospital admission;
(2) restore individual functioning to a level permitting
return to the community;
(3) strengthen family and community support; and
(4) facilitate discharge, after care, and follow-up as
patients return to the community.
Subd. 2. [NEED FOR SERVICES.] The commissioner shall
determine the need for the psychiatric services provided by the
department based upon individual needs assessments of persons in
the regional treatment centers state-operated services as
required by section 245.474, subdivision 2, and an evaluation
of: (1) regional treatment center state-operated service
programs, (2) programs needed in the region for persons who
require hospitalization, and (3) available epidemiologic data.
Throughout its planning and implementation, the assessment
process must be discussed with the state advisory council on
mental health in accordance with its duties under section
245.697. Continuing assessment of this information must be
considered in planning for and implementing changes in
state-operated programs and facilities for persons with mental
illness. By January 31, 1990, the commissioner shall submit a
proposal for renovation or new construction of the facilities at
Anoka, Brainerd, Moose Lake, and Fergus Falls. Expansion may be
considered only after a thorough analysis of need and in
conjunction with a comprehensive mental health plan.
Subd. 3. [DISSEMINATION OF ADMISSION AND STAY CRITERIA.]
The commissioner shall periodically disseminate criteria for
admission and continued stay in a regional treatment center and
security hospital state-operated services facility. The
commissioner shall disseminate the criteria to the courts of the
state and counties.
Sec. 42. Minnesota Statutes 2002, section 253.20, is
amended to read:
253.20 [MINNESOTA SECURITY HOSPITAL.]
The commissioner of human services is hereby authorized and
directed to shall erect, equip, and maintain in connection with
a state hospital at St. Peter a suitable building to be known as
the Minnesota Security Hospital, for the purpose of holding in
custody and caring for such persons with mental illness or
mental retardation as providing a secure treatment facility as
defined in section 253B.02, subdivision 18a, for persons who may
be committed thereto there by courts of criminal jurisdiction,
or otherwise, or transferred thereto there by the commissioner
of human services, and for such persons as may be declared
insane who are found to be mentally ill while confined in any
penal institution correctional facility, or who may be found to
be mentally ill and dangerous, and the commissioner shall
supervise and manage the same as in the case of other state
hospitals.
Sec. 43. Minnesota Statutes 2002, section 253.26, is
amended to read:
253.26 [TRANSFERS OF PATIENTS OR RESIDENTS.]
When any person of the state hospital for patients with
mental illness or residents with mental retardation is found by
the commissioner of human services to have homicidal tendencies
or to be under sentence or indictment or information the person
may be transferred by the commissioner to the Minnesota Security
Hospital for safekeeping and treatment The commissioner of human
services may transfer a committed patient to the Minnesota
Security Hospital following a determination that the patient's
behavior presents a danger to others and treatment in a secure
treatment facility is necessary. The commissioner shall
establish a written policy creating the transfer criteria.
Sec. 44. Minnesota Statutes 2002, section 253B.02,
subdivision 18a, is amended to read:
Subd. 18a. [SECURE TREATMENT FACILITY.] "Secure treatment
facility" means the Minnesota security hospital or the Minnesota
sexual psychopathic personality treatment center and the
Minnesota sex offender program facility in Moose Lake and any
portion of the Minnesota sex offender program operated by the
Minnesota sex offender program at the Minnesota security
hospital, but does not include services or programs administered
by the secure treatment facility outside a secure environment.
Sec. 45. Minnesota Statutes 2002, section 253B.04,
subdivision 1, is amended to read:
Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a)
Voluntary admission is preferred over involuntary commitment and
treatment. Any person 16 years of age or older may request to
be admitted to a treatment facility as a voluntary patient for
observation, evaluation, diagnosis, care and treatment without
making formal written application. Any person under the age of
16 years may be admitted as a patient with the consent of a
parent or legal guardian if it is determined by independent
examination that there is reasonable evidence that (1) the
proposed patient has a mental illness, or is mentally retarded
or chemically dependent; and (2) the proposed patient is
suitable for treatment. The head of the treatment facility
shall not arbitrarily refuse any person seeking admission as a
voluntary patient. In making decisions regarding admissions,
the facility shall use clinical admission criteria consistent
with the current applicable inpatient admission standards
established by the American Psychiatric Association or the
American Academy of Child and Adolescent Psychiatry. These
criteria must be no more restrictive than, and must be
consistent with, the requirements of section 62Q.53. The
facility may not refuse to admit a person voluntarily solely
because the person does not meet the criteria for involuntary
holds under section 253B.05 or the definition of mental illness
under section 253B.02, subdivision 13.
(b) In addition to the consent provisions of paragraph (a),
a person who is 16 or 17 years of age who refuses to consent
personally to admission may be admitted as a patient for mental
illness or chemical dependency treatment with the consent of a
parent or legal guardian if it is determined by an independent
examination that there is reasonable evidence that the proposed
patient is chemically dependent or has a mental illness and is
suitable for treatment. The person conducting the examination
shall notify the proposed patient and the parent or legal
guardian of this determination.
(c) A person who is voluntarily participating in treatment
for a mental illness is not subject to civil commitment under
this chapter if the person:
(1) has given informed consent or, if lacking capacity, is
a person for whom legally valid substitute consent has been
given; and
(2) is participating in a medically appropriate course of
treatment, including clinically appropriate and lawful use of
neuroleptic medication and electroconvulsive therapy. The
limitation on commitment in this paragraph does not apply if,
based on clinical assessment, the court finds that it is
unlikely that the person will remain in and cooperate with a
medically appropriate course of treatment absent commitment and
the standards for commitment are otherwise met. This paragraph
does not apply to a person for whom commitment proceedings are
initiated pursuant to rule 20.01 or 20.02 of the Rules of
Criminal Procedure, or a person found by the court to meet the
requirements under section 253B.02, subdivision 17.
Legally valid substitute consent may be provided by a proxy
under a health care directive, a guardian or conservator with
authority to consent to mental health treatment, or consent to
admission under subdivision 1a or 1b.
Sec. 46. Minnesota Statutes 2002, section 253B.05,
subdivision 3, is amended to read:
Subd. 3. [DURATION OF HOLD.] (a) Any person held pursuant
to this section may be held up to 72 hours, exclusive of
Saturdays, Sundays, and legal holidays after admission. If a
petition for the commitment of the person is filed in the
district court in the county of the person's residence or of the
county in which the treatment facility is located, the court may
issue a judicial hold order pursuant to section 253B.07,
subdivision 2b.
(b) During the 72-hour hold period, a court may not release
a person held under this section unless the court has received a
written petition for release and held a summary hearing
regarding the release. The petition must include the name of
the person being held, the basis for and location of the hold,
and a statement as to why the hold is improper. The petition
also must include copies of any written documentation under
subdivision 1 or 2 in support of the hold, unless the person
holding the petitioner refuses to supply the documentation. The
hearing must be held as soon as practicable and may be conducted
by means of a telephone conference call or similar method by
which the participants are able to simultaneously hear each
other. If the court decides to release the person, the court
shall direct the release and shall issue written findings
supporting the decision. The release may not be delayed pending
the written order. Before deciding to release the person, the
court shall make every reasonable effort to provide notice of
the proposed release to:
(1) any specific individuals identified in a statement
under subdivision 1 or 2 or individuals identified in the record
who might be endangered if the person was not held;
(2) the examiner whose written statement was a basis for a
hold under subdivision 1; and
(3) the peace or health officer who applied for a hold
under subdivision 2.
(c) If a person is intoxicated in public and held under
this section for detoxification, a treatment facility may
release the person without providing notice under paragraph (d)
as soon as the treatment facility determines the person is no
longer a danger to themselves or others. Notice must be
provided to the peace officer or health officer who transported
the person, or the appropriate law enforcement agency, if the
officer or agency requests notification.
(c) (d) If a treatment facility releases a person during
the 72-hour hold period, the head of the treatment facility
shall immediately notify the agency which employs the peace or
health officer who transported the person to the treatment
facility under this section.
(e) A person held under a 72-hour emergency hold must be
released by the facility within 72 hours unless a court order to
hold the person is obtained. A consecutive emergency hold order
under this section may not be issued.
Sec. 47. Minnesota Statutes 2002, section 253B.09,
subdivision 1, is amended to read:
Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds
by clear and convincing evidence that the proposed patient is a
person who is mentally ill, mentally retarded, or chemically
dependent and after careful consideration of reasonable
alternative dispositions, including but not limited to,
dismissal of petition, voluntary outpatient care, voluntary
admission to a treatment facility, appointment of a guardian or
conservator, or release before commitment as provided for in
subdivision 4, it finds that there is no suitable alternative to
judicial commitment, the court shall commit the patient to the
least restrictive treatment program or alternative programs
which can meet the patient's treatment needs consistent with
section 253B.03, subdivision 7.
(b) In deciding on the least restrictive program, the court
shall consider a range of treatment alternatives including, but
not limited to, community-based nonresidential treatment,
community residential treatment, partial hospitalization, acute
care hospital, and regional treatment center services. The
court shall also consider the proposed patient's treatment
preferences and willingness to participate voluntarily in the
treatment ordered. The court may not commit a patient to a
facility or program that is not capable of meeting the patient's
needs.
(c) If the commitment as mentally ill, chemically
dependent, or mentally retarded is to a service facility
provided by the commissioner of human services, the court shall
order the commitment to the commissioner. The commissioner
shall designate the placement of the person to the court.
(d) If the court finds a proposed patient to be a person
who is mentally ill under section 253B.02, subdivision 13,
paragraph (a), clause (2) or (4), the court shall commit to a
community-based program that meets the proposed patient's
needs. For purposes of this paragraph, a community-based
program may include inpatient mental health services at a
community hospital.
Sec. 48. Minnesota Statutes 2002, section 256.012, is
amended to read:
256.012 [MINNESOTA MERIT SYSTEM.]
Subdivision 1. [MINNESOTA MERIT SYSTEM.] The commissioner
of human services shall promulgate by rule personnel standards
on a merit basis in accordance with federal standards for a
merit system of personnel administration for all employees of
county boards engaged in the administration of community social
services or income maintenance programs, all employees of human
services boards that have adopted the rules of the Minnesota
merit system, and all employees of local social services
agencies.
Excluded from the rules are employees of institutions and
hospitals under the jurisdiction of the aforementioned boards
and agencies; employees of county personnel systems otherwise
provided for by law that meet federal merit system requirements;
duly appointed or elected members of the aforementioned boards
and agencies; and the director of community social services and
employees in positions that, upon the request of the appointing
authority, the commissioner chooses to exempt, provided the
exemption accords with the federal standards for a merit system
of personnel administration.
Subd. 2. [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of
merit system operations shall be paid by counties and other
entities that utilize merit system services. Total costs shall
be determined by the commissioner annually and must be set at a
level that neither significantly overrecovers nor underrecovers
the costs of providing the service. The costs of merit system
services shall be prorated among participating counties in
accordance with an agreement between the commissioner and these
counties. Participating counties will be billed quarterly in
advance and shall pay their share of the costs upon receipt of
the billing.
(b) This subdivision does not apply to counties with
personnel systems otherwise provided by law that meet federal
merit system requirements. A county that applies to withdraw
from the merit system must notify the commissioner of the
county's intent to develop its own personnel system. This
notice must be provided in writing by December 31 of the year
preceding the year of final participation in the merit system.
The county may withdraw after the commissioner has certified
that its personnel system meets federal merit system
requirements.
(c) A county merit system operations account is established
in the special revenue fund. Payments received by the
commissioner for merit system costs must be deposited in the
merit system operations account and must be used for the purpose
of providing the services and administering the merit system.
(d) County payment of merit system costs is effective July
1, 2003, however payment for the period from July 1, 2003
through December 31, 2003, shall be made no later than January
31, 2004.
Subd. 3. [PARTICIPATING COUNTY CONSULTATION.] The
commissioner shall ensure that participating counties are
consulted regularly and offered the opportunity to provide input
on the management of the merit system to ensure effective use of
resources and to monitor system performance.
Sec. 49. [256.0451] [HEARING PROCEDURES.]
Subdivision 1. [SCOPE.] The requirements in this section
apply to all fair hearings and appeals under section 256.045,
subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6),
and (7). Except as provided in subdivisions 3 and 19, the
requirements under this section apply to fair hearings and
appeals under section 256.045, subdivision 3, paragraph (a),
clauses (4), (8), and (9).
The term "person" is used in this section to mean an
individual who, on behalf of themselves or their household, is
appealing or disputing or challenging an action, a decision, or
a failure to act, by an agency in the human services system.
When a person involved in a proceeding under this section is
represented by an attorney or by an authorized representative,
the term "person" also refers to the person's attorney or
authorized representative. Any notice sent to the person
involved in the hearing must also be sent to the person's
attorney or authorized representative.
The term "agency" includes the county human services
agency, the state human services agency, and, where applicable,
any entity involved under a contract, subcontract, grant, or
subgrant with the state agency or with a county agency, that
provides or operates programs or services in which appeals are
governed by section 256.045.
Subd. 2. [ACCESS TO FILES.] A person involved in a fair
hearing appeal has the right of access to the person's complete
case files and to examine all private welfare data on the person
which has been generated, collected, stored, or disseminated by
the agency. A person involved in a fair hearing appeal has the
right to a free copy of all documents in the case file involved
in a fair hearing appeal. "Case file" means the information,
documents, and data, in whatever form, which have been
generated, collected, stored, or disseminated by the agency in
connection with the person and the program or service involved.
Subd. 3. [AGENCY APPEAL SUMMARY.] (a) Except in fair
hearings and appeals under section 256.045, subdivision 3,
paragraph (a), clauses (4), (8), and (9), the agency involved in
an appeal must prepare a state agency appeal summary for each
fair hearing appeal. The state agency appeal summary shall be
mailed or otherwise delivered to the person who is involved in
the appeal at least three working days before the date of the
hearing. The state agency appeal summary must also be mailed or
otherwise delivered to the department's appeals office at least
three working days before the date of the fair hearing appeal.
(b) In addition, the appeals referee shall confirm that the
state agency appeal summary is mailed or otherwise delivered to
the person involved in the appeal as required under paragraph
(a). The person involved in the fair hearing should be
provided, through the state agency appeal summary or other
reasonable methods, appropriate information about the procedures
for the fair hearing and an adequate opportunity to prepare.
These requirements apply equally to the state agency or an
entity under contract when involved in the appeal.
(c) The contents of the state agency appeal summary must be
adequate to inform the person involved in the appeal of the
evidence on which the agency relies and the legal basis for the
agency's action or determination.
Subd. 4. [ENFORCING ACCESS TO FILES.] A person involved in
a fair hearing appeal may enforce the right of access to data
and copies of the case file by making a request to the appeals
referee. The appeals referee will make an appropriate order
enforcing the person's rights under the Minnesota Government
Data Practices Act, including but not limited to, ordering
access to files, data, and documents; continuing a hearing to
allow adequate time for access to data; or prohibiting use by
the agency of files, data, or documents which have been
generated, collected, stored, or disseminated without compliance
with the Minnesota Government Data Practices Act and which have
not been provided to the person involved in the appeal.
Subd. 5. [PREHEARING CONFERENCES.] (a) The appeals referee
prior to a fair hearing appeal may hold a prehearing conference
to further the interests of justice or efficiency and must
include the person involved in the appeal. A person involved in
a fair hearing appeal or the agency may request a prehearing
conference. The prehearing conference may be conducted by
telephone, in person, or in writing. The prehearing conference
may address the following:
(1) disputes regarding access to files, evidence,
subpoenas, or testimony;
(2) the time required for the hearing or any need for
expedited procedures or decision;
(3) identification or clarification of legal or other
issues that may arise at the hearing;
(4) identification of and possible agreement to factual
issues; and
(5) scheduling and any other matter which will aid in the
proper and fair functioning of the hearing.
(b) The appeals referee shall make a record or otherwise
contemporaneously summarize the prehearing conference in
writing, which shall be sent to both the person involved in the
hearing, the person's attorney or authorized representative, and
the agency.
Subd. 6. [APPEAL REQUEST FOR EMERGENCY ASSISTANCE OR
URGENT MATTER.] (a) When an appeal involves an application for
emergency assistance, the agency involved shall mail or
otherwise deliver the state agency appeal summary to the
department's appeals office within two working days of receiving
the request for an appeal. A person may also request that a
fair hearing be held on an emergency basis when the issue
requires an immediate resolution. The appeals referee shall
schedule the fair hearing on the earliest available date
according to the urgency of the issue involved. Issuance of the
recommended decision after an emergency hearing shall be
expedited.
(b) The commissioner shall issue a written decision within
five working days of receiving the recommended decision, shall
immediately inform the parties of the outcome by telephone, and
shall mail the decision no later than two working days following
the date of the decision.
Subd. 7. [CONTINUANCE, RESCHEDULING, OR ADJOURNING A
HEARING.] (a) A person involved in a fair hearing, or the
agency, may request a continuance, a rescheduling, or an
adjournment of a hearing for a reasonable period of time. The
grounds for granting a request for a continuance, a
rescheduling, or adjournment of a hearing include, but are not
limited to, the following:
(1) to reasonably accommodate the appearance of a witness;
(2) to ensure that the person has adequate opportunity for
preparation and for presentation of evidence and argument;
(3) to ensure that the person or the agency has adequate
opportunity to review, evaluate, and respond to new evidence, or
where appropriate, to require that the person or agency review,
evaluate, and respond to new evidence;
(4) to permit the person involved and the agency to
negotiate toward resolution of some or all of the issues where
both agree that additional time is needed;
(5) to permit the agency to reconsider a previous action or
determination;
(6) to permit or to require the performance of actions not
previously taken; and
(7) to provide additional time or to permit or require
additional activity by the person or agency as the interests of
fairness may require.
(b) Requests for continuances or for rescheduling may be
made orally or in writing. The person or agency requesting the
continuance or rescheduling must first make reasonable efforts
to contact the other participants in the hearing or their
representatives, and seek to obtain an agreement on the
request. Requests for continuance or rescheduling should be
made no later than three working days before the scheduled date
of the hearing, unless there is a good cause as specified in
subdivision 13. Granting a continuance or rescheduling may be
conditioned upon a waiver by the requester of applicable time
limits, but should not cause unreasonable delay.
Subd. 8. [SUBPOENAS.] A person involved in a fair hearing
or the agency may request a subpoena for a witness, for
evidence, or for both. A reasonable number of subpoenas shall
be issued to require the attendance and the testimony of
witnesses, and the production of evidence relating to any issue
of fact in the appeal hearing. The request for a subpoena must
show a need for the subpoena and the general relevance to the
issues involved. The subpoena shall be issued in the name of
the department and shall be served and enforced as provided in
section 357.22 and the Minnesota Rules of Civil Procedure.
An individual or entity served with a subpoena may petition
the appeals referee in writing to vacate or modify a subpoena.
The appeals referee shall resolve such a petition in a
prehearing conference involving all parties and shall make a
written decision. A subpoena may be vacated or modified if the
appeals referee determines that the testimony or evidence sought
does not relate with reasonable directness to the issues of the
fair hearing appeal; that the subpoena is unreasonable, over
broad, or oppressive; that the evidence sought is repetitious or
cumulative; or that the subpoena has not been served reasonably
in advance of the time when the appeal hearing will be held.
Subd. 9. [NO EX PARTE CONTACT.] The appeals referee shall
not have ex parte contact on substantive issues with the agency
or with any person or witness in a fair hearing appeal. No
employee of the department or agency shall review, interfere
with, change, or attempt to influence the recommended decision
of the appeals referee in any fair hearing appeal, except
through the procedure allowed in subdivision 18. The
limitations in this subdivision do not affect the commissioner's
authority to review or reconsider decisions or make final
decisions.
Subd. 10. [TELEPHONE OR FACE-TO-FACE HEARING.] A fair
hearing appeal may be conducted by telephone, by other
electronic media, or by an in-person, face-to-face hearing. At
the request of the person involved in a fair hearing appeal or
their representative, a face-to-face hearing shall be conducted
with all participants personally present before the appeals
referee.
Subd. 11. [HEARING FACILITIES AND EQUIPMENT.] The appeals
referee shall conduct the hearing in the county where the person
involved resides, unless an alternate location is mutually
agreed upon before the hearing, or unless the person has agreed
to a hearing by telephone. Hearings under section 256.045,
subdivision 3, paragraph (a), clauses (4), (8), and (9), must be
conducted in the county where the determination was made, unless
an alternate location is mutually agreed upon before the
hearing. The hearing room shall be of sufficient size and
layout to adequately accommodate both the number of individuals
participating in the hearing and any identified special needs of
any individual participating in the hearing. The appeals
referee shall ensure that all communication and recording
equipment that is necessary to conduct the hearing and to create
an adequate record is present and functioning properly. If any
necessary communication or recording equipment fails or ceases
to operate effectively, the appeals referee shall take any steps
necessary, including stopping or adjourning the hearing, until
the necessary equipment is present and functioning properly.
All reasonable efforts shall be undertaken to prevent and avoid
any delay in the hearing process caused by defective
communication or recording equipment.
Subd. 12. [INTERPRETER AND TRANSLATION SERVICES.] The
appeals referee has a duty to inquire and to determine whether
any participant in the hearing needs the services of an
interpreter or translator in order to participate in or to
understand the hearing process. Necessary interpreter or
translation services must be provided at no charge to the person
involved in the hearing. If it appears that interpreter or
translation services are needed but are not available for the
scheduled hearing, the appeals referee shall continue or
postpone the hearing until appropriate services can be provided.
Subd. 13. [FAILURE TO APPEAR; GOOD CAUSE.] If a person
involved in a fair hearing appeal fails to appear at the
hearing, the appeals referee may dismiss the appeal. The person
may reopen the appeal if within ten working days the person
submits information to the appeals referee to show good cause
for not appearing. Good cause can be shown when there is:
(1) a death or serious illness in the person's family;
(2) a personal injury or illness which reasonably prevents
the person from attending the hearing;
(3) an emergency, crisis, or unforeseen event which
reasonably prevents the person from attending the hearing;
(4) an obligation or responsibility of the person which a
reasonable person, in the conduct of one's affairs, could
reasonably determine takes precedence over attending the
hearing;
(5) lack of or failure to receive timely notice of the
hearing in the preferred language of the person involved in the
hearing; and
(6) excusable neglect, excusable inadvertence, excusable
mistake, or other good cause as determined by the appeals
referee.
Subd. 14. [COMMENCEMENT OF HEARING.] The appeals referee
shall begin each hearing by describing the process to be
followed in the hearing, including the swearing-in of witnesses,
how testimony and evidence are presented, the order of examining
and cross-examining witnesses, and the opportunity for an
opening statement and a closing statement. The appeals referee
shall identify for the participants the issues to be addressed
at the hearing and shall explain to the participants the burden
of proof which applies to the person involved and the agency.
The appeals referee shall confirm, prior to proceeding with the
hearing, that the state agency appeal summary, if required under
subdivision 3, has been properly completed and provided to the
person involved in the hearing, and that the person has been
provided documents and an opportunity to review the case file,
as provided in this section.
Subd. 15. [CONDUCT OF THE HEARING.] The appeals referee
shall act in a fair and impartial manner at all times. At the
beginning of the hearing the agency must designate one person as
their representative who shall be responsible for presenting the
agency's evidence and questioning any witnesses. The appeals
referee shall make sure that the person and the agency are
provided sufficient time to present testimony and evidence, to
confront and cross-examine all adverse witnesses, and to make
any relevant statement at the hearing. The appeals referee
shall make reasonable efforts to explain the hearing process to
persons who are not represented, and shall ensure that the
hearing is conducted fairly and efficiently. Upon the
reasonable request of the person or the agency involved, the
appeals referee may direct witnesses to remain outside the
hearing room, except during their individual testimony. The
appeals referee shall not terminate the hearing before affording
the person and the agency a complete opportunity to submit all
admissible evidence, and reasonable opportunity for oral or
written statement. When a hearing extends beyond the time which
was anticipated, the hearing shall be rescheduled or continued
from day-to-day until completion. Hearings that have been
continued shall be timely scheduled to minimize delay in the
disposition of the appeal.
Subd. 16. [SCOPE OF ISSUES ADDRESSED AT THE HEARING.] The
hearing shall address the correctness and legality of the
agency's action and shall not be limited simply to a review of
the propriety of the agency's action. The person involved may
raise and present evidence on all legal claims or defenses
arising under state or federal law as a basis for appealing or
disputing an agency action, but not constitutional claims beyond
the jurisdiction of the fair hearing. The appeals referee may
take official notice of adjudicative facts.
Subd. 17. [BURDEN OF PERSUASION.] The burden of persuasion
is governed by specific state or federal law and regulations
that apply to the subject of the hearing. If there is no
specific law, then the participant in the hearing who asserts
the truth of a claim is under the burden to persuade the appeals
referee that the claim is true.
Subd. 18. [INVITING COMMENT BY DEPARTMENT.] The appeals
referee or the commissioner may determine that a written comment
by the department about the policy implications of a specific
legal issue could help resolve a pending appeal. Such a written
policy comment from the department shall be obtained only by a
written request that is also sent to the person involved and to
the agency or its representative. When such a written comment
is received, both the person involved in the hearing and the
agency shall have adequate opportunity to review, evaluate, and
respond to the written comment, including submission of
additional testimony or evidence, and cross-examination
concerning the written comment.
Subd. 19. [DEVELOPING THE RECORD.] The appeals referee
shall accept all evidence, except evidence privileged by law,
that is commonly accepted by reasonable people in the conduct of
their affairs as having probative value on the issues to be
addressed at the hearing. Except in fair hearings and appeals
under section 256.045, subdivision 3, paragraph (a), clauses
(4), (8), and (9), in cases involving medical issues such as a
diagnosis, a physician's report, or a review team's decision,
the appeals referee shall consider whether it is necessary to
have a medical assessment other than that of the individual
making the original decision. When necessary, the appeals
referee shall require an additional assessment be obtained at
agency expense and made part of the hearing record. The appeals
referee shall ensure for all cases that the record is
sufficiently complete to make a fair and accurate decision.
Subd. 20. [UNREPRESENTED PERSONS.] In cases involving
unrepresented persons, the appeals referee shall take
appropriate steps to identify and develop in the hearing
relevant facts necessary for making an informed and fair
decision. These steps may include, but are not limited to,
asking questions of witnesses, and referring the person to a
legal services office. An unrepresented person shall be
provided an adequate opportunity to respond to testimony or
other evidence presented by the agency at the hearing. The
appeals referee shall ensure that an unrepresented person has a
full and reasonable opportunity at the hearing to establish a
record for appeal.
Subd. 21. [CLOSING OF THE RECORD.] The agency must present
its evidence prior to or at the hearing. The agency shall not
be permitted to submit evidence after the hearing except by
agreement at the hearing between the person involved, the
agency, and the appeals referee. If evidence is submitted after
the hearing, based on such an agreement, the person involved and
the agency must be allowed sufficient opportunity to respond to
the evidence. When necessary, the record shall remain open to
permit a person to submit additional evidence on the issues
presented at the hearing.
Subd. 22. [DECISIONS.] A timely, written decision must be
issued in every appeal. Each decision must contain a clear
ruling on the issues presented in the appeal hearing, and should
contain a ruling only on questions directly presented by the
appeal and the arguments raised in the appeal.
(a) [TIMELINESS.] A written decision must be issued within
90 days of the date the person involved requested the appeal
unless a shorter time is required by law. An additional 30 days
is provided in those cases where the commissioner refuses to
accept the recommended decision.
(b) [CONTENTS OF HEARING DECISION.] The decision must
contain both findings of fact and conclusions of law, clearly
separated and identified. The findings of fact must be based on
the entire record. Each finding of fact made by the appeals
referee shall be supported by a preponderance of the evidence
unless a different standard is required under the regulations of
a particular program. The "preponderance of the evidence"
means, in light of the record as a whole, the evidence leads the
appeals referee to believe that the finding of fact is more
likely to be true than not true. The legal claims or arguments
of a participant do not constitute either a finding of fact or a
conclusion of law, except to the extent the appeals referee
adopts an argument as a finding of fact or conclusion of law.
The decision shall contain at least the following:
(1) a listing of the date and place of the hearing and the
participants at the hearing;
(2) a clear and precise statement of the issues, including
the dispute under consideration and the specific points which
must be resolved in order to decide the case;
(3) a listing of the material, including exhibits, records,
reports, placed into evidence at the hearing, and upon which the
hearing decision is based;
(4) the findings of fact based upon the entire hearing
record. The findings of fact must be adequate to inform the
participants and any interested person in the public of the
basis of the decision. If the evidence is in conflict on an
issue which must be resolved, the findings of fact must state
the reasoning used in resolving the conflict;
(5) conclusions of law that address the legal authority for
the hearing and the ruling, and which give appropriate attention
to the claims of the participants to the hearing;
(6) a clear and precise statement of the decision made
resolving the dispute under consideration in the hearing; and
(7) written notice of the right to appeal to district court
or to request reconsideration, and of the actions required and
the time limits for taking appropriate action to appeal to
district court or to request a reconsideration.
(c) [NO INDEPENDENT INVESTIGATION.] The appeals referee
shall not independently investigate facts or otherwise rely on
information not presented at the hearing. The appeals referee
may not contact other agency personnel, except as provided in
subdivision 18. The appeals referee's recommended decision must
be based exclusively on the testimony and evidence presented at
the hearing, and legal arguments presented, and the appeals
referee's research and knowledge of the law.
(d) [RECOMMENDED DECISION.] The commissioner will review
the recommended decision and accept or refuse to accept the
decision according to section 256.045, subdivision 5.
Subd. 23. [REFUSAL TO ACCEPT RECOMMENDED ORDERS.] (a) If
the commissioner refuses to accept the recommended order from
the appeals referee, the person involved, the person's attorney
or authorized representative, and the agency shall be sent a
copy of the recommended order, a detailed explanation of the
basis for refusing to accept the recommended order, and the
proposed modified order.
(b) The person involved and the agency shall have at least
ten business days to respond to the proposed modification of the
recommended order. The person involved and the agency may
submit a legal argument concerning the proposed modification,
and may propose to submit additional evidence that relates to
the proposed modified order.
Subd. 24. [RECONSIDERATION.] Reconsideration may be
requested within 30 days of the date of the commissioner's final
order. If reconsideration is requested, the other participants
in the appeal shall be informed of the request. The person
seeking reconsideration has the burden to demonstrate why the
matter should be reconsidered. The request for reconsideration
may include legal argument and may include proposed additional
evidence supporting the request. The other participants shall
be sent a copy of all material submitted in support of the
request for reconsideration and must be given ten days to
respond.
(a) [FINDINGS OF FACT.] When the requesting party raises a
question as to the appropriateness of the findings of fact, the
commissioner shall review the entire record.
(b) [CONCLUSIONS OF LAW.] When the requesting party
questions the appropriateness of a conclusion of law, the
commissioner shall consider the recommended decision, the
decision under reconsideration, and the material submitted in
connection with the reconsideration. The commissioner shall
review the remaining record as necessary to issue a reconsidered
decision.
(c) [WRITTEN DECISION.] The commissioner shall issue a
written decision on reconsideration in a timely fashion. The
decision must clearly inform the parties that this constitutes
the final administrative decision, advise the participants of
the right to seek judicial review, and the deadline for doing so.
Subd. 25. [ACCESS TO APPEAL DECISIONS.] Appeal decisions
must be maintained in a manner so that the public has ready
access to previous decisions on particular topics, subject to
appropriate procedures for safeguarding names, personal
identifying information, and other private data on the
individual persons involved in the appeal.
Sec. 50. Minnesota Statutes 2002, section 256B.092,
subdivision 5, is amended to read:
Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall
apply for any federal waivers necessary to secure, to the extent
allowed by law, federal financial participation under United
States Code, title 42, sections 1396 et seq., as amended, for
the provision of services to persons who, in the absence of the
services, would need the level of care provided in a regional
treatment center or a community intermediate care facility for
persons with mental retardation or related conditions. The
commissioner may seek amendments to the waivers or apply for
additional waivers under United States Code, title 42, sections
1396 et seq., as amended, to contain costs. The commissioner
shall ensure that payment for the cost of providing home and
community-based alternative services under the federal waiver
plan shall not exceed the cost of intermediate care services
including day training and habilitation services that would have
been provided without the waivered services.
The commissioner shall seek an amendment to the 1915c home
and community-based waiver to allow properly licensed adult
foster care homes to provide residential services to up to five
individuals with mental retardation or a related condition. If
the amendment to the waiver is approved, adult foster care
providers that can accommodate five individuals shall increase
their capacity to five beds, provided the providers continue to
meet all applicable licensing requirements.
(b) The commissioner, in administering home and
community-based waivers for persons with mental retardation and
related conditions, shall ensure that day services for eligible
persons are not provided by the person's residential service
provider, unless the person or the person's legal representative
is offered a choice of providers and agrees in writing to
provision of day services by the residential service provider.
The individual service plan for individuals who choose to have
their residential service provider provide their day services
must describe how health, safety, and protection needs will be
met by frequent and regular contact with persons other than the
residential service provider.
Sec. 51. Minnesota Statutes 2002, section 256B.092, is
amended by adding a subdivision to read:
Subd. 5a. [INCREASING ADULT FOSTER CARE CAPACITY TO SERVE
FIVE PERSONS.] (a) When an adult foster care provider increases
the capacity of an existing home licensed to serve four persons
to serve a fifth person under this section, the county agency
shall reduce the contracted per diem cost for room and board and
the mental retardation or a related condition waiver services of
the existing foster care home by an average of 14 percent for
all individuals living in that home. A county agency may
average the required per diem rate reductions across several
adult foster care homes that expand capacity under this section,
to achieve the necessary overall per diem reduction.
(b) Following the contract changes in paragraph (a), the
commissioner shall adjust:
(1) individual county allocations for mental retardation or
a related condition waivered services by the amount of savings
that results from the changes made for mental retardation or a
related condition waiver recipients for whom the county is
financially responsible; and
(2) group residential housing rate payments to the adult
foster home by the amount of savings that results from the
changes made.
(c) Effective July 1, 2003, when a new five-person adult
foster care home is licensed under this section, county agencies
shall not establish group residential housing room and board
rates and mental retardation or a related condition waiver
service rates for the new home that exceed 86 percent of the
average per diem room and board and mental retardation or a
related condition waiver services costs of four-person homes
serving persons with comparable needs and in the same geographic
area. A county agency developing more than one new five-person
adult foster care home may average the required per diem rates
across the homes to achieve the necessary overall per diem
reductions.
(d) The commissioner shall reduce the individual county
allocations for mental retardation or a related condition
waivered services by the savings resulting from the per diem
limits on adult foster care recipients for whom the county is
financially responsible, and shall limit the group residential
housing rate for a new five-person adult foster care home.
Sec. 52. Minnesota Statutes 2002, section 257.0769, is
amended to read:
257.0769 [FUNDING FOR THE OMBUDSPERSON PROGRAM.]
Subdivision 1. [APPROPRIATIONS.] (a) Money is appropriated
from the special fund authorized by section 256.01, subdivision
2, clause (15), to the Indian affairs council for the purposes
of sections 257.0755 to 257.0768.
(b) Money is appropriated from the special fund authorized
by section 256.01, subdivision 2, clause (15), to the council on
affairs of Chicano/Latino people for the purposes of sections
257.0755 to 257.0768.
(c) Money is appropriated from the special fund authorized
by section 256.01, subdivision 2, clause (15), to the Council of
Black Minnesotans for the purposes of sections 257.0755 to
257.0768.
(d) Money is appropriated from the special fund authorized
by section 256.01, subdivision 2, clause (15), to the Council on
Asian-Pacific Minnesotans for the purposes of sections 257.0755
to 257.0768.
Subd. 2. [TITLE IV-E REIMBURSEMENT.] The commissioner
shall obtain federal title IV-E financial participation for
eligible activity by the ombudsperson for families under section
257.0755. The ombudsperson for families shall maintain and
transmit to the department of human services documentation that
is necessary in order to obtain federal funds.
Sec. 53. Minnesota Statutes 2002, section 259.21,
subdivision 6, is amended to read:
Subd. 6. [AGENCY.] "Agency" means an organization or
department of government designated or authorized by law to
place children for adoption or any person, group of persons,
organization, association or society licensed or certified by
the commissioner of human services to place children for
adoption, including a Minnesota federally recognized tribe.
Sec. 54. Minnesota Statutes 2002, section 259.67,
subdivision 7, is amended to read:
Subd. 7. [REIMBURSEMENT OF COSTS.] (a) Subject to rules of
the commissioner, and the provisions of this subdivision a
child-placing agency licensed in Minnesota or any other state,
or local or tribal social services agency shall receive a
reimbursement from the commissioner equal to 100 percent of the
reasonable and appropriate cost of providing adoption services
for a child certified as eligible for adoption assistance under
subdivision 4. Such assistance may include adoptive family
recruitment, counseling, and special training when needed. A
child-placing agency licensed in Minnesota or any other state
shall receive reimbursement for adoption services it purchases
for or directly provides to an eligible child. A local or
tribal social services agency shall receive such reimbursement
only for adoption services it purchases for an eligible child.
(b) A child-placing agency licensed in Minnesota or any
other state or local or tribal social services agency seeking
reimbursement under this subdivision shall enter into a
reimbursement agreement with the commissioner before providing
adoption services for which reimbursement is sought. No
reimbursement under this subdivision shall be made to an agency
for services provided prior to entering a reimbursement
agreement. Separate reimbursement agreements shall be made for
each child and separate records shall be kept on each child for
whom a reimbursement agreement is made. Funds encumbered and
obligated under such an agreement for the child remain available
until the terms of the agreement are fulfilled or the agreement
is terminated.
(c) When a local or tribal social services agency uses a
purchase of service agreement to provide services reimbursable
under a reimbursement agreement, the commissioner may make
reimbursement payments directly to the agency providing the
service if direct reimbursement is specified by the purchase of
service agreement, and if the request for reimbursement is
submitted by the local or tribal social services agency along
with a verification that the service was provided.
Sec. 55. Minnesota Statutes 2002, section 393.07,
subdivision 1, is amended to read:
Subdivision 1. [PUBLIC CHILD WELFARE PROGRAM.] (a) To
assist in carrying out the child protection, delinquency
prevention and family assistance responsibilities of the state,
the local social services agency shall administer a program of
social services and financial assistance to be known as the
public child welfare program. The public child welfare program
shall be supervised by the commissioner of human services and
administered by the local social services agency in accordance
with law and with rules of the commissioner.
(b) The purpose of the public child welfare program is to
assure protection for and financial assistance to children who
are confronted with social, physical, or emotional problems
requiring protection and assistance. These problems include,
but are not limited to the following:
(1) mental, emotional, or physical handicap;
(2) birth of a child to a mother who was not married to the
child's father when the child was conceived nor when the child
was born, including but not limited to costs of prenatal care,
confinement and other care necessary for the protection of a
child born to a mother who was not married to the child's father
at the time of the child's conception nor at the birth;
(3) dependency, neglect;
(4) delinquency;
(5) abuse or rejection of a child by its parents;
(6) absence of a parent or guardian able and willing to
provide needed care and supervision;
(7) need of parents for assistance with child rearing
problems, or in placing the child in foster care.
(c) A local social services agency shall make the services
of its public child welfare program available as required by
law, by the commissioner, or by the courts and shall cooperate
with other agencies, public or private, dealing with the
problems of children and their parents as provided in this
subdivision.
The public child welfare program shall be available in
divorce cases for investigations of children and home conditions
and for supervision of children when directed by the court
hearing the divorce.
(d) A local social services agency may rent, lease, or
purchase property, or in any other way approved by the
commissioner, contract with individuals or agencies to provide
needed facilities for foster care of children. It may purchase
services or child care from duly authorized individuals,
agencies or institutions when in its judgment the needs of a
child or the child's family can best be met in this way.
Sec. 56. Minnesota Statutes 2002, section 393.07,
subdivision 5, is amended to read:
Subd. 5. [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT;
MERIT SYSTEM.] The commissioner of human services shall have
authority to require such methods of administration as are
necessary for compliance with requirements of the federal Social
Security Act, as amended, and for the proper and efficient
operation of all welfare programs. This authority to require
methods of administration includes methods relating to the
establishment and maintenance of personnel standards on a merit
basis as concerns all employees of local social services
agencies except those employed in an institution, sanitarium, or
hospital. The commissioner of human services shall exercise no
authority with respect to the selection, tenure of office, and
compensation of any individual employed in accordance with such
methods. The adoption of methods relating to the establishment
and maintenance of personnel standards on a merit basis of all
such employees of the local social services agencies and the
examination thereof, and the administration thereof shall be
directed and controlled exclusively by the commissioner of human
services.
Notwithstanding the provisions of any other law to the
contrary, every employee of every local social services agency
who occupies a position which requires as prerequisite to
eligibility therefor graduation from an accredited four year
college or a certificate of registration as a registered nurse
under section 148.231, must be employed in such position under
the merit system established under authority of this
subdivision. Every such employee now employed by a local social
services agency and who is not under said merit system is
transferred, as of January 1, 1962, to a position of comparable
classification in the merit system with the same status therein
as the employee had in the county of employment prior thereto
and every such employee shall be subject to and have the benefit
of the merit system, including seniority within the local social
services agency, as though the employee had served thereunder
from the date of entry into the service of the local social
services agency.
By March 1, 1996, the commissioner of human services shall
report to the chair of the senate health care and family
services finance division and the chair of the house health and
human services finance division on options for the delivery of
merit-based employment services by entities other than the
department of human services in order to reduce the
administrative costs to the state while maintaining compliance
with applicable federal regulations.
Sec. 57. Minnesota Statutes 2002, section 518.167,
subdivision 1, is amended to read:
Subdivision 1. [COURT ORDER.] In contested custody
proceedings, and in other custody proceedings if a parent or the
child's custodian requests, the court may order an investigation
and report concerning custodial arrangements for the child. If
the county elects to conduct an investigation, the county may
charge a fee. The investigation and report may be made by the
county welfare agency or department of court services.
Sec. 58. Minnesota Statutes 2002, section 518.551,
subdivision 7, is amended to read:
Subd. 7. [SERVICE FEE FEES AND COST RECOVERY FEES FOR IV-D
SERVICES.] When the public agency responsible for child support
enforcement provides child support collection services either to
a public assistance recipient or to a party who does not receive
public assistance, the public agency may upon written notice to
the obligor charge a monthly collection fee equivalent to the
full monthly cost to the county of providing collection
services, in addition to the amount of the child support which
was ordered by the court. The fee shall be deposited in the
county general fund. The service fee assessed is limited to ten
percent of the monthly court ordered child support and shall not
be assessed to obligors who are current in payment of the
monthly court ordered child support. (a) When a recipient of
IV-D services is no longer receiving assistance under the
state's title IV-A, IV-E foster care, medical assistance, or
MinnesotaCare programs, the public authority responsible for
child support enforcement must notify the recipient, within five
working days of the notification of ineligibility, that IV-D
services will be continued unless the public authority is
notified to the contrary by the recipient. The notice must
include the implications of continuing to receive IV-D services,
including the available services and fees, cost recovery fees,
and distribution policies relating to fees.
(b) An application fee of $25 shall be paid by the person
who applies for child support and maintenance collection
services, except persons who are receiving public assistance as
defined in section 256.741 and, if enacted, the diversionary
work program under section 256J.95, persons who transfer from
public assistance to nonpublic assistance status, and minor
parents and parents enrolled in a public secondary school, area
learning center, or alternative learning program approved by the
commissioner of children, families, and learning.
(c) When the public authority provides full IV-D services
to an obligee who has applied for those services, upon written
notice to the obligee, the public authority must charge a cost
recovery fee of one percent of the amount collected. This fee
must be deducted from the amount of the child support and
maintenance collected and not assigned under section 256.741,
before disbursement to the obligee. This fee does not apply to
an obligee who:
(1) is currently receiving assistance under the state's
title IV-A, IV-E foster care, medical assistance, or
MinnesotaCare programs; or
(2) has received assistance under the state's title IV-A or
IV-E foster care programs, until the person has not received
this assistance for 24 consecutive months.
(d) When the public authority provides full IV-D services
to an obligor who has applied for such services, upon written
notice to the obligor, the public authority must charge a cost
recovery fee of one percent of the monthly court ordered child
support and maintenance obligation. The fee may be collected
through income withholding, as well as by any other enforcement
remedy available to the public authority responsible for child
support enforcement.
(e) Fees assessed by state and federal tax agencies for
collection of overdue support owed to or on behalf of a person
not receiving public assistance must be imposed on the person
for whom these services are provided. The public authority upon
written notice to the obligee shall assess a fee of $25 to the
person not receiving public assistance for each successful
federal tax interception. The fee must be withheld prior to the
release of the funds received from each interception and
deposited in the general fund.
(f) Cost recovery fees collected under paragraphs (c) and
(d) shall be considered child support program income according
to Code of Federal Regulations, title 45, section 304.50, and
shall be deposited in the cost recovery fee account established
under paragraph (h). The commissioner of human services must
elect to recover costs based on either actual or standardized
costs.
However, (g) The limitations of this subdivision on the
assessment of fees shall not apply to the extent inconsistent
with the requirements of federal law for receiving funds for the
programs under Title IV-A and Title IV-D of the Social Security
Act, United States Code, title 42, sections 601 to 613 and
United States Code, title 42, sections 651 to 662.
(h) The commissioner of human services is authorized to
establish a special revenue fund account to receive child
support cost recovery fees. A portion of the nonfederal share
of these fees may be retained for expenditures necessary to
administer the fee, and must be transferred to the child support
system special revenue account. The remaining nonfederal share
of the cost recovery fee must be retained by the commissioner
and dedicated to the child support general fund county
performance based grant account authorized under sections
256.979 and 256.9791.
[EFFECTIVE DATE.] This section is effective July 1, 2004,
except paragraph (d) is effective July 1, 2005.
Sec. 59. Minnesota Statutes 2002, section 518.6111,
subdivision 2, is amended to read:
Subd. 2. [APPLICATION.] This section applies to all
support orders issued by a court or an administrative tribunal
and orders for or notices of withholding issued by the public
authority according to section 518.5513, subdivision 5,
paragraph (a), clause (5).
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 60. Minnesota Statutes 2002, section 518.6111,
subdivision 3, is amended to read:
Subd. 3. [ORDER.] Every support order must address income
withholding. Whenever a support order is initially entered or
modified, the full amount of the support order must be
withheld subject to income withholding from the income of the
obligor. If the obligee or obligor applies for either full IV-D
services or for income withholding only services from the public
authority responsible for child support enforcement, the full
amount of the support order must be withheld from the income of
the obligor and forwarded to the public authority. Every order
for support or maintenance shall provide for a conspicuous
notice of the provisions of this section that complies with
section 518.68, subdivision 2. An order without this notice
remains subject to this section. This section applies
regardless of the source of income of the person obligated to
pay the support or maintenance.
A payor of funds shall implement income withholding
according to this section upon receipt of an order for or notice
of withholding. The notice of withholding shall be on a form
provided by the commissioner of human services.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 61. Minnesota Statutes 2002, section 518.6111,
subdivision 4, is amended to read:
Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of
human services shall prepare and make available to the courts a
notice of services that explains child support and maintenance
collection services available through the public authority,
including income withholding, and the fees for such services.
Upon receiving a petition for dissolution of marriage or legal
separation, the court administrator shall promptly send the
notice of services to the petitioner and respondent at the
addresses stated in the petition.
(b) Either the obligee or obligor may at any time apply to
the public authority for either full IV-D services or for income
withholding only services.
Upon receipt of a support order requiring income
withholding, a petitioner or respondent, who is not a recipient
of public assistance and does not receive child support services
from the public authority, shall apply to the public authority
for either full child support collection services or for income
withholding only services.
(c) For those persons applying for income withholding only
services, a monthly service fee of $15 must be charged to the
obligor. This fee is in addition to the amount of the support
order and shall be withheld through income withholding. The
public authority shall explain the service options in this
section to the affected parties and encourage the application
for full child support collection services.
(d) If the obligee is not a current recipient of public
assistance as defined in section 256.741, the person who applied
for services may at any time choose to terminate either full
IV-D services or income withholding only services regardless of
whether income withholding is currently in place. The obligee
or obligor may reapply for either full IV-D services or income
withholding only services at any time. Unless the applicant is
a recipient of public assistance as defined in section 256.741,
a $25 application fee shall be charged at the time of each
application.
(e) When a person terminates IV-D services, if an arrearage
for public assistance as defined in section 256.741 exists, the
public authority may continue income withholding, as well as use
any other enforcement remedy for the collection of child
support, until all public assistance arrears are paid in full.
Income withholding shall be in an amount equal to 20 percent of
the support order in effect at the time the services terminated.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 62. Minnesota Statutes 2002, section 518.6111,
subdivision 16, is amended to read:
Subd. 16. [WAIVER.] (a) If the public authority is
providing child support and maintenance enforcement services and
child support or maintenance is not assigned under section
256.741, the court may waive the requirements of this section if
the court finds there is no arrearage in child support and
maintenance as of the date of the hearing and:
(1) one party demonstrates and the court finds determines
there is good cause to waive the requirements of this section or
to terminate an order for or notice of income withholding
previously entered under this section. The court must make
written findings to include the reasons income withholding would
not be in the best interests of the child. In cases involving a
modification of support, the court must also make a finding that
support payments have been timely made; or
(2) all parties reach an the obligee and obligor sign a
written agreement and the agreement providing for an alternative
payment arrangement which is approved reviewed and entered in
the record by the court after a finding that the agreement is
likely to result in regular and timely payments. The court's
findings waiving the requirements of this paragraph shall
include a written explanation of the reasons why income
withholding would not be in the best interests of the child.
In addition to the other requirements in this subdivision,
if the case involves a modification of support, the court shall
make a finding that support has been timely made.
(b) If the public authority is not providing child support
and maintenance enforcement services and child support or
maintenance is not assigned under section 256.741, the court may
waive the requirements of this section if the parties sign a
written agreement.
(c) If the court waives income withholding, the obligee or
obligor may at any time request income withholding under
subdivision 7.
[EFFECTIVE DATE.] This section is effective July 1, 2004.
Sec. 63. [STATE-OPERATED SERVICES STUDY.]
The commissioner of human services shall study the services
provided to persons with developmental disabilities who have
complex care needs. The commissioner shall analyze:
(1) the needs of the target population;
(2) the methods of providing services to the target
population;
(3) the costs and cost-effectiveness of providing services
to the target population;
(4) factors that encourage and inhibit vendors, including
state-operated community services (SOCS), to provide services to
the target population;
(5) alternative populations that could be served by
state-operated residential facilities; and
(6) the population served by Minnesota extended treatment
options and the cost-effectiveness of these services.
The commissioner shall report on the results of the study
under this section to the chairs of the house and senate
committees with jurisdiction over state-operated services by
January 15, 2004.
Sec. 64. [STATE-OPERATED SERVICES REFINANCING STRATEGY.]
Subdivision 1. [REDESIGN OF MENTAL HEALTH SAFETY NET.] (a)
Pursuant to Minnesota Statutes, sections 246.0135, 251.011, and
251.013, the commissioner of human services must seek specific
legislative authorization to close any regional treatment center
or state-operated nursing home or any program at a regional
treatment center or state-operated nursing home.
(b) In developing and seeking legislative authorization for
any proposals to restructure state-operated services under this
subdivision, the commissioner must consider:
(1) the needs and preferences of the individuals served by
affected state-operated services programs and their families;
(2) the location of necessary support services, as
identified in the service or treatment plans of individuals
served by affected state-operated services programs;
(3) the appropriate grouping of individuals served by a
community-based state-operated services program;
(4) the availability of qualified staff to provide services
in community-based state-operated services programs;
(5) the need for state-operated services programs in
certain geographical regions in the state; and
(6) whether commuting distance to the program for staff and
families is reasonable.
(c) The commissioner's proposals to close a regional
treatment center, state-operated nursing home or program
operated by a regional treatment center or state-operated
nursing home under this subdivision must not result in a net
reduction in the total number of services in any catchment area
in the state and must ensure that any new community-based
programs are located in areas that are convenient to the
individuals receiving services and their families.
(d) Legislative authorization as required by Minnesota
Statutes, sections 246.0135, 251.011, and 251.013, shall mean
language specifically authorizing the commissioner's proposals,
the authorization to transfer land on which a regional treatment
center is located to a nonstate entity, or the authorization to
demolish buildings in which programs are or were housed.
Subd. 2. [REDEVELOPMENT PLAN.] (a) In closing any regional
treatment center or state-operated nursing home, the
commissioner shall develop or aid in the development of a
comprehensive redevelopment plan for any facilities or land
vacated as a result of the proposal in consultation with the
local governmental entity in the jurisdiction in which the
facility is located. If a local government entity cannot be
secured for facility redevelopment, then the commissioner shall
develop the plan in collaboration with affected communities.
The plan must include specific information on the redevelopment
of the affected facilities or land, specific information about
the implementation schedule for the plan, proposed legislation,
and letters of commitment regarding the reuse and redevelopment
of the facilities or land vacated as a result of the proposal.
(b) The commissioner shall not implement a redevelopment
plan under this subdivision until a local governmental entity in
which any regional treatment center is located that is affected
by the commissioner's redevelopment plan approves the plan.
Subd. 3. [STAFFING.] When closing or restructuring a
regional treatment center or state-operated nursing home or a
program at a regional treatment center or state-operated nursing
home, the commissioner shall comply with the provisions of the
applicable collective bargaining agreements or future negotiated
agreements, and the agreement authorized under Minnesota
Statutes, section 252.50, subdivision 11.
Subd. 4. [STATE-OPERATED SERVICES COSTS.] (a) Programs
that remain at a regional treatment center campus during and
after the restructuring of state-operated services shall not be
assessed any disproportional increase in fees, charges, or other
costs associated with operating and maintaining the campus.
Increased costs associated with inflation are permissible.
(b) There shall be no increase in the county share of the
cost of care provided in state-operated services without
legislative authority.
Subd. 5. [REQUEST FOR FEDERAL WAIVER.] By January 1, 2004,
the commissioner of human services shall apply to the federal
government for a waiver from Medicaid requirements to permit
medical assistance coverage for:
(1) mental health treatment services provided by an
existing program located at a regional treatment center with a
capacity of more than 15 beds; and
(2) mental health treatment services provided by a new
program at a facility with a capacity of more than 15 beds.
Sec. 65. [FEDERAL GRANTS TO MAINTAIN INDEPENDENCE AND
EMPLOYMENT.]
(a) The commissioner of human services shall seek federal
funding to participate in grant activities authorized under
Public Law 106-170, the Ticket to Work and Work Incentives
Improvement Act of 1999. The purpose of the federal grant funds
are to establish:
(1) a demonstration project to improve the availability of
health care services and benefits to workers with potentially
severe physical or mental impairments that are likely to lead to
disability without access to Medicaid services; and
(2) a comprehensive initiative to remove employment
barriers that includes linkages with non-Medicaid programs,
including those administered by the Social Security
Administration and the Department of Labor.
(b) The state's proposal for a demonstration project in
paragraph (a), clause (1), shall focus on assisting workers with:
(1) a serious mental illness as defined by the federal
Center for Mental Health Services;
(2) concurrent mental health and chemical dependency
conditions; and
(3) young adults up to the age of 24 who have a physical or
mental impairment that is severe and will potentially lead to a
determination of disability by the Social Security
Administration or state medical review team.
(c) The commissioner is authorized to take the actions
necessary to design and implement the demonstration project in
paragraph (a), clause (1), that include:
(1) establishing work-related requirements for
participation in the demonstration project;
(2) working with stakeholders to establish methods that
identify the population that will be served in the demonstration
project;
(3) seeking funding for activities to design, implement,
and evaluate the demonstration project;
(4) taking necessary administrative actions to implement
the demonstration project by July 1, 2004, or within 180 days of
receiving formal notice from the Centers for Medicare and
Medicaid Services that a grant has been awarded;
(5) establishing limits on income and resources;
(6) establishing a method to coordinate health care
benefits and payments with other coverage that is available to
the participants;
(7) establishing premiums based on guidelines that are
consistent with those found in Minnesota Statutes, section
256B.057, subdivision 9, for employed persons with disabilities;
(8) notifying local agencies of potentially eligible
individuals in accordance with Minnesota Statutes, section
256B.19, subdivision 2c; and
(9) limiting the caseload of qualifying individuals
participating in the demonstration project.
(d) The state's proposal for the comprehensive employment
initiative in paragraph (a), clause (2), shall focus on:
(1) infrastructure development that creates incentives for
greater work effort and participation by people with
disabilities or workers with severe physical or mental
impairments;
(2) consumer access to information and benefit assistance
that enables the person to maximize employment and career
advancement potential;
(3) improved consumer access to essential assistance and
support;
(4) enhanced linkages between state and federal agencies to
decrease the barriers to employment experienced by persons with
disabilities or workers with severe physical or mental
impairments; and
(5) research efforts to provide useful information to guide
future policy development on both the state and federal levels.
(e) Funds awarded by the federal government for the
purposes of this section are appropriated to the commissioner of
human services.
(f) The commissioner shall report to the chairs of the
senate and house of representatives finance divisions having
jurisdiction over health care issues on the federal approval of
the waiver under this section and the projected savings in the
November and February forecasts.
The commissioner must consider using the savings to
increase GAMC hospital rates to the July 1, 2003, levels as a
supplemental budget proposal in the 2004 legislative session.
Sec. 66. [CONVEYANCE OF SURPLUS STATE LAND; CASS COUNTY.]
(a) Notwithstanding Minnesota Statutes, chapter 94, or
other law, administrative rule, or commissioner's order to the
contrary, the commissioner of administration may convey to Cass
county or a regional jail authority for no consideration all the
buildings and land that are described in paragraph (c), except
the land described in paragraph (d).
(b) The conveyance shall be in a form approved by the
attorney general and subject to Minnesota Statutes, section
16A.695. The commissioner of administration shall have a
registered land surveyor prepare a legal description of the
property to be conveyed. The attorney general may make
necessary changes in the legal description to correct errors and
ensure accuracy.
(c) The land and buildings of the Ah-Gwah-Ching property
that may be conveyed to Cass county or a regional jail authority
are located in that part of the South Half, Section 35, Township
142 North, Range 31 West and that part of Government Lot 6,
Section 2, Township 141 North, Range 31 West, in Cass county,
depicted on the certificate of survey prepared by Landecker and
Associates, Inc. dated April 25, 2002. The land described in
paragraph (d) is excepted from the conveyance.
(d) That portion of the Ah-Gwah-Ching property to be
excepted from the conveyance to Cass county or a regional jail
authority is the land located between the shoreline and the top
of the bluff line and is approximately described as follows:
(1) all that part of the Southeast Quarter of Southwest
Quarter, Section 35, Township 142 North, Range 31 West, lying
southeasterly of a line that lies 450 feet southeasterly of and
parallel with Minnesota Highway No. 290;
(2) Government Lot 4, Section 35, Township 142 North, Range
31 West;
(3) that part of Government Lot 3, Section 35, Township 142
North, Range 31 West, lying southerly of Minnesota Highway No.
290 and westerly of Minnesota Highway No. 371; and
(4) that part of Government Lot 6, Section 2, Township 141
North, Range 31 West, lying southeasterly of the 1,410 foot
contour.
The commissioner of administration shall determine the exact
legal description upon further site analysis and the preparation
of the surveyor's legal description described in paragraph (b).
(e) Notwithstanding anything herein to the contrary, a
conveyance under this section to Cass county or a regional jail
authority may include a conveyance by a bill of sale of the
water treatment facilities located within the land described in
paragraph (d) and a nonexclusive appurtenant easement for such
facilities over the land upon which such facilities are located,
including ingress and egress as determined by the commissioner.
The easement shall be in a form approved by the attorney general.
(f) At the option of the state, Cass county or the regional
jail authority must, for a period of at least two years, allow
the state to lease the space necessary to operate its programs
for the cost of utilities for the leased space. During the term
of the lease, the state shall be responsible for any and all
maintenance and repairs the state determines are necessary for
its use of the leased space.
Sec. 67. [REVISOR'S INSTRUCTION.]
For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 68. [REPEALER.]
(a) Minnesota Statutes 2002, sections 246.017, subdivision
2; 246.022; 246.06; 246.07; 246.08; 246.11; 246.19; 246.42;
252.025, subdivisions 1, 2, 4, 5, and 6; 252.032; 252.10;
253.015, subdivisions 2 and 3; 253.10; 253.19; 253.201; 253.202;
253.25; 253.27; 256.05; 256.06; 256.08; 256.09; 256.10; and
268A.08, are repealed.
(b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020;
9545.2030; and 9545.2040, are repealed.
ARTICLE 7
HEALTH MISCELLANEOUS
Section 1. Minnesota Statutes 2002, section 41A.09,
subdivision 2a, is amended to read:
Subd. 2a. [DEFINITIONS.] For the purposes of this section,
the terms defined in this subdivision have the meanings given
them.
(a) "Ethanol" means fermentation ethyl alcohol derived from
agricultural products, including potatoes, cereal, grains,
cheese whey, and sugar beets; forest products; or other
renewable resources, including residue and waste generated from
the production, processing, and marketing of agricultural
products, forest products, and other renewable resources, that:
(1) meets all of the specifications in ASTM specification D
4806-88 D4806-01; and
(2) is denatured as specified in Code of Federal
Regulations, title 27, parts 20 and 21.
(b) "Wet alcohol" means agriculturally derived fermentation
ethyl alcohol having a purity of at least 50 percent but less
than 99 percent.
(c) "Anhydrous alcohol" means fermentation ethyl alcohol
derived from agricultural products as described in paragraph
(a), but that does not meet ASTM specifications or is not
denatured and is shipped in bond for further processing.
(d) "Ethanol plant" means a plant at which ethanol,
anhydrous alcohol, or wet alcohol is produced.
Sec. 2. Minnesota Statutes 2002, section 62A.31,
subdivision 1f, is amended to read:
Subd. 1f. [SUSPENSION BASED ON ENTITLEMENT TO MEDICAL
ASSISTANCE.] (a) The policy or certificate must provide that
benefits and premiums under the policy or certificate shall be
suspended for any period that may be provided by federal
regulation at the request of the policyholder or certificate
holder for the period, not to exceed 24 months, in which the
policyholder or certificate holder has applied for and is
determined to be entitled to medical assistance under title XIX
of the Social Security Act, but only if the policyholder or
certificate holder notifies the issuer of the policy or
certificate within 90 days after the date the individual becomes
entitled to this assistance.
(b) If suspension occurs and if the policyholder or
certificate holder loses entitlement to this medical assistance,
the policy or certificate shall be automatically reinstated,
effective as of the date of termination of this entitlement, if
the policyholder or certificate holder provides notice of loss
of the entitlement within 90 days after the date of the loss and
pays the premium attributable to the period, effective as of the
date of termination of entitlement.
(c) The policy must provide that upon reinstatement (1)
there is no additional waiting period with respect to treatment
of preexisting conditions, (2) coverage is provided which is
substantially equivalent to coverage in effect before the date
of the suspension, and (3) premiums are classified on terms that
are at least as favorable to the policyholder or certificate
holder as the premium classification terms that would have
applied to the policyholder or certificate holder had coverage
not been suspended.
Sec. 3. Minnesota Statutes 2002, section 62A.31,
subdivision 1u, is amended to read:
Subd. 1u. [GUARANTEED ISSUE FOR ELIGIBLE PERSONS.] (a)(1)
Eligible persons are those individuals described in paragraph
(b) who apply to enroll under the Medicare supplement policy not
later than 63 days after the date of the termination of
enrollment described in paragraph (b), seek to enroll under the
policy during the period specified in paragraph (c), and who
submit evidence of the date of termination or disenrollment with
the application for a Medicare supplement policy.
(2) With respect to eligible persons, an issuer shall not:
deny or condition the issuance or effectiveness of a Medicare
supplement policy described in paragraph (c) that is offered and
is available for issuance to new enrollees by the issuer;
discriminate in the pricing of such a Medicare supplement policy
because of health status, claims experience, receipt of health
care, medical condition, or age; or impose an exclusion of
benefits based upon a preexisting condition under such a
Medicare supplement policy.
(b) An eligible person is an individual described in any of
the following:
(1) the individual is enrolled under an employee welfare
benefit plan that provides health benefits that supplement the
benefits under Medicare; and the plan terminates, or the plan
ceases to provide all such supplemental health benefits to the
individual;
(2) the individual is enrolled with a Medicare+Choice
organization under a Medicare+Choice plan under Medicare part C,
and any of the following circumstances apply, or the individual
is 65 years of age or older and is enrolled with a Program of
All-Inclusive Care for the Elderly (PACE) provider under section
1894 of the federal Social Security Act, and there are
circumstances similar to those described in this clause that
would permit discontinuance of the individual's enrollment with
the provider if the individual were enrolled in a
Medicare+Choice plan:
(i) the organization's or plan's certification under
Medicare part C has been terminated or the organization has
terminated or otherwise discontinued providing the plan in the
area in which the individual resides;
(ii) the individual is no longer eligible to elect the plan
because of a change in the individual's place of residence or
other change in circumstances specified by the secretary, but
not including termination of the individual's enrollment on the
basis described in section 1851(g)(3)(B) of the federal Social
Security Act, United States Code, title 42, section
1395w-21(g)(3)(b) (where the individual has not paid premiums on
a timely basis or has engaged in disruptive behavior as
specified in standards under section 1856 of the federal Social
Security Act, United States Code, title 42, section 1395w-26),
or the plan is terminated for all individuals within a residence
area;
(iii) the individual demonstrates, in accordance with
guidelines established by the Secretary, that:
(A) the organization offering the plan substantially
violated a material provision of the organization's contract in
relation to the individual, including the failure to provide an
enrollee on a timely basis medically necessary care for which
benefits are available under the plan or the failure to provide
such covered care in accordance with applicable quality
standards; or
(B) the organization, or agent or other entity acting on
the organization's behalf, materially misrepresented the plan's
provisions in marketing the plan to the individual; or
(iv) the individual meets such other exceptional conditions
as the secretary may provide;
(3)(i) the individual is enrolled with:
(A) an eligible organization under a contract under section
1876 of the federal Social Security Act, United States Code,
title 42, section 1395mm (Medicare risk or cost);
(B) a similar organization operating under demonstration
project authority, effective for periods before April 1, 1999;
(C) an organization under an agreement under section
1833(a)(1)(A) of the federal Social Security Act, United States
Code, title 42, section 1395l(a)(1)(A) (health care prepayment
plan); or
(D) an organization under a Medicare Select policy under
section 62A.318 or the similar law of another state; and
(ii) the enrollment ceases under the same circumstances
that would permit discontinuance of an individual's election of
coverage under clause (2);
(4) the individual is enrolled under a Medicare supplement
policy, and the enrollment ceases because:
(i)(A) of the insolvency of the issuer or bankruptcy of the
nonissuer organization; or
(B) of other involuntary termination of coverage or
enrollment under the policy;
(ii) the issuer of the policy substantially violated a
material provision of the policy; or
(iii) the issuer, or an agent or other entity acting on the
issuer's behalf, materially misrepresented the policy's
provisions in marketing the policy to the individual;
(5)(i) the individual was enrolled under a Medicare
supplement policy and terminates that enrollment and
subsequently enrolls, for the first time, with any
Medicare+Choice organization under a Medicare+Choice plan under
Medicare part C; any eligible organization under a contract
under section 1876 of the federal Social Security Act, United
States Code, title 42, section 1395mm (Medicare risk or cost);
any similar organization operating under demonstration project
authority; an organization under an agreement under section
1833(a)(1)(A) of the federal Social Security Act, United States
Code, title 42, section 1395l(a)(1)(A) (health care prepayment
plan); any PACE provider under section 1894 of the federal
Social Security Act, or a Medicare Select policy under section
62A.318 or the similar law of another state; and
(ii) the subsequent enrollment under paragraph (a) item (i)
is terminated by the enrollee during any period within the first
12 months of such the subsequent enrollment during which the
enrollee is permitted to terminate the subsequent enrollment
under section 1851(e) of the federal Social Security Act; or
(6) the individual, upon first enrolling for benefits under
Medicare part B, enrolls in a Medicare+Choice plan under
Medicare part C, or with a PACE provider under section 1894 of
the federal Social Security Act, and disenrolls from the plan by
not later than 12 months after the effective date of enrollment.
(c)(1) In the case of an individual described in paragraph
(b), clause (1), the guaranteed issue period begins on the date
the individual receives a notice of termination or cessation of
all supplemental health benefits or, if a notice is not
received, notice that a claim has been denied because of a
termination or cessation, and ends 63 days after the date of the
applicable notice.
(2) In the case of an individual described in paragraph
(b), clause (2), (3), (5), or (6), whose enrollment is
terminated involuntarily, the guaranteed issue period begins on
the date that the individual receives a notice of termination
and ends 63 days after the date the applicable coverage is
terminated.
(3) In the case of an individual described in paragraph
(b), clause (4), item (i), the guaranteed issue period begins on
the earlier of: (i) the date that the individual receives a
notice of termination, a notice of the issuer's bankruptcy or
insolvency, or other such similar notice if any; and (ii) the
date that the applicable coverage is terminated, and ends on the
date that is 63 days after the date the coverage is terminated.
(4) In the case of an individual described in paragraph
(b), clause (2), (4), (5), or (6), who disenrolls voluntarily,
the guaranteed issue period begins on the date that is 60 days
before the effective date of the disenrollment and ends on the
date that is 63 days after the effective date.
(5) In the case of an individual described in paragraph (b)
but not described in this paragraph, the guaranteed issue period
begins on the effective date of disenrollment and ends on the
date that is 63 days after the effective date.
(d)(1) In the case of an individual described in paragraph
(b), clause (5), or deemed to be so described, pursuant to this
paragraph, whose enrollment with an organization or provider
described in paragraph (b), clause (5), item (i), is
involuntarily terminated within the first 12 months of
enrollment, and who, without an intervening enrollment, enrolls
with another such organization or provider, the subsequent
enrollment is deemed to be an initial enrollment described in
paragraph (b), clause (5).
(2) In the case of an individual described in paragraph
(b), clause (6), or deemed to be so described, pursuant to this
paragraph, whose enrollment with a plan or in a program
described in paragraph (b), clause (6), is involuntarily
terminated within the first 12 months of enrollment, and who,
without an intervening enrollment, enrolls in another such plan
or program, the subsequent enrollment is deemed to be an initial
enrollment described in paragraph (b), clause (6).
(3) For purposes of paragraph (b), clauses (5) and (6), no
enrollment of an individual with an organization or provider
described in paragraph (b), clause (5), item (i), or with a plan
or in a program described in paragraph (b), clause (6), may be
deemed to be an initial enrollment under this paragraph after
the two-year period beginning on the date on which the
individual first enrolled with the organization, provider, plan,
or program.
(e) The Medicare supplement policy to which eligible
persons are entitled under:
(1) paragraph (b), clauses (1) to (4), is any Medicare
supplement policy that has a benefit package consisting of the
basic Medicare supplement plan described in section 62A.316,
paragraph (a), plus any combination of the three optional riders
described in section 62A.316, paragraph (b), clauses (1) to (3),
offered by any issuer;
(2) paragraph (b), clause (5), is the same Medicare
supplement policy in which the individual was most recently
previously enrolled, if available from the same issuer, or, if
not so available, any policy described in clause (1) offered by
any issuer;
(3) paragraph (b), clause (6), shall include any Medicare
supplement policy offered by any issuer.
(d) (f)(1) At the time of an event described in paragraph
(b), because of which an individual loses coverage or benefits
due to the termination of a contract or agreement, policy, or
plan, the organization that terminates the contract or
agreement, the issuer terminating the policy, or the
administrator of the plan being terminated, respectively, shall
notify the individual of the individual's rights under this
subdivision, and of the obligations of issuers of Medicare
supplement policies under paragraph (a). The notice must be
communicated contemporaneously with the notification of
termination.
(2) At the time of an event described in paragraph (b),
because of which an individual ceases enrollment under a
contract or agreement, policy, or plan, the organization that
offers the contract or agreement, regardless of the basis for
the cessation of enrollment, the issuer offering the policy, or
the administrator of the plan, respectively, shall notify the
individual of the individual's rights under this subdivision,
and of the obligations of issuers of Medicare supplement
policies under paragraph (a). The notice must be communicated
within ten working days of the issuer receiving notification of
disenrollment.
(e) (g) Reference in this subdivision to a situation in
which, or to a basis upon which, an individual's coverage has
been terminated does not provide authority under the laws of
this state for the termination in that situation or upon that
basis.
(f) (h) An individual's rights under this subdivision are
in addition to, and do not modify or limit, the individual's
rights under subdivision 1h.
Sec. 4. Minnesota Statutes 2002, section 62A.31, is
amended by adding a subdivision to read:
Subd. 7. [MEDICARE PRESCRIPTION DRUG BENEFIT.] If Congress
enacts legislation creating a prescription drug benefit in the
Medicare program, nothing in this section or any other section
shall prohibit an issuer of a Medicare supplement policy from
offering this prescription drug benefit consistent with the
applicable federal law or regulations. If an issuer offers the
federal benefit, such an offer shall be deemed to meet the
issuer's mandatory offer obligations under this section and may,
at the discretion of the issuer, constitute replacement coverage
as defined in subdivision 1i for any existing policy containing
a prescription drug benefit.
Sec. 5. Minnesota Statutes 2002, section 62A.315, is
amended to read:
62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN;
COVERAGE.]
The extended basic Medicare supplement plan must have a
level of coverage so that it will be certified as a qualified
plan pursuant to section 62E.07, and will provide:
(1) coverage for all of the Medicare part A inpatient
hospital deductible and coinsurance amounts, and 100 percent of
all Medicare part A eligible expenses for hospitalization not
covered by Medicare;
(2) coverage for the daily copayment amount of Medicare
part A eligible expenses for the calendar year incurred for
skilled nursing facility care;
(3) coverage for the copayment coinsurance amount or in the
case of hospital outpatient department services paid under a
prospective payment system, the co-payment amount, of Medicare
eligible expenses under Medicare part B regardless of hospital
confinement, and the Medicare part B deductible amount;
(4) 80 percent of the usual and customary hospital and
medical expenses and supplies described in section 62E.06,
subdivision 1, not to exceed any charge limitation established
by the Medicare program or state law, the usual and customary
hospital and medical expenses and supplies, described in section
62E.06, subdivision 1, while in a foreign country, and
prescription drug expenses, not covered by Medicare;
(5) coverage for the reasonable cost of the first three
pints of blood, or equivalent quantities of packed red blood
cells as defined under federal regulations under Medicare parts
A and B, unless replaced in accordance with federal regulations;
(6) 100 percent of the cost of immunizations and routine
screening procedures for cancer, including mammograms and pap
smears;
(7) preventive medical care benefit: coverage for the
following preventive health services:
(i) an annual clinical preventive medical history and
physical examination that may include tests and services from
clause (ii) and patient education to address preventive health
care measures;
(ii) any one or a combination of the following preventive
screening tests or preventive services, the frequency of which
is considered medically appropriate:
(A) fecal occult blood test and/or digital rectal
examination;
(B) dipstick urinalysis for hematuria, bacteriuria, and
proteinuria;
(C) pure tone (air only) hearing screening test
administered or ordered by a physician;
(D) serum cholesterol screening every five years;
(E) thyroid function test;
(F) diabetes screening;
(iii) any other tests or preventive measures determined
appropriate by the attending physician.
Reimbursement shall be for the actual charges up to 100
percent of the Medicare-approved amount for each service as if
Medicare were to cover the service as identified in American
Medical Association current procedural terminology (AMA CPT)
codes to a maximum of $120 annually under this benefit. This
benefit shall not include payment for any procedure covered by
Medicare;
(8) at-home recovery benefit: coverage for services to
provide short-term at-home assistance with activities of daily
living for those recovering from an illness, injury, or surgery:
(i) for purposes of this benefit, the following definitions
shall apply:
(A) "activities of daily living" include, but are not
limited to, bathing, dressing, personal hygiene, transferring,
eating, ambulating, assistance with drugs that are normally
self-administered, and changing bandages or other dressings;
(B) "care provider" means a duly qualified or licensed home
health aide/homemaker, personal care aide, or nurse provided
through a licensed home health care agency or referred by a
licensed referral agency or licensed nurses registry;
(C) "home" means a place used by the insured as a place of
residence, provided that the place would qualify as a residence
for home health care services covered by Medicare. A hospital
or skilled nursing facility shall not be considered the
insured's place of residence;
(D) "at-home recovery visit" means the period of a visit
required to provide at-home recovery care, without limit on the
duration of the visit, except each consecutive four hours in a
24-hour period of services provided by a care provider is one
visit;
(ii) coverage requirements and limitations:
(A) at-home recovery services provided must be primarily
services that assist in activities of daily living;
(B) the insured's attending physician must certify that the
specific type and frequency of at-home recovery services are
necessary because of a condition for which a home care plan of
treatment was approved by Medicare;
(C) coverage is limited to:
(I) no more than the number and type of at-home recovery
visits certified as medically necessary by the insured's
attending physician. The total number of at-home recovery
visits shall not exceed the number of Medicare-approved home
health care visits under a Medicare-approved home care plan of
treatment;
(II) the actual charges for each visit up to a maximum
reimbursement of $40 per visit;
(III) $1,600 per calendar year;
(IV) seven visits in any one week;
(V) care furnished on a visiting basis in the insured's
home;
(VI) services provided by a care provider as defined in
this section;
(VII) at-home recovery visits while the insured is covered
under the policy or certificate and not otherwise excluded;
(VIII) at-home recovery visits received during the period
the insured is receiving Medicare-approved home care services or
no more than eight weeks after the service date of the last
Medicare-approved home health care visit;
(iii) coverage is excluded for:
(A) home care visits paid for by Medicare or other
government programs; and
(B) care provided by family members, unpaid volunteers, or
providers who are not care providers.
Sec. 6. Minnesota Statutes 2002, section 62A.316, is
amended to read:
62A.316 [BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.]
(a) The basic Medicare supplement plan must have a level of
coverage that will provide:
(1) coverage for all of the Medicare part A inpatient
hospital coinsurance amounts, and 100 percent of all Medicare
part A eligible expenses for hospitalization not covered by
Medicare, after satisfying the Medicare part A deductible;
(2) coverage for the daily copayment amount of Medicare
part A eligible expenses for the calendar year incurred for
skilled nursing facility care;
(3) coverage for the copayment coinsurance amount, or in
the case of outpatient department services paid under a
prospective payment system, the co-payment amount, of Medicare
eligible expenses under Medicare part B regardless of hospital
confinement, subject to the Medicare part B deductible amount;
(4) 80 percent of the hospital and medical expenses and
supplies incurred during travel outside the United States as a
result of a medical emergency;
(5) coverage for the reasonable cost of the first three
pints of blood, or equivalent quantities of packed red blood
cells as defined under federal regulations under Medicare parts
A and B, unless replaced in accordance with federal regulations;
(6) 100 percent of the cost of immunizations and routine
screening procedures for cancer screening including mammograms
and pap smears; and
(7) 80 percent of coverage for all physician prescribed
medically appropriate and necessary equipment and supplies used
in the management and treatment of diabetes. Coverage must
include persons with gestational, type I, or type II diabetes.
(b) Only the following optional benefit riders may be added
to this plan:
(1) coverage for all of the Medicare part A inpatient
hospital deductible amount;
(2) a minimum of 80 percent of eligible medical expenses
and supplies not covered by Medicare part B, not to exceed any
charge limitation established by the Medicare program or state
law;
(3) coverage for all of the Medicare part B annual
deductible;
(4) coverage for at least 50 percent, or the equivalent of
50 percent, of usual and customary prescription drug expenses;
(5) coverage for the following preventive health services:
(i) an annual clinical preventive medical history and
physical examination that may include tests and services from
clause (ii) and patient education to address preventive health
care measures;
(ii) any one or a combination of the following preventive
screening tests or preventive services, the frequency of which
is considered medically appropriate:
(A) fecal occult blood test and/or digital rectal
examination;
(B) dipstick urinalysis for hematuria, bacteriuria, and
proteinuria;
(C) pure tone (air only) hearing screening test,
administered or ordered by a physician;
(D) serum cholesterol screening every five years;
(E) thyroid function test;
(F) diabetes screening;
(iii) any other tests or preventive measures determined
appropriate by the attending physician.
Reimbursement shall be for the actual charges up to 100
percent of the Medicare-approved amount for each service, as if
Medicare were to cover the service as identified in American
Medical Association current procedural terminology (AMA CPT)
codes, to a maximum of $120 annually under this benefit. This
benefit shall not include payment for a procedure covered by
Medicare;
(6) coverage for services to provide short-term at-home
assistance with activities of daily living for those recovering
from an illness, injury, or surgery:
(i) For purposes of this benefit, the following definitions
apply:
(A) "activities of daily living" include, but are not
limited to, bathing, dressing, personal hygiene, transferring,
eating, ambulating, assistance with drugs that are normally
self-administered, and changing bandages or other dressings;
(B) "care provider" means a duly qualified or licensed home
health aide/homemaker, personal care aid, or nurse provided
through a licensed home health care agency or referred by a
licensed referral agency or licensed nurses registry;
(C) "home" means a place used by the insured as a place of
residence, provided that the place would qualify as a residence
for home health care services covered by Medicare. A hospital
or skilled nursing facility shall not be considered the
insured's place of residence;
(D) "at-home recovery visit" means the period of a visit
required to provide at-home recovery care, without limit on the
duration of the visit, except each consecutive four hours in a
24-hour period of services provided by a care provider is one
visit;
(ii) Coverage requirements and limitations:
(A) at-home recovery services provided must be primarily
services that assist in activities of daily living;
(B) the insured's attending physician must certify that the
specific type and frequency of at-home recovery services are
necessary because of a condition for which a home care plan of
treatment was approved by Medicare;
(C) coverage is limited to:
(I) no more than the number and type of at-home recovery
visits certified as necessary by the insured's attending
physician. The total number of at-home recovery visits shall
not exceed the number of Medicare-approved home care visits
under a Medicare-approved home care plan of treatment;
(II) the actual charges for each visit up to a maximum
reimbursement of $40 per visit;
(III) $1,600 per calendar year;
(IV) seven visits in any one week;
(V) care furnished on a visiting basis in the insured's
home;
(VI) services provided by a care provider as defined in
this section;
(VII) at-home recovery visits while the insured is covered
under the policy or certificate and not otherwise excluded;
(VIII) at-home recovery visits received during the period
the insured is receiving Medicare-approved home care services or
no more than eight weeks after the service date of the last
Medicare-approved home health care visit;
(iii) Coverage is excluded for:
(A) home care visits paid for by Medicare or other
government programs; and
(B) care provided by family members, unpaid volunteers, or
providers who are not care providers;
(7) coverage for at least 50 percent, or the equivalent of
50 percent, of usual and customary prescription drug expenses to
a maximum of $1,200 paid by the issuer annually under this
benefit. An issuer of Medicare supplement insurance policies
that elects to offer this benefit rider shall also make
available coverage that contains the rider specified in clause
(4).
Sec. 7. Minnesota Statutes 2002, section 62A.65,
subdivision 7, is amended to read:
Subd. 7. [SHORT-TERM COVERAGE.] (a) For purposes of this
section, "short-term coverage" means an individual health plan
that:
(1) is issued to provide coverage for a period of 185 days
or less, except that the health plan may permit coverage to
continue until the end of a period of hospitalization for a
condition for which the covered person was hospitalized on the
day that coverage would otherwise have ended;
(2) is nonrenewable, provided that the health carrier may
provide coverage for one or more subsequent periods that satisfy
clause (1), if the total of the periods of coverage do not
exceed a total of 185 365 days out of any 365-day 555-day
period, plus any additional days covered as a result of
hospitalization on the day that a period of coverage would
otherwise have ended;
(3) does not cover any preexisting conditions, including
ones that originated during a previous identical policy or
contract with the same health carrier where coverage was
continuous between the previous and the current policy or
contract; and
(4) is available with an immediate effective date without
underwriting upon receipt of a completed application indicating
eligibility under the health carrier's eligibility requirements,
provided that coverage that includes optional benefits may be
offered on a basis that does not meet this requirement.
(b) Short-term coverage is not subject to subdivisions 2
and 5. Short-term coverage may exclude as a preexisting
condition any injury, illness, or condition for which the
covered person had medical treatment, symptoms, or any
manifestations before the effective date of the coverage, but
dependent children born or placed for adoption during the policy
period must not be subject to this provision.
(c) Notwithstanding subdivision 3, and section 62A.021, a
health carrier may combine short-term coverage with its most
commonly sold individual qualified plan, as defined in section
62E.02, other than short-term coverage, for purposes of
complying with the loss ratio requirement.
(d) The 185 365 day coverage limitation provided in
paragraph (a) applies to the total number of days of short-term
coverage that covers a person, regardless of the number of
policies, contracts, or health carriers that provide the
coverage. A written application for short-term coverage must
ask the applicant whether the applicant has been covered by
short-term coverage by any health carrier within the 365 555
days immediately preceding the effective date of the coverage
being applied for. Short-term coverage issued in violation of
the 185-day 365-day limitation is valid until the end of its
term and does not lose its status as short-term coverage, in
spite of the violation. A health carrier that knowingly issues
short-term coverage in violation of the 185-day 365-day
limitation is subject to the administrative penalties otherwise
available to the commissioner of commerce or the commissioner of
health, as appropriate.
(e) Time spent under short-term coverage counts as time
spent under a preexisting condition limitation for purposes of
group or individual health plans, other than short-term
coverage, subsequently issued to that person, or to cover that
person, by any health carrier, if the person maintains
continuous coverage as defined in section 62L.02. Short-term
coverage is a health plan and is qualifying coverage as defined
in section 62L.02. Notwithstanding any other law to the
contrary, a health carrier is not required under any
circumstances to provide a person covered by short-term coverage
the right to obtain coverage on a guaranteed issue basis under
another health plan offered by the health carrier, as a result
of the person's enrollment in short-term coverage.
[EFFECTIVE DATE.] This section is effective the day
following final enactment and applies to policies issued on or
after that date.
Sec. 8. Minnesota Statutes 2002, section 62D.095,
subdivision 2, is amended to read:
Subd. 2. [CO-PAYMENTS.] (a) A health maintenance contract
may impose a co-payment as authorized under Minnesota Rules,
part 4685.0801, or under this section.
(b) A health maintenance organization may impose a flat fee
co-payment on outpatient office visits not to exceed 40 percent
of the median provider's charges for similar services or goods
received by the enrollees as calculated under Minnesota Rules,
part 4685.0801. A health maintenance organization may impose a
flat fee co-payment on outpatient prescription drugs not to
exceed 50 percent of the median provider's charges for similar
services or goods received by the enrollees as calculated under
Minnesota Rules, part 4685.0801.
(c) If a health maintenance contract is permitted to impose
a co-payment for preexisting health status under sections 62D.01
to 62D.30, these provisions may vary with respect to length of
enrollment in the health plan.
Sec. 9. Minnesota Statutes 2002, section 62D.095, is
amended by adding a subdivision to read:
Subd. 6. [PUBLIC PROGRAMS.] This section does not apply to
the prepaid medical assistance program, the MinnesotaCare
program, the prepaid general assistance program, the federal
Medicare program, or the health plans provided through any of
those programs.
Sec. 10. Minnesota Statutes 2002, section 62E.06,
subdivision 1, is amended to read:
Subdivision 1. [NUMBER THREE PLAN.] A plan of health
coverage shall be certified as a number three qualified plan if
it otherwise meets the requirements established by chapters 62A,
62C, and 62Q, and the other laws of this state, whether or not
the policy is issued in Minnesota, and meets or exceeds the
following minimum standards:
(a) The minimum benefits for a covered individual shall,
subject to the other provisions of this subdivision, be equal to
at least 80 percent of the cost of covered services in excess of
an annual deductible which does not exceed $150 per person. The
coverage shall include a limitation of $3,000 per person on
total annual out-of-pocket expenses for services covered under
this subdivision. The coverage shall be subject to a maximum
lifetime benefit of not less than $1,000,000.
The $3,000 limitation on total annual out-of-pocket
expenses and the $1,000,000 maximum lifetime benefit shall not
be subject to change or substitution by use of an actuarially
equivalent benefit.
(b) Covered expenses shall be the usual and customary
charges for the following services and articles when prescribed
by a physician:
(1) hospital services;
(2) professional services for the diagnosis or treatment of
injuries, illnesses, or conditions, other than dental, which are
rendered by a physician or at the physician's direction;
(3) drugs requiring a physician's prescription;
(4) services of a nursing home for not more than 120 days
in a year if the services would qualify as reimbursable services
under Medicare;
(5) services of a home health agency if the services would
qualify as reimbursable services under Medicare;
(6) use of radium or other radioactive materials;
(7) oxygen;
(8) anesthetics;
(9) prostheses other than dental but including scalp hair
prostheses worn for hair loss suffered as a result of alopecia
areata;
(10) rental or purchase, as appropriate, of durable medical
equipment other than eyeglasses and hearing aids, unless
coverage is required under section 62Q.675;
(11) diagnostic x-rays and laboratory tests;
(12) oral surgery for partially or completely unerupted
impacted teeth, a tooth root without the extraction of the
entire tooth, or the gums and tissues of the mouth when not
performed in connection with the extraction or repair of teeth;
(13) services of a physical therapist;
(14) transportation provided by licensed ambulance service
to the nearest facility qualified to treat the condition; or a
reasonable mileage rate for transportation to a kidney dialysis
center for treatment; and
(15) services of an occupational therapist.
(c) Covered expenses for the services and articles
specified in this subdivision do not include the following:
(1) any charge for care for injury or disease either (i)
arising out of an injury in the course of employment and subject
to a workers' compensation or similar law, (ii) for which
benefits are payable without regard to fault under coverage
statutorily required to be contained in any motor vehicle, or
other liability insurance policy or equivalent self-insurance,
or (iii) for which benefits are payable under another policy of
accident and health insurance, Medicare, or any other
governmental program except as otherwise provided by section
62A.04, subdivision 3, clause (4);
(2) any charge for treatment for cosmetic purposes other
than for reconstructive surgery when such service is incidental
to or follows surgery resulting from injury, sickness, or other
diseases of the involved part or when such service is performed
on a covered dependent child because of congenital disease or
anomaly which has resulted in a functional defect as determined
by the attending physician;
(3) care which is primarily for custodial or domiciliary
purposes which would not qualify as eligible services under
Medicare;
(4) any charge for confinement in a private room to the
extent it is in excess of the institution's charge for its most
common semiprivate room, unless a private room is prescribed as
medically necessary by a physician, provided, however, that if
the institution does not have semiprivate rooms, its most common
semiprivate room charge shall be considered to be 90 percent of
its lowest private room charge;
(5) that part of any charge for services or articles
rendered or prescribed by a physician, dentist, or other health
care personnel which exceeds the prevailing charge in the
locality where the service is provided; and
(6) any charge for services or articles the provision of
which is not within the scope of authorized practice of the
institution or individual rendering the services or articles.
(d) The minimum benefits for a qualified plan shall
include, in addition to those benefits specified in clauses (a)
and (e), benefits for well baby care, effective July 1, 1980,
subject to applicable deductibles, coinsurance provisions, and
maximum lifetime benefit limitations.
(e) Effective July 1, 1979, the minimum benefits of a
qualified plan shall include, in addition to those benefits
specified in clause (a), a second opinion from a physician on
all surgical procedures expected to cost a total of $500 or more
in physician, laboratory, and hospital fees, provided that the
coverage need not include the repetition of any diagnostic tests.
(f) Effective August 1, 1985, the minimum benefits of a
qualified plan must include, in addition to the benefits
specified in clauses (a), (d), and (e), coverage for special
dietary treatment for phenylketonuria when recommended by a
physician.
(g) Outpatient mental health coverage is subject to section
62A.152, subdivision 2.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to policies, contracts, and certificates issued or
renewed on or after that date.
Sec. 11. Minnesota Statutes 2002, section 62J.17,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For purposes of this section, the
terms defined in this subdivision have the meanings given.
(a) "Access" means the financial, temporal, and geographic
availability of health care to individuals who need it.
(b) "Capital expenditure" means an expenditure which, under
generally accepted accounting principles, is not properly
chargeable as an expense of operation and maintenance.
(c) "Cost" means the amount paid by consumers or third
party payers for health care services or products.
(d) "Date of the major spending commitment" means the date
the provider formally obligated itself to the major spending
commitment. The obligation may be incurred by entering into a
contract, making a down payment, issuing bonds or entering a
loan agreement to provide financing for the major spending
commitment, or taking some other formal, tangible action
evidencing the provider's intention to make the major spending
commitment.
(e) "Health care service" means:
(1) a service or item that would be covered by the medical
assistance program under chapter 256B if provided in accordance
with medical assistance requirements to an eligible medical
assistance recipient; and
(2) a service or item that would be covered by medical
assistance except that it is characterized as experimental,
cosmetic, or voluntary.
"Health care service" does not include retail,
over-the-counter sales of nonprescription drugs and other retail
sales of health-related products that are not generally paid for
by medical assistance and other third-party coverage.
(f) "Major spending commitment" means an expenditure in
excess of $500,000 $1,000,000 for:
(1) acquisition of a unit of medical equipment;
(2) a capital expenditure for a single project for the
purposes of providing health care services, other than for the
acquisition of medical equipment;
(3) offering a new specialized service not offered before;
(4) planning for an activity that would qualify as a major
spending commitment under this paragraph; or
(5) a project involving a combination of two or more of the
activities in clauses (1) to (4).
The cost of acquisition of medical equipment, and the
amount of a capital expenditure, is the total cost to the
provider regardless of whether the cost is distributed over time
through a lease arrangement or other financing or payment
mechanism.
(g) "Medical equipment" means fixed and movable equipment
that is used by a provider in the provision of a health care
service. "Medical equipment" includes, but is not limited to,
the following:
(1) an extracorporeal shock wave lithotripter;
(2) a computerized axial tomography (CAT) scanner;
(3) a magnetic resonance imaging (MRI) unit;
(4) a positron emission tomography (PET) scanner; and
(5) emergency and nonemergency medical transportation
equipment and vehicles.
(h) "New specialized service" means a specialized health
care procedure or treatment regimen offered by a provider that
was not previously offered by the provider, including, but not
limited to:
(1) cardiac catheterization services involving high-risk
patients as defined in the Guidelines for Coronary Angiography
established by the American Heart Association and the American
College of Cardiology;
(2) heart, heart-lung, liver, kidney, bowel, or pancreas
transplantation service, or any other service for
transplantation of any other organ;
(3) megavoltage radiation therapy;
(4) open heart surgery;
(5) neonatal intensive care services; and
(6) any new medical technology for which premarket approval
has been granted by the United States Food and Drug
Administration, excluding implantable and wearable devices.
Sec. 12. Minnesota Statutes 2002, section 62J.23, is
amended by adding a subdivision to read:
Subd. 5. [AUDITS OF EXEMPT PROVIDERS.] The commissioner
may audit the referral patterns of providers that qualify for
exceptions under the federal Stark Law, United States Code,
title 42, section 1395nn. The commissioner has access to
provider records according to section 144.99, subdivision 2.
The commissioner shall report to the legislature any audit
results that reveal a pattern of referrals by a provider for the
furnishing of health services to an entity with which the
provider has a direct or indirect financial relationship.
Sec. 13. [62J.26] [EVALUATION OF PROPOSED HEALTH COVERAGE
MANDATES.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given unless the
context otherwise requires:
(1) "commissioner" means the commissioner of commerce;
(2) "health plan" means a health plan as defined in section
62A.011, subdivision 3, but includes coverage listed in clauses
(7) and (10) of that definition;
(3) "mandated health benefit proposal" means a proposal
that would statutorily require a health plan to do the following:
(i) provide coverage or increase the amount of coverage for
the treatment of a particular disease, condition, or other
health care need;
(ii) provide coverage or increase the amount of coverage of
a particular type of health care treatment or service or of
equipment, supplies, or drugs used in connection with a health
care treatment or service; or
(iii) provide coverage for care delivered by a specific
type of provider.
"Mandated health benefit proposal" does not include health
benefit proposals amending the scope of practice of a licensed
health care professional.
Subd. 2. [EVALUATION PROCESS AND CONTENT.] (a) The
commissioner, in consultation with the commissioners of health
and employee relations, must evaluate mandated health benefit
proposals as provided under subdivision 3.
(b) The purpose of the evaluation is to provide the
legislature with a complete and timely analysis of all
ramifications of any mandated health benefit proposal. The
evaluation must include, in addition to other relevant
information, the following:
(1) scientific and medical information on the proposed
health benefit, on the potential for harm or benefit to the
patient, and on the comparative benefit or harm from alternative
forms of treatment;
(2) public health, economic, and fiscal impacts of the
proposed mandate on persons receiving health services in
Minnesota, on the relative cost-effectiveness of the benefit,
and on the health care system in general;
(3) the extent to which the service is generally utilized
by a significant portion of the population;
(4) the extent to which insurance coverage for the proposed
mandated benefit is already generally available;
(5) the extent to which the mandated coverage will increase
or decrease the cost of the service; and
(6) the commissioner may consider actuarial analysis done
by health insurers in determining the cost of the proposed
mandated benefit.
(c) The commissioner must summarize the nature and quality
of available information on these issues, and, if possible, must
provide preliminary information to the public. The commissioner
may conduct research on these issues or may determine that
existing research is sufficient to meet the informational needs
of the legislature. The commissioner may seek the assistance
and advice of researchers, community leaders, or other persons
or organizations with relevant expertise.
Subd. 3. [REQUESTS FOR EVALUATION.] (a) Whenever a
legislative measure containing a mandated health benefit
proposal is introduced as a bill or offered as an amendment to a
bill, or is likely to be introduced as a bill or offered as an
amendment, a chair of any standing legislative committee that
has jurisdiction over the subject matter of the proposal may
request that the commissioner complete an evaluation of the
proposal under this section, to inform any committee of floor
action by either house of the legislature.
(b) The commissioner must conduct an evaluation described
in subdivision 2 of each mandated health benefit proposal for
which an evaluation is requested under paragraph (a), unless the
commissioner determines under paragraph (c) or subdivision 4
that priorities and resources do not permit its evaluation.
(c) If requests for evaluation of multiple proposals are
received, the commissioner must consult with the chairs of the
standing legislative committees having jurisdiction over the
subject matter of the mandated health benefit proposals to
prioritize the requests and establish a reporting date for each
proposal to be evaluated. The commissioner is not required to
direct an unreasonable quantity of the commissioner's resources
to these evaluations.
Subd. 4. [SOURCES OF FUNDING.] (a) The commissioner need
not use any funds for purposes of this section other than as
provided in this subdivision or as specified in an appropriation.
(b) The commissioner may seek and accept funding from
sources other than the state to pay for evaluations under this
section to supplement or replace state appropriations. Any
money received under this paragraph must be deposited in the
state treasury, credited to a separate account for this purpose
in the special revenue fund, and is appropriated to the
commissioner for purposes of this section.
(c) If a request for an evaluation under this section has
been made, the commissioner may use for purposes of the
evaluation:
(1) any funds appropriated to the commissioner specifically
for purposes of this section; or
(2) funds available under paragraph (b), if use of the
funds for evaluation of that mandated health benefit proposal is
consistent with any restrictions imposed by the source of the
funds.
(d) The commissioner must ensure that the source of the
funding has no influence on the process or outcome of the
evaluation.
Subd. 5. [REPORT TO LEGISLATURE.] The commissioner must
submit a written report on the evaluation to the legislature no
later than 180 days after the request. The report must be
submitted in compliance with sections 3.195 and 3.197.
[EFFECTIVE DATE.] This section is effective January 1, 2004.
Sec. 14. Minnesota Statutes 2002, section 62J.52,
subdivision 1, is amended to read:
Subdivision 1. [UNIFORM BILLING FORM HCFA 1450.] (a) On
and after January 1, 1996, all institutional inpatient hospital
services, ancillary services, institutionally owned or operated
outpatient services rendered by providers in Minnesota, and
institutional or noninstitutional home health services that are
not being billed using an equivalent electronic billing format,
must be billed using the uniform billing form HCFA 1450, except
as provided in subdivision 5.
(b) The instructions and definitions for the use of the
uniform billing form HCFA 1450 shall be in accordance with the
uniform billing form manual specified by the commissioner. In
promulgating these instructions, the commissioner may utilize
the manual developed by the National Uniform Billing Committee,
as adopted and finalized by the Minnesota uniform billing
committee.
(c) Services to be billed using the uniform billing form
HCFA 1450 include: institutional inpatient hospital services
and distinct units in the hospital such as psychiatric unit
services, physical therapy unit services, swing bed (SNF)
services, inpatient state psychiatric hospital services,
inpatient skilled nursing facility services, home health
services (Medicare part A), and hospice services; ancillary
services, where benefits are exhausted or patient has no
Medicare part A, from hospitals, state psychiatric hospitals,
skilled nursing facilities, and home health (Medicare part B);
institutional owned or operated outpatient services such as
waivered services, hospital outpatient services, including
ambulatory surgical center services, hospital referred
laboratory services, hospital-based ambulance services, and
other hospital outpatient services, skilled nursing facilities,
home health, including infusion therapy, freestanding renal
dialysis centers, comprehensive outpatient rehabilitation
facilities (CORF), outpatient rehabilitation facilities (ORF),
rural health clinics, and community mental health centers; home
health services such as home health intravenous therapy
providers, waivered services, personal care attendants, and
hospice; and any other health care provider certified by the
Medicare program to use this form.
(d) On and after January 1, 1996, a mother and newborn
child must be billed separately, and must not be combined on one
claim form.
Sec. 15. Minnesota Statutes 2002, section 62J.52,
subdivision 2, is amended to read:
Subd. 2. [UNIFORM BILLING FORM HCFA 1500.] (a) On and
after January 1, 1996, all noninstitutional health care services
rendered by providers in Minnesota except dental or pharmacy
providers, that are not currently being billed using an
equivalent electronic billing format, must be billed using the
health insurance claim form HCFA 1500, except as provided in
subdivision 5.
(b) The instructions and definitions for the use of the
uniform billing form HCFA 1500 shall be in accordance with the
manual developed by the administrative uniformity committee
entitled standards for the use of the HCFA 1500 form, dated
February 1994, as further defined by the commissioner.
(c) Services to be billed using the uniform billing form
HCFA 1500 include physician services and supplies, durable
medical equipment, noninstitutional ambulance services,
independent ancillary services including occupational therapy,
physical therapy, speech therapy and audiology, home infusion
therapy, podiatry services, optometry services, mental health
licensed professional services, substance abuse licensed
professional services, nursing practitioner professional
services, certified registered nurse anesthetists,
chiropractors, physician assistants, laboratories, medical
suppliers, and other health care providers such as day activity
centers and freestanding ambulatory surgical centers.
Sec. 16. Minnesota Statutes 2002, section 62J.692,
subdivision 3, is amended to read:
Subd. 3. [APPLICATION PROCESS.] (a) A clinical medical
education program conducted in Minnesota by a teaching
institution to train physicians, doctor of pharmacy
practitioners, dentists, chiropractors, or physician assistants
is eligible for funds under subdivision 4 if the program:
(1) is funded, in part, by patient care revenues;
(2) occurs in patient care settings that face increased
financial pressure as a result of competition with nonteaching
patient care entities; and
(3) emphasizes primary care or specialties that are in
undersupply in Minnesota.
(b) A clinical medical education program for advanced
practice nursing is eligible for funds under subdivision 4 if
the program meets the eligibility requirements in paragraph (a),
clauses (1) to (3), and is sponsored by the University of
Minnesota Academic Health Center, the Mayo Foundation, or
institutions that are part of the Minnesota state colleges and
universities system or members of the Minnesota private college
council.
(c) Applications must be submitted to the commissioner by a
sponsoring institution on behalf of an eligible clinical medical
education program and must be received by October 31 of each
year for distribution in the following year. An application for
funds must contain the following information:
(1) the official name and address of the sponsoring
institution and the official name and site address of the
clinical medical education programs on whose behalf the
sponsoring institution is applying;
(2) the name, title, and business address of those persons
responsible for administering the funds;
(3) for each clinical medical education program for which
funds are being sought; the type and specialty orientation of
trainees in the program; the name, site address, and medical
assistance provider number of each training site used in the
program; the total number of trainees at each training site; and
the total number of eligible trainee FTEs at each site. Only
those training sites that host 0.5 FTE or more eligible trainees
for a program may be included in the program's application; and
(4) other supporting information the commissioner deems
necessary to determine program eligibility based on the criteria
in paragraph paragraphs (a) and (b) and to ensure the equitable
distribution of funds.
(c) (d) An application must include the information
specified in clauses (1) to (3) for each clinical medical
education program on an annual basis for three consecutive
years. After that time, an application must include the
information specified in clauses (1) to (3) in the first year of
each biennium:
(1) audited clinical training costs per trainee for each
clinical medical education program when available or estimates
of clinical training costs based on audited financial data;
(2) a description of current sources of funding for
clinical medical education costs, including a description and
dollar amount of all state and federal financial support,
including Medicare direct and indirect payments; and
(3) other revenue received for the purposes of clinical
training.
(d) (e) An applicant that does not provide information
requested by the commissioner shall not be eligible for funds
for the current funding cycle.
Sec. 17. Minnesota Statutes 2002, section 62J.692,
subdivision 4, is amended to read:
Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner
shall annually distribute 90 percent of available medical
education funds to all qualifying applicants based on the
following criteria a distribution formula that reflects a
summation of two factors:
(1) total medical education funds available for
distribution; an education factor, which is determined by the
total number of eligible trainee FTEs and the total statewide
average costs per trainee, by type of trainee, in each clinical
medical education program; and
(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. a public program volume factor, which is determined by
the total volume of public program revenue received by each
training site as a percentage of all public program revenue
received by all training sites in the fund pool.
In this formula, the education factor is weighted at 67
percent and the public program volume factor is weighted at 33
percent.
Public program revenue for the distribution formula
includes revenue from medical assistance, prepaid medical
assistance, general assistance medical care, and prepaid general
assistance medical care. Training sites that receive no public
program revenue are ineligible for funds available under this
paragraph. Total statewide average costs per trainee for
medical residents is based on audited clinical training costs
per trainee in primary care clinical medical education programs
for medical residents. Total statewide average costs per
trainee for dental residents is based on audited clinical
training costs per trainee in clinical medical education
programs for dental students. Total statewide average costs per
trainee for pharmacy residents is based on audited clinical
training costs per trainee in clinical medical education
programs for pharmacy students.
(b) The commissioner shall annually distribute ten percent
of total available medical education funds to all qualifying
applicants based on the percentage received by each applicant
under paragraph (a). These funds are to be used to offset
clinical education costs at eligible clinical training sites
based on criteria developed by the clinical medical education
program. Applicants may choose to distribute funds allocated
under this paragraph based on the distribution formula described
in paragraph (a). Applicants may also choose to distribute
funds to clinical training sites with a valid Minnesota medical
assistance identification number that host fewer than 0.5
eligible trainee FTE's for a clinical medical education program.
(c) Funds distributed shall not be used to displace current
funding appropriations from federal or state sources.
(c) (d) 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 allocated under paragraph (a) 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
Centers for Medicare and Medicaid Services, 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) (e) 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 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 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. 18. Minnesota Statutes 2002, section 62J.692,
subdivision 5, is amended to read:
Subd. 5. [REPORT.] (a) Sponsoring institutions receiving
funds under this section must sign and submit a medical
education grant verification report (GVR) to verify that the
correct grant amount was forwarded to each eligible training
site. If the sponsoring institution fails to submit the GVR by
the stated deadline, or to request and meet the deadline for an
extension, the sponsoring institution is required to return the
full amount of funds received to the commissioner 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.
(b) The reports must provide verification of the
distribution of the funds and must include:
(1) the total number of eligible trainee FTEs in each
clinical medical education program;
(2) the name of each funded program and, for each program,
the dollar amount distributed to each training site;
(3) documentation of any discrepancies between the initial
grant distribution notice included in the commissioner's
approval letter and the actual distribution;
(4) a statement by the sponsoring institution describing
the distribution of funds allocated under subdivision 4,
paragraph (b), including information on which clinical training
sites received funding and the rationale used for determining
funding priorities;
(5) a statement by the sponsoring institution stating that
the completed grant verification report is valid and accurate;
and
(5) (6) other information the commissioner, with advice
from the advisory committee, deems appropriate to evaluate the
effectiveness of the use of funds for medical education.
(c) By February 15 of each year, the commissioner, with
advice from the advisory committee, shall provide an annual
summary report to the legislature on the implementation of this
section.
Sec. 19. Minnesota Statutes 2002, section 62J.692,
subdivision 7, is amended to read:
Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN
SERVICES.] (a) The amount transferred according to section
256B.69, subdivision 5c, paragraph (a), clause (1), shall be
distributed by the commissioner annually to clinical medical
education programs that meet the qualifications of subdivision 3
based on a distribution formula that reflects a summation of two
factors: the formula in subdivision 4, paragraph (a).
(1) an education factor, which is determined by the total
number of eligible trainee FTEs and the total statewide average
costs per trainee, by type of trainee, in each clinical medical
education program; and
(2) a public program volume factor, which is determined by
the total volume of public program revenue received by each
training site as a percentage of all public program revenue
received by all training sites in the fund pool created under
this subdivision.
In this formula, the education factor shall be weighted at
50 percent and the public program volume factor shall be
weighted at 50 percent.
Public program revenue for the distribution formula shall
include revenue from medical assistance, prepaid medical
assistance, general assistance medical care, and prepaid general
assistance medical care. Training sites that receive no public
program revenue shall be ineligible for funds available under
this paragraph.
(b) Fifty percent of the amount transferred according to
section 256B.69, subdivision 5c, paragraph (a), clause (2),
shall be distributed by the commissioner to the University of
Minnesota board of regents for the purposes described in
sections 137.38 to 137.40. Of the remaining amount transferred
according to section 256B.69, subdivision 5c, paragraph (a),
clause (2), 24 percent of the amount shall be distributed by the
commissioner to the Hennepin County Medical Center for clinical
medical education. The remaining 26 percent of the amount
transferred shall be distributed by the commissioner in
accordance with subdivision 7a. If the federal approval is not
obtained for the matching funds under section 256B.69,
subdivision 5c, paragraph (a), clause (2), 100 percent of the
amount transferred under this paragraph shall be distributed by
the commissioner to the University of Minnesota board of regents
for the purposes described in sections 137.38 to 137.40.
(c) The amount transferred according to section 256B.69,
subdivision 5c, paragraph (a), clause (3), shall be distributed
by the commissioner upon receipt to the University of Minnesota
board of regents for the purposes of clinical graduate medical
education.
Sec. 20. Minnesota Statutes 2002, section 62J.694, is
amended by adding a subdivision to read:
Subd. 5. [EFFECTIVE DATE.] This section is only in effect
if there are funds available in the medical education endowment
fund.
Sec. 21. Minnesota Statutes 2002, section 62L.05,
subdivision 4, is amended to read:
Subd. 4. [BENEFITS.] The medical services and supplies
listed in this subdivision are the benefits that must be covered
by the small employer plans described in subdivisions 2 and 3.
Benefits under this subdivision may be provided through the
managed care procedures practiced by health carriers:
(1) inpatient and outpatient hospital services, excluding
services provided for the diagnosis, care, or treatment of
chemical dependency or a mental illness or condition, other than
those conditions specified in clauses (10), (11), and (12). The
health care services required to be covered under this clause
must also be covered if rendered in a nonhospital environment,
on the same basis as coverage provided for those same treatments
or services if rendered in a hospital, provided, however, that
this sentence must not be interpreted as expanding the types or
extent of services covered;
(2) physician, chiropractor, and nurse practitioner
services for the diagnosis or treatment of illnesses, injuries,
or conditions;
(3) diagnostic x-rays and laboratory tests;
(4) ground transportation provided by a licensed ambulance
service to the nearest facility qualified to treat the
condition, or as otherwise required by the health carrier;
(5) services of a home health agency if the services
qualify as reimbursable services under Medicare;
(6) services of a private duty registered nurse if
medically necessary, as determined by the health carrier;
(7) the rental or purchase, as appropriate, of durable
medical equipment, other than eyeglasses and hearing aids,
unless coverage is required under section 62Q.675;
(8) child health supervision services up to age 18, as
defined in section 62A.047;
(9) maternity and prenatal care services, as defined in
sections 62A.041 and 62A.047;
(10) inpatient hospital and outpatient services for the
diagnosis and treatment of certain mental illnesses or
conditions, as defined by the International Classification of
Diseases-Clinical Modification (ICD-9-CM), seventh edition
(1990) and as classified as ICD-9 codes 295 to 299;
(11) ten hours per year of outpatient mental health
diagnosis or treatment for illnesses or conditions not described
in clause (10);
(12) 60 hours per year of outpatient treatment of chemical
dependency; and
(13) 50 percent of eligible charges for prescription drugs,
up to a separate annual maximum out-of-pocket expense of $1,000
per individual for prescription drugs, and 100 percent of
eligible charges thereafter.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to policies, contracts, and certificates issued or
renewed on or after that date.
Sec. 22. Minnesota Statutes 2002, section 62Q.19,
subdivision 1, is amended to read:
Subdivision 1. [DESIGNATION.] (a) The commissioner shall
designate essential community providers. The criteria for
essential community provider designation shall be the following:
(1) a demonstrated ability to integrate applicable
supportive and stabilizing services with medical care for
uninsured persons and high-risk and special needs populations,
underserved, and other special needs populations; and
(2) a commitment to serve low-income and underserved
populations by meeting the following requirements:
(i) has nonprofit status in accordance with chapter 317A;
(ii) has tax exempt status in accordance with the Internal
Revenue Service Code, section 501(c)(3);
(iii) charges for services on a sliding fee schedule based
on current poverty income guidelines; and
(iv) does not restrict access or services because of a
client's financial limitation;
(3) status as a local government unit as defined in section
62D.02, subdivision 11, a hospital district created or
reorganized under sections 447.31 to 447.37, an Indian tribal
government, an Indian health service unit, or a community health
board as defined in chapter 145A;
(4) a former state hospital that specializes in the
treatment of cerebral palsy, spina bifida, epilepsy, closed head
injuries, specialized orthopedic problems, and other disabling
conditions; or
(5) a rural hospital that has qualified for a sole
community hospital financial assistance grant in the past three
years under section 144.1484, subdivision 1. For these rural
hospitals, the essential community provider designation applies
to all health services provided, including both inpatient and
outpatient services. For purposes of this section, "sole
community hospital" means a rural hospital that:
(i) is eligible to be classified as a sole community
hospital according to Code of Federal Regulations, title 42,
section 412.92, or is located in a community with a population
of less than 5,000 and located more than 25 miles from a like
hospital currently providing acute short-term services;
(ii) has experienced net operating income losses in two of
the previous three most recent consecutive hospital fiscal years
for which audited financial information is available; and
(iii) consists of 40 or fewer licensed beds.
(b) Prior to designation, the commissioner shall publish
the names of all applicants in the State Register. The public
shall have 30 days from the date of publication to submit
written comments to the commissioner on the application. No
designation shall be made by the commissioner until the 30-day
period has expired.
(c) The commissioner may designate an eligible provider as
an essential community provider for all the services offered by
that provider or for specific services designated by the
commissioner.
(d) For the purpose of this subdivision, supportive and
stabilizing services include at a minimum, transportation, child
care, cultural, and linguistic services where appropriate.
Sec. 23. Minnesota Statutes 2002, section 62Q.19,
subdivision 2, is amended to read:
Subd. 2. [APPLICATION.] (a) Any provider may apply to the
commissioner for designation as an essential community provider
by submitting an application form developed by the
commissioner. Except as provided in paragraph
paragraphs (d) and (e), applications must be accepted within two
years after the effective date of the rules adopted by the
commissioner to implement this section.
(b) Each application submitted must be accompanied by an
application fee in an amount determined by the commissioner.
The fee shall be no more than what is needed to cover the
administrative costs of processing the application.
(c) The name, address, contact person, and the date by
which the commissioner's decision is expected to be made shall
be classified as public data under section 13.41. All other
information contained in the application form shall be
classified as private data under section 13.41 until the
application has been approved, approved as modified, or denied
by the commissioner. Once the decision has been made, all
information shall be classified as public data unless the
applicant designates and the commissioner determines that the
information contains trade secret information.
(d) The commissioner shall accept an application for
designation as an essential community provider until June 30,
2001, from:
(1) one applicant that is a nonprofit community health care
facility, certified as a medical assistance provider effective
April 1, 1998, that provides culturally competent health care to
an underserved Southeast Asian immigrant and refugee population
residing in the immediate neighborhood of the facility;
(2) one applicant that is a nonprofit home health care
provider, certified as a Medicare and a medical assistance
provider that provides culturally competent home health care
services to a low-income culturally diverse population;
(3) up to five applicants that are nonprofit community
mental health centers certified as medical assistance providers
that provide mental health services to children with serious
emotional disturbance and their families or to adults with
serious and persistent mental illness; and
(4) one applicant that is a nonprofit provider certified as
a medical assistance provider that provides mental health, child
development, and family services to children with physical and
mental health disorders and their families.
(e) The commissioner shall accept an application for
designation as an essential community provider until June 30,
2003, from one applicant that is a nonprofit community clinic
located in Hennepin county that provides health care to an
underserved American Indian population and that is collaborating
with other neighboring organizations on a community diabetes
project and an immunization project.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 24. [62Q.675] [HEARING AIDS; PERSONS 18 OR YOUNGER.]
A health plan must cover hearing aids for individuals 18
years of age or younger for hearing loss due to functional
congenital malformation of the ears that is not correctable by
other covered procedures. Coverage required under this section
is limited to one hearing aid in each ear every three years. No
special deductible, coinsurance, co-payment, or other limitation
on the coverage under this section that is not generally
applicable to other coverages under the plan may be imposed.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to policies, contracts, and certificates issued or
renewed on or after that date.
Sec. 25. Minnesota Statutes 2002, section 144.1222, is
amended by adding a subdivision to read:
Subd. 1a. [FEES.] All plans and specifications for public
swimming pool and spa construction, installation, or alteration
or requests for a variance that are submitted to the
commissioner according to Minnesota Rules, part 4717.3975, shall
be accompanied by the appropriate fees. If the commissioner
determines, upon review of the plans, that inadequate fees were
paid, the necessary additional fees shall be paid before plan
approval. For purposes of determining fees, a project is
defined as a proposal to construct or install a public pool,
spa, special purpose pool, or wading pool and all associated
water treatment equipment and drains, gutters, decks, water
recreation features, spray pads, and those design and safety
features that are within five feet of any pool or spa. The
commissioner shall charge the following fees for plan review and
inspection of public pools and spas and for requests for
variance from the public pool and spa rules:
(1) each spa pool, $500;
(2) projects valued at $250,000 or less, a minimum of $800
per pool plus:
(i) for each slide, an additional $400; and
(ii) for each spa pool, an additional $500;
(3) projects valued at $250,000 or more, 0.5 percent of
documented estimated project cost to a maximum fee of $10,000;
(4) alterations to an existing pool without changing the
size or configuration of the pool, $400;
(5) removal or replacement of pool disinfection equipment
only, $75; and
(6) request for variance from the public pool and spa
rules, $500.
Sec. 26. Minnesota Statutes 2002, section 144.125, is
amended to read:
144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS
HERITABLE AND CONGENITAL DISORDERS.]
Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty
of (1) the administrative officer or other person in charge of
each institution caring for infants 28 days or less of age, (2)
the person required in pursuance of the provisions of section
144.215, to register the birth of a child, or (3) the nurse
midwife or midwife in attendance at the birth, to arrange to
have administered to every infant or child in its care tests for
inborn errors of metabolism in accordance with heritable and
congenital disorders according to subdivision 2 and rules
prescribed by the state commissioner of health. In determining
which tests must be administered, the commissioner shall take
into consideration the adequacy of laboratory methods to detect
the inborn metabolic error, the ability to treat or prevent
medical conditions caused by the inborn metabolic error, and the
severity of the medical conditions caused by the inborn
metabolic error. Testing and the recording and reporting of
test results shall be performed at the times and in the manner
prescribed by the commissioner of health. The commissioner
shall charge laboratory service fees so that the total of fees
collected will approximate the costs of conducting the tests and
implementing and maintaining a system to follow-up infants with
inborn metabolic errors heritable or congenital disorders. The
laboratory service fee is $61 per specimen. Costs associated
with capital expenditures and the development of new procedures
may be prorated over a three-year period when calculating the
amount of the fees.
Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The
commissioner shall periodically revise the list of tests to be
administered for determining the presence of a heritable or
congenital disorder. Revisions to the list shall reflect
advances in medical science, new and improved testing methods,
or other factors that will improve the public health. In
determining whether a test must be administered, the
commissioner shall take into consideration the adequacy of
laboratory methods to detect the heritable or congenital
disorder, the ability to treat or prevent medical conditions
caused by the heritable or congenital disorder, and the severity
of the medical conditions caused by the heritable or congenital
disorder. The list of tests to be performed may be revised if
the changes are recommended by the advisory committee
established under section 144.1255, approved by the
commissioner, and published in the State Register. The revision
is exempt from the rulemaking requirements in chapter 14 and
sections 14.385 and 14.386 do not apply.
Subd. 3. [OBJECTION OF PARENTS TO TEST.] Persons with a
duty to perform testing under subdivision 1 shall advise parents
of infants (1) that the blood or tissue samples used to perform
testing thereunder as well as the results of such testing may be
retained by the department of health, (2) the benefit of
retaining the blood or tissue sample, and (3) that the following
options are available to them with respect to the testing:
(i) to decline to have the tests, or
(ii) to elect to have the tests but to require that all
blood samples and records of test results be destroyed within 24
months of the testing. If the parents of an infant object in
writing to testing for heritable and congenital disorders or
elect to require that blood samples and test results be
destroyed, the objection or election shall be recorded on a form
that is signed by a parent or legal guardian and made part of
the infant's medical record. A written objection exempts an
infant from the requirements of this section and section 144.128.
Sec. 27. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND
CONGENITAL DISORDERS.]
Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1,
2003, the commissioner of health shall appoint an advisory
committee to provide advice and recommendations to the
commissioner concerning tests and treatments for heritable and
congenital disorders found in newborn children. Membership of
the committee shall include, but not be limited to, at least one
member from each of the following representative groups:
(1) parents and other consumers;
(2) primary care providers;
(3) clinicians and researchers specializing in newborn
diseases and disorders;
(4) genetic counselors;
(5) birth hospital representatives;
(6) newborn screening laboratory professionals;
(7) nutritionists; and
(8) other experts as needed representing related fields
such as emerging technologies and health insurance.
(b) The terms and removal of members are governed by
section 15.059. Members shall not receive per diems but shall
be compensated for expenses. Notwithstanding section 15.059,
subdivision 5, the advisory committee does not expire.
Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's
activities include, but are not limited to:
(1) collection of information on the efficacy and
reliability of various tests for heritable and congenital
disorders;
(2) collection of information on the availability and
efficacy of treatments for heritable and congenital disorders;
(3) collection of information on the severity of medical
conditions caused by heritable and congenital disorders;
(4) discussion and assessment of the benefits of performing
tests for heritable or congenital disorders as compared to the
costs, treatment limitations, or other potential disadvantages
of requiring the tests;
(5) discussion and assessment of ethical considerations
surrounding the testing, treatment, and handling of data and
specimens generated by the testing requirements of sections
144.125 to 144.128; and
(6) providing advice and recommendations to the
commissioner concerning tests and treatments for heritable and
congenital disorders found in newborn children.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 28. Minnesota Statutes 2002, section 144.128, is
amended to read:
144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF
CASES COMMISSIONER'S DUTIES.]
The commissioner shall:
(1) notify the physicians of newborns tested of the results
of the tests performed;
(1) (2) make arrangements referrals for the necessary
treatment of diagnosed cases of hemoglobinopathy,
phenylketonuria, and other inborn errors of metabolism heritable
or congenital disorders when treatment is indicated and the
family is uninsured and, because of a lack of available income,
is unable to pay the cost of the treatment;
(2) (3) maintain a registry of the cases of
hemoglobinopathy, phenylketonuria, and other inborn errors of
metabolism heritable and congenital disorders detected by the
screening program for the purpose of follow-up services; and
(3) (4) adopt rules to carry out section 144.126 and this
section sections 144.125 to 144.128.
Sec. 29. Minnesota Statutes 2002, section 144.1481,
subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT; MEMBERSHIP.] The
commissioner of health shall establish a 15-member rural health
advisory committee. The committee shall consist of the
following members, all of whom must reside outside the
seven-county metropolitan area, as defined in section 473.121,
subdivision 2:
(1) two members from the house of representatives of the
state of Minnesota, one from the majority party and one from the
minority party;
(2) two members from the senate of the state of Minnesota,
one from the majority party and one from the minority party;
(3) a volunteer member of an ambulance service based
outside the seven-county metropolitan area;
(4) a representative of a hospital located outside the
seven-county metropolitan area;
(5) a representative of a nursing home located outside the
seven-county metropolitan area;
(6) a medical doctor or doctor of osteopathy licensed under
chapter 147;
(7) a midlevel practitioner;
(8) a registered nurse or licensed practical nurse;
(9) a licensed health care professional from an occupation
not otherwise represented on the committee;
(10) a representative of an institution of higher education
located outside the seven-county metropolitan area that provides
training for rural health care providers; and
(11) three consumers, at least one of whom must be an
advocate for persons who are mentally ill or developmentally
disabled.
The commissioner will make recommendations for committee
membership. Committee members will be appointed by the
governor. In making appointments, the governor shall ensure
that appointments provide geographic balance among those areas
of the state outside the seven-county metropolitan area. The
chair of the committee shall be elected by the members. The
advisory committee is governed by section 15.059, except that
the members do not receive per diem
compensation. Notwithstanding section 15.059, the advisory
committee does not expire.
Sec. 30. Minnesota Statutes 2002, section 144.1483, is
amended to read:
144.1483 [RURAL HEALTH INITIATIVES.]
The commissioner of health, through the office of rural
health, and consulting as necessary with the commissioner of
human services, the commissioner of commerce, the higher
education services office, and other state agencies, shall:
(1) develop a detailed plan regarding the feasibility of
coordinating rural health care services by organizing individual
medical providers and smaller hospitals and clinics into
referral networks with larger rural hospitals and clinics that
provide a broader array of services;
(2) develop and implement a program to assist rural
communities in establishing community health centers, as
required by section 144.1486;
(3) administer the program of financial assistance
established under section 144.1484 for rural hospitals in
isolated areas of the state that are in danger of closing
without financial assistance, and that have exhausted local
sources of support;
(4) develop recommendations regarding health education and
training programs in rural areas, including but not limited to a
physician assistants' training program, continuing education
programs for rural health care providers, and rural outreach
programs for nurse practitioners within existing training
programs;
(5) (4) develop a statewide, coordinated recruitment
strategy for health care personnel and maintain a database on
health care personnel as required under section 144.1485;
(6) (5) develop and administer technical assistance
programs to assist rural communities in: (i) planning and
coordinating the delivery of local health care services; and
(ii) hiring physicians, nurse practitioners, public health
nurses, physician assistants, and other health personnel;
(7) (6) study and recommend changes in the regulation of
health care personnel, such as nurse practitioners and physician
assistants, related to scope of practice, the amount of on-site
physician supervision, and dispensing of medication, to address
rural health personnel shortages;
(8) (7) support efforts to ensure continued funding for
medical and nursing education programs that will increase the
number of health professionals serving in rural areas;
(9) (8) support efforts to secure higher reimbursement for
rural health care providers from the Medicare and medical
assistance programs;
(10) (9) coordinate the development of a statewide plan for
emergency medical services, in cooperation with the emergency
medical services advisory council;
(11) (10) establish a Medicare rural hospital flexibility
program pursuant to section 1820 of the federal Social Security
Act, United States Code, title 42, section 1395i-4, by
developing a state rural health plan and designating, consistent
with the rural health plan, rural nonprofit or public hospitals
in the state as critical access hospitals. Critical access
hospitals shall include facilities that are certified by the
state as necessary providers of health care services to
residents in the area. Necessary providers of health care
services are designated as critical access hospitals on the
basis of being more than 20 miles, defined as official mileage
as reported by the Minnesota department of transportation, from
the next nearest hospital, being the sole hospital in the
county, being a hospital located in a county with a designated
medically underserved area or health professional shortage area,
or being a hospital located in a county contiguous to a county
with a medically underserved area or health professional
shortage area. A critical access hospital located in a county
with a designated medically underserved area or a health
professional shortage area or in a county contiguous to a county
with a medically underserved area or health professional
shortage area shall continue to be recognized as a critical
access hospital in the event the medically underserved area or
health professional shortage area designation is subsequently
withdrawn; and
(12) (11) carry out other activities necessary to address
rural health problems.
Sec. 31. Minnesota Statutes 2002, section 144.1488,
subdivision 4, is amended to read:
Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be
eligible to apply to the commissioner for the loan repayment
program, health professionals must be citizens or nationals of
the United States, must not have any unserved obligations for
service to a federal, state, or local government, or other
entity, must have a current and unrestricted Minnesota license
to practice, and must be ready to begin full-time clinical
practice upon signing a contract for obligated service.
(b) Eligible providers are those specified by the federal
Bureau of Primary Health Care Health Professions in the policy
information notice for the state's current federal grant
application. A health professional selected for participation
is not eligible for loan repayment until the health professional
has an employment agreement or contract with an eligible loan
repayment site and has signed a contract for obligated service
with the commissioner.
Sec. 32. Minnesota Statutes 2002, section 144.1491,
subdivision 1, is amended to read:
Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A
program participant who fails to complete two the required years
of obligated service shall repay the amount paid, as well as a
financial penalty based upon the length of the service
obligation not fulfilled. If the participant has served at
least one year, the financial penalty is the number of unserved
months multiplied by $1,000. If the participant has served less
than one year, the financial penalty is the total number of
obligated months multiplied by $1,000 specified by the federal
Bureau of Health Professions in the policy information notice
for the state's current federal grant application. The
commissioner shall report to the appropriate health-related
licensing board a participant who fails to complete the service
obligation and fails to repay the amount paid or fails to pay
any financial penalty owed under this subdivision.
Sec. 33. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN
FORGIVENESS PROGRAM.]
Subdivision 1. [DEFINITIONS.] (a) For purposes of this
section, the following definitions apply.
(b) "Designated rural area" means:
(1) an area in Minnesota outside the counties of Anoka,
Carver, Dakota, Hennepin, Ramsey, Scott, and Washington,
excluding the cities of Duluth, Mankato, Moorhead, Rochester,
and St. Cloud; or
(2) a municipal corporation, as defined under section
471.634, that is physically located, in whole or in part, in an
area defined as a designated rural area under clause (1).
(c) "Emergency circumstances" means those conditions that
make it impossible for the participant to fulfill the service
commitment, including death, total and permanent disability, or
temporary disability lasting more than two years.
(d) "Medical resident" means an individual participating in
a medical residency in family practice, internal medicine,
obstetrics and gynecology, pediatrics, or psychiatry.
(e) "Midlevel practitioner" means a nurse practitioner,
nurse-midwife, nurse anesthetist, advanced clinical nurse
specialist, or physician assistant.
(f) "Nurse" means an individual who has completed training
and received all licensing or certification necessary to perform
duties as a licensed practical nurse or registered nurse.
(g) "Nurse-midwife" means a registered nurse who has
graduated from a program of study designed to prepare registered
nurses for advanced practice as nurse-midwives.
(h) "Nurse practitioner" means a registered nurse who has
graduated from a program of study designed to prepare registered
nurses for advanced practice as nurse practitioners.
(i) "Physician" means an individual who is licensed to
practice medicine in the areas of family practice, internal
medicine, obstetrics and gynecology, pediatrics, or psychiatry.
(j) "Physician assistant" means a person registered under
chapter 147A.
(k) "Qualified educational loan" means a government,
commercial, or foundation loan for actual costs paid for
tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a
health care professional.
(l) "Underserved urban community" means a Minnesota urban
area or population included in the list of designated primary
medical care health professional shortage areas (HPSAs),
medically underserved areas (MUAs), or medically underserved
populations (MUPs) maintained and updated by the United States
Department of Health and Human Services.
Subd. 2. [CREATION OF ACCOUNT.] A health professional
education loan forgiveness program account is established. The
commissioner of health shall use money from the account to
establish a loan forgiveness program for medical residents
agreeing to practice in designated rural areas or underserved
urban communities, for midlevel practitioners agreeing to
practice in designated rural areas, and for nurses who agree to
practice in a Minnesota nursing home or intermediate care
facility for persons with mental retardation or related
conditions. Appropriations made to the account do not cancel
and are available until expended, except that at the end of each
biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing
commitments shall cancel to the fund.
Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate
in the loan forgiveness program, an individual must:
(1) be a medical resident or be enrolled in a midlevel
practitioner, registered nurse, or a licensed practical nurse
training program; and
(2) submit an application to the commissioner of health.
(b) An applicant selected to participate must sign a
contract to agree to serve a minimum three-year full-time
service obligation according to subdivision 2, which shall begin
no later than March 31 following completion of required training.
Subd. 4. [LOAN FORGIVENESS.] The commissioner of health
may select applicants each year for participation in the loan
forgiveness program, within the limits of available funding.
The commissioner shall distribute available funds for loan
forgiveness proportionally among the eligible professions
according to the vacancy rate for each profession in the
required geographic area or facility type specified in
subdivision 2. The commissioner shall allocate funds for
physician loan forgiveness so that 75 percent of the funds
available are used for rural physician loan forgiveness and 25
percent of the funds available are used for underserved urban
communities loan forgiveness. If the commissioner does not
receive enough qualified applicants each year to use the entire
allocation of funds for urban underserved communities, the
remaining funds may be allocated for rural physician loan
forgiveness. Applicants are responsible for securing their own
qualified educational loans. The commissioner shall select
participants based on their suitability for practice serving the
required geographic area or facility type specified in
subdivision 2, as indicated by experience or training. The
commissioner shall give preference to applicants closest to
completing their training. For each year that a participant
meets the service obligation required under subdivision 3, up to
a maximum of four years, the commissioner shall make annual
disbursements directly to the participant equivalent to 15
percent of the average educational debt for indebted graduates
in their profession in the year closest to the applicant's
selection for which information is available, not to exceed the
balance of the participant's qualifying educational loans.
Before receiving loan repayment disbursements and as requested,
the participant must complete and return to the commissioner an
affidavit of practice form provided by the commissioner
verifying that the participant is practicing as required under
subdivisions 2 and 3. The participant must provide the
commissioner with verification that the full amount of loan
repayment disbursement received by the participant has been
applied toward the designated loans. After each disbursement,
verification must be received by the commissioner and approved
before the next loan repayment disbursement is made.
Participants who move their practice remain eligible for loan
repayment as long as they practice as required under subdivision
2.
Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant
does not fulfill the required minimum commitment of service
according to subdivision 3, the commissioner of health shall
collect from the participant the total amount paid to the
participant under the loan forgiveness program plus interest at
a rate established according to section 270.75. The
commissioner shall deposit the money collected in the health
care access fund to be credited to the health professional
education loan forgiveness program account established in
subdivision 2. The commissioner shall allow waivers of all or
part of the money owed the commissioner as a result of a
nonfulfillment penalty if emergency circumstances prevented
fulfillment of the minimum service commitment.
Subd. 6. [RULES.] The commissioner may adopt rules to
implement this section.
Sec. 34. Minnesota Statutes 2002, section 144.1502,
subdivision 4, is amended to read:
Subd. 4. [LOAN FORGIVENESS.] The commissioner of health
may accept up to 14 applicants per each year for participation
in the loan forgiveness program, within the limits of available
funding. Applicants are responsible for securing their own
loans. The commissioner shall select participants based on
their suitability for practice serving public program patients,
as indicated by experience or training. The commissioner shall
give preference to applicants who have attended a Minnesota
dentistry educational institution and to applicants closest to
completing their training. For each year that a participant
meets the service obligation required under subdivision 3, up to
a maximum of four years, the commissioner shall make annual
disbursements directly to the participant equivalent to $10,000
per year of service, not to exceed $40,000 15 percent of the
average educational debt for indebted dental school graduates in
the year closest to the applicant's selection for which
information is available or the balance of the qualifying
educational loans, whichever is less. Before receiving loan
repayment disbursements and as requested, the participant must
complete and return to the commissioner an affidavit of practice
form provided by the commissioner verifying that the participant
is practicing as required under subdivision 3. The participant
must provide the commissioner with verification that the full
amount of loan repayment disbursement received by the
participant has been applied toward the designated loans. After
each disbursement, verification must be received by the
commissioner and approved before the next loan repayment
disbursement is made. Participants who move their practice
remain eligible for loan repayment as long as they practice as
required under subdivision 3.
Sec. 35. Minnesota Statutes 2002, section 144.396,
subdivision 1, is amended to read:
Subdivision 1. [PURPOSE.] The legislature finds that it is
important to reduce the prevalence of tobacco use among the
youth of this state. It is a goal of the state to reduce
tobacco use among youth by 30 25 percent by the year 2005, and
to promote statewide and local tobacco use prevention activities
to achieve this goal.
Sec. 36. Minnesota Statutes 2002, section 144.396,
subdivision 5, is amended to read:
Subd. 5. [STATEWIDE TOBACCO PREVENTION GRANTS.] (a) To the
extent funds are appropriated for the purposes of this
subdivision, the commissioner of health shall award competitive
grants to eligible applicants for projects and initiatives
directed at the prevention of tobacco use. The project areas
for grants include:
(1) statewide public education and information campaigns
which include implementation at the local level; and
(2) coordinated special projects, including training and
technical assistance, a resource clearinghouse, and contracts
with ethnic and minority communities.
(b) Eligible applicants may include, but are not limited
to, nonprofit organizations, colleges and universities,
professional health associations, community health boards, and
other health care organizations. Applicants must submit
proposals to the commissioner. The proposals must specify the
strategies to be implemented to target tobacco use among youth,
and must take into account the need for a coordinated statewide
tobacco prevention effort.
(c) The commissioner must give priority to applicants who
demonstrate that the proposed project:
(1) is research based or based on proven effective
strategies;
(2) is designed to coordinate with other activities and
education messages related to other health initiatives;
(3) utilizes and enhances existing prevention activities
and resources; or
(4) involves innovative approaches preventing tobacco use
among youth.
Sec. 37. Minnesota Statutes 2002, section 144.396,
subdivision 7, is amended to read:
Subd. 7. [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.]
The commissioner shall distribute the funds available under
section 144.395, subdivision 2, paragraph (c), clause
(3) appropriated for the purpose of local health promotion and
protection activities to community health boards for local
health promotion and protection activities for local health
initiatives other than tobacco prevention aimed at high risk
health behaviors among youth. The commissioner shall distribute
these funds to the community health boards based on demographics
and other need-based factors relating to health.
Sec. 38. Minnesota Statutes 2002, section 144.396,
subdivision 10, is amended to read:
Subd. 10. [REPORT.] The commissioner of health shall
submit an annual a biennial report to the chairs and members of
the house health and human services finance committee and the
senate health and family security budget division on the
statewide and local projects and community health board
prevention activities funded under this section. These reports
must include information on grant recipients, activities that
were conducted using grant funds, and evaluation data and
outcome measures, if available. These reports are due by
January 15 of each year the odd-numbered years, beginning in
2001.
Sec. 39. Minnesota Statutes 2002, section 144.396,
subdivision 11, is amended to read:
Subd. 11. [AUDITS.] The legislative auditor shall may
audit tobacco use prevention and local public health endowment
fund expenditures to ensure that the money is spent for tobacco
use prevention measures and public health initiatives.
Sec. 40. Minnesota Statutes 2002, section 144.396,
subdivision 12, is amended to read:
Subd. 12. [ENDOWMENT FUND FUNDS NOT TO SUPPLANT EXISTING
FUNDING.] Appropriations from the tobacco use prevention and
local public health endowment fund Funds appropriated to the
statewide tobacco prevention grants, local tobacco prevention
grants, or the local public health promotion and prevention must
not be used as a substitute for traditional sources of funding
tobacco use prevention activities or public health initiatives.
Any local unit of government receiving money under this section
must ensure that existing local financial efforts remain in
place.
Sec. 41. Minnesota Statutes 2002, section 144.414,
subdivision 3, is amended to read:
Subd. 3. [HEALTH CARE FACILITIES AND CLINICS.] (a) Smoking
is prohibited in any area of a hospital, health care clinic,
doctor's office, or other health care-related facility, other
than a nursing home, boarding care facility, or licensed
residential facility, except as allowed in this subdivision.
(b) Smoking by patients in a chemical dependency treatment
program or mental health program may be allowed in a separated
well-ventilated area pursuant to a policy established by the
administrator of the program that identifies circumstances in
which prohibiting smoking would interfere with the treatment of
persons recovering from chemical dependency or mental illness.
(c) Smoking by participants in peer reviewed scientific
studies related to the health effects of smoking may be allowed
in a separated room ventilated at a rate of 60 cubic feet per
minute per person pursuant to a policy that is approved by the
commissioner and is established by the administrator of the
program to minimize exposure of nonsmokers to smoke.
[EFFECTIVE DATE.] This section is effective January 1, 2004.
Sec. 42. [144.5509] [RADIATION THERAPY FACILITY
CONSTRUCTION.]
(a) A radiation therapy facility may be constructed only by
an entity owned, operated, or controlled by a hospital licensed
according to sections 144.50 to 144.56 either alone or in
cooperation with another entity.
(b) This section expires August 1, 2008.
[EFFECTIVE DATE.] This section is effective the day
following final enactment and applies to construction commenced
on or after that date.
Sec. 43. Minnesota Statutes 2002, section 144.551,
subdivision 1, is amended to read:
Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.]
(a) The following construction or modification may not be
commenced:
(1) any erection, building, alteration, reconstruction,
modernization, improvement, extension, lease, or other
acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one
physical facility, complex, or site to another, or otherwise
results in an increase or redistribution of hospital beds within
the state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a
hospital, clinic, or other health care facility that is a
national referral center engaged in substantial programs of
patient care, medical research, and medical education meeting
state and national needs that receives more than 40 percent of
its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a
health care facility held an approved certificate of need on May
1, 1984, regardless of the date of expiration of the
certificate;
(3) a project for which a certificate of need was denied
before July 1, 1990, if a timely appeal results in an order
reversing the denial;
(4) a project exempted from certificate of need
requirements by Laws 1981, chapter 200, section 2;
(5) a project involving consolidation of pediatric
specialty hospital services within the Minneapolis-St. Paul
metropolitan area that would not result in a net increase in the
number of pediatric specialty hospital beds among the hospitals
being consolidated;
(6) a project involving the temporary relocation of
pediatric-orthopedic hospital beds to an existing licensed
hospital that will allow for the reconstruction of a new
philanthropic, pediatric-orthopedic hospital on an existing site
and that will not result in a net increase in the number of
hospital beds. Upon completion of the reconstruction, the
licenses of both hospitals must be reinstated at the capacity
that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds
within a hospital building or identifiable complex of buildings
provided the relocation or redistribution does not result in:
(i) an increase in the overall bed capacity at that site; (ii)
relocation of hospital beds from one physical site or complex to
another; or (iii) redistribution of hospital beds within the
state or a region of the state;
(8) relocation or redistribution of hospital beds within a
hospital corporate system that involves the transfer of beds
from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the
capacity of the closed facility is transferred; (ii) the
capacity of the site or complex to which the beds are
transferred does not increase by more than 50 percent; (iii) the
beds are not transferred outside of a federal health systems
agency boundary in place on July 1, 1983; and (iv) the
relocation or redistribution does not involve the construction
of a new hospital building;
(9) a construction project involving up to 35 new beds in a
psychiatric hospital in Rice county that primarily serves
adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a
combined licensed capacity of 130 beds or less if: (i) the new
hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement
hospital, either at the time of construction of the initial
building or as the result of future expansion, will not exceed
70 licensed hospital beds, or the combined licensed capacity of
the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an
existing state facility operated by the commissioner of human
services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one
regional treatment center site to another; or from one building
or site to a new or existing building or site on the same
campus;
(12) the construction or relocation of hospital beds
operated by a hospital having a statutory obligation to provide
hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds;
(13) a construction project involving the addition of up to
31 new beds in an existing nonfederal hospital in Beltrami
county; or
(14) a construction project involving the addition of up to
eight new beds in an existing nonfederal hospital in Otter Tail
county with 100 licensed acute care beds;
(15) a construction project involving the addition of 20
new hospital beds used for rehabilitation services in an
existing hospital in Carver county serving the southwest
suburban metropolitan area. Beds constructed under this clause
shall not be eligible for reimbursement under medical
assistance, general assistance medical care, or MinnesotaCare;
or
(16) a project for the construction or relocation of up to
20 hospital beds for the operation of up to two psychiatric
facilities or units for children provided that the operation of
the facilities or units have received the approval of the
commissioner of human services.
Sec. 44. Minnesota Statutes 2002, section 144E.50,
subdivision 5, is amended to read:
Subd. 5. [DISTRIBUTION.] Money from the fund shall be
distributed according to this subdivision. Ninety-three and
one-third Ninety-five percent of the fund shall be distributed
annually on a contract for services basis with each of the eight
regional emergency medical services systems designated by the
board. The systems shall be governed by a body consisting of
appointed representatives from each of the counties in that
region and shall also include representatives from emergency
medical services organizations. The board shall contract with a
regional entity only if the contract proposal satisfactorily
addresses proposed emergency medical services activities in the
following areas: personnel training, transportation
coordination, public safety agency cooperation, communications
systems maintenance and development, public involvement, health
care facilities involvement, and system management. If each of
the regional emergency medical services systems submits a
satisfactory contract proposal, then this part of the fund shall
be distributed evenly among the regions. If one or more of the
regions does not contract for the full amount of its even share
or if its proposal is unsatisfactory, then the board may
reallocate the unused funds to the remaining regions on a pro
rata basis. Six and two-thirds Five percent of the fund shall
be used by the board to support regionwide reporting systems and
to provide other regional administration and technical
assistance.
Sec. 45. Minnesota Statutes 2002, section 145.881,
subdivision 1, is amended to read:
Subdivision 1. [COMPOSITION OF TASK FORCE.] The
commissioner shall establish and appoint a maternal and child
health advisory task force consisting of 15 members who will
provide equal representation from:
(1) professionals with expertise in maternal and child
health services;
(2) representatives of community health boards as defined
in section 145A.02, subdivision 5; and
(3) consumer representatives interested in the health of
mothers and children.
No members shall be employees of the state department of
health. Section 15.059 governs the maternal and child health
advisory task force. Notwithstanding section 15.059, the
maternal and child health advisory task force expires June 30,
2007.
Sec. 46. Minnesota Statutes 2002, section 145A.10,
subdivision 10, is amended to read:
Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A
state community health advisory committee is established to
advise, consult with, and make recommendations to the
commissioner on the development, maintenance, funding, and
evaluation of community health services. Each community health
board may appoint a member to serve on the committee. The
committee must meet at least quarterly, and special meetings may
be called by the committee chair or a majority of the members.
Members or their alternates may receive a per diem and must be
reimbursed for travel and other necessary expenses while engaged
in their official duties. Notwithstanding section 15.059, the
state community health advisory committee does not expire.
(b) The city councils or county boards that have
established or are members of a community health board must
appoint a community health advisory committee to advise, consult
with, and make recommendations to the community health board on
matters relating to the development, maintenance, funding, and
evaluation of community health services. The committee must
consist of at least five members and must be generally
representative of the population and health care providers of
the community health service area. The committee must meet at
least three times a year and at the call of the chair or a
majority of the members. Members may receive a per diem and
reimbursement for travel and other necessary expenses while
engaged in their official duties.
(c) State and local advisory committees must adopt bylaws
or operating procedures that specify the length of terms of
membership, procedures for assuring that no more than half of
these terms expire during the same year, and other matters
relating to the conduct of committee business. Bylaws or
operating procedures may allow one alternate to be appointed for
each member of a state or local advisory committee. Alternates
may be given full or partial powers and duties of members.
Sec. 47. Minnesota Statutes 2002, section 147A.08, is
amended to read:
147A.08 [EXEMPTIONS.]
(a) This chapter does not apply to, control, prevent, or
restrict the practice, service, or activities of persons listed
in section 147.09, clauses (1) to (6) and (8) to (13), persons
regulated under section 214.01, subdivision 2, or persons
defined in section 144.1495 144.1501, subdivision 1,
paragraphs (a) to (d) (e), (g), and (h).
(b) Nothing in this chapter shall be construed to require
registration of:
(1) a physician assistant student enrolled in a physician
assistant or surgeon assistant educational program accredited by
the Committee on Allied Health Education and Accreditation or by
its successor agency approved by the board;
(2) a physician assistant employed in the service of the
federal government while performing duties incident to that
employment; or
(3) technicians, other assistants, or employees of
physicians who perform delegated tasks in the office of a
physician but who do not identify themselves as a physician
assistant.
Sec. 48. Minnesota Statutes 2002, section 148.5194,
subdivision 1, is amended to read:
Subdivision 1. [FEE PRORATION.] The commissioner shall
prorate the registration fee for clinical fellowship, temporary,
and first time registrants according to the number of months
that have elapsed between the date registration is issued and
the date registration expires or must be renewed under section
148.5191, subdivision 4.
Sec. 49. Minnesota Statutes 2002, section 148.5194,
subdivision 2, is amended to read:
Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial
registration and biennial registration, clinical fellowship
registration, temporary registration, or renewal is $200.
Sec. 50. Minnesota Statutes 2002, section 148.5194,
subdivision 3, is amended to read:
Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL
REGISTRATION.] The fee for initial registration and biennial
registration, clinical fellowship registration, temporary
registration, or renewal is $200.
Sec. 51. Minnesota Statutes 2002, section 148.5194, is
amended by adding a subdivision to read:
Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written
verification of credentialed status is $25.
Sec. 52. Minnesota Statutes 2002, section 148.6445,
subdivision 7, is amended to read:
Subd. 7. [CERTIFICATION VERIFICATION TO OTHER STATES.] The
fee for certification verification of licensure to other states
is $25.
Sec. 53. [148C.12] [FEES.]
Subdivision 1. [APPLICATION FEE.] The application fee is
$295.
Subd. 2. [BIENNIAL RENEWAL FEE.] The license renewal fee
is $295. If the commissioner changes the renewal schedule and
the expiration date is less than two years, the fee must be
prorated.
Subd. 3. [TEMPORARY PERMIT FEE.] The initial fee for
applicants under section 148C.04, subdivision 6, paragraph (a),
is $100. The fee for annual renewal of a temporary permit is
$100.
Subd. 4. [EXAMINATION FEE.] The examination fee for the
written examination is $95 and for the oral examination is $200.
Subd. 5. [INACTIVE RENEWAL FEE.] The inactive renewal fee
is $150.
Subd. 6. [LATE FEE.] The late fee is 25 percent of the
biennial renewal fee, the inactive renewal fee, or the annual
fee for renewal of temporary practice status.
Subd. 7. [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The
fee for renewal of a license that has expired for less than two
years is the total of the biennial renewal fee, the late fee,
and a fee of $100 for review and approval of the continuing
education report.
Subd. 8. [FEE FOR LICENSE VERIFICATIONS.] The fee for
license verification to institutions and other jurisdictions is
$25.
Subd. 9. [SURCHARGE FEE.] Notwithstanding section
16A.1285, subdivision 2, a surcharge of $99 shall be paid at the
time of initial application for or renewal of an alcohol and
drug counselor license until June 30, 2013.
Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable.
Sec. 54. Minnesota Statutes 2002, section 153A.17, is
amended to read:
153A.17 [EXPENSES; FEES.]
The expenses for administering the certification
requirements including the complaint handling system for hearing
aid dispensers in sections 153A.14 and 153A.15 and the consumer
information center under section 153A.18 must be paid from
initial application and examination fees, renewal fees,
penalties, and fines. All fees are nonrefundable. The
certificate application fee is $165 for audiologists registered
under section 148.511 and $490 for all others $350, the
examination fee is $200 $250 for the written portion and
$200 $250 for the practical portion each time one or the other
is taken, and the trainee application fee
is $100 $200. Notwithstanding the policy set forth in section
16A.1285, subdivision 2, a surcharge of $165 for audiologists
registered under section 148.511 and $330 for all others shall
be paid at the time of application or renewal until June 30,
2003, to recover the commissioner's accumulated direct
expenditures for administering the requirements of this
chapter. The penalty fee for late submission of a renewal
application is $200. The fee for verification of certification
to other jurisdictions or entities is $25. All fees, penalties,
and fines received must be deposited in the state government
special revenue fund. The commissioner may prorate the
certification fee for new applicants based on the number of
quarters remaining in the annual certification period.
Sec. 55. Minnesota Statutes 2002, section 239.761,
subdivision 3, is amended to read:
Subd. 3. [GASOLINE.] (a) Gasoline that is not blended with
ethanol must not be contaminated with water or other impurities
and must comply with ASTM specification D 4814-96 D4814-01.
Gasoline that is not blended with ethanol must also comply with
the volatility requirements in Code of Federal Regulations,
title 40, part 80.
(b) After gasoline is sold, transferred, or otherwise
removed from a refinery or terminal, a person responsible for
the product:
(1) may blend the gasoline with agriculturally derived
ethanol as provided in subdivision 4;
(2) shall not blend the gasoline with any oxygenate other
than denatured, agriculturally derived ethanol;
(3) shall not blend the gasoline with other petroleum
products that are not gasoline or denatured, agriculturally
derived ethanol;
(4) shall not blend the gasoline with products commonly and
commercially known as casinghead gasoline, absorption gasoline,
condensation gasoline, drip gasoline, or natural gasoline; and
(5) may blend the gasoline with a detergent additive, an
antiknock additive, or an additive designed to replace
tetra-ethyl lead, that is registered by the EPA.
Sec. 56. Minnesota Statutes 2002, section 239.761,
subdivision 4, is amended to read:
Subd. 4. [GASOLINE BLENDED WITH ETHANOL.] (a) Gasoline may
be blended with up to ten percent, by volume, agriculturally
derived, denatured ethanol that complies with the requirements
of subdivision 5.
(b) A gasoline-ethanol blend must:
(1) comply with the volatility requirements in Code of
Federal Regulations, title 40, part 80;
(2) comply with ASTM specification D 4814-96 D4814-01, or
the gasoline base stock from which a gasoline-ethanol blend was
produced must comply with ASTM specification D 4814-96 D4814-01;
and
(3) not be blended with casinghead gasoline, absorption
gasoline, condensation gasoline, drip gasoline, or natural
gasoline after the gasoline-ethanol blend has been sold,
transferred, or otherwise removed from a refinery or terminal.
Sec. 57. Minnesota Statutes 2002, section 239.761,
subdivision 5, is amended to read:
Subd. 5. [DENATURED ETHANOL.] Denatured ethanol that is to
be blended with gasoline must be agriculturally derived and must
comply with ASTM specification D 4806-95b D4806-01. This
includes the requirement that ethanol may be denatured only as
specified in Code of Federal Regulations, title 27, parts 20 and
21.
Sec. 58. Minnesota Statutes 2002, section 239.761,
subdivision 6, is amended to read:
Subd. 6. [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.] (a)
A person responsible for the product shall comply with the
following requirements:
(1) after July 1, 2000, gasoline containing in excess of
one-third of one percent, in total, of the nonethanol oxygenates
listed in paragraph (b) may must not be sold or offered for sale
at any time in this state; and
(2) after July 1, 2005, gasoline containing any of the
nonethanol oxygenates listed in paragraph (b) may must not be
sold or offered for sale in this state.
(b) The oxygenates prohibited under paragraph (a) are:
(1) methyl tertiary butyl ether, as defined in section
296A.01, subdivision 34;
(2) ethyl tertiary butyl ether, as defined in section
296A.01, subdivision 18; or
(3) tertiary amyl methyl ether.
(c) Gasoline that is blended with an a nonethanol oxygenate
, other than denatured ethanol, must comply with ASTM
specification D 4814-96 D4814-01. Nonethanol oxygenates, other
than denatured ethanol, must not be blended into gasoline after
the gasoline has been sold, transferred, or otherwise removed
from a refinery or terminal.
Sec. 59. Minnesota Statutes 2002, section 239.761,
subdivision 7, is amended to read:
Subd. 7. [HEATING FUEL OIL.] Heating fuel oil must comply
with ASTM specification D 396-96 D396-01.
Sec. 60. Minnesota Statutes 2002, section 239.761,
subdivision 8, is amended to read:
Subd. 8. [DIESEL FUEL OIL.] Diesel fuel oil must comply
with ASTM specification D 975-96a D975-01a.
Sec. 61. Minnesota Statutes 2002, section 239.761,
subdivision 9, is amended to read:
Subd. 9. [KEROSENE.] Kerosene must comply with ASTM
specification D 3699-96a D3699-01.
Sec. 62. Minnesota Statutes 2002, section 239.761,
subdivision 10, is amended to read:
Subd. 10. [AVIATION GASOLINE.] Aviation gasoline must
comply with ASTM specification D 910-96 D910-00.
Sec. 63. Minnesota Statutes 2002, section 239.761,
subdivision 11, is amended to read:
Subd. 11. [AVIATION TURBINE FUEL, JET FUEL.] Aviation
turbine fuel and jet fuel must comply with ASTM specification D
1655-96c D1655-01.
Sec. 64. Minnesota Statutes 2002, section 239.761,
subdivision 12, is amended to read:
Subd. 12. [GAS TURBINE FUEL OIL.] Fuel oil for use in
nonaviation gas turbine engines must comply with ASTM
specification D 2880-96a D2880-00.
Sec. 65. Minnesota Statutes 2002, section 239.761,
subdivision 13, is amended to read:
Subd. 13. [E85.] A blend of ethanol and gasoline,
containing at least 60 percent ethanol and not more than 85
percent ethanol, produced for use as a motor fuel in alternative
fuel vehicles as defined in section 296A.01, subdivision 5, must
comply with ASTM specification D 5798-96 D5798-99.
Sec. 66. Minnesota Statutes 2002, section 239.792, is
amended to read:
239.792 [GASOLINE OCTANE.]
Subdivision 1. [DISCLOSURE.] A manufacturer, hauler,
blender, agent, jobber, consignment agent, importer, or
distributor who sells, delivers, or distributes gasoline or
gasoline-oxygenate blends, shall provide, at the time of
delivery, a bill of lading or shipping manifest to the person
who receives the gasoline. The bill or manifest must state the
minimum octane of the gasoline delivered. The stated octane
number must be the average of the "motor method" octane number
and the "research method" octane number as determined by the
test methods in ASTM specification D 4814-96 D4814-01, or by a
test method adopted by department rule.
Subd. 2. [DISPENSER LABELING.] A person responsible for
the product shall clearly, conspicuously, and permanently label
each gasoline dispenser that is used to sell gasoline or
gasoline-oxygenate blends at retail or to dispense gasoline or
gasoline-oxygenate blends into the fuel supply tanks of motor
vehicles, with the minimum octane of the gasoline dispensed.
The label must meet the following requirements:
(a) The octane number displayed on the label must represent
the average of the "motor method" octane number and the
"research method" octane number as determined by the test
methods in ASTM specification D 4814-96 D4814-01, or by a test
method adopted by department rule.
(b) The label must be at least 2-1/2 inches high and three
inches wide, with a yellow background, black border, and black
figures and letters.
(c) The number representing the octane of the gasoline must
be at least one inch high.
(d) The label must include the words "minimum octane" and
the term "(R+M)/2" or "(RON+MON)/2."
Sec. 67. [246.0141] [TOBACCO USE PROHIBITED.]
No patient, staff, guest, or visitor on the grounds or in a
state regional treatment center, the Minnesota security
hospital, the Minnesota sex offender program, or the Minnesota
extended treatment options program may possess or use tobacco or
a tobacco related device. For the purposes of this section,
"tobacco" and "tobacco related device" have the meanings given
in section 609.685, subdivision 1. This section does not
prohibit the possession or use of tobacco or a tobacco related
device by an adult as part of a traditional Indian spiritual or
cultural ceremony. For purposes of this section, an Indian is a
person who is a member of an Indian tribe as defined in section
260.755, subdivision 12.
[EFFECTIVE DATE.] This section is effective January 1, 2004.
Sec. 68. Minnesota Statutes 2002, section 295.55,
subdivision 2, is amended to read:
Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a)
Each hospital or surgical center must make estimated payments of
the taxes for the calendar year in monthly installments to the
commissioner within 15 days after the end of the month.
(b) Estimated tax payments are not required of hospitals or
surgical centers if: (1) the tax for the current calendar year
is less than $500; or (2) the tax for the previous calendar year
is less than $500, if the taxpayer had a tax liability and was
doing business the entire year; or (3) if a hospital has been
allowed a grant under section 144.1484, subdivision 2, for the
year.
(c) Underpayment of estimated installments bear interest at
the rate specified in section 270.75, from the due date of the
payment until paid or until the due date of the annual return
whichever comes first. An underpayment of an estimated
installment is the difference between the amount paid and the
lesser of (1) 90 percent of one-twelfth of the tax for the
calendar year or (2) one-twelfth of the total tax for the
previous calendar year if the taxpayer had a tax liability and
was doing business the entire year.
Sec. 69. Minnesota Statutes 2002, section 296A.01,
subdivision 2, is amended to read:
Subd. 2. [AGRICULTURAL ALCOHOL GASOLINE.] "Agricultural
alcohol gasoline" means a gasoline-ethanol blend of up to ten
percent agriculturally derived fermentation ethanol derived from
agricultural products, such as potatoes, cereal, grains, cheese
whey, sugar beets, forest products, or other renewable
resources, that:
(1) meets the specifications in ASTM specification D
4806-95b D4806-01; and
(2) is denatured as specified in Code of Federal
Regulations, title 27, parts 20 and 21.
Sec. 70. Minnesota Statutes 2002, section 296A.01,
subdivision 7, is amended to read:
Subd. 7. [AVIATION GASOLINE.] "Aviation gasoline" means
any gasoline that is capable of use for the purpose of producing
or generating power for propelling internal combustion engine
aircraft, that meets the specifications in ASTM specification D
910-96 D910-00, and that either:
(1) is invoiced and billed by a producer, manufacturer,
refiner, or blender to a distributor or dealer, by a distributor
to a dealer or consumer, or by a dealer to consumer, as
"aviation gasoline"; or
(2) whether or not invoiced and billed as provided in
clause (1), is received, sold, stored, or withdrawn from storage
by any person, to be used for the purpose of producing or
generating power for propelling internal combustion engine
aircraft.
Sec. 71. Minnesota Statutes 2002, section 296A.01,
subdivision 8, is amended to read:
Subd. 8. [AVIATION TURBINE FUEL AND JET FUEL.] "Aviation
turbine fuel" and "jet fuel" mean blends of hydrocarbons derived
from crude petroleum, natural gasoline, and synthetic
hydrocarbons, intended for use in aviation turbine engines, and
that meet the specifications in ASTM specification D
1655-96c D1655-01.
Sec. 72. Minnesota Statutes 2002, section 296A.01,
subdivision 14, is amended to read:
Subd. 14. [DIESEL FUEL OIL.] "Diesel fuel oil" means a
petroleum distillate or blend of petroleum distillate and
residual fuels, intended for use as a motor fuel in internal
combustion diesel engines, that meets the specifications in ASTM
specification D 975-96a D975-01A. Diesel fuel includes number 1
and number 2 fuel oils. K-1 kerosene is not diesel fuel unless
it is blended with diesel fuel for use in motor vehicles.
Sec. 73. Minnesota Statutes 2002, section 296A.01,
subdivision 19, is amended to read:
Subd. 19. [E85.] "E85" means a petroleum product that is a
blend of agriculturally derived denatured ethanol and gasoline
or natural gasoline that typically contains 85 percent ethanol
by volume, but at a minimum must contain 60 percent ethanol by
volume. For the purposes of this chapter, the energy content of
E85 will be considered to be 82,000 BTUs per gallon. E85
produced for use as a motor fuel in alternative fuel vehicles as
defined in subdivision 5 must comply with ASTM specification D
5798-96 D5798-99.
Sec. 74. Minnesota Statutes 2002, section 296A.01,
subdivision 20, is amended to read:
Subd. 20. [ETHANOL, DENATURED.] "Ethanol, denatured" means
ethanol that is to be blended with gasoline, has been
agriculturally derived, and complies with ASTM specification D
4806-95b D4806-01. This includes the requirement that ethanol
may be denatured only as specified in Code of Federal
Regulations, title 27, parts 20 and 21.
Sec. 75. Minnesota Statutes 2002, section 296A.01,
subdivision 22, is amended to read:
Subd. 22. [GAS TURBINE FUEL OIL.] "Gas turbine fuel oil"
means fuel that contains mixtures of hydrocarbon oils free of
inorganic acid and excessive amounts of solid or fibrous foreign
matter, intended for use in nonaviation gas turbine engines, and
that meets the specifications in ASTM specification D 2880-96a
D2880-00.
Sec. 76. Minnesota Statutes 2002, section 296A.01,
subdivision 23, is amended to read:
Subd. 23. [GASOLINE.] (a) "Gasoline" means:
(1) all products commonly or commercially known or sold as
gasoline regardless of their classification or uses, except
casinghead gasoline, absorption gasoline, condensation gasoline,
drip gasoline, or natural gasoline that under the requirements
of section 239.761, subdivision 3, must not be blended with
gasoline that has been sold, transferred, or otherwise removed
from a refinery or terminal; and
(2) any liquid prepared, advertised, offered for sale or
sold for use as, or commonly and commercially used as, a fuel in
spark-ignition, internal combustion engines, and that when
tested by the weights and measures division meets the
specifications in ASTM specification D 4814-96 D4814-01.
(b) Gasoline that is not blended with ethanol must not be
contaminated with water or other impurities and must comply with
both ASTM specification D 4814-96 D4814-01 and the volatility
requirements in Code of Federal Regulations, title 40, part 80.
(c) After gasoline is sold, transferred, or otherwise
removed from a refinery or terminal, a person responsible for
the product:
(1) may blend the gasoline with agriculturally derived
ethanol, as provided in subdivision 24;
(2) must not blend the gasoline with any oxygenate other
than denatured, agriculturally derived ethanol;
(3) must not blend the gasoline with other petroleum
products that are not gasoline or denatured, agriculturally
derived ethanol;
(4) must not blend the gasoline with products commonly and
commercially known as casinghead gasoline, absorption gasoline,
condensation gasoline, drip gasoline, or natural gasoline; and
(5) may blend the gasoline with a detergent additive, an
antiknock additive, or an additive designed to replace
tetra-ethyl lead, that is registered by the EPA.
Sec. 77. Minnesota Statutes 2002, section 296A.01,
subdivision 24, is amended to read:
Subd. 24. [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.]
"Gasoline blended with nonethanol oxygenate" means gasoline
blended with ETBE, MTBE, or other alcohol or ether, except
denatured ethanol, that is approved as an oxygenate by the EPA,
and that complies with ASTM specification D 4814-96 D4814-01.
Oxygenates, other than denatured ethanol, must not be blended
into gasoline after the gasoline has been sold, transferred, or
otherwise removed from a refinery or terminal.
Sec. 78. Minnesota Statutes 2002, section 296A.01,
subdivision 25, is amended to read:
Subd. 25. [GASOLINE BLENDED WITH ETHANOL.] "Gasoline
blended with ethanol" means gasoline blended with up to ten
percent, by volume, agriculturally derived, denatured ethanol.
The blend must comply with the volatility requirements in Code
of Federal Regulations, title 40, part 80. The blend must also
comply with ASTM specification D 4814-96 D4814-01, or the
gasoline base stock from which a gasoline-ethanol blend was
produced must comply with ASTM specification D 4814-96 D4814-01;
and the gasoline-ethanol blend must not be blended with
casinghead gasoline, absorption gasoline, condensation gasoline,
drip gasoline, or natural gasoline after the gasoline-ethanol
blend has been sold, transferred, or otherwise removed from a
refinery or terminal. The blend need not comply with ASTM
specification D 4814-96 D4814-01 if it is subjected to a
standard distillation test. For a distillation test, a
gasoline-ethanol blend is not required to comply with the
temperature specification at the 50 percent liquid recovery
point, if the gasoline from which the gasoline-ethanol blend was
produced complies with all of the distillation specifications.
Sec. 79. Minnesota Statutes 2002, section 296A.01,
subdivision 26, is amended to read:
Subd. 26. [HEATING FUEL OIL.] "Heating fuel oil" means a
petroleum distillate, blend of petroleum distillates and
residuals, or petroleum residual heating fuel that meets the
specifications in ASTM specification D 396-96 D396-01.
Sec. 80. Minnesota Statutes 2002, section 296A.01,
subdivision 28, is amended to read:
Subd. 28. [KEROSENE.] "Kerosene" means a refined petroleum
distillate consisting of a homogeneous mixture of hydrocarbons
essentially free of water, inorganic acidic and basic compounds,
and excessive amounts of particulate contaminants and that meets
the specifications in ASTM specification D 3699-96a D3699-01.
Sec. 81. Minnesota Statutes 2002, section 296A.01, is
amended by adding a subdivision to read:
Subd. 38a. [NONETHANOL OXYGENATE.] "Nonethanol oxygenate"
means ETBE or MTBE, as defined in this section, or other alcohol
or ether, except denatured ethanol, that is approved as an
oxygenate by the EPA.
Sec. 82. Minnesota Statutes 2002, section 326.42, is
amended to read:
326.42 [APPLICATIONS, FEES.]
Subdivision 1. [APPLICATION.] Applications for plumber's
license shall be made to the state commissioner of health, with
fee. Unless the applicant is entitled to a renewal, the
applicant shall be licensed by the state commissioner of health
only after passing a satisfactory examination by the examiners
showing fitness. Examination fees for both journeyman and
master plumbers shall be in an amount prescribed by the state
commissioner of health pursuant to section 144.122. Upon being
notified that of having successfully passed the examination for
original license the applicant shall submit an application, with
the license fee herein provided. License fees shall be in an
amount prescribed by the state commissioner of health pursuant
to section 144.122. Licenses shall expire and be renewed as
prescribed by the commissioner pursuant to section 144.122.
Subd. 2. [FEES.] Plumbing system plans and specifications
that are submitted to the commissioner for review shall be
accompanied by the appropriate plan examination fees. If the
commissioner determines, upon review of the plans, that
inadequate fees were paid, the necessary additional fees shall
be paid prior to plan approval. The commissioner shall charge
the following fees for plan reviews and audits of plumbing
installations for public, commercial, and industrial buildings:
(1) systems with both water distribution and drain, waste,
and vent systems and having:
(i) 25 or fewer drainage fixture units, $150;
(ii) 26 to 50 drainage fixture units, $250;
(iii) 51 to 150 drainage fixture units, $350;
(iv) 151 to 249 drainage fixture units, $500;
(v) 250 or more drainage fixture units, $3 per drainage
fixture unit to a maximum of $4,000; and
(vi) interceptors, separators, or catch basins, $70 per
interceptor, separator, or catch basin;
(2) building sewer service only, $150;
(3) building water service only, $150;
(4) building water distribution system only, no drainage
system, $5 per supply fixture unit or $150, whichever is
greater;
(5) storm drainage system, a minimum fee of $150 or:
(i) $50 per drain opening, up to a maximum of $500; and
(ii) $70 per interceptor, separator, or catch basin;
(6) manufactured home park or campground, 1 to 25 sites,
$300;
(7) manufactured home park or campground, 26 to 50 sites,
$350;
(8) manufactured home park or campground, 51 to 125 sites,
$400;
(9) manufactured home park or campground, more than 125
sites, $500;
(10) accelerated review, double the regular fee, one-half
to be refunded if no response from the commissioner within 15
business days; and
(11) revision to previously reviewed or incomplete plans:
(i) review of plans for which commissioner has issued two
or more requests for additional information, per review, $100 or
ten percent of the original fee, whichever is greater;
(ii) proposer-requested revision with no increase in
project scope, $50 or ten percent of original fee, whichever is
greater; and
(iii) proposer-requested revision with an increase in
project scope, $50 plus the difference between the original
project fee and the revised project fee.
Sec. 83. Minnesota Statutes 2002, section 471.59,
subdivision 1, is amended to read:
Subdivision 1. [AGREEMENT.] Two or more governmental
units, by agreement entered into through action of their
governing bodies, may jointly or cooperatively exercise any
power common to the contracting parties or any similar powers,
including those which are the same except for the territorial
limits within which they may be exercised. The agreement may
provide for the exercise of such powers by one or more of the
participating governmental units on behalf of the other
participating units. The term "governmental unit" as used in
this section includes every city, county, town, school district,
other political subdivision of this or another state, another
state, the University of Minnesota, nonprofit hospitals licensed
under sections 144.50 to 144.56, and any agency of the state of
Minnesota or the United States, and includes any instrumentality
of a governmental unit. For the purpose of this section, an
instrumentality of a governmental unit means an instrumentality
having independent policy making and appropriating authority.
Sec. 84. 2003 S.F. No. 1019, section 2, if enacted, is
amended to read:
Sec. 2. [144.7063] [DEFINITIONS.]
Subdivision 1. [SCOPE.] Unless the context clearly
indicates otherwise, for the purposes of sections 144.706 to
144.7069, the terms defined in this section have the meanings
given them.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Subd. 3. [FACILITY.] "Facility" means a hospital licensed
under sections 144.50 to 144.58.
Subd. 4. [SERIOUS DISABILITY.] "Serious disability" means
(1) a physical or mental impairment that substantially limits
one or more of the major life activities of an individual,
(2) or a loss of bodily function, if the impairment or loss
lasts more than seven days or is still present at the time of
discharge from an inpatient health care facility, or (3) (2)
loss of a body part.
Subd. 5. [SURGERY.] "Surgery" means the treatment of
disease, injury, or deformity by manual or operative methods.
Surgery includes endoscopies and other invasive procedures.
Sec. 85. 2003 S.F. No. 1019, section 3, if enacted, is
amended to read:
Sec. 3. [144.7065] [FACILITY REQUIREMENTS TO REPORT,
ANALYZE, AND CORRECT.]
Subdivision 1. [REPORTS OF ADVERSE HEALTH CARE EVENTS
REQUIRED.] Each facility shall report to the commissioner the
occurrence of any of the adverse health care events described in
subdivisions 2 to 7 as soon as is reasonably and practically
possible, but no later than 15 working days after discovery of
the event. The report shall be filed in a format specified by
the commissioner and shall identify the facility but shall not
include any identifying information for any of the health care
professionals, facility employees, or patients involved. The
commissioner may consult with experts and organizations familiar
with patient safety when developing the format for reporting and
in further defining events in order to be consistent with
industry standards.
Subd. 2. [SURGICAL EVENTS.] Events reportable under this
subdivision are:
(1) surgery performed on a wrong body part that is not
consistent with the documented informed consent for that
patient. Reportable events under this clause do not include
situations requiring prompt action that occur in the course of
surgery or situations whose urgency precludes obtaining informed
consent;
(2) surgery performed on the wrong patient;
(3) the wrong surgical procedure performed on a patient
that is not consistent with the documented informed consent for
that patient. Reportable events under this clause do not
include situations requiring prompt action that occur in the
course of surgery or situations whose urgency precludes
obtaining informed consent;
(4) retention of a foreign object in a patient after
surgery or other procedure, excluding objects intentionally
implanted as part of a planned intervention and objects present
prior to surgery that are intentionally retained; and
(5) death during or immediately after surgery of a normal,
healthy patient who has no organic, physiologic, biochemical, or
psychiatric disturbance and for whom the pathologic processes
for which the operation is to be performed are localized and do
not entail a systemic disturbance.
Subd. 3. [PRODUCT OR DEVICE EVENTS.] Events reportable
under this subdivision are:
(1) patient death or serious disability associated with the
use of contaminated drugs, devices, or biologics provided by the
facility when the contamination is the result of generally
detectable contaminants in drugs, devices, or biologics
regardless of the source of the contamination or the product;
(2) patient death or serious disability associated with the
use or function of a device in patient care in which the device
is used or functions other than as intended. "Device" includes,
but is not limited to, catheters, drains, and other specialized
tubes, infusion pumps, and ventilators; and
(3) patient death or serious disability associated with
intravascular air embolism that occurs while being cared for in
a facility, excluding deaths associated with neurosurgical
procedures known to present a high risk of intravascular air
embolism.
Subd. 4. [PATIENT PROTECTION EVENTS.] Events reportable
under this subdivision are:
(1) an infant discharged to the wrong person;
(2) patient death or serious disability associated with
patient disappearance for more than four hours, excluding events
involving adults who have decision-making capacity; and
(3) patient suicide or attempted suicide resulting in
serious disability while being cared for in a facility due to
patient actions after admission to the facility, excluding
deaths resulting from self-inflicted injuries that were the
reason for admission to the facility.
Subd. 5. [CARE MANAGEMENT EVENTS.] Events reportable under
this subdivision are:
(1) patient death or serious disability associated with a
medication error, including, but not limited to, errors
involving the wrong drug, the wrong dose, the wrong patient, the
wrong time, the wrong rate, the wrong preparation, or the wrong
route of administration, excluding reasonable differences in
clinical judgment on drug selection and dose;
(2) patient death or serious disability associated with a
hemolytic reaction due to the administration of ABO-incompatible
blood or blood products;
(3) maternal death or serious disability associated with
labor or delivery in a low-risk pregnancy while being cared for
in a facility, including events that occur within 42 days
postdelivery and excluding deaths from pulmonary or amniotic
fluid embolism, acute fatty liver of pregnancy, or
cardiomyopathy;
(4) patient death or serious disability directly related to
hypoglycemia, the onset of which occurs while the patient is
being cared for in a facility;
(5) death or serious disability, including kernicterus,
associated with failure to identify and treat hyperbilirubinemia
in neonates during the first 28 days of life.
"Hyperbilirubinemia" means bilirubin levels greater than 30
milligrams per deciliter;
(6) stage 3 or 4 ulcers acquired after admission to a
facility, excluding progression from stage 2 to stage 3 if stage
2 was recognized upon admission; and
(7) patient death or serious disability due to spinal
manipulative therapy.
Subd. 6. [ENVIRONMENTAL EVENTS.] Events reportable under
this subdivision are:
(1) patient death or serious disability associated with an
electric shock while being cared for in a facility, excluding
events involving planned treatments such as electric
countershock;
(2) any incident in which a line designated for oxygen or
other gas to be delivered to a patient contains the wrong gas or
is contaminated by toxic substances;
(3) patient death or serious disability associated with a
burn incurred from any source while being cared for in a
facility;
(4) patient death associated with a fall while being cared
for in a facility; and
(5) patient death or serious disability associated with the
use or lack of restraints or bedrails while being cared for in a
facility.
Subd. 7. [CRIMINAL EVENTS.] Events reportable under this
subdivision are:
(1) any instance of care ordered by or provided by someone
impersonating a physician, nurse, pharmacist, or other licensed
health care provider;
(2) abduction of a patient of any age;
(3) sexual assault on a patient within or on the grounds of
a facility; and
(4) death or significant injury of a patient or staff
member resulting from a physical assault that occurs within or
on the grounds of a facility.
Subd. 8. [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION PLAN.]
Following the occurrence of an adverse health care event, the
facility must conduct a root cause analysis of the event.
Following the analysis, the facility must: (1) implement a
corrective action plan to implement the findings of the analysis
or (2) report to the commissioner any reasons for not taking
corrective action. If the root cause analysis and the
implementation of a corrective action plan are complete at the
time an event must be reported, the findings of the analysis and
the corrective action plan must be included in the report of the
event. The findings of the root cause analysis and a copy of
the corrective action plan must otherwise be filed with the
commissioner within 60 days of the event.
Subd. 9. [ELECTRONIC REPORTING.] The commissioner must
design the reporting system so that a facility may file by
electronic means the reports required under this section. The
commissioner shall encourage a facility to use the electronic
filing option when that option is feasible for the facility.
Subd. 10. [RELATION TO OTHER LAW.] (a) Adverse health
events described in subdivisions 2 to 6 do not constitute
"maltreatment" or "a physical injury that is not reasonably
explained" under section 626.557 and are excluded from the
reporting requirements of section 626.557, provided the facility
makes a determination within 24 hours of the discovery of the
event that this section is applicable and the facility files the
reports required under this section in a timely fashion.
(b) A facility that has determined that an event described
in subdivisions 2 to 6 has occurred must inform persons who are
mandated reporters under section 626.5572, subdivision 16, of
that determination. A mandated reporter otherwise required to
report under section 626.557, subdivision 3, paragraph (e), is
relieved of the duty to report an event that the facility
determines under paragraph (a) to be reportable under
subdivisions 2 to 6.
(c) The protections and immunities applicable to voluntary
reports under section 626.557 are not affected by this section.
(d) Notwithstanding section 626.557, a lead agency under
section 626.5572, subdivision 13, is not required to conduct an
investigation of an event described in subdivisions 2 to 6.
Sec. 86. 2003 S.F. No. 1019, section 7, if enacted, is
amended to read:
Sec. 7. [ADVERSE HEALTH CARE EVENTS REPORTING SYSTEM
TRANSITION PERIOD.]
(a) Effective July 1, 2003, limited implementation of the
Adverse Health Care Events Reporting Act shall begin, provided
the commissioner of health has secured sufficient nonstate funds
for this purpose. During this period, the commissioner must:
(1) solicit additional nonstate funds to support full
implementation of the system;
(2) work with organizations and experts familiar with
patient safety to review reporting categories in Minnesota
Statutes, section 144.7065, make necessary clarifications, and
develop educational materials; and
(3) monitor activities of the National Quality Forum and
other patient safety organizations, other states, and the
federal government in the area of patient safety.
(b) Effective July 1, 2003, facilities defined in Minnesota
Statutes, section 144.7063, subdivision 3, shall report any
adverse health care events, as defined in Minnesota Statutes,
section 144.7065, to the incident reporting system maintained by
the Minnesota Hospital Association. The association shall
provide a summary report to the commissioner that identifies the
types of events by category. The association shall consult with
the commissioner regarding the data to be reported to the
commissioner, storage of data received by the association but
not reported to the commissioner, and eventual retrieval by the
commissioner of stored data.
(c) The commissioner shall report to the legislature by
January 15 of 2004 and 2005, with a list of the number of
reported events by type and recommendations, if any, for
reporting system modifications, including additional categories
of events that should be reported.
(d) From July 1, 2003, until full implementation of the
reporting system, the commissioner of health shall not make a
final disposition as defined in Minnesota Statutes, section
626.5572, subdivision 8, for investigations conducted in
licensed hospitals under the provisions of Minnesota Statutes,
section 626.557. The commissioner's findings in these cases
shall identify noncompliance with federal certification or state
licensure rules or laws.
(e) Effective July 1, 2004, the reporting system shall be
fully implemented, provided (1) the commissioner has secured
sufficient funds from nonstate sources to operate the system
during fiscal year 2005, and (2) the commissioner has notified
facilities by April 1, 2004, of their duty to report.
(f) Effective July 1, 2005, the reporting system shall be
operated with state appropriations.
Sec. 87. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.]
(a) The commissioner's authority to collect the certificate
application fee from hearing instrument dispensers under
Minnesota Statutes, section 153A.17, is suspended for certified
hearing instrument dispensers renewing certification in fiscal
year 2004.
(b) The commissioner's authority to collect the license
renewal fee from occupational therapy practitioners under
Minnesota Statutes, section 148.6445, subdivision 2, is
suspended for fiscal years 2004 and 2005.
Sec. 88. [REVISOR'S INSTRUCTION.]
(a) The revisor of statutes shall delete the reference to
"144.1495" in Minnesota Statutes, section 62Q.145, and insert
"144.1501."
(b) For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 89. [REPEALER.]
(a) Minnesota Statutes 2002, sections 62J.15; 62J.152;
62J.451; 62J.452; 144.126; 144.1484; 144.1494; 144.1495;
144.1496; 144.1497; 144A.36; 144A.38; 148.5194, subdivision 3a;
and 148.6445, subdivision 9, are repealed.
(b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125;
4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170;
4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220;
4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270;
4763.0285; 4763.0295; and 4763.0300, are repealed.
ARTICLE 8
LOCAL PUBLIC HEALTH GRANTS
Section 1. Minnesota Statutes 2002, section 144E.11,
subdivision 6, is amended to read:
Subd. 6. [REVIEW CRITERIA.] When reviewing an application
for licensure, the board and administrative law judge shall
consider the following factors:
(1) the relationship of the proposed service or expansion
in primary service area to the current community health plan as
approved by the commissioner of health under section 145A.12,
subdivision 4;
(2) the recommendations or comments of the governing bodies
of the counties, municipalities, community health boards as
defined under section 145A.09, subdivision 2, and regional
emergency medical services system designated under section
144E.50 in which the service would be provided;
(3) (2) the deleterious effects on the public health from
duplication, if any, of ambulance services that would result
from granting the license;
(4) (3) the estimated effect of the proposed service or
expansion in primary service area on the public health; and
(5) (4) whether any benefit accruing to the public health
would outweigh the costs associated with the proposed service or
expansion in primary service area. The administrative law judge
shall recommend that the board either grant or deny a license or
recommend that a modified license be granted. The reasons for
the recommendation shall be set forth in detail. The
administrative law judge shall make the recommendations and
reasons available to any individual requesting them.
Sec. 2. Minnesota Statutes 2002, section 145.88, is
amended to read:
145.88 [PURPOSE.]
The legislature finds that it is in the public interest to
assure:
(a) statewide planning and coordination of maternal and
child health services through the acquisition and analysis of
population-based health data, provision of technical support and
training, and coordination of the various public and private
maternal and child health efforts; and
(b) support for targeted maternal and child health services
in communities with significant populations of high risk, low
income families through a grants process.
Federal money received by the Minnesota department of
health, pursuant to United States Code, title 42, sections 701
to 709, shall be expended to:
(1) assure access to quality maternal and child health
services for mothers and children, especially those of low
income and with limited availability to health services and
those children at risk of physical, neurological, emotional, and
developmental problems arising from chemical abuse by a mother
during pregnancy;
(2) reduce infant mortality and the incidence of
preventable diseases and handicapping conditions among children;
(3) reduce the need for inpatient and long-term care
services and to otherwise promote the health of mothers and
children, especially by providing preventive and primary care
services for low-income mothers and children and prenatal,
delivery and postpartum care for low-income mothers;
(4) provide rehabilitative services for blind and disabled
children under age 16 receiving benefits under title XVI of the
Social Security Act; and
(5) provide and locate medical, surgical, corrective and
other service for children who are crippled or who are suffering
from conditions that lead to crippling.
Sec. 3. Minnesota Statutes 2002, section 145.881,
subdivision 2, is amended to read:
Subd. 2. [DUTIES.] The advisory task force shall meet on a
regular basis to perform the following duties:
(a) review and report on the health care needs of mothers
and children throughout the state of Minnesota;
(b) review and report on the type, frequency and impact of
maternal and child health care services provided to mothers and
children under existing maternal and child health care programs,
including programs administered by the commissioner of health;
(c) establish, review, and report to the commissioner a
list of program guidelines and criteria which the advisory task
force considers essential to providing an effective maternal and
child health care program to low income populations and high
risk persons and fulfilling the purposes defined in section
145.88;
(d) review staff recommendations of the department of
health regarding maternal and child health grant awards before
the awards are made;
(e) make recommendations to the commissioner for the use of
other federal and state funds available to meet maternal and
child health needs;
(f) (e) make recommendations to the commissioner of health
on priorities for funding the following maternal and child
health services: (1) prenatal, delivery and postpartum care, (2)
comprehensive health care for children, especially from birth
through five years of age, (3) adolescent health services, (4)
family planning services, (5) preventive dental care, (6)
special services for chronically ill and handicapped children
and (7) any other services which promote the health of mothers
and children; and
(g) make recommendations to the commissioner of health on
the process to distribute, award and administer the maternal and
child health block grant funds; and
(h) review the measures that are used to define the
variables of the funding distribution formula in section
145.882, subdivision 4, every two years and make recommendations
to the commissioner of health for changes based upon principles
established by the advisory task force for this purpose.
(f) establish, in consultation with the commissioner and
the state community health advisory committee established under
section 145A.10, subdivision 10, paragraph (a), statewide
outcomes that will improve the health status of mothers and
children as required in section 145A.12, subdivision 7.
Sec. 4. Minnesota Statutes 2002, section 145.882,
subdivision 1, is amended to read:
Subdivision 1. [FUNDING LEVELS AND ADVISORY TASK FORCE
REVIEW.] Any decrease in the amount of federal funding to the
state for the maternal and child health block grant must be
apportioned to reflect a proportional decrease for each
recipient. Any increase in the amount of federal funding to the
state must be distributed under subdivisions 2, and 3, and 4.
The advisory task force shall review and recommend the
proportion of maternal and child health block grant funds to be
expended for indirect costs, direct services and special
projects.
Sec. 5. Minnesota Statutes 2002, section 145.882,
subdivision 2, is amended to read:
Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.]
Beginning January 1, 1986, up to one-third of the total maternal
and child health block grant money may be retained by the
commissioner of health for administrative and technical
assistance services, projects of regional or statewide
significance, direct services to children with handicaps, and
other activities of the commissioner. to:
(1) meet federal maternal and child block grant
requirements of a statewide needs assessment every five years
and prepare the annual federal block grant application and
report;
(2) collect and disseminate statewide data on the health
status of mothers and children within one year of the end of the
year;
(3) provide technical assistance to community health boards
in meeting statewide outcomes under section 145A.12, subdivision
7;
(4) evaluate the impact of maternal and child health
activities on the health status of mothers and children;
(5) provide services to children under age 16 receiving
benefits under title XVI of the Social Security Act; and
(6) perform other maternal and child health activities
listed in section 145.88 and as deemed necessary by the
commissioner.
Sec. 6. Minnesota Statutes 2002, section 145.882,
subdivision 3, is amended to read:
Subd. 3. [ALLOCATION TO COMMUNITY HEALTH SERVICES
AREAS BOARDS.] (a) The maternal and child health block grant
money remaining after distributions made under subdivision 2
must be allocated according to the formula in subdivision 4 to
community health services areas section 145A.131, subdivision 2,
for distribution by to community health boards. as defined in
section 145A.02, subdivision 5, to qualified programs that
provide essential services within the community health services
area as long as:
(1) the Minneapolis community health service area is
allocated at least $1,626,215 per year;
(2) the St. Paul community health service area is allocated
at least $822,931 per year; and
(3) all other community health service areas are allocated
at least $30,000 per county per year or their 1988-1989 funding
cycle award, whichever is less.
(b) Notwithstanding paragraph (a), if the total amount of
maternal and child health block grant funding decreases, the
decrease must be apportioned to reflect a proportional decrease
for each recipient, including recipients who would otherwise
receive a guaranteed minimum allocation under paragraph (a). A
community health board that receives funding under this section
shall provide at least a 50 percent match for funds received
under United States Code, title 42, sections 701 to 709.
Eligible funds must be used to meet match requirements.
Eligible funds include funds from local property taxes,
reimbursements from third parties, fees, other funds, donations,
nonfederal grants, or state funds received under the local
public health grant defined in section 145A.131, that are used
for maternal and child health activities as described in section
145.882, subdivision 7.
Sec. 7. Minnesota Statutes 2002, section 145.882, is
amended by adding a subdivision to read:
Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a
community health board decides not to participate in maternal
and child health block grant activities under subdivision 3 or
the commissioner determines under section 145A.131, subdivision
7, not to fund the community health board, the commissioner is
responsible for directing maternal and child health block grant
activities in that community health board's geographic area.
The commissioner may elect to directly provide public health
activities to meet the statewide outcomes or to contract with
other governmental units or nonprofit organizations.
Sec. 8. Minnesota Statutes 2002, section 145.882,
subdivision 7, is amended to read:
Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and
child health block grant money allocated to a community health
board or community health services area under this section must
be used for qualified programs for high risk and low-income
individuals. Block grant money must be used for programs that:
(1) specifically address the highest risk populations,
particularly low-income and minority groups with a high rate of
infant mortality and children with low birth weight, by
providing services, including prepregnancy family planning
services, calculated to produce measurable decreases in infant
mortality rates, instances of children with low birth weight,
and medical complications associated with pregnancy and
childbirth, including infant mortality, low birth rates, and
medical complications arising from chemical abuse by a mother
during pregnancy;
(2) specifically target pregnant women whose age, medical
condition, maternal history, or chemical abuse substantially
increases the likelihood of complications associated with
pregnancy and childbirth or the birth of a child with an
illness, disability, or special medical needs;
(3) specifically address the health needs of young children
who have or are likely to have a chronic disease or disability
or special medical needs, including physical, neurological,
emotional, and developmental problems that arise from chemical
abuse by a mother during pregnancy;
(4) provide family planning and preventive medical care for
specifically identified target populations, such as minority and
low-income teenagers, in a manner calculated to decrease the
occurrence of inappropriate pregnancy and minimize the risk of
complications associated with pregnancy and childbirth; or
(5) specifically address the frequency and severity of
childhood and adolescent health issues, including injuries in
high risk target populations by providing services calculated to
produce measurable decreases in mortality and morbidity.;
However, money may be used for this purpose only if the
community health board's application includes program components
for the purposes in clauses (1) to (4) in the proposed
geographic service area and the total expenditure for
injury-related programs under this clause does not exceed ten
percent of the total allocation under subdivision 3.
(b) Maternal and child health block grant money may be used
for purposes other than the purposes listed in this subdivision
only under the following conditions:
(1) the community health board or community health services
area can demonstrate that existing programs fully address the
needs of the highest risk target populations described in this
subdivision; or
(2) the money is used to continue projects that received
funding before creation of the maternal and child health block
grant in 1981.
(c) Projects that received funding before creation of the
maternal and child health block grant in 1981, must be allocated
at least the amount of maternal and child health special project
grant funds received in 1989, unless (1) the local board of
health provides equivalent alternative funding for the project
from another source; or (2) the local board of health
demonstrates that the need for the specific services provided by
the project has significantly decreased as a result of changes
in the demographic characteristics of the population, or other
factors that have a major impact on the demand for services. If
the amount of federal funding to the state for the maternal and
child health block grant is decreased, these projects must
receive a proportional decrease as required in subdivision 1.
Increases in allocation amounts to local boards of health under
subdivision 4 may be used to increase funding levels for these
projects.
(6) specifically address preventing child abuse and
neglect, reducing juvenile delinquency, promoting positive
parenting and resiliency in children, and promoting family
health and economic sufficiency through public health nurse home
visits under section 145A.17; or
(7) specifically address nutritional issues of women,
infants, and young children through WIC clinic services.
Sec. 9. [145.8821] [ACCOUNTABILITY.]
(a) Coordinating with the statewide outcomes established
under section 145A.12, subdivision 7, and with accountability
measures outlined in section 145A.131, subdivision 7, each
community health board that receives money under section
145.882, subdivision 3, shall select by February 1, 2005, and
every five years thereafter, up to two statewide maternal and
child health outcomes.
(b) For the period January 1, 2004, to December 31, 2005,
each community health board must work toward the Healthy People
2010 goal to reduce the state's percentage of low birth weight
infants.
(c) The commissioner shall monitor and evaluate whether
each community health board has made sufficient progress toward
the selected outcomes established in paragraph (b) and under
section 145A.12, subdivision 7.
(d) Community health boards shall provide the commissioner
with annual information necessary to evaluate progress toward
selected statewide outcomes and to meet federal reporting
requirements.
Sec. 10. Minnesota Statutes 2002, section 145.883,
subdivision 1, is amended to read:
Subdivision 1. [SCOPE.] For purposes of sections 145.881
to 145.888 145.883, the terms defined in this section shall have
the meanings given them.
Sec. 11. Minnesota Statutes 2002, section 145.883,
subdivision 9, is amended to read:
Subd. 9. [COMMUNITY HEALTH SERVICES AREA BOARD.]
"Community health services area board" means a city, county, or
multicounty area that is organized as a community health board
under section 145A.09 and for which a state subsidy is received
under sections 145A.09 to 145A.13 a board of health established,
operating, and eligible for a local public health grant under
sections 145A.09 to 145A.131.
Sec. 12. Minnesota Statutes 2002, section 145A.02,
subdivision 5, is amended to read:
Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health
board" means a board of health established, operating, and
eligible for a subsidy local public health grant under sections
145A.09 to 145A.13 145A.131.
Sec. 13. Minnesota Statutes 2002, section 145A.02,
subdivision 6, is amended to read:
Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health
services" means activities designed to protect and promote the
health of the general population within a community health
service area by emphasizing the prevention of disease, injury,
disability, and preventable death through the promotion of
effective coordination and use of community resources, and by
extending health services into the community. Program
categories of community health services include disease
prevention and control, emergency medical care, environmental
health, family health, health promotion, and home health care.
Sec. 14. Minnesota Statutes 2002, section 145A.02,
subdivision 7, is amended to read:
Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community
health service area" means a city, county, or multicounty area
that is organized as a community health board under section
145A.09 and for which a subsidy local public health grant is
received under sections 145A.09 to 145A.13 145A.131.
Sec. 15. Minnesota Statutes 2002, section 145A.06,
subdivision 1, is amended to read:
Subdivision 1. [GENERALLY.] In addition to other powers
and duties provided by law, the commissioner has the powers
listed in subdivisions 2 to 4 5.
Sec. 16. Minnesota Statutes 2002, section 145A.09,
subdivision 2, is amended to read:
Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of
health that meets the requirements of sections 145A.09
to 145A.13 145A.131 is a community health board and is eligible
for a community health subsidy local public health grant under
section 145A.13 145A.131.
Sec. 17. Minnesota Statutes 2002, section 145A.09,
subdivision 4, is amended to read:
Subd. 4. [CITIES.] A city that received a subsidy under
section 145A.13 and that meets the requirements of sections
145A.09 to 145A.13 145A.131 is eligible for a community health
subsidy local public health grant under section
145A.13 145A.131.
Sec. 18. Minnesota Statutes 2002, section 145A.09,
subdivision 7, is amended to read:
Subd. 7. [WITHDRAWAL.] (a) A county or city that has
established or joined a community health board may withdraw from
the subsidy local public health grant program authorized by
sections 145A.09 to 145A.13 145A.131 by resolution of its
governing body in accordance with section 145A.03, subdivision
3, and this subdivision.
(b) A county or city may not withdraw from a joint powers
community health board during the first two calendar years
following that county's or city's initial adoption of the joint
powers agreement.
(c) The withdrawal of a county or city from a community
health board does not affect the eligibility for the community
health subsidy local public health grant of any remaining county
or city for one calendar year following the effective date of
withdrawal.
(d) The amount of additional annual payment for calendar
year 1985 made pursuant to Minnesota Statutes 1984, section
145.921, subdivision 4, must be subtracted from the subsidy for
a county that, due to withdrawal from a community health board,
ceases to meet the terms and conditions under which that
additional annual payment was made The local public health grant
for a county that chooses to withdraw from a multicounty
community health board shall be reduced by the amount of the
local partnership incentive under section 145A.131, subdivision
2, paragraph (c).
Sec. 19. Minnesota Statutes 2002, section 145A.10,
subdivision 2, is amended to read:
Subd. 2. [PREEMPTION.] (a) Not later than 365 days after
the approval of a community health plan by the
commissioner formation of a community health board, any other
board of health within the community health service area for
which the plan has been prepared must cease operation, except as
authorized in a joint powers agreement under section 145A.03,
subdivision 2, or delegation agreement under section 145A.07,
subdivision 2, or as otherwise allowed by this subdivision.
(b) This subdivision does not preempt or otherwise change
the powers and duties of any city or county eligible for subsidy
a local public health grant under section 145A.09.
(c) This subdivision does not preempt the authority to
operate a community health services program of any city of the
first or second class operating an existing program of community
health services located within a county with a population of
300,000 or more persons until the city council takes action to
allow the county to preempt the city's powers and duties.
Sec. 20. Minnesota Statutes 2002, section 145A.10, is
amended by adding a subdivision to read:
Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and
standards established under section 145A.12, and with input from
the community, the community health board shall:
(1) establish local public health priorities based on an
assessment of community health needs and assets; and
(2) determine the mechanisms by which the community health
board will address the local public health priorities
established under clause (1) and achieve the statewide outcomes
established under sections 145.8821 and 145A.12, subdivision 7,
within the limits of available funding. In determining the
mechanisms to address local public health priorities and achieve
statewide outcomes, the community health board shall seek public
input or consider the recommendations of the community health
advisory committee and the following essential public health
services:
(i) monitor health status to identify community health
problems;
(ii) diagnose and investigate problems and health hazards
in the community;
(iii) inform, educate, and empower people about health
issues;
(iv) mobilize community partnerships to identify and solve
health problems;
(v) develop policies and plans that support individual and
community health efforts;
(vi) enforce laws and regulations that protect health and
ensure safety;
(vii) link people to needed personal health care services;
(viii) ensure a competent public health and personal health
care workforce;
(ix) evaluate effectiveness, accessibility, and quality of
personal and population-based health services; and
(x) research for new insights and innovative solutions to
health problems.
(b) By February 1, 2005, and every five years thereafter,
each community health board that receives a local public health
grant under section 145A.131 shall notify the commissioner in
writing of the statewide outcomes established under sections
145.8821 and 145A.12, subdivision 7, that the board will address
and the local priorities established under paragraph (a) that
the board will address.
(c) Each community health board receiving a local public
health grant under section 145A.131 must submit an annual report
to the commissioner documenting progress toward the achievement
of statewide outcomes established under sections 145.8821 and
145A.12, subdivision 7, and the local public health priorities
established under paragraph (a), using reporting standards and
procedures established by the commissioner and in compliance
with all applicable federal requirements. If a community health
board has identified additional local priorities for use of the
local public health grant since the last notification of
outcomes and priorities under paragraph (b), the community
health board shall notify the commissioner of the additional
local public health priorities in the annual report.
Sec. 21. Minnesota Statutes 2002, section 145A.10,
subdivision 10, is amended to read:
Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A
state community health advisory committee is established to
advise, consult with, and make recommendations to the
commissioner on the development, maintenance, funding, and
evaluation of community health services. Each community health
board may appoint a member to serve on the committee. The
committee must meet at least quarterly, and special meetings may
be called by the committee chair or a majority of the members.
Members or their alternates may receive a per diem and must be
reimbursed for travel and other necessary expenses while engaged
in their official duties.
(b) The city councils or county boards that have
established or are members of a community health board must may
appoint a community health advisory committee to advise, consult
with, and make recommendations to the community health board on
matters relating to the development, maintenance, funding, and
evaluation of community health services. The committee must
consist of at least five members and must be generally
representative of the population and health care providers of
the community health service area. The committee must meet at
least three times a year and at the call of the chair or a
majority of the members. Members may receive a per diem and
reimbursement for travel and other necessary expenses while
engaged in their official duties.
(c) State and local advisory committees must adopt bylaws
or operating procedures that specify the length of terms of
membership, procedures for assuring that no more than half of
these terms expire during the same year, and other matters
relating to the conduct of committee business. Bylaws or
operating procedures may allow one alternate to be appointed for
each member of a state or local advisory committee. Alternates
may be given full or partial powers and duties of members the
duties under subdivision 5a.
Sec. 22. Minnesota Statutes 2002, section 145A.11,
subdivision 2, is amended to read:
Subd. 2. [CONSIDERATION OF COMMUNITY HEALTH PLAN LOCAL
PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In
levying taxes authorized under section 145A.08, subdivision 3, a
city council or county board that has formed or is a member of a
community health board must consider the income and expenditures
required to meet the objectives of the community health plan for
its area local public health priorities established under
section 145A.10, subdivision 5a, and statewide outcomes
established under section 145A.12, subdivision 7.
Sec. 23. Minnesota Statutes 2002, section 145A.11,
subdivision 4, is amended to read:
Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH
SERVICES.] A city council or county board that has established
or is a member of a community health board may by ordinance
adopt and enforce minimum standards for services provided
according to sections 145A.02 and 145A.10, subdivision 5. An
ordinance must not conflict with state law or with more
stringent standards established either by rule of an agency of
state government or by the provisions of the charter or
ordinances of any city organized under section 145A.09,
subdivision 4.
Sec. 24. Minnesota Statutes 2002, section 145A.12,
subdivision 1, is amended to read:
Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The
commissioner must assist community health boards in the
development, administration, and implementation of community
health services. This assistance may consist of but is not
limited to:
(1) informational resources, consultation, and training to
help community health boards plan, develop, integrate, provide
and evaluate community health services; and
(2) administrative and program guidelines and standards,
developed with the advice of the state community health advisory
committee. Adoption of these guidelines by a community health
board is not a prerequisite for plan approval as prescribed in
subdivision 4.
Sec. 25. Minnesota Statutes 2002, section 145A.12,
subdivision 2, is amended to read:
Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter
14, and in consultation with the state community health advisory
committee, the commissioner may adopt rules to set standards for
administrative and program personnel to ensure competence in
administration and planning and in each program area defined in
section 145A.02.
Sec. 26. Minnesota Statutes 2002, section 145A.12, is
amended by adding a subdivision to read:
Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in
consultation with the state community health advisory committee
established under section 145A.10, subdivision 10, paragraph
(a), shall establish statewide outcomes for local public health
grant funds allocated to community health boards between January
1, 2004, and December 31, 2005.
(b) At least one statewide outcome must be established in
each of the following public health areas:
(1) preventing diseases;
(2) protecting against environmental hazards;
(3) preventing injuries;
(4) promoting healthy behavior;
(5) responding to disasters; and
(6) ensuring access to health services.
(c) The commissioner shall use Minnesota's public health
goals established under section 62J.212 and the essential public
health services under section 145A.10, subdivision 5a, as a
basis for the development of statewide outcomes.
(d) The statewide maternal and child health outcomes
established under section 145.8821 shall be included as
statewide outcomes under this section.
(e) By December 31, 2004, and every five years thereafter,
the commissioner, in consultation with the state community
health advisory committee established under section 145A.10,
subdivision 10, paragraph (a), and the maternal and child health
advisory task force established under section 145.881, shall
develop statewide outcomes for the local public health grant
established under section 145A.131, based on state and local
assessment data regarding the health of Minnesota residents, the
essential public health services under section 145A.10, and
current Minnesota public health goals established under section
62J.212.
Sec. 27. Minnesota Statutes 2002, section 145A.13, is
amended by adding a subdivision to read:
Subd. 4. [EXPIRATION.] This section expires January 1,
2004.
Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.]
Subdivision 1. [FUNDING FORMULA FOR COMMUNITY HEALTH
BOARDS.] (a) Base funding for each community health board
eligible for a local public health grant under section 145A.09,
subdivision 2, shall be determined by each community health
board's fiscal year 2003 allocations, prior to unallotment, for
the following grant programs: community health services
subsidy; state and federal maternal and child health special
projects grants; family home visiting grants, TANF MN ENABL
grants, TANF youth risk behavior grants, and available women,
infants, and children grant funds in fiscal year 2003, prior to
unallotment, distributed based on the proportion of WIC
participants served in fiscal year 2003 within the CHS service
area.
(b) Base funding for a community health board eligible for
a local public health grant under section 145A.09, subdivision
2, as determined in paragraph (a), shall be adjusted by the
percentage difference between the base, as calculated in
paragraph (a), and the funding available for the local public
health grant.
(c) Multicounty community health boards shall receive a
local partnership base of up to $5,000 per year for each county
included in the community health board.
(d) The state community health advisory committee may
recommend a formula to the commissioner to use in distributing
state and federal funds to community health boards organized and
operating under sections 145A.09 to 145A.131 to achieve locally
identified priorities under section 145A.12, subdivision 7, by
July 1, 2004, for use in distributing funds to community health
boards beginning January 1, 2006, and thereafter.
Subd. 2. [LOCAL MATCH.] (a) A community health board that
receives a local public health grant shall provide at least a 75
percent match for the state funds received through the local
public health grant described in subdivision 1, and subject to
paragraphs (b) to (d).
(b) Eligible funds must be used to meet match requirements.
Eligible funds include funds from local property taxes,
reimbursements from third parties, fees, other local funds, and
donations or nonfederal grants that are used for community
health services described in section 145A.02, subdivision 6.
(c) When the amount of local matching funds for a community
health board is less than the amount required under paragraph
(a), the local public health grant provided for that community
health board under this section shall be reduced proportionally.
(d) A city organized under the provision of sections
145A.09 to 145A.131 that levies a tax for provision of community
health services is exempt from any county levy for the same
services to the extent of the levy imposed by the city.
Subd. 3. [ACCOUNTABILITY.] (a) Community health boards
accepting local public health grants must document progress
toward the statewide outcomes established in section 145A.12,
subdivision 7, to maintain eligibility to receive the local
public health grant.
(b) In determining whether or not the community health
board is documenting progress toward statewide outcomes, the
commissioner shall consider the following factors:
(1) whether the community health board has documented
progress to meeting essential local activities related to the
statewide outcomes, as specified in the grant agreement;
(2) the effort put forth by the community health board
toward the selected statewide outcomes;
(3) whether the community health board has previously
failed to document progress toward selected statewide outcomes
under this section;
(4) the amount of funding received by the community health
board to address the statewide outcomes; and
(5) other factors as the commissioner may require, if the
commissioner specifically identifies the additional factors in
the commissioner's written notice of determination.
(c) If the commissioner determines that a community health
board has not by the applicable deadline documented progress
toward the selected statewide outcomes established under section
145.8821 or 145A.12, subdivision 7, the commissioner shall
notify the community health board in writing and recommend
specific actions that the community health board should take
over the following 12 months to maintain eligibility for the
local public health grant.
(d) During the 12 months following the written
notification, the commissioner shall provide administrative and
program support to assist the community health board in taking
the actions recommended in the written notification.
(e) If the community health board has not taken the
specific actions recommended by the commissioner within 12
months following written notification, the commissioner may
determine not to distribute funds to the community health board
under section 145A.12, subdivision 2, for the next fiscal year.
(f) If the commissioner determines not to distribute funds
for the next fiscal year, the commissioner must give the
community health board written notice of this determination and
allow the community health board to appeal the determination in
writing.
(g) If the commissioner determines not to distribute funds
for the next fiscal year to a community health board that has
not documented progress toward the statewide outcomes and not
taken the actions recommended by the commissioner, the
commissioner may retain local public health grant funds that the
community health board would have otherwise received and
directly carry out essential local activities to meet the
statewide outcomes, or contract with other units of government
or community-based organizations to carry out essential local
activities related to the statewide outcomes.
(h) If the community health board that does not document
progress toward the statewide outcomes is a city, the
commissioner shall distribute the local public health funds that
would have been allocated to that city to the county in which
the city is located, if that county is part of a community
health board.
(i) The commissioner shall establish a reporting system by
which community health boards will document their progress
toward statewide outcomes. This system will be developed in
consultation with the state community health services advisory
committee established in section 145A.10, subdivision 10,
paragraph (a), and the maternal and the child health advisory
committee established in section 145.881.
Subd. 4. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A
STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a
community health board and operates as a board of health or if a
community health board elects not to accept the local public
health grant, the commissioner may retain the amount of funding
that would have been allocated to the community health board
using the formula described in subdivision 1 and assume
responsibility for public health activities to meet the
statewide outcomes in the geographic area served by the board of
health or community health board. The commissioner may elect to
directly provide public health activities to meet the statewide
outcomes or contract with other units of government or with
community-based organizations. If a city that is currently a
community health board withdraws from a community health board
or elects not to accept the local public health grant, the local
public health grant funds that would have been allocated to that
city shall be distributed to the county in which the city is
located, if the county is part of a community health board.
Subd. 5. [LOCAL PUBLIC HEALTH PRIORITIES.] Community
health boards may use their local public health grant to address
local public health priorities identified under section 145A.10,
subdivision 5a.
Sec. 29. Minnesota Statutes 2002, section 145A.14,
subdivision 2, is amended to read:
Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may
make special grants to community health boards to establish,
operate, or subsidize clinic facilities and services to furnish
health services for American Indians who reside off reservations.
(b) To qualify for a grant under this subdivision the
community health plan submitted by the community health board
must contain a proposal for the delivery of the services and
documentation that representatives of the Indian community
affected by the plan were involved in its development.
(c) Applicants must submit for approval a plan and budget
for the use of the funds in the form and detail specified by the
commissioner.
(d) (c) Applicants must keep records, including records of
expenditures to be audited, as the commissioner specifies.
Sec. 30. Minnesota Statutes 2002, section 145A.14, is
amended by adding a subdivision to read:
Subd. 2a. [TRIBAL GOVERNMENTS.] (a) Of the funding
available for local public health grants, $1,500,000 per year is
available to tribal governments for:
(1) maternal and child health activities under section
145.882, subdivision 7;
(2) activities to reduce health disparities under section
145.928, subdivision 10; and
(3) emergency preparedness.
(b) The commissioner, in consultation with tribal
governments, shall establish a formula for distributing the
funds and developing the outcomes to be measured.
Sec. 31. [REVISOR'S INSTRUCTION.]
(a) The revisor of statutes shall delete "145A.13" and
insert "145A.131" in Minnesota Statutes, sections 145A.03,
subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1;
256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02,
subdivision 2.
(b) For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 32. [REPEALER.]
(a) Minnesota Statutes 2002, sections 144.401; 145.882,
subdivisions 4, 5, 6, and 8; 145.883, subdivisions 4 and 7;
145.884; 145.885; 145.886; 145.888; 145.889; 145.890; 145A.02,
subdivisions 9, 10, 11, 12, 13, and 14; 145A.09, subdivision 6;
145A.10, subdivisions 5, 6, and 8; 145A.11, subdivision 3;
145A.12, subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and
4; and 145A.17, subdivision 2, are repealed.
(b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030;
4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080;
4736.0090; 4736.0120; and 4736.0130, are repealed effective
January 1, 2004.
(c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300;
4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800;
4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300;
4705.1400; 4705.1500; and 4705.1600, are repealed effective June
30, 2004.
ARTICLE 9
CHILD CARE AND MISCELLANEOUS PROVISIONS
Section 1. Minnesota Statutes 2002, section 119B.011,
subdivision 5, is amended to read:
Subd. 5. [CHILD CARE.] "Child care" means the care of a
child by someone other than a parent or, stepparent, legal
guardian, eligible relative caregiver, or the spouses of any of
the foregoing in or outside the child's own home for gain or
otherwise, on a regular basis, for any part of a 24-hour day.
Sec. 2. Minnesota Statutes 2002, section 119B.011,
subdivision 6, is amended to read:
Subd. 6. [CHILD CARE FUND.] "Child care fund" means a
program under this chapter providing:
(1) financial assistance for child care to parents engaged
in employment, job search, or education and training leading to
employment, or an at-home infant care subsidy; and
(2) grants to develop, expand, and improve the access and
availability of child care services statewide.
Sec. 3. Minnesota Statutes 2002, section 119B.011,
subdivision 15, is amended to read:
Subd. 15. [INCOME.] "Income" means earned or unearned
income received by all family members, including public
assistance cash benefits and at-home infant care subsidy
payments, unless specifically excluded and child support and
maintenance distributed to the family under section 256.741,
subdivision 15. The following are excluded from income: funds
used to pay for health insurance premiums for family members,
Supplemental Security Income, scholarships, work-study income,
and grants that cover costs or reimbursement for tuition, fees,
books, and educational supplies; student loans for tuition,
fees, books, supplies, and living expenses; state and federal
earned income tax credits; assistance specifically excluded as
income by law; in-kind income such as food stamps, energy
assistance, foster care assistance, medical assistance, child
care assistance, and housing subsidies; earned income of
full-time or part-time students up to the age of 19, who have
not earned a high school diploma or GED high school equivalency
diploma including earnings from summer employment; grant awards
under the family subsidy program; nonrecurring lump sum income
only to the extent that it is earmarked and used for the purpose
for which it is paid; and any income assigned to the public
authority according to section 256.741.
Sec. 4. Minnesota Statutes 2002, section 119B.011,
subdivision 19, is amended to read:
Subd. 19. [PROVIDER.] "Provider" means: (1) an individual
or child care center or facility, either licensed or unlicensed,
providing legal child care services as defined under section
245A.03; or (2) an individual or child care center or facility
holding a valid child care license issued by another state or a
tribe and providing child care services in the licensing state
or in the area under the licensing tribe's jurisdiction. A
legally unlicensed registered family child care provider must be
at least 18 years of age, and not a member of the MFIP
assistance unit or a member of the family receiving child care
assistance to be authorized under this chapter.
Sec. 5. Minnesota Statutes 2002, section 119B.011, is
amended by adding a subdivision to read:
Subd. 19a. [REGISTRATION.] "Registration" means the
process used by a county to determine whether the provider
selected by a family applying for or receiving child care
assistance to care for that family's children meets the
requirements necessary for payment of child care assistance for
care provided by that provider.
Sec. 6. Minnesota Statutes 2002, section 119B.011,
subdivision 20, is amended to read:
Subd. 20. [TRANSITION YEAR FAMILIES.] (a) "Transition year
families" means families who have received MFIP assistance, or
who were eligible to receive MFIP assistance after choosing to
discontinue receipt of the cash portion of MFIP assistance under
section 256J.31, subdivision 12, for at least three of the last
six months before losing eligibility for MFIP or families
participating in work first under chapter 256K who meet the
requirements of section 256K.07. Transition year child care may
be used to support employment or job search. Transition year
child care is not available to families who have been
disqualified from MFIP due to fraud.
(b) "Transition year extension year families" means
families who have completed their transition year of child care
assistance under this subdivision and who are eligible for, but
on a waiting list for, services under section 119B.03. For
purposes of sections 119B.03, subdivision 3, and 119B.05,
subdivision 1, clause (2), families participating in extended
transition year shall not be considered transition year
families. Transition year extension child care may be used to
support employment or a job search that meets the requirements
of section 119B.10 for the length of time necessary for families
to be moved from the basic sliding fee waiting list into the
basic sliding fee program.
Sec. 7. Minnesota Statutes 2002, section 119B.011,
subdivision 21, is amended to read:
Subd. 21. [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of
overpayments" means the reduction of child care assistance
payments to an eligible family or a child care provider in order
to correct an overpayment to the family even when the
overpayment is due to agency error or other circumstances
outside the responsibility or control of the family of child
care assistance.
Sec. 8. Minnesota Statutes 2002, section 119B.02,
subdivision 1, is amended to read:
Subdivision 1. [CHILD CARE SERVICES.] The commissioner
shall develop standards for county and human services boards to
provide child care services to enable eligible families to
participate in employment, training, or education programs.
Within the limits of available appropriations, the commissioner
shall distribute money to counties to reduce the costs of child
care for eligible families. The commissioner shall adopt rules
to govern the program in accordance with this section. The
rules must establish a sliding schedule of fees for parents
receiving child care services. The rules shall provide that
funds received as a lump sum payment of child support arrearages
shall not be counted as income to a family in the month received
but shall be prorated over the 12 months following receipt and
added to the family income during those months. In the rules
adopted under this section, county and human services boards
shall be authorized to establish policies for payment of child
care spaces for absent children, when the payment is required by
the child's regular provider. The rules shall not set a maximum
number of days for which absence payments can be made, but
instead shall direct the county agency to set limits and pay for
absences according to the prevailing market practice in the
county. County policies for payment of absences shall be
subject to the approval of the commissioner. The commissioner
shall maximize the use of federal money under title I and title
IV of Public Law Number 104-193, the Personal Responsibility and
Work Opportunity Reconciliation Act of 1996, and other programs
that provide federal or state reimbursement for child care
services for low-income families who are in education, training,
job search, or other activities allowed under those programs.
Money appropriated under this section must be coordinated with
the programs that provide federal reimbursement for child care
services to accomplish this purpose. Federal reimbursement
obtained must be allocated to the county that spent money for
child care that is federally reimbursable under programs that
provide federal reimbursement for child care services. The
counties shall use the federal money to expand child care
services. The commissioner may adopt rules under chapter 14 to
implement and coordinate federal program requirements.
Sec. 9. [119B.025] [DUTIES OF COUNTIES.]
Subdivision 1. [FACTORS WHICH MUST BE VERIFIED.] (a) The
county shall verify the following at all initial child care
applications using the universal application:
(1) identity of adults;
(2) presence of the minor child in the home, if
questionable;
(3) relationship of minor child to the parent, stepparent,
legal guardian, eligible relative caretaker, or the spouses of
any of the foregoing;
(4) age;
(5) immigration status, if related to eligibility;
(6) social security number, if given;
(7) income;
(8) spousal support and child support payments made to
persons outside the household;
(9) residence; and
(10) inconsistent information, if related to eligibility.
(b) If a family did not use the universal application to
apply for child care assistance, the family must complete the
universal application at its next eligibility redetermination
and the county must verify the factors listed in paragraph (a)
as part of that redetermination. Once a family has completed a
universal application, the county shall use the redetermination
form described in paragraph (c) for that family's subsequent
redeterminations.
(c) The commissioner shall develop a recertification form
to redetermine eligibility that minimizes paperwork for the
county and the participant.
Subd. 2. [SOCIAL SECURITY NUMBERS.] The county must
request social security numbers from all applicants for child
care assistance under this chapter. A county may not deny child
care assistance solely on the basis of failure of an applicant
to report a social security number.
Sec. 10. Minnesota Statutes 2002, section 119B.03,
subdivision 4, is amended to read:
Subd. 4. [FUNDING PRIORITY.] (a) First priority for child
care assistance under the basic sliding fee program must be
given to eligible non-MFIP families who do not have a high
school or general equivalency diploma or who need remedial and
basic skill courses in order to pursue employment or to pursue
education leading to employment and who need child care
assistance to participate in the education program. Within this
priority, the following subpriorities must be used:
(1) child care needs of minor parents;
(2) child care needs of parents under 21 years of age; and
(3) child care needs of other parents within the priority
group described in this paragraph.
(b) Second priority must be given to parents who have
completed their MFIP or work first transition year.
(c) Third priority must be given to families who are
eligible for portable basic sliding fee assistance through the
portability pool under subdivision 9.
(d) Families under paragraph (b) must be added to the basic
sliding fee waiting list on the date they begin transition year
under section 119B.011, subdivision 20, and must be moved into
basic sliding fee as soon as possible after they complete their
transition year.
Sec. 11. Minnesota Statutes 2002, section 119B.03,
subdivision 9, is amended to read:
Subd. 9. [PORTABILITY POOL.] (a) The commissioner shall
establish a pool of up to five percent of the annual
appropriation for the basic sliding fee program to provide
continuous child care assistance for eligible families who move
between Minnesota counties. At the end of each allocation
period, any unspent funds in the portability pool must be used
for assistance under the basic sliding fee program. If
expenditures from the portability pool exceed the amount of
money available, the reallocation pool must be reduced to cover
these shortages.
(b) To be eligible for portable basic sliding fee
assistance, a family that has moved from a county in which it
was receiving basic sliding fee assistance to a county with a
waiting list for the basic sliding fee program must:
(1) meet the income and eligibility guidelines for the
basic sliding fee program; and
(2) notify the new county of residence within 30 60 days of
moving and apply for basic sliding fee assistance in submit
information to the new county of residence to verify eligibility
for the basic sliding fee program.
(c) The receiving county must:
(1) accept administrative responsibility for applicants for
portable basic sliding fee assistance at the end of the two
months of assistance under the Unitary Residency Act;
(2) continue basic sliding fee assistance for the lesser of
six months or until the family is able to receive assistance
under the county's regular basic sliding program; and
(3) notify the commissioner through the quarterly reporting
process of any family that meets the criteria of the portable
basic sliding fee assistance pool.
Sec. 12. Minnesota Statutes 2002, section 119B.05,
subdivision 1, is amended to read:
Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible
for child care assistance under the MFIP child care program are:
(1) MFIP participants who are employed or in job search and
meet the requirements of section 119B.10;
(2) persons who are members of transition year families
under section 119B.011, subdivision 20, and meet the
requirements of section 119B.10;
(3) families who are participating in employment
orientation or job search, or other employment or training
activities that are included in an approved employability
development plan under chapter 256K;
(4) MFIP families who are participating in work job search,
job support, employment, or training activities as required in
their job search support or employment plan, or in appeals,
hearings, assessments, or orientations according to chapter
256J;
(5) MFIP families who are participating in social services
activities under chapter 256J or 256K as required in their
employment plan approved according to chapter 256J or 256K; and
(6) families who are participating in programs as required
in tribal contracts under section 119B.02, subdivision 2, or
256.01, subdivision 2; and
(7) families who are participating in the transition year
extension under section 119B.011, subdivision 20, paragraph (a).
Sec. 13. Minnesota Statutes 2002, section 119B.08,
subdivision 3, is amended to read:
Subd. 3. [CHILD CARE FUND PLAN.] The county and designated
administering agency shall submit a biennial child care fund
plan to the commissioner an annual child care fund plan in its
biennial community social services plan. The commissioner shall
establish the dates by which the county must submit the plans.
The plan shall include:
(1) a narrative of the total program for child care
services, including all policies and procedures that affect
eligible families and are used to administer the child care
funds;
(2) the methods used by the county to inform eligible
families of the availability of child care assistance and
related services;
(3) the provider rates paid for all children with special
needs by provider type;
(4) the county prioritization policy for all eligible
families under the basic sliding fee program; and
(5) other a description of strategies to coordinate and
maximize public and private community resources, including
school districts, health care facilities, government agencies,
neighborhood organizations, and other resources knowledgeable in
early childhood development, in particular to coordinate child
care assistance with existing community-based programs and
service providers including child care resource and referral
programs, early childhood family education, school readiness,
Head Start, local interagency early intervention committees,
special education services, early childhood screening, and other
early childhood care and education services and programs to the
extent possible, to foster collaboration among agencies and
other community-based programs that provide flexible,
family-focused services to families with young children and to
facilitate transition into kindergarten. The county must
describe a method by which to share information, responsibility,
and accountability among service and program providers;
(2) a description of procedures and methods to be used to
make copies of the proposed state plan reasonably available to
the public, including members of the public particularly
interested in child care policies such as parents, child care
providers, culturally specific service organizations, child care
resource and referral programs, interagency early intervention
committees, potential collaborative partners and agencies
involved in the provision of care and education to young
children, and allowing sufficient time for public review and
comment; and
(3) information as requested by the department to ensure
compliance with the child care fund statutes and rules
promulgated by the commissioner.
The commissioner shall notify counties within 60 90 days of
the date the plan is submitted whether the plan is approved or
the corrections or information needed to approve the plan. The
commissioner shall withhold a county's allocation until it has
an approved plan. Plans not approved by the end of the second
quarter after the plan is due may result in a 25 percent
reduction in allocation. Plans not approved by the end of the
third quarter after the plan is due may result in a 100 percent
reduction in the allocation to the county. Counties are to
maintain services despite any reduction in their allocation due
to plans not being approved.
Sec. 14. Minnesota Statutes 2002, section 119B.09,
subdivision 1, is amended to read:
Subdivision 1. [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL
APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services
must be available to families who need child care to find or
keep employment or to obtain the training or education necessary
to find employment and who:
(1) meet the requirements of section 119B.05; receive MFIP
assistance; and are participating in employment and training
services under chapter 256J or 256K;
(2) have household income below the eligibility levels for
MFIP; or
(3) have household income within a range established by the
commissioner less than or equal to 175 percent of the federal
poverty guidelines, adjusted for family size, at program entry
and less than 250 percent of the federal poverty guidelines,
adjusted for family size, at program exit.
(b) Child care services must be made available as in-kind
services.
(c) All applicants for child care assistance and families
currently receiving child care assistance must be assisted and
required to cooperate in establishment of paternity and
enforcement of child support obligations for all children in the
family as a condition of program eligibility. For purposes of
this section, a family is considered to meet the requirement for
cooperation when the family complies with the requirements of
section 256.741.
Sec. 15. Minnesota Statutes 2002, section 119B.09,
subdivision 2, is amended to read:
Subd. 2. [SLIDING FEE.] Child care services to
families with incomes in the commissioner's established range
must be made available on a sliding fee basis. The upper limit
of the range must be neither less than 70 percent nor more than
90 percent of the state median income for a family of four,
adjusted for family size.
Sec. 16. Minnesota Statutes 2002, section 119B.09,
subdivision 7, is amended to read:
Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The
date of eligibility for child care assistance under this chapter
is the later of the date the application was signed; the
beginning date of employment, education, or training; or the
date a determination has been made that the applicant is a
participant in employment and training services under Minnesota
Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K. The
date of eligibility for the basic sliding fee at-home infant
child care program is the later of the date the infant is born
or, in a county with a basic sliding fee waiting list, the date
the family applies for at-home infant child care.
(b) Payment ceases for a family under the at-home infant
child care program when a family has used a total of 12 months
of assistance as specified under section 119B.061. Payment of
child care assistance for employed persons on MFIP is effective
the date of employment or the date of MFIP eligibility,
whichever is later. Payment of child care assistance for MFIP
or work first participants in employment and training services
is effective the date of commencement of the services or the
date of MFIP or work first eligibility, whichever is later.
Payment of child care assistance for transition year child care
must be made retroactive to the date of eligibility for
transition year child care.
Sec. 17. Minnesota Statutes 2002, section 119B.09, is
amended by adding a subdivision to read:
Subd. 9. [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE
PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family
child care providers are not eligible to receive child care
assistance subsidies under this chapter for their own children
or children in their custody.
Sec. 18. Minnesota Statutes 2002, section 119B.09, is
amended by adding a subdivision to read:
Subd. 10. [PAYMENT OF FUNDS.] All federal, state, and
local child care funds must be paid directly to the parent when
a provider cares for children in the children's own home. In
all other cases, all federal, state, and local child care funds
must be paid directly to the child care provider, either
licensed or legal nonlicensed, on behalf of the eligible family.
Sec. 19. Minnesota Statutes 2002, section 119B.11,
subdivision 2a, is amended to read:
Subd. 2a. [RECOVERY OF OVERPAYMENTS.] (a) An amount of
child care assistance paid to a recipient in excess of the
payment due is recoverable by the county agency under paragraphs
(b) and (c), even when the overpayment was caused by agency
error or circumstances outside the responsibility and control of
the family or provider.
(b) An overpayment must be recouped or recovered from the
family if the overpayment benefited the family by causing the
family to pay less for child care expenses than the family
otherwise would have been required to pay under child care
assistance program requirements. If the family remains eligible
for child care assistance, the overpayment must be recovered
through recoupment as identified in Minnesota Rules,
part 3400.0140, subpart 19 3400.0187, except that the
overpayments must be calculated and collected on a service
period basis. If the family no longer remains eligible for
child care assistance, the county may choose to initiate efforts
to recover overpayments from the family for overpayment less
than $50. If the overpayment is greater than or equal to $50,
the county shall seek voluntary repayment of the overpayment
from the family. If the county is unable to recoup the
overpayment through voluntary repayment, the county shall
initiate civil court proceedings to recover the overpayment
unless the county's costs to recover the overpayment will exceed
the amount of the overpayment. A family with an outstanding
debt under this subdivision is not eligible for child care
assistance until: (1) the debt is paid in full; or (2)
satisfactory arrangements are made with the county to retire the
debt consistent with the requirements of this chapter and
Minnesota Rules, chapter 3400, and the family is in compliance
with the arrangements.
(c) The county must recover an overpayment from a provider
if the overpayment did not benefit the family by causing it to
receive more child care assistance or to pay less for child care
expenses than the family otherwise would have been eligible to
receive or required to pay under child care assistance program
requirements, and benefited the provider by causing the provider
to receive more child care assistance than otherwise would have
been paid on the family's behalf under child care assistance
program requirements. If the provider continues to care for
children receiving child care assistance, the overpayment must
be recovered through reductions in child care assistance
payments for services as described in an agreement with the
county. The provider may not charge families using that
provider more to cover the cost of recouping the overpayment.
If the provider no longer cares for children receiving child
care assistance, the county may choose to initiate efforts to
recover overpayments of less than $50 from the provider. If the
overpayment is greater than or equal to $50, the county shall
seek voluntary repayment of the overpayment from the provider.
If the county is unable to recoup the overpayment through
voluntary repayment, the county shall initiate civil court
proceedings to recover the overpayment unless the county's costs
to recover the overpayment will exceed the amount of the
overpayment. A provider with an outstanding debt under this
subdivision is not eligible to care for children receiving child
care assistance until: (1) the debt is paid in full; or (2)
satisfactory arrangements are made with the county to retire the
debt consistent with the requirements of this chapter and
Minnesota Rules, chapter 3400, and the provider is in compliance
with the arrangements.
(d) When both the family and the provider acted together to
intentionally cause the overpayment, both the family and the
provider are jointly liable for the overpayment regardless of
who benefited from the overpayment. The county must recover the
overpayment as provided in paragraphs (b) and (c). When the
family or the provider is in compliance with a repayment
agreement, the party in compliance is eligible to receive child
care assistance or to care for children receiving child care
assistance despite the other party's noncompliance with
repayment arrangements.
Sec. 20. Minnesota Statutes 2002, section 119B.12,
subdivision 2, is amended to read:
Subd. 2. [PARENT FEE.] A family must be assessed a parent
fee for each service period. A family's monthly parent fee must
be a fixed percentage of its annual gross income. Parent fees
must apply to families eligible for child care assistance under
sections 119B.03 and 119B.05. Income must be as defined in
section 119B.011, subdivision 15. The fixed percent is based on
the relationship of the family's annual gross income to 100
percent of state median income the annual federal poverty
guidelines. Beginning January 1, 1998, parent fees must begin
at 75 percent of the poverty level. The minimum parent fees for
families between 75 percent and 100 percent of poverty level
must be $5 per month. Parent fees must be established in rule
and must provide for graduated movement to full payment.
Sec. 21. [119B.125] [PROVIDER REQUIREMENTS.]
Subdivision 1. [AUTHORIZATION.] Except as provided in
subdivision 5, a county must authorize the provider chosen by an
applicant or a participant before the county can authorize
payment for care provided by that provider. The commissioner
must establish the requirements necessary for authorization of
providers.
Subd. 2. [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person
who meets any of the conditions under paragraphs (b) to (n) must
not be authorized as a legal nonlicensed family child care
provider. For purposes of this subdivision, a finding that a
delinquency petition is proven in juvenile court must be
considered a conviction in state district court.
(b) The person has been convicted of one of the following
offenses or has admitted to committing or a preponderance of the
evidence indicates that the person has committed an act that
meets the definition of one of the following offenses: 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; 609.322, solicitation,
inducement, or promotion of prostitution; 609.323, receiving
profit from 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; 609.365,
incest; 609.377, felony malicious punishment of a child;
617.246, use of minors in sexual performance; 617.247,
possession of pictorial representation of a minor; 609.2242 to
609.2243, felony 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 or country where the
elements are substantially similar to any of the offenses listed
in this paragraph.
(c) Less than 15 years have passed since the discharge of
the sentence imposed for the offense and the person has received
a felony conviction for one of the following offenses, or the
person has admitted to committing or a preponderance of the
evidence indicates that the person has committed an act that
meets the definition of a felony conviction for one of the
following offenses: sections 609.20 to 609.205, manslaughter in
the first or second degree; 609.21, criminal vehicular homicide;
609.215, aiding suicide or aiding attempted suicide; 609.221 to
609.2231, assault in the first, second, third, or fourth degree;
609.224, repeat offenses of fifth degree assault; 609.228, great
bodily harm caused by distribution of drugs; 609.2325, criminal
abuse of a vulnerable adult; 609.2335, financial exploitation of
a vulnerable adult; 609.235, use of drugs to injure or
facilitate a crime; 609.24, simple robbery; 617.241, repeat
offenses of obscene materials and performances; 609.245,
aggravated robbery; 609.25, kidnapping; 609.255, false
imprisonment; 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; 609.27, coercion; 609.275, attempt to
coerce; 609.324, subdivision 1, other prohibited acts, minor
engaged in prostitution; 609.3451, repeat offenses of criminal
sexual conduct in the fifth degree; 609.378, neglect or
endangerment of a child; 609.52, theft; 609.521, possession of
shoplifting gear; 609.561 to 609.563, arson in the first,
second, or third degree; 609.582, burglary in the first, second,
third, or fourth degree; 609.625, aggravated forgery; 609.63,
forgery; 609.631, check forgery, offering a forged check;
609.635, obtaining signature by false pretenses; 609.66,
dangerous weapon; 609.665, setting a spring gun; 609.67,
unlawfully owning, possessing, or operating a machine gun;
609.687, adulteration; 609.71, riot; 609.713, terrorist threats;
609.749, harassment, stalking; 260.221, grounds for termination
of parental rights; 152.021 to 152.022, controlled substance
crime in the first or second degree; 152.023, subdivision 1,
clause (3) or (4), or 152.023, subdivision 2, clause (4),
controlled substance crime in third degree; 152.024, subdivision
1, clause (2), (3), or (4), controlled substance crime in fourth
degree; 617.23, repeat offenses of indecent exposure; an attempt
or conspiracy to commit any of these offenses as defined in
Minnesota Statutes; or an offense in any other state or country
where the elements are substantially similar to any of the
offenses listed in this paragraph.
(d) Less than ten years have passed since the discharge of
the sentence imposed for the offense and the person has received
a gross misdemeanor conviction for one of the following offenses
or the person has admitted to committing or a preponderance of
the evidence indicates that the person has committed an act that
meets the definition of a gross misdemeanor conviction for one
of the following offenses: sections 609.224, fifth degree
assault; 609.2242 to 609.2243, domestic assault; 518B.01,
subdivision 14, violation of an order for protection; 609.3451,
fifth degree criminal sexual conduct; 609.746, repeat offenses
of interference with privacy; 617.23, repeat offenses of
indecent exposure; 617.241, obscene materials and performances;
617.243, indecent literature, distribution; 617.293,
disseminating or displaying harmful material to minors; 609.71,
riot; 609.66, dangerous weapons; 609.749, harassment, stalking;
609.224, subdivision 2, paragraph (c), fifth degree assault
against a vulnerable adult by a caregiver; 609.23, mistreatment
of persons confined; 609.231, mistreatment of residents or
patients; 609.2325, criminal abuse of a vulnerable adult;
609.2335, financial exploitation of a vulnerable adult; 609.233,
criminal neglect of a vulnerable adult; 609.234, failure to
report maltreatment of a vulnerable adult; 609.72, subdivision
3, disorderly conduct against a vulnerable adult; 609.265,
abduction; 609.378, neglect or endangerment of a child; 609.377,
malicious punishment of a child; 609.324, subdivision 1a, other
prohibited acts, minor engaged in prostitution; 609.33,
disorderly house; 609.52, theft; 609.582, burglary in the first,
second, third, or fourth degree; 609.631, check forgery,
offering a forged check; 609.275, attempt to coerce; an attempt
or conspiracy to commit any of these offenses as defined in
Minnesota Statutes; or an offense in any other state or country
where the elements are substantially similar to any of the
offenses listed in this paragraph.
(e) Less than seven years have passed since the discharge
of the sentence imposed for the offense and the person has
received a misdemeanor conviction for one of the following
offenses or the person has admitted to committing or a
preponderance of the evidence indicates that the person has
committed an act that meets the definition of a misdemeanor
conviction for one of the following offenses: sections 609.224,
fifth degree assault; 609.2242, domestic assault; 518B.01,
violation of an order for protection; 609.3232, violation of an
order for protection; 609.746, interference with privacy;
609.79, obscene or harassing telephone calls; 609.795, letter,
telegram, or package, opening, harassment; 617.23, indecent
exposure; 609.2672, assault of an unborn child, third degree;
617.293, dissemination and display of harmful materials to
minors; 609.66, dangerous weapons; 609.665, spring guns; an
attempt or conspiracy to commit any of these offenses as defined
in Minnesota Statutes; or an offense in any other state or
country where the elements are substantially similar to any of
the offenses listed in this paragraph.
(f) The person has been identified by the county's child
protection agency or by the statewide child protection database
as the person allegedly responsible for physical or sexual abuse
of a child within the last seven years.
(g) The person has been identified by the county's adult
protection agency or by the statewide adult protection database
as the person responsible for abuse or neglect of a vulnerable
adult within the last seven years.
(h) The person has refused to give written consent for
disclosure of criminal history records.
(i) The person has been denied a family child care license
or has received a fine or a sanction as a licensed child care
provider that has not been reversed on appeal.
(j) The person has a family child care licensing
disqualification that has not been set aside.
(k) The person has admitted or a county has found that
there is a preponderance of evidence that fraudulent information
was given to the county for application purposes or was used in
submitting bills for payment.
(l) The person has been convicted or there is a
preponderance of evidence of the crime of theft by wrongfully
obtaining public assistance.
(m) The person has a household member age 13 or older who
has access to children during the hours that care is provided
and who meets one of the conditions listed in paragraphs (b) to
(l).
(n) The person has a household member ages ten to 12 who
has access to children during the hours that care is provided;
information or circumstances exist which provide the county with
articulable suspicion that further pertinent information may
exist showing the household member meets one of the conditions
listed in paragraphs (b) to (l); and the household member
actually meets one of the conditions listed in paragraphs (b) to
(l).
Subd. 3. [AUTHORIZATION EXCEPTION.] When a county denies a
person authorization as a legal nonlicensed family child care
provider under subdivision 2, the county later may authorize
that person as a provider if the following conditions are met:
(1) after receiving notice of the denial of the
authorization, the person applies for and obtains a valid child
care license issued under chapter 245A, issued by a tribe, or
issued by another state;
(2) the person maintains the valid child care license; and
(3) the person is providing child care in the state of
licensure or in the area under the jurisdiction of the licensing
tribe.
Subd. 4. [UNSAFE CARE.] A county may deny authorization as
a child care provider to any applicant or rescind authorization
of any provider when the county knows or has reason to believe
that the provider is unsafe or that the circumstances of the
chosen child care arrangement are unsafe. The county must
include the conditions under which a provider or care
arrangement will be determined to be unsafe in the county's
child care fund plan under section 119B.08, subdivision 3.
Subd. 5. [PROVISIONAL PAYMENT.] After a county receives a
completed application from a provider, the county may issue
provisional authorization and payment to the provider during the
time needed to determine whether to give final authorization to
the provider.
Subd. 6. [RECORD KEEPING REQUIREMENT.] All providers must
keep daily attendance records for children receiving child care
assistance and must make those records available immediately to
the county upon request. The daily attendance records must be
retained for six years after the date of service. A county may
deny authorization as a child care provider to any applicant or
rescind authorization of any provider when the county knows or
has reason to believe that the provider has not complied with
the record keeping requirement in this subdivision.
Sec. 22. Minnesota Statutes 2002, section 119B.13,
subdivision 1, is amended to read:
Subdivision 1. [SUBSIDY RESTRICTIONS.] The maximum rate
paid for child care assistance under the child care fund may not
exceed the 75th percentile rate for like-care arrangements in
the county as surveyed by the commissioner. A rate which
includes a provider bonus paid under subdivision 2 or a special
needs rate paid under subdivision 3 may be in excess of the
maximum rate allowed under this subdivision. The department
shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child
in care up to the maximum established. The commissioner shall
determine the maximum rate for each type of care on an hourly,
full-day, and weekly basis, including special needs and
handicapped care. Not less than once every two years, the
commissioner shall evaluate market practices for payment of
absences and shall establish policies for payment of absent days
that reflect current market practice.
When the provider charge is greater than the maximum
provider rate allowed, the parent is responsible for payment of
the difference in the rates in addition to any family copayment
fee.
Sec. 23. Minnesota Statutes 2002, section 119B.13, is
amended by adding a subdivision to read:
Subd. 1b. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER
RATES.] (a) Legal nonlicensed family child care providers
receiving reimbursement under this chapter must be paid on an
hourly basis for care provided to families receiving assistance.
(b) The maximum rate paid to legal nonlicensed family child
care providers must be 80 percent of the county maximum hourly
rate for licensed family child care providers. In counties
where the maximum hourly rate for licensed family child care
providers is higher than the maximum weekly rate for those
providers divided by 50, the maximum hourly rate that may be
paid to legal nonlicensed family child care providers is the
rate equal to the maximum weekly rate for licensed family child
care providers divided by 50 and then multiplied by 0.80.
(c) A rate which includes a provider bonus paid under
subdivision 2 or a special needs rate paid under subdivision 3
may be in excess of the maximum rate allowed under this
subdivision.
(d) Legal nonlicensed family child care providers receiving
reimbursement under this chapter may not be paid registration
fees for families receiving assistance.
Sec. 24. Minnesota Statutes 2002, section 119B.13,
subdivision 6, is amended to read:
Subd. 6. [PROVIDER PAYMENTS.] (a) Counties or the state
shall make vendor payments to the child care provider or pay the
parent directly for eligible child care expenses.
(b) If payments for child care assistance are made to
providers, the provider shall bill the county for services
provided within ten days of the end of the month of service
period. If bills are submitted in accordance with the
provisions of this subdivision within ten days of the end of the
service period, a county or the state shall issue payment to the
provider of child care under the child care fund within 30 days
of receiving an invoice a bill from the provider. Counties or
the state may establish policies that make payments on a more
frequent basis.
(c) All bills must be submitted within 60 days of the last
date of service on the bill. A county may pay a bill submitted
more than 60 days after the last date of service if the provider
shows good cause why the bill was not submitted within 60 days.
Good cause must be defined in the county's child care fund plan
under section 119B.08, subdivision 3, and the definition of good
cause must include county error. A county may not pay any bill
submitted more than a year after the last date of service on the
bill.
(d) A county may stop payment issued to a provider or may
refuse to pay a bill submitted by a provider if:
(1) the provider admits to intentionally giving the county
materially false information on the provider's billing forms; or
(2) a county finds by a preponderance of the evidence that
the provider intentionally gave the county materially false
information on the provider's billing forms.
(e) A county's payment policies must be included in the
county's child care plan under section 119B.08, subdivision 3.
If payments are made by the state, in addition to being in
compliance with this subdivision, the payments must be made in
compliance with section 16A.124.
Sec. 25. Minnesota Statutes 2002, section 119B.16, is
amended by adding a subdivision to read:
Subd. 1a. [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This
subdivision applies to providers caring for children receiving
child care assistance.
(b) A provider to whom a county agency has assigned
responsibility for an overpayment may request a fair hearing in
accordance with section 256.045 for the limited purpose of
challenging the assignment of responsibility for the overpayment
and the amount of the overpayment. The scope of the fair
hearing does not include the issues of whether the provider
wrongfully obtained public assistance in violation of section
256.98 or was properly disqualified under section 256.98,
subdivision 8, paragraph (c), unless the fair hearing has been
combined with an administrative disqualification hearing brought
against the provider under section 256.046.
Sec. 26. Minnesota Statutes 2002, section 119B.16, is
amended by adding a subdivision to read:
Subd. 1b. [JOINT FAIR HEARINGS.] When a provider requests
a fair hearing under subdivision 1a, the family in whose case
the overpayment was created must be made a party to the fair
hearing. All other issues raised by the family must be resolved
in the same proceeding. When a family requests a fair hearing
and claims that the county should have assigned responsibility
for an overpayment to a provider, the provider must be made a
party to the fair hearing. The referee assigned to a fair
hearing may join a family or a provider as a party to the fair
hearing whenever joinder of that party is necessary to fully and
fairly resolve overpayment issues raised in the appeal.
Sec. 27. Minnesota Statutes 2002, section 119B.16,
subdivision 2, is amended to read:
Subd. 2. [INFORMAL CONFERENCE.] The county agency shall
offer an informal conference to applicants and recipients
adversely affected by an agency action to attempt to resolve the
dispute. The county agency shall offer an informal conference
to providers to whom the county agency has assigned
responsibility for an overpayment in an attempt to resolve the
dispute. The county agency or the provider may ask the family
in whose case the overpayment arose to participate in the
informal conference, but the family may refuse to do so. The
county agency shall advise adversely affected applicants and,
recipients, and providers that a request for a conference with
the agency is optional and does not delay or replace the right
to a fair hearing.
Sec. 28. Minnesota Statutes 2002, section 119B.19,
subdivision 7, is amended to read:
Subd. 7. [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.]
Within each region, a child care resource and referral program
must:
(1) maintain one database of all existing child care
resources and services and one database of family referrals;
(2) provide a child care referral service for families;
(3) develop resources to meet the child care service needs
of families;
(4) increase the capacity to provide culturally responsive
child care services;
(5) coordinate professional development opportunities for
child care and school-age care providers;
(6) administer and award child care services grants;
(7) administer and provide loans for child development
education and training; and
(8) cooperate with the Minnesota Child Care Resource and
Referral Network and its member programs to develop effective
child care services and child care resources; and
(9) assist in fostering coordination, collaboration, and
planning among child care programs and community programs such
as school readiness, Head Start, early childhood family
education, local interagency early intervention committees,
early childhood screening, special education services, and other
early childhood care and education services and programs that
provide flexible, family-focused services to families with young
children to the extent possible.
Sec. 29. Minnesota Statutes 2002, section 119B.21,
subdivision 11, is amended to read:
Subd. 11. [STATEWIDE ADVISORY TASK FORCE.] The
commissioner may convene a statewide advisory task force to
advise the commissioner on statewide grants or other child care
issues. The following groups must be represented: family child
care providers, child care center programs, school-age care
providers, parents who use child care services, health services,
social services, Head Start, public schools, school-based early
childhood programs, special education programs, employers, and
other citizens with demonstrated interest in child care issues.
Additional members may be appointed by the commissioner. The
commissioner may compensate members for their travel, child
care, and child care provider substitute expenses for attending
task force meetings. The commissioner may also pay a stipend to
parent representatives for participating in task force meetings.
Sec. 30. Minnesota Statutes 2002, section 119B.23,
subdivision 3, is amended to read:
Subd. 3. [BIENNIAL PLAN.] The county board shall
biennially develop a plan for the distribution of money for
child care services as part of the community social services
plan described in section 256E.09 child care fund plan under
section 119B.08. All licensed child care programs shall be
given written notice concerning the availability of money and
the application process.
Sec. 31. Minnesota Statutes 2002, section 256.046,
subdivision 1, is amended to read:
Subdivision 1. [HEARING AUTHORITY.] A local agency must
initiate an administrative fraud disqualification hearing for
individuals, including child care providers caring for children
receiving child care assistance, accused of wrongfully obtaining
assistance or intentional program violations, in lieu of a
criminal action when it has not been pursued, in the aid to
families with dependent children program formerly codified in
sections 256.72 to 256.87, MFIP, child care assistance programs,
general assistance, family general assistance program formerly
codified in section 256D.05, subdivision 1, clause (15),
Minnesota supplemental aid, medical care, or food stamp
programs. The hearing is subject to the requirements of section
256.045 and the requirements in Code of Federal Regulations,
title 7, section 273.16, for the food stamp program and title
45, section 235.112, as of September 30, 1995, for the cash
grant and, medical care programs, and child care assistance
under chapter 119B.
Sec. 32. Minnesota Statutes 2002, section 256.0471,
subdivision 1, is amended to read:
Subdivision 1. [QUALIFYING OVERPAYMENT.] Any overpayment
for assistance granted under section 119B.05 chapter 119B, the
MFIP program formerly codified under sections 256.031 to
256.0361, and the AFDC program formerly codified under sections
256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K;
and the food stamp program, except agency error claims, become a
judgment by operation of law 90 days after the notice of
overpayment is personally served upon the recipient in a manner
that is sufficient under rule 4.03(a) of the Rules of Civil
Procedure for district courts, or by certified mail, return
receipt requested. This judgment shall be entitled to full
faith and credit in this and any other state.
Sec. 33. Minnesota Statutes 2002, section 256.98,
subdivision 8, is amended to read:
Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person
found to be guilty of wrongfully obtaining assistance by a
federal or state court or by an administrative hearing
determination, or waiver thereof, through a disqualification
consent agreement, or as part of any approved diversion plan
under section 401.065, or any court-ordered stay which carries
with it any probationary or other conditions, in the Minnesota
family investment program, the food stamp program, the general
assistance program, the group residential housing program, or
the Minnesota supplemental aid program shall be disqualified
from that program. In addition, any person disqualified from
the Minnesota family investment program shall also be
disqualified from the food stamp program. The needs of that
individual shall not be taken into consideration in determining
the grant level for that assistance unit:
(1) for one year after the first offense;
(2) for two years after the second offense; and
(3) permanently after the third or subsequent offense.
The period of program disqualification shall begin on the
date stipulated on the advance notice of disqualification
without possibility of postponement for administrative stay or
administrative hearing and shall continue through completion
unless and until the findings upon which the sanctions were
imposed are reversed by a court of competent jurisdiction. The
period for which sanctions are imposed is not subject to
review. The sanctions provided under this subdivision are in
addition to, and not in substitution for, any other sanctions
that may be provided for by law for the offense involved. A
disqualification established through hearing or waiver shall
result in the disqualification period beginning immediately
unless the person has become otherwise ineligible for
assistance. If the person is ineligible for assistance, the
disqualification period begins when the person again meets the
eligibility criteria of the program from which they were
disqualified and makes application for that program.
(b) A family receiving assistance through child care
assistance programs under chapter 119B with a family member who
is found to be guilty of wrongfully obtaining child care
assistance by a federal court, state court, or an administrative
hearing determination or waiver, through a disqualification
consent agreement, as part of an approved diversion plan under
section 401.065, or a court-ordered stay with probationary or
other conditions, is disqualified from child care assistance
programs. The disqualifications must be for periods of three
months, six months, and two years for the first, second, and
third offenses respectively. Subsequent violations must result
in permanent disqualification. During the disqualification
period, disqualification from any child care program must extend
to all child care programs and must be immediately applied.
(c) A provider caring for children receiving assistance
through child care assistance programs under chapter 119B is
disqualified from receiving payment for child care services from
the child care assistance program under chapter 119B when the
provider is found to have wrongfully obtained child care
assistance by a federal court, state court, or an administrative
hearing determination or waiver under section 256.046, through a
disqualification consent agreement, as part of an approved
diversion plan under section 401.065, or a court-ordered stay
with probationary or other conditions. The disqualification
must be for a period of one year for the first offense and two
years for the second offense. Any subsequent violation must
result in permanent disqualification. The disqualification
period must be imposed immediately after a determination is made
under this paragraph. During the disqualification period, the
provider is disqualified from receiving payment from any child
care program under chapter 119B.
Sec. 34. [DIRECTION TO COMMISSIONER; PROVIDER RATES.]
The provider rates determined under Minnesota Statutes,
section 119B.13, for fiscal year 2003 and implemented on July 1,
2002, are to be continued in effect through June 30, 2005. The
commissioner of human services is directed to evaluate the costs
of child care in Minnesota, to examine the differences in the
cost of child care in rural and metropolitan areas, and to make
recommendations to the legislature for containing future cost
increases in the child care program under Minnesota Statutes,
chapter 119B, in a manner that complies with federal child care
and development block grant requirements for promoting parental
choice and permits the department to track the effect of rate
changes on child care assistance program costs, the availability
of different types of care throughout the state, the length of
waiting lists, and the care options available to program
participants. The commissioner shall also examine the
allocation formula under Minnesota Statutes, section 119B.03,
and make recommendations to the legislature in order to create a
more equitable formula. The commissioner shall consider the
impact any recommendations might have on work incentives for low
and middle income families and possible changes to MFIP child
care, basic sliding fee child care, and the dependent care tax
credit. The commissioner shall make recommendations to the
legislature by January 15, 2005.
The commissioner shall also study the relationship between
child care assistance subsidies and tax credits or tax
incentives related to child care expenses, and include this
information in the January 15, 2005, report to the legislature
under this section.
Sec. 35. [CHILD CARE WAITING LIST.]
Notwithstanding Minnesota Statutes, section 119B.03,
subdivision 6, the commissioner may manage the child care
assistance waiting list under Minnesota Statutes, section
119B.03, subdivision 2, on a regional or statewide basis in
order to ensure that families listed under higher priority
categories, as determined by Minnesota Statutes, section
119B.03, subdivision 4, are served before families listed under
lower priority categories.
Sec. 36. [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.]
Notwithstanding Minnesota Rules, part 3400.0100, subpart 4,
the parent fee schedule is as follows:
Income Range Co-payment (as a percentage of
(as a percentage of the adjusted gross income)
federal poverty guidelines)
0-74.99% $ 0/month
75.00-99.99% $10/month
100.00-104.99% 3.85%
105.00-109.99% 3.85%
110.00-114.99% 3.85%
115.00-119.99% 3.85%
120.00-124.99% 4.29%
125.00-139.99% 4.29%
140.00-144.99% 4.73%
145.00-149.99% 4.73%
150.00-154.99% 4.73%
155.00-159.99% 5.65%
160.00-164.99% 5.65%
165.00-169.99% 6.56%
170.00-174.99% 7.00%
175.00-179.99% 7.44%
180.00-184.99% 8.31%
185.00-189.99% 8.75%
190.00-194.99% 9.19%
195.00-199.99% 10.06%
200.00-209.99% 12.25%
210.00-224.99% 16.10%
225.00-229.99% 17.15%
230.00-234.99% 19.25%
235.00-239.99% 19.78%
240.00-244.99% 21.35%
245.00-249.99% 22.00%
250% ineligible
A family's monthly co-payment fee is the fixed percentage
established for the income range multiplied by the highest
possible income within that income range.
Sec. 37. [ELIGIBILITY FOR FAMILIES WITH HOUSEHOLD INCOME
GREATER THAN 250 PERCENT OF THE FEDERAL POVERTY GUIDELINES.]
Families receiving child care assistance on July 1, 2003,
who have household income greater than 250 percent of the
federal poverty guidelines, adjusted for family size, are
eligible to continue receiving child care assistance until the
family's next eligibility redetermination.
Sec. 38. [REPEALER.]
(a) Minnesota Statutes 2002, sections 119B.061 and 119B.13,
subdivision 2, are repealed.
(b) Laws 2000, chapter 489, article 1, section 36, and Laws
2001, First Special Session chapter 3, article 1, section 16,
are repealed.
ARTICLE 10
CHILD SUPPORT FEDERAL COMPLIANCE
Section 1. Minnesota Statutes 2002, section 13.69,
subdivision 1, is amended to read:
Subdivision 1. [CLASSIFICATIONS.] (a) The following
government data of the department of public safety are private
data:
(1) medical data on driving instructors, licensed drivers,
and applicants for parking certificates and special license
plates issued to physically handicapped persons;
(2) other data on holders of a disability certificate under
section 169.345, except that data that are not medical data may
be released to law enforcement agencies;
(3) social security numbers in driver's license and motor
vehicle registration records, except that social security
numbers must be provided to the department of revenue for
purposes of tax administration and, the department of labor and
industry for purposes of workers' compensation administration
and enforcement, and the department of natural resources for
purposes of license application administration; and
(4) data on persons listed as standby or temporary
custodians under section 171.07, subdivision 11, except that the
data must be released to:
(i) law enforcement agencies for the purpose of verifying
that an individual is a designated caregiver; or
(ii) law enforcement agencies who state that the license
holder is unable to communicate at that time and that the
information is necessary for notifying the designated caregiver
of the need to care for a child of the license holder.
The department may release the social security number only
as provided in clause (3) and must not sell or otherwise provide
individual social security numbers or lists of social security
numbers for any other purpose.
(b) The following government data of the department of
public safety are confidential data: data concerning an
individual's driving ability when that data is received from a
member of the individual's family.
Sec. 2. [97A.482] [LICENSE APPLICATIONS; COLLECTION OF
SOCIAL SECURITY NUMBERS.]
(a) All applicants for individual noncommercial game and
fish licenses under this chapter and chapters 97B and 97C must
include the applicant's social security number on the license
application. If an applicant does not have a social security
number, the applicant must certify that the applicant does not
have a social security number.
(b) The social security numbers collected by the
commissioner on game and fish license applications are private
data under section 13.49, subdivision 1, and must be provided by
the commissioner to the commissioner of human services for child
support enforcement purposes. Title IV-D of the Social Security
Act, United States Code, title 42, section 666(a)(13), requires
the collection of social security numbers on game and fish
license applications for child support enforcement purposes.
Sec. 3. Minnesota Statutes 2002, section 171.06,
subdivision 3, is amended to read:
Subd. 3. [CONTENTS OF APPLICATION; OTHER INFORMATION.] (a)
An application must:
(1) state the full name, date of birth, sex, and residence
address of the applicant;
(2) as may be required by the commissioner, contain a
description of the applicant and any other facts pertaining to
the applicant, the applicant's driving privileges, and the
applicant's ability to operate a motor vehicle with safety;
(3) for a class C, class B, or class A driver's license,
state:
(i) the applicant's social security number or, for a class
D driver's license, have a space for the applicant's social
security number and state that providing the number is optional,
or otherwise convey that the applicant is not required to enter
the social security number; or
(ii) if the applicant does not have a social security
number and is applying for a Minnesota identification card,
instruction permit, or class D provisional or driver's license,
that the applicant certifies that the applicant does not have a
social security number;
(4) contain a space where the applicant may indicate a
desire to make an anatomical gift according to paragraph (b);
and
(5) contain a notification to the applicant of the
availability of a living will/health care directive designation
on the license under section 171.07, subdivision 7.
(b) If the applicant does not indicate a desire to make an
anatomical gift when the application is made, the applicant must
be offered a donor document in accordance with section 171.07,
subdivision 5. The application must contain statements
sufficient to comply with the requirements of the Uniform
Anatomical Gift Act (1987), sections 525.921 to 525.9224, so
that execution of the application or donor document will make
the anatomical gift as provided in section 171.07, subdivision
5, for those indicating a desire to make an anatomical gift.
The application must be accompanied by information describing
Minnesota laws regarding anatomical gifts and the need for and
benefits of anatomical gifts, and the legal implications of
making an anatomical gift, including the law governing
revocation of anatomical gifts. The commissioner shall
distribute a notice that must accompany all applications for and
renewals of a driver's license or Minnesota identification
card. The notice must be prepared in conjunction with a
Minnesota organ procurement organization that is certified by
the federal Department of Health and Human Services and must
include:
(1) a statement that provides a fair and reasonable
description of the organ donation process, the care of the donor
body after death, and the importance of informing family members
of the donation decision; and
(2) a telephone number in a certified Minnesota organ
procurement organization that may be called with respect to
questions regarding anatomical gifts.
(c) The application must be accompanied also by information
containing relevant facts relating to:
(1) the effect of alcohol on driving ability;
(2) the effect of mixing alcohol with drugs;
(3) the laws of Minnesota relating to operation of a motor
vehicle while under the influence of alcohol or a controlled
substance; and
(4) the levels of alcohol-related fatalities and accidents
in Minnesota and of arrests for alcohol-related violations.
Sec. 4. Minnesota Statutes 2002, section 171.07, is
amended by adding a subdivision to read:
Subd. 14. [USE OF SOCIAL SECURITY NUMBER.] An applicant's
social security number must not be displayed, encrypted, or
encoded on the driver's license or Minnesota identification card
or included in a magnetic strip or bar code used to store data
on the license or Minnesota identification card. The social
security number must not be used as a Minnesota driver's license
or identification number.
Sec. 5. Minnesota Statutes 2002, section 518.551,
subdivision 12, is amended to read:
Subd. 12. [OCCUPATIONAL LICENSE SUSPENSION.] (a) Upon
motion of an obligee, if the court finds that the obligor is or
may be licensed by a licensing board listed in section 214.01 or
other state, county, or municipal agency or board that issues an
occupational license and the obligor is in arrears in
court-ordered child support or maintenance payments or both in
an amount equal to or greater than three times the obligor's
total monthly support and maintenance payments and is not in
compliance with a written payment agreement pursuant to section
518.553 that is approved by the court, a child support
magistrate, or the public authority, the court shall direct the
licensing board or other licensing agency to suspend the license
under section 214.101. The court's order must be stayed for 90
days in order to allow the obligor to execute a written payment
agreement pursuant to section 518.553. The payment agreement
must be approved by either the court or the public authority
responsible for child support enforcement. If the obligor has
not executed or is not in compliance with a written payment
agreement pursuant to section 518.553 after the 90 days expires,
the court's order becomes effective. If the obligor is a
licensed attorney, the court shall report the matter to the
lawyers professional responsibility board for appropriate action
in accordance with the rules of professional conduct. The
remedy under this subdivision is in addition to any other
enforcement remedy available to the court.
(b) If a public authority responsible for child support
enforcement finds that the obligor is or may be licensed by a
licensing board listed in section 214.01 or other state, county,
or municipal agency or board that issues an occupational license
and the obligor is in arrears in court-ordered child support or
maintenance payments or both in an amount equal to or greater
than three times the obligor's total monthly support and
maintenance payments and is not in compliance with a written
payment agreement pursuant to section 518.553 that is approved
by the court, a child support magistrate, or the public
authority, the court or the public authority shall direct the
licensing board or other licensing agency to suspend the license
under section 214.101. If the obligor is a licensed attorney,
the public authority may report the matter to the lawyers
professional responsibility board for appropriate action in
accordance with the rules of professional conduct. The remedy
under this subdivision is in addition to any other enforcement
remedy available to the public authority.
(c) At least 90 days before notifying a licensing authority
or the lawyers professional responsibility board under paragraph
(b), the public authority shall mail a written notice to the
license holder addressed to the license holder's last known
address that the public authority intends to seek license
suspension under this subdivision and that the license holder
must request a hearing within 30 days in order to contest the
suspension. If the license holder makes a written request for a
hearing within 30 days of the date of the notice, a court
hearing or a hearing under section 484.702 must be held.
Notwithstanding any law to the contrary, the license holder must
be served with 14 days' notice in writing specifying the time
and place of the hearing and the allegations against the license
holder. The notice may be served personally or by mail. If the
public authority does not receive a request for a hearing within
30 days of the date of the notice, and the obligor does not
execute a written payment agreement pursuant to section 518.553
that is approved by the public authority within 90 days of the
date of the notice, the public authority shall direct the
licensing board or other licensing agency to suspend the
obligor's license under paragraph (b), or shall report the
matter to the lawyers professional responsibility board.
(d) The public authority or the court shall notify the
lawyers professional responsibility board for appropriate action
in accordance with the rules of professional responsibility
conduct or order the licensing board or licensing agency to
suspend the license if the judge finds that:
(1) the person is licensed by a licensing board or other
state agency that issues an occupational license;
(2) the person has not made full payment of arrearages
found to be due by the public authority; and
(3) the person has not executed or is not in compliance
with a payment plan approved by the court, a child support
magistrate, or the public authority.
(e) Within 15 days of the date on which the obligor either
makes full payment of arrearages found to be due by the court or
public authority or executes and initiates good faith compliance
with a written payment plan approved by the court, a child
support magistrate, or the public authority, the court, a child
support magistrate, or the public authority responsible for
child support enforcement shall notify the licensing board or
licensing agency or the lawyers professional responsibility
board that the obligor is no longer ineligible for license
issuance, reinstatement, or renewal under this subdivision.
(f) In addition to the criteria established under this
section for the suspension of an obligor's occupational license,
a court, a child support magistrate, or the public authority may
direct the licensing board or other licensing agency to suspend
the license of a party who has failed, after receiving notice,
to comply with a subpoena relating to a paternity or child
support proceeding. Notice to an obligor of intent to suspend
must be served by first class mail at the obligor's last known
address. The notice must inform the obligor of the right to
request a hearing. If the obligor makes a written request
within ten days of the date of the hearing, a hearing must be
held. At the hearing, the only issues to be considered are
mistake of fact and whether the obligor received the subpoena.
(g) The license of an obligor who fails to remain in
compliance with an approved written payment agreement may be
suspended. Notice to the obligor of an intent to suspend under
this paragraph must be served by first class mail at the
obligor's last known address and must include a notice of
hearing. The notice must be served upon the obligor not less
than ten days before the date of the hearing. Prior to
suspending a license for noncompliance with an approved written
payment agreement, the public authority must mail to the
obligor's last known address a written notice that (1) the
public authority intends to seek suspension of the obligor's
occupational license under this paragraph, and (2) the obligor
must request a hearing, within 30 days of the date of the
notice, to contest the suspension. If, within 30 days of the
date of the notice, the public authority does not receive a
written request for a hearing and the obligor does not comply
with an approved written payment agreement, the public authority
must direct the licensing board or other licensing agency to
suspend the obligor's license under paragraph (b), and, if the
obligor is a licensed attorney, must report the matter to the
lawyers professional responsibility board. If the obligor makes
a written request for a hearing within 30 days of the date of
the notice, a court hearing must be held. Notwithstanding any
law to the contrary, the obligor must be served with 14 days'
notice in writing specifying the time and place of the hearing
and the allegations against the obligor. The notice may be
served personally or by mail to the obligor's last known
address. If the obligor appears at the hearing and the judge
court determines that the obligor has failed to comply with an
approved written payment agreement, the judge shall court or
public authority must notify the occupational licensing board or
other licensing agency to suspend the obligor's license under
paragraph (c) (b) and, if the obligor is a licensed attorney,
must report the matter to the lawyers professional
responsibility board. If the obligor fails to appear at the
hearing, the public authority may court or public authority must
notify the occupational or licensing board or other licensing
agency to suspend the obligor's license under paragraph (c) (b),
and if the obligor is a licensed attorney, must report the
matter to the lawyers professional responsibility board.
Sec. 6. Minnesota Statutes 2002, section 518.551,
subdivision 13, is amended to read:
Subd. 13. [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion
of an obligee, which has been properly served on the obligor and
upon which there has been an opportunity for hearing, if a court
finds that the obligor has been or may be issued a driver's
license by the commissioner of public safety and the obligor is
in arrears in court-ordered child support or maintenance
payments, or both, in an amount equal to or greater than three
times the obligor's total monthly support and maintenance
payments and is not in compliance with a written payment
agreement pursuant to section 518.553 that is approved by the
court, a child support magistrate, or the public authority, the
court shall order the commissioner of public safety to suspend
the obligor's driver's license. The court's order must be
stayed for 90 days in order to allow the obligor to execute a
written payment agreement pursuant to section 518.553. The
payment agreement must be approved by either the court or the
public authority responsible for child support enforcement. If
the obligor has not executed or is not in compliance with a
written payment agreement pursuant to section 518.553 after the
90 days expires, the court's order becomes effective and the
commissioner of public safety shall suspend the obligor's
driver's license. The remedy under this subdivision is in
addition to any other enforcement remedy available to the
court. An obligee may not bring a motion under this paragraph
within 12 months of a denial of a previous motion under this
paragraph.
(b) If a public authority responsible for child support
enforcement determines that the obligor has been or may be
issued a driver's license by the commissioner of public safety
and the obligor is in arrears in court-ordered child support or
maintenance payments or both in an amount equal to or greater
than three times the obligor's total monthly support and
maintenance payments and not in compliance with a written
payment agreement pursuant to section 518.553 that is approved
by the court, a child support magistrate, or the public
authority, the public authority shall direct the commissioner of
public safety to suspend the obligor's driver's license. The
remedy under this subdivision is in addition to any other
enforcement remedy available to the public authority.
(c) At least 90 days prior to notifying the commissioner of
public safety according to paragraph (b), the public authority
must mail a written notice to the obligor at the obligor's last
known address, that it intends to seek suspension of the
obligor's driver's license and that the obligor must request a
hearing within 30 days in order to contest the suspension. If
the obligor makes a written request for a hearing within 30 days
of the date of the notice, a court hearing must be held.
Notwithstanding any law to the contrary, the obligor must be
served with 14 days' notice in writing specifying the time and
place of the hearing and the allegations against the obligor.
The notice must include information that apprises the obligor of
the requirement to develop a written payment agreement that is
approved by a court, a child support magistrate, or the public
authority responsible for child support enforcement regarding
child support, maintenance, and any arrearages in order to avoid
license suspension. The notice may be served personally or by
mail. If the public authority does not receive a request for a
hearing within 30 days of the date of the notice, and the
obligor does not execute a written payment agreement pursuant to
section 518.553 that is approved by the public authority within
90 days of the date of the notice, the public authority shall
direct the commissioner of public safety to suspend the
obligor's driver's license under paragraph (b).
(d) At a hearing requested by the obligor under paragraph
(c), and on finding that the obligor is in arrears in
court-ordered child support or maintenance payments or both in
an amount equal to or greater than three times the obligor's
total monthly support and maintenance payments, the district
court or child support magistrate shall order the commissioner
of public safety to suspend the obligor's driver's license or
operating privileges unless the court or child support
magistrate determines that the obligor has executed and is in
compliance with a written payment agreement pursuant to section
518.553 that is approved by the court, a child support
magistrate, or the public authority.
(e) An obligor whose driver's license or operating
privileges are suspended may:
(1) provide proof to the public authority responsible for
child support enforcement that the obligor is in compliance with
all written payment agreements pursuant to section 518.553;
(2) bring a motion for reinstatement of the driver's
license. At the hearing, if the court or child support
magistrate orders reinstatement of the driver's license, the
court or child support magistrate must establish a written
payment agreement pursuant to section 518.553; or
(3) seek a limited license under section 171.30. A limited
license issued to an obligor under section 171.30 expires 90
days after the date it is issued.
Within 15 days of the receipt of that proof or a court
order, the public authority shall inform the commissioner of
public safety that the obligor's driver's license or operating
privileges should no longer be suspended.
(f) On January 15, 1997, and every two years after that,
the commissioner of human services shall submit a report to the
legislature that identifies the following information relevant
to the implementation of this section:
(1) the number of child support obligors notified of an
intent to suspend a driver's license;
(2) the amount collected in payments from the child support
obligors notified of an intent to suspend a driver's license;
(3) the number of cases paid in full and payment agreements
executed in response to notification of an intent to suspend a
driver's license;
(4) the number of cases in which there has been
notification and no payments or payment agreements;
(5) the number of driver's licenses suspended;
(6) the cost of implementation and operation of the
requirements of this section; and
(7) the number of limited licenses issued and number of
cases in which payment agreements are executed and cases are
paid in full following issuance of a limited license.
(g) In addition to the criteria established under this
section for the suspension of an obligor's driver's license, a
court, a child support magistrate, or the public authority may
direct the commissioner of public safety to suspend the license
of a party who has failed, after receiving notice, to comply
with a subpoena relating to a paternity or child support
proceeding. Notice to an obligor of intent to suspend must be
served by first class mail at the obligor's last known address.
The notice must inform the obligor of the right to request a
hearing. If the obligor makes a written request within ten days
of the date of the hearing, a hearing must be held. At the
hearing, the only issues to be considered are mistake of fact
and whether the obligor received the subpoena.
(h) The license of an obligor who fails to remain in
compliance with an approved written payment agreement may be
suspended. Notice to the obligor of an intent to suspend under
this paragraph must be served by first class mail at the
obligor's last known address and must include a notice of
hearing. The notice must be served upon the obligor not less
than ten days before the date of the hearing. Prior to
suspending a license for noncompliance with an approved written
payment agreement, the public authority must mail to the
obligor's last known address a written notice that (1) the
public authority intends to seek suspension of the obligor's
driver's license under this paragraph, and (2) the obligor must
request a hearing, within 30 days of the date of the notice, to
contest the suspension. If, within 30 days of the date of the
notice, the public authority does not receive a written request
for a hearing and the obligor does not comply with an approved
written payment agreement, the public authority must direct the
department of public safety to suspend the obligor's license
under paragraph (b). If the obligor makes a written request for
a hearing within 30 days of the date of the notice, a court
hearing must be held. Notwithstanding any law to the contrary,
the obligor must be served with 14 days' notice in writing
specifying the time and place of the hearing and the allegations
against the obligor. The notice may be served personally or by
mail at the obligor's last known address. If the obligor
appears at the hearing and the judge court determines that the
obligor has failed to comply with an approved written payment
agreement, the judge court or public authority shall notify the
department of public safety to suspend the obligor's license
under paragraph (c) (b). If the obligor fails to appear at the
hearing, the public authority may court or public authority must
notify the department of public safety to suspend the obligor's
license under paragraph (c) (b).
Sec. 7. Laws 1997, chapter 245, article 2, section 11, is
amended to read:
Sec. 11. [FEDERAL FUNDS FOR VISITATION AND ACCESS.]
The commissioner of human services may accept on behalf of
the state any federal funding received under Public Law Number
104-193 for access and visitation programs, and shall transfer
these funds to the state court administrator for the cooperation
for the children pilot project and the parent education program
under Minnesota Statutes, section 518.571 must administer the
funds for the activities allowed under federal law. The
commissioner may distribute the funds on a competitive basis and
must monitor, evaluate, and report on the access and visitation
programs in accordance with any applicable regulations.
Sec. 8. [EFFECTIVE DATE.]
Sections 1 to 4 are effective August 1, 2003.
ARTICLE 11
COMMUNITY SERVICES ACT
Section 1. [256M.01] [CITATION.]
Sections 256M.01 to 256M.80 may be cited as the "Children
and Community Services Act." This act establishes a fund to
address the needs of children, adolescents, and adults within
each county in accordance with a service plan entered into by
the board of county commissioners of each county and the
commissioner. The service plan shall specify the outcomes to be
achieved, the general strategies to be employed, and the
respective state and county roles. The service plan shall be
reviewed and updated every two years, or sooner if both the
state and the county deem it necessary.
Sec. 2. [256M.10] [DEFINITIONS.]
Subdivision 1. [SCOPE.] For the purposes of sections
256M.01 to 256M.80, the terms defined in this section have the
meanings given them.
Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children
and community services" means services provided or arranged for
by county boards for children, adolescents and other individuals
in transition from childhood to adulthood, and adults who
experience dependency, abuse, neglect, poverty, disability,
chronic health conditions, or other factors, including ethnicity
and race, that may result in poor outcomes or disparities, as
well as services for family members to support those individuals.
These services may be provided by professionals or
nonprofessionals, including the person's natural supports in the
community.
(b) Children and community services do not include services
under the public assistance programs known as the Minnesota
family investment program, Minnesota supplemental aid, medical
assistance, general assistance, general assistance medical care,
MinnesotaCare, or community health services.
Subd. 3. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 4. [COUNTY BOARD.] "County board" means the board of
county commissioners in each county.
Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE
GRANTS.] "Former children's services and community service
grants" means allocations for the following grants:
(1) community social service grants under sections 252.24,
256E.06, and 256E.14;
(2) family preservation grants under section 256F.05,
subdivision 3;
(3) concurrent permanency planning grants under section
260C.213, subdivision 5;
(4) social service block grants (Title XX) under section
256E.07; and
(5) children's mental health grants under sections 245.4886
and 260.152.
Subd. 6. [HUMAN SERVICES BOARD.] "Human services board"
means a board established under section 402.02; Laws 1974,
chapter 293; or Laws 1976, chapter 340.
Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN
SERVICES.]
Subdivision 1. [GENERAL SUPERVISION.] Each year the
commissioner shall allocate funds to each county with an
approved service plan according to section 256M.40 and service
plans under section 256M.30. The funds shall be used to address
the needs of children, adolescents, and adults. The
commissioner, in consultation with counties, shall provide
technical assistance and evaluate county performance in
achieving outcomes.
Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall:
(1) provide necessary information and assistance to each
county for establishing baselines and desired improvements on
mental health, safety, permanency, and well-being for children
and adolescents;
(2) provide training, technical assistance, and other
supports to each county board to assist in needs assessment,
planning, implementation, and monitoring of outcomes and service
quality;
(3) use data collection, evaluation of service outcomes,
and the review and approval of county service plans to supervise
county performance in the delivery of children and community
services;
(4) specify requirements for reports, including fiscal
reports to account for funds distributed;
(5) request waivers from federal programs as necessary to
implement this act; and
(6) have authority under sections 14.055 and 14.056 to
grant a variance to existing state rules as needed to eliminate
barriers to achieving desired outcomes.
Subd. 3. [SANCTIONS.] The commissioner shall establish and
maintain a monitoring program designed to reduce the possibility
of noncompliance with federal laws and federal regulations that
may result in federal fiscal sanctions. If a county is not
complying with federal law or federal regulation and the
noncompliance may result in federal fiscal sanctions, the
commissioner may withhold a portion of the county's share of
state and federal funds for that program. The amount withheld
must be equal to the percentage difference between the level of
compliance maintained by the county and the level of compliance
required by the federal regulations, multiplied by the county's
share of state and federal funds for the program. The state and
federal funds may be withheld until the county is found to be in
compliance with all federal laws or federal regulations
applicable to the program. If a county remains out of
compliance for more than six consecutive months, the
commissioner may reallocate the withheld funds to counties that
are in compliance with the federal regulations.
Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner
must comply with the following procedures when reducing county
funds under subdivision 3.
(a) The commissioner shall notify the county, by certified
mail, of the statute, rule, federal law, or federal regulation
with which the county has not complied.
(b) The commissioner shall give the county 30 days to
demonstrate to the commissioner that the county is in compliance
with the statute, rule, federal law, or federal regulation cited
in the notice or to develop a corrective action plan to address
the problem. Upon request from the county, the commissioner
shall provide technical assistance to the county in developing a
corrective action plan. The county shall have 30 days from the
date the technical assistance is provided to develop the
corrective action plan.
(c) The commissioner shall take no further action if the
county demonstrates compliance with the statute, rule, federal
law, or federal regulation cited in the notice.
(d) The commissioner shall review and approve or disapprove
the corrective action plan within 30 days after the commissioner
receives the corrective action plan.
(e) If the commissioner approves the corrective action plan
submitted by the county, the county has 90 days after the date
of approval to implement the corrective action plan.
(f) If the county fails to demonstrate compliance or fails
to implement the corrective action plan approved by the
commissioner, the commissioner may reduce the county's share of
state or federal funds according to subdivision 3.
Sec. 4. [256M.30] [SERVICE PLAN.]
Subdivision 1. [SERVICE PLAN SUBMITTED TO COMMISSIONER.]
Effective January 1, 2004, and each two-year period thereafter,
each county must have a biennial service plan approved by the
commissioner in order to receive funds. Counties may submit
multicounty or regional service plans.
Subd. 2. [CONTENTS.] The service plan shall be completed
in a form prescribed by the commissioner. The plan must include:
(1) a statement of the needs of the children, adolescents,
and adults who experience the conditions defined in section
256M.10, subdivision 2, paragraph (a), and strengths and
resources available in the community to address those needs;
(2) strategies the county will pursue to achieve the
performance targets. Strategies must include specification of
how funds under this section and other community resources will
be used to achieve desired performance targets;
(3) a description of the county's process to solicit public
input and a summary of that input;
(4) beginning with the service plans submitted for the
period from January 1, 2006, through December 21, 2007,
performance targets on statewide indicators for each county to
measure outcomes of children's mental health, and child safety,
permanency, and well-being. The commissioner shall consult with
counties and other stakeholders to develop these indicators and
collect baseline data to inform the establishment of individual
county performance targets for the 2006-2007 biennium and
subsequent plans; and
(5) a budget for services to be provided with funds under
this section. The county must budget at least 40 percent of
funds appropriated under sections 256M.01 to 256M.80 for
services to ensure the mental health, safety, permanency, and
well-being of children from low-income families. The
commissioner may reduce the portion of child and community
services funds that must be budgeted by a county for services to
children in low-income families if:
(i) the incidence of children in low-income families within
the county's population is significantly below the statewide
median; or
(ii) the county has successfully achieved past performance
targets for children's mental health, and child safety,
permanency, and well-being and its proposed service plan is
judged by the commissioner to provide an adequate level of
service to the population with less funding.
Subd. 3. [CONTINUITY OF SERVICES.] In developing the plan
required under this section, a county shall endeavor, within the
limits of funds available, to consider the continuing need for
services and programs for children and persons with disabilities
that were funded by the former children's services and community
service grants.
Subd. 4. [INFORMATION.] The commissioner shall provide
each county with information and technical assistance needed to
complete the service plan, including: information on children's
mental health, and child safety, permanency, and well-being in
the county; comparisons with other counties; baseline
performance on outcome measures; and promising program practices.
Subd. 5. [TIMELINES.] The preliminary service plan must be
submitted to the commissioner by October 15, 2003, and October
15 of every two years thereafter.
Subd. 6. [PUBLIC COMMENT.] The county board must determine
how citizens in the county will participate in the development
of the service plan and provide opportunities for such
participation. The county must allow a period of no less than
30 days prior to the submission of the plan to the commissioner
to solicit comments from the public on the contents of the plan.
Subd. 7. [COMMISSIONER'S RESPONSIBILITIES.] The
commissioner must, within 60 days of receiving each county
service plan, inform the county if the service plan has been
approved. If the service plan is not approved, the commissioner
must inform the county of any revisions needed for approval.
Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES
GRANT ALLOCATION.]
Subdivision 1. [FORMULA.] The commissioner shall allocate
state funds appropriated for children and community services
grants to each county board on a calendar year basis in an
amount determined according to the formula in paragraphs (a) to
(c).
(a) For July 1, 2003, through December 31, 2003, the
commissioner shall allocate funds to each county equal to that
county's allocation for the grants under section 256M.10,
subdivision 5, for calendar year 2003 less payments made on or
before June 30, 2003.
(b) For calendar year 2004 and 2005, the commissioner shall
allocate available funds to each county in proportion to that
county's share of the calendar year 2003 allocations for the
grants under section 256M.10, subdivision 5.
(c) For calendar year 2006 and each calendar year
thereafter, the commissioner shall allocate available funds to
each county in proportion to that county's share in the
preceding calendar year.
Subd. 2. [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The
commissioner shall study whether and how to dedicate a portion
of the allocated funds for projects of regional significance.
The study shall include an analysis of the amount of annual
funding to be dedicated for projects of regional significance
and what efforts these projects must support. The commissioner
shall submit a report to the chairs of the house and senate
committees with jurisdiction over children and community
services grants by January 15, 2005. The commissioner of
finance, in preparing the proposed biennial budget for fiscal
years 2006 and 2007, is instructed to include $25 million each
year in funding for projects of regional significance under this
chapter.
Subd. 3. [PAYMENTS.] Calendar year allocations under
subdivision 1 shall be paid to counties on or before July 10 of
each year.
Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES
GRANT ALLOCATION.]
In federal fiscal year 2004 and subsequent years, money for
social services received from the federal government to
reimburse counties for social service expenditures according to
Title XX of the Social Security Act shall be allocated to each
county according to section 256M.40, except for funds allocated
for administrative purposes and migrant day care.
Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.]
Subdivision 1. [RESPONSIBILITIES.] The county board of
each county shall be responsible for administration and funding
of children and community services as defined in section
256M.10, subdivision 1. Each county board shall singly or in
combination with other county boards use funds available to the
county under this act to carry out these responsibilities. The
county board shall coordinate and facilitate the effective use
of formal and informal helping systems to best support and
nurture children, adolescents, and adults within the county who
experience dependency, abuse, neglect, poverty, disability,
chronic health conditions, or other factors, including ethnicity
and race, that may result in poor outcomes or disparities, as
well as services for family members to support such
individuals. This includes assisting individuals to function at
the highest level of ability while maintaining family and
community relationships to the greatest extent possible.
Subd. 2. [DAY TRAINING AND HABILITATION SERVICES;
ALTERNATIVE HABILITATION SERVICES.] To the extent provided in
the county service plan under section 256M.30, the county board
of each county shall be responsible for providing day training
and habilitation services or alternative habilitation services
during the day for persons with developmental disabilities to
the extent this is required by the person's individualized
service plan.
Subd. 3. [REPORTS.] The county board shall provide
necessary reports and data as required by the commissioner.
Subd. 4. [CONTRACTS FOR SERVICES.] The county board may
contract with a human services board, a multicounty board
established by a joint powers agreement, other political
subdivisions, a children's mental health collaborative, a family
services collaborative, or private organizations in discharging
its duties.
Subd. 5. [EXEMPTION FROM LIABILITY.] The state of
Minnesota, the county boards, or the agencies acting on behalf
of the county boards in the implementation and administration of
children and community services shall not be liable for damages,
injuries, or liabilities sustained through the purchase of
services by the individual, the individual's family, or the
authorized representative under this section.
Subd. 6. [FEES FOR SERVICES.] The county board may
establish a schedule of fees based upon clients' ability to pay
to be charged to recipients of children and community services.
Payment, in whole or in part, for services may be accepted from
any person except that no fee may be charged to persons or
families whose adjusted gross household income is below the
federal poverty level. When services are provided to any
person, including a recipient of aids administered by the
federal, state, or county government, payment of any charges due
may be billed to and accepted from a public assistance agency or
from any public or private corporation.
Sec. 8. [256M.70] [FISCAL LIMITATIONS.]
Subdivision 1. [DEMONSTRATION OF REASONABLE EFFORT.] The
county shall make reasonable efforts to comply with all children
and community services requirements. For the purposes of this
section, a county is making reasonable efforts if the county has
made efforts to comply with requirements within the limits of
available funding, including efforts to identify and apply for
commonly available state and federal funding for services.
Subd. 2. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a
county has made reasonable efforts to provide services according
to the service plan under section 256M.30, but funds
appropriated for purposes of sections 256M.01 to 256M.80 are
insufficient, then the county may limit services that do not
meet the following criteria while giving the highest funding
priority to clauses (1), (2), and (3):
(1) services needed to protect individuals from
maltreatment, abuse, and neglect;
(2) emergency and crisis services needed to protect clients
from physical, emotional, or psychological harm;
(3) services that maintain a person in the person's home or
least restrictive setting;
(4) assessment of persons applying for services and
referral to appropriate services when necessary;
(5) public guardianship services;
(6) case management for persons with developmental
disabilities, children with serious emotional disturbances, and
adults with serious and persistent mental illness; and
(7) fulfilling licensing responsibilities delegated to the
county by the commissioner under section 245A.16.
Subd. 3. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES
DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or
terminates services to an individual due to fiscal limitations,
the county must meet the requirements in this section. The
county must notify the individual and the individual's guardian
in writing of the reason for the denial, reduction, or
termination of services and must inform the individual and the
individual's guardian in writing that the county will, upon
request, meet to discuss alternatives before services are
terminated or reduced.
Sec. 9. [256M.80] [PROGRAM EVALUATION.]
Subdivision 1. [COUNTY EVALUATION.] Each county shall
submit to the commissioner data from the past calendar year on
the outcomes and performance indicators in the service plan.
The commissioner shall prescribe standard methods to be used by
the counties in providing the data. The data shall be submitted
no later than March 1 of each year, beginning with March 1, 2005.
Subd. 2. [STATEWIDE EVALUATION.] Six months after the end
of the first full calendar year and annually thereafter, the
commissioner shall prepare a report on the counties' progress in
improving the outcomes of children, adolescents, and adults
related to mental health, safety, permanency, and well-being.
This report shall be disseminated throughout the state.
Sec. 10. [256M.90] [GRANTS AND PURCHASE OF SERVICE
CONTRACTS.]
Subdivision 1. [AUTHORITY.] The local agency may purchase
community social services by grant or purchase of service
contract from agencies or individuals approved as vendors.
Subd. 2. [DUTIES OF LOCAL AGENCY.] The local agency must:
(1) use a written grant or purchase of service contract
when purchasing community social services. Every grant and
purchase of service contract must be completed, signed, and
approved by all parties to the agreement, including the county
board, unless the county board has designated the local agency
to sign on its behalf. No service shall be provided before the
effective date of the grant or purchase of service contract;
(2) determine a client's eligibility for purchased
services, or delegate the responsibility for making the
preliminary determination to the approved vendor under the terms
of the grant or purchase of service contract;
(3) ensure the development of an individual social service
plan based on the client's needs;
(4) monitor purchased services and evaluate grants and
contracts on the basis of client outcomes; and
(5) purchase only from approved vendors.
Subd. 3. [LOCAL AGENCY CRITERIA.] When the local agency
chooses to purchase community social services from a vendor that
is not subject to state licensing laws or department rules, the
local agency must establish written criteria for vendor approval
to ensure the health, safety, and well being of clients.
Subd. 4. [CASE RECORDS AND REPORTING REQUIREMENTS.] Case
records and data reporting requirements for grants and purchased
services are the same as case record and data reporting
requirements for direct services.
Subd. 5. [FILES.] The local agency must keep an
administrative file for each grant and contract.
Subd. 6. [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD
COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting
within and across county lines and lead county contracts.
(a) Once a local agency and an approved vendor execute a
contract that meets the requirements of this subdivision, the
contract governs all other purchases of service from the vendor
by all other local agencies for the term of the contract. The
local agency that negotiated and entered into the contract
becomes the lead county for the contract.
(b) When the local agency in the county where a vendor is
located wants to purchase services from that vendor and the
vendor has no contract with the local agency or any other
county, the local agency must negotiate and execute a contract
with the vendor.
(c) When a local agency in one county wants to purchase
services from a vendor located in another county, it must notify
the local agency in the county where the vendor is located.
Within 30 days of being notified, the local agency in the
vendor's county must:
(1) if it has a contract with the vendor, send a copy to
the inquiring agency;
(2) if there is a contract with the vendor for which
another local agency is the lead county, identify the lead
county to the inquiring agency; or
(3) if no local agency has a contract with the vendor,
inform the inquiring agency whether it will negotiate a contract
and become the lead county. If the agency where the vendor is
located will not negotiate a contract with the vendor because of
concerns related to clients' health and safety, the agency must
share those concerns with the inquiring agency.
(d) If the local agency in the county where the vendor is
located declines to negotiate a contract with the vendor or
fails to respond within 30 days of receiving the notification
under paragraph (c), the inquiring agency is authorized to
negotiate a contract and must notify the local agency that
declined or failed to respond.
(e) When the inquiring county under paragraph (d) becomes
the lead county for a contract and the contract expires and
needs to be renegotiated, that county must again follow the
requirements under paragraph (c) and notify the local agency
where the vendor is located. The local agency where the vendor
is located has the option of becoming the lead county for the
new contract. If the local agency does not exercise the option,
paragraph (d) applies.
(f) This subdivision does not affect the requirement to
seek county concurrence under section 256B.092, subdivision 8a,
when the services are to be purchased for a person with mental
retardation or a related condition or under section 245.4711,
subdivision 3, when the services to be purchased are for an
adult with serious and persistent mental illness.
Subd. 7. [CONTRACTS WITH COMMUNITY MENTAL HEALTH
BOARDS.] A local agency within the geographic area served by a
community mental health board authorized by sections 245.61 to
245.69, may contract directly with the community mental health
board. However, if a local agency outside of the geographic
area served by a community mental health board wishes to
purchase services from the board, the local agency must follow
the requirements under subdivision 6.
Subd. 8. [PLACEMENT AGREEMENTS.] A placement agreement
must be used for residential services. Placement agreements are
valid when signed by authorized representatives of the facility
and the county of financial responsibility. If the county of
financial responsibility and the county where the approved
vendor is located are not the same, the county of financial
responsibility must, if requested, mail a copy of the placement
agreement to the county where the approved vendor is providing
the service and to the lead county within ten calendar days
after the date on which the placement agreement is signed. The
placement agreement must specify that the service will be
provided in accordance with the individual service plan as
required and must specify the unit cost, the date of placement,
and the date for the review of the placement. A placement
agreement may also be used for nonresidential services.
Sec. 11. [REVISOR'S INSTRUCTION.]
For sections in Minnesota Statutes and Minnesota Rules
affected by the repealed sections in this article, the revisor
shall delete internal cross-references where appropriate and
make changes necessary to correct the punctuation, grammar, or
structure of the remaining text and preserve its meaning.
Sec. 12. [REPEALER.]
(a) Minnesota Statutes 2002, sections 245.478; 245.4886;
245.4888; 245.496; 254A.17; 256E.01; 256E.02; 256E.03; 256E.04;
256E.05; 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10;
256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02;
256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11;
256F.12; 256F.14; 257.075; 257.81; 260.152; and 626.562, are
repealed.
(b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030;
9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080;
9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed.
ARTICLE 12
HEALTH CARE
Section 1. Minnesota Statutes 2002, section 62J.692,
subdivision 8, is amended to read:
Subd. 8. [FEDERAL FINANCIAL PARTICIPATION.] (a) The
commissioner of human services shall seek to maximize federal
financial participation in payments for medical education and
research costs. If the commissioner of human services
determines that federal financial participation is available for
the medical education and research, the commissioner of health
shall transfer to the commissioner of human services the amount
of state funds necessary to maximize the federal funds
available. The amount transferred to the commissioner of human
services, plus the amount of federal financial participation,
shall be distributed to medical assistance providers in
accordance with the distribution methodology described in
subdivision 4.
(b) For the purposes of paragraph (a), the commissioner
shall use physician clinic rates where possible to maximize
federal financial participation.
Sec. 2. Minnesota Statutes 2002, section 256.01,
subdivision 2, is amended to read:
Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of
section 241.021, subdivision 2, the commissioner of human
services shall:
(1) Administer and supervise all forms of public assistance
provided for by state law and other welfare activities or
services as are vested in the commissioner. Administration and
supervision of human services activities or services includes,
but is not limited to, assuring timely and accurate distribution
of benefits, completeness of service, and quality program
management. In addition to administering and supervising human
services activities vested by law in the department, the
commissioner shall have the authority to:
(a) require county agency participation in training and
technical assistance programs to promote compliance with
statutes, rules, federal laws, regulations, and policies
governing human services;
(b) monitor, on an ongoing basis, the performance of county
agencies in the operation and administration of human services,
enforce compliance with statutes, rules, federal laws,
regulations, and policies governing welfare services and promote
excellence of administration and program operation;
(c) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit
determinations;
(d) require county agencies to make an adjustment to the
public assistance benefits issued to any individual consistent
with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;
(e) delay or deny payment of all or part of the state and
federal share of benefits and administrative reimbursement
according to the procedures set forth in section 256.017;
(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. 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.
(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. 3. Minnesota Statutes 2002, section 256.046,
subdivision 1, is amended to read:
Subdivision 1. [HEARING AUTHORITY.] A local agency must
initiate an administrative fraud disqualification hearing for
individuals accused of wrongfully obtaining assistance or
intentional program violations, in lieu of a criminal action
when it has not been pursued, in the aid to families with
dependent children program formerly codified in sections 256.72
to 256.87, MFIP, child care assistance programs, general
assistance, family general assistance program formerly codified
in section 256D.05, subdivision 1, clause (15), Minnesota
supplemental aid, medical care, or food stamp programs, general
assistance medical care, MinnesotaCare for adults without
children, and upon federal approval, all categories of medical
assistance and remaining categories of MinnesotaCare except for
children through age 18. The hearing is subject to the
requirements of section 256.045 and the requirements in Code of
Federal Regulations, title 7, section 273.16, for the food stamp
program and title 45, section 235.112, as of September 30, 1995,
for the cash grant and medical care programs.
Sec. 4. [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.]
Subdivision 1. [ESTABLISHMENT; ADMINISTRATION.] The
commissioner of human services shall establish and administer
the prescription drug discount program, effective July 1, 2005.
Subd. 2. [COMMISSIONER'S AUTHORITY.] The commissioner
shall administer a drug rebate program for drugs purchased
according to the prescription drug discount program. The
commissioner shall require a rebate agreement from all
manufacturers of covered drugs as defined in section 256B.0625,
subdivision 13. For each drug, the amount of the rebate shall
be equal to the rebate as defined for purposes of the federal
rebate program in United States Code, title 42, section
1396r-8. The rebate program shall utilize the terms and
conditions used for the federal rebate program established
according to section 1927 of title XIX of the federal Social
Security Act.
Subd. 3. [DEFINITIONS.] For the purpose of this section,
the following terms have the meanings given them:
(a) "Commissioner" means the commissioner of human services.
(b) "Manufacturer" means a manufacturer as defined in
section 151.44, paragraph (c).
(c) "Covered prescription drug" means a prescription drug
as defined in section 151.44, paragraph (d), that is covered
under medical assistance as described in section 256B.0625,
subdivision 13, and that is provided by a manufacturer that has
a fully executed rebate agreement with the commissioner under
this section and complies with that agreement.
(d) "Health carrier" means an insurance company licensed
under chapter 60A to offer, sell, or issue an individual or
group policy of accident and sickness insurance as defined in
section 62A.01; a nonprofit health service plan corporation
operating under chapter 62C; a health maintenance organization
operating under chapter 62D; a joint self-insurance employee
health plan operating under chapter 62H; a community integrated
systems network licensed under chapter 62N; a fraternal benefit
society operating under chapter 64B; a city, county, school
district, or other political subdivision providing self-insured
health coverage under section 461.617 or sections 471.98 to
471.982; and a self-funded health plan under the Employee
Retirement Income Security Act of 1974, as amended.
(e) "Participating pharmacy" means a pharmacy as defined in
section 151.01, subdivision 2, that agrees to participate in the
prescription drug discount program.
(f) "Enrolled individual" means a person who is eligible
for the program under subdivision 4 and has enrolled in the
program according to subdivision 5.
Subd. 4. [ELIGIBLE PERSONS.] To be eligible for the
program, an applicant must:
(1) be a permanent resident of Minnesota as defined in
section 256L.09, subdivision 4;
(2) not be enrolled in medical assistance, general
assistance medical care, MinnesotaCare, or the prescription drug
program under section 256.955;
(3) not be enrolled in and have currently available
prescription drug coverage under a health plan offered by a
health carrier or under a pharmacy benefit program offered by a
pharmaceutical manufacturer;
(4) not be enrolled in and have currently available
prescription drug coverage under a Medicare supplement plan, as
defined in sections 62A.31 to 62A.44, or policies, contracts, or
certificates that supplement Medicare issued by health
maintenance organizations or those policies, contracts, or
certificates governed by section 1833 or 1876 of the federal
Social Security Act, United States Code, title 42, section 1395,
et. seq., as amended; and
(5) have a gross household income that does not exceed 250
percent of the federal poverty guidelines.
Subd. 5. [APPLICATION PROCEDURE.] (a) Applications and
information on the program must be made available at county
social services agencies, health care provider offices, and
agencies and organizations serving senior citizens. Individuals
shall submit applications and any information specified by the
commissioner as being necessary to verify eligibility directly
to the commissioner. The commissioner shall determine an
applicant's eligibility for the program within 30 days from the
date the application is received. Eligibility begins the month
after approval.
(b) The commissioner shall develop an application form that
does not exceed one page in length and requires information
necessary to determine eligibility for the program.
Subd. 6. [PARTICIPATING PHARMACY.] According to a valid
prescription, a participating pharmacy must sell a covered
prescription drug to an enrolled individual at the pharmacy's
usual and customary retail price, minus an amount that is equal
to the rebate amount described in subdivision 8, plus the amount
of any administrative fee and switch fee established by the
commissioner under subdivision 10. Each participating pharmacy
shall provide the commissioner with all information necessary to
administer the program, including, but not limited to,
information on prescription drug sales to enrolled individuals
and usual and customary retail prices.
Subd. 7. [NOTIFICATION OF REBATE AMOUNT.] The commissioner
shall notify each drug manufacturer, each calendar quarter or
according to a schedule to be established by the commissioner,
of the amount of the rebate owed on the prescription drugs sold
by participating pharmacies to enrolled individuals.
Subd. 8. [PROVISION OF REBATE.] To the extent that a
manufacturer's prescription drugs are prescribed to a resident
of this state, the manufacturer must provide a rebate equal to
the rebate provided under the medical assistance program for any
prescription drug distributed by the manufacturer that is
purchased by an enrolled individual at a participating
pharmacy. The manufacturer must provide full payment within 30
days of receipt of the state invoice for the rebate, or
according to a schedule to be established by the commissioner.
The commissioner shall deposit all rebates received into the
Minnesota prescription drug dedicated fund established under
subdivision 11. The manufacturer must provide the commissioner
with any information necessary to verify the rebate determined
per drug.
Subd. 9. [PAYMENT TO PHARMACIES.] The commissioner shall
distribute on a biweekly basis an amount that is equal to an
amount collected under subdivision 8 to each participating
pharmacy based on the prescription drugs sold by that pharmacy
to enrolled individuals, minus the amount of the administrative
fee established by the commissioner under subdivision 10.
Subd. 10. [ADMINISTRATIVE FEE; SWITCH FEE.] (a) The
commissioner shall establish a reasonable administrative fee
that covers the commissioner's expenses for enrollment,
processing claims, and distributing rebates under this program.
(b) The commissioner shall establish a reasonable switch
fee that covers expenses incurred by pharmacies in formatting
for electronic submission claims for prescription drugs sold to
enrolled individuals.
Subd. 11. [DEDICATED FUND; CREATION; USE OF FUND.] (a) The
Minnesota prescription drug dedicated fund is established as an
account in the state treasury. The commissioner of finance
shall credit to the dedicated fund all rebates paid under
subdivision 8, any federal funds received for the program, and
any appropriations or allocations designated for the fund. The
commissioner of finance shall ensure that fund money is invested
under section 11A.25. All money earned by the fund must be
credited to the fund. The fund shall earn a proportionate share
of the total state annual investment income.
(b) Money in the fund is appropriated to the commissioner
of human services to reimburse participating pharmacies for
prescription drug discounts provided to enrolled individuals
under this section, to reimburse the commissioner of human
services for costs related to enrollment, processing claims,
distributing rebates, and for other reasonable administrative
costs related to administration of the prescription drug
discount program, and to repay the appropriation provided for
this section. The commissioner must administer the program so
that the costs total no more than funds appropriated plus the
drug rebate proceeds.
Subd. 12. [EXPIRATION.] This section expires upon the
effective date of an expanded prescription drug benefit under
Medicare.
[EFFECTIVE DATE.] This section is effective July 1, 2005.
Sec. 5. Minnesota Statutes 2002, section 256.955,
subdivision 2a, is amended to read:
Subd. 2a. [ELIGIBILITY.] An individual satisfying the
following requirements and the requirements described in
subdivision 2, paragraph (d), is eligible for the prescription
drug program:
(1) is at least 65 years of age or older; and
(2) is eligible as a qualified Medicare beneficiary
according to section 256B.057, subdivision 3, or 3a, or 3b,
clause (1), or is eligible under section 256B.057, subdivision
3, or 3a, or 3b, clause (1), and is also eligible for medical
assistance or general assistance medical care with a spenddown
as defined in section 256B.056, subdivision 5.
Sec. 6. Minnesota Statutes 2002, section 256.955,
subdivision 3, is amended to read:
Subd. 3. [PRESCRIPTION DRUG COVERAGE.] Coverage under the
program shall be limited to those prescription drugs that:
(1) are covered under the medical assistance program as
described in section 256B.0625, subdivision 13; and
(2) are provided by manufacturers that have fully executed
senior drug rebate agreements with the commissioner and comply
with such agreements; and
(3) for a specific enrollee, are not covered under an
assistance program offered by a pharmaceutical manufacturer, as
determined by the board on aging under section 256.975,
subdivision 9, except that this shall not apply to qualified
individuals under this section who are also eligible for medical
assistance with a spenddown as described in subdivision 2a,
clause (2), and subdivision 2b, clause (2).
[EFFECTIVE DATE.] This section is effective 90 days after
implementation by the board of aging of the prescription drug
assistance program under section 256.975, subdivision 9.
Sec. 7. Minnesota Statutes 2002, section 256.955, is
amended by adding a subdivision to read:
Subd. 4a. [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE
PROGRAM.] County social service agencies, in coordination with
the commissioner and the Minnesota board on aging, shall refer
individuals applying to the prescription drug program, or
enrolled in the prescription drug program, to the prescription
drug assistance program for all required prescription drugs that
the board on aging determines, under section 256.975,
subdivision 9, are covered under an assistance program offered
by a pharmaceutical manufacturer. Applicants and enrollees
referred to the prescription drug assistance program remain
eligible for coverage under the prescription drug program of all
prescription drugs covered under subdivision 3. The board on
aging shall phase-in participation of enrollees, over a period
of 90 days, after implementation of the program under section
256.975, subdivision 9. This subdivision does not apply to
individuals who are also eligible for medical assistance with a
spenddown as defined in section 256B.056, subdivision 5.
[EFFECTIVE DATE.] This section is effective 90 days after
implementation by the board of aging of the prescription drug
assistance program under section 256.975, subdivision 9.
Sec. 8. Minnesota Statutes 2002, section 256.969,
subdivision 2b, is amended to read:
Subd. 2b. [OPERATING PAYMENT RATES.] In determining
operating payment rates for admissions occurring on or after the
rate year beginning January 1, 1991, and every two years after,
or more frequently as determined by the commissioner, the
commissioner shall obtain operating data from an updated base
year and establish operating payment rates per admission for
each hospital based on the cost-finding methods and allowable
costs of the Medicare program in effect during the base year.
Rates under the general assistance medical care, medical
assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, and January 1, 2005. The
base year operating payment rate per admission is standardized
by the case mix index and adjusted by the hospital cost index,
relative values, and disproportionate population adjustment.
The cost and charge data used to establish operating rates shall
only reflect inpatient services covered by medical assistance
and shall not include property cost information and costs
recognized in outlier payments.
Sec. 9. Minnesota Statutes 2002, section 256.969,
subdivision 3a, is amended to read:
Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings
under the medical assistance program must not be submitted until
the recipient is discharged. However, the commissioner shall
establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless
of diagnostic category. Except as provided in section 256.9693,
medical assistance reimbursement for treatment of mental illness
shall be reimbursed based on diagnostic classifications.
Individual hospital payments established under this section and
sections 256.9685, 256.9686, and 256.9695, in addition to third
party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for
the medical assistance covered inpatient services paid for the
same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and
general assistance medical care services. The limitation on
general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that
have rates established under subdivision 11 or 12, must be
limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related
hospitals one entity and may merge the payment rates while
maintaining separate provider numbers. The operating and
property base rates per admission or per day shall be derived
from the best Medicare and claims data available when rates are
established. The commissioner shall determine the best Medicare
and claims data, taking into consideration variables of recency
of the data, audit disposition, settlement status, and the
ability to set rates in a timely manner. The commissioner shall
notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the
admissions data used to establish relative values. Base year
changes from 1981 to the base year established for the rate year
beginning January 1, 1991, and for subsequent rate years, shall
not be limited to the limits ending June 30, 1987, on the
maximum rate of increase under subdivision 1. The commissioner
may adjust base year cost, relative value, and case mix index
data to exclude the costs of services that have been
discontinued by the October 1 of the year preceding the rate
year or that are paid separately from inpatient services.
Inpatient stays that encompass portions of two or more rate
years shall have payments established based on payment rates in
effect at the time of admission unless the date of admission
preceded the rate year in effect by six months or more. In this
case, operating payment rates for services rendered during the
rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the
hospital cost index.
(b) For fee-for-service admissions occurring on or after
July 1, 2002, the total payment, before third-party liability
and spenddown, made to hospitals for inpatient services is
reduced by .5 percent from the current statutory rates.
(c) In addition to the reduction in paragraph (b), the
total payment for fee-for-service admissions occurring on or
after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five
percent from the current statutory rates. Mental health
services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this
paragraph.
Sec. 10. Minnesota Statutes 2002, section 256.969, is
amended by adding a subdivision to read:
Subd. 8b. [ADMISSIONS FOR PERSONS WHO APPLY DURING
HOSPITALIZATION.] For admissions for individuals under section
256D.03, subdivision 3, paragraph (a), clause (2), that occur
before the date of eligibility, payment for the days that the
patient is eligible shall be established according to the
methods of subdivision 14.
[EFFECTIVE DATE.] This section is effective October 1, 2003.
Sec. 11. Minnesota Statutes 2002, section 256.975, is
amended by adding a subdivision to read:
Subd. 9. [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota
board on aging shall establish and administer a prescription
drug assistance program to assist individuals in accessing
programs offered by pharmaceutical manufacturers that provide
free or discounted prescription drugs or provide coverage for
prescription drugs. The board shall use computer software
programs to:
(1) list eligibility requirements for pharmaceutical
assistance programs offered by manufacturers;
(2) list drugs that are included in a supplemental rebate
contract between the commissioner and a pharmaceutical
manufacturer under section 256.01, subdivision 2, clause (23);
and
(3) link individuals with the pharmaceutical assistance
programs most appropriate for the individual. The board shall
make information on the prescription drug assistance program
available to interested individuals and health care providers
and shall coordinate the program with the statewide information
and assistance service provided through the Senior LinkAge Line
under subdivision 7.
(b) The board shall work with the commissioner and county
social service agencies to coordinate the enrollment of
individuals who are referred to the prescription drug assistance
program from the prescription drug program, as required under
section 256.955, subdivision 4a.
Sec. 12. Minnesota Statutes 2002, section 256.98,
subdivision 3, is amended to read:
Subd. 3. [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The
amount of the assistance incorrectly paid under this section is:
(a) the difference between the amount of assistance
actually received on the basis of misrepresented or concealed
facts and the amount to which the recipient would have been
entitled had the specific concealment or misrepresentation not
occurred. Unless required by law, rule, or regulation, earned
income disregards shall not be applied to earnings not reported
by the recipient; or
(b) equal to all payments for health care services,
including capitation payments made to a health plan, made on
behalf of a person enrolled in MinnesotaCare, medical
assistance, or general assistance medical care, for which the
person was not entitled due to the concealment or
misrepresentation of facts.
Sec. 13. Minnesota Statutes 2002, section 256.98,
subdivision 4, is amended to read:
Subd. 4. [RECOVERY OF ASSISTANCE.] The amount of
assistance determined to have been incorrectly paid is
recoverable from:
(1) the recipient or the recipient's estate by the county
or the state as a debt due the county or the state or both; and
(2) any person found to have taken independent action to
establish eligibility for, conspired with, or aided and abetted,
any recipient of public assistance found to have been
incorrectly paid.
The obligations established under this subdivision shall be
joint and several and shall extend to all cases involving client
error as well as cases involving wrongfully obtained assistance.
MinnesotaCare participants who have been found to have
wrongfully obtained assistance as described in subdivision 1,
but who otherwise remain eligible for the program, may agree to
have their MinnesotaCare premiums increased by an amount equal
to ten percent of their premiums or $10 per month, whichever is
greater, until the debt is satisfied.
Sec. 14. Minnesota Statutes 2002, section 256.98,
subdivision 8, is amended to read:
Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person
found to be guilty of wrongfully obtaining assistance by a
federal or state court or by an administrative hearing
determination, or waiver thereof, through a disqualification
consent agreement, or as part of any approved diversion plan
under section 401.065, or any court-ordered stay which carries
with it any probationary or other conditions, in the Minnesota
family investment program, the food stamp program, the general
assistance program, the group residential housing program, or
the Minnesota supplemental aid program shall be disqualified
from that program. In addition, any person disqualified from
the Minnesota family investment program shall also be
disqualified from the food stamp program. The needs of that
individual shall not be taken into consideration in determining
the grant level for that assistance unit:
(1) for one year after the first offense;
(2) for two years after the second offense; and
(3) permanently after the third or subsequent offense.
The period of program disqualification shall begin on the
date stipulated on the advance notice of disqualification
without possibility of postponement for administrative stay or
administrative hearing and shall continue through completion
unless and until the findings upon which the sanctions were
imposed are reversed by a court of competent jurisdiction. The
period for which sanctions are imposed is not subject to
review. The sanctions provided under this subdivision are in
addition to, and not in substitution for, any other sanctions
that may be provided for by law for the offense involved. A
disqualification established through hearing or waiver shall
result in the disqualification period beginning immediately
unless the person has become otherwise ineligible for
assistance. If the person is ineligible for assistance, the
disqualification period begins when the person again meets the
eligibility criteria of the program from which they were
disqualified and makes application for that program.
(b) A family receiving assistance through child care
assistance programs under chapter 119B with a family member who
is found to be guilty of wrongfully obtaining child care
assistance by a federal court, state court, or an administrative
hearing determination or waiver, through a disqualification
consent agreement, as part of an approved diversion plan under
section 401.065, or a court-ordered stay with probationary or
other conditions, is disqualified from child care assistance
programs. The disqualifications must be for periods of three
months, six months, and two years for the first, second, and
third offenses respectively. Subsequent violations must result
in permanent disqualification. During the disqualification
period, disqualification from any child care program must extend
to all child care programs and must be immediately applied.
(c) Any person found to be guilty of wrongfully obtaining
general assistance medical care, MinnesotaCare for adults
without children, and upon federal approval, all categories of
medical assistance and remaining categories of MinnesotaCare,
except for children through age 18, by a federal or state court
or by an administrative hearing determination, or waiver
thereof, through a disqualification consent agreement, or as
part of any approved diversion plan under section 401.065, or
any court-ordered stay which carries with it any probationary or
other conditions, is disqualified from that program. The period
of disqualification is one year after the first offense, two
years after the second offense, and permanently after the third
or subsequent offense. The period of program disqualification
shall begin on the date stipulated on the advance notice of
disqualification without possibility of postponement for
administrative stay or administrative hearing and shall continue
through completion unless and until the findings upon which the
sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not
subject to review. The sanctions provided under this
subdivision are in addition to, and not in substitution for, any
other sanctions that may be provided for by law for the offense
involved.
Sec. 15. Minnesota Statutes 2002, section 256B.055, is
amended by adding a subdivision to read:
Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.]
Beginning October 1, 2003, persons who would be eligible for
medical assistance under this chapter but for residing in a
facility that is determined by the commissioner or the federal
Centers for Medicare and Medicaid Services to be an institution
for mental diseases are eligible for medical assistance without
federal financial participation, except that coverage shall not
include payment for a nursing facility determined to be an
institution for mental diseases.
Sec. 16. Minnesota Statutes 2002, section 256B.056,
subdivision 1a, is amended to read:
Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless
specifically required by state law or rule or federal law or
regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons
whose eligibility category is based on blindness, disability, or
age of 65 or more years, the methodologies for the supplemental
security income program shall be used. Increases in benefits
under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each
year. Effective upon federal approval, for children eligible
under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical
assistance is determined without regard to parental income,
child support payments, including any payments made by an
obligor in satisfaction of or in addition to a temporary or
permanent order for child support, and social security payments
are not counted as income. For families and children, which
includes all other eligibility categories, the methodologies
under the state's AFDC plan in effect as of July 16, 1996, as
required by the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193,
shall be used, except that effective July 1, 2002, the $90 and
$30 and one-third earned income disregards shall not apply and
the disregard specified in subdivision 1c shall apply October 1,
2003, the earned income disregards and deductions are limited to
those in subdivision 1c. For these purposes, a "methodology"
does not include an asset or income standard, or accounting
method, or method of determining effective dates.
Sec. 17. Minnesota Statutes 2002, section 256B.056,
subdivision 1c, is amended to read:
Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.]
(a)(1) For children ages one to five whose eligibility is
determined under section 256B.057, subdivision 2, 21 percent of
countable earned income shall be disregarded for up to four
months. This clause expires July 1, 2003.
(2) For applications processed within one calendar month
prior to the date clause (1) expires, eligibility shall be
determined by applying the income standards and methodologies in
effect prior to the date of the expiration for any months in the
six-month budget period before the expiration date and the
income standards and methodologies in effect on the expiration
date for any months in the six-month budget period on or after
that date. The income standards for each month shall be added
together and compared to the applicant's total countable income
for the six-month budget period to determine eligibility.
(3) For children ages one through 18 whose eligibility is
determined under section 256B.057, subdivision 2, the following
deductions shall be applied to income counted toward the child's
eligibility as allowed under the state's AFDC plan in effect as
of July 16, 1996: $90 work expense, dependent care, and child
support paid under court order. This clause is effective
October 1, 2003.
(b) For families with children whose eligibility is
determined using the standard specified in section 256B.056,
subdivision 4, paragraph (c), 17 percent of countable earned
income shall be disregarded for up to four months and the
following deductions shall be applied to each individual's
income counted toward eligibility as allowed under the state's
AFDC plan in effect as of July 16, 1996: dependent care and
child support paid under court order.
(c) If the four month disregard in paragraph (b) has been
applied to the wage earner's income for four months, the
disregard shall not be applied again until the wage earner's
income has not been considered in determining medical assistance
eligibility for 12 consecutive months.
[EFFECTIVE DATE.] The amendments to paragraphs (b) and (c)
are effective July 1, 2003.
Sec. 18. Minnesota Statutes 2002, section 256B.056,
subdivision 3c, is amended to read:
Subd. 3c. [ASSET LIMITATIONS FOR FAMILIES AND CHILDREN.] A
household of two or more persons must not own more than
$30,000 $20,000 in total net assets, and a household of one
person must not own more than $15,000 $10,000 in total net
assets. In addition to these maximum amounts, an eligible
individual or family may accrue interest on these amounts, but
they must be reduced to the maximum at the time of an
eligibility redetermination. The value of assets that are not
considered in determining eligibility for medical assistance for
families and children is the value of those assets excluded
under the AFDC state plan as of July 16, 1996, as required by
the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (PRWORA), Public Law Number 104-193, with the
following exceptions:
(1) household goods and personal effects are not
considered;
(2) capital and operating assets of a trade or business up
to $200,000 are not considered;
(3) one motor vehicle is excluded for each person of legal
driving age who is employed or seeking employment;
(4) one burial plot and all other burial expenses equal to
the supplemental security income program asset limit are not
considered for each individual;
(5) court-ordered settlements up to $10,000 are not
considered;
(6) individual retirement accounts and funds are not
considered; and
(7) assets owned by children are not considered.
Sec. 19. Minnesota Statutes 2002, section 256B.057,
subdivision 1, is amended to read:
Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a)(1) An
infant less than one year of age or a pregnant woman who has
written verification of a positive pregnancy test from a
physician or licensed registered nurse, is eligible for medical
assistance if countable family income is equal to or less than
275 percent of the federal poverty guideline for the same family
size. A pregnant woman who has written verification of a
positive pregnancy test from a physician or licensed registered
nurse is eligible for medical assistance if countable family
income is equal to or less than 200 percent of the federal
poverty guideline for the same family size. For purposes of
this subdivision, "countable family income" means the amount of
income considered available using the methodology of the AFDC
program under the state's AFDC plan as of July 16, 1996, as
required by the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193,
except for the earned income disregard and employment deductions.
(2) For applications processed within one calendar month
prior to the effective date, eligibility shall be determined by
applying the income standards and methodologies in effect prior
to the effective date for any months in the six-month budget
period before that date and the income standards and
methodologies in effect on the effective date for any months in
the six-month budget period on or after that date. The income
standards for each month shall be added together and compared to
the applicant's total countable income for the six-month budget
period to determine eligibility.
(b)(1) An amount equal to the amount of earned income
exceeding 275 percent of the federal poverty guideline, up to a
maximum of the amount by which the combined total of 185 percent
of the federal poverty guideline plus the earned income
disregards and deductions of the AFDC program under the state's
AFDC plan as of July 16, 1996, as required by the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law Number 104-193, exceeds 275 percent of the
federal poverty guideline will be deducted for pregnant women
and infants less than one year of age. This clause expires July
1, 2003.
(2) For applications processed within one calendar month
prior to the date clause (1) expires, eligibility shall be
determined by applying the income standards and methodologies in
effect prior to the date of the expiration for any months in the
six-month budget period before the expiration date and the
income standards and methodologies in effect on the expiration
date for any months in the six-month budget period on or after
that date. The income standards for each month shall be added
together and compared to the applicant's total countable income
for the six-month budget period to determine eligibility.
(c) Dependent care and child support paid under court order
shall be deducted from the countable income of pregnant women.
(b) (d) An infant born on or after January 1, 1991, to a
woman who was eligible for and receiving medical assistance on
the date of the child's birth shall continue to be eligible for
medical assistance without redetermination until the child's
first birthday, as long as the child remains in the woman's
household.
[EFFECTIVE DATE.] This section is effective February 1,
2004, or upon federal approval, whichever is later, except where
a different date is specified in the text.
Sec. 20. Minnesota Statutes 2002, section 256B.057,
subdivision 2, is amended to read:
Subd. 2. [CHILDREN.] (a) Except as specified in
subdivision 1b, effective July 1, 2002 October 1, 2003, a child
one through 18 years of age in a family whose countable income
is no greater than 170 150 percent of the federal poverty
guidelines for the same family size, is eligible for medical
assistance.
(b) For applications processed within one calendar month
prior to the effective date, eligibility shall be determined by
applying the income standards and methodologies in effect prior
to the effective date for any months in the six-month budget
period before that date and the income standards and
methodologies in effect on the effective date for any months in
the six-month budget period on or after that date. The income
standards for each month shall be added together and compared to
the applicant's total countable income for the six-month budget
period to determine eligibility.
Sec. 21. Minnesota Statutes 2002, section 256B.057,
subdivision 3b, is amended to read:
Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1,
1998, to the extent of the federal allocation to Minnesota
contingent upon federal funding, a person who would otherwise be
eligible as a qualified Medicare beneficiary under subdivision
3, except that the person's income is in excess of the limit, is
eligible as a qualifying individual according to the following
criteria:
(1) if the person's income is greater than 120 percent, but
less than 135 percent of the official federal poverty guidelines
for the applicable family size, the person is eligible for
medical assistance reimbursement of Medicare Part B premiums; or
(2) if the person's income is equal to or greater than 135
percent but less than 175 percent of the official federal
poverty guidelines for the applicable family size, the person is
eligible for medical assistance reimbursement of that portion of
the Medicare Part B premium attributable to an increase in Part
B expenditures which resulted from the shift of home care
services from Medicare Part A to Medicare Part B under Public
Law Number 105-33, section 4732, the Balanced Budget Act of 1997.
The commissioner shall limit enrollment of qualifying
individuals under this subdivision according to the requirements
of Public Law Number 105-33, section 4732.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 22. Minnesota Statutes 2002, section 256B.057,
subdivision 9, is amended to read:
Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical
assistance may be paid for a person who is employed and who:
(1) meets the definition of disabled under the supplemental
security income program;
(2) is at least 16 but less than 65 years of age;
(3) meets the asset limits in paragraph (b); and
(4) effective November 1, 2003, pays a premium, if
required, and other obligations under paragraph (c) (d).
Any spousal income or assets shall be disregarded for purposes
of eligibility and premium determinations.
After the month of enrollment, a person enrolled in medical
assistance under this subdivision who:
(1) is temporarily unable to work and without receipt of
earned income due to a medical condition, as verified by a
physician, may retain eligibility for up to four calendar
months; or
(2) effective January 1, 2004, loses employment for reasons
not attributable to the enrollee, may retain eligibility for up
to four consecutive months after the month of job loss. To
receive a four-month extension, enrollees must verify the
medical condition or provide notification of job loss. All
other eligibility requirements must be met and the enrollee must
pay all calculated premium costs for continued eligibility.
(b) For purposes of determining eligibility under this
subdivision, a person's assets must not exceed $20,000,
excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts,
401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
(3) medical expense accounts set up through the person's
employer.
(c)(1) Effective January 1, 2004, for purposes of
eligibility, there will be a $65 earned income disregard. To be
eligible, a person applying for medical assistance under this
subdivision must have earned income above the disregard level.
(2) Effective January 1, 2004, to be considered earned
income, Medicare, social security, and applicable state and
federal income taxes must be withheld. To be eligible, a person
must document earned income tax withholding.
(d)(1) A person whose earned and unearned income is equal
to or greater than 100 percent of federal poverty guidelines for
the applicable family size must pay a premium to be eligible for
medical assistance under this subdivision. The premium shall be
based on the person's gross earned and unearned income and the
applicable family size using a sliding fee scale established by
the commissioner, which begins at one percent of income at 100
percent of the federal poverty guidelines and increases to 7.5
percent of income for those with incomes at or above 300 percent
of the federal poverty guidelines. Annual adjustments in the
premium schedule based upon changes in the federal poverty
guidelines shall be effective for premiums due in July of each
year.
(2) Effective January 1, 2004, all enrollees must pay a
premium to be eligible for medical assistance under this
subdivision. An enrollee shall pay the greater of a $35 premium
or the premium calculated in clause (1).
(3) Effective November 1, 2003, all enrollees who receive
unearned income must pay one-half of one percent of unearned
income in addition to the premium amount.
(4) Effective November 1, 2003, for enrollees whose income
does not exceed 200 percent of the federal poverty guidelines
and who are also enrolled in Medicare, the commissioner must
reimburse the enrollee for Medicare Part B premiums under
section 256B.0625, subdivision 15, paragraph (a).
(d) (e) A person's eligibility and premium shall be
determined by the local county agency. Premiums must be paid to
the commissioner. All premiums are dedicated to the
commissioner.
(e) (f) Any required premium shall be determined at
application and redetermined annually at recertification at the
enrollee's six-month income review or when a change in income or
family household size occurs is reported. Enrollees must report
any change in income or household size within ten days of when
the change occurs. A decreased premium resulting from a
reported change in income or household size shall be effective
the first day of the next available billing month after the
change is reported. Except for changes occurring from annual
cost-of-living increases, a change resulting in an increased
premium shall not affect the premium amount until the next
six-month review.
(f) (g) Premium payment is due upon notification from the
commissioner of the premium amount required. Premiums may be
paid in installments at the discretion of the commissioner.
(g) (h) Nonpayment of the premium shall result in denial or
termination of medical assistance unless the person demonstrates
good cause for nonpayment. Good cause exists if the
requirements specified in Minnesota Rules, part 9506.0040,
subpart 7, items B to D, are met. Except when an installment
agreement is accepted by the commissioner, all persons
disenrolled for nonpayment of a premium must pay any past due
premiums as well as current premiums due prior to being
reenrolled. Nonpayment shall include payment with a returned,
refused, or dishonored instrument. The commissioner may require
a guaranteed form of payment as the only means to replace a
returned, refused, or dishonored instrument.
[EFFECTIVE DATE.] This section is effective November 1,
2003, except that the amendments to Minnesota Statutes 2002,
section 256B.057, subdivision 9, paragraphs (f) and (h), are
effective July 1, 2003.
Sec. 23. Minnesota Statutes 2002, section 256B.057,
subdivision 10, is amended to read:
Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR
CERVICAL CANCER.] (a) Medical assistance may be paid for a
person who:
(1) has been screened for breast or cervical cancer by the
Minnesota breast and cervical cancer control program, and
program funds have been used to pay for the person's screening;
(2) according to the person's treating health professional,
needs treatment, including diagnostic services necessary to
determine the extent and proper course of treatment, for breast
or cervical cancer, including precancerous conditions and early
stage cancer;
(3) meets the income eligibility guidelines for the
Minnesota breast and cervical cancer control program;
(4) is under age 65;
(5) is not otherwise eligible for medical assistance under
United States Code, title 42, section 1396(a)(10)(A)(i); and
(6) is not otherwise covered under creditable coverage, as
defined under United States Code, title 42, section
300gg(c) 1396a(aa).
(b) Medical assistance provided for an eligible person
under this subdivision shall be limited to services provided
during the period that the person receives treatment for breast
or cervical cancer.
(c) A person meeting the criteria in paragraph (a) is
eligible for medical assistance without meeting the eligibility
criteria relating to income and assets in section 256B.056,
subdivisions 1a to 5b.
Sec. 24. Minnesota Statutes 2002, section 256B.0595,
subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers
of assets made on or before August 10, 1993, if a person or the
person's spouse has given away, sold, or disposed of, for less
than fair market value, any asset or interest therein, except
assets other than the homestead that are excluded under the
supplemental security program, within 30 months before or any
time after the date of institutionalization if the person has
been determined eligible for medical assistance, or within 30
months before or any time after the date of the first approved
application for medical assistance if the person has not yet
been determined eligible for medical assistance, the person is
ineligible for long-term care services for the period of time
determined under subdivision 2.
(b) Effective for transfers made after August 10, 1993, a
person, a person's spouse, or any person, court, or
administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of the
person or person's spouse, may not give away, sell, or dispose
of, for less than fair market value, any asset or interest
therein, except assets other than the homestead that are
excluded under the supplemental security income program, for the
purpose of establishing or maintaining medical assistance
eligibility. This applies to all transfers, including those
made by a community spouse after the month in which the
institutionalized spouse is determined eligible for medical
assistance. For purposes of determining eligibility for
long-term care services, any transfer of such assets within 36
months before or any time after an institutionalized person
applies for medical assistance, or 36 months before or any time
after a medical assistance recipient becomes institutionalized,
for less than fair market value may be considered. Any such
transfer is presumed to have been made for the purpose of
establishing or maintaining medical assistance eligibility and
the person is ineligible for long-term care services for the
period of time determined under subdivision 2, unless the person
furnishes convincing evidence to establish that the transaction
was exclusively for another purpose, or unless the transfer is
permitted under subdivision 3 or 4. Notwithstanding the
provisions of this paragraph, in the case of payments from a
trust or portions of a trust that are considered transfers of
assets under federal law, any transfers made within 60 months
before or any time after an institutionalized person applies for
medical assistance and within 60 months before or any time after
a medical assistance recipient becomes institutionalized, may be
considered.
(c) This section applies to transfers, for less than fair
market value, of income or assets, including assets that are
considered income in the month received, such as inheritances,
court settlements, and retroactive benefit payments or income to
which the person or the person's spouse is entitled but does not
receive due to action by the person, the person's spouse, or any
person, court, or administrative body with legal authority to
act in place of, on behalf of, at the direction of, or upon the
request of the person or the person's spouse.
(d) This section applies to payments for care or personal
services provided by a relative, unless the compensation was
stipulated in a notarized, written agreement which was in
existence when the service was performed, the care or services
directly benefited the person, and the payments made represented
reasonable compensation for the care or services provided. A
notarized written agreement is not required if payment for the
services was made within 60 days after the service was provided.
(e) This section applies to the portion of any asset or
interest that a person, a person's spouse, or any person, court,
or administrative body with legal authority to act in place of,
on behalf of, at the direction of, or upon the request of the
person or the person's spouse, transfers to any annuity that
exceeds the value of the benefit likely to be returned to the
person or spouse while alive, based on estimated life expectancy
using the life expectancy tables employed by the supplemental
security income program to determine the value of an agreement
for services for life. The commissioner may adopt rules
reducing life expectancies based on the need for long-term
care. This section applies to an annuity described in this
paragraph purchased on or after March 1, 2002, that:
(1) is not purchased from an insurance company or financial
institution that is subject to licensing or regulation by the
Minnesota department of commerce or a similar regulatory agency
of another state;
(2) does not pay out principal and interest in equal
monthly installments; or
(3) does not begin payment at the earliest possible date
after annuitization.
(f) For purposes of this section, long-term care services
include services in a nursing facility, services that are
eligible for payment according to section 256B.0625, subdivision
2, because they are provided in a swing bed, intermediate care
facility for persons with mental retardation, and home and
community-based services provided pursuant to sections
256B.0915, 256B.092, and 256B.49. For purposes of this
subdivision and subdivisions 2, 3, and 4, "institutionalized
person" includes a person who is an inpatient in a nursing
facility or in a swing bed, or intermediate care facility for
persons with mental retardation or who is receiving home and
community-based services under sections 256B.0915, 256B.092, and
256B.49.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 25. Minnesota Statutes 2002, section 256B.0595, is
amended by adding a subdivision to read:
Subd. 1b. [PROHIBITED TRANSFERS.] (a) Notwithstanding any
contrary provisions of this section, this subdivision applies to
transfers involving recipients of medical assistance that are
made on or after July 1, 2003, and to all transfers involving
persons who apply for medical assistance on or after July 1,
2003, if the transfer occurred within 72 months before the
person applies for medical assistance, except that this
subdivision does not apply to transfers made prior to July 1,
2003. A person, a person's spouse, or any person, court, or
administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of the
person or the person's spouse, may not give away, sell, dispose
of, or reduce ownership or control of any income, asset, or
interest therein for less than fair market value for the purpose
of establishing or maintaining medical assistance eligibility.
This applies to all transfers, including those made by a
community spouse after the month in which the institutionalized
spouse is determined eligible for medical assistance. For
purposes of determining eligibility for medical assistance
services, any transfer of such income or assets for less than
fair market value within 72 months before or any time after a
person applies for medical assistance may be considered. Any
such transfer is presumed to have been made for the purpose of
establishing or maintaining medical assistance eligibility, and
the person is ineligible for medical assistance services for the
period of time determined under subdivision 2b, unless the
person furnishes convincing evidence to establish that the
transaction was exclusively for another purpose or unless the
transfer is permitted under subdivision 3b or 4b.
(b) This section applies to transfers to trusts. The
commissioner shall determine valid trust purposes under this
section. Assets placed into a trust that is not for a valid
purpose shall always be considered available for the purposes of
medical assistance eligibility, regardless of when the trust is
established.
(c) This section applies to transfers of income or assets
for less than fair market value, including assets that are
considered income in the month received, such as inheritances,
court settlements, and retroactive benefit payments or income to
which the person or the person's spouse is entitled but does not
receive due to action by the person, the person's spouse, or any
person, court, or administrative body with legal authority to
act in place of, on behalf of, at the direction of, or upon the
request of the person or the person's spouse.
(d) This section applies to payments for care or personal
services provided by a relative, unless the compensation was
stipulated in a notarized written agreement that was in
existence when the service was performed, the care or services
directly benefited the person, and the payments made represented
reasonable compensation for the care or services provided. A
notarized written agreement is not required if payment for the
services was made within 60 days after the service was provided.
(e) This section applies to the portion of any income,
asset, or interest therein that a person, a person's spouse, or
any person, court, or administrative body with legal authority
to act in place of, on behalf of, at the direction of, or upon
the request of the person or the person's spouse, transfers to
any annuity that exceeds the value of the benefit likely to be
returned to the person or the person's spouse while alive, based
on estimated life expectancy, using the life expectancy tables
employed by the supplemental security income program, or based
on a shorter life expectancy if the annuitant had a medical
condition that would shorten the annuitant's life expectancy and
that was diagnosed before funds were placed into the annuity.
The agency may request and receive a physician's statement to
determine if the annuitant had a diagnosed medical condition
that would shorten the annuitant's life expectancy. If so, the
agency shall determine the expected value of the benefits based
upon the physician's statement instead of using a life
expectancy table. This section applies to an annuity described
in this paragraph purchased on or after March 1, 2002, that:
(1) is not purchased from an insurance company or financial
institution that is subject to licensing or regulation by the
Minnesota department of commerce or a similar regulatory agency
of another state;
(2) does not pay out principal and interest in equal
monthly installments; or
(3) does not begin payment at the earliest possible date
after annuitization.
(f) Transfers under this section shall affect
determinations of eligibility for all medical assistance
services or long-term care services, whichever receives federal
approval.
[EFFECTIVE DATE.] (a) This section is effective July 1,
2003, to the extent permitted by federal law. If any provision
of this section is prohibited by federal law, the provision
shall become effective when federal law is changed to permit its
application or a waiver is received. The commissioner of human
services shall notify the revisor of statutes when federal law
is enacted or a waiver or other federal approval is received and
publish a notice in the State Register. The commissioner must
include the notice in the first State Register published after
the effective date of the federal changes.
(b) If, by July 1, 2003, any provision of this section is
not effective because of prohibitions in federal law, the
commissioner of human services shall apply to the federal
government by August 1, 2003, for a waiver of those prohibitions
or other federal authority, and that provision shall become
effective upon receipt of a federal waiver or other federal
approval, notification to the revisor of statutes, and
publication of a notice in the State Register to that effect.
In applying for federal approval to extend the lookback period,
the commissioner shall seek the longest lookback period the
federal government will approve, not to exceed 72 months.
Sec. 26. Minnesota Statutes 2002, section 256B.0595,
subdivision 2, is amended to read:
Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any
uncompensated transfer occurring on or before August 10, 1993,
the number of months of ineligibility for long-term care
services shall be the lesser of 30 months, or the uncompensated
transfer amount divided by the average medical assistance rate
for nursing facility services in the state in effect on the date
of application. The amount used to calculate the average
medical assistance payment rate shall be adjusted each July 1 to
reflect payment rates for the previous calendar year. The
period of ineligibility begins with the month in which the
assets were transferred. If the transfer was not reported to
the local agency at the time of application, and the applicant
received long-term care services during what would have been the
period of ineligibility if the transfer had been reported, a
cause of action exists against the transferee for the cost of
long-term care services provided during the period of
ineligibility, or for the uncompensated amount of the transfer,
whichever is less. The action may be brought by the state or
the local agency responsible for providing medical assistance
under chapter 256G. The uncompensated transfer amount is the
fair market value of the asset at the time it was given away,
sold, or disposed of, less the amount of compensation received.
(b) For uncompensated transfers made after August 10, 1993,
the number of months of ineligibility for long-term care
services shall be the total uncompensated value of the resources
transferred divided by the average medical assistance rate for
nursing facility services in the state in effect on the date of
application. The amount used to calculate the average medical
assistance payment rate shall be adjusted each July 1 to reflect
payment rates for the previous calendar year. The period of
ineligibility begins with the first day of the month after the
month in which the assets were transferred except that if one or
more uncompensated transfers are made during a period of
ineligibility, the total assets transferred during the
ineligibility period shall be combined and a penalty period
calculated to begin in on the first day of the month after the
month in which the first uncompensated transfer was made. If
the transfer was not reported to the local agency at the time of
application, and the applicant received medical assistance
services during what would have been the period of ineligibility
if the transfer had been reported, a cause of action exists
against the transferee for the cost of medical assistance
services provided during the period of ineligibility, or for the
uncompensated amount of the transfer, whichever is less. The
action may be brought by the state or the local agency
responsible for providing medical assistance under chapter
256G. The uncompensated transfer amount is the fair market
value of the asset at the time it was given away, sold, or
disposed of, less the amount of compensation received.
Effective for transfers made on or after March 1, 1996,
involving persons who apply for medical assistance on or after
April 13, 1996, no cause of action exists for a transfer unless:
(1) the transferee knew or should have known that the
transfer was being made by a person who was a resident of a
long-term care facility or was receiving that level of care in
the community at the time of the transfer;
(2) the transferee knew or should have known that the
transfer was being made to assist the person to qualify for or
retain medical assistance eligibility; or
(3) the transferee actively solicited the transfer with
intent to assist the person to qualify for or retain eligibility
for medical assistance.
(c) If a calculation of a penalty period results in a
partial month, payments for long-term care services shall be
reduced in an amount equal to the fraction, except that in
calculating the value of uncompensated transfers, if the total
value of all uncompensated transfers made in a month not
included in an existing penalty period does not exceed $200,
then such transfers shall be disregarded for each month prior to
the month of application for or during receipt of medical
assistance.
[EFFECTIVE DATE.] Paragraph (b) of this section is
effective July 1, 2003.
Sec. 27. Minnesota Statutes 2002, section 256B.0595, is
amended by adding a subdivision to read:
Subd. 2b. [PERIOD OF INELIGIBILITY.] (a) Notwithstanding
any contrary provisions of this section, this subdivision
applies to transfers, including transfers to trusts, involving
recipients of medical assistance that are made on or after July
1, 2003, and to all transfers involving persons who apply for
medical assistance on or after July 1, 2003, regardless of when
the transfer occurred, except that this subdivision does not
apply to transfers made prior to July 1, 2003. For any
uncompensated transfer occurring within 72 months prior to the
date of application, at any time after application, or while
eligible, the number of months of cumulative ineligibility for
medical assistance services shall be the total uncompensated
value of the assets and income transferred divided by the
statewide average per-person nursing facility payment made by
the state in effect at the time a penalty for a transfer is
determined. The amount used to calculate the average per-person
nursing facility payment shall be adjusted each July 1 to
reflect average payments for the previous calendar year. For
applicants, the period of ineligibility begins with the month in
which the person applied for medical assistance and satisfied
all other requirements for eligibility, or the first month the
local agency becomes aware of the transfer and can give proper
notice, if later. For recipients, the period of ineligibility
begins in the first month after the month the agency becomes
aware of the transfer and can give proper notice, except that
penalty periods for transfers made during a period of
ineligibility as determined under this section shall begin in
the month following the existing period of ineligibility. If
the transfer was not reported to the local agency, and the
applicant received medical assistance services during what would
have been the period of ineligibility if the transfer had been
reported, a cause of action exists against the transferee for
the cost of medical assistance services provided during the
period of ineligibility or for the uncompensated amount of the
transfer that was not recovered from the transferor through the
implementation of a penalty period under this subdivision,
whichever is less. Recovery shall include the costs incurred
due to the action. The action may be brought by the state or
the local agency responsible for providing medical assistance
under chapter 256B. The total uncompensated value is the fair
market value of the income or asset at the time it was given
away, sold, or disposed of, less the amount of compensation
received. No cause of action exists for a transfer unless:
(1) the transferee knew or should have known that the
transfer was being made by a person who was a resident of a
long-term care facility or was receiving that level of care in
the community at the time of the transfer;
(2) the transferee knew or should have known that the
transfer was being made to assist the person to qualify for or
retain medical assistance eligibility; or
(3) the transferee actively solicited the transfer with
intent to assist the person to qualify for or retain eligibility
for medical assistance.
(b) If a calculation of a penalty period results in a
partial month, payments for medical assistance services shall be
reduced in an amount equal to the fraction, except that in
calculating the value of uncompensated transfers, if the total
value of all uncompensated transfers made in a month not
included in an existing penalty period does not exceed $200,
then such transfers shall be disregarded for each month prior to
the month of application for or during receipt of medical
assistance.
(c) Ineligibility under this section shall apply to medical
assistance services or long-term care services, whichever
receives federal approval.
[EFFECTIVE DATE.] (a) This section is effective July 1,
2003, to the extent permitted by federal law. If any provision
of this section is prohibited by federal law, the provision
shall become effective when federal law is changed to permit its
application or a waiver is received. The commissioner of human
services shall notify the revisor of statutes when federal law
is enacted or a waiver or other federal approval is received and
publish a notice in the State Register. The commissioner must
include the notice in the first State Register published after
the effective date of the federal changes.
(b) If, by July 1, 2003, any provision of this section is
not effective because of prohibitions in federal law, the
commissioner of human services shall apply to the federal
government by August 1, 2003, for a waiver of those prohibitions
or other federal authority, and that provision shall become
effective upon receipt of a federal waiver or other federal
approval, notification to the revisor of statutes, and
publication of a notice in the State Register to that effect.
In applying for federal approval to extend the lookback period,
the commissioner shall seek the longest lookback period the
federal government will approve, not to exceed 72 months.
Sec. 28. Minnesota Statutes 2002, section 256B.0595, is
amended by adding a subdivision to read:
Subd. 3b. [HOMESTEAD EXCEPTION TO TRANSFER
PROHIBITION.] (a) This subdivision applies to transfers
involving recipients of medical assistance that are made on or
after July 1, 2003, and to all transfers involving persons who
apply for medical assistance on or after July 1, 2003,
regardless of when the transfer occurred, except that this
subdivision does not apply to transfers made prior to July 1,
2003. A person is not ineligible for medical assistance
services due to a transfer of assets for less than fair market
value as described in subdivision 1b, if the asset transferred
was a homestead, and:
(1) a satisfactory showing is made that the individual
intended to dispose of the homestead at fair market value or for
other valuable consideration; or
(2) the local agency grants a waiver of a penalty resulting
from a transfer for less than fair market value because denial
of eligibility would cause undue hardship for the individual and
there exists an imminent threat to the individual's health and
well-being. Whenever an applicant or recipient is denied
eligibility because of a transfer for less than fair market
value, the local agency shall notify the applicant or recipient
that the applicant or recipient may request a waiver of the
penalty if the denial of eligibility will cause undue hardship.
In evaluating a waiver, the local agency shall take into account
whether the individual was the victim of financial exploitation,
whether the individual has made reasonable efforts to recover
the transferred property or resource, and other factors relevant
to a determination of hardship. If the local agency does not
approve a hardship waiver, the local agency shall issue a
written notice to the individual stating the reasons for the
denial and the process for appealing the local agency's decision.
(b) When a waiver is granted under paragraph (a), clause
(2), a cause of action exists against the person to whom the
homestead was transferred for that portion of medical assistance
services granted within 72 months of the date the transferor
applied for medical assistance and satisfied all other
requirements for eligibility or the amount of the uncompensated
transfer, whichever is less, together with the costs incurred
due to the action. The action shall be brought by the state
unless the state delegates this responsibility to the local
agency responsible for providing medical assistance under
chapter 256B.
[EFFECTIVE DATE.] (a) This section is effective July 1,
2003, to the extent permitted by federal law. If any provision
of this section is prohibited by federal law, the provision
shall become effective when federal law is changed to permit its
application or a waiver is received. The commissioner of human
services shall notify the revisor of statutes when federal law
is enacted or a waiver or other federal approval is received and
publish a notice in the State Register. The commissioner must
include the notice in the first State Register published after
the effective date of the federal changes.
(b) If, by July 1, 2003, any provision of this section is
not effective because of prohibitions in federal law, the
commissioner of human services shall apply to the federal
government by August 1, 2003, for a waiver of those prohibitions
or other federal authority, and that provision shall become
effective upon receipt of a federal waiver or other federal
approval, notification to the revisor of statutes, and
publication of a notice in the State Register to that effect.
In applying for federal approval to extend the lookback period,
the commissioner shall seek the longest lookback period the
federal government will approve, not to exceed 72 months.
Sec. 29. Minnesota Statutes 2002, section 256B.0595, is
amended by adding a subdivision to read:
Subd. 4b. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] This
subdivision applies to transfers involving recipients of medical
assistance that are made on or after July 1, 2003, and to all
transfers involving persons who apply for medical assistance on
or after July 1, 2003, regardless of when the transfer occurred,
except that this subdivision does not apply to transfers made
prior to July 1, 2003. A person or a person's spouse who made a
transfer prohibited by subdivision 1b is not ineligible for
medical assistance services if one of the following conditions
applies:
(1) the assets or income were transferred to the
individual's spouse or to another for the sole benefit of the
spouse, except that after eligibility is established and the
assets have been divided between the spouses as part of the
asset allowance under section 256B.059, no further transfers
between spouses may be made;
(2) the institutionalized spouse, prior to being
institutionalized, transferred assets or income to a spouse,
provided that the spouse to whom the assets or income were
transferred does not then transfer those assets or income to
another person for less than fair market value. At the time
when one spouse is institutionalized, assets must be allocated
between the spouses as provided under section 256B.059;
(3) the assets or income were transferred to a trust for
the sole benefit of the individual's child who is blind or
permanently and totally disabled as determined in the
supplemental security income program and the trust reverts to
the state upon the disabled child's death to the extent the
medical assistance has paid for services for the grantor or
beneficiary of the trust. This clause applies to a trust
established after the commissioner publishes a notice in the
State Register that the commissioner has been authorized to
implement this clause due to a change in federal law or the
approval of a federal waiver;
(4) a satisfactory showing is made that the individual
intended to dispose of the assets or income either at fair
market value or for other valuable consideration; or
(5) the local agency determines that denial of eligibility
for medical assistance services would cause undue hardship and
grants a waiver of a penalty resulting from a transfer for less
than fair market value because there exists an imminent threat
to the individual's health and well-being. Whenever an
applicant or recipient is denied eligibility because of a
transfer for less than fair market value, the local agency shall
notify the applicant or recipient that the applicant or
recipient may request a waiver of the penalty if the denial of
eligibility will cause undue hardship. In evaluating a waiver,
the local agency shall take into account whether the individual
was the victim of financial exploitation, whether the individual
has made reasonable efforts to recover the transferred property
or resource, and other factors relevant to a determination of
hardship. If the local agency does not approve a hardship
waiver, the local agency shall issue a written notice to the
individual stating the reasons for the denial and the process
for appealing the local agency's decision. When a waiver is
granted, a cause of action exists against the person to whom the
assets were transferred for that portion of medical assistance
services granted within 72 months of the date the transferor
applied for medical assistance and satisfied all other
requirements for eligibility, or the amount of the uncompensated
transfer, whichever is less, together with the costs incurred
due to the action. The action shall be brought by the state
unless the state delegates this responsibility to the local
agency responsible for providing medical assistance under this
chapter.
[EFFECTIVE DATE.] (a) This section is effective July 1,
2003, to the extent permitted by federal law. If any provision
of this section is prohibited by federal law, the provision
shall become effective when federal law is changed to permit its
application or a waiver is received. The commissioner of human
services shall notify the revisor of statutes when federal law
is enacted or a waiver or other federal approval is received and
publish a notice in the State Register. The commissioner must
include the notice in the first State Register published after
the effective date of the federal changes.
(b) If, by July 1, 2003, any provision of this section is
not effective because of prohibitions in federal law, the
commissioner of human services shall apply to the federal
government by August 1, 2003, for a waiver of those prohibitions
or other federal authority, and that provision shall become
effective upon receipt of a federal waiver or other federal
approval, notification to the revisor of statutes, and
publication of a notice in the State Register to that effect.
In applying for federal approval to extend the lookback period,
the commissioner shall seek the longest lookback period the
federal government will approve, not to exceed 72 months.
Sec. 30. [256B.0596] [MENTAL HEALTH CASE MANAGEMENT.]
Counties shall contract with eligible providers willing to
provide mental health case management services under section
256B.0625, subdivision 20. In order to be eligible, in addition
to general provider requirements under this chapter, the
provider must:
(1) be willing to provide the mental health case management
services; and
(2) have a minimum of at least one contact with the client
per week.
Sec. 31. Minnesota Statutes 2002, section 256B.06,
subdivision 4, is amended to read:
Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for
medical assistance is limited to citizens of the United States,
qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States.
(b) "Qualified noncitizen" means a person who meets one of
the following immigration criteria:
(1) admitted for lawful permanent residence according to
United States Code, title 8;
(2) admitted to the United States as a refugee according to
United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title
8, section 1158;
(4) granted withholding of deportation according to United
States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according to
United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to United
States Code, title 8, section 1153(a)(7);
(7) determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996, title V of the
Omnibus Consolidated Appropriations Bill, Public Law Number
104-200;
(8) is a child of a noncitizen determined to be a battered
noncitizen by the United States Attorney General according to
the Illegal Immigration Reform and Immigrant Responsibility Act
of 1996, title V, of the Omnibus Consolidated Appropriations
Bill, Public Law Number 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined
in section 501(e) of Public Law Number 96-422, the Refugee
Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the
United States before August 22, 1996, who otherwise meet the
eligibility requirements of chapter 256B, are eligible for
medical assistance with federal financial participation.
(d) All qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the
eligibility requirements of chapter 256B, are eligible for
medical assistance with federal financial participation through
November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who
entered the United States on or after August 22, 1996, and who
otherwise meet the eligibility requirements of chapter 256B are
eligible for medical assistance with federal participation for
five years if they meet one of the following criteria:
(i) refugees admitted to the United States according to
United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States
Code, title 8, section 1158;
(iii) persons granted withholding of deportation according
to United States Code, title 8, section 1253(h);
(iv) veterans of the United States Armed Forces with an
honorable discharge for a reason other than noncitizen status,
their spouses and unmarried minor dependent children; or
(v) persons on active duty in the United States Armed
Forces, other than for training, their spouses and unmarried
minor dependent children.
Beginning December 1, 1996, qualified noncitizens who do
not meet one of the criteria in items (i) to (v) are eligible
for medical assistance without federal financial participation
as described in paragraph (j).
(e) Noncitizens who are not qualified noncitizens as
defined in paragraph (b), who are lawfully residing in the
United States and who otherwise meet the eligibility
requirements of chapter 256B, are eligible for medical
assistance under clauses (1) to (3). These individuals must
cooperate with the Immigration and Naturalization Service to
pursue any applicable immigration status, including citizenship,
that would qualify them for medical assistance with federal
financial participation.
(1) Persons who were medical assistance recipients on
August 22, 1996, are eligible for medical assistance with
federal financial participation through December 31, 1996.
(2) Beginning January 1, 1997, persons described in clause
(1) are eligible for medical assistance without federal
financial participation as described in paragraph (j).
(3) Beginning December 1, 1996, persons residing in the
United States prior to August 22, 1996, who were not receiving
medical assistance and persons who arrived on or after August
22, 1996, are eligible for medical assistance without federal
financial participation as described in paragraph (j).
(f) Nonimmigrants who otherwise meet the eligibility
requirements of chapter 256B are eligible for the benefits as
provided in paragraphs (g) to (i). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes
listed in United States Code, title 8, section 1101(a)(15).
(g) Payment shall also be made for care and services that
are furnished to noncitizens, regardless of immigration status,
who otherwise meet the eligibility requirements of chapter 256B,
if such care and services are necessary for the treatment of an
emergency medical condition, except for organ transplants and
related care and services and routine prenatal care.
(h) For purposes of this subdivision, the term "emergency
medical condition" means a medical condition that meets the
requirements of United States Code, title 42, section 1396b(v).
(i) Pregnant noncitizens who are undocumented or
nonimmigrants, who otherwise meet the eligibility requirements
of chapter 256B, are eligible for medical assistance payment
without federal financial participation for care and services
through the period of pregnancy, and 60 days postpartum, except
for labor and delivery.
(j) Qualified noncitizens as described in paragraph (d),
and all other noncitizens lawfully residing in the United States
as described in paragraph (e), who are ineligible for medical
assistance with federal financial participation and who
otherwise meet the eligibility requirements of chapter 256B and
of this paragraph, are eligible for medical assistance without
federal financial participation. Qualified noncitizens as
described in paragraph (d) are only eligible for medical
assistance without federal financial participation for five
years from their date of entry into the United States.
(k) The commissioner shall submit to the legislature by
December 31, 1998, a report on the number of recipients and cost
of coverage of care and services made according to paragraphs
(i) and (j). Beginning October 1, 2003, persons who are
receiving care and rehabilitation services from a nonprofit
center established to serve victims of torture and are otherwise
ineligible for medical assistance under chapter 256B or general
assistance medical care under section 256D.03 are eligible for
medical assistance without federal financial participation.
These individuals are eligible only for the period during which
they are receiving services from the center. Individuals
eligible under this clause shall not be required to participate
in prepaid medical assistance.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
except where a different date is specified in the text.
Sec. 32. Minnesota Statutes 2002, section 256B.061, is
amended to read:
256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.]
(a) If any individual has been determined to be eligible
for medical assistance, it will be made available for care and
services included under the plan and furnished in or after the
third month before the month in which the individual made
application for such assistance, if such individual was, or upon
application would have been, eligible for medical assistance at
the time the care and services were furnished. The commissioner
may limit, restrict, or suspend the eligibility of an individual
for up to one year upon that individual's conviction of a
criminal offense related to application for or receipt of
medical assistance benefits.
(b) On the basis of information provided on the completed
application, an applicant who meets the following criteria shall
be determined eligible beginning in the month of application:
(1) whose gross income is less than 90 percent of the
applicable income standard;
(2) whose total liquid assets are less than 90 percent of
the asset limit;
(3) does not reside in a long-term care facility; and
(4) meets all other eligibility requirements.
The applicant must provide all required verifications within 30
days' notice of the eligibility determination or eligibility
shall be terminated.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
or upon federal approval, whichever is later.
Sec. 33. Minnesota Statutes 2002, section 256B.0625,
subdivision 5a, is amended to read:
Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY
SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a)
[COVERAGE.] Medical assistance covers home-based intensive early
intervention behavior therapy for children with autism spectrum
disorders, effective July 1, 2007. Children with autism
spectrum disorder, and their custodial parents or foster
parents, may access other covered services to treat autism
spectrum disorder, and are not required to receive intensive
early intervention behavior therapy services under this
subdivision. Intensive early intervention behavior therapy does
not include coverage for services to treat developmental
disorders of language, early onset psychosis, Rett's disorder,
selective mutism, social anxiety disorder, stereotypic movement
disorder, dementia, obsessive compulsive disorder, schizoid
personality disorder, avoidant personality disorder, or reactive
attachment disorder. If a child with autism spectrum disorder
is diagnosed to have one or more of these conditions, intensive
early intervention behavior therapy includes coverage only for
services necessary to treat the autism spectrum disorder.
(b) Subd. 5b. [PURPOSE OF INTENSIVE EARLY INTERVENTION
BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to
improve the child's behavioral functioning, to prevent
development of challenging behaviors, to eliminate autistic
behaviors, to reduce the risk of out-of-home placement, and to
establish independent typical functioning in language and social
behavior. The procedures used to accomplish these goals are
based upon research in applied behavior analysis.
(c) Subd. 5c. [ELIGIBLE CHILDREN.] A child is eligible to
initiate IEIBTS if, the child meets the additional eligibility
criteria in paragraph (d) and in a diagnostic assessment by a
mental health professional who is not under the employ of the
service provider, the child:
(1) is found to have an autism spectrum disorder;
(2) has a current IQ of either untestable, or at least 30;
(3) if nonverbal, initiated behavior therapy by 42 months
of age;
(4) if verbal, initiated behavior therapy by 48 months of
age; or
(5) if having an IQ of at least 50, initiated behavior
therapy by 84 months of age.
To continue after six-month individualized treatment plan (ITP)
reviews, at least one of the child's custodial parents or foster
parents must participate in an average of at least five hours of
documented behavior therapy per week for six months, and
consistently implement behavior therapy recommendations 24 hours
a day. To continue after six-month individualized treatment
plan (ITP) reviews, the child must show documented progress
toward mastery of six-month benchmark behavior objectives. The
maximum number of months during which services may be billed is
54, or up to the month of August in the first year in which the
child completes first grade, whichever comes last. If
significant progress towards treatment goals has not been
achieved after 24 months of treatment, treatment must be
discontinued.
(d) Subd. 5d. [ADDITIONAL ELIGIBILITY CRITERIA.] A child
is eligible to initiate IEIBTS if:
(1) in medical and diagnostic assessments by medical and
mental health professionals, it is determined that the child
does not have severe or profound mental retardation;
(2) an accurate assessment of the child's hearing has been
performed, including audiometry if the brain stem auditory
evokes response;
(3) a blood lead test has been performed prior to
initiation of treatment; and
(4) an EEG or neurologic evaluation is done, prior to
initiation of treatment, if the child has a history of staring
spells or developmental regression.
(e) Subd. 5e. [COVERED SERVICES.] The focus of IEIBTS must
be to treat the principal diagnostic features of the autism
spectrum disorder. All IEIBTS must be delivered by a team of
practitioners under the consistent supervision of a single
clinical supervisor. A mental health professional must develop
the ITP for IEIBTS. The ITP must include six-month benchmark
behavior objectives. All behavior therapy must be based upon
research in applied behavior analysis, with an emphasis upon
positive reinforcement of carefully task-analyzed skills for
optimum rates of progress. All behavior therapy must be
consistently applied and generalized throughout the 24-hour day
and seven-day week by all of the child's regular care
providers. When placing the child in school activities, a
majority of the peers must have no mental health diagnosis, and
the child must have sufficient social skills to succeed with 80
percent of the school activities. Reactive consequences, such
as redirection, correction, positive practice, or time-out, must
be used only when necessary to improve the child's success when
proactive procedures alone have not been effective. IEIBTS must
be delivered by a team of behavior therapy practitioners who are
employed under the direction of the same agency. The team may
deliver up to 200 billable hours per year of direct clinical
supervisor services, up to 700 billable hours per year of senior
behavior therapist services, and up to 1,800 billable hours per
year of direct behavior therapist services. A one-hour clinical
review meeting for the child, parents, and staff must be
scheduled 50 weeks a year, at which behavior therapy is reviewed
and planned. At least one-quarter of the annual clinical
supervisor billable hours shall consist of on-site clinical
meeting time. At least one-half of the annual senior behavior
therapist billable hours shall consist of direct services to the
child or parents. All of the behavioral therapist billable
hours shall consist of direct on-site services to the child or
parents. None of the senior behavior therapist billable hours
or behavior therapist billable hours shall consist of clinical
meeting time. If there is any regression of the autistic
spectrum disorder after 12 months of therapy, a neurologic
consultation must be performed.
(f) Subd. 5f. [PROVIDER QUALIFICATIONS.] The provider
agency must be capable of delivering consistent applied behavior
analysis (ABA) based behavior therapy in the home. The site
director of the agency must be a mental health professional and
a board certified behavior analyst certified by the behavior
analyst certification board. Each clinical supervisor must be a
certified associate behavior analyst certified by the behavior
analyst certification board or have equivalent experience in
applied behavior analysis.
(g) Subd. 5g. [SUPERVISION REQUIREMENTS.] (1) Each
behavior therapist practitioner must be continuously supervised
while in the home until the practitioner has mastered
competencies for independent practice. Each behavior therapist
must have mastered three credits of academic content and
practice in an applied behavior analysis sequence at an
accredited university before providing more than 12 months of
therapy. A college degree or minimum hours of experience are
not required. Each behavior therapist must continue training
through weekly direct observation by the senior behavior
therapist, through demonstrated performance in clinical meetings
with the clinical supervisor, and annual training in applied
behavior analysis.
(2) Each senior behavior therapist practitioner must have
mastered the senior behavior therapy competencies, completed one
year of practice as a behavior therapist, and six months of
co-therapy training with another senior behavior therapist or
have an equivalent amount of experience in applied behavior
analysis. Each senior behavior therapist must have mastered 12
credits of academic content and practice in an applied behavior
analysis sequence at an accredited university before providing
more than 12 months of senior behavior therapy. Each senior
behavior therapist must continue training through demonstrated
performance in clinical meetings with the clinical supervisor,
and annual training in applied behavior analysis.
(3) Each clinical supervisor practitioner must have
mastered the clinical supervisor and family consultation
competencies, completed two years of practice as a senior
behavior therapist and one year of co-therapy training with
another clinical supervisor, or equivalent experience in applied
behavior analysis. Each clinical supervisor must continue
training through annual training in applied behavior analysis.
(h) Subd. 5h. [PLACE OF SERVICE.] IEIBTS are provided
primarily in the child's home and community. Services may be
provided in the child's natural school or preschool classroom,
home of a relative, natural recreational setting, or day care.
(i) Subd. 5i. [PRIOR AUTHORIZATION REQUIREMENTS.] Prior
authorization shall be required for services provided after 200
hours of clinical supervisor, 700 hours of senior behavior
therapist, or 1,800 hours of behavior therapist services per
year.
(j) Subd. 5j. [PAYMENT RATES.] The following payment rates
apply:
(1) for an IEIBTS clinical supervisor practitioner under
supervision of a mental health professional, the lower of the
submitted charge or $67 per hour unit;
(2) for an IEIBTS senior behavior therapist practitioner
under supervision of a mental health professional, the lower of
the submitted charge or $37 per hour unit; or
(3) for an IEIBTS behavior therapist practitioner under
supervision of a mental health professional, the lower of the
submitted charge or $27 per hour unit.
An IEIBTS practitioner may receive payment for travel time which
exceeds 50 minutes one-way. The maximum payment allowed will be
$0.51 per minute for up to a maximum of 300 hours per year.
For any week during which the above charges are made to
medical assistance, payments for the following services are
excluded: supervising mental health professional hours and
personal care attendant, home-based mental health,
family-community support, or mental health behavioral aide hours.
(k) Subd. 5k. [REPORT.] The commissioner shall collect
evidence of the effectiveness of intensive early intervention
behavior therapy services and present a report to the
legislature by July 1, 2006 2010.
Sec. 34. Minnesota Statutes 2002, section 256B.0625,
subdivision 9, is amended to read:
Subd. 9. [DENTAL SERVICES.] (a) Medical assistance covers
dental services. Dental services include, with prior
authorization, fixed bridges that are cost-effective for persons
who cannot use removable dentures because of their medical
condition.
(b) Coverage of dental services for adults age 21 and over
who are not pregnant is subject to a $500 annual benefit limit
and covered services are limited to:
(1) diagnostic and preventative services;
(2) basic restorative services; and
(3) emergency services.
Emergency services, dentures, and extractions related to
dentures are not included in the $500 annual benefit limit.
Sec. 35. Minnesota Statutes 2002, section 256B.0625,
subdivision 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.
(b) The dispensed quantity of a prescription drug must not
exceed a 34-day supply, unless authorized by the commissioner.
(c) Medical assistance covers the following
over-the-counter drugs when prescribed by a licensed
practitioner or by a licensed pharmacist who meets standards
established by the commissioner, in consultation with the board
of pharmacy: 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 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. A pharmacist may prescribe over-the-counter
medications as provided under this paragraph for purposes of
receiving reimbursement under Medicaid. When prescribing
over-the-counter drugs under this paragraph, licensed
pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for
potential adverse interactions, and make referrals as needed to
other health care professionals.
Subd. 13c. [FORMULARY COMMITTEE.] The commissioner, after
receiving recommendations from professional medical associations
and professional pharmacist pharmacy associations, and consumer
groups 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 carry out
duties as described in subdivisions 13 to 13g. The formulary
committee shall be comprised of four licensed physicians
actively engaged in the practice of medicine in Minnesota one of
whom must be actively engaged in the treatment of persons with
mental illness; at least three licensed pharmacists actively
engaged in the practice of pharmacy in Minnesota; and one
consumer representative; the remainder to be made up of health
care professionals who are licensed in their field and have
recognized knowledge in the clinically appropriate prescribing,
dispensing, and monitoring of covered outpatient drugs. Members
of the formulary committee shall not be employed by the
department of human services. Committee members shall serve
three-year terms and shall serve without compensation. Members
may be reappointed once by the commissioner. The formulary
committee shall meet at least quarterly. The commissioner may
require more frequent formulary committee meetings as needed.
An honorarium of $100 per meeting and reimbursement for mileage
shall be paid to each committee member in attendance.
Subd. 13d. [DRUG FORMULARY.] (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) (1) drugs or products for which there is no federal
funding;
(ii) (2) 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 as provided in subdivision 13;
(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 (3) drugs used for weight
loss, except that medically necessary lipase inhibitors may be
covered for a recipient with type II diabetes;
(iv) (4) drugs for which medical value has not been
established; and
(v) (5) 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.
Subd. 13e. [PAYMENT RATES.] (c) (a) 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 amount of
payment basis must be reduced to reflect all discount amounts
applied to the charge by any provider/insurer agreement or
contract for submitted charges to medical assistance programs.
The net submitted charge may not be greater than the patient
liability for the service. 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 11.5 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 11.5 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.
(b) 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.
(c) 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 or on the maximum
allowable cost established by the commissioner.
(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 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 paragraphs (a) to (c).
Subd. 13f. [PRIOR AUTHORIZATION.] (a) 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;
(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. The formulary committee shall
establish general criteria to be used for the prior
authorization of brand-name drugs for which generically
equivalent drugs are available, but the committee is not
required to review each brand-name drug for which a generically
equivalent drug is available.
(b) Prior authorization may be required by the commissioner
before certain formulary drugs are eligible for payment. The
formulary committee may recommend drugs for prior authorization
directly to the commissioner. The commissioner may also request
that the formulary committee review a drug for prior
authorization. Before the commissioner may require prior
authorization for a drug:
(1) the commissioner must provide information to the
formulary committee on the impact that placing the drug on prior
authorization may have on the quality of patient care and on
program costs, information regarding whether the drug is subject
to clinical abuse or misuse, and relevant data from the state
Medicaid program if such data is available;
(2) the formulary committee must review the drug, taking
into account medical and clinical data and the information
provided by the commissioner; and
(3) the formulary committee must hold a public forum and
receive public comment for an additional 15 days.
The commissioner must provide a 15-day notice period before
implementing the prior authorization.
(c) Prior authorization shall not be required or utilized
for any atypical antipsychotic drug prescribed for the treatment
of mental illness if:
(1) there is no generically equivalent drug available; and
(2) the drug was initially prescribed for the recipient
prior to July 1, 2003; or
(3) the drug is part of the recipient's current course of
treatment.
This paragraph applies to any multistate preferred drug list or
supplemental drug rebate program established or administered by
the commissioner.
(h) (d) 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 if the prior authorization is
used in conjunction with any supplemental drug rebate program or
multistate preferred drug list established or administered by
the commissioner. This paragraph expires July 1, 2003 2005.
(e) The commissioner may require prior authorization for
brand name drugs whenever a generically equivalent product is
available, even if the prescriber specifically indicates
"dispense as written-brand necessary" on the prescription as
required by section 151.21, subdivision 2.
Subd. 13g. [PREFERRED DRUG LIST.] (a) The commissioner
shall adopt and implement a preferred drug list by January 1,
2004. The commissioner may enter into a contract with a vendor
or one or more states for the purpose of participating in a
multistate preferred drug list and supplemental rebate program.
The commissioner shall ensure that any contract meets all
federal requirements and maximizes federal financial
participation. The commissioner shall publish the preferred
drug list annually in the State Register and shall maintain an
accurate and up-to-date list on the agency Web site.
(b) The commissioner may add to, delete from, and otherwise
modify the preferred drug list, after consulting with the
formulary committee and appropriate medical specialists and
providing public notice and the opportunity for public comment.
(c) The commissioner shall adopt and administer the
preferred drug list as part of the administration of the
supplemental drug rebate program. Reimbursement for
prescription drugs not on the preferred drug list may be subject
to prior authorization, unless the drug manufacturer signs a
supplemental rebate contract.
(d) For purposes of this subdivision, "preferred drug list"
means a list of prescription drugs within designated therapeutic
classes selected by the commissioner, for which prior
authorization based on the identity of the drug or class is not
required.
(e) The commissioner shall seek any federal waivers or
approvals necessary to implement this subdivision.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 36. Minnesota Statutes 2002, section 256B.0625,
subdivision 17, is amended to read:
Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance
covers transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by
nonambulatory eligible persons in obtaining emergency or
nonemergency medical care when paid directly to an ambulance
company, common carrier, or other recognized providers of
transportation services. For the purpose of this subdivision, a
person who is incapable of transport by taxicab or bus shall be
considered to be nonambulatory.
(b) Medical assistance covers special transportation, as
defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
if the provider receives and maintains a current physician's
order by the recipient's attending physician certifying that the
recipient has a physical or mental impairment that would
prohibit the recipient from safely accessing and using a bus,
taxi, other commercial transportation, or private automobile.
The commissioner may use an order by the recipient's attending
physician to certify that the recipient requires special
transportation services. Special transportation includes
driver-assisted service to eligible individuals.
Driver-assisted service includes passenger pickup at and return
to the individual's residence or place of business, assistance
with admittance of the individual to the medical facility, and
assistance in passenger securement or in securing of wheelchairs
or stretchers in the vehicle. The commissioner shall establish
maximum medical assistance reimbursement rates for special
transportation services for persons who need a
wheelchair-accessible van or stretcher-accessible vehicle and
for those who do not need a wheelchair-accessible van or
stretcher-accessible vehicle. The average of these two rates
per trip must not exceed $15 for the base rate and $1.40 per
mile. Special transportation provided to nonambulatory persons
who do not need a wheelchair-accessible van or
stretcher-accessible vehicle, may be reimbursed at a lower rate
than special transportation provided to persons who need a
wheelchair-accessible van or stretcher-accessible
vehicle. Special transportation providers must obtain written
documentation from the health care service provider who is
serving the recipient being transported, identifying the time
that the recipient arrived. Special transportation providers
may not bill for separate base rates for the continuation of a
trip beyond the original destination. Special transportation
providers must take recipients to the nearest appropriate health
care provider, using the most direct route available. The
maximum medical assistance reimbursement rates for special
transportation services are:
(1) $18 for the base rate and $1.40 per mile for services
to eligible persons who need a wheelchair-accessible van;
(2) $12 for the base rate and $1.35 per mile for services
to eligible persons who do not need a wheelchair-accessible van;
and
(3) $36 for the base rate and $1.40 per mile, and an
attendant rate of $9 per trip, for services to eligible persons
who need a stretcher-accessible vehicle.
Sec. 37. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.]
Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in
subdivision 2, the medical assistance benefit plan shall include
the following co-payments for all recipients, effective for
services provided on or after October 1, 2003:
(1) $3 per nonpreventive visit. For purposes of this
subdivision, a visit means an episode of service which is
required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory
setting by a physician or physician ancillary, chiropractor,
podiatrist, nurse midwife, advanced practice nurse, audiologist,
optician, or optometrist;
(2) $3 for eyeglasses;
(3) $6 for nonemergency visits to a hospital-based
emergency room; and
(4) $3 per brand-name drug prescription and $1 per generic
drug prescription, subject to a $20 per month maximum for
prescription drug co-payments. No co-payments shall apply to
antipsychotic drugs when used for the treatment of mental
illness.
(b) Recipients of medical assistance are responsible for
all co-payments in this subdivision.
Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the
following exceptions:
(1) children under the age of 21;
(2) pregnant women for services that relate to the
pregnancy or any other medical condition that may complicate the
pregnancy;
(3) recipients expected to reside for at least 30 days in a
hospital, nursing home, or intermediate care facility for the
mentally retarded;
(4) recipients receiving hospice care;
(5) 100 percent federally funded services provided by an
Indian health service;
(6) emergency services;
(7) family planning services;
(8) services that are paid by Medicare, resulting in the
medical assistance program paying for the coinsurance and
deductible; and
(9) co-payments that exceed one per day per provider for
nonpreventive visits, eyeglasses, and nonemergency visits to a
hospital-based emergency room.
Subd. 3. [COLLECTION.] The medical assistance
reimbursement to the provider shall be reduced by the amount of
the co-payment, except that reimbursement for prescription drugs
shall not be reduced once a recipient has reached the $20 per
month maximum for prescription drug co-payments. The provider
collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the
co-payment, except as provided in subdivision 4.
Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business
practice of a provider to refuse service to an individual with
uncollected debt, the provider may include uncollected
co-payments under this section. A provider must give advance
notice to a recipient with uncollected debt before services can
be denied.
Sec. 38. Minnesota Statutes 2002, section 256B.0635,
subdivision 1, is amended to read:
Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30,
2002, medical assistance may be paid for persons who received
MFIP or medical assistance for families and children in at least
three of six months preceding the month in which the person
became ineligible for MFIP or medical assistance, if the
ineligibility was due to an increase in hours of employment or
employment income or due to the loss of an earned income
disregard. In addition, to receive continued assistance under
this section, persons who received medical assistance for
families and children but did not receive MFIP must have had
income less than or equal to the assistance standard for their
family size under the state's AFDC plan in effect as of July 16,
1996, increased by three percent effective July 1, 2000, at the
time medical assistance eligibility began. A person who is
eligible for extended medical assistance is entitled to six
months of assistance without reapplication, unless the
assistance unit ceases to include a dependent child. For a
person under 21 years of age, medical assistance may not be
discontinued within the six-month period of extended eligibility
until it has been determined that the person is not otherwise
eligible for medical assistance. Medical assistance may be
continued for an additional six months if the person meets all
requirements for the additional six months, according to title
XIX of the Social Security Act, as amended by section 303 of the
Family Support Act of 1988, Public Law Number 100-485.
(b) Beginning July 1, 2002, contingent upon federal
funding, medical assistance for families and children may be
paid for persons who were eligible under section 256B.055,
subdivision 3a, in at least three of six months preceding the
month in which the person became ineligible under that section
if the ineligibility was due to an increase in hours of
employment or employment income or due to the loss of an earned
income disregard. A person who is eligible for extended medical
assistance is entitled to six months of assistance without
reapplication, unless the assistance unit ceases to include a
dependent child, except medical assistance may not be
discontinued for that dependent child under 21 years of age
within the six-month period of extended eligibility until it has
been determined that the person is not otherwise eligible for
medical assistance. Medical assistance may be continued for an
additional six months if the person meets all requirements for
the additional six months, according to title XIX of the Social
Security Act, as amended by section 303 of the Family Support
Act of 1988, Public Law Number 100-485.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 39. Minnesota Statutes 2002, section 256B.0635,
subdivision 2, is amended to read:
Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until
June 30, 2002, medical assistance may be paid for persons who
received MFIP or medical assistance for families and children in
at least three of the six months preceding the month in which
the person became ineligible for MFIP or medical assistance, if
the ineligibility was the result of the collection of child or
spousal support under part D of title IV of the Social Security
Act. In addition, to receive continued assistance under this
section, persons who received medical assistance for families
and children but did not receive MFIP must have had income less
than or equal to the assistance standard for their family size
under the state's AFDC plan in effect as of July 16, 1996,
increased by three percent effective July 1, 2000, at the time
medical assistance eligibility began. A person who is eligible
for extended medical assistance under this subdivision is
entitled to four months of assistance without reapplication,
unless the assistance unit ceases to include a dependent child,
except medical assistance may not be discontinued for that
dependent child under 21 years of age within the four-month
period of extended eligibility until it has been determined that
the person is not otherwise eligible for medical assistance.
(b) Beginning July 1, 2002, contingent upon federal
funding, medical assistance for families and children may be
paid for persons who were eligible under section 256B.055,
subdivision 3a, in at least three of the six months preceding
the month in which the person became ineligible under that
section if the ineligibility was the result of the collection of
child or spousal support under part D of title IV of the Social
Security Act. A person who is eligible for extended medical
assistance under this subdivision is entitled to four months of
assistance without reapplication, unless the assistance unit
ceases to include a dependent child, except medical assistance
may not be discontinued for that dependent child under 21 years
of age within the four-month period of extended eligibility
until it has been determined that the person is not otherwise
eligible for medical assistance.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 40. Minnesota Statutes 2002, section 256B.15,
subdivision 1, is amended to read:
Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND
CONSTRUCTION; DEFINITION.] (a) It is the policy of this state
that individuals or couples, either or both of whom participate
in the medical assistance program, use their own assets to pay
their share of the total cost of their care during or after
their enrollment in the program according to applicable federal
law and the laws of this state. The following provisions apply:
(1) subdivisions 1c to 1k shall not apply to claims arising
under this section which are presented under section 525.313;
(2) the provisions of subdivisions 1c to 1k expanding the
interests included in an estate for purposes of recovery under
this section give effect to the provisions of United States
Code, title 42, section 1396p, governing recoveries, but do not
give rise to any express or implied liens in favor of any other
parties not named in these provisions;
(3) the continuation of a recipient's life estate or joint
tenancy interest in real property after the recipient's death
for the purpose of recovering medical assistance under this
section modifies common law principles holding that these
interests terminate on the death of the holder;
(4) all laws, rules, and regulations governing or involved
with a recovery of medical assistance shall be liberally
construed to accomplish their intended purposes;
(5) a deceased recipient's life estate and joint tenancy
interests continued under this section shall be owned by the
remaindermen or surviving joint tenants as their interests may
appear on the date of the recipient's death. They shall not be
merged into the remainder interest or the interests of the
surviving joint tenants by reason of ownership. They shall be
subject to the provisions of this section. Any conveyance,
transfer, sale, assignment, or encumbrance by a remainderman, a
surviving joint tenant, or their heirs, successors, and assigns
shall be deemed to include all of their interest in the deceased
recipient's life estate or joint tenancy interest continued
under this section; and
(6) the provisions of subdivisions 1c to 1k continuing a
recipient's joint tenancy interests in real property after the
recipient's death do not apply to a homestead owned of record,
on the date the recipient dies, by the recipient and the
recipient's spouse as joint tenants with a right of
survivorship. Homestead means the real property occupied by the
surviving joint tenant spouse as their sole residence on the
date the recipient dies and classified and taxed to the
recipient and surviving joint tenant spouse as homestead
property for property tax purposes in the calendar year in which
the recipient dies. For purposes of this exemption, real
property the recipient and their surviving joint tenant spouse
purchase solely with the proceeds from the sale of their prior
homestead, own of record as joint tenants, and qualify as
homestead property under section 273.124 in the calendar year in
which the recipient dies and prior to the recipient's death
shall be deemed to be real property classified and taxed to the
recipient and their surviving joint tenant spouse as homestead
property in the calendar year in which the recipient dies. The
surviving spouse, or any person with personal knowledge of the
facts, may provide an affidavit describing the homestead
property affected by this clause and stating facts showing
compliance with this clause. The affidavit shall be prima facie
evidence of the facts it states.
(b) For purposes of this section, "medical assistance"
includes the medical assistance program under this chapter and
the general assistance medical care program under chapter 256D,
but does not include the alternative care program for nonmedical
assistance recipients under section 256B.0913, subdivision 4.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to estates of decedents who die on or after that
date.
Sec. 41. Minnesota Statutes 2002, section 256B.15,
subdivision 1a, is amended to read:
Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person
receives any medical assistance hereunder, on the person's
death, if single, or on the death of the survivor of a married
couple, either or both of whom received medical assistance, or
as otherwise provided for in this section, the total amount paid
for medical assistance rendered for the person and spouse shall
be filed as a claim against the estate of the person or the
estate of the surviving spouse in the court having jurisdiction
to probate the estate or to issue a decree of descent according
to sections 525.31 to 525.313.
A claim shall be filed if medical assistance was rendered
for either or both persons under one of the following
circumstances:
(a) the person was over 55 years of age, and received
services under this chapter, excluding alternative care;
(b) the person resided in a medical institution for six
months or longer, received services under this chapter excluding
alternative care, and, at the time of institutionalization or
application for medical assistance, whichever is later, the
person could not have reasonably been expected to be discharged
and returned home, as certified in writing by the person's
treating physician. For purposes of this section only, a
"medical institution" means a skilled nursing facility,
intermediate care facility, intermediate care facility for
persons with mental retardation, nursing facility, or inpatient
hospital; or
(c) the person received general assistance medical care
services under chapter 256D.
The claim shall be considered an expense of the last
illness of the decedent for the purpose of section 524.3-805.
Any statute of limitations that purports to limit any county
agency or the state agency, or both, to recover for medical
assistance granted hereunder shall not apply to any claim made
hereunder for reimbursement for any medical assistance granted
hereunder. Notice of the claim shall be given to all heirs and
devisees of the decedent whose identity can be ascertained with
reasonable diligence. The notice must include procedures and
instructions for making an application for a hardship waiver
under subdivision 5; time frames for submitting an application
and determination; and information regarding appeal rights and
procedures. Counties are entitled to one-half of the nonfederal
share of medical assistance collections from estates that are
directly attributable to county effort. Counties are entitled
to ten percent of the collections for alternative care directly
attributable to county effort.
[EFFECTIVE DATE.] The amendments in this section relating
to the alternative care program are effective July 1, 2003, and
apply to the estates of decedents who die on or after that
date. The remaining amendments in this section are effective
August 1, 2003, and apply to the estates of decedents who die on
and after that date.
Sec. 42. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency
with a claim or potential claim under this section may file a
notice of potential claim under this subdivision anytime before
or within one year after a medical assistance recipient dies.
The claimant shall be the state agency. A notice filed prior to
the recipient's death shall not take effect and shall not be
effective as notice until the recipient dies. A notice filed
after a recipient dies shall be effective from the time of
filing.
(b) The notice of claim shall be filed or recorded in the
real estate records in the office of the county recorder or
registrar of titles for each county in which any part of the
property is located. The recorder shall accept the notice for
recording or filing. The registrar of titles shall accept the
notice for filing if the recipient has a recorded interest in
the property. The registrar of titles shall not carry forward
to a new certificate of title any notice filed more than one
year from the date of the recipient's death.
(c) The notice must be dated, state the name of the
claimant, the medical assistance recipient's name and social
security number if filed before their death and their date of
death if filed after they die, the name and date of death of any
predeceased spouse of the medical assistance recipient for whom
a claim may exist, a statement that the claimant may have a
claim arising under this section, generally identify the
recipient's interest in the property, contain a legal
description for the property and whether it is abstract or
registered property, a statement of when the notice becomes
effective and the effect of the notice, be signed by an
authorized representative of the state agency, and may include
such other contents as the state agency may deem appropriate.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to the estates of decedents who die on or after that
date.
Sec. 43. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1d. [EFFECT OF NOTICE.] From the time it takes
effect, the notice shall be notice to remaindermen, joint
tenants, or to anyone else owning or acquiring an interest in or
encumbrance against the property described in the notice that
the medical assistance recipient's life estate, joint tenancy,
or other interests in the real estate described in the notice:
(1) shall, in the case of life estate and joint tenancy
interests, continue to exist for purposes of this section, and
be subject to liens and claims as provided in this section;
(2) shall be subject to a lien in favor of the claimant
effective upon the death of the recipient and dealt with as
provided in this section;
(3) may be included in the recipient's estate, as defined
in this section; and
(4) may be subject to administration and all other
provisions of chapter 524 and may be sold, assigned,
transferred, or encumbered free and clear of their interest or
encumbrance to satisfy claims under this section.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to the estates of decedents who die on or after that
date.
Sec. 44. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The
claimant may fully or partially release the notice and the lien
arising out of the notice of record in the real estate records
where the notice is filed or recorded at any time. The claimant
may give a full or partial release to extinguish any life
estates or joint tenancy interests which are or may be continued
under this section or whose existence or nonexistence may create
a cloud on the title to real property at any time whether or not
a notice has been filed. The recorder or registrar of titles
shall accept the release for recording or filing. If the
release is a partial release, it must include a legal
description of the property being released.
(b) At any time, the claimant may, at the claimant's
discretion, wholly or partially release, subordinate, modify, or
amend the recorded notice and the lien arising out of the notice.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to the estates of decedents who die on or after that
date.
Sec. 45. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a
lien in favor of the department of human services against the
recipient's interests in the real estate it describes for a
period of 20 years from the date of filing or the date of the
recipient's death, whichever is later. Notwithstanding any law
or rule to the contrary, a recipient's life estate and joint
tenancy interests shall not end upon the recipient's death but
shall continue according to subdivisions 1h, 1i, and 1j. The
amount of the lien shall be equal to the total amount of the
claims that could be presented in the recipient's estate under
this section.
(b) If no estate has been opened for the deceased
recipient, any holder of an interest in the property may apply
to the lien holder for a statement of the amount of the lien or
for a full or partial release of the lien. The application
shall include the applicant's name, current mailing address,
current home and work telephone numbers, and a description of
their interest in the property, a legal description of the
recipient's interest in the property, and the deceased
recipient's name, date of birth, and social security number.
The lien holder shall send the applicant by certified mail,
return receipt requested, a written statement showing the amount
of the lien, whether the lien holder is willing to release the
lien and under what conditions, and inform them of the right to
a hearing under section 256.045. The lien holder shall have the
discretion to compromise and settle the lien upon any terms and
conditions the lien holder deems appropriate.
(c) Any holder of an interest in property subject to the
lien has a right to request a hearing under section 256.045 to
determine the validity, extent, or amount of the lien. The
request must be in writing, and must include the names, current
addresses, and home and business telephone numbers for all other
parties holding an interest in the property. A request for a
hearing by any holder of an interest in the property shall be
deemed to be a request for a hearing by all parties owning
interests in the property. Notice of the hearing shall be given
to the lien holder, the party filing the appeal, and all of the
other holders of interests in the property at the addresses
listed in the appeal by certified mail, return receipt
requested, or by ordinary mail. Any owner of an interest in the
property to whom notice of the hearing is mailed shall be deemed
to have waived any and all claims or defenses in respect to the
lien unless they appear and assert any claims or defenses at the
hearing.
(d) If the claim the lien secures could be filed under
subdivision 1h, the lien holder may collect, compromise, settle,
or release the lien upon any terms and conditions it deems
appropriate. If the claim the lien secures could be filed under
subdivision 1i or 1j, the lien may be adjusted or enforced to
the same extent had it been filed under subdivisions 1i and 1j,
and the provisions of subdivisions 1i, clause (f), and lj,
clause (d), shall apply to voluntary payment, settlement, or
satisfaction of the lien.
(e) If no probate proceedings have been commenced for the
recipient as of the date the lien holder executes a release of
the lien on a recipient's life estate or joint tenancy interest,
created for purposes of this section, the release shall
terminate the life estate or joint tenancy interest created
under this section as of the date it is recorded or filed to the
extent of the release. If the claimant executes a release for
purposes of extinguishing a life estate or a joint tenancy
interest created under this section to remove a cloud on title
to real property, the release shall have the effect of
extinguishing any life estate or joint tenancy interests in the
property it describes which may have been continued by reason of
this section retroactive to the date of death of the deceased
life tenant or joint tenant except as provided for in section
514.981, subdivision 6.
(f) If the deceased recipient's estate is probated, a claim
shall be filed under this section. The amount of the lien shall
be limited to the amount of the claim as finally allowed. If
the claim the lien secures is filed under subdivision 1h, the
lien may be released in full after any allowance of the claim
becomes final or according to any agreement to settle and
satisfy the claim. The release shall release the lien but shall
not extinguish or terminate the interest being released. If the
claim the lien secures is filed under subdivision 1i or 1j, the
lien shall be released after the lien under subdivision 1i or 1j
is filed or recorded, or settled according to any agreement to
settle and satisfy the claim. The release shall not extinguish
or terminate the interest being released. If the claim is
finally disallowed in full, the claimant shall release the
claimant's lien at the claimant's expense.
[EFFECTIVE DATE.] This section takes effect on August 1,
2003, and applies to the estates of decedents who die on or
after that date.
Sec. 46. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or
rule to the contrary, if a claim is presented under this
section, interests or the proceeds of interests in real property
a decedent owned as a life tenant or a joint tenant with a right
of survivorship shall be part of the decedent's estate, subject
to administration, and shall be dealt with as provided in this
section.
[EFFECTIVE DATE.] This section takes effect on August 1,
2003, and applies to the estates of decedents who die on or
after that date.
Sec. 47. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL
ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to
(k) apply if a person received medical assistance for which a
claim may be filed under this section and died single, or the
surviving spouse of the couple and was not survived by any of
the persons described in subdivisions 3 and 4.
(b) For purposes of this section, the person's estate
consists of: (1) their probate estate; (2) all of the person's
interests or proceeds of those interests in real property the
person owned as a life tenant or as a joint tenant with a right
of survivorship at the time of the person's death; (3) all of
the person's interests or proceeds of those interests in
securities the person owned in beneficiary form as provided
under sections 524.6-301 to 524.6-311 at the time of the
person's death, to the extent they become part of the probate
estate under section 524.6-307; and (4) all of the person's
interests in joint accounts, multiple party accounts, and pay on
death accounts, or the proceeds of those accounts, as provided
under sections 524.6-201 to 524.6-214 at the time of the
person's death to the extent they become part of the probate
estate under section 524.6-207. Notwithstanding any law or rule
to the contrary, a state or county agency with a claim under
this section shall be a creditor under section 524.6-307.
(c) Notwithstanding any law or rule to the contrary, the
person's life estate or joint tenancy interest in real property
not subject to a medical assistance lien under sections 514.980
to 514.985 on the date of the person's death shall not end upon
the person's death and shall continue as provided in this
subdivision. The life estate in the person's estate shall be
that portion of the interest in the real property subject to the
life estate that is equal to the life estate percentage factor
for the life estate as listed in the Life Estate Mortality Table
of the health care program's manual for a person who was the age
of the medical assistance recipient on the date of the person's
death. The joint tenancy interest in real property in the
estate shall be equal to the fractional interest the person
would have owned in the jointly held interest in the property
had they and the other owners held title to the property as
tenants in common on the date the person died.
(d) The court upon its own motion, or upon motion by the
personal representative or any interested party, may enter an
order directing the remaindermen or surviving joint tenants and
their spouses, if any, to sign all documents, take all actions,
and otherwise fully cooperate with the personal representative
and the court to liquidate the decedent's life estate or joint
tenancy interests in the estate and deliver the cash or the
proceeds of those interests to the personal representative and
provide for any legal and equitable sanctions as the court deems
appropriate to enforce and carry out the order, including an
award of reasonable attorney fees.
(e) The personal representative may make, execute, and
deliver any conveyances or other documents necessary to convey
the decedent's life estate or joint tenancy interest in the
estate that are necessary to liquidate and reduce to cash the
decedent's interest or for any other purposes.
(f) Subject to administration, all costs, including
reasonable attorney fees, directly and immediately related to
liquidating the decedent's life estate or joint tenancy interest
in the decedent's estate, shall be paid from the gross proceeds
of the liquidation allocable to the decedent's interest and the
net proceeds shall be turned over to the personal representative
and applied to payment of the claim presented under this section.
(g) The personal representative shall bring a motion in the
district court in which the estate is being probated to compel
the remaindermen or surviving joint tenants to account for and
deliver to the personal representative all or any part of the
proceeds of any sale, mortgage, transfer, conveyance, or any
disposition of real property allocable to the decedent's life
estate or joint tenancy interest in the decedent's estate, and
do everything necessary to liquidate and reduce to cash the
decedent's interest and turn the proceeds of the sale or other
disposition over to the personal representative. The court may
grant any legal or equitable relief including, but not limited
to, ordering a partition of real estate under chapter 558
necessary to make the value of the decedent's life estate or
joint tenancy interest available to the estate for payment of a
claim under this section.
(h) Subject to administration, the personal representative
shall use all of the cash or proceeds of interests to pay an
allowable claim under this section. The remaindermen or
surviving joint tenants and their spouses, if any, may enter
into a written agreement with the personal representative or the
claimant to settle and satisfy obligations imposed at any time
before or after a claim is filed.
(i) The personal representative may, at their discretion,
provide any or all of the other owners, remaindermen, or
surviving joint tenants with an affidavit terminating the
decedent's estate's interest in real property the decedent owned
as a life tenant or as a joint tenant with others, if the
personal representative determines in good faith that neither
the decedent nor any of the decedent's predeceased spouses
received any medical assistance for which a claim could be filed
under this section, or if the personal representative has filed
an affidavit with the court that the estate has other assets
sufficient to pay a claim, as presented, or if there is a
written agreement under paragraph (h), or if the claim, as
allowed, has been paid in full or to the full extent of the
assets the estate has available to pay it. The affidavit may be
recorded in the office of the county recorder or filed in the
office of the registrar of titles for the county in which the
real property is located. Except as provided in section
514.981, subdivision 6, when recorded or filed, the affidavit
shall terminate the decedent's interest in real estate the
decedent owned as a life tenant or a joint tenant with others.
The affidavit shall: (1) be signed by the personal
representative; (2) identify the decedent and the interest being
terminated; (3) give recording information sufficient to
identify the instrument that created the interest in real
property being terminated; (4) legally describe the affected
real property; (5) state that the personal representative has
determined that neither the decedent nor any of the decedent's
predeceased spouses received any medical assistance for which a
claim could be filed under this section; (6) state that the
decedent's estate has other assets sufficient to pay the claim,
as presented, or that there is a written agreement between the
personal representative and the claimant and the other owners or
remaindermen or other joint tenants to satisfy the obligations
imposed under this subdivision; and (7) state that the affidavit
is being given to terminate the estate's interest under this
subdivision, and any other contents as may be appropriate.
The recorder or registrar of titles shall accept the affidavit
for recording or filing. The affidavit shall be effective as
provided in this section and shall constitute notice even if it
does not include recording information sufficient to identify
the instrument creating the interest it terminates. The
affidavit shall be conclusive evidence of the stated facts.
(j) The holder of a lien arising under subdivision 1c shall
release the lien at the holder's expense against an interest
terminated under paragraph (h) to the extent of the termination.
(k) If a lien arising under subdivision 1c is not released
under paragraph (j), prior to closing the estate, the personal
representative shall deed the interest subject to the lien to
the remaindermen or surviving joint tenants as their interests
may appear. Upon recording or filing, the deed shall work a
merger of the recipient's life estate or joint tenancy interest,
subject to the lien, into the remainder interest or interest the
decedent and others owned jointly. The lien shall attach to and
run with the property to the extent of the decedent's interest
at the time of the decedent's death.
[EFFECTIVE DATE.] This section takes effect on August 1,
2003, and applies to the estates of decedents who die on or
after that date.
Sec. 48. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE
AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision,
the person's estate consists of the person's probate estate and
all of the person's interests in real property the person owned
as a life tenant or a joint tenant at the time of the person's
death.
(b) Notwithstanding any law or rule to the contrary, this
subdivision applies if a person received medical assistance for
which a claim could be filed under this section but for the fact
the person was survived by a spouse or by a person listed in
subdivision 3, or if subdivision 4 applies to a claim arising
under this section.
(c) The person's life estate or joint tenancy interests in
real property not subject to a medical assistance lien under
sections 514.980 to 514.985 on the date of the person's death
shall not end upon death and shall continue as provided in this
subdivision. The life estate in the estate shall be the portion
of the interest in the property subject to the life estate that
is equal to the life estate percentage factor for the life
estate as listed in the Life Estate Mortality Table of the
health care program's manual for a person who was the age of the
medical assistance recipient on the date of the person's death.
The joint tenancy interest in the estate shall be equal to the
fractional interest the medical assistance recipient would have
owned in the jointly held interest in the property had they and
the other owners held title to the property as tenants in common
on the date the medical assistance recipient died.
(d) The county agency shall file a claim in the estate
under this section on behalf of the claimant who shall be the
commissioner of human services, notwithstanding that the
decedent is survived by a spouse or a person listed in
subdivision 3. The claim, as allowed, shall not be paid by the
estate and shall be disposed of as provided in this paragraph.
The personal representative or the court shall make, execute,
and deliver a lien in favor of the claimant on the decedent's
interest in real property in the estate in the amount of the
allowed claim on forms provided by the commissioner to the
county agency filing the lien. The lien shall bear interest as
provided under section 524.3-806, shall attach to the property
it describes upon filing or recording, and shall remain a lien
on the real property it describes for a period of 20 years from
the date it is filed or recorded. The lien shall be a
disposition of the claim sufficient to permit the estate to
close.
(e) The state or county agency shall file or record the
lien in the office of the county recorder or registrar of titles
for each county in which any of the real property is located.
The recorder or registrar of titles shall accept the lien for
filing or recording. All recording or filing fees shall be paid
by the department of human services. The recorder or registrar
of titles shall mail the recorded lien to the department of
human services. The lien need not be attested, certified, or
acknowledged as a condition of recording or filing. Upon
recording or filing of a lien against a life estate or a joint
tenancy interest, the interest subject to the lien shall merge
into the remainder interest or the interest the recipient and
others owned jointly. The lien shall attach to and run with the
property to the extent of the decedent's interest in the
property at the time of the decedent's death as determined under
this section.
(f) The department shall make no adjustment or recovery
under the lien until after the decedent's spouse, if any, has
died, and only at a time when the decedent has no surviving
child described in subdivision 3. The estate, any owner of an
interest in the property which is or may be subject to the lien,
or any other interested party, may voluntarily pay off, settle,
or otherwise satisfy the claim secured or to be secured by the
lien at any time before or after the lien is filed or recorded.
Such payoffs, settlements, and satisfactions shall be deemed to
be voluntary repayments of past medical assistance payments for
the benefit of the deceased recipient, and neither the process
of settling the claim, the payment of the claim, or the
acceptance of a payment shall constitute an adjustment or
recovery that is prohibited under this subdivision.
(g) The lien under this subdivision may be enforced or
foreclosed in the manner provided by law for the enforcement of
judgment liens against real estate or by a foreclosure by action
under chapter 581. When the lien is paid, satisfied, or
otherwise discharged, the state or county agency shall prepare
and file a release of lien at its own expense. No action to
foreclose the lien shall be commenced unless the lien holder has
first given 30 days' prior written notice to pay the lien to the
owners and parties in possession of the property subject to the
lien. The notice shall: (1) include the name, address, and
telephone number of the lien holder; (2) describe the lien; (3)
give the amount of the lien; (4) inform the owner or party in
possession that payment of the lien in full must be made to the
lien holder within 30 days after service of the notice or the
lien holder may begin proceedings to foreclose the lien; and (5)
be served by personal service, certified mail, return receipt
requested, ordinary first class mail, or by publishing it once
in a newspaper of general circulation in the county in which any
part of the property is located. Service of the notice shall be
complete upon mailing or publication.
[EFFECTIVE DATE.] This section takes effect August 1, 2003,
and applies to estates of decedents who die on or after that
date.
Sec. 49. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY
OTHER SURVIVORS.] For purposes of this subdivision, the
provisions in subdivision 1i, paragraphs (a) to (c) apply.
(a) If payment of a claim filed under this section is
limited as provided in subdivision 4, and if the estate does not
have other assets sufficient to pay the claim in full, as
allowed, the personal representative or the court shall make,
execute, and deliver a lien on the property in the estate that
is exempt from the claim under subdivision 4 in favor of the
commissioner of human services on forms provided by the
commissioner to the county agency filing the claim. If the
estate pays a claim filed under this section in full from other
assets of the estate, no lien shall be filed against the
property described in subdivision 4.
(b) The lien shall be in an amount equal to the unpaid
balance of the allowed claim under this section remaining after
the estate has applied all other available assets of the estate
to pay the claim. The property exempt under subdivision 4 shall
not be sold, assigned, transferred, conveyed, encumbered, or
distributed until after the personal representative has
determined the estate has other assets sufficient to pay the
allowed claim in full, or until after the lien has been filed or
recorded. The lien shall bear interest as provided under
section 524.3-806, shall attach to the property it describes
upon filing or recording, and shall remain a lien on the real
property it describes for a period of 20 years from the date it
is filed or recorded. The lien shall be a disposition of the
claim sufficient to permit the estate to close.
(c) The state or county agency shall file or record the
lien in the office of the county recorder or registrar of titles
in each county in which any of the real property is located.
The department shall pay the filing fees. The lien need not be
attested, certified, or acknowledged as a condition of recording
or filing. The recorder or registrar of titles shall accept the
lien for filing or recording.
(d) The commissioner shall make no adjustment or recovery
under the lien until none of the persons listed in subdivision 4
are residing on the property or until the property is sold or
transferred. The estate or any owner of an interest in the
property that is or may be subject to the lien, or any other
interested party, may voluntarily pay off, settle, or otherwise
satisfy the claim secured or to be secured by the lien at any
time before or after the lien is filed or recorded. The
payoffs, settlements, and satisfactions shall be deemed to be
voluntary repayments of past medical assistance payments for the
benefit of the deceased recipient and neither the process of
settling the claim, the payment of the claim, or acceptance of a
payment shall constitute an adjustment or recovery that is
prohibited under this subdivision.
(e) A lien under this subdivision may be enforced or
foreclosed in the manner provided for by law for the enforcement
of judgment liens against real estate or by a foreclosure by
action under chapter 581. When the lien has been paid,
satisfied, or otherwise discharged, the claimant shall prepare
and file a release of lien at the claimant's expense. No action
to foreclose the lien shall be commenced unless the lien holder
has first given 30 days prior written notice to pay the lien to
the record owners of the property and the parties in possession
of the property subject to the lien. The notice shall: (1)
include the name, address, and telephone number of the lien
holder; (2) describe the lien; (3) give the amount of the lien;
(4) inform the owner or party in possession that payment of the
lien in full must be made to the lien holder within 30 days
after service of the notice or the lien holder may begin
proceedings to foreclose the lien; and (5) be served by personal
service, certified mail, return receipt requested, ordinary
first class mail, or by publishing it once in a newspaper of
general circulation in the county in which any part of the
property is located. Service shall be complete upon mailing or
publication.
(f) Upon filing or recording of a lien against a life
estate or joint tenancy interest under this subdivision, the
interest subject to the lien shall merge into the remainder
interest or the interest the decedent and others owned jointly,
effective on the date of recording and filing. The lien shall
attach to and run with the property to the extent of the
decedent's interest in the property at the time of the
decedent's death as determined under this section.
(g)(1) An affidavit may be provided by a personal
representative, at their discretion, stating the personal
representative has determined in good faith that a decedent
survived by a spouse or a person listed in subdivision 3, or by
a person listed in subdivision 4, or the decedent's predeceased
spouse did not receive any medical assistance giving rise to a
claim under this section, or that the real property described in
subdivision 4 is not needed to pay in full a claim arising under
this section.
(2) The affidavit shall: (i) describe the property and the
interest being extinguished; (ii) name the decedent and give the
date of death; (iii) state the facts listed in clause (1); (iv)
state that the affidavit is being filed to terminate the life
estate or joint tenancy interest created under this subdivision;
(v) be signed by the personal representative; and (vi) contain
any other information that the affiant deems appropriate.
(3) Except as provided in section 514.981, subdivision 6,
when the affidavit is filed or recorded, the life estate or
joint tenancy interest in real property that the affidavit
describes shall be terminated effective as of the date of filing
or recording. The termination shall be final and may not be set
aside for any reason.
[EFFECTIVE DATE.] This section takes effect on August 1,
2003, and applies to the estates of decedents who die on or
after that date.
Sec. 50. Minnesota Statutes 2002, section 256B.15, is
amended by adding a subdivision to read:
Subd. 1k. [FILING.] Any notice, lien, release, or other
document filed under subdivisions 1c to 1l, and any lien,
release of lien, or other documents relating to a lien filed
under subdivisions 1h, 1i, and 1j must be filed or recorded in
the office of the county recorder or registrar of titles, as
appropriate, in the county where the affected real property is
located. Notwithstanding section 386.77, the state or county
agency shall pay any applicable filing fee. An attestation,
certification, or acknowledgment is not required as a condition
of filing. If the property described in the filing is
registered property, the registrar of titles shall record the
filing on the certificate of title for each parcel of property
described in the filing. If the property described in the
filing is abstract property, the recorder shall file and index
the property in the county's grantor-grantee indexes and any
tract indexes the county maintains for each parcel of property
described in the filing. The recorder or registrar of titles
shall return the filed document to the party filing it at no
cost. If the party making the filing provides a duplicate copy
of the filing, the recorder or registrar of titles shall show
the recording or filing data on the copy and return it to the
party at no extra cost.
[EFFECTIVE DATE.] This section takes effect on August 1,
2003, and applies to the estates of decedents who die on or
after that date.
Sec. 51. Minnesota Statutes 2002, section 256B.15,
subdivision 3, is amended to read:
Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED
CHILDREN.] If a decedent who is survived by a spouse, or was
single, or who was the surviving spouse of a married couple, and
is survived by a child who is under age 21 or blind or
permanently and totally disabled according to the supplemental
security income program criteria, no a claim shall be filed
against the estate according to this section.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to decedents who die on or after that date.
Sec. 52. Minnesota Statutes 2002, section 256B.15,
subdivision 4, is amended to read:
Subd. 4. [OTHER SURVIVORS.] If the decedent who was single
or the surviving spouse of a married couple is survived by one
of the following persons, a claim exists against the estate in
an amount not to exceed the value of the nonhomestead property
included in the estate and the personal representative shall
make, execute, and deliver to the county agency a lien against
the homestead property in the estate for any unpaid balance of
the claim to the claimant as provided under this section:
(a) a sibling who resided in the decedent medical
assistance recipient's home at least one year before the
decedent's institutionalization and continuously since the date
of institutionalization; or
(b) a son or daughter or a grandchild who resided in the
decedent medical assistance recipient's home for at least two
years immediately before the parent's or grandparent's
institutionalization and continuously since the date of
institutionalization, and who establishes by a preponderance of
the evidence having provided care to the parent or grandparent
who received medical assistance, that the care was provided
before institutionalization, and that the care permitted the
parent or grandparent to reside at home rather than in an
institution.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to decedents who die on or after that date.
Sec. 53. Minnesota Statutes 2002, section 256B.195,
subdivision 3, is amended to read:
Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a)
Effective July 15, 2001, the commissioner shall make the
following payments to the hospitals indicated after noon on the
15th of each month:
(1) to Hennepin County Medical Center, any federal matching
funds available to match the payments received by the medical
center under subdivision 2, to increase payments for medical
assistance admissions and to recognize higher medical assistance
costs in institutions that provide high levels of charity care;
and
(2) to Regions hospital, any federal matching funds
available to match the payments received by the hospital under
subdivision 2, to increase payments for medical assistance
admissions and to recognize higher medical assistance costs in
institutions that provide high levels of charity care.
(b) Effective July 15, 2001, the following percentages of
the transfers under subdivision 2 shall be retained by the
commissioner for deposit each month into the general fund:
(1) 18 percent, plus any federal matching funds, shall be
allocated for the following purposes:
(i) during the fiscal year beginning July 1, 2001, of the
amount available under this clause, 39.7 percent shall be
allocated to make increased hospital payments under section
256.969, subdivision 26; 34.2 percent shall be allocated to fund
the amounts due from small rural hospitals, as defined in
section 144.148, for overpayments under section 256.969,
subdivision 5a, resulting from a determination that medical
assistance and general assistance payments exceeded the charge
limit during the period from 1994 to 1997; and 26.1 percent
shall be allocated to the commissioner of health for rural
hospital capital improvement grants under section 144.148; and
(ii) during fiscal years beginning on or after July 1,
2002, of the amount available under this clause, 55 percent
shall be allocated to make increased hospital payments under
section 256.969, subdivision 26, and 45 percent shall be
allocated to the commissioner of health for rural hospital
capital improvement grants under section 144.148; and
(2) 11 percent shall be allocated to the commissioner of
health to fund community clinic grants under section 145.9268.
(c) This subdivision shall apply to fee-for-service
payments only and shall not increase capitation payments or
payments made based on average rates.
(d) Medical assistance rate or payment changes, including
those required to obtain federal financial participation under
section 62J.692, subdivision 8, shall precede the determination
of intergovernmental transfer amounts determined in this
subdivision. Participation in the intergovernmental transfer
program shall not result in the offset of any health care
provider's receipt of medical assistance payment increases other
than limits resulting from hospital-specific charge limits and
limits on disproportionate share hospital payments.
(e) Effective July 1, 2003, if the amount available for
allocation under paragraph (b) is greater than the amounts
available during March 2003, after any increase in
intergovernmental transfers and payments that result from
section 256.969, subdivision 3a, paragraph (c), are paid to the
general fund, any additional amounts available under this
subdivision after reimbursement of the transfers under
subdivision 2 shall be allocated to increase medical assistance
payments, subject to hospital-specific charge limits and limits
on disproportionate share hospital payments, as follows:
(1) if the payments under subdivision 5 are approved, the
amount shall be paid to the largest ten percent of hospitals as
measured by 2001 payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nonstate
government hospital category. Payments shall be allocated
according to each hospital's proportionate share of the 2001
payments; or
(2) if the payments under subdivision 5 are not approved,
the amount shall be paid to the largest ten percent of hospitals
as measured by 2001 payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nonstate
government category and to the largest ten percent of hospitals
as measured by payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nongovernment
hospital category. Payments shall be allocated according to
each hospital's proportionate share of the 2001 payments in
their respective category of nonstate government and
nongovernment. The commissioner shall determine which hospitals
are in the nonstate government and nongovernment hospital
categories.
Sec. 54. Minnesota Statutes 2002, section 256B.195,
subdivision 5, is amended to read:
Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL
CENTER.] (a) Upon federal approval of the inclusion of Fairview
University Medical Center in the nonstate government
category payments in paragraph (b), the commissioner shall
establish an intergovernmental transfer with the University of
Minnesota in an amount determined by the commissioner based on
the increase in the amount of Medicare upper payment limit due
solely to the inclusion of Fairview University Medical Center as
a nonstate government hospital and limited available for
nongovernment hospitals adjusted by hospital-specific charge
limits and the amount available under the hospital-specific
disproportionate share limit.
(b) Effective July 1, 2003, the commissioner shall increase
payments for medical assistance admissions at Fairview
University Medical Center by 71 percent of the transfer plus any
federal matching payments on that amount, to increase payments
for medical assistance admissions and to recognize higher
medical assistance costs in institutions that provide high
levels of charity care. From this payment, Fairview University
Medical Center shall pay to the University of Minnesota the cost
of the transfer, on the same day the payment is received.
Eighteen percent of the transfer plus any federal matching
payments shall be used as specified in subdivision 3, paragraph
(b), clause (1). Payments under section 256.969, subdivision
26, may be increased above the 90 percent level specified in
that subdivision within the limits of additional funding
available under this subdivision. Eleven percent of the
transfer shall be used to increase the grants under section
145.9268 Twenty-nine percent of the transfer plus federal
matching funds available as a result of the transfers in
subdivision 5 shall be paid to the largest ten percent of
hospitals in the nongovernment hospital category as measured by
2001 payments for medical assistance, general assistance medical
care, and MinnesotaCare. Payments shall be allocated according
to each hospital's proportionate share of the 2001 payments.
The commissioner shall determine which hospitals are in the
nongovernment hospital category.
Sec. 55. Minnesota Statutes 2002, section 256B.32,
subdivision 1, is amended to read:
Subdivision 1. [FACILITY FEE PAYMENT.] (a) The
commissioner shall establish a facility fee payment mechanism
that will pay a facility fee to all enrolled outpatient
hospitals for each emergency room or outpatient clinic visit
provided on or after July 1, 1989. This payment mechanism may
not result in an overall increase in outpatient payment rates.
This section does not apply to federally mandated maximum
payment limits, department approved program packages, or
services billed using a nonoutpatient hospital provider number.
(b) For fee-for-service services provided on or after July
1, 2002, the total payment, before third-party liability and
spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory
rates.
(c) In addition to the reduction in paragraph (b), the
total payment for fee-for-service services provided on or after
July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced
five percent from the current statutory rates. Facilities
defined under section 256.969, subdivision 16, are excluded from
this paragraph.
Sec. 56. Minnesota Statutes 2002, section 256B.69,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For the purposes of this section,
the following terms have the meanings given.
(a) "Commissioner" means the commissioner of human services.
For the remainder of this section, the commissioner's
responsibilities for methods and policies for implementing the
project will be proposed by the project advisory committees and
approved by the commissioner.
(b) "Demonstration provider" means a health maintenance
organization, community integrated service network, or
accountable provider network authorized and operating under
chapter 62D, 62N, or 62T that participates in the demonstration
project according to criteria, standards, methods, and other
requirements established for the project and approved by the
commissioner. For purposes of this section, a county board, or
group of county boards operating under a joint powers agreement,
is considered a demonstration provider if the county or group of
county boards meets the requirements of section 256B.692.
Notwithstanding the above, Itasca county may continue to
participate as a demonstration provider until July 1, 2004.
(c) "Eligible individuals" means those persons eligible for
medical assistance benefits as defined in sections 256B.055,
256B.056, and 256B.06.
(d) "Limitation of choice" means suspending freedom of
choice while allowing eligible individuals to choose among the
demonstration providers.
(e) This paragraph supersedes paragraph (c) as long as the
Minnesota health care reform waiver remains in effect. When the
waiver expires, this paragraph expires and the commissioner of
human services shall publish a notice in the State Register and
notify the revisor of statutes. "Eligible individuals" means
those persons eligible for medical assistance benefits as
defined in sections 256B.055, 256B.056, and 256B.06.
Notwithstanding sections 256B.055, 256B.056, and 256B.06, an
individual who becomes ineligible for the program because of
failure to submit income reports or recertification forms in a
timely manner, shall remain enrolled in the prepaid health plan
and shall remain eligible to receive medical assistance coverage
through the last day of the month following the month in which
the enrollee became ineligible for the medical assistance
program.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
or upon federal approval, whichever is later.
Sec. 57. Minnesota Statutes 2002, section 256B.69,
subdivision 4, is amended to read:
Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner
shall develop criteria to determine when limitation of choice
may be implemented in the experimental counties. The criteria
shall ensure that all eligible individuals in the county have
continuing access to the full range of medical assistance
services as specified in subdivision 6.
(b) The commissioner shall exempt the following persons
from participation in the project, in addition to those who do
not meet the criteria for limitation of choice:
(1) persons eligible for medical assistance according to
section 256B.055, subdivision 1;
(2) persons eligible for medical assistance due to
blindness or disability as determined by the social security
administration or the state medical review team, unless:
(i) they are 65 years of age or older; or
(ii) they reside in Itasca county or they reside in a
county in which the commissioner conducts a pilot project under
a waiver granted pursuant to section 1115 of the Social Security
Act;
(3) recipients who currently have private coverage through
a health maintenance organization;
(4) recipients who are eligible for medical assistance by
spending down excess income for medical expenses other than the
nursing facility per diem expense;
(5) recipients who receive benefits under the Refugee
Assistance Program, established under United States Code, title
8, section 1522(e);
(6) children who are both determined to be severely
emotionally disturbed and receiving case management services
according to section 256B.0625, subdivision 20;
(7) adults who are both determined to be seriously and
persistently mentally ill and received case management services
according to section 256B.0625, subdivision 20; and
(8) persons eligible for medical assistance according to
section 256B.057, subdivision 10; and
(9) persons with access to cost-effective
employer-sponsored private health insurance or persons enrolled
in an individual health plan determined to be cost-effective
according to section 256B.0625, subdivision 15.
Children under age 21 who are in foster placement may enroll in
the project on an elective basis. Individuals excluded under
clauses (6) and (7) may choose to enroll on an elective
basis. The commissioner may enroll recipients in the prepaid
medical assistance program for seniors who are (1) age 65 and
over, and (2) eligible for medical assistance by spending down
excess income.
(c) The commissioner may allow persons with a one-month
spenddown who are otherwise eligible to enroll to voluntarily
enroll or remain enrolled, if they elect to prepay their monthly
spenddown to the state.
(d) The commissioner may require those individuals to
enroll in the prepaid medical assistance program who otherwise
would have been excluded under paragraph (b), clauses (1), (3),
and (8), and under Minnesota Rules, part 9500.1452, subpart 2,
items H, K, and L.
(e) Before limitation of choice is implemented, eligible
individuals shall be notified and after notification, shall be
allowed to choose only among demonstration providers. The
commissioner may assign an individual with private coverage
through a health maintenance organization, to the same health
maintenance organization for medical assistance coverage, if the
health maintenance organization is under contract for medical
assistance in the individual's county of residence. After
initially choosing a provider, the recipient is allowed to
change that choice only at specified times as allowed by the
commissioner. If a demonstration provider ends participation in
the project for any reason, a recipient enrolled with that
provider must select a new provider but may change providers
without cause once more within the first 60 days after
enrollment with the second provider.
Sec. 58. Minnesota Statutes 2002, section 256B.69,
subdivision 5, is amended to read:
Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The
commissioner shall establish the method and amount of payments
for services. The commissioner shall annually contract with
demonstration providers to provide services consistent with
these established methods and amounts for payment.
If allowed by the commissioner, a demonstration provider
may contract with an insurer, health care provider, nonprofit
health service plan corporation, or the commissioner, to provide
insurance or similar protection against the cost of care
provided by the demonstration provider or to provide coverage
against the risks incurred by demonstration providers under this
section. The recipients enrolled with a demonstration provider
are a permissible group under group insurance laws and chapter
62C, the Nonprofit Health Service Plan Corporations Act. Under
this type of contract, the insurer or corporation may make
benefit payments to a demonstration provider for services
rendered or to be rendered to a recipient. Any insurer or
nonprofit health service plan corporation licensed to do
business in this state is authorized to provide this insurance
or similar protection.
Payments to providers participating in the project are
exempt from the requirements of sections 256.966 and 256B.03,
subdivision 2. The commissioner shall complete development of
capitation rates for payments before delivery of services under
this section is begun. For payments made during calendar year
1990 and later years, the commissioner shall contract with an
independent actuary to establish prepayment rates.
By January 15, 1996, the commissioner shall report to the
legislature on the methodology used to allocate to participating
counties available administrative reimbursement for advocacy and
enrollment costs. The report shall reflect the commissioner's
judgment as to the adequacy of the funds made available and of
the methodology for equitable distribution of the funds. The
commissioner must involve participating counties in the
development of the report.
Beginning July 1, 2004, the commissioner may include
payments for elderly waiver services and 180 days of nursing
home care in capitation payments for the prepaid medical
assistance program for recipients age 65 and older. Payments
for elderly waiver services shall be made no earlier than the
month following the month in which services were received.
Sec. 59. Minnesota Statutes 2002, section 256B.69,
subdivision 5a, 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. The
commissioner may issue separate contracts with requirements
specific to services to medical assistance recipients age 65 and
older.
(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. Each performance target must
be quantifiable, objective, measurable, and reasonably
attainable, except in the case of a performance target based on
a federal or state law or rule. Criteria for assessment of each
performance target must be outlined in writing prior to the
contract effective date. The withheld funds 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 or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount
withheld under this paragraph that is reasonably expected to be
returned.
[EFFECTIVE DATE.] This section is effective for services
rendered on or after July 1, 2003, except that the amendment to
paragraph (c) is effective for services rendered on or after
January 1, 2004.
Sec. 60. Minnesota Statutes 2002, section 256B.69,
subdivision 5c, is amended to read:
Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a)
Except as provided in paragraph (c), the commissioner of human
services shall transfer each year to the medical education and
research fund established under section 62J.692, the following:
(1) an amount equal to the reduction in the prepaid medical
assistance and prepaid general assistance medical care payments
as specified in this clause. Until January 1, 2002, the county
medical assistance and general assistance medical care
capitation base rate prior to plan specific adjustments and
after the regional rate adjustments under section 256B.69,
subdivision 5b, is reduced 6.3 percent for Hennepin county, two
percent for the remaining metropolitan counties, and no
reduction for nonmetropolitan Minnesota counties; and after
January 1, 2002, the county medical assistance and general
assistance medical care capitation base rate prior to plan
specific adjustments is reduced 6.3 percent for Hennepin county,
two percent for the remaining metropolitan counties, and 1.6
percent for nonmetropolitan Minnesota counties. Nursing
facility and elderly waiver payments and demonstration project
payments operating under subdivision 23 are excluded from this
reduction. The amount calculated under this clause shall not be
adjusted for periods already paid due to subsequent changes to
the capitation payments;
(2) beginning July 1, 2001, $2,537,000 2003, $2,157,000
from the capitation rates paid under this section plus any
federal matching funds on this amount;
(3) beginning July 1, 2002, an additional $12,700,000 from
the capitation rates paid under this section; and
(4) beginning July 1, 2003, an additional $4,700,000 from
the capitation rates paid under this section.
(b) This subdivision shall be effective upon approval of a
federal waiver which allows federal financial participation in
the medical education and research fund.
(c) Effective July 1, 2003, the amount reduced from the
prepaid general assistance medical care payments under paragraph
(a), clause (1), shall be transferred to the general fund.
Sec. 61. Minnesota Statutes 2002, section 256B.69, is
amended by adding a subdivision to read:
Subd. 5h. [PAYMENT REDUCTION.] In addition to the
reduction in subdivision 5g, the total payment made to managed
care plans under the medical assistance program is reduced 1.0
percent for services provided on or after October 1, 2003, and
an additional 1.0 percent for services provided on or after
January 1, 2004. This provision excludes payments for nursing
home services, home and community-based waivers, and payments to
demonstration projects for persons with disabilities.
Sec. 62. Minnesota Statutes 2002, section 256B.69,
subdivision 6a, is amended to read:
Subd. 6a. [NURSING HOME SERVICES.] (a) Notwithstanding
Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 180
days of nursing facility services as defined in section
256B.0625, subdivision 2, which are provided in a nursing
facility certified by the Minnesota department of health for
services provided and eligible for payment under Medicaid, shall
be covered under the prepaid medical assistance program for
individuals who are not residing in a nursing facility at the
time of enrollment in the prepaid medical assistance
program. The commissioner may develop a schedule to phase in
implementation of the 180-day provision.
(b) For individuals enrolled in the Minnesota senior health
options project authorized under subdivision 23, nursing
facility services shall be covered according to the terms and
conditions of the federal agreement governing that demonstration
project.
Sec. 63. Minnesota Statutes 2002, section 256B.69,
subdivision 6b, is amended to read:
Subd. 6b. [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a)
For individuals enrolled in the Minnesota senior health options
project authorized under subdivision 23, elderly waiver services
shall be covered according to the terms and conditions of the
federal agreement governing that demonstration project.
(b) For individuals under age 65 enrolled in demonstrations
authorized under subdivision 23, home and community-based waiver
services shall be covered according to the terms and conditions
of the federal agreement governing that demonstration project.
(c) Notwithstanding Minnesota Rules, part 9500.1457,
subpart 1, item C, elderly waiver services shall be covered
under the prepaid medical assistance program for all individuals
who are eligible according to section 256B.0915. The
commissioner may develop a schedule to phase in implementation
of these waiver services.
Sec. 64. Minnesota Statutes 2002, section 256B.69, is
amended by adding a subdivision to read:
Subd. 6d. [PRESCRIPTION DRUGS.] Effective January 1, 2004,
the commissioner may exclude or modify coverage for prescription
drugs from the prepaid managed care contracts entered into under
this section in order to increase savings to the state by
collecting additional prescription drug rebates. The contracts
must maintain incentives for the managed care plan to manage
drug costs and utilization and may require that the managed care
plans maintain an open drug formulary. In order to manage drug
costs and utilization, the contracts may authorize the managed
care plans to use preferred drug lists and prior authorization.
This subdivision is contingent on federal approval of the
managed care contract changes and the collection of additional
prescription drug rebates.
Sec. 65. Minnesota Statutes 2002, section 256B.69,
subdivision 8, is amended to read:
Subd. 8. [PREADMISSION SCREENING WAIVER.] Except as
applicable to the project's operation, the provisions of section
256B.0911 are waived for the purposes of this section for
recipients enrolled with demonstration providers or in the
prepaid medical assistance program for seniors.
Sec. 66. Minnesota Statutes 2002, section 256B.75, is
amended to read:
256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.]
(a) For outpatient hospital facility fee payments for
services rendered on or after October 1, 1992, the commissioner
of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992,
except for those services for which there is a federal maximum
allowable payment. Effective for services rendered on or after
January 1, 2000, payment rates for nonsurgical outpatient
hospital facility fees and emergency room facility fees shall be
increased by eight percent over the rates in effect on December
31, 1999, except for those services for which there is a federal
maximum allowable payment. Services for which there is a
federal maximum allowable payment shall be paid at the lower of
(1) submitted charge, or (2) the federal maximum allowable
payment. Total aggregate payment for outpatient hospital
facility fee services shall not exceed the Medicare upper
limit. If it is determined that a provision of this section
conflicts with existing or future requirements of the United
States government with respect to federal financial
participation in medical assistance, the federal requirements
prevail. The commissioner may, in the aggregate, prospectively
reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the
Medicare upper limitations.
(b) Notwithstanding paragraph (a), payment for outpatient,
emergency, and ambulatory surgery hospital facility fee services
for critical access hospitals designated under section 144.1483,
clause (11), shall be paid on a cost-based payment system that
is based on the cost-finding methods and allowable costs of the
Medicare program.
(c) Effective for services provided on or after July 1,
2003, rates that are based on the Medicare outpatient
prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical
assistance data. The commissioner shall provide a proposal to
the 2003 legislature to define and implement this provision.
(d) For fee-for-service services provided on or after July
1, 2002, the total payment, before third-party liability and
spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory
rate.
(e) In addition to the reduction in paragraph (d), the
total payment for fee-for-service services provided on or after
July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced
five percent from the current statutory rates. Facilities
defined under section 256.969, subdivision 16, are excluded from
this paragraph.
Sec. 67. Minnesota Statutes 2002, 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 Centers for Medicare and Medicaid
Services' common procedural coding system 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 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.
(f) Effective for services rendered on or after January 1,
2007, the commissioner shall make payments for physician and
professional services based on the Medicare relative value units
(RVUs). This change shall be budget neutral and the cost of
implementing RVUs will be incorporated in the established
conversion factor.
Sec. 68. Minnesota Statutes 2002, section 256D.03,
subdivision 3, is amended to read:
Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.]
(a) General assistance medical care may be paid for any person
who is not eligible for medical assistance under chapter 256B,
including eligibility for medical assistance based on a
spenddown of excess income according to section 256B.056,
subdivision 5, or MinnesotaCare as defined in paragraph (b),
except as provided in paragraph (c);, and:
(1) who is receiving assistance under section 256D.05,
except for families with children who are eligible under
Minnesota family investment program (MFIP), or who is having a
payment made on the person's behalf under sections 256I.01 to
256I.06, or who resides in group residential housing as defined
in chapter 256I and can meet a spenddown using the cost of
remedial services received through group residential housing; or
(2)(i) who is a resident of Minnesota; and
(i) who has gross countable income not in excess of 75
percent of the federal poverty guidelines for the family size,
using a six-month budget period and whose equity in assets is
not in excess of $1,000 per assistance unit. Exempt assets, the
reduction of excess assets, and the waiver of excess assets must
conform to the medical assistance program in chapter
256B section 256B.056, subdivision 3, with the following
exception: the maximum amount of undistributed funds in a trust
that could be distributed to or on behalf of the beneficiary by
the trustee, assuming the full exercise of the trustee's
discretion under the terms of the trust, must be applied toward
the asset maximum; and or
(ii) who has gross countable income not in excess above 75
percent of the assistance standards established in section
256B.056, subdivision 5c, paragraph (b), or whose excess income
is spent down to that standard using a six-month budget period.
The method for calculating earned income disregards and
deductions for a person who resides with a dependent child under
age 21 shall follow the AFDC income disregard and deductions in
effect under the July 16, 1996, AFDC state plan. The earned
income and work expense deductions for a person who does not
reside with a dependent child under age 21 shall be the same as
the method used to determine eligibility for a person under
section 256D.06, subdivision 1, except the disregard of the
first $50 of earned income is not allowed;
(3) who would be eligible for medical assistance except
that the person resides in a facility that is determined by the
commissioner or the federal Centers for Medicare and Medicaid
Services to be an institution for mental diseases; or
(4) who is ineligible for medical assistance under chapter
256B or general assistance medical care under any other
provision of this section, and is receiving care and
rehabilitation services from a nonprofit center established to
serve victims of torture. These individuals are eligible for
general assistance medical care only for the period during which
they are receiving services from the center. During this period
of eligibility, individuals eligible under this clause shall not
be required to participate in prepaid general assistance medical
care the federal poverty guidelines but not in excess of 175
percent of the federal poverty guidelines for the family size,
using a six-month budget period, whose equity in assets is not
in excess of the limits in section 256B.056, subdivision 3c, and
who applies during an inpatient hospitalization.
(b) Beginning January 1, 2000, General assistance medical
care may not be paid for applicants or recipients who meet all
eligibility requirements of MinnesotaCare as defined in sections
256L.01 to 256L.16, and are:
(i) adults with dependent children under 21 whose gross
family income is equal to or less than 275 percent of the
federal poverty guidelines; or.
(ii) adults without children with earned income and whose
family gross income is between 75 percent of the federal poverty
guidelines and the amount set by section 256L.04, subdivision 7,
shall be terminated from general assistance medical care upon
enrollment in MinnesotaCare. Earned income is deemed available
to family members as defined in section 256D.02, subdivision 8.
(c) For services rendered on or after July 1, 1997,
eligibility is limited to one month prior to application if the
person is determined eligible in the prior month applications
received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible
under paragraph (a), clause (2), item (i), a redetermination of
eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during
inpatient hospitalization but may reapply if there is a
subsequent period of inpatient hospitalization. Beginning
January 1, 2000, Minnesota health care program applications
completed by recipients and applicants who are persons described
in paragraph (b), may be returned to the county agency to be
forwarded to the department of human services or sent directly
to the department of human services for enrollment in
MinnesotaCare. If all other eligibility requirements of this
subdivision are met, eligibility for general assistance medical
care shall be available in any month during which a
MinnesotaCare eligibility determination and enrollment are
pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance
medical care shall be sent to an applicant or recipient. If all
other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be
available until enrollment in MinnesotaCare subject to the
provisions of paragraph (e).
(d) The date of an initial Minnesota health care program
application necessary to begin a determination of eligibility
shall be the date the applicant has provided a name, address,
and social security number, signed and dated, to the county
agency or the department of human services. If the applicant is
unable to provide an initial application a name, address, social
security number, and signature when health care is delivered due
to a medical condition or disability, a health care provider may
act on the person's an applicant's behalf to complete the
establish the date of an initial Minnesota health care program
application by providing the county agency or department of
human services with provider identification and a temporary
unique identifier for the applicant. The applicant must
complete the remainder of the application and provide necessary
verification before eligibility can be determined. The county
agency must assist the applicant in obtaining verification if
necessary. On the basis of information provided on the
completed application, an applicant who meets the following
criteria shall be determined eligible beginning in the month of
application:
(1) has gross income less than 90 percent of the applicable
income standard;
(2) has liquid assets that total within $300 of the asset
standard;
(3) does not reside in a long-term care facility; and
(4) meets all other eligibility requirements.
The applicant must provide all required verifications within 30
days' notice of the eligibility determination or eligibility
shall be terminated.
(e) County agencies are authorized to use all automated
databases containing information regarding recipients' or
applicants' income in order to determine eligibility for general
assistance medical care or MinnesotaCare. Such use shall be
considered sufficient in order to determine eligibility and
premium payments by the county agency.
(f) General assistance medical care is not available for a
person in a correctional facility unless the person is detained
by law for less than one year in a county correctional or
detention facility as a person accused or convicted of a crime,
or admitted as an inpatient to a hospital on a criminal hold
order, and the person is a recipient of general assistance
medical care at the time the person is detained by law or
admitted on a criminal hold order and as long as the person
continues to meet other eligibility requirements of this
subdivision.
(g) General assistance medical care is not available for
applicants or recipients who do not cooperate with the county
agency to meet the requirements of medical assistance. General
assistance medical care is limited to payment of emergency
services only for applicants or recipients as described in
paragraph (b), whose MinnesotaCare coverage is denied or
terminated for nonpayment of premiums as required by sections
256L.06 and 256L.07.
(h) In determining the amount of assets of an
individual eligible under paragraph (a), clause (2), item (i),
there shall be included any asset or interest in an asset,
including an asset excluded under paragraph (a), that was given
away, sold, or disposed of for less than fair market value
within the 60 months preceding application for general
assistance medical care or during the period of eligibility.
Any transfer described in this paragraph shall be presumed to
have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes
convincing evidence to establish that the transaction was
exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair
market value at the time it was given away, sold, or disposed
of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility,
including partial months, shall be calculated by dividing the
uncompensated transfer amount by the average monthly per person
payment made by the medical assistance program to skilled
nursing facilities for the previous calendar year. The
individual shall remain ineligible until this fixed period has
expired. The period of ineligibility may exceed 30 months, and
a reapplication for benefits after 30 months from the date of
the transfer shall not result in eligibility unless and until
the period of ineligibility has expired. The period of
ineligibility begins in the month the transfer was reported to
the county agency, or if the transfer was not reported, the
month in which the county agency discovered the transfer,
whichever comes first. For applicants, the period of
ineligibility begins on the date of the first approved
application.
(i) When determining eligibility for any state benefits
under this subdivision, the income and resources of all
noncitizens shall be deemed to include their sponsor's income
and resources as defined in the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, title IV, Public Law
Number 104-193, sections 421 and 422, and subsequently set out
in federal rules.
(j)(1) An Undocumented noncitizen or a nonimmigrant
is noncitizens and nonimmigrants are ineligible for general
assistance medical care other than emergency services, except an
individual eligible under paragraph (a), clause (4), remains
eligible through September 30, 2003. For purposes of this
subdivision, a nonimmigrant is an individual in one or more of
the classes listed in United States Code, title 8, section
1101(a)(15), and an undocumented noncitizen is an individual who
resides in the United States without the approval or
acquiescence of the Immigration and Naturalization Service.
(2) This paragraph does not apply to a child under age 18,
to a Cuban or Haitian entrant as defined in Public Law Number
96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is
aged, blind, or disabled as defined in Code of Federal
Regulations, title 42, sections 435.520, 435.530, 435.531,
435.540, and 435.541, or effective October 1, 1998, to an
individual eligible for general assistance medical care under
paragraph (a), clause (4), who cooperates with the Immigration
and Naturalization Service to pursue any applicable immigration
status, including citizenship, that would qualify the individual
for medical assistance with federal financial participation.
(k) For purposes of paragraphs (g) and (j), "emergency
services" has the meaning given in Code of Federal Regulations,
title 42, section 440.255(b)(1), except that it also means
services rendered because of suspected or actual pesticide
poisoning.
(l) Notwithstanding any other provision of law, a
noncitizen who is ineligible for medical assistance due to the
deeming of a sponsor's income and resources, is ineligible for
general assistance medical care.
(l) Effective July 1, 2003, general assistance medical care
emergency services end.
[EFFECTIVE DATE.] (a) The amendments to paragraph (a),
clauses (1) to (4), and paragraphs (b), (c), and (h), are
effective October 1, 2003. For applications processed within
one calendar month prior to the effective date, eligibility will
be determined by applying the income standards and methodologies
in effect prior to the effective date for any months in the
six-month budget period before that date and the income
standards and methodologies in effect on the effective date for
any months in the six-month budget period on or after that
date. The income standards for each month will be added
together and compared to the applicant's total countable income
for the six-month budget period to determine eligibility.
(b) The amendments to paragraphs (d), (g), (j), and (k),
are effective July 1, 2003.
Sec. 69. Minnesota Statutes 2002, section 256D.03,
subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.]
(a)(i) For a person who is eligible under subdivision 3,
paragraph (a), clause (3) (2), item (i), general assistance
medical care covers, except as provided in paragraph (c):
(1) inpatient hospital services;
(2) outpatient hospital services;
(3) services provided by Medicare certified rehabilitation
agencies;
(4) prescription drugs and other products recommended
through the process established in section 256B.0625,
subdivision 13;
(5) equipment necessary to administer insulin and
diagnostic supplies and equipment for diabetics to monitor blood
sugar level;
(6) eyeglasses and eye examinations provided by a physician
or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray services;
(10) physician's services;
(11) medical transportation except special transportation;
(12) chiropractic services as covered under the medical
assistance program;
(13) podiatric services;
(14) dental services and dentures, subject to the
limitations specified in section 256B.0625, subdivision 9;
(15) outpatient services provided by a mental health center
or clinic that is under contract with the county board and is
established under section 245.62;
(16) day treatment services for mental illness provided
under contract with the county board;
(17) prescribed medications for persons who have been
diagnosed as mentally ill as necessary to prevent more
restrictive institutionalization;
(18) psychological services, medical supplies and
equipment, and Medicare premiums, coinsurance and deductible
payments;
(19) medical equipment not specifically listed in this
paragraph when the use of the equipment will prevent the need
for costlier services that are reimbursable under this
subdivision;
(20) services performed by a certified pediatric nurse
practitioner, a certified family nurse practitioner, a certified
adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or
a certified geriatric nurse practitioner in independent
practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an
inpatient basis is not included as part of the cost for
inpatient services included in the operating payment rate, and
(3) the service is within the scope of practice of the nurse
practitioner's license as a registered nurse, as defined in
section 148.171;
(21) services of a certified public health nurse or a
registered nurse practicing in a public health nursing clinic
that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the
scope of practice of the public health nurse's license as a
registered nurse, as defined in section 148.171; and
(22) telemedicine consultations, to the extent they are
covered under section 256B.0625, subdivision 3b.
(ii) Effective October 1, 2003, for a person who is
eligible under subdivision 3, paragraph (a), clause (2), item
(ii), general assistance medical care coverage is limited to
inpatient hospital services, including physician services
provided during the inpatient hospital stay. A $1,000
deductible is required for each inpatient hospitalization.
(b) Except as provided in paragraph (c), for a recipient
who is eligible under subdivision 3, paragraph (a), clause (1)
or (2), general assistance medical care covers the services
listed in paragraph (a) with the exception of special
transportation services.
(c) Gender reassignment surgery and related services are
not covered services under this subdivision unless the
individual began receiving gender reassignment services prior to
July 1, 1995.
(d) (c) In order to contain costs, the commissioner of
human services shall select vendors of medical care who can
provide the most economical care consistent with high medical
standards and shall where possible contract with organizations
on a prepaid capitation basis to provide these services. The
commissioner shall consider proposals by counties and vendors
for prepaid health plans, competitive bidding programs, block
grants, or other vendor payment mechanisms designed to provide
services in an economical manner or to control utilization, with
safeguards to ensure that necessary services are provided.
Before implementing prepaid programs in counties with a county
operated or affiliated public teaching hospital or a hospital or
clinic operated by the University of Minnesota, the commissioner
shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to
participate in the program in a manner that reflects the risk of
adverse selection and the nature of the patients served by the
hospital, provided the terms of participation in the program are
competitive with the terms of other participants considering the
nature of the population served. Payment for services provided
pursuant to this subdivision shall be as provided to medical
assistance vendors of these services under sections 256B.02,
subdivision 8, and 256B.0625. For payments made during fiscal
year 1990 and later years, the commissioner shall consult with
an independent actuary in establishing prepayment rates, but
shall retain final control over the rate methodology.
Notwithstanding the provisions of subdivision 3, an individual
who becomes ineligible for general assistance medical care
because of failure to submit income reports or recertification
forms in a timely manner, shall remain enrolled in the prepaid
health plan and shall remain eligible for general assistance
medical care coverage through the last day of the month in which
the enrollee became ineligible for general assistance medical
care.
(e) There shall be no copayment required of any recipient
of benefits for any services provided under this subdivision.
A hospital receiving a reduced payment as a result of this
section may apply the unpaid balance toward satisfaction of the
hospital's bad debts.
(d) Recipients eligible under subdivision 3, paragraph (a),
clause (2), item (i), shall pay the following co-payments for
services provided on or after October 1, 2003:
(1) $3 per nonpreventive visit. For purposes of this
subdivision, a visit means an episode of service which is
required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory
setting by a physician or physician ancillary, chiropractor,
podiatrist, nurse midwife, mental health professional, advanced
practice nurse, physical therapist, occupational therapist,
speech therapist, audiologist, optician, or optometrist;
(2) $25 for eyeglasses;
(3) $25 for nonemergency visits to a hospital-based
emergency room;
(4) $3 per brand-name drug prescription and $1 per generic
drug prescription, subject to a $20 per month maximum for
prescription drug co-payments. No co-payments shall apply to
antipsychotic drugs when used for the treatment of mental
illness; and
(5) 50 percent coinsurance on basic restorative dental
services.
(e) Recipients of general assistance medical care are
responsible for all co-payments in this subdivision. The
general assistance medical care reimbursement to the provider
shall be reduced by the amount of the co-payment, except that
reimbursement for prescription drugs shall not be reduced once a
recipient has reached the $20 per month maximum for prescription
drug co-payments. The provider collects the co-payment from the
recipient. Providers may not deny services to recipients who
are unable to pay the co-payment, except as provided in
paragraph (f).
(f) If it is the routine business practice of a provider to
refuse service to an individual with uncollected debt, the
provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient
with uncollected debt before services can be denied.
(f) (g) Any county may, from its own resources, provide
medical payments for which state payments are not made.
(g) (h) Chemical dependency services that are reimbursed
under chapter 254B must not be reimbursed under general
assistance medical care.
(h) (i) The maximum payment for new vendors enrolled in the
general assistance medical care program after the base year
shall be determined from the average usual and customary charge
of the same vendor type enrolled in the base year.
(i) (j) The conditions of payment for services under this
subdivision are the same as the conditions specified in rules
adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.
(k) Inpatient and outpatient payments shall be reduced by
five percent, effective July 1, 2003. This reduction is in
addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (i).
(l) Payments for all other health services except
inpatient, outpatient, and pharmacy services shall be reduced by
five percent, effective July 1, 2003.
(m) Payments to managed care plans shall be reduced by five
percent for services provided on or after October 1, 2003.
(n) A hospital receiving a reduced payment as a result of
this section may apply the unpaid balance toward satisfaction of
the hospital's bad debts.
[EFFECTIVE DATE.] This section is effective October 1,
2003, except that paragraph (c) is effective July 1, 2003.
Sec. 70. Minnesota Statutes 2002, section 256G.05,
subdivision 2, is amended to read:
Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not
required for receiving emergency assistance in the Minnesota
supplemental aid program. The receipt of emergency assistance
must not be used as a factor in determining county or state
residence. Non-Minnesota residents are not eligible for
emergency general assistance medical care, except emergency
hospital services, and professional services incident to the
hospital services, for the treatment of acute trauma resulting
from an accident occurring in Minnesota. To be eligible under
this subdivision a non-Minnesota resident must verify that they
are not eligible for coverage under any other health care
program, including coverage from a program in their state of
residence.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 71. Minnesota Statutes 2002, section 256L.03,
subdivision 1, is amended to read:
Subdivision 1. [COVERED HEALTH SERVICES.] For individuals
under section 256L.04, subdivision 7, with income no greater
than 75 percent of the federal poverty guidelines or for
families with children under section 256L.04, subdivision 1, all
subdivisions of this section apply. "Covered health services"
means the health services reimbursed under chapter 256B, with
the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care
services other than preventive services services covered under
section 256B.0625, subdivision 9, paragraph (b), orthodontic
services, nonemergency medical transportation services, personal
care assistant and case management services, nursing home or
intermediate care facilities services, inpatient mental health
services, and chemical dependency services. Effective July 1,
1998, adult dental care for nonpreventive services with the
exception of orthodontic services is available to persons who
qualify under section 256L.04, subdivisions 1 to 7, with family
gross income equal to or less than 175 percent of the federal
poverty guidelines. Outpatient mental health services covered
under the MinnesotaCare program are limited to diagnostic
assessments, psychological testing, explanation of findings,
medication management by a physician, day treatment, partial
hospitalization, and individual, family, and group psychotherapy.
No public funds shall be used for coverage of abortion
under MinnesotaCare except where the life of the female would be
endangered or substantial and irreversible impairment of a major
bodily function would result if the fetus were carried to term;
or where the pregnancy is the result of rape or incest.
Covered health services shall be expanded as provided in
this section.
[EFFECTIVE DATE.] This section is effective October 1, 2003.
Sec. 72. [256L.035] [LIMITED BENEFITS COVERAGE FOR CERTAIN
SINGLE ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.]
(a) "Covered health services" for individuals under section
256L.04, subdivision 7, with income above 75 percent, but not
exceeding 175 percent, of the federal poverty guideline means:
(1) inpatient hospitalization benefits with a ten percent
co-payment up to $1,000 and subject to an annual limitation of
$10,000;
(2) physician services provided during an inpatient stay;
and
(3) physician services not provided during an inpatient
stay, outpatient hospital services, chiropractic services, lab
and diagnostic services, and prescription drugs, subject to an
aggregate cap of $2,000 per calendar year and the following
co-payments:
(i) $50 co-pay per emergency room visit;
(ii) $3 co-pay per prescription drug; and
(iii) $5 co-pay per nonpreventive physician visit.
For purposes of this subdivision, "a visit" means an
episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is
delivered in an ambulatory setting by a physician or physician
ancillary.
Enrollees are responsible for all co-payments in this
subdivision.
(b) The November 2006 MinnesotaCare forecast for the
biennium beginning July 1, 2007, shall assume an adjustment in
the aggregate cap on the services identified in paragraph (a),
clause (3), in $1,000 increments up to a maximum of $10,000, but
not less than $2,000, to the extent that the balance in the
health care access fund is sufficient in each year of the
biennium to pay for this benefit level. The aggregate cap shall
be adjusted according to the forecast.
(c) Reimbursement to the providers shall be reduced by the
amount of the co-payment, except that reimbursement for
prescription drugs shall not be reduced once a recipient has
reached the $20 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the
recipient. Providers may not deny services to recipients who
are unable to pay the co-payment, except as provided in
paragraph (d).
(d) If it is the routine business practice of a provider to
refuse service to an individual with uncollected debt, the
provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient
with uncollected debt before services can be denied.
[EFFECTIVE DATE.] This section is effective October 1, 2003.
Sec. 73. Minnesota Statutes 2002, section 256L.04,
subdivision 1, is amended to read:
Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with
children with family income equal to or less than 275 percent of
the federal poverty guidelines for the applicable family size
shall be eligible for MinnesotaCare according to this section.
All other provisions of sections 256L.01 to 256L.18, including
the insurance-related barriers to enrollment under section
256L.07, shall apply unless otherwise specified.
(b) Parents who enroll in the MinnesotaCare program must
also enroll their children and dependent siblings, if the
children and their dependent siblings are eligible. Children
and dependent siblings may be enrolled separately without
enrollment by parents. However, if one parent in the household
enrolls, both parents must enroll, unless other insurance is
available. If one child from a family is enrolled, all children
must be enrolled, unless other insurance is available. If one
spouse in a household enrolls, the other spouse in the household
must also enroll, unless other insurance is available. Families
cannot choose to enroll only certain uninsured members.
(c) Beginning October 1, 2003, the dependent sibling
definition no longer applies to the MinnesotaCare program.
These persons are no longer counted in the parental household
and may apply as a separate household.
(d) Beginning July 1, 2003, or upon federal approval,
whichever is later, parents are not eligible for MinnesotaCare
if their gross income exceeds $50,000.
[EFFECTIVE DATE.] This section is effective October 1,
2003, unless the statutory language specifies a different
effective date.
Sec. 74. Minnesota Statutes 2002, section 256L.04,
subdivision 10, is amended to read:
Subd. 10. [CITIZENSHIP REQUIREMENTS.] Eligibility for
MinnesotaCare is limited to citizens of the United States,
qualified noncitizens, and other persons residing lawfully in
the United States as described in section 256B.06, subdivision
4, paragraphs (a) to (e) and (j). Undocumented noncitizens and
nonimmigrants are ineligible for MinnesotaCare. For purposes of
this subdivision, a nonimmigrant is an individual in one or more
of the classes listed in United States Code, title 8, section
1101(a)(15), and an undocumented noncitizen is an individual who
resides in the United States without the approval or
acquiescence of the Immigration and Naturalization Service.
Subd. 10a. [SPONSOR'S INCOME AND RESOURCES DEEMED
AVAILABLE; DOCUMENTATION.] When determining eligibility for any
federal or state benefits under sections 256L.01 to 256L.18, the
income and resources of all noncitizens whose sponsor signed an
affidavit of support as defined under United States Code, title
8, section 1183a, shall be deemed to include their sponsors'
income and resources as defined in the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996, title IV,
Public Law Number 104-193, sections 421 and 422, and
subsequently set out in federal rules. To be eligible for the
program, noncitizens must provide documentation of their
immigration status.
Sec. 75. Minnesota Statutes 2002, section 256L.05,
subdivision 3a, is amended to read:
Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January
1, 1999, an enrollee's eligibility must be renewed every 12
months. The 12-month period begins in the month after the month
the application is approved.
(b) Beginning October 1, 2004, an enrollee's eligibility
must be renewed every six months. The first six-month period of
eligibility begins in the month after the month the application
is approved. Each new period of eligibility must take into
account any changes in circumstances that impact eligibility and
premium amount. An enrollee must provide all the information
needed to redetermine eligibility by the first day of the month
that ends the eligibility period. The premium for the new
period of eligibility must be received as provided in section
256L.06 in order for eligibility to continue.
Sec. 76. Minnesota Statutes 2002, section 256L.05,
subdivision 4, is amended to read:
Subd. 4. [APPLICATION PROCESSING.] The commissioner of
human services shall determine an applicant's eligibility for
MinnesotaCare no more than 30 days from the date that the
application is received by the department of human services.
Beginning January 1, 2000, this requirement also applies to
local county human services agencies that determine eligibility
for MinnesotaCare. Once annually at application or
reenrollment, to prevent processing delays, applicants or
enrollees who, from the information provided on the application,
appear to meet eligibility requirements shall be enrolled upon
timely payment of premiums. The enrollee must provide all
required verifications within 30 days of notification of the
eligibility determination or coverage from the program shall be
terminated. Enrollees who are determined to be ineligible when
verifications are provided shall be disenrolled from the program.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
or upon federal approval, whichever is later.
Sec. 77. Minnesota Statutes 2002, section 256L.06,
subdivision 3, is amended to read:
Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums
are dedicated to the commissioner for MinnesotaCare.
(b) The commissioner shall develop and implement procedures
to: (1) require enrollees to report changes in income; (2)
adjust sliding scale premium payments, based upon changes in
enrollee income; and (3) disenroll enrollees from MinnesotaCare
for failure to pay required premiums. Failure to pay includes
payment with a dishonored check, a returned automatic bank
withdrawal, or a refused credit card or debit card payment. The
commissioner may demand a guaranteed form of payment, including
a cashier's check or a money order, as the only means to replace
a dishonored, returned, or refused payment.
(c) Premiums are calculated on a calendar month basis and
may be paid on a monthly, quarterly, or annual semiannual basis,
with the first payment due upon notice from the commissioner of
the premium amount required. The commissioner shall inform
applicants and enrollees of these premium payment options.
Premium payment is required before enrollment is complete and to
maintain eligibility in MinnesotaCare. Premium payments
received before noon are credited the same day. Premium
payments received after noon are credited on the next working
day.
(d) Nonpayment of the premium will result in disenrollment
from the plan effective for the calendar month for which the
premium was due. Persons disenrolled for nonpayment or who
voluntarily terminate coverage from the program may not reenroll
until four calendar months have elapsed. Persons disenrolled
for nonpayment who pay all past due premiums as well as current
premiums due, including premiums due for the period of
disenrollment, within 20 days of disenrollment, shall be
reenrolled retroactively to the first day of disenrollment.
Persons disenrolled for nonpayment or who voluntarily terminate
coverage from the program may not reenroll for four calendar
months unless the person demonstrates good cause for
nonpayment. Good cause does not exist if a person chooses to
pay other family expenses instead of the premium. The
commissioner shall define good cause in rule.
[EFFECTIVE DATE.] This section is effective October 1, 2004.
Sec. 78. Minnesota Statutes 2002, section 256L.07,
subdivision 1, is amended to read:
Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children
enrolled in the original children's health plan as of September
30, 1992, children who enrolled in the MinnesotaCare program
after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross
incomes that are equal to or less than 175 150 percent of the
federal poverty guidelines are eligible without meeting the
requirements of subdivision 2 and the four-month requirement in
subdivision 3, as long as they maintain continuous coverage in
the MinnesotaCare program or medical assistance. Children who
apply for MinnesotaCare on or after the implementation date of
the employer-subsidized health coverage program as described in
Laws 1998, chapter 407, article 5, section 45, who have family
gross incomes that are equal to or less than 175 150 percent of
the federal poverty guidelines, must meet the requirements of
subdivision 2 to be eligible for MinnesotaCare.
(b) Families enrolled in MinnesotaCare under section
256L.04, subdivision 1, whose income increases above 275 percent
of the federal poverty guidelines, are no longer eligible for
the program and shall be disenrolled by the commissioner.
Individuals enrolled in MinnesotaCare under section 256L.04,
subdivision 7, whose income increases above 175 percent of the
federal poverty guidelines are no longer eligible for the
program and shall be disenrolled by the commissioner. For
persons disenrolled under this subdivision, MinnesotaCare
coverage terminates the last day of the calendar month following
the month in which the commissioner determines that the income
of a family or individual exceeds program income limits.
(c)(1) Notwithstanding paragraph (b), individuals and
families enrolled in MinnesotaCare under section 256L.04,
subdivision 1, may remain enrolled in MinnesotaCare if ten
percent of their annual income is less than the annual premium
for a policy with a $500 deductible available through the
Minnesota comprehensive health association. Individuals and
Families who are no longer eligible for MinnesotaCare under this
subdivision shall be given an 18-month notice period from the
date that ineligibility is determined before
disenrollment. This clause expires February 1, 2004.
(2) Effective February 1, 2004, notwithstanding paragraph
(b), children may remain enrolled in MinnesotaCare if ten
percent of their annual family income is less than the annual
premium for a policy with a $500 deductible available through
the Minnesota comprehensive health association. Children who
are no longer eligible for MinnesotaCare under this clause shall
be given a 12-month notice period from the date that
ineligibility is determined before disenrollment. The premium
for children remaining eligible under this clause shall be the
maximum premium determined under section 256L.15, subdivision 2,
paragraph (b).
(d) Effective July 1, 2003, notwithstanding paragraphs (b)
and (c), parents are no longer eligible for MinnesotaCare if
gross household income exceeds $50,000.
[EFFECTIVE DATE.] The amendments to paragraph (a) are
effective July 1, 2003. The amendments to paragraph (c), clause
(1), are effective October 1, 2003.
Sec. 79. Minnesota Statutes 2002, section 256L.07,
subdivision 3, is amended to read:
Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and
individuals enrolled in the MinnesotaCare program must have no
health coverage while enrolled or for at least four months prior
to application and renewal. Children enrolled in the original
children's health plan and children in families with income
equal to or less than 175 150 percent of the federal poverty
guidelines, who have other health insurance, are eligible if the
coverage:
(1) lacks two or more of the following:
(i) basic hospital insurance;
(ii) medical-surgical insurance;
(iii) prescription drug coverage;
(iv) dental coverage; or
(v) vision coverage;
(2) requires a deductible of $100 or more per person per
year; or
(3) lacks coverage because the child has exceeded the
maximum coverage for a particular diagnosis or the policy
excludes a particular diagnosis.
The commissioner may change this eligibility criterion for
sliding scale premiums in order to remain within the limits of
available appropriations. The requirement of no health coverage
does not apply to newborns.
(b) Medical assistance, general assistance medical care,
and the Civilian Health and Medical Program of the Uniformed
Service, CHAMPUS, or other coverage provided under United States
Code, title 10, subtitle A, part II, chapter 55, are not
considered insurance or health coverage for purposes of the
four-month requirement described in this subdivision.
(c) For purposes of this subdivision, Medicare Part A or B
coverage under title XVIII of the Social Security Act, United
States Code, title 42, sections 1395c to 1395w-4, is considered
health coverage. An applicant or enrollee may not refuse
Medicare coverage to establish eligibility for MinnesotaCare.
(d) Applicants who were recipients of medical assistance or
general assistance medical care within one month of application
must meet the provisions of this subdivision and subdivision 2.
(e) Effective October 1, 2003, applicants who were
recipients of medical assistance and had cost-effective health
insurance which was paid for by medical assistance are exempt
from the four-month requirement under this section.
[EFFECTIVE DATE.] This section is effective July 1, 2003,
except where a different effective date is specified in the text.
Sec. 80. Minnesota Statutes 2002, section 256L.12,
subdivision 6, is amended to read:
Subd. 6. [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are
responsible for all copayments in section sections 256L.03,
subdivision 4 5, and 256L.035, and shall pay copayments to the
managed care plan or to its participating providers. The
enrollee is also responsible for payment of inpatient hospital
charges which exceed the MinnesotaCare benefit limit.
Sec. 81. Minnesota Statutes 2002, section 256L.12,
subdivision 9, is amended to read:
Subd. 9. [RATE SETTING; PERFORMANCE WITHHOLDS.] (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, to
December 31, 2003, the commissioner shall withhold .5 percent of
managed care plan payments under this section pending completion
of performance targets. The withheld funds 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.
(c) For services rendered on or after January 1, 2004, the
commissioner shall withhold five percent of managed care plan
payments under this section pending completion of performance
targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the
case of a performance target based on a federal or state law or
rule. Criteria for assessment of each performance target must
be outlined in writing prior to the contract effective date.
The withheld funds must be returned no sooner than July 1 and no
later than July 31 of the following calendar year if performance
targets in the contract are achieved. A managed care plan or a
county-based purchasing plan under section 256B.692 may include
as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.
[EFFECTIVE DATE.] This section is effective for services
rendered on or after July 1, 2003, except as otherwise provided
in the statutory language.
Sec. 82. Minnesota Statutes 2002, section 256L.12, is
amending by adding a subdivision to read:
Subd. 9a. [RATE SETTING; RATABLE REDUCTION.] For services
rendered on or after October 1, 2003, the total payment made to
managed care plans under the MinnesotaCare program is reduced
1.0 percent.
Sec. 83. Minnesota Statutes 2002, section 256L.15,
subdivision 1, is amended to read:
Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with
children and individuals shall pay a premium determined
according to a sliding fee based on a percentage of the family's
gross family income subdivision 2.
(b) Pregnant women and children under age two are exempt
from the provisions of section 256L.06, subdivision 3, paragraph
(b), clause (3), requiring disenrollment for failure to pay
premiums. For pregnant women, this exemption continues until
the first day of the month following the 60th day postpartum.
Women who remain enrolled during pregnancy or the postpartum
period, despite nonpayment of premiums, shall be disenrolled on
the first of the month following the 60th day postpartum for the
penalty period that otherwise applies under section 256L.06,
unless they begin paying premiums.
Sec. 84. Minnesota Statutes 2002, section 256L.15,
subdivision 2, is amended to read:
Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF
GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall
establish a sliding fee scale to determine the percentage of
gross individual or family income that households at different
income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on
the enrollee's gross individual or family income. The sliding
fee scale must contain separate tables based on enrollment of
one, two, or three or more persons. The sliding fee scale
begins with a premium of 1.5 percent of gross individual or
family income for individuals or families with incomes below the
limits for the medical assistance program for families and
children in effect on January 1, 1999, and proceeds through the
following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9,
7.4, and 8.8 percent. These percentages are matched to evenly
spaced income steps ranging from the medical assistance income
limit for families and children in effect on January 1, 1999, to
275 percent of the federal poverty guidelines for the applicable
family size, up to a family size of five. The sliding fee scale
for a family of five must be used for families of more than
five. Effective October 1, 2003, the commissioner shall
increase each percentage by 0.5 percentage points for enrollees
with income greater than 100 percent but not exceeding 200
percent of the federal poverty guidelines and shall increase
each percentage by 1.0 percentage points for families and
children with incomes greater than 200 percent of the federal
poverty guidelines. The sliding fee scale and percentages are
not subject to the provisions of chapter 14. If a family or
individual reports increased income after enrollment, premiums
shall not be adjusted until eligibility renewal.
(b)(1) Enrolled individuals and families whose gross annual
income increases above 275 percent of the federal poverty
guideline shall pay the maximum premium. This clause expires
effective February 1, 2004.
(2) Effective February 1, 2004, children in families whose
gross income is above 275 percent of the federal poverty
guidelines shall pay the maximum premium.
(3) The maximum premium is defined as a base charge for
one, two, or three or more enrollees so that if all
MinnesotaCare cases paid the maximum premium, the total revenue
would equal the total cost of MinnesotaCare medical coverage and
administration. In this calculation, administrative costs shall
be assumed to equal ten percent of the total. The costs of
medical coverage for pregnant women and children under age two
and the enrollees in these groups shall be excluded from the
total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or
more enrollees shall be three times the maximum premium for one.
[EFFECTIVE DATE.] The amendments to this section are
effective October 1, 2003, unless specified otherwise in the
statutory text.
Sec. 85. Minnesota Statutes 2002, section 256L.15,
subdivision 3, is amended to read:
Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium
of $48 is required for all children in families with income at
or less than 175 150 percent of federal poverty guidelines.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 86. Minnesota Statutes 2002, section 256L.17,
subdivision 2, is amended to read:
Subd. 2. [LIMIT ON TOTAL ASSETS.] (a) Effective July 1,
2002, or upon federal approval, whichever is later, in order to
be eligible for the MinnesotaCare program, a household of two or
more persons must not own more than $30,000 $20,000 in total net
assets, and a household of one person must not own more
than $15,000 $10,000 in total net assets.
(b) For purposes of this subdivision, assets are determined
according to section 256B.056, subdivision 3c.
[EFFECTIVE DATE.] This section is effective July 1, 2003.
Sec. 87. Minnesota Statutes 2002, section 295.53,
subdivision 1, is amended to read:
Subdivision 1. [EXEMPTIONS.] (a) The following payments
are excluded from the gross revenues subject to the hospital,
surgical center, or health care provider taxes under sections
295.50 to 295.57:
(1) payments received for services provided under the
Medicare program, including payments received from the
government, and organizations governed by sections 1833 and 1876
of title XVIII of the federal Social Security Act, United States
Code, title 42, section 1395, and enrollee deductibles,
coinsurance, and co-payments, whether paid by the Medicare
enrollee or by a Medicare supplemental coverage as defined in
section 62A.011, subdivision 3, clause (10). Payments for
services not covered by Medicare are taxable;
(2) medical assistance payments including payments received
directly from the government or from a prepaid plan;
(3) payments received for home health care services;
(4) (3) payments received from hospitals or surgical
centers for goods and services on which liability for tax is
imposed under section 295.52 or the source of funds for the
payment is exempt under clause (1), (2), (7), (8),
(10) (7), (13) (10), or (20) (17);
(5) (4) payments received from health care providers for
goods and services on which liability for tax is imposed under
this chapter or the source of funds for the payment is exempt
under clause (1), (2), (7), (8), (10) (7), (13) (10),
or (20) (17);
(6) (5) amounts paid for legend drugs, other than
nutritional products, to a wholesale drug distributor who is
subject to tax under section 295.52, subdivision 3, reduced by
reimbursements received for legend drugs otherwise exempt under
this chapter;
(7) payments received under the general assistance medical
care program including payments received directly from the
government or from a prepaid plan;
(8) payments received for providing services under the
MinnesotaCare program including payments received directly from
the government or from a prepaid plan and enrollee deductibles,
coinsurance, and copayments. For purposes of this clause,
coinsurance means the portion of payment that the enrollee is
required to pay for the covered service;
(9) (6) payments received by a health care provider or the
wholly owned subsidiary of a health care provider for care
provided outside Minnesota;
(10) (7) payments received from the chemical dependency
fund under chapter 254B;
(11) (8) payments received in the nature of charitable
donations that are not designated for providing patient services
to a specific individual or group;
(12) (9) payments received for providing patient services
incurred through a formal program of health care research
conducted in conformity with federal regulations governing
research on human subjects. Payments received from patients or
from other persons paying on behalf of the patients are subject
to tax;
(13) (10) payments received from any governmental agency
for services benefiting the public, not including payments made
by the government in its capacity as an employer or insurer or
payments made by the government for services provided under
medical assistance, general assistance medical care, or the
MinnesotaCare program;
(14) (11) payments received for services provided by
community residential mental health facilities licensed under
Minnesota Rules, parts 9520.0500 to 9520.0690, community support
programs and family community support programs approved under
Minnesota Rules, parts 9535.1700 to 9535.1760, and community
mental health centers as defined in section 245.62, subdivision
2;
(15) (12) government payments received by a regional
treatment center;
(16) (13) payments received for hospice care services;
(17) (14) payments received by a health care provider for
hearing aids and related equipment or prescription eyewear
delivered outside of Minnesota;
(18) (15) payments received by an educational institution
from student tuition, student activity fees, health care service
fees, government appropriations, donations, or grants. Fee for
service payments and payments for extended coverage are taxable;
(19) (16) payments received for services provided by:
assisted living programs and congregate housing programs; and
(20) (17) payments received under the federal Employees
Health Benefits Act, United States Code, title 5, section
8909(f), as amended by the Omnibus Reconciliation Act of 1990.
(b) Payments received by wholesale drug distributors for
legend drugs sold directly to veterinarians or veterinary bulk
purchasing organizations are excluded from the gross revenues
subject to the wholesale drug distributor tax under sections
295.50 to 295.59.
[EFFECTIVE DATE.] This section is effective for services
rendered on or after January 1, 2004.
Sec. 88. Minnesota Statutes 2002, section 297I.15,
subdivision 1, is amended to read:
Subdivision 1. [GOVERNMENT PAYMENTS.] Premiums under
medical assistance, general assistance medical care, the
MinnesotaCare program, and the Minnesota comprehensive health
insurance plan and all payments, revenues, and reimbursements
received from the federal government for Medicare-related
coverage as defined in section 62A.31, subdivision 3, are not
subject to tax under this chapter.
[EFFECTIVE DATE.] This section is effective for premiums
paid to health carriers on or after January 1, 2004.
Sec. 89. Minnesota Statutes 2002, section 297I.15,
subdivision 4, is amended to read:
Subd. 4. [PREMIUMS PAID TO HEALTH CARRIERS BY STATE.] A
health carrier as defined in section 62A.011 is exempt from the
taxes imposed under this chapter on premiums paid to it by the
state. Premiums paid by the state under medical assistance,
general assistance medical care, and the MinnesotaCare program
are not exempt under this subdivision.
[EFFECTIVE DATE.] This section is effective for premiums
paid to health carriers on or after January 1, 2004.
Sec. 90. Minnesota Statutes 2002, section 514.981,
subdivision 6, is amended to read:
Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES
AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on
the real property it describes for a period of ten years from
the date it attaches according to section 514.981, subdivision
2, paragraph (a), except as otherwise provided for in sections
514.980 to 514.985. The agency may renew a medical assistance
lien for an additional ten years from the date it would
otherwise expire by recording or filing a certificate of renewal
before the lien expires. The certificate shall be recorded or
filed in the office of the county recorder or registrar of
titles for the county in which the lien is recorded or filed.
The certificate must refer to the recording or filing data for
the medical assistance lien it renews. The certificate need not
be attested, certified, or acknowledged as a condition for
recording or filing. The registrar of titles or the recorder
shall file, record, index, and return the certificate of renewal
in the same manner as provided for medical assistance liens in
section 514.982, subdivision 2.
(b) A medical assistance lien is not enforceable against
the real property of an estate to the extent there is a
determination by a court of competent jurisdiction, or by an
officer of the court designated for that purpose, that there are
insufficient assets in the estate to satisfy the agency's
medical assistance lien in whole or in part because of the
homestead exemption under section 256B.15, subdivision 4, the
rights of the surviving spouse or minor children under section
524.2-403, paragraphs (a) and (b), or claims with a priority
under section 524.3-805, paragraph (a), clauses (1) to (4). For
purposes of this section, the rights of the decedent's adult
children to exempt property under section 524.2-403, paragraph
(b), shall not be considered costs of administration under
section 524.3-805, paragraph (a), clause (1).
(c) Notwithstanding any law or rule to the contrary, the
provisions in clauses (1) to (7) apply if a life estate subject
to a medical assistance lien ends according to its terms, or if
a medical assistance recipient who owns a life estate or any
interest in real property as a joint tenant that is subject to a
medical assistance lien dies.
(1) The medical assistance recipient's life estate or joint
tenancy interest in the real property shall not end upon the
recipient's death but shall merge into the remainder interest or
other interest in real property the medical assistance recipient
owned in joint tenancy with others. The medical assistance lien
shall attach to and run with the remainder or other interest in
the real property to the extent of the medical assistance
recipient's interest in the property at the time of the
recipient's death as determined under this section.
(2) If the medical assistance recipient's interest was a
life estate in real property, the lien shall be a lien against
the portion of the remainder equal to the percentage factor for
the life estate of a person the medical assistance recipient's
age on the date the life estate ended according to its terms or
the date of the medical assistance recipient's death as listed
in the Life Estate Mortality Table in the health care program's
manual.
(3) If the medical assistance recipient owned the interest
in real property in joint tenancy with others, the lien shall be
a lien against the portion of that interest equal to the
fractional interest the medical assistance recipient would have
owned in the jointly owned interest had the medical assistance
recipient and the other owners held title to that interest as
tenants in common on the date the medical assistance recipient
died.
(4) The medical assistance lien shall remain a lien against
the remainder or other jointly owned interest for the length of
time and be renewable as provided in paragraph (a).
(5) Subdivision 5, paragraphs (a), clause (4), (b), clauses
(1) and (2); and subdivision 6, paragraph (b), do not apply to
medical assistance liens which attach to interests in real
property as provided under this subdivision.
(6) The continuation of a medical assistance recipient's
life estate or joint tenancy interest in real property after the
medical assistance recipient's death for the purpose of
recovering medical assistance provided for in sections 514.980
to 514.985 modifies common law principles holding that these
interests terminate on the death of the holder.
(7) Notwithstanding any law or rule to the contrary, no
release, satisfaction, discharge, or affidavit under section
256B.15 shall extinguish or terminate the life estate or joint
tenancy interest of a medical assistance recipient subject to a
lien under sections 514.980 to 514.985 on the date the recipient
dies.
(8) The provisions of clauses (1) to (7) do not apply to a
homestead owned of record, on the date the recipient dies, by
the recipient and the recipient's spouse as joint tenants with a
right of survivorship. Homestead means the real property
occupied by the surviving joint tenant spouse as their sole
residence on the date the recipient dies and classified and
taxed to the recipient and surviving joint tenant spouse as
homestead property for property tax purposes in the calendar
year in which the recipient dies. For purposes of this
exemption, real property the recipient and their surviving joint
tenant spouse purchase solely with the proceeds from the sale of
their prior homestead, own of record as joint tenants, and
qualify as homestead property under section 273.124 in the
calendar year in which the recipient dies and prior to the
recipient's death shall be deemed to be real property classified
and taxed to the recipient and their surviving joint tenant
spouse as homestead property in the calendar year in which the
recipient dies. The surviving spouse, or any person with
personal knowledge of the facts, may provide an affidavit
describing the homestead property affected by this clause and
stating facts showing compliance with this clause. The
affidavit shall be prima facie evidence of the facts it states.
[EFFECTIVE DATE.] This section is effective August 1, 2003,
and applies to all medical assistance liens recorded or filed on
or after that date.
Sec. 91. Minnesota Statutes 2002, section 641.15,
subdivision 2, is amended to read:
Subd. 2. [MEDICAL AID.] Except as provided in section
466.101, the county board shall pay the costs of medical
services provided to prisoners. The amount paid by the Anoka
county board for a medical service shall not exceed the maximum
allowed medical assistance payment rate for the service, as
determined by the commissioner of human services. The county is
entitled to reimbursement from the prisoner for payment of
medical bills to the extent that the prisoner to whom the
medical aid was provided has the ability to pay the bills. The
prisoner shall, at a minimum, incur copayment obligations for
health care services provided by a county correctional
facility. The county board shall determine the copayment
amount. Notwithstanding any law to the contrary, the copayment
shall be deducted from any of the prisoner's funds held by the
county, to the extent possible. If there is a disagreement
between the county and a prisoner concerning the prisoner's
ability to pay, the court with jurisdiction over the defendant
shall determine the extent, if any, of the prisoner's ability to
pay for the medical services. If a prisoner is covered by
health or medical insurance or other health plan when medical
services are provided, the county providing the medical services
has a right of subrogation to be reimbursed by the insurance
carrier for all sums spent by it for medical services to the
prisoner that are covered by the policy of insurance or health
plan, in accordance with the benefits, limitations, exclusions,
provider restrictions, and other provisions of the policy or
health plan. The county may maintain an action to enforce this
subrogation right. The county does not have a right of
subrogation against the medical assistance program or the
general assistance medical care program.
Sec. 92. [PHARMACY PLUS WAIVER.]
(a) The commissioner of human services shall seek a
pharmacy plus federal waiver for the prescription drug program
in Minnesota Statutes, section 256.955, that uses the
accumulated savings from all pharmacy and asset transfer
provisions in this act and previously adopted pharmacy savings
strategies as the factor to prove fiscal neutrality. If the
waiver is approved and federal funds are received for the
prescription drug program, the commissioner shall expand
eligibility for the program in the following order:
(1) increase income eligibility up to 135 percent of the
federal poverty guidelines for individuals eligible under
Minnesota Statutes, section 256.955, subdivision 2a; and
(2) increase income eligibility up to 135 percent of the
federal poverty guidelines for individuals eligible under
Minnesota Statutes, section 256.955, subdivision 2b.
(b) If eligibility is increased, the commissioner shall
publish the new income eligibility levels for the program in the
State Register and shall inform the agencies and organizations
serving senior citizens and persons with disabilities.
Sec. 93. [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
CRITERIA AND POTENTIAL COST SAVINGS.]
The commissioner of human services, in consultation with
the commissioner of transportation and special transportation
service providers, shall review eligibility criteria for medical
assistance special transportation services and shall evaluate
whether the level of special transportation services provided
should be based on the degree of impairment of the client, as
well as the medical diagnosis. The commissioner shall also
evaluate methods for reducing the cost of special transportation
services, including, but not limited to:
(1) requiring providers to maintain a daily log book
confirming delivery of clients to medical facilities;
(2) requiring providers to implement commercially available
computer mapping programs to calculate mileage for purposes of
reimbursement;
(3) restricting special transportation service from being
provided solely for trips to pharmacies;
(4)modifying eligibility for special transportation;
(5) expanding alternatives to the use of special
transportation services;
(6) improving the process of certifying persons as eligible
for special transportation services; and
(7) examining the feasibility and benefits of licensing
special transportation providers.
The commissioner shall present recommendations for changes
in the eligibility criteria and potential cost-savings for
special transportation services to the chairs and ranking
minority members of the house and senate committees having
jurisdiction over health and human services spending by January
15, 2004. The commissioner is prohibited from using a broker or
coordinator to manage special transportation services until July
1, 2005, except for the purposes of checking for recipient
eligibility, authorizing recipients for appropriate level of
transportation, and monitoring provider compliance with
Minnesota Statutes, section 256B.0625, subdivision 17. This
prohibition does not apply to the purchase or management of
common carrier transportation.
Sec. 94. [FEDERAL APPROVAL.]
If the amendments to Minnesota Statutes, sections 256.046,
subdivision 1, and 256.98, subdivision 8, are not effective
because of prohibitions in federal law, the commissioner of
human services shall seek the federal waivers and authority
necessary to implement the provisions.
Sec. 95. [WITHHOLD EXEMPTION.]
The commissioner of human services may exempt from the five
percent withhold in Minnesota Statutes, section 256B.69,
subdivision 5a, paragraph (c), and the five percent withhold in
Minnesota Statutes, section 256L.12, subdivision 9, paragraph
(b), a managed care plan that has entered into a managed care
contract with the commissioner in accordance with Minnesota
Statutes, section 256B.69 or 256L.12, if the contract was the
initial contract between the managed care plan and the
commissioner, and it was entered into after January 1, 2000.
If an exemption is given, the exemption shall only apply
for the first five years of operation of the managed care plan.
Sec. 96. [DRUG PURCHASING PROGRAM.]
The commissioner of human services, in consultation with
other state agencies, shall evaluate whether participation in a
multistate or multiagency drug purchasing program can reduce
costs or improve the operations of the drug benefit programs
administered by the commissioner and other state agencies. The
commissioner shall also evaluate the possibility of contracting
with a vendor or other states for purposes of participating in a
multistate or multiagency drug purchasing program. The
commissioner shall submit the recommendations to the legislature
by January 15, 2004.
Sec. 97. [MAIL ORDER DISPENSING OF PRESCRIPTION DRUGS.]
The commissioner of human services shall assess the cost
savings that could be generated by the mail order dispensing of
prescription drugs to recipients of medical assistance, general
assistance medical care, and the prescription drug program. The
report shall include the viability of contracting with mail
order pharmacy vendors to provide mail order dispensing for
state public programs. The commissioner shall report to the
chairs and ranking minority members of the health and human
services finance committees by January 7, 2004.
Sec. 98. [NONPROFIT FOUNDATION GRANTS.]
(a) The commissioner of human services may accept grants or
donations from a nonprofit charitable foundation for the purpose
of increasing dental access in the medical assistance program.
(b) The commissioner may increase the critical access
dental payments under Minnesota Statutes, section 256B.76,
paragraph (c), and use any money received under paragraph (a)
for the nonfederal state share of the medical assistance cost.
Sec. 99. [PHARMACEUTICAL CARE DEMONSTRATION PROJECT.]
(a) The commissioner shall seek federal approval for a
demonstration project to provide culturally specific
pharmaceutical care to American Indian medical assistance
recipients who are age 55 and older. In developing the
demonstration project, the commissioner shall consult with
organizations and health care providers experienced in
developing and implementing culturally competent intervention
strategies to manage the use of prescription drugs,
over-the-counter drugs, other drug products, and native
therapies by American Indian elders.
(b) For purposes of this section, "pharmaceutical care"
means the provision of drug therapy and native therapy for the
purpose of improving a patient's quality of life by: (1) curing
a disease; (2) eliminating or reducing a patient's symptoms; (3)
arresting or slowing a disease process; or (4) preventing a
disease or a symptom. Pharmaceutical care involves the
documented process through which a pharmacist cooperates with a
patient and other professionals in designing, implementing, and
monitoring a therapeutic plan that is expected to produce
specific therapeutic outcomes, through the identification,
resolution, and prevention of drug-related problems. Nothing in
this project shall be construed to expand or modify the scope of
practice of the pharmacist as defined in Minnesota Statutes,
section 151.01, subdivision 27.
(c) Upon receipt of federal approval, the commissioner
shall report to the legislature for legislative approval for
implementation of the demonstration project.
Sec. 100. [HEALTH CARE PROGRAM REDUCTIONS.]
The commissioner of human services may implement changes to
the medical assistance, general assistance medical care, and
MinnesotaCare programs, which will result in a reduction in
state expenditures during the period of July 1, 2004, through
June 30, 2005. The commissioner may use the following options
to achieve this savings:
(1) require providers to use generally accepted clinical
practice guidelines for specific services;
(2) implement clinical care coordination programs,
including chronic and acute care disease management programs;
and
(3) volume purchase health services as established in
Minnesota Statutes, section 256B.04, subdivision 14, except that
special transportation services shall be subject to the
timelines established in Minnesota Statutes, section 256B.0625,
subdivision 17.
The commissioner shall notify the chairs of the house and
senate health and human services policy and finance committees
of any changes implemented as a result of this section.
Sec. 101. [REPEALER.]
(a) Minnesota Statutes 2002, sections 256.955, subdivision
8; and 256B.057, subdivision 1b, are repealed July 1, 2003.
(b) Minnesota Statutes 2002, section 256B.055, subdivision
10a, is repealed July 1, 2003, or upon federal approval,
whichever is later.
ARTICLE 13A
HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS
Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]
The dollar amounts shown in the columns marked
"APPROPRIATIONS" are added to or, if shown in parentheses, are
subtracted from the appropriations in Laws 2001, First Special
Session chapter 9, as amended by Laws 2002, chapter 220, and
Laws 2002, chapter 374, and are appropriated from the general
fund, or any other fund named, to the agencies and for the
purposes specified in this article, to be available for the
fiscal year indicated for each purpose. The figure "2003" used
in this article means that the appropriation or appropriations
listed under it are available for the fiscal year ending June
30, 2003.
SUMMARY BY FUND
2003
General $103,756,000
Health Care Access (1,492,000)
Federal TANF 20,419,000
APPROPRIATIONS
Available for the Year
Ending June 30, 2003
Sec. 2. COMMISSIONER OF
HUMAN SERVICES
Subdivision 1. Total
Appropriation $128,203,000
Summary by Fund
General 109,276,000
Health Care Access (1,492,000)
Federal TANF 20,419,000
Subd. 2. Administrative
Reimbursement/Pass-through 1,180,000
Subd. 3. Basic Health Care
Grants
General 59,364,000
Health Care Access (1,492,000)
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) MinnesotaCare Grants
Health Care Access (1,492,000)
(b) MA Basic Health Care Grants -
Families and Children
General 14,708,000
(c) MA Basic Health Care Grants -
Elderly and Disabled
General 15,137,000
(d) General Assistance Medical Care
Grants
General 29,519,000
Subd. 4. Continuing Care Grants
General 56,615,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Medical Assistance Long-Term Care
Waivers and Home Care Grants
General 57,388,000
(b) Medical Assistance Long-Term Care
Facilities Grants
General 678,000
(c) Group Residential Housing Grants
General (1,451,000)
Subd. 5. Economic Support Grants
General (6,703,000)
Federal TANF 19,239,000
The amounts that may be spent from the
appropriation for each purpose are as
follows:
(a) Assistance to Families Grants
General (9,306,000)
Federal TANF 19,239,000
(b) General Assistance Grants
General 3,491,000
(c) Minnesota Supplemental Aid Grants
General (888,000)
Sec. 3. COMMISSIONER OF HEALTH
Subdivision 1. Total Appropriation (5,520,000)
Summary by Fund
General (5,520,000)
Subd. 2. Access and Quality Improvement (5,520,000)
Sec. 4. [EFFECTIVE DATE.]
Sections 1 to 3 are effective the day following final
enactment.
ARTICLE 13B
DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING
FORECAST ADJUSTMENT
Section 1. [ADJUSTMENT.]
The dollar amounts shown are added to or, if shown in
parentheses, are subtracted from the appropriations in Laws
2001, First Special Session chapter 6, as amended by Laws 2002,
chapter 220, and Laws 2002, chapter 374, or other law, and are
appropriated from the general fund to the department of
children, families, and learning for the purposes specified in
this article, to be available for the fiscal year indicated for
each purpose. The figure "2003" used in this article means that
the appropriation or appropriations listed are available for the
fiscal year ending June 30, 2003.
2003
APPROPRIATION CHANGE
Sec. 2. APPROPRIATIONS; EARLY CHILDHOOD
AND FAMILY EDUCATION
MFIP Child Care 6,817,000
ARTICLE 13C
APPROPRIATIONS
Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]
The sums shown in the columns marked "APPROPRIATIONS" are
appropriated from the general fund, or any other fund named, to
the agencies and for the purposes specified in the sections of
this article, to be available for the fiscal years indicated for
each purpose. The figures "2004" and "2005" where used in this
article, mean that the appropriation or appropriations listed
under them are available for the fiscal year ending June 30,
2004, or June 30, 2005, respectively. Where a dollar amount
appears in parentheses, it means a reduction of an appropriation.
SUMMARY BY FUND
BIENNIAL
2004 2005 TOTAL
General $3,765,212,000 $3,727,319,000 $7,492,531,000
State Government
Special Revenue 45,337,000 45,104,000 90,441,000
Health Care
Access 294,090,000 308,525,000 602,615,000
Federal TANF 261,552,000 270,364,000 531,916,000
Lottery Prize
Fund 1,556,000 1,556,000 3,112,000
Special Revenue 3,340,000 3,340,000 6,680,000
TOTAL $4,371,087,000 $4,356,208,000 $8,727,295,000
APPROPRIATIONS
Available for the Year
Ending June 30
2004 2005
Sec. 2. COMMISSIONER OF
HUMAN SERVICES
Subdivision 1. Total
Appropriation $4,111,558,000 $4,110,496,000
Summary by Fund
General 3,566,163,000 3,541,854,000
State Government
Special Revenue 534,000 534,000
Health Care
Access 287,753,000 302,188,000
Federal TANF 255,552,000 264,364,000
Lottery Cash
Flow 1,556,000 1,556,000
[FEDERAL CONTINGENCY APPROPRIATION.]
(a) Any additional federal Medicaid
funds made available under title IV of
the federal Jobs and Growth Tax Relief
Reconciliation Act of 2003 are
appropriated to the commissioner of
human services for use in the state's
medical assistance and MinnesotaCare
programs. The commissioners of human
services and finance shall report to
the legislative advisory committee on
the additional federal Medicaid
matching funds that will be available
to the state.
(b) Contingent upon the availability of
these funds, the following policies
shall become effective and necessary
funds are appropriated for those
purposes:
(1) medical assistance and
MinnesotaCare eligibility and local
financial participation changes
provided for in this act may be
implemented prior to September 2, 2003,
or may be delayed as necessary to
maximize the use of federal funds
received under title IV of the Jobs and
Growth Tax Relief Reconciliation Act of
2003;
(2) the aggregate cap on the services
identified in Minnesota Statutes,
section 256L.035, paragraph (a), clause
(3), shall be increased from $2,000 to
$5,000. This increase shall expire at
the end of fiscal year 2007. Funds may
be transferred from the general fund to
the health care access fund as
necessary to implement this provision;
and
(3) the following payment shifts shall
not be implemented:
(i) MFIP payment shift found in
subdivision 11;
(ii) the county payment shift found in
subdivision 1; and
(iii) the delay in medical assistance
and general assistance medical care
fee-for-service payments found in
subdivision 6.
(c) Notwithstanding section 14,
paragraphs (a) and (b) shall expire
June 30, 2007.
[RECEIPTS FOR SYSTEMS PROJECTS.]
Appropriations and federal receipts for
information system projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized
in Minnesota Statutes, section
256.014. Money appropriated for
computer projects approved by the
Minnesota office of technology, funded
by the legislature, and approved by the
commissioner of finance may be
transferred from one project to another
and from development to operations as
the commissioner of human services
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel but is
available for ongoing development and
operations.
[GIFTS.] Notwithstanding Minnesota
Statutes, chapter 7, the commissioner
may accept on behalf of the state
additional funding from sources other
than state funds for the purpose of
financing the cost of assistance
program grants or nongrant
administration. All additional funding
is appropriated to the commissioner for
use as designated by the grantor of
funding.
[SYSTEMS CONTINUITY.] In the event of
disruption of technical systems or
computer operations, the commissioner
may use available grant appropriations
to ensure continuity of payments for
maintaining the health, safety, and
well-being of clients served by
programs administered by the department
of human services. Grant funds must be
used in a manner consistent with the
original intent of the appropriation.
[NONFEDERAL SHARE TRANSFERS.] The
nonfederal share of activities for
which federal administrative
reimbursement is appropriated to the
commissioner may be transferred to the
special revenue fund.
[TANF FUNDS APPROPRIATED TO OTHER
ENTITIES.] Any expenditures from the
TANF block grant shall be expended in
accordance with the requirements and
limitations of part A of title IV of
the Social Security Act, as amended,
and any other applicable federal
requirement or limitation. Prior to
any expenditure of these funds, the
commissioner shall assure that funds
are expended in compliance with the
requirements and limitations of federal
law and that any reporting requirements
of federal law are met. It shall be
the responsibility of any entity to
which these funds are appropriated to
implement a memorandum of understanding
with the commissioner that provides the
necessary assurance of compliance prior
to any expenditure of funds. The
commissioner shall receipt TANF funds
appropriated to other state agencies
and coordinate all related interagency
accounting transactions necessary to
implement these appropriations.
Unexpended TANF funds appropriated to
any state, local, or nonprofit entity
cancel at the end of the state fiscal
year unless appropriating language
permits otherwise.
[TANF FUNDS TRANSFERRED TO OTHER
FEDERAL GRANTS.] The commissioner must
authorize transfers from TANF to other
federal block grants so that funds are
available to meet the annual
expenditure needs as appropriated.
Transfers may be authorized prior to
the expenditure year with the agreement
of the receiving entity. Transferred
funds must be expended in the year for
which the funds were appropriated
unless appropriation language permits
otherwise. In accelerating transfer
authorizations, the commissioner must
aim to preserve the future potential
transfer capacity from TANF to other
block grants.
[TANF MAINTENANCE OF EFFORT.] (a) In
order to meet the basic maintenance of
effort (MOE) requirements of the TANF
block grant specified under Code of
Federal Regulations, title 45, section
263.1, the commissioner may only report
nonfederal money expended for allowable
activities listed in the following
clauses as TANF/MOE expenditures:
(1) MFIP cash, diversionary work
program, and food assistance benefits
under Minnesota Statutes, chapter 256J;
(2) the child care assistance programs
under Minnesota Statutes, sections
119B.03 and 119B.05, and county child
care administrative costs under
Minnesota Statutes, section 119B.15;
(3) state and county MFIP
administrative costs under Minnesota
Statutes, chapters 256J and 256K;
(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
(5) expenditures made on behalf of
noncitizen MFIP recipients who qualify
for the medical assistance without
federal financial participation program
under Minnesota Statutes, section
256B.06, subdivision 4, paragraphs (d),
(e), and (j); and
(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671.
(b) The commissioner shall ensure that
sufficient qualified nonfederal
expenditures are made each year to meet
the state's TANF/MOE requirements. For
the activities listed in paragraph (a),
clauses (2) to (6), the commissioner
may only report expenditures that are
excluded from the definition of
assistance under Code of Federal
Regulations, title 45, section 260.31.
(c) By August 31 of each year, the
commissioner shall make a preliminary
calculation to determine the likelihood
that the state will meet its annual
federal work participation requirement
under Code of Federal Regulations,
title 45, sections 261.21 and 261.23,
after adjustment for any caseload
reduction credit under Code of Federal
Regulations, title 45, section 261.41.
If the commissioner determines that the
state will meet its federal work
participation rate for the federal
fiscal year ending that September, the
commissioner may reduce the expenditure
under paragraph (a), clause (1), to the
extent allowed under Code of Federal
Regulations, title 45, section
263.1(a)(2).
(d) For fiscal years beginning with
state fiscal year 2003, the
commissioner shall assure that the
maintenance of effort used by the
commissioner of finance for the
February and November forecasts
required under Minnesota Statutes,
section 16A.103, contains expenditures
under paragraph (a), clause (1), equal
to at least 25 percent of the total
required under Code of Federal
Regulations, title 45, section 263.1.
(e) If nonfederal expenditures for the
programs and purposes listed in
paragraph (a) are insufficient to meet
the state's TANF/MOE requirements, the
commissioner shall recommend additional
allowable sources of nonfederal
expenditures to the legislature, if the
legislature is or will be in session to
take action to specify additional
sources of nonfederal expenditures for
TANF/MOE before a federal penalty is
imposed. The commissioner shall
otherwise provide notice to the
legislative commission on planning and
fiscal policy under paragraph (g).
(f) If the commissioner uses authority
granted under section 11, or similar
authority granted by a subsequent
legislature, to meet the state's
TANF/MOE requirement in a reporting
period, the commissioner shall inform
the chairs of the appropriate
legislative committees about all
transfers made under that authority for
this purpose.
(g) If the commissioner determines that
nonfederal expenditures under paragraph
(a) are insufficient to meet TANF/MOE
expenditure requirements, and if the
legislature is not or will not be in
session to take timely action to avoid
a federal penalty, the commissioner may
report nonfederal expenditures from
other allowable sources as TANF/MOE
expenditures after the requirements of
this paragraph are met. The
commissioner may report nonfederal
expenditures in addition to those
specified under paragraph (a) as
nonfederal TANF/MOE expenditures, but
only ten days after the commissioner of
finance has first submitted the
commissioner's recommendations for
additional allowable sources of
nonfederal TANF/MOE expenditures to the
members of the legislative commission
on planning and fiscal policy for their
review.
(h) The commissioner of finance shall
not incorporate any changes in federal
TANF expenditures or nonfederal
expenditures for TANF/MOE that may
result from reporting additional
allowable sources of nonfederal
TANF/MOE expenditures under the interim
procedures in paragraph (g) into the
February or November forecasts required
under Minnesota Statutes, section
16A.103, unless the commissioner of
finance has approved the additional
sources of expenditures under paragraph
(g).
(i) Minnesota Statutes, section
256.011, subdivision 3, which requires
that federal grants or aids secured or
obtained under that subdivision be used
to reduce any direct appropriations
provided by law, do not apply if the
grants or aids are federal TANF funds.
(j) Notwithstanding section 14,
paragraph (a), clauses (1) to (6), and
paragraphs (b) to (j) expire June 30,
2007.
[WORKING FAMILY CREDIT EXPENDITURES AS
TANF MOE.] The commissioner may claim
as TANF maintenance of effort up to the
following amounts of working family
credit expenditures for the following
fiscal years:
(1) fiscal year 2004, $7,013,000;
(2) fiscal year 2005, $25,133,000;
(3) fiscal year 2006, $6,942,000; and
(4) fiscal year 2007, $6,707,000.
[FISCAL YEAR 2003 APPROPRIATIONS
CARRYFORWARD.] Effective the day
following final enactment,
notwithstanding Minnesota Statutes,
section 16A.28, or any other law to the
contrary, state agencies and
constitutional offices may carry
forward unexpended and unencumbered
nongrant operating balances from fiscal
year 2003 general fund appropriations
into fiscal year 2004 to offset general
budget reductions.
[TRANSFER OF GRANT BALANCES.] Effective
the day following final enactment, the
commissioner of human services, with
the approval of the commissioner of
finance and after notification of the
chair of the senate health, human
services and corrections budget
division and the chair of the house of
representatives health and human
services finance committee, may
transfer unencumbered appropriation
balances for the biennium ending June
30, 2003, in fiscal year 2003 among the
MFIP, MFIP child care assistance under
Minnesota Statutes, section 119B.05,
general assistance, general assistance
medical care, medical assistance,
Minnesota supplemental aid, and group
residential housing programs, and the
entitlement portion of the chemical
dependency consolidated treatment fund,
and between fiscal years of the
biennium.
[TANF APPROPRIATION CANCELLATION.]
Notwithstanding the provisions of Laws
2000, chapter 488, article 1, section
16, any prior appropriations of TANF
funds to the department of trade and
economic development or to the job
skills partnership board or any
transfers of TANF funds from another
agency to the department of trade and
economic development or to the job
skills partnership board are not
available until expended, and if
unobligated as of June 30, 2003, these
appropriations or transfers shall
cancel to the TANF fund.
[SHIFT COUNTY PAYMENT.] The
commissioner shall make up to 100
percent of the calendar year 2005
payments to counties for developmental
disabilities semi-independent living
services grants, developmental
disabilities family support grants, and
adult mental health grants from fiscal
year 2006 appropriations. This is a
onetime payment shift. Calendar year
2006 and future payments for these
grants are not affected by this shift.
This provision expires June 30, 2006.
[CAPITATION RATE INCREASE.] Of the
health care access fund appropriations
to the University of Minnesota in the
higher education omnibus appropriation
bill, $2,157,000 in fiscal year 2004
and $2,157,000 in fiscal year 2005 are
to be used to increase the capitation
payments under Minnesota Statutes,
section 256B.69. Notwithstanding the
provisions of section 14, this
provision shall not expire.
Subd. 2. Agency Management
Summary by Fund
General 41,473,000 27,868,000
State Government
Special Revenue 415,000 415,000
Health Care Access 3,673,000 3,673,000
Federal TANF 320,000 320,000
The amounts that may be spent from the
appropriation for each purpose are as
follows:
(a) Financial Operations
General 8,751,000 9,056,000
Health Care Access 828,000 828,000
Federal TANF 220,000 220,000
[SPECIAL REVENUE FUND TRANSFER.]
Notwithstanding any law to the
contrary, excluding accounts authorized
under Minnesota Statutes, section
16A.1286, and chapter 254B, the
commissioner shall transfer $1,400,000
of uncommitted special revenue fund
balances to the general fund upon final
enactment. The actual transfers shall
be identified within the standard
information provided to the chairs of
the house health and human services
finance committee and the senate
health, human services, and corrections
budget division in December 2003.
(b) Legal and
Regulation Operations
General 7,896,000 8,168,000
State Government
Special Revenue 415,000 415,000
Health Care Access 244,000 244,000
Federal TANF 100,000 100,000
(c) Management Operations
General 17,373,000 3,076,000
Health Care Access 1,623,000 1,623,000
(d) Information Technology
Operations
General 7,453,000 7,568,000
Health Care Access 978,000 978,000
Subd. 3. Revenue and Pass-Through
Federal TANF 55,855,000 53,315,000
[TANF TRANSFER TO SOCIAL SERVICES BLOCK
GRANT.] $3,137,000 in fiscal year 2005
is appropriated to the commissioner for
the purposes of providing services for
families with children whose incomes
are at or below 200 percent of the
federal poverty guidelines. The
commissioner shall authorize a
sufficient transfer of funds from the
state's federal TANF block grant to the
state's federal social services block
grant to meet this appropriation. The
funds shall be distributed to counties
for the children and community services
grant according to the formula for the
state appropriations in Minnesota
Statutes, chapter 256M.
[TANF FUNDS FOR FISCAL YEAR 2006 AND
FISCAL YEAR 2007 REFINANCING.]
$12,692,000 in fiscal year 2006 and
$9,192,000 in fiscal year 2007 in TANF
funds are available to the commissioner
to replace general funds in the amount
of $12,692,000 in fiscal year 2006 and
$9,192,000 in fiscal year 2007 in
expenditures that may be counted toward
TANF maintenance of effort requirements
or as an allowable TANF expenditure.
[ADJUSTMENTS IN TANF TRANSFER TO CHILD
CARE AND DEVELOPMENT FUND.] Transfers
of TANF to the child care development
fund for the purposes of MFIP child
care assistance shall be reduced by
$116,000 in fiscal year 2004 and shall
be increased by $1,976,000 in fiscal
year 2005.
Subd. 4. Children's Services Grants
Summary by Fund
General 111,264,000 94,020,000
Federal TANF -0- 3,137,000
[ADOPTION ASSISTANCE INCENTIVE GRANTS.]
Federal funds available during fiscal
year 2004 and fiscal year 2005, for
adoption incentive grants are
appropriated to the commissioner for
these purposes.
[ADOPTION ASSISTANCE AND RELATIVE
CUSTODY ASSISTANCE.] The commissioner
may transfer unencumbered appropriation
balances for adoption assistance and
relative custody assistance between
fiscal years and between programs.
[CHILDREN AND COMMUNITY SERVICES
GRANTS.] Counties shall not reduce
children and community service grant
expenditures for services to adults
with disabilities by more than the
overall percentage of the reduction in
the county's allocation of children and
community service grant funds when
compared to the county's calendar year
2003 allocation of former children's
services and community service grants
defined under Minnesota Statutes,
section 256M.10, subdivision 5.
[OUT-OF-HOME PLACEMENT.] Minnesota
youth who require out-of-home placement
through a corrections order must be
placed in a Minnesota program or
facility unless a program in a border
state is closer to the youth's home or
there is no vacancy in an appropriate
in-state program or facility. If no
appropriate, cost-effective regional or
in-state program is available, this
must be documented in the case plan
prior to placement in an out-of-state
facility. Justification for
out-of-state placement of Minnesota
youth must be included in reports to
the Minnesota department of corrections.
Subd. 5. Children's Services Management
General 5,221,000 5,283,000
Subd. 6. Basic Health Care Grants
Summary by Fund
General 1,499,941,000 1,533,016,000
Health Care Access 268,151,000 282,605,000
[UPDATING FEDERAL POVERTY GUIDELINES.]
Annual updates to the federal poverty
guidelines are effective each July 1,
following publication by the United
States Department of Health and Human
Services for health care programs under
Minnesota Statutes, chapters 256, 256B,
256D, and 256L.
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) MinnesotaCare Grants
Health Care Access 267,401,000 281,855,000
[MINNESOTACARE FEDERAL RECEIPTS.]
Receipts received as a result of
federal participation pertaining to
administrative costs of the Minnesota
health care reform waiver shall be
deposited as nondedicated revenue in
the health care access fund. Receipts
received as a result of federal
participation pertaining to grants
shall be deposited in the federal fund
and shall offset health care access
funds for payments to providers.
[MINNESOTACARE FUNDING.] The
commissioner may expend money
appropriated from the health care
access fund for MinnesotaCare in either
fiscal year of the biennium.
(b) MA Basic Health Care Grants -
Families and Children
General 568,254,000 582,161,000
[SERVICES TO PREGNANT WOMEN.] The
commissioner shall use available
federal money for the State-Children's
Health Insurance Program for medical
assistance services provided to
pregnant women who are not otherwise
eligible for federal financial
participation beginning in fiscal year
2003. This federal money shall be
deposited in the federal fund and shall
offset general funds for payments to
providers. Notwithstanding section 14,
this paragraph shall not expire.
[MANAGED CARE RATE INCREASE.] (a)
Effective January 1, 2004, the
commissioner of human services shall
increase the total payments to managed
care plans under Minnesota Statutes,
section 256B.69, by an amount equal to
the cost increases to the managed care
plans from by the elimination of: (1)
the exemption from the taxes imposed
under Minnesota Statutes, section
297I.05, subdivision 5, for premiums
paid by the state for medical
assistance, general assistance medical
care, and the MinnesotaCare program;
and (2) the exemption of gross revenues
subject to the taxes imposed under
Minnesota Statutes, sections 295.50 to
295.57, for payments paid by the state
for services provided under medical
assistance, general assistance medical
care, and the MinnesotaCare program.
Any increase based on clause (2) must
be reflected in provider rates paid by
the managed care plan unless the
managed care plan is a staff model
health plan company.
(b) The commissioner of human services
shall increase by two percent the
fee-for-service payments under medical
assistance, general assistance medical
care, and the MinnesotaCare program for
services subject to the hospital,
surgical center, or health care
provider taxes under Minnesota
Statutes, sections 295.50 to 295.57,
effective for services rendered on or
after January 1, 2004.
(c) The commissioner of finance shall
transfer from the health care access
fund to the general fund the following
amounts in the fiscal years indicated:
2004, $16,587,000; 2005, $46,322,000;
2006, $49,413,000; and 2007,
$52,659,000.
(d) For fiscal years after 2007, the
commissioner of finance shall transfer
from the health care access fund to the
general fund an amount equal to the
revenue collected by the commissioner
of revenue on the following:
(1) gross revenues received by
hospitals, surgical centers, and health
care providers as payments for services
provided under medical assistance,
general assistance medical care, and
the MinnesotaCare program, including
payments received directly from the
state or from a prepaid plan, under
Minnesota Statutes, sections 295.50 to
295.57; and
(2) premiums paid by the state under
medical assistance, general assistance
medical care, and the MinnesotaCare
program under Minnesota Statutes,
section 297I.05, subdivision 5.
The commissioner of finance shall
monitor and adjust if necessary the
amount transferred each fiscal year
from the health care access fund to the
general fund to ensure that the amount
transferred equals the tax revenue
collected for the items described in
clauses (1) and (2) for that fiscal
year.
(e) Notwithstanding section 14, these
provisions shall not expire.
(c) MA Basic Health Care Grants - Elderly
and Disabled
General 695,421,000 741,605,000
[DELAY MEDICAL ASSISTANCE
FEE-FOR-SERVICE - ACUTE CARE.] The
following payments in fiscal year 2005
from the Medicaid Management
Information System that would otherwise
have been made to providers for medical
assistance and general assistance
medical care services shall be delayed
and included in the first payment in
fiscal year 2006:
(1) for hospitals, the last two
payments; and
(2) for nonhospital providers, the last
payment.
This payment delay shall not include
payments to skilled nursing facilities,
intermediate care facilities for mental
retardation, prepaid health plans, home
health agencies, personal care nursing
providers, and providers of only waiver
services. The provisions of Minnesota
Statutes, section 16A.124, shall not
apply to these delayed payments.
Notwithstanding section 14, this
provision shall not expire.
[DEAF AND HARD-OF-HEARING SERVICES.]
If, after making reasonable efforts,
the service provider for mental health
services to persons who are deaf or
hearing impaired is not able to earn
$227,000 through participation in
medical assistance intensive
rehabilitation services in fiscal year
2005, the commissioner shall transfer
$227,000 minus medical assistance
earnings achieved by the grantee to
deaf and hard-of-hearing grants to
enable the provider to continue
providing services to eligible persons.
(d) General Assistance Medical Care
Grants
General 223,960,000 196,617,000
(e) Health Care Grants - Other
Assistance
General 3,067,000 3,407,000
Health Care Access 750,000 750,000
[MINNESOTA PRESCRIPTION DRUG DEDICATED
FUND.] Of the general fund
appropriation, $284,000 in fiscal year
2005 is appropriated to the
commissioner for the prescription drug
dedicated fund established under the
prescription drug discount program.
[DENTAL ACCESS GRANTS CARRYOVER
AUTHORITY.] Any unspent portion of the
appropriation from the health care
access fund in fiscal years 2002 and
2003 for dental access grants under
Minnesota Statutes, section 256B.53,
shall not cancel but shall be allowed
to carry forward to be spent in the
biennium beginning July 1, 2003, for
these purposes.
[STOP-LOSS FUND ACCOUNT.] The
appropriation to the purchasing
alliance stop-loss fund account
established under Minnesota Statutes,
section 256.956, subdivision 2, for
fiscal years 2004 and 2005 shall only
be available for claim reimbursements
for qualifying enrollees who are
members of purchasing alliances that
meet the requirements described under
Minnesota Statutes, section 256.956,
subdivision 1, paragraph (f), clauses
(1), (2), and (3).
(f) Prescription Drug Program
General 9,239,000 9,226,000
[PRESCRIPTION DRUG ASSISTANCE PROGRAM.]
Of the general fund appropriation,
$702,000 in fiscal year 2004 and
$887,000 in fiscal year 2005 are for
the commissioner to establish and
administer the prescription drug
assistance program through the
Minnesota board on aging.
[REBATE REVENUE RECAPTURE.] Any funds
received by the state from a drug
manufacturer due to errors in the
pharmaceutical pricing used by the
manufacturer in determining the
prescription drug rebate are
appropriated to the commissioner to
augment funding of the prescription
drug program established in Minnesota
Statutes, section 256.955.
Subd. 7. Health Care Management
Summary by Fund
General 24,845,000 26,199,000
Health Care Access 14,522,000 14,533,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Health Care Policy Administration
General 5,523,000 7,223,000
Health Care Access 1,066,000 1,200,000
[PAYMENT CODE STUDY.] Of this
appropriation, $345,000 each year is
for a study to determine the
appropriateness of eliminating
reimbursement for certain payment codes
under medical assistance, general
assistance medical care, or
MinnesotaCare. As part of the study,
the commissioner shall also examine
covered services under the Minnesota
health care programs and make
recommendations on possible
modification of the services covered
under the program. The commissioner
shall report to the legislature by
January 15, 2005, with an analysis of
the feasibility of this approach, a
list of codes, if any, to be eliminated
from the payment system, and estimates
of savings to be obtained from this
approach.
[TRANSFERS FROM HEALTH CARE ACCESS
FUND.] (a) Notwithstanding Minnesota
Statutes, section 295.581, to the
extent available resources in the
health care access fund exceed
expenditures in that fund during fiscal
years 2005 to 2007, the excess annual
funds shall be transferred from the
health care access fund to the general
fund on June 30 of fiscal years 2005,
2006, and 2007. These transfers shall
not be reduced to accommodate
MinnesotaCare expansions. The
estimated amounts to be transferred are:
(1) in fiscal year 2005, $192,442,000;
(2) in fiscal year 2006, $52,943,000;
and
(3) in fiscal year 2007, $59,105,000.
These estimates shall be updated with
each forecast, but in no case shall the
transfers exceed the amounts listed in
clauses (1) to (3).
(b) The commissioner shall limit
transfers under paragraph (a) in order
to avoid implementation of Minnesota
Statutes, section 256L.02, subdivision
3, paragraph (b).
(c) For fiscal years 2004 to 2007,
MinnesotaCare shall be a forecasted
program and, if necessary, the
commissioner shall reduce transfers
under paragraph (a) to meet forecasted
expenditures.
(d) The department of human services in
recommending its 2007-2008 budget shall
consider the repayment of the amount
transferred in fiscal years 2006 and
2007 from the health care access fund
to the general fund to the health care
access fund.
(e) Notwithstanding section 14, this
section is in effect until June 30,
2007.
[MINNESOTACARE OUTREACH REIMBURSEMENT.]
Federal administrative reimbursement
resulting from MinnesotaCare outreach
is appropriated to the commissioner for
this activity.
[MINNESOTA SENIOR HEALTH OPTIONS
REIMBURSEMENT.] Federal administrative
reimbursement resulting from the
Minnesota senior health options project
is appropriated to the commissioner for
this activity.
[UTILIZATION REVIEW.] Federal
administrative reimbursement resulting
from prior authorization and inpatient
admission certification by a
professional review organization shall
be dedicated to the commissioner for
these purposes. A portion of these
funds must be used for activities to
decrease unnecessary pharmaceutical
costs in medical assistance.
(b) Health Care Operations
General 19,322,000 18,976,000
Health Care Access 13,456,000 13,333,000
[PREPAID MEDICAL PROGRAMS.] For all
counties in which the PMAP program has
been operating for 12 or more months,
state funding for the nonfederal share
of prepaid medical assistance program
administration costs for county managed
care advocacy and enrollment operations
is eliminated. State funding will
continue for these activities for
counties and tribes establishing new
PMAP programs for a maximum of 16
months (four months prior to beginning
PMAP enrollment and through the first
12 months of their PMAP program
operation). Those counties operating
PMAP programs for less than 12 months
can continue to receive state funding
for advocacy and enrollment activities
through their first year of operation.
Subd. 8. State-operated Services
General 195,062,000 186,775,000
[MITIGATION RELATED TO STATE-OPERATED
SERVICES RESTRUCTURING.] Money
appropriated to finance mitigation
expenses related to restructuring
state-operated services programs and
administrative services may be
transferred between fiscal years within
the biennium.
[REPAIRS AND BETTERMENTS.] The
commissioner may transfer unencumbered
appropriation balances between fiscal
years within the biennium for the state
residential facilities repairs and
betterments account and special
equipment.
[ONETIME REDUCTION TO DEDICATED
REVENUES.] (a) For fiscal year 2003
only, the commissioner shall transfer
$4,700,000 of state-operated services
fund balances from the accounts
indicated to the general fund as
follows:
(1) $3,200,000 from traumatic brain
injury enterprises;
(2) $1,000,000 from lease income; and
(3) $500,000 from ICF/MR depreciation.
(b) Paragraph (a) is effective the day
following final enactment.
Subd. 9. Continuing Care Grants
Summary by Fund
General 1,504,933,000 1,490,958,000
Lottery Prize Fund 1,408,000 1,408,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Community Social Services
General 496,000 371,000
(b) Aging and Adult Service Grant
General 12,998,000 13,951,000
[LONG-TERM CARE PROGRAM REDUCTIONS.]
For the biennium ending June 30, 2005,
state funding for the following state
long-term care programs is reduced by
15 percent from the level of state
funding provided on June 30, 2003:
SAIL project grants under Minnesota
Statutes, section 256B.0917; senior
nutrition programs under Minnesota
Statutes, section 256.9752; foster
grandparents program under Minnesota
Statutes, section 256.976; retired
senior volunteer program under
Minnesota Statutes, section 256.9753;
and the senior companion program under
Minnesota Statutes, section 256.977.
(c) Deaf and Hard-of-hearing
Service Grants
General 1,719,000 1,490,000
(d) Mental Health Grants
General 53,479,000 34,690,000
Lottery Prize Fund 1,408,000 1,408,000
[RESTRUCTURING OF ADULT MENTAL HEALTH
SERVICES.] The commissioner may make
transfers that do not increase the
state share of costs to effectively
implement the restructuring of adult
mental health services.
[COMPULSIVE GAMBLING.] Of the
appropriation from the lottery prize
fund, $250,000 each year is for the
following purposes:
(1) $100,000 each year is for a grant
to the Southeast Asian Problem Gambling
Consortium. The consortium must
provide statewide compulsive gambling
prevention and treatment services for
Lao, Hmong, Vietnamese, and Cambodian
families, adults, and adolescents. The
appropriation in this clause shall not
become part of base level funding for
the biennium beginning July 1, 2005.
Any unencumbered balance of the
appropriation in the first year does
not cancel but is available for the
second year; and
(2) $150,000 each year is for a grant
to a compulsive gambling council
located in St. Louis county. The
gambling council must provide a
statewide compulsive gambling
prevention and education project for
adolescents. Any unencumbered balance
of the appropriation in the first year
of the biennium does not cancel but is
available for the second year.
(e) Community Support Grants
General 12,523,000 9,093,000
[CENTERS FOR INDEPENDENT LIVING STUDY.]
The commissioner of human services, in
consultation with the commissioner of
economic security, the centers for
independent living, and consumer
representatives, shall study the
financing of the centers for
independent living authorized under
Minnesota Statutes, section 268A.11,
and make recommendations on options to
maximize federal financial
participation. Study components shall
include:
(1) the demographics of individuals
served by the centers for independent
living;
(2) the range of services the centers
for independent living provide to these
individuals;
(3) other publicly funded services
received by individuals supported by
the centers; and
(4) strategies for maximizing federal
financial participation for eligible
activities carried out by centers for
independent living.
The commissioner shall report with
fiscal and programmatic recommendations
to the chairs of the appropriate house
of representatives and senate finance
and policy committees by January 15,
2004.
(f) Medical Assistance Long-Term
Care Waivers and Home Care Grants
General 659,211,000 718,665,000
[RATE AND ALLOCATION DECREASES FOR
CONTINUING CARE PROGRAMS.]
Notwithstanding any law or rule to the
contrary, the commissioner of human
services shall decrease reimbursement
rates or reduce allocations to assure
the necessary reductions in state
spending for the providers or programs
listed in paragraphs (a) to (d). The
decreases are effective for services
rendered on or after July 1, 2003.
(a) Effective July 1, 2003, the
commissioner shall reduce payment rates
for services and individual or service
limits by one percent. The rate
decreases described in this section
must be applied to:
(1) home and community-based waivered
services for the elderly under
Minnesota Statutes, section 256B.0915;
(2) day training and habilitation
services for adults with mental
retardation or related conditions under
Minnesota Statutes, sections 252.40 to
252.46;
(3) the group residential housing
supplementary service rate under
Minnesota Statutes, section 256I.05,
subdivision 1a;
(4) chemical dependency residential and
nonresidential service rates under
Minnesota Statutes, section 245B.03;
(5) consumer support grants under
Minnesota Statutes, section 256.476;
and
(6) home and community-based services
for alternative care services under
Minnesota Statutes, section 256B.0913.
(b) The commissioner shall reduce
allocations made available to county
agencies for home and community-based
waivered services to assure a
one-percent reduction in state spending
for services rendered on or after July
1, 2003. The commissioner shall apply
the allocation decreases described in
this section to:
(1) persons with mental retardation or
related conditions under Minnesota
Statutes, section 256B.501;
(2) waivered services under community
alternatives for disabled individuals
under Minnesota Statutes, section
256B.49;
(3) community alternative care waivered
services under Minnesota Statutes,
section 256B.49; and
(4) traumatic brain injury waivered
services under Minnesota Statutes,
section 256B.49.
County agencies will be responsible for
100 percent of any spending in excess
of the allocation made by the
commissioner. Nothing in this section
shall be construed as reducing the
county's responsibility to offer and
make available feasible home and
community-based options to eligible
waiver recipients within the resources
allocated to them for that purpose.
(c) The commissioner shall reduce deaf
and hard-of-hearing grants by one
percent on July 1, 2003.
(d) Effective July 1, 2003, the
commissioner shall reduce payment rates
for each facility reimbursed under
Minnesota Statutes, section 256B.5012,
by decreasing the total operating
payment rate for intermediate care
facilities for the mentally retarded by
one percent. For each facility, the
commissioner shall multiply the
adjustment by the total payment rate,
excluding the property-related payment
rate, in effect on June 30, 2003. A
facility whose payment rates are
governed by closure agreements,
receivership agreements, or Minnesota
Rules, part 9553.0075, is not subject
to an adjustment otherwise taken under
this subdivision.
Notwithstanding section 14, these
adjustments shall not expire.
[REDUCE GROWTH IN MR/RC WAIVER.] The
commissioner shall reduce the growth in
the MR/RC waiver by not allocating the
300 additional diversion allocations
that are included in the February 2003
forecast for the fiscal years that
begin on July 1, 2003, and July 1, 2004.
[MANAGE THE GROWTH IN THE TBI WAIVER.]
During the fiscal years beginning on
July 1, 2003, and July 1, 2004, the
commissioner shall allocate money for
home and community-based programs
covered under Minnesota Statutes,
section 256B.49, to assure a reduction
in state spending that is equivalent to
limiting the caseload growth of the TBI
waiver to 150 in each year of the
biennium. Priorities for the
allocation of funds shall be for
individuals anticipated to be
discharged from institutional settings
or who are at imminent risk of a
placement in an institutional setting.
[TARGETED CASE MANAGEMENT FOR HOME CARE
RECIPIENTS.] Implementation of the
targeted case management benefit for
home care recipients, according to
Minnesota Statutes, section 256B.0621,
subdivisions 2, 3, 5, 6, 7, 9, and 10,
will be delayed until July 1, 2005.
[COMMON SERVICE MENU.] Implementation
of the common service menu option
within the home and community-based
waivers, according to Minnesota
Statutes, section 256B.49, subdivision
16, will be delayed until July 1, 2005.
[LIMITATION ON COMMUNITY ALTERNATIVES
FOR DISABLED INDIVIDUALS CASELOAD
GROWTH.] For the biennium ending June
30, 2005, the commissioner shall limit
the allocations made available in the
community alternatives for disabled
individuals waiver program in order not
to exceed average caseload growth of 95
per month from June 2003 program
levels, plus any additional
legislatively authorized program
growth. The commissioner shall
allocate available resources to achieve
the following outcomes:
(1) the establishment of feasible and
viable alternatives for persons in
institutional or hospital settings to
relocate to home and community-based
settings;
(2) the availability of timely
assistance to persons at imminent risk
of institutional or hospital placement
or whose health and safety is at
immediate risk; and
(3) the maximum provision of essential
community supports to eligible persons
in need of and waiting for home and
community-based service alternatives.
The commissioner may reallocate
resources from one county or region to
another if available funding in that
county or region is not likely to be
spent and the reallocation is necessary
to achieve the outcomes specified in
this paragraph.
(g) Medical Assistance Long-term
Care Facilities Grants
General 543,999,000 514,483,000
(h) Alternative Care Grants
General 75,206,000 66,351,000
[ALTERNATIVE CARE TRANSFER.] Any money
allocated to the alternative care
program that is not spent for the
purposes indicated does not cancel but
shall be transferred to the medical
assistance account.
[ALTERNATIVE CARE APPROPRIATION.] The
commissioner may expend the money
appropriated for the alternative care
program for that purpose in either year
of the biennium.
[ALTERNATIVE CARE IMPLEMENTATION OF
CHANGES TO FEES AND ELIGIBILITY.]
Changes to Minnesota Statutes, section
256B.0913, subdivision 4, paragraph
(d), and subdivision 12, are effective
July 1, 2003, for all persons found
eligible for the alternative care
program on or after July 1, 2003. All
recipients of alternative care funding
as of June 30, 2003, shall be subject
to Minnesota Statutes, section
256B.0913, subdivision 4, paragraph
(d), and subdivision 12, on the annual
reassessment and review of their
eligibility after July 1, 2003, but no
later than January 1, 2004.
(i) Group Residential Housing Grants
General 94,996,000 80,472,000
[GROUP RESIDENTIAL HOUSING COSTS
REFINANCED.] (1) Effective July 1,
2004, the commissioner shall increase
the home and community-based service
rates and county allocations provided
to programs for persons with
disabilities established under section
1915(c) of the Social Security Act to
the extent that these programs will be
paying for the costs above the rate
established in Minnesota Statutes,
section 256I.05, subdivision 1.
(2) For persons in receipt of services
under Minnesota Statutes, section
256B.0915, who reside in licensed adult
foster care beds for which a
supplemental room and board payment was
being made under Minnesota Statutes,
section 256I.05, subdivision 1,
counties may request an exception to
the individual caps specified in
Minnesota Statutes, section 256B.0915,
subdivision 3, paragraph (b), not to
exceed the difference between the
individual cap and the client's monthly
service expenditures plus the amount of
the supplemental room and board rate.
The county must submit a request to
exceed the individual cap to the
commissioner for approval.
(j) Chemical Dependency
Entitlement Grants
General 49,251,000 50,337,000
(k) Chemical Dependency Nonentitlement
Grants
General 1,055,000 1,055,000
Subd. 10. Continuing Care Management
Summary by Fund
General 21,697,000 21,206,000
State Government
Special Revenue 119,000 119,000
Lottery Prize Fund 148,000 148,000
[APPROPRIATION; REPORT ON LONG-TERM
CARE FINANCING REFORM.] Money
appropriated to the commissioner for
fiscal year 2004 for the report on
long-term care financing reform and
long-term care insurance purchase
incentives shall not cancel but shall
be available to the commissioner for
that purpose in fiscal year 2005.
Subd. 11. Economic Support Grants
Summary by Fund
General 122,647,000 117,198,000
Federal TANF 199,009,000 207,224,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Minnesota Family Investment Program
General 59,922,000 39,375,000
Federal TANF 106,535,000 110,543,000
(b) Work Grants
General 666,000 14,678,000
Federal TANF 92,474,000 96,681,000
[MFIP SUPPORT SERVICES COUNTY AND
TRIBAL ALLOCATION.] When determining
the funds available for the
consolidated MFIP support services
grant in the 18-month period ending
December 31, 2004, the commissioner
shall apportion the funds appropriated
for fiscal year 2005 in such manner as
necessary to provide $14,000,000 more
to counties and tribes for the period
ending December 31, 2004, than would
have been available had the funds been
evenly divided within the fiscal year
between the period before December 31,
2004, and the period after December 31,
2004.
For allocations for the calendar years
starting January 1, 2005, the
commissioner shall apportion the funds
appropriated for each fiscal year in
such manner as necessary to provide
$14,000,000 more to counties and tribes
for the period ending December 31 of
that year than would have been
available had the funds been evenly
divided within the fiscal year between
the period before December 31 and the
period after December 31.
(c) Economic Support Grants - Other
Assistance
General 3,358,000 3,463,000
[SUPPORTIVE HOUSING.] Of the general
fund appropriation, $500,000 each year
is to provide services to families who
are participating in the supportive
housing and managed care pilot project
under Minnesota Statutes, section
256K.25. This appropriation shall not
become part of base level funding for
the biennium beginning July 1, 2007.
(d) Child Support Enforcement Grants
General 3,571,000 3,503,000
(e) General Assistance Grants
General 24,901,000 24,732,000
[GENERAL ASSISTANCE STANDARD.] The
commissioner shall set the monthly
standard of assistance for general
assistance units consisting of an adult
recipient who is childless and
unmarried or living apart from parents
or a legal guardian at $203. The
commissioner may reduce this amount
according to Laws 1997, chapter 85,
article 3, section 54.
[EMERGENCY GENERAL ASSISTANCE.] The
amount appropriated for emergency
general assistance funds is limited to
no more than $7,889,812 in each fiscal
year of 2004 and 2005. Funds to
counties shall be allocated by the
commissioner using the allocation
method specified in Minnesota Statutes,
section 256D.06.
(f) Minnesota Supplemental Aid Grants
General 30,229,000 31,447,000
[EMERGENCY MINNESOTA SUPPLEMENTAL AID
FUNDS.] The amount appropriated for
emergency Minnesota supplemental aid
funds is limited to no more than
$1,138,707 in fiscal year 2004 and
$1,017,000 in fiscal year 2005. Funds
to counties shall be allocated by the
commissioner using the allocation
method specified in Minnesota Statutes,
section 256D.46.
Subd. 12. Economic Support
Management
Summary by Fund
General 39,080,000 39,331,000
Health Care Access 1,407,000 1,377,000
Federal TANF 368,000 368,000
The amounts that may be spent from this
appropriation for each purpose are as
follows:
(a) Economic Support
Policy Administration
General 5,360,000 5,587,000
Federal TANF 368,000 368,000
(b) Economic Support
Operations
General 33,720,000 33,744,000
Health Care Access 1,407,000 1,377,000
[SPENDING AUTHORITY FOR FOOD STAMPS
ENHANCED FUNDING.] In the event that
Minnesota qualifies for the U.S.
Department of Agriculture Food and
Nutrition Services Food Stamp Program
enhanced funding beginning in federal
fiscal year 2002, the funding is
appropriated to the commissioner. The
commissioner shall retain 25 percent of
the funding, with the other 75 percent
divided among the counties according to
a formula that takes into account each
county's impact on the statewide food
stamp error rate.
[CHILD SUPPORT PAYMENT CENTER.]
Payments to the commissioner from other
governmental units, private
enterprises, and individuals for
services performed by the child support
payment center must be deposited in the
state systems account authorized under
Minnesota Statutes, section 256.014.
These payments are appropriated to the
commissioner for the operation of the
child support payment center or system,
according to Minnesota Statutes,
section 256.014.
[CHILD SUPPORT COST RECOVERY FEES.] The
commissioner shall transfer $247,000 of
child support cost recovery fees
collected in fiscal year 2005 to the
PRISM special revenue account to offset
PRISM system costs of implementing the
fee.
[FINANCIAL INSTITUTION DATA MATCH AND
PAYMENT OF FEES.] The commissioner is
authorized to allocate up to $310,000
each year in fiscal year 2004 and
fiscal year 2005 from the PRISM special
revenue account to make payments to
financial institutions in exchange for
performing data matches between account
information held by financial
institutions and the public authority's
database of child support obligors as
authorized by Minnesota Statutes,
section 13B.06, subdivision 7.
[CONSISTENT ACCOUNTING FOR PROGRAMS TO
BE TRANSFERRED.] To ensure consistent
accounting, including forecasting,
budgeting, cost allocation, and
financial reporting, the commissioner
may establish accounts and processes in
the state's accounting system so the
programs being transferred from other
state agencies are integrated into the
department's standard accounting
policies and procedures.
Sec. 3. COMMISSIONER OF HEALTH
Subdivision 1. Total
Appropriation 104,995,000 106,328,000
Summary by Fund
General 59,842,000 61,438,000
State Government
Special Revenue 32,880,000 32,617,000
Health Care Access 6,273,000 6,273,000
Federal TANF 6,000,000 6,000,000
Subd. 2. Health Improvement
Summary by Fund
General 44,595,000 46,459,000
State Government
Special Revenue 1,987,000 1,987,000
Health Care Access 3,510,000 3,510,000
Federal TANF 6,000,000 6,000,000
[TOBACCO PREVENTION ENDOWMENT FUND
TRANSFERS.] (a) On July 1, 2003, the
commissioner of finance shall transfer
$4,000,000 from the tobacco use
prevention and local public health
endowment expendable trust fund to the
general fund.
(b) Notwithstanding Minnesota Statutes,
section 16A.62, any remaining
unexpended balance in the fund after
the transfer in paragraph (a) shall be
transferred to the miscellaneous
special revenue fund and dedicated to
the commissioner of health for local
tobacco prevention grants under
Minnesota Statutes, section 144.396,
subdivision 6. Of this amount the
commissioner may retain up to $150,000
for administration and evaluation costs.
(c) Of the general fund appropriation
for fiscal year 2005, $3,280,000 is to
the commissioner for the grants
specified in paragraph (b).
[TANF APPROPRIATIONS.] TANF funds
appropriated to the commissioner are
available for home visiting and
nutritional activities listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7), and
eliminating health disparities
activities under Minnesota Statutes,
section 145.928, subdivision 10.
Funding shall be distributed to
community health boards and tribal
governments based on the formula in
Minnesota Statutes, section 145A.131,
subdivisions 1 and 2.
[TANF CARRYFORWARD.] Any unexpended
balance of the TANF appropriation in
the first year of the biennium does not
cancel but is available for the second
year.
[MINNESOTA CHILDREN WITH SPECIAL HEALTH
NEEDS CARRYFORWARD.] General fund
appropriations for treatment services
in the services for Minnesota children
with special health needs program are
available for either year of the
biennium.
[TRANSFER OF ENDOWMENT FUNDS.] On July
1, 2003, the commissioner of finance
shall transfer the tobacco use
prevention and local public health
endowment fund and the medical
education endowment fund to the general
fund.
Subd. 3. Health Quality and
Access
Summary by Fund
General 868,000 606,000
State Government
Special Revenue 8,888,000 8,888,000
Health Care Access 2,763,000 2,763,000
[STATE GOVERNMENT SPECIAL REVENUE FUND
TRANSFERS.] On July 1, 2003, the
commissioner of finance shall transfer
$4,000,000 from the state government
special revenue fund to the general
fund.
[NURSING HOME RECEIVERSHIP COSTS.] In
the event that other funds are not
available, the commissioner is
authorized to expend up to $230,000
from the fiscal year 2003 state
government special revenue
appropriation for nursing home
regulation for those costs associated
with nursing home receiverships
necessary to protect the health and
safety of residents. The commissioner
shall assert claims against any and all
appropriate parties seeking
reimbursement of any funds expended.
This provision is effective the day
following final enactment.
[NURSING PROVIDERS WORK GROUP.] The
commissioner shall establish a working
group consisting of nursing home and
boarding care home providers,
representatives of nursing home
residents, and other health care
providers to review current licensure
provisions and evaluate the continued
appropriateness of these provisions.
The commissioner shall present
recommendations to the legislature by
November 1, 2004.
[MERC FUNDING.] Amounts in the medical
education and research costs (MERC)
special account not to exceed
$8,660,000 in fiscal year 2004 and
$8,616,000 in fiscal year 2005 are
appropriated to the commissioner for
medical education and research funding.
Subd. 4. Health Protection
Summary by Fund
General 9,130,000 9,130,000
State Government
Special Revenue 22,005,000 21,742,000
Subd. 5. Management and Support
Services
General 5,249,000 5,243,000
Sec. 4. VETERANS NURSING HOMES BOARD
General 30,030,000 30,030,000
[VETERANS HOMES SPECIAL REVENUE
ACCOUNT.] The general fund
appropriations made to the board may be
transferred to a veterans homes special
revenue account in the special revenue
fund in the same manner as other
receipts are deposited according to
Minnesota Statutes, section 198.34, and
are appropriated to the board for the
operation of board facilities and
programs.
Sec. 5. HEALTH-RELATED BOARDS
Subdivision 1. Total
Appropriation 11,441,000 11,471,000
Summary by Fund
State Government
Special Revenue 11,377,000 11,407,000
Health Care Access 64,000 64,000
[STATE GOVERNMENT SPECIAL REVENUE
FUND.] The appropriations in this
section are from the state government
special revenue fund, except where
noted.
[NO SPENDING IN EXCESS OF REVENUES.]
The commissioner of finance shall not
permit the allotment, encumbrance, or
expenditure of money appropriated in
this section in excess of the
anticipated biennial revenues or
accumulated surplus revenues from fees
collected by the boards. Neither this
provision nor Minnesota Statutes,
section 214.06, applies to transfers
from the general contingent account.
[STATE GOVERNMENT SPECIAL REVENUE FUND
TRANSFERS.] On July 1, 2003, the
commissioner of finance shall transfer
$7,500,000 from the state government
special revenue fund to the general
fund. Of this amount, $3,500,000 shall
be transferred from the health-related
boards and $4,000,000 shall be
transferred as designated by the
commissioner of finance.
Subd. 2. Board of Chiropractic
Examiners 384,000 384,000
[CONTESTED CASE EXPENSES.] In fiscal
year 2003, $70,000 in state government
special revenue funds is transferred
from Laws 2001, First Special Session
chapter 10, article 1, section 33, to
the board of chiropractic examiners to
pay for contested case activity. These
funds are available until September 30,
2003.
Subd. 3. Board of Dentistry
State Government Special
Revenue Fund 858,000 858,000
Health Care
Access Fund 64,000 64,000
Subd. 4. Board of Dietetic and
Nutrition Practice 101,000 101,000
Subd. 5. Board of Marriage and
Family Therapy 118,000 118,000
Subd. 6. Board of Medical
Practice 3,498,000 3,498,000
Subd. 7. Board of Nursing 2,405,000 2,405,000
Subd. 8. Board of Nursing
Home Administrators 198,000 198,000
Subd. 9. Board of Optometry 96,000 96,000
Subd. 10. Board of Pharmacy 1,386,000 1,386,000
[ADMINISTRATIVE SERVICES UNIT.] Of this
appropriation, $359,000 the first year
and $359,000 the second year are for
the health boards administrative
services unit. The administrative
services unit may receive and expend
reimbursements for services performed
for other agencies.
Subd. 11. Board of Physical
Therapy 197,000 197,000
Subd. 12. Board of Podiatry 45,000 45,000
Subd. 13. Board of Psychology 680,000 680,000
Subd. 14. Board of Social
Work 1,073,000 1,073,000
Subd. 15. Board of Veterinary
Medicine 163,000 163,000
Subd. 16. Board of Behavioral
Health and Therapy 175,000 205,000
[ADDITIONAL FUNDING.] This amount is
from the state government special
revenue fund and is in addition to the
appropriation in Laws 2003, chapter
118, section 27. Licensure fees will
be increased accordingly to reimburse
the fund balance.
Sec. 6. EMERGENCY MEDICAL SERVICES BOARD
Subdivision 1. Total
Appropriation 3,027,000 3,027,000
Summary by Fund
General 2,481,000 2,481,000
State Government
Special Revenue 546,000 546,000
[HEALTH PROFESSIONAL SERVICES
ACTIVITY.] $546,000 each year from the
state government special revenue fund
is for the health professional services
activity.
[COMPREHENSIVE ADVANCED LIFE SUPPORT
ADMINISTRATIVE COSTS.] Of the
appropriation for the comprehensive
advanced life support program, not more
than $5,000 each year may be retained
by the board for administrative costs.
[ROYALTY PAYMENTS DEDICATED TO BOARD.]
Royalty payments from the sale of the
Internet-based ambulance reporting
program are appropriated to the board
and shall remain available until
expended. Notwithstanding section 14,
this provision shall not expire.
[EMERGENCY MEDICAL SERVICES REGIONAL
GRANTS.] Of this appropriation,
$657,000 each year is for the purposes
of Minnesota Statutes, section 144E.50.
[AMBULANCE TRAINING GRANT CARRYFORWARD
AND TRANSFER.] (a) Effective for fiscal
year 2003 and succeeding fiscal years,
any unspent portion of the
appropriation for ambulance training
grants shall not cancel but shall carry
forward and be used in the following
fiscal year for the purposes of
Minnesota Statutes, section 144E.50.
The board shall not retain any portion
of the appropriation carried forward
for administrative costs.
(b) Notwithstanding section 14, this
provision shall not expire.
(c) This provision is effective the day
following final enactment.
Sec. 7. COUNCIL ON DISABILITY
General 500,000 500,000
Sec. 8. OMBUDSMAN FOR MENTAL HEALTH
AND MENTAL RETARDATION
General 1,462,000 1,462,000
Sec. 9. OMBUDSMAN FOR FAMILIES
General 245,000 245,000
Sec. 10. DEPARTMENT OF CHILDREN,
FAMILIES, AND LEARNING
Subdivision 1. Total
Appropriation $ 107,829,000 $ 92,649,000
Summary by Fund
General 104,489,000 89,309,000
State Special
Revenue 3,340,000 3,340,000
Subd. 2. Child Care
[BASIC SLIDING FEE CHILD CARE.] Of this
appropriation, $27,628,000 in fiscal
year 2004 and $18,771,000 in fiscal
year 2005 are for child care assistance
according to Minnesota Statutes,
section 119B.03. These appropriations
are available to be spent either year.
The fiscal years 2006 and 2007 general
fund base for basic sliding fee child
care is $30,312,000 each year.
[MFIP CHILD CARE.] Of this
appropriation, $69,543,000 in fiscal
year 2004 and $63,720,000 in fiscal
year 2005 are for MFIP child care.
[CHILD CARE PROGRAM INTEGRITY.] Of this
appropriation, $425,000 in fiscal year
2004, and $376,000 in fiscal year 2005
are for the administrative costs of
program integrity and fraud prevention
for child care assistance under
Minnesota Statutes, chapter 119B.
[CHILD CARE DEVELOPMENT.] Of this
appropriation, $1,115,000 in fiscal
year 2004, and $1,164,000 in fiscal
year 2005 are for child care
development grants according to
Minnesota Statutes, section 119B.21.
Subd. 3. Child Care Assistance
Special Revenue Account 3,340,000 3,340,000
[CHILD SUPPORT SPECIAL REVENUE
ACCOUNT.] Appropriations and transfers
in this subdivision are from the child
support collection payments in the
special revenue fund, pursuant to
Minnesota Statutes, section 119B.074.
The sums indicated are appropriated to
the department of children, families,
and learning for the fiscal years
designated.
[CHILD CARE ASSISTANCE.] Of this
appropriation, $3,340,000 in fiscal
year 2004, and $3,340,000 in fiscal
year 2005 are for child care assistance
according to Minnesota Statutes,
section 119B.03.
[SPECIAL REVENUE ACCOUNT UNOBLIGATED
FUND TRANSFER.] On July 1, 2003, the
commissioner of finance shall transfer
$1,800,000 from the special revenue
fund to the general fund.
Subd. 4. Child Care
Assistance TANF Funds
[FEDERAL TANF TRANSFERS.] The sums
indicated in this section are
transferred from the federal TANF fund
to the child care and development fund
and are appropriated to the department
of children, families, and learning for
the fiscal years indicated. The
commissioner shall ensure that all
transferred funds are expended
according to the child care and
development fund regulations and that
maximum allowable transferred funds are
used for the following programs:
(a) For basic sliding fee child care,
$17,686,000 in fiscal year 2004 and
$17,700,000 in fiscal year 2005 are for
child care assistance under Minnesota
Statutes, section 119B.03.
(b) For MFIP/TY, $7,312,000 in fiscal
year 2004 and $4,919,000 in fiscal year
2005 are for child care assistance
under Minnesota Statutes, section
119B.05.
(c) For child care development grants
under Minnesota Statutes, section
119B.21, $14,000 is available in fiscal
year 2004.
Subd. 5. Self-Sufficiency Programs
General 5,278,000 5,278,000
[MINNESOTA ECONOMIC OPPORTUNITY
GRANTS.] Of this appropriation,
$4,000,000 in fiscal year 2004 and
$4,000,000 in fiscal year 2005 are for
Minnesota economic opportunity grants.
Any balance in the first year does not
cancel but is available in the second
year.
[FOOD SHELF PROGRAMS.] Of this
appropriation, $1,278,000 in fiscal
year 2004 and $1,278,000 in fiscal year
2005 are for food shelf programs under
Minnesota Statutes, section 119A.44.
Any balance in the first year does not
cancel but is available in the second
year.
Subd. 6. Family Assets for Independence
500,000 -0-
Any balance in the first year does not
cancel but is available in the second
year.
Sec. 11. [TRANSFERS.]
Subdivision 1. [GRANTS.] The commissioner of human
services, with the approval of the commissioner of finance, and
after notification of the chair of the senate health, human
services and corrections budget division and the chair of the
house health and human services finance committee, may transfer
unencumbered appropriation balances for the biennium ending June
30, 2005, within fiscal years among the MFIP, general
assistance, general assistance medical care, medical assistance,
MFIP child care assistance under Minnesota Statutes, section
119B.05, Minnesota supplemental aid, and group residential
housing programs, and the entitlement portion of the chemical
dependency consolidated treatment fund, and between fiscal years
of the biennium.
Subd. 2. [ADMINISTRATION.] Positions, salary money, and
nonsalary administrative money may be transferred within the
departments of human services and health and within the programs
operated by the veterans nursing homes board as the
commissioners and the board consider necessary, with the advance
approval of the commissioner of finance. The commissioner or
the board shall inform the chairs of the house health and human
services finance committee and the senate health, human services
and corrections budget division quarterly about transfers made
under this provision.
Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be
transferred to operations within the departments of human
services and health and within the programs operated by the
veterans nursing homes board without the approval of the
legislature.
Sec. 12. [INDIRECT COSTS NOT TO FUND PROGRAMS.]
The commissioners of health and of human services shall not
use indirect cost allocations to pay for the operational costs
of any program for which they are responsible.
Sec. 13. [CARRYOVER LIMITATION.]
The appropriations in this article which are allowed to be
carried forward from fiscal year 2004 to fiscal year 2005 shall
not become part of the base level funding for the 2006-2007
biennial budget, unless specifically directed by the legislature.
Sec. 14. [SUNSET OF UNCODIFIED LANGUAGE.]
All uncodified language contained in this article expires
on June 30, 2005, unless a different expiration date is explicit.
Sec. 15. [REPEALER.]
Laws 2002, chapter 374, article 9, section 8, is repealed
effective upon final enactment.
Sec. 16. [EFFECTIVE DATE.]
The provisions in this article are effective July 1, 2003,
unless a different effective date is specified.
Presented to the governor May 30, 2003
Signed by the governor June 5, 2003, 4:27 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes