Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 2005, 1st Special Session
Key: (1) language to be deleted (2) new language
CHAPTER 4-H.F.No. 139
An act relating to the operation of state government;
making changes to health and human services programs;
modifying human services policy; modifying health
policy; changing licensing provisions; changing
provisions for mental and chemical health;
establishing treatment foster care and transitional
youth intensive rehab mental health services;
enhancing family support; providing training for child
care providers and hospitals on dangers of shaking
infants and children; establishing long-term homeless
supportive services; establishing the tobacco health
impact fee; establishing a cancer drug repository
program; establishing a health information technology
and infrastructure advisory committee and a rural
pharmacy planning and transition grant program;
establishing a statewide trauma system and trauma
registry; changing long-term care provisions and
establishing a partnership; establishing a nursing
facility reimbursement system; modifying health care
programs; changing certain fees; appropriating money;
amending Minnesota Statutes 2004, sections 13.46,
subdivision 4, as amended; 16A.724; 62J.692,
subdivision 3, as amended; 62Q.251, as added; 62Q.37,
subdivision 7; 103I.101, subdivision 6; 103I.208,
subdivisions 1, as amended, 2, as amended; 103I.235,
subdivision 1; 103I.601, subdivision 2; 119B.13,
subdivision 1, by adding a subdivision; 144.122, as
amended; 144.147, subdivisions 1, 2; 144.148,
subdivision 1; 144.1483; 144.1501, subdivisions 1, 2,
3, 4; 144.226, subdivisions 1, as amended, 4, as
amended, by adding subdivisions; 144.3831, subdivision
1; 144.551, subdivision 1; 144.562, subdivision 2;
144.9504, subdivision 2; 144.98, subdivision 3;
144A.073, subdivision 10, by adding a subdivision;
144E.101, by adding a subdivision; 145.4242; 145.56,
subdivisions 2, 5; 145.9268; 147A.08; 148D.220,
subdivision 8, as added; 150A.22; 157.011, by adding a
subdivision; 157.15, by adding a subdivision; 157.16,
subdivisions 2, 3, by adding subdivisions; 157.20,
subdivisions 2, 2a; 241.01, by adding a subdivision;
243.166, subdivisions 4b, as added, 7, as amended;
245.4661, subdivisions 2, 6, by adding a subdivision;
245.4874, as amended; 245.4885, subdivisions 1, 2, by
adding a subdivision; 245A.02, subdivision 17;
245A.03, subdivisions 2, 3; 245A.035, subdivisions 1,
5; 245A.04, subdivisions 7, 13; 245A.06, by adding a
subdivision; 245A.07, subdivisions 1, 3, by adding a
subdivision; 245A.08, subdivisions 2a, 5; 245A.10,
subdivisions 4, 5; 245A.14, by adding subdivisions;
245A.144; 245A.16, subdivisions 1, 4; 245A.18;
245B.02, subdivision 10; 245B.055, subdivision 7;
245B.07, subdivision 8; 245C.03, subdivision 1;
245C.07; 245C.08, subdivisions 1, 2; 245C.10,
subdivisions 2, 3; 245C.15, subdivisions 1, as
amended, 2, 3, 4; 245C.21, subdivision 2; 245C.22,
subdivisions 3, 4, 7, as added; 245C.23, subdivision
1; 245C.24, subdivisions 2, as amended, 3; 245C.27,
subdivision 1; 245C.28, subdivision 3; 245C.30,
subdivisions 1, 2; 245C.32, subdivision 2; 246.0136,
subdivision 1; 246.13, as amended; 252.27, subdivision
2a; 253.20; 254A.035, subdivision 2; 254A.04; 256.01,
subdivision 2, by adding subdivisions; 256.019,
subdivision 1; 256.045, subdivisions 3, as amended,
3a; 256.046, subdivision 1; 256.741, subdivision 4;
256.9657, by adding a subdivision; 256.969,
subdivisions 3a, 9, 26, by adding a subdivision;
256.975, subdivision 9; 256B.02, subdivision 12;
256B.04, by adding a subdivision; 256B.055, by adding
a subdivision; 256B.056, subdivisions 5, 5a, 5b, 7, by
adding subdivisions; 256B.057, subdivision 9;
256B.0575; 256B.06, subdivision 4; 256B.0621,
subdivisions 2, 3, 4, 5, 6, 7, by adding a
subdivision; 256B.0622, subdivision 2; 256B.0625,
subdivisions 2, 3a, 9, 13, 13a, 13c, 13d, 13e, as
amended, 13f, as amended, 17, 19c, by adding
subdivisions; 256B.0627, subdivisions 1, as amended,
4, 5, as amended, 9, by adding a subdivision;
256B.0631, subdivisions 1, 3; 256B.075, subdivision 2;
256B.0911, subdivision 1a; 256B.0913, subdivisions 2,
4, 5, 5a; 256B.0916, by adding a subdivision;
256B.0924, subdivision 3; 256B.093, subdivision 1;
256B.0943, subdivision 3; 256B.095; 256B.0951,
subdivision 1; 256B.0952, subdivision 5; 256B.0953,
subdivision 1; 256B.15, subdivisions 1, 4, by adding
subdivisions; 256B.19, subdivisions 1, 1c; 256B.195,
subdivision 3; 256B.431, by adding subdivisions;
256B.432, subdivisions 1, 2, 5, by adding
subdivisions; 256B.434, subdivisions 3, 4, by adding a
subdivision; 256B.49, subdivision 16; 256B.5012, by
adding a subdivision; 256B.69, subdivisions 4, 23;
256D.03, subdivisions 3, as amended, 4; 256D.045;
256D.06, subdivisions 5, 7; 256D.44, subdivision 5;
256I.05, subdivision 1e; 256I.06, by adding a
subdivision; 256J.37, subdivision 3b; 256J.515;
256L.01, subdivisions 4, 5; 256L.03, subdivisions 1,
1b, 5; 256L.035; 256L.04, subdivision 2, by adding
subdivisions; 256L.05, subdivisions 2, 3, 3a, by
adding a subdivision; 256L.06, subdivision 3; 256L.07,
subdivisions 1, as amended, 3, by adding subdivisions;
256L.12, by adding a subdivision; 256L.15,
subdivisions 2, as amended, 3, by adding a
subdivision; 256L.17, by adding a subdivision;
256M.40, subdivision 2; 260.835; 260B.163, subdivision
6; 260C.163, subdivision 5; 295.582, as amended;
297F.185; 299C.093, as amended; 325D.32, subdivision
9; 326.42, subdivision 2; 471.61, by adding a
subdivision; 514.981, subdivision 6; 518.165, by
adding subdivisions; 549.02, by adding a subdivision;
549.04; 609A.03, subdivision 7, as amended; 626.556,
subdivision 10i, as amended; 626.557, subdivisions 9d,
14, as amended; 641.15, subdivision 2; Laws 2003,
First Special Session chapter 14, article 12, section
93; Laws 2003, First Special Session chapter 14,
article 13C, section 2, subdivision 6; Laws 2005,
chapter 107, article 1, section 6; Laws 2005, chapter
159, article 1, section 14; proposing coding for new
law in Minnesota Statutes, chapters 16A; 62J; 144;
145; 151; 245A; 245C; 256; 256B; 256K; 641; repealing
Minnesota Statutes 2004, sections 119B.074, as
amended; 144.1486; 144.1502; 157.215; 256.955;
256B.075, subdivision 5; 256D.54, subdivision 3;
256L.04, subdivision 11; 256M.40, subdivision 2;
514.991; 514.992; 514.993; 514.994; 514.995; Laws
2003, First Special Session chapter 14, article 9,
section 34; Laws 2005, chapter 107, article 2, section
51.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
LICENSING PROVISIONS
Section 1. Minnesota Statutes 2004, section 13.46,
subdivision 4, as amended by Laws 2005, chapter 163, section 40,
is amended to read:
Subd. 4. [LICENSING DATA.] (a) As used in this subdivision:
(1) "licensing data" means all data collected, maintained,
used, or disseminated by the welfare system pertaining to
persons licensed or registered or who apply for licensure or
registration or who formerly were licensed or registered under
the authority of the commissioner of human services;
(2) "client" means a person who is receiving services from
a licensee or from an applicant for licensure; and
(3) "personal and personal financial data" means Social
Security numbers, identity of and letters of reference,
insurance information, reports from the Bureau of Criminal
Apprehension, health examination reports, and social/home
studies.
(b)(1) Except as provided in paragraph (c), the following
data on current and former licensees are public: name, address,
telephone number of licensees, date of receipt of a completed
application, dates of licensure, licensed capacity, type of
client preferred, variances granted, record of training and
education in child care and child development, type of dwelling,
name and relationship of other family members, previous license
history, class of license, the existence and status of
complaints, and the number of serious injuries to or deaths of
individuals in the licensed program as reported to the
commissioner of human services, the local social services
agency, or any other county welfare agency. For purposes of
this clause, a serious injury is one that is treated by a
physician. When a correction order or fine has been issued, a
license is suspended, immediately suspended, revoked, denied, or
made conditional, or a complaint is resolved, the following data
on current and former licensees are public: the substance and
investigative findings of the licensing or maltreatment
complaint, licensing violation, or substantiated maltreatment;
the record of informal resolution of a licensing violation;
orders of hearing; findings of fact; conclusions of law;
specifications of the final correction order, fine, suspension,
immediate suspension, revocation, denial, or conditional license
contained in the record of licensing action; and the status of
any appeal of these actions.
(2) Notwithstanding sections 626.556, subdivision 11, and
626.557, subdivision 12b, when any person subject to
disqualification under section 245C.14 in connection with a
license to provide family day care for children, child care
center services, foster care for children in the provider's
home, or foster care or day care services for adults in the
provider's home is a substantiated perpetrator of maltreatment,
and the substantiated maltreatment is a reason for a licensing
action, the identity of the substantiated perpetrator of
maltreatment is public data. For purposes of this clause, a
person is a substantiated perpetrator if the maltreatment
determination has been upheld under section 256.045; 626.556,
subdivision 10i; 626.557, subdivision 9d; or chapter 14, or if
an individual or facility has not timely exercised appeal rights
under these sections.
(3) For applicants who withdraw their application prior to
licensure or denial of a license, the following data are
public: the name of the applicant, the city and county in which
the applicant was seeking licensure, the dates of the
commissioner's receipt of the initial application and completed
application, the type of license sought, and the date of
withdrawal of the application.
(4) For applicants who are denied a license, the following
data are public: the name of the applicant, the city and county
in which the applicant was seeking licensure, the dates of the
commissioner's receipt of the initial application and completed
application, the type of license sought, the date of denial of
the application, the nature of the basis for the denial, and the
status of any appeal of the denial.
(5) The following data on persons subject to
disqualification under section 245C.14 in connection with a
license to provide family day care for children, child care
center services, foster care for children in the provider's
home, or foster care or day care services for adults in the
provider's home, are public: the nature of any disqualification
set aside under section 245C.22, subdivisions 2 and 4, and the
reasons for setting aside the disqualification; the nature of
any disqualification for which a variance was granted under
sections 245A.04, subdivision 9; and 245C.30, and the reasons
for granting any variance under section 245A.04, subdivision 9;
and, if applicable, the disclosure that any person subject to a
background study under section 245C.03, subdivision 1, has
successfully passed a background study.
(6) When maltreatment is substantiated under section
626.556 or 626.557 and the victim and the substantiated
perpetrator are affiliated with a program licensed under chapter
245A, the commissioner of human services, local social services
agency, or county welfare agency may inform the license holder
where the maltreatment occurred of the identity of the
substantiated perpetrator and the victim.
(c) The following are private data on individuals under
section 13.02, subdivision 12, or nonpublic data under section
13.02, subdivision 9: personal and personal financial data on
family day care program and family foster care program
applicants and licensees and their family members who provide
services under the license.
(d) The following are private data on individuals: the
identity of persons who have made reports concerning licensees
or applicants that appear in inactive investigative data, and
the records of clients or employees of the licensee or applicant
for licensure whose records are received by the licensing agency
for purposes of review or in anticipation of a contested
matter. The names of reporters under sections 626.556 and
626.557 may be disclosed only as provided in section 626.556,
subdivision 11, or 626.557, subdivision 12b.
(e) Data classified as private, confidential, nonpublic, or
protected nonpublic under this subdivision become public data if
submitted to a court or administrative law judge as part of a
disciplinary proceeding in which there is a public hearing
concerning a license which has been suspended, immediately
suspended, revoked, or denied.
(f) Data generated in the course of licensing
investigations that relate to an alleged violation of law are
investigative data under subdivision 3.
(g) Data that are not public data collected, maintained,
used, or disseminated under this subdivision that relate to or
are derived from a report as defined in section 626.556,
subdivision 2, or 626.5572, subdivision 18, are subject to the
destruction provisions of sections 626.556, subdivision 11c, and
626.557, subdivision 12b.
(h) Upon request, not public data collected, maintained,
used, or disseminated under this subdivision that relate to or
are derived from a report of substantiated maltreatment as
defined in section 626.556 or 626.557 may be exchanged with the
Department of Health for purposes of completing background
studies pursuant to section 144.057 and with the Department of
Corrections for purposes of completing background studies
pursuant to section 241.021.
(i) Data on individuals collected according to licensing
activities under chapters 245A and 245C, and data on individuals
collected by the commissioner of human services according to
maltreatment investigations under sections 626.556 and 626.557,
may be shared with the Department of Human Rights, the
Department of Health, the Department of Corrections, the
Ombudsman for Mental Health and Retardation, and the
individual's professional regulatory board when there is reason
to believe that laws or standards under the jurisdiction of
those agencies may have been violated.
(j) In addition to the notice of determinations required
under section 626.556, subdivision 10f, if the commissioner or
the local social services agency has determined that an
individual is a substantiated perpetrator of maltreatment of a
child based on sexual abuse, as defined in section 626.556,
subdivision 2, and the commissioner or local social services
agency knows that the individual is a person responsible for a
child's care in another facility, the commissioner or local
social services agency shall notify the head of that facility of
this determination. The notification must include an
explanation of the individual's available appeal rights and the
status of any appeal. If a notice is given under this
paragraph, the government entity making the notification shall
provide a copy of the notice to the individual who is the
subject of the notice.
(k) All not public data collected, maintained, used, or
disseminated under this subdivision and subdivision 3 may be
exchanged between the Department of Human Services, Licensing
Division, and the Department of Corrections for purposes of
regulating services for which the Department of Human Services
and the Department of Corrections have regulatory authority.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 2. Minnesota Statutes 2004, section 243.166,
subdivision 4b, as added by Laws 2005, chapter 136, article 3,
section 8, is amended to read:
Subd. 4b. [HEALTH CARE FACILITY; NOTICE OF STATUS.] (a) As
used in paragraphs (b) and (c), For the purposes of this
subdivision, "health care facility" means a hospital or other
entity licensed under sections 144.50 to 144.58, a nursing home
licensed to serve adults under section 144A.02, or a group
residential housing facility or an intermediate care facility
for the mentally retarded licensed under chapter 245A. As used
in paragraph (d), "health care facility" means a nursing home
licensed to serve adults under section 144A.02, or a group
residential housing facility or an intermediate care facility
for the mentally retarded licensed under chapter 245A facility
licensed by:
(1) the commissioner of health as a hospital, boarding care
home or supervised living facility under sections 144.50 to
144.58, or a nursing home under chapter 144A; or
(2) the commissioner of human services as a residential
facility under chapter 245A to provide adult foster care, adult
mental health treatment, chemical dependency treatment to
adults, or residential services to persons with developmental
disabilities.
(b) Upon admittance to a health care facility, a person
required to register under this section shall disclose to:
(1) the health care facility employee processing the
admission the person's status as a registered predatory offender
under this section; and
(2) the person's corrections agent, or if the person does
not have an assigned corrections agent, the law enforcement
authority with whom the person is currently required to
register, that inpatient admission has occurred.
(c) A law enforcement authority or corrections agent who
receives notice under paragraph (b) or who knows that a person
required to register under this section has been admitted and is
receiving health care at a health care facility shall notify the
administrator of the facility.
(d) Except for a hospital licensed under sections 144.50 to
144.58, a health care facility that receives notice under this
subdivision that a predatory offender has been admitted to the
facility shall notify other patients residents at the facility
of this fact. If the facility determines that notice to
a patient resident is not appropriate given the patient's
resident's medical, emotional, or mental status, the facility
shall notify the patient's next of kin or emergency contact.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 3. Minnesota Statutes 2004, section 243.166,
subdivision 7, as amended by Laws 2005, chapter 136, article 5,
section 1, is amended to read:
Subd. 7. [USE OF DATA.] Except as otherwise provided in
subdivision 7a or sections 244.052 and 299C.093, the data
provided under this section is private data on individuals under
section 13.02, subdivision 12. The data may be used only for
law enforcement and corrections purposes. State-operated
services, as defined in section 246.014, are also authorized to
have access to the data for the purposes described in section
246.13, subdivision 2, paragraph (c) (b).
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 4. Minnesota Statutes 2004, section 245A.02,
subdivision 17, is amended to read:
Subd. 17. [SCHOOL AGE CHILD CARE PROGRAM.] "School age
child care program" means a program licensed or required to be
licensed as a child care center, serving more than ten children
with the primary purpose of providing child care for school age
children. School age child care program does not include
programs such as scouting, boys clubs, girls clubs, nor sports
or art programs.
Sec. 5. Minnesota Statutes 2004, section 245A.03,
subdivision 2, is amended to read:
Subd. 2. [EXCLUSION FROM LICENSURE.] (a) This chapter does
not apply to:
(1) residential or nonresidential programs that are
provided to a person by an individual who is related unless the
residential program is a child foster care placement made by a
local social services agency or a licensed child-placing agency,
except as provided in subdivision 2a;
(2) nonresidential programs that are provided by an
unrelated individual to persons from a single related family;
(3) residential or nonresidential programs that are
provided to adults who do not abuse chemicals or who do not have
a chemical dependency, a mental illness, mental retardation or a
related condition, a functional impairment, or a physical
handicap;
(4) sheltered workshops or work activity programs that are
certified by the commissioner of economic security;
(5) programs operated by a public school for children 33
months or older;
(6) nonresidential programs primarily for children that
provide care or supervision for periods of less than three hours
a day while the child's parent or legal guardian is in the same
building as the nonresidential program or present within another
building that is directly contiguous to the building in which
the nonresidential program is located;
(7) nursing homes or hospitals licensed by the commissioner
of health except as specified under section 245A.02;
(8) board and lodge facilities licensed by the commissioner
of health that provide services for five or more persons whose
primary diagnosis is mental illness that do not provide
intensive residential treatment;
(9) homes providing programs for persons placed there by a
licensed agency for legal adoption, unless the adoption is not
completed within two years;
(10) programs licensed by the commissioner of corrections;
(11) recreation programs for children or adults that are
operated or approved by a park and recreation board whose
primary purpose is to provide social and recreational
activities;
(12) programs operated by a school as defined in section
120A.22, subdivision 4, whose primary purpose is to provide
child care to school-age children;
(13) Head Start nonresidential programs which operate for
less than 31 45 days in each calendar year;
(14) noncertified boarding care homes unless they provide
services for five or more persons whose primary diagnosis is
mental illness or mental retardation;
(15) programs for children such as scouting, boys clubs,
girls clubs, and sports and art programs, and nonresidential
programs for children provided for a cumulative total of less
than 30 days in any 12-month period;
(16) residential programs for persons with mental illness,
that are located in hospitals;
(17) the religious instruction of school-age children;
Sabbath or Sunday schools; or the congregate care of children by
a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its
regular worship;
(18) camps licensed by the commissioner of health under
Minnesota Rules, chapter 4630;
(19) mental health outpatient services for adults with
mental illness or children with emotional disturbance;
(20) residential programs serving school-age children whose
sole purpose is cultural or educational exchange, until the
commissioner adopts appropriate rules;
(21) unrelated individuals who provide out-of-home respite
care services to persons with mental retardation or related
conditions from a single related family for no more than 90 days
in a 12-month period and the respite care services are for the
temporary relief of the person's family or legal representative;
(22) respite care services provided as a home and
community-based service to a person with mental retardation or a
related condition, in the person's primary residence;
(23) community support services programs as defined in
section 245.462, subdivision 6, and family community support
services as defined in section 245.4871, subdivision 17;
(24) the placement of a child by a birth parent or legal
guardian in a preadoptive home for purposes of adoption as
authorized by section 259.47;
(25) settings registered under chapter 144D which provide
home care services licensed by the commissioner of health to
fewer than seven adults; or
(26) consumer-directed community support service funded
under the Medicaid waiver for persons with mental retardation
and related conditions when the individual who provided the
service is:
(i) the same individual who is the direct payee of these
specific waiver funds or paid by a fiscal agent, fiscal
intermediary, or employer of record; and
(ii) not otherwise under the control of a residential or
nonresidential program that is required to be licensed under
this chapter when providing the service.
(b) For purposes of paragraph (a), clause (6), a building
is directly contiguous to a building in which a nonresidential
program is located if it shares a common wall with the building
in which the nonresidential program is located or is attached to
that building by skyway, tunnel, atrium, or common roof.
(c) Nothing in this chapter shall be construed to require
licensure for any services provided and funded according to an
approved federal waiver plan where licensure is specifically
identified as not being a condition for the services and funding.
Sec. 6. Minnesota Statutes 2004, section 245A.03,
subdivision 3, is amended to read:
Subd. 3. [UNLICENSED PROGRAMS.] (a) It is a misdemeanor
for an individual, corporation, partnership, voluntary
association, other organization, or a controlling individual to
provide a residential or nonresidential program without a
license and in willful disregard of this chapter unless the
program is excluded from licensure under subdivision 2.
(b) The commissioner may ask the appropriate county
attorney or the attorney general to begin proceedings to secure
a court order against the continued operation of the program, if
an individual, corporation, partnership, voluntary association,
other organization, or controlling individual has:
(1) failed to apply for a license after receiving notice
that a license is required or continues to operate without a
license after receiving notice that a license is required;
(2) continued to operate without a license after the
license has been revoked or suspended under section 245A.07, and
the commissioner has issued a final order affirming the
revocation or suspension, or the license holder did not timely
appeal the sanction; or
(3) continued to operate without a license after the
license has been temporarily suspended under section 245A.07.
The county attorney and the attorney general have a duty to
cooperate with the commissioner.
Sec. 7. Minnesota Statutes 2004, section 245A.035,
subdivision 1, is amended to read:
Subdivision 1. [GRANT OF EMERGENCY LICENSE.]
Notwithstanding section 245A.03, subdivision 2a, or 245C.13,
subdivision 2, a county agency may place a child for foster care
with a relative who is not licensed to provide foster care,
provided the requirements of subdivision 2 are met. As used in
this section, the term "relative" has the meaning given it under
section 260C.007, subdivision 27.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 8. Minnesota Statutes 2004, section 245A.035,
subdivision 5, is amended to read:
Subd. 5. [CHILD FOSTER CARE LICENSE APPLICATION.] (a) The
emergency license holder shall complete the child foster care
license application and necessary paperwork within ten days of
the placement. The county agency shall assist the emergency
license holder to complete the application. The granting of a
child foster care license to a relative shall be under the
procedures in this chapter and according to the standards set
forth by foster care rule. In licensing a relative, the
commissioner shall consider the importance of maintaining the
child's relationship with relatives as an additional significant
factor in determining whether to set aside a licensing
disqualifier under section 245C.22, or to grant a variance of
licensing requirements under sections 245C.21 to 245C.27.
(b) When the county or private child-placing agency is
processing an application for child foster care licensure of a
relative as defined in section 260B.007, subdivision 12, or
260C.007, subdivision 27, the county agency or child-placing
agency must explain the licensing process to the prospective
licensee, including the background study process and the
procedure for reconsideration of an initial disqualification for
licensure. The county or private child-placing agency must also
provide the prospective relative licensee with information
regarding appropriate options for legal representation in the
pertinent geographic area. If a relative is initially
disqualified under section 245C.14, the county or child-placing
agency must provide written notice of the reasons for the
disqualification and the right to request a reconsideration by
the commissioner as required under section 245C.17.
(c) The commissioner shall maintain licensing data so that
activities related to applications and licensing actions for
relative foster care providers may be distinguished from other
child foster care settings.
Sec. 9. Minnesota Statutes 2004, section 245A.04,
subdivision 7, is amended to read:
Subd. 7. [ISSUANCE OF A LICENSE; EXTENSION OF A LICENSE.]
(a) If the commissioner determines that the program complies
with all applicable rules and laws, the commissioner shall issue
a license. At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive
services from the program; and
(6) any special conditions of licensure.
(b) The commissioner may issue an initial license for a
period not to exceed two years if:
(1) the commissioner is unable to conduct the evaluation or
observation required by subdivision 4, paragraph (a), clauses (3)
and (4), because the program is not yet operational;
(2) certain records and documents are not available because
persons are not yet receiving services from the program; and
(3) the applicant complies with applicable laws and rules
in all other respects.
(c) A decision by the commissioner to issue a license does
not guarantee that any person or persons will be placed or cared
for in the licensed program. A license shall not be
transferable to another individual, corporation, partnership,
voluntary association, other organization, or controlling or to
another location.
(d) A license holder must notify the commissioner and
obtain the commissioner's approval before making any changes
that would alter the license information listed under paragraph
(a).
(e) The commissioner shall not issue a license if the
applicant, license holder, or controlling individual has:
(1) been disqualified and the disqualification was not set
aside;
(2) has been denied a license within the past two years; or
(3) had a license revoked within the past five years.
(f) The commissioner shall not issue a license if an
individual living in the household where the licensed services
will be provided as specified under section 245C.03, subdivision
1, has been disqualified and the disqualification has not been
set aside.
For purposes of reimbursement for meals only, under the
Child and Adult Care Food Program, Code of Federal Regulations,
title 7, subtitle B, chapter II, subchapter A, part 226,
relocation within the same county by a licensed family day care
provider, shall be considered an extension of the license for a
period of no more than 30 calendar days or until the new license
is issued, whichever occurs first, provided the county agency
has determined the family day care provider meets licensure
requirements at the new location.
Unless otherwise specified by statute, all licenses expire
at 12:01 a.m. on the day after the expiration date stated on the
license. A license holder must apply for and be granted a new
license to operate the program or the program must not be
operated after the expiration date.
Sec. 10. Minnesota Statutes 2004, section 245A.04,
subdivision 13, is amended to read:
Subd. 13. [RESIDENTIAL PROGRAMS HANDLING RESIDENT FUNDS
AND PROPERTY; ADDITIONAL REQUIREMENTS.] (a) A license holder
must ensure that residents persons served by the program retain
the use and availability of personal funds or property unless
restrictions are justified in the resident's person's individual
plan. This subdivision does not apply to programs governed by
the provisions in section 245B.07, subdivision 10.
(b) The license holder must ensure separation of resident
funds of persons served by the program from funds of the license
holder, the residential program, or program staff.
(c) Whenever the license holder assists a resident person
served by the program with the safekeeping of funds or other
property, the license holder must:
(1) immediately document receipt and disbursement of the
resident's person's funds or other property at the time of
receipt or disbursement, including the person's signature of the
resident, or the signature of the conservator, or payee; and
(2) provide a statement, at least quarterly, itemizing
receipts and disbursements of resident funds or other property;
and
(3) return to the resident person upon the
resident's person's request, funds and property in the license
holder's possession subject to restrictions in the resident's
person's treatment plan, as soon as possible, but no later than
three working days after the date of request.
(d) License holders and program staff must not:
(1) borrow money from a resident person served by the
program;
(2) purchase personal items from a resident person served
by the program;
(3) sell merchandise or personal services to a resident
person served by the program;
(4) require a resident person served by the program to
purchase items for which the license holder is eligible for
reimbursement; or
(5) use resident funds of persons served by the program to
purchase items for which the facility is already receiving
public or private payments.
Sec. 11. Minnesota Statutes 2004, section 245A.06, is
amended by adding a subdivision to read:
Subd. 8. [FAMILY CHILD CARE AND CHILD CARE CENTERS POSTING
OF ORDER.] For licensed family child care providers and child
care centers, upon receipt of any correction order or order of
conditional license issued by the commissioner under this
section, and notwithstanding a pending request for
reconsideration of the correction order or order of conditional
license by the license holder, the license holder shall post the
correction order or order of conditional license in a place that
is conspicuous to the people receiving services and all visitors
to the facility for two years. When the correction order or
order of conditional license is accompanied by a maltreatment
investigation memorandum prepared under section 626.556 or
626.557, the investigation memoranda must be posted with the
correction order or order of conditional license.
Sec. 12. Minnesota Statutes 2004, section 245A.07,
subdivision 1, is amended to read:
Subdivision 1. [SANCTIONS AVAILABLE; APPEALS; TEMPORARY
PROVISIONAL LICENSE.] (a) In addition to making a license
conditional under section 245A.06, the commissioner may propose
to suspend or revoke the license, impose a fine, or secure an
injunction against the continuing operation of the program of a
license holder who does not comply with applicable law or rule.
When applying sanctions authorized under this section, the
commissioner shall consider the nature, chronicity, or severity
of the violation of law or rule and the effect of the violation
on the health, safety, or rights of persons served by the
program.
(b) If a license holder appeals the suspension or
revocation of a license and the license holder continues to
operate the program pending a final order on the appeal, and the
license expires during this time period, the commissioner shall
issue the license holder a temporary provisional license. The
temporary provisional license is effective on the date issued
and expires on the date that a final order is issued. Unless
otherwise specified by the commissioner, variances in effect on
the date of the license sanction under appeal continue under the
temporary provisional license. If a license holder fails to
comply with applicable law or rule while operating under a
temporary provisional license, the commissioner may impose
sanctions under this section and section 245A.06, and may
terminate any prior variance. If the license holder prevails on
the appeal and the effective period of the previous license has
expired, a new license shall be issued to the license holder
upon payment of any fee required under section 245A.10. The
effective date of the new license shall be retroactive to the
date the license would have shown had no sanction been
initiated. The expiration date shall be the expiration date of
that license had no license sanction been initiated.
(c) If a license holder is under investigation and the
license is due to expire before completion of the investigation,
the program shall be issued a new license upon completion of the
reapplication requirements. Upon completion of the
investigation, a licensing sanction may be imposed against the
new license under this section, section 245A.06, or 245A.08.
(d) Failure to reapply or closure of a license by the
license holder prior to the completion of any investigation
shall not preclude the commissioner from issuing a licensing
sanction under this section, section 245A.06, or 245A.08 at the
conclusion of the investigation.
Sec. 13. Minnesota Statutes 2004, section 245A.07,
subdivision 3, is amended to read:
Subd. 3. [LICENSE SUSPENSION, REVOCATION, OR FINE.] (a)
The commissioner may suspend or revoke a license, or impose a
fine if a license holder fails to comply fully with applicable
laws or rules, if a license holder or an individual living in
the household where the licensed services are provided has a
disqualification which has not been set aside under section
245C.22, or if a license holder knowingly withholds relevant
information from or gives false or misleading information to the
commissioner in connection with an application for a license, in
connection with the background study status of an individual, or
during an investigation. A license holder who has had a license
suspended, revoked, or has been ordered to pay a fine must be
given notice of the action by certified mail or personal
service. If mailed, the notice must be mailed to the address
shown on the application or the last known address of the
license holder. The notice must state the reasons the license
was suspended, revoked, or a fine was ordered.
(a) (b) If the license was suspended or revoked, the notice
must inform the license holder of the right to a contested case
hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612. The license holder may appeal an order suspending or
revoking a license. The appeal of an order suspending or
revoking a license must be made in writing by certified mail or
personal service. If mailed, the appeal must be postmarked and
sent to the commissioner within ten calendar days after the
license holder receives notice that the license has been
suspended or revoked. If a request is made by personal service,
it must be received by the commissioner within ten calendar days
after the license holder received the order. Except as provided
in subdivision 2a, paragraph (c), a timely appeal of an order
suspending or revoking a license shall stay the suspension or
revocation until the commissioner issues a final order.
(b)(c)(1) If the license holder was ordered to pay a fine,
the notice must inform the license holder of the responsibility
for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612. The appeal of an order to pay a fine must be made in
writing by certified mail or personal service. If mailed, the
appeal must be postmarked and sent to the commissioner within
ten calendar days after the license holder receives notice that
the fine has been ordered. If a request is made by personal
service, it must be received by the commissioner within ten
calendar days after the license holder received the order.
(2) The license holder shall pay the fines assessed on or
before the payment date specified. If the license holder fails
to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder
complies. If the license holder receives state funds, the
state, county, or municipal agencies or departments responsible
for administering the funds shall withhold payments and recover
any payments made while the license is suspended for failure to
pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.
(3) A license holder shall promptly notify the commissioner
of human services, in writing, when a violation specified in the
order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected
as indicated by the order to forfeit a fine, the commissioner
may issue a second fine. The commissioner shall notify the
license holder by certified mail or personal service that a
second fine has been assessed. The license holder may appeal
the second fine as provided under this subdivision.
(4) Fines shall be assessed as follows: the license holder
shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable
adult under section 626.557; the license holder shall forfeit
$200 for each occurrence of a violation of law or rule governing
matters of health, safety, or supervision, including but not
limited to the provision of adequate staff-to-child or adult
ratios, and failure to submit a background study; and the
license holder shall forfeit $100 for each occurrence of a
violation of law or rule other than those subject to a $1,000 or
$200 fine above. For purposes of this section, "occurrence"
means each violation identified in the commissioner's fine order.
(5) When a fine has been assessed, the license holder may
not avoid payment by closing, selling, or otherwise transferring
the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the
case of a corporation, each controlling individual is personally
and jointly liable for payment.
Sec. 14. Minnesota Statutes 2004, section 245A.07, is
amended by adding a subdivision to read:
Subd. 5. [FAMILY CHILD CARE AND CHILD CARE CENTERS POSTING
OF ORDER.] For licensed family child care providers and child
care centers, upon receipt of any order of license suspension,
temporary immediate suspension, fine, or revocation issued by
the commissioner under this section, and notwithstanding a
pending appeal of the order of license suspension, temporary
immediate suspension, fine, or revocation by the license holder,
the license holder shall post the order of license suspension,
temporary immediate suspension, fine, or revocation in a place
that is conspicuous to the people receiving services and all
visitors to the facility for two years. When the order of
license suspension, temporary immediate suspension, fine, or
revocation is accompanied by a maltreatment investigation
memorandum prepared under section 626.556 or 626.557, the
investigation memoranda must be posted with the order of license
suspension, temporary immediate suspension, fine, or revocation.
Sec. 15. Minnesota Statutes 2004, section 245A.08,
subdivision 2a, is amended to read:
Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR
SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND
DISQUALIFICATIONS.] (a) When a denial of a license under section
245A.05 or a licensing sanction under section 245A.07,
subdivision 3, is based on a disqualification for which
reconsideration was requested and which was not set aside under
section 245C.22, the scope of the contested case hearing shall
include the disqualification and the licensing sanction or
denial of a license. When the licensing sanction or denial of a
license is based on a determination of maltreatment under
section 626.556 or 626.557, or a disqualification for serious or
recurring maltreatment which was not set aside, the scope of the
contested case hearing shall include the maltreatment
determination, disqualification, and the licensing sanction or
denial of a license. In such cases, a fair hearing under
section 256.045 shall not be conducted as provided for in
sections 626.556, subdivision 10i, and 626.557, subdivision 9d.
When a fine is based on a determination that the license holder
is responsible for maltreatment and the fine is issued at the
same time as the maltreatment determination, if the license
holder appeals the maltreatment and fine, the scope of the
contested case hearing shall include the maltreatment
determination and fine and reconsideration of the maltreatment
determination shall not be conducted as provided for in sections
626.556, subdivision 10i, and 626.557, subdivision 9d.
(b) In consolidated contested case hearings regarding
sanctions issued in family child care, child foster care, family
adult day services, and adult foster care, the county attorney
shall defend the commissioner's orders in accordance with
section 245A.16, subdivision 4.
(c) The commissioner's final order under subdivision 5 is
the final agency action on the issue of maltreatment and
disqualification, including for purposes of subsequent
background studies under chapter 245C and 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.
(d) When consolidated hearings under this subdivision
involve a licensing sanction based on a previous maltreatment
determination for which the commissioner has issued a final
order in an appeal of that determination under section 256.045,
or the individual failed to exercise the right to appeal the
previous maltreatment determination under section 626.556,
subdivision 10i, or 626.557, subdivision 9d, the commissioner's
order is conclusive on the issue of maltreatment. In such
cases, the scope of the administrative law judge's review shall
be limited to the disqualification and the licensing sanction or
denial of a license. In the case of a denial of a license or a
licensing sanction issued to a facility based on a maltreatment
determination regarding an individual who is not the license
holder or a household member, the scope of the administrative
law judge's review includes the maltreatment determination.
(e) If a maltreatment determination or disqualification,
which was not set aside under section 245C.22, is the basis for
a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, and the disqualified subject is
an individual other than the license holder and upon whom a
background study must be conducted under section 245C.03, the
hearings of all parties may be consolidated into a single
contested case hearing upon consent of all parties and the
administrative law judge.
(f) Notwithstanding section 245C.27, subdivision 1,
paragraph (c), when a denial of a license under section 245A.05
or a licensing sanction under section 245A.07 is based on a
disqualification for which reconsideration was requested and was
not set aside under section 245C.22, and the disqualification
was based on a conviction or an admission to any crimes listed
in section 245C.15, the scope of the administrative law judge's
review shall include the denial or sanction and a determination
whether the disqualification should be set aside. In
determining whether the disqualification should be set aside,
the administrative law judge shall consider the factors under
section 245C.22, subdivision 4, to determine whether the
individual poses a risk of harm to any person receiving services
from the license holder.
(g) Notwithstanding section 245C.30, subdivision 5, when a
licensing sanction under section 245A.07 is based on the
termination of a variance under section 245C.30, subdivision 4,
the scope of the administrative law judge's review shall include
the sanction and a determination whether the disqualification
should be set aside. In determining whether the
disqualification should be set aside, the administrative law
judge shall consider the factors under section 245C.22,
subdivision 4, to determine whether the individual poses a risk
of harm to any person receiving services from the license holder.
Sec. 16. Minnesota Statutes 2004, section 245A.08,
subdivision 5, is amended to read:
Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After
considering the findings of fact, conclusions, and
recommendations of the administrative law judge, the
commissioner shall issue a final order. The commissioner shall
consider, but shall not be bound by, the recommendations of the
administrative law judge. The appellant must be notified of the
commissioner's final order as required by chapter 14 and
Minnesota Rules, parts 1400.8505 to 1400.8612. The notice must
also contain information about the appellant's rights under
chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612.
The institution of proceedings for judicial review of the
commissioner's final order shall not stay the enforcement of the
final order except as provided in section 14.65.
Subd. 5a. [EFFECT OF FINAL ORDER ON GRANTING A SUBSEQUENT
LICENSE.] (a) A license holder and each controlling individual
of a license holder whose license has been revoked because of
noncompliance with applicable law or rule must not be granted a
license for five years following the
revocation. Notwithstanding the five-year restriction, when a
license is revoked because a person, other than the license
holder, resides in the home where services are provided and that
person has a disqualification that is not set aside and no
variance has been granted, the former license holder may reapply
for a license when:
(1) the person with a disqualification, who is not a minor
child, is no longer residing in the home and is prohibited from
residing in or returning to the home; or
(2) the person with the disqualification is a minor child,
the restriction applies until the minor child becomes an adult
and permanently moves away from the home or five years,
whichever is less.
(b) An applicant whose application was denied must not be
granted a license for two years following a denial, unless the
applicant's subsequent application contains new information
which constitutes a substantial change in the conditions that
caused the previous denial.
Sec. 17. Minnesota Statutes 2004, section 245A.14, is
amended by adding a subdivision to read:
Subd. 12. [FIRST AID TRAINING REQUIREMENTS FOR STAFF IN
CHILD CARE CENTERS AND FAMILY CHILD CARE.] Notwithstanding
Minnesota Rules, part 9503.0035, subpart 2, when children are
present in a family child care home governed by Minnesota Rules,
parts 9502.0315 to 9502.0445, or a child care center governed by
Minnesota Rules, parts 9503.0005 to 9503.0170, at least one
staff person must be present in the center or home who has been
trained in first aid. The first aid training must have been
provided by an individual approved to provide first aid
instruction. First aid training may be less than eight hours
and persons qualified to provide first aid training shall
include individuals approved as first aid instructors.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 18. Minnesota Statutes 2004, section 245A.14, is
amended by adding a subdivision to read:
Subd. 13. [CARDIOPULMONARY RESUSCITATION (CPR) TRAINING
REQUIREMENT.] (a) When children are present in a child care
center governed by Minnesota Rules, parts 9503.0005 to
9503.0170, or in a family child care home governed by Minnesota
Rules, parts 9502.0315 to 9502.0445, at least one staff person
must be present in the center or home who has been trained in
cardiopulmonary resuscitation (CPR) and in the treatment of
obstructed airways. The CPR training must have been provided by
an individual approved to provide CPR instruction, must be
repeated at least once every three years, and must be documented
in the staff person's records.
(b) Notwithstanding Minnesota Rules, part 9503.0035,
subpart 3, item A, cardiopulmonary resuscitation training may be
provided for less than four hours.
(c) Notwithstanding Minnesota Rules, part 9503.0035,
subpart 3, item C, persons qualified to provide cardiopulmonary
resuscitation training shall include individuals approved as
cardiopulmonary resuscitation instructors.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 19. Minnesota Statutes 2004, section 245A.144, is
amended to read:
245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME
AND SHAKEN BABY SYNDROME IN CHILD CARE AND CHILD FOSTER CARE
PROGRAMS.]
(a) License holders must ensure document that before staff
persons, caregivers, and helpers assist in the care of infants,
they receive training on reducing the risk of sudden infant
death syndrome and shaken baby syndrome. The training on
reducing the risk of sudden infant death syndrome and shaken
baby syndrome may be provided as:
(1) orientation training to child care center staff under
Minnesota Rules, part 9503.0035, subpart 1, as and to child
foster care providers, who care for infants, under Minnesota
Rules, part 2960.3070, subpart 1;
(2) initial training to family and group family child care
providers under Minnesota Rules, part 9502.0385, subpart 2, as;
(3) in-service training to child care center staff under
Minnesota Rules, part 9503.0035, subpart 4, and to child foster
care providers, who care for infants, under Minnesota Rules,
part 2960.3070, subpart 2; or as
(4) ongoing training to family and group family child care
providers under Minnesota Rules, part 9502.0385, subpart 3.
(b) Training required under this section must be at least
one hour in length and must be completed at least once every
five years. At a minimum, the training must address the risk
factors related to sudden infant death syndrome and shaken baby
syndrome, means of reducing the risk of sudden infant death
syndrome and shaken baby syndrome in child care, and license
holder communication with parents regarding reducing the risk of
sudden infant death syndrome and shaken baby syndrome.
(c) Training for family and group family child care
providers must be approved by the county licensing agency
according to Minnesota Rules, part 9502.0385.
(d) Training for child foster care providers must be
approved by the county licensing agency and fulfills, in part,
training required under Minnesota Rules, part 2960.3070.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 20. Minnesota Statutes 2004, section 245A.16,
subdivision 1, is amended to read:
Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a)
County agencies and private agencies that have been designated
or licensed by the commissioner to perform licensing functions
and activities under section 245A.04 and chapter 245C, to
recommend denial of applicants under section 245A.05, to issue
correction orders, to issue variances, and recommend a
conditional license under section 245A.06, or to recommend
suspending or revoking a license or issuing a fine under section
245A.07, shall comply with rules and directives of the
commissioner governing those functions and with this section.
The following variances are excluded from the delegation of
variance authority and may be issued only by the commissioner:
(1) dual licensure of family child care and child foster
care, dual licensure of child and adult foster care, and adult
foster care and family child care;
(2) adult foster care maximum capacity;
(3) adult foster care minimum age requirement;
(4) child foster care maximum age requirement;
(5) variances regarding disqualified individuals except
that county agencies may issue variances under section 245C.30
regarding disqualified individuals when the county is
responsible for conducting a consolidated reconsideration
according to sections 245C.25 and 245C.27, subdivision 2,
clauses (a) and (b), of a county maltreatment determination and
a disqualification based on serious or recurring maltreatment;
and
(6) the required presence of a caregiver in the adult
foster care residence during normal sleeping hours.
(b) County agencies must report:
(1) information about disqualification reconsiderations
under sections 245C.25 and 245C.27, subdivision 2, clauses (a)
and (b), and variances granted under paragraph (a), clause (5),
to the commissioner at least monthly in a format prescribed by
the commissioner; and
(2) for relative child foster care applicants and license
holders, the number of relatives, as defined in section
260C.007, subdivision 27, and household members of relatives who
are disqualified under section 245C.14; the disqualifying
characteristics under section 245C.15; the number of these
individuals who requested reconsideration under section 245C.21;
the number of set-asides under section 245C.22; and variances
under section 245C.30 issued. This information shall be
reported to the commissioner annually by January 15 of each year
in a format prescribed by the commissioner.
(c) For family day care programs, the commissioner may
authorize licensing reviews every two years after a licensee has
had at least one annual review.
(d) For family adult day services programs, the
commissioner may authorize licensing reviews every two years
after a licensee has had at least one annual review.
(e) A license issued under this section may be issued for
up to two years.
Sec. 21. Minnesota Statutes 2004, section 245A.16,
subdivision 4, is amended to read:
Subd. 4. [ENFORCEMENT OF THE COMMISSIONER'S ORDERS.] The
county or private agency shall enforce the commissioner's orders
under sections 245A.07, 245A.08, subdivision 5, and chapter
245C, according to the instructions of the commissioner. The
county attorney shall assist the county agency in the
enforcement and defense of the commissioner's orders under
sections 245A.07, 245A.08, and chapter 245C, according to the
instructions of the commissioner, unless a conflict of interest
exists between the county attorney and the commissioner. For
purposes of this section, a conflict of interest means that the
county attorney has a direct or shared financial interest with
the license holder or has a personal relationship or family
relationship with a party in the licensing action.
Sec. 22. Minnesota Statutes 2004, section 245A.18, is
amended to read:
245A.18 [SEAT BELT USE REQUIRED CHILD PASSENGER RESTRAINT
SYSTEMS; TRAINING REQUIREMENT.]
(a) When a nonresidential license holder provides or
arranges for transportation for children served by the license
holder, children four years old and older must be restrained by
a properly adjusted and fastened seat belt and children under
age four must be properly fastened in a child passenger
restraint system meeting federal motor vehicle safety
standards. A child passenger restraint system is not required
for a child who, in the judgment of a licensed physician, cannot
be safely transported in a child passenger restraint system
because of a medical condition, body size, or physical
disability, if the license holder possesses a written statement
from the physician that satisfies the requirements in section
169.685, subdivision 6, paragraph (b).
(b) Paragraph (a) does not apply to transportation of
children in a school bus inspected under section 169.451 that
has a gross vehicle weight rating of more than 10,000 pounds, is
designed for carrying more than ten persons, and was
manufactured after 1977.
Subdivision 1. [SEAT BELT USE.] A license holder must
comply with all seat belt and child passenger restraint system
requirements under section 169.685.
Subd. 2. [CHILD PASSENGER RESTRAINT SYSTEMS; TRAINING
REQUIREMENT.]
(a) Family and group family child care, child care centers,
child foster care, and other programs licensed by the Department
of Human Services that serve a child or children under nine
years of age must document training that fulfills the
requirements in this subdivision.
(b) Before a license holder, staff person, caregiver, or
helper transports a child or children under age nine in a motor
vehicle, the person transporting the child must satisfactorily
complete training on the proper use and installation of child
restraint systems in motor vehicles. Training completed under
this section may be used to meet initial or ongoing training
under the following:
(1) Minnesota Rules, part 2960.3070, subparts 1 and 2;
(2) Minnesota Rules, part 9502.0385, subparts 2 and 3; and
(3) Minnesota Rules, part 9503.0035, subparts 1 and 4.
(c) Training required under this section must be at least
one hour in length, completed at orientation or initial
training, and repeated at least once every five years. At a
minimum, the training must address the proper use of child
restraint systems based on the child's size, weight, and age,
and the proper installation of a car seat or booster seat in the
motor vehicle used by the license holder to transport the child
or children.
(d) Training under paragraph (c) must be provided by
individuals who are certified and approved by the Department of
Public Safety, Office of Traffic Safety. License holders may
obtain a list of certified and approved trainers through the
Department of Public Safety Web site or by contacting the agency.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 23. Minnesota Statutes 2004, section 245B.02,
subdivision 10, is amended to read:
Subd. 10. [INCIDENT.] "Incident" means any of the
following:
(1) serious injury as determined by section 245.91,
subdivision 6;
(2) a consumer's death;
(3) any medical emergencies, unexpected serious illnesses,
or accidents that require physician treatment or
hospitalization;
(4) a consumer's unauthorized absence;
(5) any fires or other events that require the relocation
of services for more than 24 hours, or circumstances involving a
law enforcement agency or fire department related to the health,
safety, or supervision of a consumer;
(6) physical aggression by a consumer against another
consumer that causes physical pain, injury, or persistent
emotional distress, including, but not limited to, hitting,
slapping, kicking, scratching, pinching, biting, pushing, and
spitting;
(7) any sexual activity between consumers involving force
or coercion as defined under section 609.341, subdivisions 3 and
14; or
(8) a report of child or vulnerable adult maltreatment
under section 626.556 or 626.557.
Sec. 24. Minnesota Statutes 2004, section 245B.055,
subdivision 7, is amended to read:
Subd. 7. [DETERMINING NUMBER OF DIRECT SERVICE STAFF
REQUIRED.] The minimum number of direct service staff members
required at any one time to meet the combined staff ratio
requirements of the persons present at that time can be
determined by following the steps in clauses (1) through (4):
(1) assign each person in attendance the three-digit
decimal below that corresponds to the staff ratio requirement
assigned to that person. A staff ratio requirement of one to
four equals 0.250. A staff ratio requirement of one to eight
equals 0.125. A staff ratio requirement of one to six equals
0.166. A staff ratio requirement of one to ten equals 0.100;
(2) add all of the three-digit decimals (one three-digit
decimal for every person in attendance) assigned in clause (1);
(3) when the sum in clause (2) falls between two whole
numbers, round off the sum to the larger of the two whole
numbers; and
(4) the larger of the two whole numbers in clause (3)
equals the number of direct service staff members needed to meet
the staff ratio requirements of the persons in attendance.
Sec. 25. Minnesota Statutes 2004, section 245B.07,
subdivision 8, is amended to read:
Subd. 8. [POLICIES AND PROCEDURES.] The license holder
must develop and implement the policies and procedures in
paragraphs (1) to (3).
(1) Policies and procedures that promote consumer health
and safety by ensuring:
(i) consumer safety in emergency situations as identified
in section 245B.05, subdivision 7;
(ii) consumer health through sanitary practices;
(iii) safe transportation, when the license holder is
responsible for transportation of consumers, with provisions for
handling emergency situations;
(iv) a system of record keeping for both individuals and
the organization, for review of incidents and emergencies, and
corrective action if needed;
(v) a plan for responding to all incidents, as defined in
section 245B.02, subdivision 10, fires, severe weather and
natural disasters, bomb threats, and other threats and reporting
all incidents required to be reported under section 245B.05,
subdivision 7;
(vi) safe medication administration as identified in
section 245B.05, subdivision 5, incorporating an observed skill
assessment to ensure that staff demonstrate the ability to
administer medications consistent with the license holder's
policy and procedures;
(vii) psychotropic medication monitoring when the consumer
is prescribed a psychotropic medication, including the use of
the psychotropic medication use checklist. If the
responsibility for implementing the psychotropic medication use
checklist has not been assigned in the individual service plan
and the consumer lives in a licensed site, the residential
license holder shall be designated; and
(viii) criteria for admission or service initiation
developed by the license holder;.
(2) Policies and procedures that protect consumer rights
and privacy by ensuring:
(i) consumer data privacy, in compliance with the Minnesota
Data Practices Act, chapter 13; and
(ii) that complaint procedures provide consumers with a
simple process to bring grievances and consumers receive a
response to the grievance within a reasonable time period. The
license holder must provide a copy of the program's grievance
procedure and time lines for addressing grievances. The
program's grievance procedure must permit consumers served by
the program and the authorized representatives to bring a
grievance to the highest level of authority in the program; and.
(3) Policies and procedures that promote continuity and
quality of consumer supports by ensuring:
(i) continuity of care and service coordination, including
provisions for service termination, temporary service
suspension, and efforts made by the license holder to coordinate
services with other vendors who also provide support to the
consumer. The policy must include the following requirements:
(A) the license holder must notify the consumer or
consumer's legal representative and the consumer's case manager
in writing of the intended termination or temporary service
suspension and the consumer's right to seek a temporary order
staying the termination or suspension of service according to
the procedures in section 256.045, subdivision 4a or subdivision
6, paragraph (c);
(B) notice of the proposed termination of services,
including those situations that began with a temporary service
suspension, must be given at least 60 days before the proposed
termination is to become effective;
(C) the license holder must provide information requested
by the consumer or consumer's legal representative or case
manager when services are temporarily suspended or upon notice
of termination;
(D) use of temporary service suspension procedures are
restricted to situations in which the consumer's behavior causes
immediate and serious danger to the health and safety of the
individual or others;
(E) prior to giving notice of service termination or
temporary service suspension, the license holder must document
actions taken to minimize or eliminate the need for service
termination or temporary service suspension; and
(F) during the period of temporary service suspension, the
license holder will work with the appropriate county agency to
develop reasonable alternatives to protect the individual and
others; and
(ii) quality services measured through a program evaluation
process including regular evaluations of consumer satisfaction
and sharing the results of the evaluations with the consumers
and legal representatives.
Sec. 26. Minnesota Statutes 2004, section 245C.03,
subdivision 1, is amended to read:
Subdivision 1. [LICENSED PROGRAMS.] (a) The commissioner
shall conduct a background study on:
(1) the person or persons applying for a license;
(2) an individual age 13 and over living in the household
where the licensed program will be provided;
(3) current or prospective 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 will 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) an individual age ten to 12 living in the household
where the licensed services will be provided when the
commissioner has reasonable cause;
(6) an individual who, without providing direct contact
services at a licensed program, may have unsupervised access to
children or vulnerable adults receiving services from a program
licensed to provide:, when the commissioner has reasonable
cause; and
(i) family child care for children;
(ii) foster care for children in the provider's own home;
or
(iii) foster care or day care services for adults in the
provider's own home; and
(7) all managerial officials as defined under section
245A.02, subdivision 5a.
The commissioner must have reasonable cause to study an
individual under this subdivision.
(b) For family child foster care settings, a short-term
substitute caregiver providing direct contact services for a
child for less than 72 hours of continuous care is not required
to receive a background study under this chapter.
Sec. 27. Minnesota Statutes 2004, section 245C.07, is
amended to read:
245C.07 [STUDY SUBJECT AFFILIATED WITH MULTIPLE LICENSED
FACILITIES.]
(a) When a license holder owns multiple facilities that are
licensed by the Department of Human Services, only one
background study is required for an individual who provides
direct contact services in one or more of the licensed
facilities if:
(1) the license holder designates one individual with one
address and telephone number as the person to receive sensitive
background study information for the multiple licensed programs
that depend on the same background study; and
(2) the individual designated to receive the sensitive
background study information is capable of determining, upon
request of the department, whether a background study subject is
providing direct contact services in one or more of the license
holder's programs and, if so, at which location or locations.
(b) 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 a notice, the commissioner
shall notify each facility identified by the background study
subject of the study results.
The background study notice the commissioner sends to the
subsequent agencies shall satisfy those facilities'
responsibilities for initiating a background study on that
individual.
Sec. 28. Minnesota Statutes 2004, section 245C.08,
subdivision 1, is amended to read:
Subdivision 1. [BACKGROUND STUDIES CONDUCTED BY
COMMISSIONER OF HUMAN SERVICES.] (a) For a background study
conducted by the commissioner, the commissioner shall review:
(1) 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);
(2) the commissioner's records relating to the maltreatment
of minors in licensed programs, and from county agency findings
of maltreatment of minors as indicated through the social
service information system;
(3) information from juvenile courts as required in
subdivision 4 for individuals listed in section 245C.03,
subdivision 1, clauses (2), (5), and (6); and
(4) information from the Bureau of Criminal Apprehension.
(b) Notwithstanding expungement by a court, the
commissioner may consider information obtained under paragraph
(a), clauses (3) and (4), unless the commissioner received
notice of the petition for expungement and the court order for
expungement is directed specifically to the commissioner.
Sec. 29. Minnesota Statutes 2004, section 245C.08,
subdivision 2, is amended to read:
Subd. 2. [BACKGROUND STUDIES CONDUCTED BY A COUNTY OR
PRIVATE AGENCY; FOSTER CARE AND FAMILY CHILD CARE.] (a) For a
background study conducted by a county or private agency for
child foster care, adult foster care, and family child care
homes, the commissioner shall review:
(1) information from the county agency's record of
substantiated maltreatment of adults and the maltreatment of
minors;
(2) information from juvenile courts as required in
subdivision 4 for individuals listed in section 245C.03,
subdivision 1, clauses (2), (5), and (6);
(3) information from the Bureau of Criminal Apprehension;
and
(4) arrest and investigative records maintained by the
Bureau of Criminal Apprehension, county attorneys, county
sheriffs, courts, county agencies, local police, the National
Criminal Records Repository, and criminal records from other
states.
(b) If the individual has resided in the county for less
than five years, the study shall include the records specified
under paragraph (a) for the previous county or counties of
residence for the past five years.
(c) Notwithstanding expungement by a court, the county or
private agency may consider information obtained under paragraph
(a), clauses (3) and (4), unless the commissioner received
notice of the petition for expungement and the court order for
expungement is directed specifically to the commissioner.
Sec. 30. Minnesota Statutes 2004, section 245C.15,
subdivision 1, as amended by Laws 2005, chapter 136, article 6,
section 2, is amended to read:
Subdivision 1. [PERMANENT DISQUALIFICATION.] (a) An
individual is disqualified under section 245C.14 if: (1)
regardless of how much time has passed since the discharge of
the sentence imposed, if any, for the offense; and (2) unless
otherwise specified, regardless of the level of the conviction
offense, the individual is convicted of has committed 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); 609.20 (manslaughter in the first degree);
609.205 (manslaughter in the second degree); 609.221 or 609.222
(assault in the first or second degree); a felony offense under
sections 609.2242 and 609.2243 (domestic assault), spousal
abuse, child abuse or neglect, or a crime against children;
609.228 (great bodily harm caused by distribution of drugs);
609.245 (aggravated robbery); 609.25 (kidnapping); 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); 609.322
(solicitation, inducement, and promotion of prostitution); a
felony offense under 609.324, subdivision 1 (other prohibited
acts); 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); 609.3451 (criminal sexual
conduct in the fifth degree); 609.3453 (criminal sexual
predatory conduct); 609.352 (solicitation of children to engage
in sexual conduct); 609.365 (incest); a felony offense under
609.377 (malicious punishment of a child); a felony offense
under 609.378 (neglect or endangerment of a child); 609.561
(arson in the first degree); 609.66, subdivision 1e (drive-by
shooting); 609.749, subdivision 3, 4, or 5 (felony-level
harassment; stalking); 609.855, subdivision 5 (shooting at or in
a public transit vehicle or facility); 617.246 (use of minors in
sexual performance prohibited); or 617.247 (possession of
pictorial representations of minors). An individual also is
disqualified under section 245C.14 regardless of how much time
has passed since the involuntary termination of the individual's
parental rights under section 260C.301.
(b) An individual's aiding and abetting, attempt, or
conspiracy to commit any of the offenses listed in paragraph
(a), as each of these offenses is defined in Minnesota Statutes,
permanently disqualifies the individual under section 245C.14.
(c) An individual's offense in any other state or country,
where the elements of the offense are substantially similar to
any of the offenses listed in paragraph (a), permanently
disqualifies the individual under section 245C.14.
(d) When a disqualification is based on a judicial
determination other than a conviction, the disqualification
period begins from the date of the court order. When a
disqualification is based on an admission, the disqualification
period begins from the date of an admission in court. When a
disqualification is based on a preponderance of evidence of a
disqualifying act, the disqualification date begins from the
date of the dismissal, the date of discharge of the sentence
imposed for a conviction for a disqualifying crime of similar
elements, or the date of the incident, whichever occurs last.
Sec. 31. Minnesota Statutes 2004, section 245C.15,
subdivision 2, is amended to read:
Subd. 2. [15-YEAR DISQUALIFICATION.] (a) An individual is
disqualified under section 245C.14 if: (1) less than 15 years
have passed since the discharge of the sentence imposed, if any,
for the offense; and (2) the individual has received a felony
conviction for committed a felony-level violation of any of the
following offenses: sections 260C.301 (grounds for termination
of parental rights) 256.98 (wrongfully obtaining
assistance); 268.182 (false representation; concealment of
facts); 393.07, subdivision 10, paragraph (c) (federal Food
Stamp Program fraud); 609.165 (felon ineligible to possess
firearm); 609.21 (criminal vehicular homicide and injury);
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); 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 crime); 609.24 (simple
robbery); 609.255 (false imprisonment); 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); 609.27
(coercion); 609.275 (attempt to coerce); repeat offenses under
609.3451 (criminal sexual conduct in the fifth degree); 609.466
(medical assistance fraud); 609.498, subdivision 1 or 1b
(aggravated first degree or first degree tampering with a
witness); 609.52 (theft); 609.521 (possession of shoplifting
gear); 609.525 (bringing stolen goods into Minnesota); 609.527
(identity theft); 609.53 (receiving stolen property); 609.535
(issuance of dishonored checks); 609.562 (arson in the second
degree); 609.563 (arson in the third degree); 609.582
(burglary); 609.611 (insurance fraud); 609.625 (aggravated
forgery); 609.63 (forgery); 609.631 (check forgery; offering a
forged check); 609.635 (obtaining signature by false pretense);
609.66 (dangerous weapons); 609.67 (machine guns and
short-barreled shotguns); 609.687 (adulteration); 609.71 (riot);
609.713 (terroristic threats); 609.82 (fraud in obtaining
credit); 609.821 (financial transaction card fraud); repeat
offenses under 617.23 (indecent exposure; penalties); repeat
offenses under 617.241 (obscene materials and performances;
distribution and exhibition prohibited; penalty); chapter 152
(drugs; controlled substance); or a felony-level conviction
involving alcohol or drug use.
(b) An individual is disqualified under section 245C.14 if
less than 15 years has passed since the individual's aiding and
abetting, attempt, or conspiracy to commit any of the offenses
listed in paragraph (a), as each of these offenses is defined in
Minnesota Statutes.
(c) For foster care and family child care an individual is
disqualified under section 245C.14 if less than 15 years has
passed since the individual's voluntary termination of the
individual's parental rights under section 260C.301, subdivision
1, paragraph (b), or 260C.301, subdivision 3.
(d) An individual is disqualified under section 245C.14 if
less than 15 years has passed since the discharge of the
sentence imposed for an offense in any other state or country,
the elements of which are substantially similar to the elements
of the offenses listed in paragraph (a).
(d) (e) If the individual studied is convicted of one of
the felonies listed in paragraph (a), but the sentence is a
gross misdemeanor or misdemeanor disposition, the individual is
disqualified but the disqualification lookback period for the
conviction is the period applicable to the gross misdemeanor or
misdemeanor disposition.
(f) When a disqualification is based on a judicial
determination other than a conviction, the disqualification
period begins from the date of the court order. When a
disqualification is based on an admission, the disqualification
period begins from the date of an admission in court. When a
disqualification is based on a preponderance of evidence of a
disqualifying act, the disqualification date begins from the
date of the dismissal, the date of discharge of the sentence
imposed for a conviction for a disqualifying crime of similar
elements, or the date of the incident, whichever occurs last.
Sec. 32. Minnesota Statutes 2004, section 245C.15,
subdivision 3, is amended to read:
Subd. 3. [TEN-YEAR DISQUALIFICATION.] (a) An individual is
disqualified under section 245C.14 if: (1) less than ten years
have passed since the discharge of the sentence imposed, if any,
for the offense; and (2) the individual has received committed a
gross misdemeanor conviction for a misdemeanor-level violation
of any of the following offenses: sections 256.98 (wrongfully
obtaining assistance); 268.182 (false representation;
concealment of facts); 393.07, subdivision 10, paragraph (c)
(federal Food Stamp Program fraud); 609.224 (assault in the
fifth degree); 609.224, subdivision 2, paragraph (c) (assault in
the fifth degree by a caregiver against a vulnerable adult);
609.2242 and 609.2243 (domestic assault); 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); 609.265
(abduction); 609.275 (attempt to coerce); 609.324, subdivision
1a (other prohibited acts; minor engaged in prostitution);
609.33 (disorderly house); 609.3451 (criminal sexual conduct in
the fifth degree); 609.377 (malicious punishment of a child);
609.378 (neglect or endangerment of a child); 609.446 (medical
assistance fraud); 609.52 (theft); 609.525 (bringing stolen
goods into Minnesota); 609.527 (identity theft); 609.53
(receiving stolen property); 609.535 (issuance of dishonored
checks); 609.582 (burglary); 609.611 (insurance fraud); 609.631
(check forgery; offering a forged check); 609.66 (dangerous
weapons); 609.71 (riot); 609.72, subdivision 3 (disorderly
conduct against a vulnerable adult); repeat offenses under
609.746 (interference with privacy); 609.749, subdivision 2
(harassment; stalking); 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); or violation of
an order for protection under section 518B.01, subdivision 14.
(b) An individual is disqualified under section 245C.14 if
less than ten years has passed since the individual's aiding and
abetting, attempt, or conspiracy to commit any of the offenses
listed in paragraph (a), as each of these offenses is defined in
Minnesota Statutes.
(c) An individual is disqualified under section 245C.14 if
less than ten years has passed since the discharge of the
sentence imposed for 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 paragraph (a).
(d) If the defendant is convicted of one of the gross
misdemeanors listed in paragraph (a), but the sentence is a
misdemeanor disposition, the individual is disqualified but the
disqualification lookback period for the conviction is the
period applicable to misdemeanors.
(e) When a disqualification is based on a judicial
determination other than a conviction, the disqualification
period begins from the date of the court order. When a
disqualification is based on an admission, the disqualification
period begins from the date of an admission in court. When a
disqualification is based on a preponderance of evidence of a
disqualifying act, the disqualification date begins from the
date of the dismissal, the date of discharge of the sentence
imposed for a conviction for a disqualifying crime of similar
elements, or the date of the incident, whichever occurs last.
Sec. 33. Minnesota Statutes 2004, section 245C.15,
subdivision 4, is amended to read:
Subd. 4. [SEVEN-YEAR DISQUALIFICATION.] (a) An individual
is disqualified under section 245C.14 if: (1) less than seven
years has passed since the discharge of the sentence imposed, if
any, for the offense; and (2) the individual has received
committed a misdemeanor conviction for a misdemeanor-level
violation of any of the following offenses: sections 256.98
(wrongfully obtaining assistance); 268.182 (false
representation; concealment of facts); 393.07, subdivision 10,
paragraph (c) (federal Food Stamp Program fraud); 609.224
(assault in the fifth degree); 609.2242 (domestic assault);
609.2335 (financial exploitation of a vulnerable adult); 609.234
(failure to report maltreatment of a vulnerable adult); 609.2672
(assault of an unborn child in the third degree); 609.27
(coercion); violation of an order for protection under 609.3232
(protective order authorized; procedures; penalties); 609.466
(medical assistance fraud); 609.52 (theft); 609.525 (bringing
stolen goods into Minnesota); 609.527 (identity theft); 609.53
(receiving stolen property); 609.535 (issuance of dishonored
checks); 609.611 (insurance fraud); 609.66 (dangerous weapons);
609.665 (spring guns); 609.746 (interference with privacy);
609.79 (obscene or harassing phone telephone calls); 609.795
(letter, telegram, or package; opening; harassment); 609.82
(fraud in obtaining credit); 609.821 (financial transaction card
fraud); 617.23 (indecent exposure; penalties); 617.293 (harmful
materials; dissemination and display to minors prohibited); or
violation of an order for protection under section 518B.01
(Domestic Abuse Act).
(b) An individual is disqualified under section 245C.14 if
less than seven years has passed since a determination or
disposition of the individual's:
(1) 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
(2) substantiated serious or recurring maltreatment of a
minor under section 626.556, a vulnerable adult under section
626.557, or serious or recurring maltreatment in any other
state, the elements of which are substantially similar to the
elements of maltreatment under section 626.556 or 626.557 for
which: (i) there is a preponderance of evidence that the
maltreatment occurred, and (ii) the subject was responsible for
the maltreatment.
(c) An individual is disqualified under section 245C.14 if
less than seven years has passed since the individual's aiding
and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraphs (a) and (b), as each of these
offenses is defined in Minnesota Statutes.
(d) An individual is disqualified under section 245C.14 if
less than seven years has passed since the discharge of the
sentence imposed for 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 paragraphs (a) and (b).
(e) When a disqualification is based on a judicial
determination other than a conviction, the disqualification
period begins from the date of the court order. When a
disqualification is based on an admission, the disqualification
period begins from the date of an admission in court. When a
disqualification is based on a preponderance of evidence of a
disqualifying act, the disqualification date begins from the
date of the dismissal, the date of discharge of the sentence
imposed for a conviction for a disqualifying crime of similar
elements, or the date of the incident, whichever occurs last.
Sec. 34. Minnesota Statutes 2004, section 245C.21,
subdivision 2, is amended to read:
Subd. 2. [TIME FRAME FOR REQUESTING RECONSIDERATION OF A
DISQUALIFICATION.] (a) When the commissioner sends an individual
a notice of disqualification based on a finding under section
245C.16, subdivision 2, paragraph (a), clause (1) or (2), the
disqualified individual must submit the request for a
reconsideration within 30 calendar days of the individual's
receipt of the notice of disqualification. If mailed, the
request for reconsideration must be postmarked and sent to the
commissioner within 30 calendar days of the individual's receipt
of the notice of disqualification. If a request for
reconsideration is made by personal service, it must be received
by the commissioner within 30 calendar days after the
individual's receipt of the notice of disqualification. Upon
showing that the information under subdivision 3 cannot be
obtained within 30 days, the disqualified individual may request
additional time, not to exceed 30 days, to obtain the
information.
(b) When the commissioner sends an individual a notice of
disqualification based on a finding under section 245C.16,
subdivision 2, paragraph (a), clause (3), the disqualified
individual must submit the request for reconsideration within 15
calendar days of the individual's receipt of the notice of
disqualification. If mailed, the request for reconsideration
must be postmarked and sent to the commissioner within 15
calendar days of the individual's receipt of the notice of
disqualification. If a request for reconsideration is made by
personal service, it must be received by the commissioner within
15 calendar days after the individual's receipt of the notice of
disqualification.
(c) An individual who was determined to have maltreated a
child under section 626.556 or a vulnerable adult under section
626.557, and who is disqualified on the basis of serious or
recurring maltreatment, may request a reconsideration of both
the maltreatment and the disqualification determinations. The
request must be submitted within 30 calendar days of the
individual's receipt of the notice of disqualification. If
mailed, the request for reconsideration must be postmarked and
sent to the commissioner within 30 calendar days of the
individual's receipt of the notice of disqualification. If a
request for reconsideration is made by personal service, it must
be received by the commissioner within 30 calendar days after
the individual's receipt of the notice of disqualification.
Sec. 35. Minnesota Statutes 2004, section 245C.22,
subdivision 3, is amended to read:
Subd. 3. [PREEMINENT WEIGHT GIVEN TO SAFETY OF PERSONS
BEING SERVED.] In reviewing a request for reconsideration of a
disqualification, the commissioner shall give preeminent weight
to the safety of each person served by the license holder,
applicant, or other entities as provided in this chapter over
the interests of the disqualified individual, license holder,
applicant, or other entity as provided in this chapter, and any
single factor under subdivision 4, paragraph (b), may be
determinative of the commissioner's decision whether to set
aside the individual's disqualification.
Sec. 36. Minnesota Statutes 2004, section 245C.22,
subdivision 4, is amended to read:
Subd. 4. [RISK OF HARM; SET ASIDE.] (a) The commissioner
may set aside the disqualification if the commissioner finds
that the individual has submitted sufficient information to
demonstrate that the individual does not pose a risk of harm to
any person served by the applicant, license holder, or other
entities as provided in this chapter.
(b) In determining whether the individual has met the
burden of proof by demonstrating the individual does not pose a
risk of harm, the commissioner shall consider:
(1) the nature, severity, and consequences of the event or
events that led to the disqualification;
(2) whether there is more than one disqualifying event;
(3) the age and vulnerability of the victim at the time of
the event;
(4) the harm suffered by the victim;
(5) the similarity between the victim and persons served by
the program;
(6) the time elapsed without a repeat of the same or
similar event;
(7) documentation of successful completion by the
individual studied of training or rehabilitation pertinent to
the event; and
(8) any other information relevant to reconsideration.
(c) If the individual requested reconsideration on the
basis that the information relied upon to disqualify the
individual was incorrect or inaccurate and the commissioner
determines that the information relied upon to disqualify the
individual is correct, the commissioner must also determine if
the individual poses a risk of harm to persons receiving
services in accordance with paragraph (b).
Sec. 37. Minnesota Statutes 2004, section 245C.22,
subdivision 7, as added by Laws 2005, chapter 136, article 6,
section 6, is amended to read:
Subd. 7. [CLASSIFICATION OF CERTAIN DATA AS PUBLIC OR
PRIVATE.] (a) Notwithstanding section 13.46, upon setting aside
a disqualification under this section, the identity of the
disqualified individual who received the set aside and the
individual's disqualifying characteristics are public data if
the set aside was:
(1) for any disqualifying characteristic under section
245C.15, when the set aside relates to a child care center or a
family child care provider licensed under chapter 245A; or
(2) for a disqualifying characteristic under section
245C.15, subdivision 2.
(b) Notwithstanding section 13.46, upon granting a variance
to a license holder under section 245C.30, the identity of the
disqualified individual who is the subject of the variance, the
individual's disqualifying characteristics under section
245C.15, and the terms of the variance are public data, when the
variance:
(1) is issued to a child care center or a family child care
provider licensed under chapter 245A; or
(2) relates to an individual with a disqualifying
characteristic under section 245C.15, subdivision 2.
(c) The identity of a disqualified individual and the
reason for disqualification remain private data when:
(1) a disqualification is not set aside and no variance is
granted;
(2) the data are not public under paragraph (a) or (b); or
(3) the disqualification is rescinded because the
information relied upon to disqualify the individual is
incorrect; or
(4) the disqualification relates to a license to provide
relative child foster care. As used in this clause, "relative"
has the meaning given it under section 260C.007, subdivision 27.
(d) Licensed family day care providers and child care
centers must notify parents considering enrollment of a child or
parents of a child attending the family day care or child care
center if the program employs or has living in the home any
individual who is the subject of either a set aside or variance.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 38. Minnesota Statutes 2004, section 245C.23,
subdivision 1, is amended to read:
Subdivision 1. [COMMISSIONER'S NOTICE OF DISQUALIFICATION
THAT IS RESCINDED OR SET ASIDE.] (a) Except as provided under
paragraph (c), If the commissioner rescinds or sets aside a
disqualification, the commissioner shall notify the
applicant or, license holder, or other entity in writing or by
electronic transmission of the decision. In the notice from the
commissioner that a disqualification has been rescinded, the
commissioner must inform the applicant, license holder, or other
entity that the information relied upon to disqualify the
individual was incorrect. In the notice from the commissioner
that a disqualification has been set aside, the commissioner
must inform the applicant, license holder that information about
the nature, or other entity of the reason for the individual's
disqualification and that information about which factors under
section 245C.22, subdivision 4, were the basis of the decision
to set aside the disqualification are available to the license
holder upon request without the consent of the background study
subject.
(b) With the written consent of the 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.
(c) If the individual studied submits a timely request for
reconsideration under section 245C.21 and the license holder was
previously sent a notice under section 245C.17, subdivision 3,
paragraph (d), and if the commissioner sets aside the
disqualification for that license holder under section 245C.22,
the commissioner shall send the license holder the same
notification received by license holders in cases where the
individual studied has no disqualifying characteristic.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 39. Minnesota Statutes 2004, section 245C.24,
subdivision 2, as amended by Laws 2005, chapter 136, article 6,
section 7, is amended to read:
Subd. 2. [PERMANENT BAR TO SET ASIDE A DISQUALIFICATION.]
The commissioner may not set aside the disqualification of an
any individual in connection with a license issued or in
application status under chapter 245A disqualified pursuant to
this chapter, regardless of how much time has passed, if
the provider individual was disqualified for a crime or conduct
listed in section 245C.15, subdivision 1.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 40. Minnesota Statutes 2004, section 245C.24,
subdivision 3, is amended to read:
Subd. 3. [TEN-YEAR BAR TO SET ASIDE DISQUALIFICATION.] (a)
The commissioner may not set aside the disqualification of an
individual in connection with a license to provide family child
care for children, foster care for children in the provider's
home, or foster care or day care services for adults in the
provider's home if: (1) less than ten years has passed since
the discharge of the sentence imposed, if any, for the offense;
and or (2) when disqualified based on a preponderance of
evidence determination under section 245A.14, subdivision 1,
paragraph (a), clause (2), or an admission under section
245A.14, subdivision 1, paragraph (a), clause (1), and less than
ten years has passed since the individual committed the act or
admitted to committing the act, whichever is later; and (3) the
individual has been convicted of committed a violation of any of
the following offenses: 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 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); or 609.72, subdivision 3 (disorderly conduct against a
vulnerable adult).
(b) The commissioner may not set aside the disqualification
of an individual if less than ten years have passed since the
individual's aiding and abetting, attempt, or conspiracy to
commit any of the offenses listed in paragraph (a) as each of
these offenses is defined in Minnesota Statutes.
(c) The commissioner may not set aside the disqualification
of an individual if less than ten years have passed since the
discharge of the sentence imposed for 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
paragraph (a).
Sec. 41. Minnesota Statutes 2004, section 245C.27,
subdivision 1, is amended to read:
Subdivision 1. [FAIR HEARING WHEN DISQUALIFICATION IS NOT
SET ASIDE.] (a) If the commissioner does not set aside or
rescind a disqualification of an individual under section
245C.22 who is 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 section 245C.15;
for a determination under section 626.556 or 626.557 of
substantiated maltreatment that was serious or recurring under
section 245C.15; or for failure to make required reports under
section 626.556, subdivision 3; or 626.557, subdivision 3,
pursuant to section 245C.15, subdivision 4, paragraph (b),
clause (1), the individual may request a fair hearing under
section 256.045, unless the disqualification is deemed
conclusive under section 245C.29.
(b) The fair hearing is the only administrative appeal of
the final agency determination for purposes of appeal by the
disqualified individual. The disqualified individual does not
have the right to challenge the accuracy and completeness of
data under section 13.04.
(c) If the individual was disqualified based on a
conviction or admission to any crimes listed in section 245C.15,
subdivisions 1 to 4, the reconsideration decision under section
245C.22 is the final agency determination for purposes of appeal
by the disqualified individual and is not subject to a hearing
under section 256.045. If the individual was disqualified based
on a judicial determination, that determination is treated the
same as a conviction for purposes of appeal.
(d) This subdivision does not apply to a public employee's
appeal of a disqualification under section 245C.28, subdivision
3.
(e) Notwithstanding paragraph (c), if the commissioner does
not set aside a disqualification of an individual who was
disqualified based on both a preponderance of evidence and a
conviction or admission, the individual may request a fair
hearing under section 256.045, unless the disqualifications are
deemed conclusive under section 245C.29. The scope of the
hearing conducted under section 256.045 with regard to the
disqualification based on a conviction or admission shall be
limited solely to whether the individual poses a risk of harm,
according to section 256.045, subdivision 3b.
Sec. 42. Minnesota Statutes 2004, section 245C.28,
subdivision 3, is amended to read:
Subd. 3. [EMPLOYEES OF PUBLIC EMPLOYER.] (a) If the
commissioner does not set aside the disqualification of an
individual who is an employee of an employer, as defined in
section 179A.03, subdivision 15, the individual may request a
contested case hearing under chapter 14. The request for a
contested case hearing must be made in writing and must be
postmarked and mailed sent within 30 calendar days after the
employee receives notice that the disqualification has not been
set aside. If the individual was disqualified based on a
conviction or admission to any crimes listed in section 245C.15,
the scope of the contested case hearing shall be limited solely
to whether the individual poses a risk of harm pursuant to
section 245C.22.
(b) If the commissioner does not set aside or rescind a
disqualification that is based on a maltreatment determination,
the scope of the contested case hearing must include the
maltreatment determination and the disqualification. In such
cases, a fair hearing must not be conducted under section
256.045.
(c) Rules adopted under this chapter may not preclude an
employee in a contested case hearing for a disqualification from
submitting evidence concerning information gathered under this
chapter.
(d) When a person an individual has been disqualified from
multiple licensed programs and the disqualifications have not
been set aside under section 245C.22, if at least one of the
disqualifications entitles the person to a contested case
hearing under this subdivision, the scope of the contested case
hearing shall include all disqualifications from licensed
programs which were not set aside.
(e) In determining whether the disqualification should be
set aside, the administrative law judge shall consider all of
the characteristics that cause the individual to be
disqualified, including those characteristics that were not
subject to review under paragraph (b), in order to determine
whether the individual poses a risk of harm. The administrative
law judge's recommendation and the commissioner's order to set
aside a disqualification that is the subject of the hearing
constitutes a determination that the individual does not pose a
risk of harm and that the individual may provide direct contact
services in the individual program specified in the set aside.
Sec. 43. Minnesota Statutes 2004, section 245C.30,
subdivision 1, is amended to read:
Subdivision 1. [LICENSE HOLDER VARIANCE.] (a) Except for
any disqualification under section 245C.15, subdivision 1, when
the commissioner has not set aside a background study subject's
disqualification, and there are conditions under which the
disqualified individual may provide direct contact services or
have access to people receiving services that minimize the risk
of harm to people receiving services, the commissioner may grant
a time-limited variance to a license holder.
(b) The variance shall state the reason for the
disqualification, the services that may be provided by the
disqualified individual, and the conditions with which the
license holder or applicant must comply for the variance to
remain in effect.
(c) Except for programs licensed to provide family child
care, foster care for children in the provider's own home, or
foster care or day care services for adults in the provider's
own home, the variance must be requested by the license holder.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 44. Minnesota Statutes 2004, section 245C.30,
subdivision 2, is amended to read:
Subd. 2. [DISCLOSURE OF REASON FOR DISQUALIFICATION.] (a)
The commissioner may not grant a variance for a disqualified
individual unless the applicant or license holder requests the
variance and the disqualified individual provides written
consent for the commissioner to disclose to the applicant or
license holder the reason for the disqualification.
(b) This subdivision does not apply to programs 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
grants a variance for a disqualified individual in connection
with a license to provide the services specified in this
paragraph, the disqualified individual's consent is not required
to disclose the reason for the disqualification to the license
holder in the variance issued under subdivision 1.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 45. [245C.301] [NOTIFICATION OF SET-ASIDE OR
VARIANCE.]
Licensed family child care providers and child care centers
must provide a written notification to parents considering
enrollment of a child or parents of a child attending the family
child care or child care center if the program employs or has
living in the home any individual who is the subject of either a
set-aside or variance.
Sec. 46. Minnesota Statutes 2004, section 246.13, as
amended by Laws 2005, chapter 136, article 5, section 2, is
amended to read:
246.13 [RECORDS OF PATIENTS AND RESIDENTS RECEIVING
STATE-OPERATED SERVICES.]
Subdivision 1. [POWERS, DUTIES, AND AUTHORITY OF
COMMISSIONER.] (a) 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-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
the person when the person left the state-operated services
facility; the vulnerable adult abuse prevention associated with
the person; and the date and cause of all deaths. The record
shall state every transfer from one 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 agency, along with
other obtainable facts as the commissioner may require. When a
patient or resident in a state-operated services facility is
discharged, transferred, or dies, the head of the state-operated
services facility or designee shall inform the commissioner of
human services of these events within ten days on forms
furnished by the commissioner.
(b) The commissioner of human services shall cause to be
devised, installed, and operated an adequate system of records
and statistics which shall consist of all basic record forms,
including patient personal records and medical record forms, and
the manner of their use shall be precisely uniform throughout
all state-operated services facilities.
Subd. 2. [DEFINITIONS; RISK ASSESSMENT AND MANAGEMENT.] (a)
As used in this section:
(1) "appropriate and necessary medical and other records"
includes patient medical records and other protected health
information as defined by Code of Federal Regulations, title 45,
section 164.501, relating to a patient in a state-operated
services facility including, but not limited to, the patient's
treatment plan and abuse prevention plan that is pertinent to
the patient's ongoing care, treatment, or placement in a
community-based treatment facility or a health care facility
that is not operated by state-operated services, and includes
information describing the level of risk posed by a patient when
the patient enters such a the facility;
(2) "community-based treatment" means the community support
services listed in section 253B.02, subdivision 4b;
(3) "criminal history data" means those data maintained or
used by the Departments of Corrections and Public Safety and by
the supervisory authorities listed in section 13.84, subdivision
1, that relate to an individual's criminal history or propensity
for violence;, including data in the Corrections Offender
Management System (COMS) and Statewide Supervision System (S3)
maintained by the Department of Corrections; the Criminal
Justice Information System (CJIS) and the Predatory Offender
Registration (POR) system maintained by the Department of Public
Safety; and the CriMNet system;
(4) "designated agency" means the agency defined in section
253B.02, subdivision 5;
(5) "law enforcement agency" means the law enforcement
agency having primary jurisdiction over the location where the
offender expects to reside upon release;
(6) "predatory offender" and "offender" mean a person who
is required to register as a predatory offender under section
243.166; and
(7) "treatment facility" means a facility as defined in
section 253B.02, subdivision 19.
(b) To promote public safety and for the purposes and
subject to the requirements of this paragraph (c), the
commissioner or the commissioner's designee shall have access
to, and may review and disclose, medical and criminal history
data as provided by this section.
(c) The commissioner or the commissioner's designee shall
disseminate data to designated treatment facility staff, special
review board members, and end-of-confinement review committee
members in accordance with Minnesota Rules, part 1205.0400, to,
as necessary to comply with Minnesota Rules, part 1205.0400:
(1) to determine whether a patient is required under state
law to register as a predatory offender according to section
243.166;
(2) to facilitate and expedite the responsibilities of the
special review board and end-of-confinement review committees by
corrections institutions and state treatment facilities;
(3) to prepare, amend, or revise the abuse prevention plans
required under section 626.557, subdivision 14, and individual
patient treatment plans required under section 253B.03,
subdivision 7;
(4) to facilitate changes of the custody and transfers,
supervision, and transport of individuals transferred between
the Department of Corrections and the Department of Human
Services; and or
(5) facilitate the exchange of data between to effectively
monitor and supervise individuals who are under the authority of
the Department of Corrections, the Department of Human Services,
and any of the supervisory authorities listed in section
13.84, regarding an individual under the authority of one or
more of these entities subdivision 1.
(c) The state-operated services treatment facility must
make a good faith effort to obtain written authorization from
the patient before releasing information from the patient's
medical record.
(d) If the patient refuses or is unable to give informed
consent to authorize the release of information required above,
the chief executive officer for state-operated services shall
provide the appropriate and necessary medical and other
records. The chief executive officer shall comply with the
minimum necessary requirements.
(d) If approved by the United States Department of Justice,
(e) The commissioner may have access to national criminal
history information the National Crime Information Center (NCIC)
database, through the Department of Public Safety, in support of
the law enforcement function functions described in paragraph
(c). If approval of the United States Department of Justice is
not obtained by the commissioner before July 1, 2007, the
authorization in this paragraph sunsets on that date (b).
Subd. 3. [COMMUNITY-BASED TREATMENT AND MEDICAL
TREATMENT.] (a) When a patient under the care and supervision of
state-operated services is released to a community-based
treatment facility or facility that provides health care
services, state-operated services may disclose all appropriate
and necessary health and other information relating to the
patient.
(b) The information that must be provided to the designated
agency, community-based treatment facility, or facility that
provides health care services includes, but is not limited to,
the patient's abuse prevention plan required under section
626.557, subdivision 14, paragraph (b).
Subd. 4. [PREDATORY OFFENDER REGISTRATION NOTIFICATION.]
(a) When a state-operated facility determines that a patient is
required under section 243.166, subdivision 1, to register as a
predatory offender or, under section 243.166, subdivision 4a, to
provide notice of a change in status, the facility shall provide
written notice to the patient of the requirement.
(b) If the patient refuses, is unable, or lacks capacity to
comply with the requirement described in paragraph (a) within
five days after receiving the notification of the duty to
comply, state-operated services staff shall obtain and disclose
the necessary data to complete the registration form or change
of status notification for the patient. The treatment facility
shall also forward the registration or change of status data
that it completes to the Bureau of Criminal Apprehension and, as
applicable, the patient's corrections agent and the law
enforcement agency in the community in which the patient
currently resides. If, after providing notification, the
patient refuses to comply with the requirements described in
paragraph (a), the treatment facility shall also notify the
county attorney in the county in which the patient is currently
residing of the refusal.
(c) The duties of state-operated services described in this
subdivision do not relieve the patient of the ongoing individual
duty to comply with the requirements of section 243.166.
Subd. 5. [LIMITATIONS ON USE OF PROCEDURE FOR BLOODBORNE
PATHOGEN TEST RESULTS PATHOGENS.] Sections 246.71, 246.711,
246.712, 246.713, 246.714, 246.715, 246.716, 246.717, 246.718,
246.719, 246.72, 246.721, and to 246.722 apply to state-operated
services facilities.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 47. Minnesota Statutes 2004, section 260B.163,
subdivision 6, is amended to read:
Subd. 6. [GUARDIAN AD LITEM.] (a) The court shall appoint
a guardian ad litem to protect the interests of the minor when
it appears, at any stage of the proceedings, that the minor is
without a parent or guardian, or that the minor's parent is a
minor or incompetent, or that the parent or guardian is
indifferent or hostile to the minor's interests. In any other
case the court may appoint a guardian ad litem to protect the
interests of the minor when the court feels that such an
appointment is desirable. The court shall appoint the guardian
ad litem on its own motion or in the manner provided for the
appointment of a guardian ad litem in the district court. The
court may appoint separate counsel for the guardian ad litem if
necessary.
(b) A guardian ad litem shall carry out the following
responsibilities:
(1) conduct an independent investigation to determine the
facts relevant to the situation of the child and the family,
which must include, unless specifically excluded by the court,
reviewing relevant documents; meeting with and observing the
child in the home setting and considering the child's wishes, as
appropriate; and interviewing parents, caregivers, and others
with knowledge relevant to the case;
(2) advocate for the child's best interests by
participating in appropriate aspects of the case and advocating
for appropriate community services when necessary;
(3) maintain the confidentiality of information related to
a case, with the exception of sharing information as permitted
by law to promote cooperative solutions that are in the best
interests of the child;
(4) monitor the child's best interests throughout the
judicial proceeding; and
(5) present written reports on the child's best interests
that include conclusions and recommendations and the facts upon
which they are based.
(c) The court may waive the appointment of a guardian ad
litem pursuant to paragraph (a), whenever counsel has been
appointed pursuant to subdivision 2 or is retained otherwise,
and the court is satisfied that the interests of the minor are
protected.
(d) In appointing a guardian ad litem pursuant to paragraph
(a), the court shall not appoint the party, or any agent or
employee thereof, filing a petition pursuant to section 260B.141
and 260C.141.
(e) The following factors shall be considered when
appointing a guardian ad litem in a case involving an Indian or
minority child:
(1) whether a person is available who is the same racial or
ethnic heritage as the child or, if that is not possible;
(2) whether a person is available who knows and appreciates
the child's racial or ethnic heritage.
(f) The court shall require a background study for each
guardian ad litem as provided under section 518.165. The court
shall have access to data collected pursuant to section 245C.32
for purposes of the background study.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 48. Minnesota Statutes 2004, section 260C.163,
subdivision 5, is amended to read:
Subd. 5. [GUARDIAN AD LITEM.] (a) The court shall appoint
a guardian ad litem to protect the interests of the minor when
it appears, at any stage of the proceedings, that the minor is
without a parent or guardian, or that the minor's parent is a
minor or incompetent, or that the parent or guardian is
indifferent or hostile to the minor's interests, and in every
proceeding alleging a child's need for protection or services
under section 260C.007, subdivision 6, except proceedings where
the sole allegation is that the child is a runaway or habitual
truant. In any other case the court may appoint a guardian ad
litem to protect the interests of the minor when the court feels
that such an appointment is desirable. The court shall appoint
the guardian ad litem on its own motion or in the manner
provided for the appointment of a guardian ad litem in the
district court. The court may appoint separate counsel for the
guardian ad litem if necessary.
(b) A guardian ad litem shall carry out the following
responsibilities:
(1) conduct an independent investigation to determine the
facts relevant to the situation of the child and the family,
which must include, unless specifically excluded by the court,
reviewing relevant documents; meeting with and observing the
child in the home setting and considering the child's wishes, as
appropriate; and interviewing parents, caregivers, and others
with knowledge relevant to the case;
(2) advocate for the child's best interests by
participating in appropriate aspects of the case and advocating
for appropriate community services when necessary;
(3) maintain the confidentiality of information related to
a case, with the exception of sharing information as permitted
by law to promote cooperative solutions that are in the best
interests of the child;
(4) monitor the child's best interests throughout the
judicial proceeding; and
(5) present written reports on the child's best interests
that include conclusions and recommendations and the facts upon
which they are based.
(c) Except in cases where the child is alleged to have been
abused or neglected, the court may waive the appointment of a
guardian ad litem pursuant to clause (a), whenever counsel has
been appointed pursuant to subdivision 2 or is retained
otherwise, and the court is satisfied that the interests of the
minor are protected.
(d) In appointing a guardian ad litem pursuant to clause
(a), the court shall not appoint the party, or any agent or
employee thereof, filing a petition pursuant to section 260C.141.
(e) The following factors shall be considered when
appointing a guardian ad litem in a case involving an Indian or
minority child:
(1) whether a person is available who is the same racial or
ethnic heritage as the child or, if that is not possible;
(2) whether a person is available who knows and appreciates
the child's racial or ethnic heritage.
(f) The court shall require a background study for each
guardian ad litem as provided under section 518.165. The court
shall have access to data collected pursuant to section 245C.32
for purposes of the background study.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 49. Minnesota Statutes 2004, section 299C.093, as
amended by Laws 2005, chapter 136, article 5, section 4, is
amended to read:
299C.093 [DATABASE OF REGISTERED PREDATORY OFFENDERS.]
The superintendent of the bureau of criminal apprehension
shall maintain a computerized data system relating to
individuals required to register as predatory offenders under
section 243.166. To the degree feasible, the system must
include the data required to be provided under section 243.166,
subdivisions 4 and 4a, and indicate the time period that the
person is required to register. The superintendent shall
maintain this data in a manner that ensures that it is readily
available to law enforcement agencies. This data is private
data on individuals under section 13.02, subdivision 12, but may
be used for law enforcement and corrections purposes.
State-operated services, as defined in section 246.014, are is
also authorized to have access to the data for the purposes
described in section 246.13, subdivision 2, paragraph (c) (b).
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 50. Minnesota Statutes 2004, section 518.165, is
amended by adding a subdivision to read:
Subd. 4. [BACKGROUND STUDY OF GUARDIAN AD LITEM.] (a) The
court shall initiate a background study through the commissioner
of human services under section 245C.32 on every guardian ad
litem appointed under this section if a background study has not
been completed on the guardian ad litem within the past three
years. The background study must be completed before the court
appoints the guardian ad litem, unless the court determines that
it is in the best interest of the child to appoint a guardian ad
litem before a background study can be completed by the
commissioner. The court shall initiate a subsequent background
study under this paragraph once every three years after the
guardian has been appointed as long as the individual continues
to serve as a guardian ad litem.
(b) The background study must include criminal history data
from the Bureau of Criminal Apprehension, other criminal history
data held by the commissioner of human services, and data
regarding whether the person has been a perpetrator of
substantiated maltreatment of a minor or a vulnerable adult.
When the information from the Bureau of Criminal Apprehension
indicates that the subject of a study under paragraph (a) is a
multistate offender or that the subject's multistate offender
status is undetermined, the court shall require a search of the
National Criminal Records Repository, and shall provide the
commissioner a set of classifiable fingerprints of the subject
of the study.
(c) The Minnesota Supreme Court shall pay the commissioner
a fee for conducting a background study under section 245C.32.
(d) Nothing precludes the court from initiating background
studies using court data on criminal convictions.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 51. Minnesota Statutes 2004, section 518.165, is
amended by adding a subdivision to read:
Subd. 5. [PROCEDURE, CRIMINAL HISTORY, AND MALTREATMENT
RECORDS BACKGROUND STUDY.] (a) When the court requests a
background study under subdivision 4, paragraph (a), the request
shall be submitted to the Department of Human Services through
the department's electronic online background study system.
(b) When the court requests a search of the National
Criminal Records Repository, the court must provide a set of
classifiable fingerprints of the subject of the study on a
fingerprint card provided by the commissioner of human services.
(c) The commissioner of human services shall provide the
court with information from the Bureau of Criminal
Apprehension's Criminal Justice Information System, other
criminal history data held by the commissioner of human
services, and data regarding substantiated maltreatment of a
minor under section 626.556, and substantiated maltreatment of a
vulnerable adult under section 626.557, within 15 working days
of receipt of a request. If the subject of the study has been
determined by the Department of Human Services or the Department
of Health to be the perpetrator of substantiated maltreatment of
a minor or vulnerable adult in a licensed facility, the response
must include a copy of the public portion of the investigation
memorandum under section 626.556, subdivision 10f, or the public
portion of the investigation memorandum under section 626.557,
subdivision 12b. When the background study shows that the
subject has been determined by a county adult protection or
child protection agency to have been responsible for
maltreatment, the court shall be informed of the county, the
date of the finding, and the nature of the maltreatment that was
substantiated. The commissioner shall provide the court with
information from the National Criminal Records Repository within
three working days of the commissioner's receipt of the data.
When the commissioner finds no criminal history or substantiated
maltreatment on a background study subject, the commissioner
shall make these results available to the court electronically
through the secure online background study system.
(d) Notwithstanding section 626.556, subdivision 10f, or
626.557, subdivision 12b, if the commissioner or county lead
agency has information that a person on whom a background study
was previously done under this section has been determined to be
a perpetrator of maltreatment of a minor or vulnerable adult,
the commissioner or the county may provide this information to
the court that requested the background study.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 52. Minnesota Statutes 2004, section 518.165, is
amended by adding a subdivision to read:
Subd. 6. [RIGHTS.] The court shall notify the subject of a
background study that the subject has the following rights:
(1) the right to be informed that the court will request a
background study on the subject for the purpose of determining
whether the person's appointment or continued appointment is in
the best interests of the child;
(2) the right to be informed of the results of the study
and to obtain from the court a copy of the results; and
(3) the right to challenge the accuracy and completeness of
the information contained in the results to the agency
responsible for creation of the data except to the extent
precluded by section 256.045, subdivision 3.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 53. Minnesota Statutes 2004, section 609A.03,
subdivision 7, as amended by Laws 2005, chapter 136, article 12,
section 11, is amended to read:
Subd. 7. [LIMITATIONS OF ORDER.] (a) Upon issuance of an
expungement order related to a charge supported by probable
cause, the DNA samples and DNA records held by the Bureau of
Criminal Apprehension and collected under authority other than
section 299C.105, shall not be sealed, returned to the subject
of the record, or destroyed.
(b) Notwithstanding the issuance of an expungement order:
(1) an expunged record may be opened for purposes of a
criminal investigation, prosecution, or sentencing, upon an ex
parte court order; and
(2) an expunged record of a conviction may be opened for
purposes of evaluating a prospective employee in a criminal
justice agency without a court order; and
(3) an expunged record of a conviction may be opened for
purposes of a background study under section 245C.08 unless the
court order for expungement is directed specifically to the
commissioner of human services.
Upon request by law enforcement, prosecution, or
corrections authorities, an agency or jurisdiction subject to an
expungement order shall inform the requester of the existence of
a sealed record and of the right to obtain access to it as
provided by this paragraph. For purposes of this section, a
"criminal justice agency" means courts or a government agency
that performs the administration of criminal justice under
statutory authority.
Sec. 54. Minnesota Statutes 2004, section 626.556,
subdivision 10i, as amended by Laws 2005, chapter 159, article
1, section 9, is amended to read:
Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL
DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON
SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a)
Administrative reconsideration is not applicable in family
assessments since no determination concerning maltreatment is
made. For investigations, except as provided under paragraph
(e), an individual or facility that the commissioner of human
services, a local social service agency, or the commissioner of
education determines has maltreated a child, an interested
person acting on behalf of the child, regardless of the
determination, who contests the investigating agency's final
determination regarding maltreatment, may request the
investigating agency to reconsider its final determination
regarding maltreatment. The request for reconsideration must be
submitted in writing to the investigating agency within 15
calendar days after receipt of notice of the final determination
regarding maltreatment or, if the request is made by an
interested person who is not entitled to notice, within 15 days
after receipt of the notice by the parent or guardian of the
child. If mailed, the request for reconsideration must be
postmarked and sent to the investigating agency within 15
calendar days of the individual's or facility's receipt of the
final determination. If the request for reconsideration is made
by personal service, it must be received by the investigating
agency within 15 calendar days after the individual's or
facility's receipt of the final determination. Effective
January 1, 2002, an individual who was determined to have
maltreated a child under this section and who was disqualified
on the basis of serious or recurring maltreatment under sections
245C.14 and 245C.15, may request reconsideration of the
maltreatment determination and the disqualification. The
request for reconsideration of the maltreatment determination
and the disqualification must be submitted within 30 calendar
days of the individual's receipt of the notice of
disqualification under sections 245C.16 and 245C.17. If mailed,
the request for reconsideration of the maltreatment
determination and the disqualification must be postmarked and
sent to the investigating agency within 30 calendar days of the
individual's receipt of the maltreatment determination and
notice of disqualification. If the request for reconsideration
is made by personal service, it must be received by the
investigating agency within 30 calendar days after the
individual's receipt of the notice of disqualification.
(b) Except as provided under paragraphs (e) and (f), if the
investigating agency denies the request or fails to act upon the
request within 15 calendar working days after receiving the
request for reconsideration, the person or facility entitled to
a fair hearing under section 256.045 may submit to the
commissioner of human services or the commissioner of education
a written request for a hearing under that section. Section
256.045 also governs hearings requested to contest a final
determination of the commissioner of education. For reports
involving maltreatment of a child in a facility, an interested
person acting on behalf of the child may request a review by the
Child Maltreatment Review Panel under section 256.022 if the
investigating agency denies the request or fails to act upon the
request or if the interested person contests a reconsidered
determination. The investigating agency shall notify persons
who request reconsideration of their rights under this
paragraph. The request must be submitted in writing to the
review panel and a copy sent to the investigating agency within
30 calendar days of receipt of notice of a denial of a request
for reconsideration or of a reconsidered determination. The
request must specifically identify the aspects of the agency
determination with which the person is dissatisfied.
(c) If, as a result of a reconsideration or review, the
investigating agency changes the final determination of
maltreatment, that agency shall notify the parties specified in
subdivisions 10b, 10d, and 10f.
(d) Except as provided under paragraph (f), if an
individual or facility contests the investigating agency's final
determination regarding maltreatment by requesting a fair
hearing under section 256.045, the commissioner of human
services shall assure that the hearing is conducted and a
decision is reached within 90 days of receipt of the request for
a hearing. The time for action on the decision may be extended
for as many days as the hearing is postponed or the record is
held open for the benefit of either party.
(e) Effective January 1, 2002, if an individual was
disqualified under sections 245C.14 and 245C.15, on the basis of
a determination of maltreatment, which was serious or recurring,
and the individual has requested reconsideration of the
maltreatment determination under paragraph (a) and requested
reconsideration of the disqualification under sections 245C.21
to 245C.27, reconsideration of the maltreatment determination
and reconsideration of the disqualification shall be
consolidated into a single reconsideration. If reconsideration
of the maltreatment determination is denied or the
disqualification is not set aside under sections 245C.21 to
245C.27, the individual may request a fair hearing under section
256.045. If an individual requests a fair hearing on the
maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment
determination and the disqualification.
(f) Effective January 1, 2002, if a maltreatment
determination or a disqualification based on serious or
recurring maltreatment is the basis for a denial of a license
under section 245A.05 or a licensing sanction under section
245A.07, the license holder has the right to a contested case
hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612. As provided for under section 245A.08, subdivision
2a, the scope of the contested case hearing shall include the
maltreatment determination, disqualification, and licensing
sanction or denial of a license. In such cases, a fair hearing
regarding the maltreatment determination shall not be conducted
under paragraph (b). When a fine is based on a determination
that the license holder is responsible for maltreatment and the
fine is issued at the same time as the maltreatment
determination, if the license holder appeals the maltreatment
and fine, reconsideration of the maltreatment determination
shall not be conducted under this section. If the disqualified
subject is an individual other than the license holder and upon
whom a background study must be conducted under chapter 245C,
the hearings of all parties may be consolidated into a single
contested case hearing upon consent of all parties and the
administrative law judge.
(g) For purposes of this subdivision, "interested person
acting on behalf of the child" means a parent or legal guardian;
stepparent; grandparent; guardian ad litem; adult stepbrother,
stepsister, or sibling; or adult aunt or uncle; unless the
person has been determined to be the perpetrator of the
maltreatment.
Sec. 55. Minnesota Statutes 2004, section 626.557,
subdivision 9d, is amended to read:
Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL
DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON
SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as
provided under paragraph (e), any individual or facility which a
lead agency determines has maltreated a vulnerable adult, or the
vulnerable adult or an interested person acting on behalf of the
vulnerable adult, regardless of the lead agency's determination,
who contests the lead agency's final disposition of an
allegation of maltreatment, may request the lead agency to
reconsider its final disposition. The request for
reconsideration must be submitted in writing to the lead agency
within 15 calendar days after receipt of notice of final
disposition or, if the request is made by an interested person
who is not entitled to notice, within 15 days after receipt of
the notice by the vulnerable adult or the vulnerable adult's
legal guardian. If mailed, the request for reconsideration must
be postmarked and sent to the lead agency within 15 calendar
days of the individual's or facility's receipt of the final
disposition. If the request for reconsideration is made by
personal service, it must be received by the lead agency within
15 calendar days of the individual's or facility's receipt of
the final disposition. An individual who was determined to have
maltreated a vulnerable adult under this section and who was
disqualified on the basis of serious or recurring maltreatment
under sections 245C.14 and 245C.15, may request reconsideration
of the maltreatment determination and the disqualification. The
request for reconsideration of the maltreatment determination
and the disqualification must be submitted in writing within 30
calendar days of the individual's receipt of the notice of
disqualification under sections 245C.16 and 245C.17. If mailed,
the request for reconsideration of the maltreatment
determination and the disqualification must be postmarked and
sent to the lead agency within 30 calendar days of the
individual's receipt of the notice of disqualification. If the
request for reconsideration is made by personal service, it must
be received by the lead agency within 30 calendar days after the
individual's receipt of the notice of disqualification.
(b) Except as provided under paragraphs (e) and (f), if the
lead agency denies the request or fails to act upon the request
within 15 calendar working days after receiving the request for
reconsideration, the person or facility entitled to a fair
hearing under section 256.045, may submit to the commissioner of
human services a written request for a hearing under that
statute. The vulnerable adult, or an interested person acting
on behalf of the vulnerable adult, may request a review by the
Vulnerable Adult Maltreatment Review Panel under section 256.021
if the lead agency denies the request or fails to act upon the
request, or if the vulnerable adult or interested person
contests a reconsidered disposition. The lead agency shall
notify persons who request reconsideration of their rights under
this paragraph. The request must be submitted in writing to the
review panel and a copy sent to the lead agency within 30
calendar days of receipt of notice of a denial of a request for
reconsideration or of a reconsidered disposition. The request
must specifically identify the aspects of the agency
determination with which the person is dissatisfied.
(c) If, as a result of a reconsideration or review, the
lead agency changes the final disposition, it shall notify the
parties specified in subdivision 9c, paragraph (d).
(d) For purposes of this subdivision, "interested person
acting on behalf of the vulnerable adult" means a person
designated in writing by the vulnerable adult to act on behalf
of the vulnerable adult, or a legal guardian or conservator or
other legal representative, a proxy or health care agent
appointed under chapter 145B or 145C, or an individual who is
related to the vulnerable adult, as defined in section 245A.02,
subdivision 13.
(e) If an individual was disqualified under sections
245C.14 and 245C.15, on the basis of a determination of
maltreatment, which was serious or recurring, and the individual
has requested reconsideration of the maltreatment determination
under paragraph (a) and reconsideration of the disqualification
under sections 245C.21 to 245C.27, reconsideration of the
maltreatment determination and requested reconsideration of the
disqualification shall be consolidated into a single
reconsideration. If reconsideration of the maltreatment
determination is denied or if the disqualification is not set
aside under sections 245C.21 to 245C.27, the individual may
request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and
the disqualification, the scope of the fair hearing shall
include both the maltreatment determination and the
disqualification.
(f) If a maltreatment determination or a disqualification
based on serious or recurring maltreatment is the basis for a
denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right
to a contested case hearing under chapter 14 and Minnesota
Rules, parts 1400.8505 to 1400.8612. As provided for under
section 245A.08, the scope of the contested case hearing shall
include the maltreatment determination, disqualification, and
licensing sanction or denial of a license. In such cases, a
fair hearing shall not be conducted under paragraph (b). When a
fine is based on a determination that the license holder is
responsible for maltreatment and the fine is issued at the same
time as the maltreatment determination, if the license holder
appeals the maltreatment and fine, reconsideration of the
maltreatment determination shall not be conducted under this
section. If the disqualified subject is an individual other
than the license holder and upon whom a background study must be
conducted under chapter 245C, the hearings of all parties may be
consolidated into a single contested case hearing upon consent
of all parties and the administrative law judge.
(g) Until August 1, 2002, an individual or facility that
was determined by the commissioner of human services or the
commissioner of health to be responsible for neglect under
section 626.5572, subdivision 17, after October 1, 1995, and
before August 1, 2001, that believes that the finding of neglect
does not meet an amended definition of neglect may request a
reconsideration of the determination of neglect. The
commissioner of human services or the commissioner of health
shall mail a notice to the last known address of individuals who
are eligible to seek this reconsideration. The request for
reconsideration must state how the established findings no
longer meet the elements of the definition of neglect. The
commissioner shall review the request for reconsideration and
make a determination within 15 calendar days. The
commissioner's decision on this reconsideration is the final
agency action.
(1) For purposes of compliance with the data destruction
schedule under subdivision 12b, paragraph (d), when a finding of
substantiated maltreatment has been changed as a result of a
reconsideration under this paragraph, the date of the original
finding of a substantiated maltreatment must be used to
calculate the destruction date.
(2) For purposes of any background studies under chapter
245C, when a determination of substantiated maltreatment has
been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under
chapter 245C that was based on this determination of
maltreatment shall be rescinded, and for future background
studies under chapter 245C the commissioner must not use the
previous determination of substantiated maltreatment as a basis
for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing
board under section 245C.31.
Sec. 56. Minnesota Statutes 2004, section 626.557,
subdivision 14, as amended by Laws 2005, chapter 136, article 5,
section 5, is amended to read:
Subd. 14. [ABUSE PREVENTION PLANS.] (a) Each facility,
except home health agencies and personal care attendant services
providers, shall establish and enforce an ongoing written abuse
prevention plan. The plan shall contain an assessment of the
physical plant, its environment, and its population identifying
factors which may encourage or permit abuse, and a statement of
specific measures to be taken to minimize the risk of abuse.
The plan shall comply with any rules governing the plan
promulgated by the licensing agency.
(b) Each facility, including a home health care agency and
personal care attendant services providers, shall develop an
individual abuse prevention plan for each vulnerable adult
residing there or receiving services from them. The plan shall
contain an individualized assessment of: (1) the person's
susceptibility to abuse by other individuals, including other
vulnerable adults; (2) the person's risk of abusing other
vulnerable adults; and (3) statements of the specific measures
to be taken to minimize the risk of abuse to that person and
other vulnerable adults. For the purposes of this paragraph,
the term "abuse" includes self-abuse.
(c) If the facility, except home health agencies and
personal care attendant services providers, knows that the
vulnerable adult has committed a violent crime or an act of
physical aggression toward others, the individual abuse
prevention plan must detail the measures to be taken to minimize
the risk that the vulnerable adult might reasonably be expected
to pose to visitors to the facility and persons outside the
facility, if unsupervised. Under this section, a facility knows
of a vulnerable adult's history of criminal misconduct or
physical aggression if it receives such information from a law
enforcement authority or through a medical record prepared by
another facility, another health care provider, or the
facility's ongoing assessments of the vulnerable adult.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 57. [EFFECTIVE DATE.]
This article is effective August 1, 2005, unless specified
otherwise.
ARTICLE 2
MENTAL AND CHEMICAL HEALTH
Section 1. Minnesota Statutes 2004, section 62J.692,
subdivision 3, as amended by Laws 2005, chapter 84, section 1,
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.
A clinical medical education program that trains
pediatricians is requested to include in its program curriculum
training in case management and medication management for
children suffering from mental illness to be eligible for funds
under subdivision 4.
(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; and
(4) other supporting information the commissioner deems
necessary to determine program eligibility based on the criteria
in paragraphs (a) and (b) and to ensure the equitable
distribution of funds.
(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) when requested, at the discretion of the
commissioner:
(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.
(e) An applicant that does not provide information
requested by the commissioner shall not be eligible for funds
for the current funding cycle.
Sec. 2. Minnesota Statutes 2004, section 245.4661, is
amended by adding a subdivision to read:
Subd. 8. [BUDGET FLEXIBILITY.] The commissioner may make
budget transfers that do not increase the state share of costs
to effectively implement the restructuring of adult mental
health services.
Sec. 3. Minnesota Statutes 2004, section 245.4874, as
amended by Laws 2005, chapter 98, article 3, section 11, is
amended to read:
245.4874 [DUTIES OF COUNTY BOARD.]
(a) The county board must:
(1) develop a system of affordable and locally available
children's mental health services according to sections 245.487
to 245.4887;
(2) establish a mechanism providing for interagency
coordination as specified in section 245.4875, subdivision 6;
(3) consider 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 245.4887;
(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 245.4887 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 245.4887;
(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;
(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) consistent with section 245.486, 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.
(b) When the county board refers clients to providers of
children's therapeutic services and supports under section
256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and
identify the reimbursement source for those requested services,
the method of payment, and the payment rate to the provider.
Sec. 4. Minnesota Statutes 2004, section 245.4885,
subdivision 1, is amended to read:
Subdivision 1. [SCREENING REQUIRED ADMISSION CRITERIA.]
The county board shall, prior to admission, except in the case
of emergency admission, screen determine the needed level of
care for all children referred for treatment of severe emotional
disturbance to in a treatment foster care setting, residential
treatment facility, or informally admitted to a regional
treatment center if public funds are used to pay for the
services. The county board shall also screen determine the
needed level of care for all children admitted to an acute care
hospital for treatment of severe emotional disturbance if public
funds other than reimbursement under chapters 256B and 256D are
used to pay for the services. If a child is admitted to a
residential treatment facility or acute care hospital for
emergency treatment or held for emergency care by a regional
treatment center under section 253B.05, subdivision 1, screening
must occur within three working days of admission.
Screening The level of care determination shall determine
whether the proposed treatment:
(1) is necessary;
(2) is appropriate to the child's individual treatment
needs;
(3) cannot be effectively provided in the child's home; and
(4) provides a length of stay as short as possible
consistent with the individual child's need.
When a screening level of care determination is conducted,
the county board may not determine that referral or admission to
a treatment foster care setting, residential treatment facility,
or acute care hospital is not appropriate solely because
services were not first provided to the child in a less
restrictive setting and the child failed to make progress toward
or meet treatment goals in the less restrictive
setting. Screening shall include both The level of care
determination must be based on a diagnostic assessment and that
includes a functional assessment which evaluates family, school,
and community living situations; and an assessment of the
child's need for care out of the home using a validated tool
which assesses a child's functional status and assigns an
appropriate level of care. The validated tool must be approved
by the commissioner of human services. If a diagnostic
assessment or including a functional assessment has been
completed by a mental health professional within the past 180
days, a new diagnostic or functional assessment need not be
completed unless in the opinion of the current treating mental
health professional the child's mental health status has changed
markedly since the assessment was completed. The child's parent
shall be notified if an assessment will not be completed and of
the reasons. A copy of the notice shall be placed in the
child's file. Recommendations developed as part of
the screening level of care determination process shall include
specific community services needed by the child and, if
appropriate, the child's family, and shall indicate whether or
not these services are available and accessible to the child and
family.
During the screening level of care determination process,
the child, child's family, or child's legal representative, as
appropriate, must be informed of the child's eligibility for
case management services and family community support services
and that an individual family community support plan is being
developed by the case manager, if assigned.
Screening The level of care determination shall be in
compliance comply with section 260C.212. Wherever possible, the
parent shall be consulted in the screening process, unless
clinically inappropriate.
The screening process level of care determination, and
placement decision, and recommendations for mental health
services must be documented in the child's record.
An alternate review process may be approved by the
commissioner if the county board demonstrates that an alternate
review process has been established by the county board and the
times of review, persons responsible for the review, and review
criteria are comparable to the standards in clauses (1) to (4).
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 5. Minnesota Statutes 2004, section 245.4885, is
amended by adding a subdivision to read:
Subd. 1a. [EMERGENCY ADMISSION.] Effective July 1, 2006,
if a child is admitted to a treatment foster care setting,
residential treatment facility, or acute care hospital for
emergency treatment or held for emergency care by a regional
treatment center under section 253B.05, subdivision 1, the level
of care determination must occur within three working days of
admission.
Sec. 6. Minnesota Statutes 2004, section 245.4885,
subdivision 2, is amended to read:
Subd. 2. [QUALIFICATIONS.] No later than July 1, 1991,
Screening Level of care determination of children for treatment
foster care, residential, and inpatient services must be
conducted by a mental health professional. Where appropriate
and available, culturally informed mental health consultants
must participate in the screening level of care determination.
Mental health professionals providing screening level of care
determination for treatment foster care, inpatient, and
residential services must not be financially affiliated with any
acute care inpatient hospital, residential treatment facility,
or regional treatment center nongovernment entity which may be
providing those services. The commissioner may waive this
requirement for mental health professional participation after
July 1, 1991, if the county documents that:
(1) mental health professionals or mental health
practitioners are unavailable to provide this service; and
(2) services are provided by a designated person with
training in human services who receives clinical supervision
from a mental health professional.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 7. Minnesota Statutes 2004, section 256B.0622,
subdivision 2, is amended to read:
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, as
defined by the standards established by the National Coalition
for Community Living, 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 the Fairweather Lodge
treatment model as defined in paragraph (a), and other
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.
Sec. 8. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 46. [MENTAL HEALTH TELEMEDICINE.] Effective January
1, 2006, and subject to federal approval, mental health services
that are otherwise covered by medical assistance as direct
face-to-face services may be provided via two-way interactive
video. Use of two-way interactive video must be medically
appropriate to the condition and needs of the person being
served. Reimbursement is at the same rates and under the same
conditions that would otherwise apply to the service. The
interactive video equipment and connection must comply with
Medicare standards in effect at the time the service is provided.
Sec. 9. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 47. [TREATMENT FOSTER CARE SERVICES.] Effective July
1, 2006, and subject to federal approval, medical assistance
covers treatment foster care services according to section
256B.0946.
Sec. 10. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 48. [PSYCHIATRIC CONSULTATION TO PRIMARY CARE
PRACTITIONERS.] Effective January 1, 2006, medical assistance
covers consultation provided by a psychiatrist via telephone,
e-mail, facsimile, or other means of communication to primary
care practitioners, including pediatricians. The need for
consultation and the receipt of the consultation must be
documented in the patient record maintained by the primary care
practitioner. If the patient consents, and subject to federal
limitations and data privacy provisions, the consultation may be
provided without the patient present.
Sec. 11. Minnesota Statutes 2004, section 256B.0943,
subdivision 3, is amended to read:
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. A client with
autism spectrum disorder or pervasive developmental disorder may
receive a diagnostic assessment once every three years, at the
request of the parent or guardian, if a mental health
professional agrees there has been little change in the
condition and that an annual assessment is not needed. 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.
Sec. 12. [256B.0946] [TREATMENT FOSTER CARE.]
Subdivision 1. [COVERED SERVICE.] (a) Effective July 1,
2006, and subject to federal approval, medical assistance covers
medically necessary services described under paragraph (b) that
are provided by a provider entity eligible under subdivision 3
to a client eligible under subdivision 2 who is placed in a
treatment foster home licensed under Minnesota Rules, parts
2960.3000 to 2960.3340.
(b) Services to children with severe emotional disturbance
residing in treatment foster care settings must meet the
relevant standards for mental health services under sections
245.487 to 245.4887. In addition, specific service components
reimbursed by medical assistance must meet the following
standards:
(1) case management service component must meet the
standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and
9505.0322, excluding subparts 6 and 10;
(2) psychotherapy and skills training components must meet
the standards for children's therapeutic services and supports
in section 256B.0943; and
(3) family psychoeducation services under supervision of a
mental health professional.
Subd. 2. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's
eligibility to receive treatment foster care under this section
shall be determined by a diagnostic assessment, an evaluation of
level of care needed, and development of an individual treatment
plan, as defined in paragraphs (a) to (c).
(a) The diagnostic assessment must:
(1) be conducted by a psychiatrist, licensed psychologist,
or licensed independent clinical social worker that is performed
within 180 days prior to the start of service;
(2) include current diagnoses on all five axes of the
client's current mental health status;
(3) determine whether or not a child meets the criteria for
severe emotional disturbance in section 245.4871, subdivision 6,
or for serious and persistent mental illness in section 245.462,
subdivision 20; and
(4) 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 status and service
needs.
(b) The evaluation of level of care must be conducted by
the placing county with an instrument approved by the
commissioner of human services. The commissioner shall update
the list of approved level of care instruments annually.
(c) The individual treatment plan must be:
(1) based on the information in the client's diagnostic
assessment;
(2) developed through a child-centered, family driven
planning process that identifies service needs and
individualized, planned, and culturally appropriate
interventions that contain specific measurable treatment goals
and objectives for the client and treatment strategies for the
client's family and foster family;
(3) reviewed at least once every 90 days and revised; and
(4) 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.
Subd. 3. [ELIGIBLE PROVIDERS.] For purposes of this
section, a provider agency must have an individual placement
agreement for each recipient and must be a licensed child
placing agency, under Minnesota Rules, parts 9543.0010 to
9543.0150, and either:
(1) a county;
(2) an Indian Health Services facility operated by a tribe
or tribal organization under funding authorized by United States
Code, title 25, sections 450f to 450n, or title 3 of the Indian
Self-Determination Act, Public Law 93-638, section 638
(facilities or providers); or
(3) a noncounty entity under contract with a county board.
Subd. 4. [ELIGIBLE PROVIDER RESPONSIBILITIES.] (a) To be
an eligible provider under this section, a provider must develop
written policies and procedures for treatment foster care
services consistent with subdivision 1, paragraph (b), clauses
(1), (2), and (3).
(b) In delivering services under this section, a treatment
foster care provider must ensure that staff caseload size
reasonably enables the provider to play an active role in
service planning, monitoring, delivering, and reviewing for
discharge planning to meet the needs of the client, the client's
foster family, and the birth family, as specified in each
client's individual treatment plan.
Subd. 5. [SERVICE AUTHORIZATION.] The commissioner will
administer authorizations for services under this section in
compliance with section 256B.0625, subdivision 25.
Subd. 6. [EXCLUDED SERVICES.] (a) Services in clauses (1)
to (4) are not eligible as components of treatment foster care
services:
(1) treatment foster care services provided in violation of
medical assistance policy in Minnesota Rules, part 9505.0220;
(2) service components of children's therapeutic services
and supports simultaneously provided by more than one treatment
foster care provider;
(3) home and community-based waiver services; and
(4) treatment foster care services provided to a child
without a level of care determination according to section
245.4885, subdivision 1.
(b) Children receiving treatment foster care services are
not eligible for medical assistance reimbursement for the
following services while receiving treatment foster care:
(1) mental health case management services under section
256B.0625, subdivision 20; and
(2) psychotherapy and skill training components of
children's therapeutic services and supports under section
256B.0625, subdivision 35b.
Sec. 13. [256B.0947] [TRANSITIONAL YOUTH INTENSIVE
REHABILITATIVE MENTAL HEALTH SERVICES.]
Subdivision 1. [SCOPE.] Subject to federal approval,
medical assistance covers medically necessary, intensive
nonresidential 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 child rehabilitative mental health services as
defined in section 256B.0943, except that these services are
provided by a multidisciplinary staff using a total team
approach consistent with assertive community treatment, or other
evidence-based practices, and directed to recipients with a
serious mental illness who require intensive services.
(b) "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.
(c) "Treatment team" means all staff who provide services
to recipients under this section. At a minimum, this includes
the clinical supervisor, mental health professionals, mental
health practitioners, mental health behavioral aides, and a
school representative familiar with the recipient's individual
education plan (IEP) if applicable.
Subd. 3. [ELIGIBILITY FOR TRANSITIONAL YOUTH.] An eligible
recipient under the age of 18 is an individual who:
(1) is age 16 or 17;
(2) is diagnosed with a medical condition, such as an
emotional disturbance or traumatic brain injury, for which
intensive nonresidential rehabilitative mental health services
are needed;
(3) has substantial disability and functional impairment in
three or more of the areas listed in section 245.462,
subdivision 11a, so that self-sufficiency upon adulthood or
emancipation is unlikely; and
(4) has had a recent diagnostic assessment by a qualified
professional that documents that intensive nonresidential
rehabilitative mental health services are medically necessary to
address identified disability and functional impairments and
individual recipient goals.
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 transition youth rehabilitative mental health
services; and
(2) be certified by the commissioner as being in compliance
with this section and section 256B.0943.
(b) 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 NONRESIDENTIAL
PROVIDERS.] (a) Services must be provided by a certified
provider entity as defined in section 256B.0943, subdivision 4
that meets the requirements in section 245B.0943, subdivisions 5
and 6.
(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 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. 7. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE
REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for
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, staff travel time to
provide rehabilitative services under this section, and
nonresidential crisis stabilization services under section
256B.0944.
(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
nonresidential intensive rehabilitative mental health 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; and
(5) the costs of other services that will be separately
reimbursed.
(d) The rate for intensive rehabilitative mental health
services must exclude medical assistance room and board rate, as
defined in section 256I.03, subdivision 6, and services not
covered under this section, such as partial hospitalization and
inpatient services. Physician services are not a component of
the treatment team and may be billed separately. 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.
(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. 8. [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.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 14. Minnesota Statutes 2004, 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;
(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 90 percent state funds and
20 ten 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 15. Minnesota Statutes 2004, 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 (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; and
(23) mental health telemedicine and psychiatric
consultation as covered under section 256B.0625, subdivisions 46
and 48.
(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) 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.
(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.
(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, advanced practice nurse, 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 restorative dental services.
(e) Co-payments shall be limited to one per day per
provider for nonpreventive visits, eyeglasses, and nonemergency
visits to a hospital-based emergency room. 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.
(g) Any county may, from its own resources, provide medical
payments for which state payments are not made.
(h) Chemical dependency services that are reimbursed under
chapter 254B must not be reimbursed under general assistance
medical care.
(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.
(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 January 1, 2006.
Sec. 16. Minnesota Statutes 2004, 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 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, or an adult mental health residential treatment
program under section 256B.0622, 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.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 17. Minnesota Statutes 2004, 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 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. Outpatient mental health services
covered under the MinnesotaCare program are limited to
diagnostic assessments, psychological testing, explanation of
findings, mental health telemedicine, psychiatric consultation,
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 January 1, 2006.
Sec. 18. [641.155] [DISCHARGE PLANS; OFFENDERS WITH
SERIOUS AND PERSISTENT MENTAL ILLNESS.]
The commissioner of corrections shall develop a model
discharge planning process for every offender with a serious and
persistent mental illness, as defined in section 245.462,
subdivision 20, paragraph (c), who has been convicted and
sentenced to serve three or more months and is being released
from a county jail or county regional jail.
An offender with a serious and persistent mental illness,
as defined in section 245.462, subdivision 20, paragraph (c),
who has been convicted and sentenced to serve three or more
months and is being released from a county jail or county
regional jail shall be referred to the appropriate staff in the
county human services department at least 60 days before being
released. The county human services department may carry out
provisions of the model discharge planning process such as:
(1) providing assistance in filling out an application for
medical assistance, general assistance medical care, or
MinnesotaCare;
(2) making a referral for case management as outlined under
section 245.467, subdivision 4;
(3) providing assistance in obtaining a state photo
identification;
(4) securing a timely appointment with a psychiatrist or
other appropriate community mental health providers; and
(5) providing prescriptions for a 30-day supply of all
necessary medications.
Sec. 19. [PRIORITY IN JANITORIAL CONTRACTS.]
When awarding contracts to provide the janitorial services
for the new Department of Human Services and Department of
Health buildings, the commissioner of administration shall give
priority to supported work vendors, provided those vendors
submit a bid that is equal to or less than bids submitted by
other vendors.
Sec. 20. [ENHANCED SEPARATION.]
A state employee covered by a collective bargaining
agreement negotiated by the exclusive representatives of the
American Federation of State, County and Municipal Employees
Council 5, who separates from employment at the Willmar Regional
Treatment Center after the center ceases to be a state facility,
is governed by the enhanced separation package agreed to by the
state of Minnesota and the American Federation of State, County
and Municipal Employees Council 5 that is scheduled to take
effect August 1, 2005, even if the center ceases to be a state
facility before August 1, 2005. This section is repealed on
August 1, 2005, or on the date the memorandum of understanding
that includes the enhanced separation package is ratified,
whichever occurs later.
Sec. 21. [PENSION COVERAGE.]
(a) This section applies to an employee of the Willmar
Regional Treatment Center whose position at the treatment center
changes from state employment to Kandiyohi County employment
during the biennium ending June 30, 2007. Notwithstanding any
law to the contrary, an employee to whom this section applies
remains a member of the Minnesota State Retirement System while
employed by Kandiyohi County unless the member elects to become
a member of the Public Employees Retirement Association.
(b) An election to become a member of the Public Employees
Retirement Association under this section must be made within
six months from the date the position changes from state
employment to Kandiyohi County employment, is irrevocable, and
must be made in a manner specified by the executive directors of
the Minnesota State Retirement System and the Public Employees
Retirement Association.
Sec. 22. [EFFECTIVE DATE.]
(a) Sections 20 and 21 are effective the day following
final enactment.
(b) The sections in this article are effective August 1,
2005, unless otherwise specified.
ARTICLE 3
FAMILY SUPPORT
Section 1. Minnesota Statutes 2004, 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)(i) Effective
July 1, 2005, the commissioner of human services shall modify
the rate tables for child care centers published in Department
of Human Services Bulletin No. 03-68-07 so that in counties with
regional or statewide cells, the higher of the 100th percentile
of the 2002 market rate survey data or the rate currently
identified in the bulletin will be the maximum rate. The rates
established in this clause will be considered as the previous
year's rates for purposes of the increase in item (iii), and
shall be compared to the 100th percentile of current market
rates.
(ii) For the period between July 1, 2005, and through the
full implementation of the new rates under item (iii), the rates
published in Department of Human Services Bulletin No. 03-68-07
as adjusted by item (i) shall remain in effect.
(iii) Beginning January 1, 2006, the maximum rate paid for
child care assistance in any county or multicounty region under
the child care fund shall be the lesser of the 75th percentile
rate for like-care arrangements in the county or multicounty
region as surveyed by the commissioner or the previous year's
rate for like-care arrangements in the county increased by 1.75
percent.
(iv) Rate changes shall be implemented for services
provided in March 2006 unless a participant eligibility
redetermination or a new provider agreement is completed between
January 1, 2006, and February 28, 2006.
As necessary, appropriate notice of adverse action must be
made according to Minnesota Rules, part 3400.0185, subparts 3
and 4.
New cases approved on or after January 1, 2006, shall have
the maximum rates under item (iii) implemented immediately.
(b) Not less than once every two years, the commissioner
shall survey rates charged by child care providers in Minnesota
to determine the 75th percentile for like-care arrangements in
counties. When the commissioner determines that, using the
commissioner's established protocol, the number of providers
responding to the survey is too small to determine the 75th
percentile rate for like-care arrangements in a county or
multicounty region, the commissioner may establish the 75th
percentile maximum rate based on like-care arrangements in a
county, region, or category that the commissioner deems to be
similar.
(c) A rate which includes a special needs rate paid under
subdivision 3 may be in excess of the maximum rate allowed under
this subdivision.
(d) 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.
(e) 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 co-payment
fee.
Sec. 2. Minnesota Statutes 2004, section 119B.13, is
amended by adding a subdivision to read:
Subd. 7. [ABSENT DAYS.] Child care providers may not be
reimbursed for more than 25 absent days per child, excluding
holidays, in a fiscal year, or for more than ten consecutive
absent days, unless the child has a documented medical condition
that causes more frequent absences. Documentation of medical
conditions must be on the forms and submitted according to the
timelines established by the commissioner.
[EFFECTIVE DATE.] This section is effective October 1, 2005.
Sec. 3. [245A.1445] [CHILD CARE PROVIDER TRAINING; DANGERS
OF SHAKING INFANTS AND YOUNG CHILDREN.]
The commissioner shall make available for viewing by all
licensed and legal nonlicensed child care providers a video
presentation on the dangers associated with shaking infants and
young children. The video presentation shall be part of the
initial and annual training of licensed child care providers.
Legal nonlicensed child care providers may participate at their
option in a video presentation session offered under this
section. The commissioner shall provide to child care providers
and interested individuals, at cost, copies of a video approved
by the commissioner of health under section 144.574 on the
dangers associated with shaking infants and young children.
Sec. 4. Minnesota Statutes 2004, section 245A.10,
subdivision 4, is amended to read:
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 $225 $400
25 to 49 persons $450 $340 $600
50 to 74 persons $600 $450 $800
75 to 99 persons $750 $565 $1,000
100 to 124 persons $900 $675 $1,200
125 to 149 persons $1,200 $900 $1,400
150 to 174 persons $1,400 $1,050 $1,600
175 to 199 persons $1,600 $1,200 $1,800
200 to 224 persons $1,800 $1,350 $2,000
225 or more persons $2,000 $1,500 $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.
Sec. 5. Minnesota Statutes 2004, 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 to the cost of services used by
making monthly payments on a sliding scale based on income,
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 computed by applying the
following schedule of rates to the adjusted gross income of the
natural or adoptive parents:
(1) 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) if the adjusted gross income is equal to or greater
than 175 percent of federal poverty guidelines and less than or
equal to 375 545 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
375 545 percent of federal poverty guidelines;
(3) if the adjusted gross income is greater than 375 545
percent of federal poverty guidelines and less than 675 percent
of federal poverty guidelines, the parental contribution shall
be 7.5 percent of adjusted gross income;
(4) if the adjusted gross income is equal to or greater
than 675 percent of federal poverty guidelines and less than 975
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 7.5 percent of
adjusted gross income at 675 percent of federal poverty
guidelines and increases to ten percent of adjusted gross income
for those with adjusted gross income up to 975 percent of
federal poverty guidelines; 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 annual adjusted
gross income is reduced by $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, 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,
except, effective retroactive to July 1, 2003, taxable capital
gains to the extent the funds have been used to purchase a home
shall not be counted as income.
(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). 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 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 retroactively
from July 1, 2005.
Sec. 6. Minnesota Statutes 2004, section 254A.035,
subdivision 2, is amended to read:
Subd. 2. [MEMBERSHIP TERMS, COMPENSATION, REMOVAL AND
EXPIRATION.] The membership of this council shall be composed of
17 persons who are American Indians and who are appointed by the
commissioner. The commissioner shall appoint one representative
from each of the following groups: Red Lake Band of Chippewa
Indians; Fond du Lac Band, Minnesota Chippewa Tribe; Grand
Portage Band, Minnesota Chippewa Tribe; Leech Lake Band,
Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa
Tribe; Bois Forte Band, Minnesota Chippewa Tribe; White Earth
Band, Minnesota Chippewa Tribe; Lower Sioux Indian Reservation;
Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton
Sioux Indian Reservation; Upper Sioux Indian Reservation;
International Falls Northern Range; Duluth Urban Indian
Community; and two representatives from the Minneapolis Urban
Indian Community and two from the St. Paul Urban Indian
Community. The terms, compensation, and removal of American
Indian Advisory Council members shall be as provided in section
15.059. The council expires June 30, 2001 2008.
[EFFECTIVE DATE.] This section is effective retroactively
from June 30, 2001.
Sec. 7. Minnesota Statutes 2004, section 254A.04, is
amended to read:
254A.04 [CITIZENS ADVISORY COUNCIL.]
There is hereby created an Alcohol and Other Drug Abuse
Advisory Council to advise the Department of Human Services
concerning the problems of alcohol and other drug dependency and
abuse, composed of ten members. Five members shall be
individuals whose interests or training are in the field of
alcohol dependency and abuse; and five members whose interests
or training are in the field of dependency and abuse of drugs
other than alcohol. The terms, compensation and removal of
members shall be as provided in section 15.059. The council
expires June 30, 2001 2008. The commissioner of human services
shall appoint members whose terms end in even-numbered years.
The commissioner of health shall appoint members whose terms end
in odd-numbered years.
[EFFECTIVE DATE.] This section is effective retroactively
from June 30, 2001.
Sec. 8. Minnesota Statutes 2004, section 256.01, is
amended by adding a subdivision to read:
Subd. 14b. [AMERICAN INDIAN CHILD WELFARE PROJECTS.] (a)
The commissioner of human services may authorize projects to
test tribal delivery of child welfare services to American
Indian children and their parents and custodians living on the
reservation. The commissioner has authority to solicit and
determine which tribes may participate in a project. Grants may
be issued to Minnesota Indian tribes to support the projects.
The commissioner may waive existing state rules as needed to
accomplish the projects. Notwithstanding section 626.556, the
commissioner may authorize projects to use alternative methods
of investigating and assessing reports of child maltreatment,
provided that the projects comply with the provisions of section
626.556 dealing with the rights of individuals who are subjects
of reports or investigations, including notice and appeal rights
and data practices requirements. The commissioner may seek any
federal approvals necessary to carry out the projects as well as
seek and use any funds available to the commissioner, including
use of federal funds, foundation funds, existing grant funds,
and other funds. The commissioner is authorized to advance
state funds as necessary to operate the projects. Federal
reimbursement applicable to the projects is appropriated to the
commissioner for the purposes of the projects. The projects
must be required to address responsibility for safety,
permanency, and well-being of children.
(b) For the purposes of this section, "American Indian
child" means a person under 18 years of age who is a tribal
member or eligible for membership in one of the tribes chosen
for a project under this subdivision and who is residing on the
reservation of that tribe.
(c) In order to qualify for an American Indian child
welfare project, a tribe must:
(1) be one of the existing tribes with reservation land in
Minnesota;
(2) have a tribal court with jurisdiction over child
custody proceedings;
(3) have a substantial number of children for whom
determinations of maltreatment have occurred;
(4) have capacity to respond to reports of abuse and
neglect under section 626.556;
(5) provide a wide range of services to families in need of
child welfare services; and
(6) have a tribal-state title IV-E agreement in effect.
(d) Grants awarded under this section may be used for the
nonfederal costs of providing child welfare services to American
Indian children on the tribe's reservation, including costs
associated with:
(1) assessment and prevention of child abuse and neglect;
(2) family preservation;
(3) facilitative, supportive, and reunification services;
(4) out-of-home placement for children removed from the
home for child protective purposes; and
(5) other activities and services approved by the
commissioner that further the goals of providing safety,
permanency, and well-being of American Indian children.
(e) When a tribe has initiated a project and has been
approved by the commissioner to assume child welfare
responsibilities for American Indian children of that tribe
under this section, the affected county social service agency is
relieved of responsibility for responding to reports of abuse
and neglect under section 626.556 for those children during the
time within which the tribal project is in effect and funded.
The commissioner shall work with tribes and affected counties to
develop procedures for data collection, evaluation, and
clarification of ongoing role and financial responsibilities of
the county and tribe for child welfare services prior to
initiation of the project. Children who have not been
identified by the tribe as participating in the project shall
remain the responsibility of the county. Nothing in this
section shall alter responsibilities of the county for law
enforcement or court services.
(f) The commissioner shall collect information on outcomes
relating to child safety, permanency, and well-being of American
Indian children who are served in the projects. Participating
tribes must provide information to the state in a format and
completeness deemed acceptable by the state to meet state and
federal reporting requirements.
Sec. 9. Minnesota Statutes 2004, section 256B.0924,
subdivision 3, is amended to read:
Subd. 3. [ELIGIBILITY.] Persons are eligible to receive
targeted case management services under this section if the
requirements in paragraphs (a) and (b) are met.
(a) The person must be assessed and determined by the local
county agency to:
(1) be age 18 or older;
(2) be receiving medical assistance;
(3) have significant functional limitations; and
(4) be in need of service coordination to attain or
maintain living in an integrated community setting.
(b) The person must be a vulnerable adult in need of adult
protection as defined in section 626.5572, or is an adult with
mental retardation as defined in section 252A.02, subdivision 2,
or a related condition as defined in section 252.27, subdivision
1a, and is not receiving home and community-based waiver
services, or is an adult who lacks a permanent residence and who
has been without a permanent residence for at least one year or
on at least four occasions in the last three years.
Sec. 10. Minnesota Statutes 2004, section 256B.093,
subdivision 1, is amended to read:
Subdivision 1. [STATE TRAUMATIC BRAIN INJURY PROGRAM.] The
commissioner of human services shall:
(1) maintain a statewide traumatic brain injury program;
(2) supervise and coordinate services and policies for
persons with traumatic brain injuries;
(3) contract with qualified agencies or employ staff to
provide statewide administrative case management and
consultation;
(4) maintain an advisory committee to provide
recommendations in reports to the commissioner regarding program
and service needs of persons with traumatic brain injuries;
(5) investigate the need for the development of rules or
statutes for the traumatic brain injury home and community-based
services waiver;
(6) investigate present and potential models of service
coordination which can be delivered at the local level; and
(7) the advisory committee required by clause (4) must
consist of no fewer than ten members and no more than 30
members. The commissioner shall appoint all advisory committee
members to one- or two-year terms and appoint one member as
chair. Notwithstanding section 15.059, subdivision 5, the
advisory committee does not terminate until June 30, 2005 2008.
Sec. 11. Minnesota Statutes 2004, section 256D.06,
subdivision 5, is amended to read:
Subd. 5. [ELIGIBILITY; REQUIREMENTS.] (a) Any applicant,
otherwise eligible for general assistance and possibly eligible
for maintenance benefits from any other source shall (a) (1)
make application for those benefits within 30 days of the
general assistance application; and (b) (2) execute an interim
assistance authorization agreement on a form as directed by the
commissioner.
(b) The commissioner shall review a denial of an
application for other maintenance benefits and may require a
recipient of general assistance to file an appeal of the denial
if appropriate. If found eligible for benefits from other
sources, and a payment received from another source relates to
the period during which general assistance was also being
received, the recipient shall be required to reimburse the
county agency for the interim assistance paid. Reimbursement
shall not exceed the amount of general assistance paid during
the time period to which the other maintenance benefits apply
and shall not exceed the state standard applicable to that time
period.
(c) The commissioner shall adopt rules authorizing county
agencies or other client representatives to retain from the
amount recovered under an interim assistance agreement 25
percent plus actual reasonable fees, costs, and disbursements of
appeals and litigation, of providing special assistance to the
recipient in processing the recipient's claim for maintenance
benefits from another source. The may contract with the county
agencies, qualified agencies, organizations, or persons to
provide advocacy and support services to process claims for
federal disability benefits for applicants or recipients of
services or benefits supervised by the commissioner using money
retained under this section shall be from the state share of the
recovery. The commissioner or the county agency may contract
with qualified persons to provide the special assistance.
(d) The rules adopted by the commissioner shall include the
may provide methods by which county agencies shall identify,
refer, and assist recipients who may be eligible for benefits
under federal programs for the disabled. This subdivision does
not require repayment of per diem payments made to shelters for
battered women pursuant to section 256D.05, subdivision 3.
(e) The total amount of interim assistance recoveries
retained under this section for advocacy, support, and claim
processing services shall not exceed 35 percent of the interim
assistance recoveries in the prior fiscal year.
Sec. 12. Minnesota Statutes 2004, section 256D.06,
subdivision 7, is amended to read:
Subd. 7. [SSI CONVERSIONS AND BACK CLAIMS.] (a) [SSI
CONVERSIONS.] The commissioner of human services shall contract
with agencies or organizations capable of ensuring that clients
who are presently receiving assistance under sections 256D.01 to
256D.21, and who may be eligible for benefits under the federal
Supplemental Security Income program, apply and, when eligible,
are converted to the federal income assistance program and made
eligible for health care benefits under the medical assistance
program. The commissioner shall ensure that money owing to the
state under interim assistance agreements is collected.
(b) [BACK CLAIMS FOR FEDERAL HEALTH CARE BENEFITS.] The
commissioner shall also directly or through contract implement
procedures for collecting federal Medicare and medical
assistance funds for which clients converted to SSI are
retroactively eligible.
(c) [ADDITIONAL REQUIREMENTS.] The commissioner shall
begin contracting contract with agencies to ensure
implementation of this section within 14 days after April 29,
1992. County contracts with providers for residential services
shall include the requirement that providers screen residents
who may be eligible for federal benefits and provide that
information to the local agency. The commissioner shall modify
the MAXIS computer system to provide information on clients who
have been on general assistance for two years or longer. The
list of clients shall be provided to local services for
screening under this section.
(d) [REPORT.] The commissioner shall report to the
legislature by January 15, 1993, on the implementation of this
section. The report shall contain information on the following:
(1) the number of clients converted from general assistance
to SSI, by county;
(2) information on the organizations involved;
(3) the amount of money collected through interim
assistance agreements;
(4) the amount of money collected in federal Medicare or
Medicaid funds;
(5) problems encountered in processing conversions and back
claims; and
(6) recommended changes to enhance recoveries and maximize
the receipt of federal money in the most efficient way possible.
Sec. 13. Minnesota Statutes 2004, section 256I.05,
subdivision 1e, is amended to read:
Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.]
Notwithstanding the provisions of subdivisions 1a and 1c,
beginning July 1, 2001 2005, a county agency shall negotiate a
supplementary rate in addition to the rate specified in
subdivision 1, equal to 46 percent of the amount specified in
subdivision 1a not to exceed $700 per month, including any
legislatively authorized inflationary adjustments, for a group
residential housing provider that:
(1) is located in Hennepin County and has had a group
residential housing contract with the county since June 1996;
(2) operates in three separate locations a 71-bed 75-bed
facility, a 50-bed facility, and two 40-bed facilities a 26-bed
facility; and
(3) serves a chemically dependent clientele, providing 24
hours per day supervision and limiting a resident's maximum
length of stay to 13 months out of a consecutive 24-month period.
Sec. 14. Minnesota Statutes 2004, section 256J.37,
subdivision 3b, is amended 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 up to $125 per for an MFIP assistance unit
that includes one or more SSI recipient recipients who
resides reside in the household, and who would otherwise be
included in the MFIP assistance unit under section 256J.24,
subdivision 2, but is are excluded solely due to the SSI
recipient status under section 256J.24, subdivision 3, paragraph
(a), clause (1). If the SSI recipient receives or recipients
receive 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.
[EFFECTIVE DATE.] This section is effective the first day
of the second month after the date of approval by the United
States Department of Agriculture.
Sec. 15. Minnesota Statutes 2004, section 256J.515, is
amended to read:
256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.]
During the first meeting with participants, job counselors
must ensure that an overview of employment and training services
is provided that:
(1) stresses the necessity and opportunity of immediate
employment;
(2) outlines the job search resources offered;
(3) outlines education or training opportunities available;
(4) describes the range of work activities, including
activities under section 256J.49, subdivision 13, clause (18),
that are allowable under MFIP to meet the individual needs of
participants;
(5) explains the requirements to comply with an employment
plan;
(6) explains the consequences for failing to comply;
(7) explains the services that are available to support job
search and work and education; and
(8) provides referral information about shelters and
programs for victims of family violence and the time limit
exemption for family violence victims; and
(9) explains the probationary employment periods new
employees may serve after being hired and any assistance with
job retention services that may be available.
Failure to attend the overview of employment and training
services without good cause results in the imposition of a
sanction under section 256J.46.
An applicant who requests and qualifies for a family
violence waiver is exempt from attending a group overview.
Information usually presented in an overview must be covered
during the development of an employment plan under section
256J.521, subdivision 3.
Sec. 16. [256K.26] [LONG-TERM HOMELESS SUPPORTIVE
SERVICES.]
Subdivision 1. [ESTABLISHMENT AND PURPOSE.] The
commissioner shall establish the long-term homeless supportive
services fund to provide integrated services needed to stabilize
individuals, families, and youth living in supportive housing
developed to further the goals set forth in Laws 2003, chapter
128, article 15, section 9.
Subd. 2. [IMPLEMENTATION.] The commissioner, in
consultation with the commissioners of the Department of
Corrections and the Minnesota Housing Finance Agency, counties,
providers and funders of supportive housing and services, shall
develop application requirements and make funds available
according to this section, with the goal of providing maximum
flexibility in program design.
Subd. 3. [DEFINITIONS.] For purposes of this section, the
following terms have the meanings given:
(1) "long-term homelessness" means lacking a permanent
place to live continuously for one year or more or at least four
times in the past three years; and
(2) "household" means an individual, family, or
unaccompanied minor experiencing long-term homelessness.
Subd. 4. [COUNTY ELIGIBILITY.] Counties are eligible for
funding under this section. Priority will be given to proposals
submitted on behalf of multicounty partnerships.
Subd. 5. [CONTENT OF PROPOSALS.] Proposals will be
evaluated on the extent to which they:
(1) include partnerships with providers of services or
other partners;
(2) develop strategies to enhance housing stability for
people experiencing long-term homelessness by integrating
services and establishing consistent services and procedures
across jurisdictions as appropriate;
(3) evidence a commitment to working with the commissioners
of human services, corrections, and the Housing Finance Agency
to identify appropriate households to be served under this
section and serve households as defined in subdivision 3. The
commissioner may also set criteria for serving people at
significant risk of experiencing long-term homelessness, with a
priority on serving families with minor children;
(4) ensure that projects make maximum use of mainstream
resources, including employment, social, and health services,
and leverage additional public and private resources in order to
serve the maximum number of households;
(5) demonstrate cost-effectiveness by identifying and
prioritizing those services most necessary for housing
stability; and
(6) evaluate and report on outcomes of the projects
according to protocols developed by the commissioner of human
services in cooperation with the commissioners of corrections
and the Housing Finance Agency. Evaluation would include
methods for determining the quality of the integrated service
approach, improvement in outcomes, cost savings, or reduction in
service disparities that may result.
Subd. 6. [OUTCOMES.] Projects will be selected to further
the following outcomes:
(1) reduce the number of Minnesota individuals and families
that experience long-term homelessness;
(2) increase the number of housing opportunities with
supportive services;
(3) develop integrated, cost-effective service models that
address the multiple barriers to obtaining housing stability
faced by people experiencing long-term homelessness, including
abuse, neglect, chemical dependency, disability, chronic health
problems, or other factors including ethnicity and race that may
result in poor outcomes or service disparities;
(4) encourage partnerships among counties, community
agencies, schools, and other providers so that the service
delivery system is seamless for people experiencing long-term
homelessness;
(5) increase employability, self-sufficiency, and other
social outcomes for individuals and families experiencing
long-term homelessness; and
(6) reduce inappropriate use of emergency health care,
shelter, chemical dependency, foster care, child protection,
corrections, and similar services used by people experiencing
long-term homelessness.
Subd. 7. [ELIGIBLE SERVICES.] Services eligible for
funding under this section are all services needed to maintain
households in permanent supportive housing, as determined by the
county or counties administering the project or projects.
Subd. 8. [FAMILIES EXPERIENCING LONG-TERM
HOMELESSNESS.] The commissioner, in consultation with the
commissioners of housing finance and corrections, shall assess
whether the definition of long-term homelessness impacts the
ability of families with minor children experiencing
homelessness to obtain services necessary to support housing
stability.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 17. Minnesota Statutes 2004, section 260.835, is
amended to read:
260.835 [AMERICAN INDIAN CHILD WELFARE ADVISORY COUNCIL.]
Subdivision 1. [CREATION.] The commissioner shall appoint
an American Indian Advisory Council to help formulate policies
and procedures relating to Indian child welfare services and to
make recommendations regarding approval of grants provided under
section 260.785, subdivisions 1, 2, and 3. The council shall
consist of 17 members appointed by the commissioner and must
include representatives of each of the 11 Minnesota reservations
who are authorized by tribal resolution, one representative from
the Duluth Urban Indian Community, three representatives from
the Minneapolis Urban Indian Community, and two representatives
from the St. Paul Urban Indian Community. Representatives from
the urban Indian communities must be selected through an open
appointments process under section 15.0597. The terms,
compensation, and removal of American Indian Child Welfare
Advisory Council members shall be as provided in section 15.059.
Subd. 2. [EXPIRATION.] Notwithstanding section 15.059,
subdivision 5, the American Indian Child Welfare Advisory
Council expires June 30, 2008.
[EFFECTIVE DATE.] This section is effective retroactively
from June 30, 2003.
Sec. 18. [RECOMMENDATIONS ON STANDARD STATEWIDE CHILD CARE
LICENSE FEE; REPORT.]
The commissioner of human services in conjunction with the
Minnesota Association of County Social Service Administrators
and the Minnesota Licensed Family Child Care Association, shall
examine the feasibility of a statewide standard for setting
license fees and background study fees for licensed family child
care providers, and shall make recommendations on the
feasibility of a statewide standard for setting license fees and
background study fees in a report to the chairs of the senate
and house of representatives committees having jurisdiction over
child care issues. The report is due January 15, 2006.
Sec. 19. [PARENT FEE SCHEDULE.]
(a) Notwithstanding Minnesota Rules, part 3400.0100,
subpart 4, the parent fee schedule is as follows:
Income Range (as a Co-payment (as a
percent of the federal percentage of adjusted
poverty guidelines) gross income)
0-74.99% $0/month
75.00-99.99% $5/month
100.00-104.99% 3.23%
105.00-109.99% 3.23%
110.00-114.99% 3.23%
115.00-119.99% 3.23%
120.00-124.99% 3.60%
125.00-129.99% 3.60%
130.00-134.99% 3.60%
135.00-139.99% 3.60%
140.00-144.99% 3.97%
145.00-149.99% 3.97%
150.00-154.99% 3.97%
155.00-159.99% 4.75%
160.00-164.99% 4.75%
165.00-169.99% 5.51%
170.00-174.99% 5.88%
175.00-179.99% 6.25%
180.00-184.99% 6.98%
185.00-189.99% 7.35%
190.00-194.99% 7.72%
195.00-199.99% 8.45%
200.00-204.99% 9.92%
205.00-209.99% 12.22%
210.00-214.99% 12.65%
215.00-219.99% 13.09%
220.00-224.99% 13.52%
225.00-229.99% 14.35%
230.00-234.99% 15.71%
235.00-239.99% 16.28%
240.00-244.99% 17.37%
245.00-249.99% 18.00%
250% ineligible
(b) This schedule is effective January 1, 2006, and shall
be implemented at or before the participant's next eligibility
redetermination. The parent fee schedule in Laws 2003, First
Special Session chapter 14, article 9, section 36, shall remain
in effect until the schedule in this section is fully
implemented.
(c) 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. 20. [REPEALER.]
(a) Laws 2003, First Special Session chapter 14, article 9,
section 34, is repealed.
(b) Minnesota Statutes 2004, sections 119B.074, 256D.54,
subdivision 3, and 256M.40, subdivision 2, are repealed.
Sec. 21. [EFFECTIVE DATE.]
The sections in this article are effective August 1, 2005,
unless otherwise specified.
ARTICLE 4
HEALTH IMPACT FEE
Section 1. [16A.725] [HEALTH IMPACT FUND AND FUND
REIMBURSEMENTS.]
Subdivision 1. [HEALTH IMPACT FUND.] There is created in
the state treasury a health impact fund to which must be
credited all revenue from the health impact fee under section
256.9658 and any floor stocks fee enacted into law.
Subd. 2. [CERTIFIED TOBACCO EXPENDITURES.] By April 30 of
each year, the commissioner of human services shall certify to
the commissioner of finance the state share, by fund, of tobacco
use attributable costs for the previous fiscal year in Minnesota
health care programs, including medical assistance, general
assistance medical care, and MinnesotaCare, or other applicable
expenditures.
Subd. 3. [FUND REIMBURSEMENTS.] (a) Each fiscal year, the
commissioner of finance shall first transfer from the health
impact fund to the general fund an amount sufficient to offset
the general fund cost of the certified expenditures under
subdivision 2 or the balance of the fund, whichever is less.
(b) If any balance remains in the health impact fund after
the transfer in paragraph (a), the commissioner of finance shall
transfer to the health care access fund the amount sufficient to
offset the health care access fund cost of the certified
expenditures in subdivision 2, or the balance of the fund,
whichever is less.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 2. [256.9658] [TOBACCO HEALTH IMPACT FEE.]
Subdivision 1. [PURPOSE.] A tobacco use health impact fee
is imposed on and collected from cigarette distributors and
tobacco products distributors to recover for the state health
costs related to or caused by tobacco use and to reduce tobacco
use, particularly by youths.
Subd. 2. [DEFINITIONS.] The definitions under section
297F.01 apply to this section.
Subd. 3. [FEE IMPOSED.] (a) A fee is imposed upon the sale
of cigarettes in this state, upon having cigarettes in
possession in this state with intent to sell, upon any person
engaged in business as a distributor, and upon the use or
storage by consumers of cigarettes. The fee is imposed at the
following rates:
(1) on cigarettes weighing not more than three pounds per
thousand, 37.5 mills on each cigarette; and
(2) on cigarettes weighing more than three pounds per
thousand, 75 mills on each cigarette.
(b) A fee is imposed upon all tobacco products in this
state and upon any person engaged in business as a distributor
in an amount equal to the liability for tax under section
297F.05, subdivision 3, or on a consumer of tobacco products
equal to the tax under section 297F.05, subdivision 4.
Liability for the fee is in addition to the tax under section
297F.05, subdivision 3 or 4.
Subd. 4. [PAYMENT.] A distributor must pay the fee at the
same time and in the same manner as provided for payment of tax
under chapter 297F.
Subd. 5. [FEE ON USE OF UNSTAMPED CIGARETTES.] Any person,
other than a distributor, that purchases or possesses cigarettes
that have not been stamped and on which the fee imposed under
this section has not been paid is liable for the fee under this
section on the possession or use of those cigarettes.
Subd. 6. [ADMINISTRATION.] The audit, assessment,
interest, appeal, refund, penalty, enforcement, administrative,
and collection provisions of chapters 270C and 297F apply to the
fee imposed under this section.
Subd. 7. [CIGARETTE STAMP.] (a) The stamp in section
297F.08 must be affixed to each package and is prima facie
evidence that the fee imposed by this section has been paid.
(b) Notwithstanding any other provisions of this section,
the fee due on the return is based upon actual stamps purchased
during the reporting period.
Subd. 8. [LICENSE REVOCATION.] The commissioner of revenue
may revoke or suspend the license of a distributor for failure
to pay the fee or otherwise comply with the requirements under
this section. The provisions and procedures under section
297F.04 apply to a suspension or revocation under this
subdivision.
Subd. 9. [DEPOSIT OF REVENUES.] The commissioner of
revenue shall deposit the revenues from the fee under this
section in the state treasury and credit them to the health
impact fund.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 3. Minnesota Statutes 2004, section 297F.185, is
amended to read:
297F.185 [REVOCATION OF SALES AND USE TAX PERMITS.]
(a) If a retailer purchases for resale from an unlicensed
seller more than 20,000 cigarettes or $500 or more worth of
tobacco products, the commissioner may revoke the person's sales
and use tax permit as provided in section 297A.86.
(b) The commissioner may revoke a retailer's sales or use
permit as provided in section 297A.86 if the retailer, directly
or indirectly, purchases for resale cigarettes without the
proper stamp affixed.
[EFFECTIVE DATE.] This section is effective for violations
occurring on or after August 1, 2005.
Sec. 4. Minnesota Statutes 2004, section 325D.32,
subdivision 9, is amended to read:
Subd. 9. [BASIC COST OF CIGARETTES.] "Basic cost of
cigarettes" means the gross invoice cost of cigarettes to the
wholesaler or retailer plus the full face value of any stamps
which may be required by any cigarette tax or fee act of this
state, unless included by the manufacturer in the list price.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 5. [FLOOR STOCKS FEE.]
Subdivision 1. [CIGARETTES.] A floor stocks cigarette fee
is imposed on every person engaged in the business in this state
as a distributor, retailer, subjobber, vendor, manufacturer, or
manufacturer's representative of cigarettes, on the stamped
cigarettes and unaffixed stamps in the person's possession or
under the person's control at 12:01 a.m. on August 1, 2005. The
fee is imposed at the following rates:
(1) on cigarettes weighing not more than three pounds per
thousand, 37.5 mills on each cigarette; and
(2) on cigarettes weighing more than three pounds per
thousand, 75 mills on each cigarette.
Each distributor, on or before August 10, 2005, shall file
a return with the commissioner of revenue, in the form the
commissioner prescribes, showing the stamped cigarettes and
unaffixed stamps on hand at 12:01 a.m. on August 1, 2005, and
the amount of fee due on the cigarettes and unaffixed stamps.
Each retailer, subjobber, vendor, manufacturer, or
manufacturer's representative, on or before August 10, 2005,
shall file a return with the commissioner of revenue, in the
form the commissioner prescribes, showing the cigarettes on hand
at 12:01 a.m. on August 1, 2005, and the amount of fee due on
the cigarettes. The fee imposed by this section is due and
payable on or before September 7, 2005, and after that date
bears interest at the rate of one percent per month.
Subd. 2. [AUDIT AND ENFORCEMENT.] The fee imposed by this
section is subject to the audit, assessment, interest, appeal,
refund, penalty, enforcement, administrative, and collection
provisions of Minnesota Statutes, chapters 270C and 297F. The
commissioner of revenue may require a distributor to receive and
maintain copies of floor stocks fee returns filed by all persons
requesting a credit for returned cigarettes.
Subd. 3. [DEPOSIT OF PROCEEDS.] The commissioner of
revenue shall deposit the revenues from the fee under this
section in the state treasury and credit them to the health
impact fund.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 6. [TOBACCO PRODUCTS FLOOR STOCKS FEE.]
A floor stocks fee is imposed upon every person engaged in
business in this state as a distributor of tobacco products, at
the rate of 35 percent of the wholesale sales price of each
tobacco product in the distributor's possession or under the
distributor's control at 12:01 a.m. on August 1, 2005. Each
distributor, by August 10, 2005, shall file a return with the
commissioner, in the form the commissioner prescribes, showing
the tobacco products on hand at 12:01 a.m. on August 1, 2005,
and the amount of fees due on them. The fee imposed by this
section is due and payable by September 7, 2005, and after that
bears interest at the rate of one percent a month.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
ARTICLE 5
MISCELLANEOUS
Section 1. Minnesota Statutes 2004, section 148D.220,
subdivision 8, as added by Laws 2005, chapter 147, article 1,
section 49, is amended to read:
Subd. 8. [SEXUAL CONDUCT WITH A FORMER CLIENT.] (a) A
social worker who has engaged in diagnosing, counseling, or
treating a client with mental, emotional, or behavioral
disorders must not engage in or suggest sexual conduct with the
former client under any circumstances for a period of two years
following the termination of the professional relationship.
After two years following the termination of the professional
relationship, a social worker who has engaged in diagnosing,
counseling, or treating a client with mental, emotional, or
behavioral disorder must not engage in or suggest sexual conduct
with the former client under any circumstances unless:
(1) the social worker did not intentionally or
unintentionally coerce, exploit, deceive, or manipulate the
former client at any time;
(2) the social worker did not represent to the former
client that sexual conduct with the social worker is consistent
with or part of the client's treatment;
(3) the social worker's sexual conduct was not detrimental
to the former client at any time;
(4) the former client is not emotionally dependent on the
social worker and does not continue to relate to the social
worker as a client; and
(5) the social worker is not emotionally dependent on the
client and does not continue to relate to the former client as a
social worker.
(b) If there is an alleged violation of paragraph (a), the
social worker assumes the full burden of demonstrating to the
board that the social worker did not intentionally or
unintentionally coerce, exploit, deceive, or manipulate the
client, and the social worker's sexual conduct was not
detrimental to the client at any time. Upon request, a social
worker must provide information to the board addressing:
(1) the amount of time that has passed since termination of
services;
(2) the duration, intensity, and nature of services;
(3) the circumstances of termination of services;
(4) the former client's emotional, mental, and behavioral
history;
(5) the former client's current emotional, mental, and
behavioral status;
(6) the likelihood of adverse impact on the former client;
and
(7) the existence of actions, conduct, or statements made
by the social worker during the course of services suggesting or
inviting the possibility of a sexual relationship with the
client following termination of services.
(c) A social worker who has provided social work services
other than those described in paragraph (a) to a client must not
engage in or suggest sexual conduct with the former client if a
reasonable and prudent social worker would conclude after
appropriate assessment that engaging in such behavior with the
former client would create an unacceptable risk of harm to the
former client.
Sec. 2. [151.55] [CANCER DRUG REPOSITORY PROGRAM.]
Subdivision 1. [DEFINITIONS.] (a) For the purposes of this
section, the terms defined in this subdivision have the meanings
given.
(b) "Board" means the Board of Pharmacy.
(c) "Cancer drug" means a prescription drug that is used to
treat:
(1) cancer or the side effects of cancer; or
(2) the side effects of any prescription drug that is used
to treat cancer or the side effects of cancer.
(d) "Cancer drug repository" means a medical facility or
pharmacy that has notified the board of its election to
participate in the cancer drug repository program.
(e) "Cancer supply" or "supplies" means prescription and
nonprescription cancer supplies needed to administer a cancer
drug.
(f) "Dispense" has the meaning given in section 151.01,
subdivision 30.
(g) "Distribute" means to deliver, other than by
administering or dispensing.
(h) "Donor" means an individual and not a drug manufacturer
or wholesale drug distributor who donates a cancer drug or
supply according to the requirements of the cancer drug
repository program.
(i) "Medical facility" means an institution defined in
section 144.50, subdivision 2.
(j) "Medical supplies" means any prescription and
nonprescription medical supply needed to administer a cancer
drug.
(k) "Pharmacist" has the meaning given in section 151.01,
subdivision 3.
(l) "Pharmacy" means any pharmacy registered with the Board
of Pharmacy according to section 151.19, subdivision 1.
(m) "Practitioner" has the meaning given in section 151.01,
subdivision 23.
(n) "Prescription drug" means a legend drug as defined in
section 151.01, subdivision 17.
(o) "Side effects of cancer" means symptoms of cancer.
(p) "Single-unit-dose packaging" means a single-unit
container for articles intended for administration as a single
dose, direct from the container.
(q) "Tamper-evident unit dose packaging" means a container
within which a drug is sealed so that the contents cannot be
opened without obvious destruction of the seal.
Subd. 2. [ESTABLISHMENT.] The Board of Pharmacy shall
establish and maintain a cancer drug repository program, under
which any person may donate a cancer drug or supply for use by
an individual who meets the eligibility criteria specified under
subdivision 4. Under the program, donations may be made on the
premises of a medical facility or pharmacy that elects to
participate in the program and meets the requirements specified
under subdivision 3.
Subd. 3. [REQUIREMENTS FOR PARTICIPATION BY PHARMACIES AND
MEDICAL FACILITIES.] (a) To be eligible for participation in the
cancer drug repository program, a pharmacy or medical facility
must be licensed and in compliance with all applicable federal
and state laws and administrative rules.
(b) Participation in the cancer drug repository program is
voluntary. A pharmacy or medical facility may elect to
participate in the cancer drug repository program by submitting
the following information to the board, in a form provided by
the board:
(1) the name, street address, and telephone number of the
pharmacy or medical facility;
(2) the name and telephone number of a pharmacist who is
employed by or under contract with the pharmacy or medical
facility, or other contact person who is familiar with the
pharmacy's or medical facility's participation in the cancer
drug repository program; and
(3) a statement indicating that the pharmacy or medical
facility meets the eligibility requirements under paragraph (a)
and the chosen level of participation under paragraph (c).
(c) A pharmacy or medical facility may fully participate in
the cancer drug repository program by accepting, storing, and
dispensing or administering donated drugs and supplies, or may
limit its participation to only accepting and storing donated
drugs and supplies. If a pharmacy or facility chooses to limit
its participation, the pharmacy or facility shall distribute any
donated drugs to a fully participating cancer drug repository
according to subdivision 8.
(d) A pharmacy or medical facility may withdraw from
participation in the cancer drug repository program at any time
upon notification to the board. A notice to withdraw from
participation may be given by telephone or regular mail.
Subd. 4. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] Any
Minnesota resident who is diagnosed with cancer is eligible to
receive drugs or supplies under the cancer drug repository
program. Drugs and supplies shall be dispensed or administered
according to the priority given under subdivision 6, paragraph
(d).
Subd. 5. [DONATIONS OF CANCER DRUGS AND SUPPLIES.] (a) Any
one of the following persons may donate legally obtained cancer
drugs or supplies to a cancer drug repository, if the drugs or
supplies meet the requirements under paragraph (b) or (c) as
determined by a pharmacist who is employed by or under contract
with a cancer drug repository:
(1) an individual who is 18 years old or older; or
(2) a pharmacy, medical facility, drug manufacturer, or
wholesale drug distributor, if the donated drugs have not been
previously dispensed.
(b) A cancer drug is eligible for donation under the cancer
drug repository program only if the following requirements are
met:
(1) the donation is accompanied by a cancer drug repository
donor form described under paragraph (d) that is signed by the
person making the donation or that person's authorized
representative;
(2) the drug's expiration date is at least six months later
than the date that the drug was donated;
(3) the drug is in its original, unopened, tamper-evident
unit dose packaging that includes the drug's lot number and
expiration date. Single-unit dose drugs may be accepted if the
single-unit-dose packaging is unopened; and
(4) the drug is not adulterated or misbranded.
(c) Cancer supplies are eligible for donation under the
cancer drug repository program only if the following
requirements are met:
(1) the supplies are not adulterated or misbranded;
(2) the supplies are in their original, unopened, sealed
packaging; and
(3) the donation is accompanied by a cancer drug repository
donor form described under paragraph (d) that is signed by the
person making the donation or that person's authorized
representative.
(d) The cancer drug repository donor form must be provided
by the board and shall state that to the best of the donor's
knowledge the donated drug or supply has been properly stored
and that the drug or supply has never been opened, used,
tampered with, adulterated, or misbranded. The board shall make
the cancer drug repository donor form available on the Board of
Pharmacy's Web site.
(e) Controlled substances and drugs and supplies that do
not meet the criteria under this subdivision are not eligible
for donation or acceptance under the cancer drug repository
program.
(f) Drugs and supplies may be donated on the premises of a
cancer drug repository to a pharmacist designated by the
repository. A drop box may not be used to deliver or accept
donations.
(g) Cancer drugs and supplies donated under the cancer drug
repository program must be stored in a secure storage area under
environmental conditions appropriate for the drugs or supplies
being stored. Donated drugs and supplies may not be stored with
nondonated inventory.
Subd. 6. [DISPENSING REQUIREMENTS.] (a) Drugs and supplies
must be dispensed by a licensed pharmacist pursuant to a
prescription by a practitioner or may be dispensed or
administered by a practitioner according to the requirements of
chapter 151 and within the practitioner's scope of practice.
(b) Cancer drugs and supplies shall be visually inspected
by the pharmacist or practitioner before being dispensed or
administered for adulteration, misbranding, and date of
expiration. Drugs or supplies that have expired or appear upon
visual inspection to be adulterated, misbranded, or tampered
with in any way may not be dispensed or administered.
(c) Before a cancer drug or supply may be dispensed or
administered to an individual, the individual must sign a cancer
drug repository recipient form provided by the board
acknowledging that the individual understands the information
stated on the form. The form shall include the following
information:
(1) that the drug or supply being dispensed or administered
has been donated and may have been previously dispensed;
(2) that a visual inspection has been conducted by the
pharmacist or practitioner to ensure that the drug has not
expired, has not been adulterated or misbranded, and is in its
original, unopened packaging; and
(3) that the dispensing pharmacist, the dispensing or
administering practitioner, the cancer drug repository, the
Board of Pharmacy, and any other participant of the cancer drug
repository program cannot guarantee the safety of the drug or
supply being dispensed or administered and that the pharmacist
or practitioner has determined that the drug or supply is safe
to dispense or administer based on the accuracy of the donor's
form submitted with the donated drug or supply and the visual
inspection required to be performed by the pharmacist or
practitioner before dispensing or administering.
The board shall make the cancer drug repository form available
on the Board of Pharmacy's Web site.
(d) Drugs and supplies shall only be dispensed or
administered to individuals who meet the eligibility
requirements in subdivision 4 and in the following order of
priority:
(1) individuals who are uninsured;
(2) individuals who are enrolled in medical assistance,
general assistance medical care, MinnesotaCare, Medicare, or
other public assistance health care; and
(3) all other individuals who are otherwise eligible under
subdivision 4 to receive drugs or supplies from a cancer drug
repository.
Subd. 7. [HANDLING FEES.] A cancer drug repository may
charge the individual receiving a drug or supply a handling fee
of no more than 250 percent of the medical assistance program
dispensing fee for each cancer drug or supply dispensed or
administered.
Subd. 8. [DISTRIBUTION OF DONATED CANCER DRUGS AND
SUPPLIES.] (a) Cancer drug repositories may distribute drugs and
supplies donated under the cancer drug repository program to
other repositories if requested by a participating repository.
(b) A cancer drug repository that has elected not to
dispense donated drugs or supplies shall distribute any donated
drugs and supplies to a participating repository upon request of
the repository.
(c) If a cancer drug repository distributes drugs or
supplies under paragraph (a) or (b), the repository shall
complete a cancer drug repository donor form provided by the
board. The completed form and a copy of the donor form that was
completed by the original donor under subdivision 5 shall be
provided to the fully participating cancer drug repository at
the time of distribution.
Subd. 9. [RESALE OF DONATED DRUGS OR SUPPLIES.] Donated
drugs and supplies may not be resold.
Subd. 10. [RECORD-KEEPING REQUIREMENTS.] (a) Cancer drug
repository donor and recipient forms shall be maintained for at
least five years.
(b) A record of destruction of donated drugs and supplies
that are not dispensed under subdivision 6 shall be maintained
by the dispensing repository for at least five years. For each
drug or supply destroyed, the record shall include the following
information:
(1) the date of destruction;
(2) the name, strength, and quantity of the cancer drug
destroyed;
(3) the name of the person or firm that destroyed the drug;
and
(4) the source of the drugs or supplies destroyed.
Subd. 11. [LIABILITY.] (a) The manufacturer of a drug or
supply is not subject to criminal or civil liability for injury,
death, or loss to a person or to property for causes of action
described in clauses (1) and (2). A manufacturer is not liable
for:
(1) the intentional or unintentional alteration of the drug
or supply by a party not under the control of the manufacturer;
or
(2) the failure of a party not under the control of the
manufacturer to transfer or communicate product or consumer
information or the expiration date of the donated drug or supply.
(b) A medical facility or pharmacy participating in the
program, a pharmacist dispensing a drug or supply pursuant to
the program, a practitioner dispensing or administering a drug
or supply pursuant to the program, or a donor of a cancer drug
or supply as defined in subdivision 1 is immune from civil
liability for an act or omission that causes injury to or the
death of an individual to whom the cancer drug or supply is
dispensed and no disciplinary action shall be taken against a
pharmacist or practitioner so long as the drug or supply is
donated, accepted, distributed, and dispensed according to the
requirements of this section. This immunity does not apply if
the act or omission involves reckless, wanton, or intentional
misconduct, or malpractice unrelated to the quality of the
cancer drug or supply.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 3. Minnesota Statutes 2004, section 241.01, is
amended by adding a subdivision to read:
Subd. 10. [PURCHASING FOR PRESCRIPTION DRUGS.] In
accordance with section 241.021, subdivision 4, the commissioner
may contract with a separate entity to purchase prescription
drugs for persons confined in institutions under the control of
the commissioner. Local governments may participate in this
purchasing pool in order to purchase prescription drugs for
those persons confined in local correctional facilities in which
the local government has responsibility for providing health
care. If any county participates, the commissioner shall
appoint a county representative to any committee convened by the
commissioner for the purpose of establishing a drug formulary to
be used for state and local correctional facilities.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 4. Minnesota Statutes 2004, section 245.4661,
subdivision 2, is amended to read:
Subd. 2. [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The
pilot projects shall be established to design, plan, and improve
the mental health service delivery system for adults with
serious and persistent mental illness that would:
(1) provide an expanded array of services from which
clients can choose services appropriate to their needs;
(2) be based on purchasing strategies that improve access
and coordinate services without cost shifting;
(3) incorporate existing state facilities and resources
into the community mental health infrastructure through creative
partnerships with local vendors; and
(4) utilize existing categorical funding streams and
reimbursement sources in combined and creative ways, except
appropriations to regional treatment centers and all funds that
are attributable to the operation of state-operated services are
excluded unless appropriated specifically by the legislature for
a purpose consistent with this section or section 246.0136,
subdivision 1.
(b) All projects funded by January 1, 1997, must complete
the planning phase and be operational by June 30, 1997; all
projects funded by January 1, 1998, must be operational by June
30, 1998.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 5. Minnesota Statutes 2004, section 245.4661,
subdivision 6, is amended to read:
Subd. 6. [DUTIES OF COMMISSIONER.] (a) For purposes of the
pilot projects, the commissioner shall facilitate integration of
funds or other resources as needed and requested by each
project. These resources may include:
(1) residential services funds administered under Minnesota
Rules, parts 9535.2000 to 9535.3000, in an amount to be
determined by mutual agreement between the project's managing
entity and the commissioner of human services after an
examination of the county's historical utilization of facilities
located both within and outside of the county and licensed under
Minnesota Rules, parts 9520.0500 to 9520.0690;
(2) community support services funds administered under
Minnesota Rules, parts 9535.1700 to 9535.1760;
(3) other mental health special project funds;
(4) medical assistance, general assistance medical care,
MinnesotaCare and group residential housing if requested by the
project's managing entity, and if the commissioner determines
this would be consistent with the state's overall health care
reform efforts; and
(5) regional treatment center nonfiscal resources to the
extent agreed to by the project's managing entity and the
regional treatment center consistent with section 246.0136,
subdivision 1.
(b) The commissioner shall consider the following criteria
in awarding start-up and implementation grants for the pilot
projects:
(1) the ability of the proposed projects to accomplish the
objectives described in subdivision 2;
(2) the size of the target population to be served; and
(3) geographical distribution.
(c) The commissioner shall review overall status of the
projects initiatives at least every two years and recommend any
legislative changes needed by January 15 of each odd-numbered
year.
(d) The commissioner may waive administrative rule
requirements which are incompatible with the implementation of
the pilot project.
(e) The commissioner may exempt the participating counties
from fiscal sanctions for noncompliance with requirements in
laws and rules which are incompatible with the implementation of
the pilot project.
(f) The commissioner may award grants to an entity
designated by a county board or group of county boards to pay
for start-up and implementation costs of the pilot project.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 6. Minnesota Statutes 2004, section 245A.10,
subdivision 5, is amended to read:
Subd. 5. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS
WITHOUT A LICENSED CAPACITY.] (a) Except as provided
in paragraph paragraphs (b) and (c), 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.
(c) A program licensed to provide residential-based
habilitation services under the home and community-based waiver
for persons with developmental disabilities shall pay an annual
license fee that includes a base rate of $250 plus $38 times the
number of clients served on the first day of August of the
current license year. State-operated programs are exempt from
the license fee under this paragraph.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 7. Minnesota Statutes 2004, section 245C.10,
subdivision 2, is amended to read:
Subd. 2. [SUPPLEMENTAL NURSING SERVICES AGENCIES.] The
commissioner shall recover the cost of the background studies
initiated by supplemental nursing services agencies registered
under section 144A.71, subdivision 1, through a fee of no more
than $8 $20 per study charged to the agency. The fees collected
under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 8. Minnesota Statutes 2004, section 245C.10,
subdivision 3, is amended to read:
Subd. 3. [PERSONAL CARE PROVIDER ORGANIZATIONS.] The
commissioner shall recover the cost of background studies
initiated by a personal care provider organization under section
256B.0627 through a fee of no more than $12 $20 per study
charged to the organization responsible for submitting the
background study form. The fees collected under this
subdivision are appropriated to the commissioner for the purpose
of conducting background studies.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 9. Minnesota Statutes 2004, section 245C.32,
subdivision 2, is amended to read:
Subd. 2. [USE.] (a) The commissioner may also use these
systems and records to obtain and provide criminal history data
from the Bureau of Criminal Apprehension, criminal history data
held by the commissioner, and data about substantiated
maltreatment under section 626.556 or 626.557, for other
purposes, provided that:
(1) the background study is specifically authorized in
statute; or
(2) the request is made with the informed consent of the
subject of the study as provided in section 13.05, subdivision 4.
(b) An individual making a request under paragraph (a),
clause (2), must agree in writing not to disclose the data to
any other individual without the consent of the subject of the
data.
(c) The commissioner may recover the cost of obtaining and
providing background study data by charging the individual or
entity requesting the study a fee of no more than $12 $20 per
study. The fees collected under this paragraph are appropriated
to the commissioner for the purpose of conducting background
studies.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 10. Minnesota Statutes 2004, section 246.0136,
subdivision 1, is amended to read:
Subdivision 1. [PLANNING FOR ENTERPRISE ACTIVITIES.] The
commissioner of human services is directed to study and make
recommendations to the legislature on establishing enterprise
activities within state-operated services. Before implementing
an enterprise activity, the commissioner must obtain statutory
authorization for its implementation, except that the
commissioner has authority to implement enterprise activities
for adult mental health, adolescent services, and to establish a
public group practice without statutory authorization.
Enterprise activities are defined as the range of services,
which are delivered by state employees, needed by people with
disabilities and are fully funded by public or private
third-party health insurance or other revenue sources available
to clients that provide reimbursement for the services
provided. Enterprise activities within state-operated services
shall specialize in caring for vulnerable people for whom no
other providers are available or for whom state-operated
services may be the provider selected by the payer. In
subsequent biennia after an enterprise activity is established
within a state-operated service, the base state appropriation
for that state-operated service shall be reduced proportionate
to the size of the enterprise activity.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 11. Minnesota Statutes 2004, section 253.20, is
amended to read:
253.20 [MINNESOTA SECURITY HOSPITAL.]
The commissioner of human services shall erect, equip, and
maintain in St. Peter a and other geographic locations under the
control of the commissioner of human services suitable
building buildings to be known as the Minnesota Security
Hospital, for the purpose of providing a secure treatment
facility as defined in section 253B.02, subdivision 18a, for
persons who may be committed there by courts, or otherwise, or
transferred there by the commissioner of human services, and for
persons who are found to be mentally ill while confined in any
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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 12. Minnesota Statutes 2004, 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 carry out the specific duties in paragraphs (a)
through (aa) (bb):
(a) 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:
(1) require county agency participation in training and
technical assistance programs to promote compliance with
statutes, rules, federal laws, regulations, and policies
governing human services;
(2) 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;
(3) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit
determinations;
(4) 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;
(5) 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;
(6) make contracts with and grants to public and private
agencies and organizations, both profit and nonprofit, and
individuals, using appropriated funds; and
(7) 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.
(b) 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.
(c) 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.
(d) 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.
(e) 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.
(f) 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.
(g) Establish and maintain any administrative units
reasonably necessary for the performance of administrative
functions common to all divisions of the department.
(h) 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.
(i) Act as coordinating referral and informational center
on requests for service for newly arrived immigrants coming to
Minnesota.
(j) 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.
(k) 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.
(l) 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:
(1) 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; and
(2) a comprehensive plan, including estimated project
costs, shall be approved by the Legislative Advisory Commission
and filed with the commissioner of administration.
(m) 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.
(n) 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:
(1) 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; and
(2) notwithstanding the provisions of clause (1), 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 clause (1), 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 clause (1).
(o) 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.
(p) 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.
(q) Have the authority to establish and enforce the
following county reporting requirements:
(1) 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;
(2) 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;
(3) if the required reports are not received by the
deadlines established in clause (2), 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;
(4) 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;
(5) 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;
(6) the commissioner may not delay payments, withhold
funds, or require repayment under clause (3) or (5) 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 clause (3) or (5), the county board may appeal the action
according to sections 14.57 to 14.69; and
(7) counties subject to withholding of funds under clause
(3) or forfeiture or repayment of funds under clause (5) shall
not reduce or withhold benefits or services to clients to cover
costs incurred due to actions taken by the commissioner under
clause (3) or (5).
(r) 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.
(s) 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.
(t) 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.
(u) 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 rebate as defined for purposes of the
federal rebate program in United States Code, title 42, section
1396r-8. 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.
(v) 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.
(w) 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.
(x) 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.
(y) 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.
(z) Designate community information and referral call
centers and incorporate cost reimbursement claims from the
designated community information and referral call centers into
the federal cost reimbursement claiming processes of the
department according to federal law, rule, and regulations.
Existing information and referral centers provided by Greater
Twin Cities United Way or existing call centers for which
Greater Twin Cities United Way has legal authority to represent,
shall be included in these designations upon review by the
commissioner and assurance that these services are accredited
and in compliance with national standards. Any reimbursement is
appropriated to the commissioner and all designated information
and referral centers shall receive payments according to normal
department schedules established by the commissioner upon final
approval of allocation methodologies from the United States
Department of Health and Human Services Division of Cost
Allocation or other appropriate authorities.
(aa) 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.
(bb) Authorize the method of payment to or from the
department as part of the human services programs administered
by the department. This authorization includes the receipt or
disbursement of funds held by the department in a fiduciary
capacity as part of the human services programs administered by
the department.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 13. Minnesota Statutes 2004, section 256.741,
subdivision 4, is amended to read:
Subd. 4. [EFFECT OF ASSIGNMENT.] Assignments in this
section take effect upon a determination that the applicant is
eligible for public assistance. The amount of support assigned
under this subdivision may not exceed the total amount of public
assistance issued or the total support obligation, whichever is
less. Child care support collections made according to an
assignment under subdivision 2, paragraph (c), must be
deposited, subject to any limitations of federal law, by the
commissioner of human services in the child support collection
account in the special revenue fund and appropriated to the
commissioner of education for child care assistance under
section 119B.03. These collections are in addition to state and
federal funds appropriated to the child care in the general fund.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 14. Minnesota Statutes 2004, section 256M.40,
subdivision 2, is amended to read:
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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 15. Minnesota Statutes 2004, section 295.582, as
amended by Laws 2005, chapter 77, section 7, is amended to read:
295.582 [AUTHORITY.]
Subdivision 1. [WHOLESALE DRUG DISTRIBUTOR TAX.] (a) A
hospital, surgical center, or health care provider that is
subject to a tax under section 295.52, or a pharmacy that has
paid additional expense transferred under this section by a
wholesale drug distributor, may transfer additional expense
generated by section 295.52 obligations on to all third-party
contracts for the purchase of health care services on behalf of
a patient or consumer. Nothing shall prohibit a pharmacy from
transferring the additional expense generated under section
295.52 to a pharmacy benefits manager. The additional expense
transferred to the third-party purchaser or a pharmacy benefits
manager must not exceed the tax percentage specified in section
295.52 multiplied against the gross revenues received under the
third-party contract, and the tax percentage specified in
section 295.52 multiplied against co-payments and deductibles
paid by the individual patient or consumer. The expense must
not be generated on revenues derived from payments that are
excluded from the tax under section 295.53. All third-party
purchasers of health care services including, but not limited
to, third-party purchasers regulated under chapter 60A, 62A,
62C, 62D, 62H, 62N, 64B, 65A, 65B, 79, or 79A, or under section
471.61 or 471.617, and pharmacy benefits managers must pay the
transferred expense in addition to any payments due under
existing contracts with the hospital, surgical center, pharmacy,
or health care provider, to the extent allowed under federal
law. A third-party purchaser of health care services includes,
but is not limited to, a health carrier or community integrated
service network that pays for health care services on behalf of
patients or that reimburses, indemnifies, compensates, or
otherwise insures patients for health care services. For
purposes of this section, a pharmacy benefits manager means an
entity that performs pharmacy benefits management. A
third-party purchaser or pharmacy benefits manager shall comply
with this section regardless of whether the third-party
purchaser or pharmacy benefits manager is a for-profit,
not-for-profit, or nonprofit entity. A wholesale drug
distributor may transfer additional expense generated by section
295.52 obligations to entities that purchase from the
wholesaler, and the entities must pay the additional expense.
Nothing in this section limits the ability of a hospital,
surgical center, pharmacy, wholesale drug distributor, or health
care provider to recover all or part of the section 295.52
obligation by other methods, including increasing fees or
charges.
(b) Any hospital, surgical center, or health care provider
subject to a tax under section 295.52 or a pharmacy that has
paid additional expense transferred under this section by a
wholesale drug distributor may file a complaint with the
commissioner responsible for regulating the third-party
purchaser if at any time the third-party purchaser fails to
comply with paragraph (a).
(c) If the commissioner responsible for regulating the
third-party purchaser finds at any time that the third-party
purchaser has not complied with paragraph (a), the commissioner
may take enforcement action against a third-party purchaser
which is subject to the commissioner's regulatory jurisdiction
and which does not allow a hospital, surgical center, pharmacy,
or provider to pass-through the tax. The commissioner may by
order fine or censure the third-party purchaser or revoke or
suspend the certificate of authority or license of the
third-party purchaser to do business in this state if the
commissioner finds that the third-party purchaser has not
complied with this section. The third-party purchaser may
appeal the commissioner's order through a contested case hearing
in accordance with chapter 14.
Subd. 2. [AGREEMENT.] A contracting agreement between a
third-party purchaser or a pharmacy benefits manager and a
resident or nonresident pharmacy registered under chapter 151,
may not prohibit:
(1) a pharmacy that has paid additional expense transferred
under this section by a wholesale drug distributor from
exercising its option under this section to transfer such
additional expenses generated by the section 295.52 obligations
on to the third-party purchaser or pharmacy benefits manager; or
(2) a pharmacy that is subject to tax under section 295.52,
subdivision 4, from exercising its option under this section to
recover all or part of the section 295.52 obligations from the
third-party purchaser or a pharmacy benefits manager.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 16. Minnesota Statutes 2004, section 471.61, is
amended by adding a subdivision to read:
Subd. 5. [PROVISION OF LONG-TERM CARE INSURANCE.] Any
political subdivision, or any two or more political subdivisions
acting jointly, may contract with an insurance company licensed
to do business in this state for the voluntary purchase of
long-term care insurance by the employees and their dependents
of the political subdivision or subdivisions. The coverage may
be through a group policy or through individual coverage.
Sec. 17. Minnesota Statutes 2004, 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. For all other
counties, medical providers shall charge no higher than the rate
negotiated between the county and the provider. In the absence
of an agreement between the county and the provider, the
provider may charge no more than the discounted rate the
provider has negotiated with the nongovernmental third-party
payer that provided the most revenue to the provider during the
previous calendar year. 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 co-payment obligations for health care services provided
by a county correctional facility. The county board shall
determine the co-payment amount. Notwithstanding any law to the
contrary, the co-payment 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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 18. Laws 2003, First Special Session chapter 14,
article 13C, section 2, subdivision 6, is amended to read:
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
applicable tax rate in effect under
Minnesota Statutes, section 295.52, 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 19. [REPEALER.]
Minnesota Statutes 2004, section 119B.074, as amended by
Laws 2005, chapter 98, article 1, section 5, is repealed
effective August 1, 2005. House File No. 138, article 11,
section 6, if enacted in the 2005 First Special Session, is
repealed effective upon final enactment.
ARTICLE 6
HEALTH DEPARTMENT
Section 1. [62J.495] [HEALTH INFORMATION TECHNOLOGY AND
INFRASTRUCTURE ADVISORY COMMITTEE.]
Subdivision 1. [ESTABLISHMENT; MEMBERS; DUTIES.] (a) The
commissioner shall establish a Health Information Technology and
Infrastructure Advisory Committee governed by section 15.059 to
advise the commissioner on the following matters:
(1) assessment of the use of health information technology
by the state, licensed health care providers and facilities, and
local public health agencies;
(2) recommendations for implementing a statewide
interoperable health information infrastructure, to include
estimates of necessary resources, and for determining standards
for administrative data exchange, clinical support programs,
patient privacy requirements, and maintenance of the security
and confidentiality of individual patient data; and
(3) other related issues as requested by the commissioner.
(b) The members of the Health Information Technology and
Infrastructure Advisory Committee shall include the
commissioners, or commissioners' designees, of health, human
services, administration, and commerce and additional members to
be appointed by the commissioner to include persons representing
Minnesota's local public health agencies, licensed hospitals and
other licensed facilities and providers, private purchasers, the
medical and nursing professions, health insurers and health
plans, the state quality improvement organization, academic and
research institutions, consumer advisory organizations with an
interest and expertise in health information technology, and
other stakeholders as identified by the Health Information
Technology and Infrastructure Advisory Committee.
Subd. 2. [ANNUAL REPORT.] The commissioner shall prepare
and issue an annual report not later than January 30 of each
year outlining progress to date in implementing a statewide
health information infrastructure and recommending future
projects.
Subd. 3. [EXPIRATION.] Notwithstanding section 15.059,
this section expires June 30, 2009.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 2. Minnesota Statutes 2004, section 103I.101,
subdivision 6, is amended to read:
Subd. 6. [FEES FOR VARIANCES.] The commissioner shall
charge a nonrefundable application fee of $150 $175 to cover the
administrative cost of processing a request for a variance or
modification of rules adopted by the commissioner under this
chapter.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 3. Minnesota Statutes 2004, section 103I.208,
subdivision 1, as amended by Laws 2005, chapter 106, section 24,
is amended to read:
Subdivision 1. [WELL NOTIFICATION FEE.] The well
notification fee to be paid by a property owner is:
(1) for a new water supply well, $150 $175, which includes
the state core function fee;
(2) for a well sealing, $30 $35 for each well, which
includes the state core function fee, except that for monitoring
wells constructed on a single property, having depths within a
25 foot range, and sealed within 48 hours of start of
construction, a single fee of $30 $35; and
(3) for construction of a dewatering well, $150 $175, which
includes the state core function fee, for each dewatering well
except a dewatering project comprising five or more dewatering
wells shall be assessed a single fee of $750 $875 for the
dewatering wells recorded on the notification.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 4. Minnesota Statutes 2004, section 103I.208,
subdivision 2, as amended by Laws 2005, chapter 106, section 25,
is amended to read:
Subd. 2. [PERMIT FEE.] The permit fee to be paid by a
property owner is:
(1) for a water supply well that is not in use under a
maintenance permit, $125 $150 annually;
(2) for construction of a monitoring well, $150 $175, which
includes the state core function fee;
(3) for a monitoring well that is unsealed under a
maintenance permit, $125 $150 annually;
(4) for monitoring wells used as a leak detection device at
a single motor fuel retail outlet, a single petroleum bulk
storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee
is $150 $175, which includes the state core function fee, per
site regardless of the number of wells constructed on the site,
and the annual fee for a maintenance permit for unsealed
monitoring wells is $125 $150 per site regardless of the number
of monitoring wells located on site;
(5) for a groundwater thermal exchange device, in addition
to the notification fee for water supply wells, $150 $175, which
includes the state core function fee;
(6) for a vertical heat exchanger, $150 $175;
(7) for a dewatering well that is unsealed under a
maintenance permit, $125 $150 annually for each dewatering well,
except a dewatering project comprising more than five dewatering
wells shall be issued a single permit for $625 $750 annually for
dewatering wells recorded on the permit; and
(8) for an elevator boring, $150 $175 for each boring.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 5. Minnesota Statutes 2004, section 103I.235,
subdivision 1, is amended to read:
Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before
signing an agreement to sell or transfer real property, the
seller must disclose in writing to the buyer information about
the status and location of all known wells on the property, by
delivering to the buyer either a statement by the seller that
the seller does not know of any wells on the property, or a
disclosure statement indicating the legal description and
county, and a map drawn from available information showing the
location of each well to the extent practicable. In the
disclosure statement, the seller must indicate, for each well,
whether the well is in use, not in use, or sealed.
(b) At the time of closing of the sale, the disclosure
statement information, name and mailing address of the buyer,
and the quartile, section, township, and range in which each
well is located must be provided on a well disclosure
certificate signed by the seller or a person authorized to act
on behalf of the seller.
(c) A well disclosure certificate need not be provided if
the seller does not know of any wells on the property and the
deed or other instrument of conveyance contains the statement:
"The Seller certifies that the Seller does not know of any wells
on the described real property."
(d) If a deed is given pursuant to a contract for deed, the
well disclosure certificate required by this subdivision shall
be signed by the buyer or a person authorized to act on behalf
of the buyer. If the buyer knows of no wells on the property, a
well disclosure certificate is not required if the following
statement appears on the deed followed by the signature of the
grantee or, if there is more than one grantee, the signature of
at least one of the grantees: "The Grantee certifies that the
Grantee does not know of any wells on the described real
property." The statement and signature of the grantee may be on
the front or back of the deed or on an attached sheet and an
acknowledgment of the statement by the grantee is not required
for the deed to be recordable.
(e) This subdivision does not apply to the sale, exchange,
or transfer of real property:
(1) that consists solely of a sale or transfer of severed
mineral interests; or
(2) that consists of an individual condominium unit as
described in chapters 515 and 515B.
(f) For an area owned in common under chapter 515 or 515B
the association or other responsible person must report to the
commissioner by July 1, 1992, the location and status of all
wells in the common area. The association or other responsible
person must notify the commissioner within 30 days of any change
in the reported status of wells.
(g) For real property sold by the state under section
92.67, the lessee at the time of the sale is responsible for
compliance with this subdivision.
(h) If the seller fails to provide a required well
disclosure certificate, the buyer, or a person authorized to act
on behalf of the buyer, may sign a well disclosure certificate
based on the information provided on the disclosure statement
required by this section or based on other available information.
(i) A county recorder or registrar of titles may not record
a deed or other instrument of conveyance dated after October 31,
1990, for which a certificate of value is required under section
272.115, or any deed or other instrument of conveyance dated
after October 31, 1990, from a governmental body exempt from the
payment of state deed tax, unless the deed or other instrument
of conveyance contains the statement made in accordance with
paragraph (c) or (d) or is accompanied by the well disclosure
certificate containing all the information required by paragraph
(b) or (d). The county recorder or registrar of titles must not
accept a certificate unless it contains all the required
information. The county recorder or registrar of titles shall
note on each deed or other instrument of conveyance accompanied
by a well disclosure certificate that the well disclosure
certificate was received. The notation must include the
statement "No wells on property" if the disclosure certificate
states there are no wells on the property. The well disclosure
certificate shall not be filed or recorded in the records
maintained by the county recorder or registrar of titles. After
noting "No wells on property" on the deed or other instrument of
conveyance, the county recorder or registrar of titles shall
destroy or return to the buyer the well disclosure certificate.
The county recorder or registrar of titles shall collect from
the buyer or the person seeking to record a deed or other
instrument of conveyance, a fee of $30 $40 for receipt of a
completed well disclosure certificate. By the tenth day of each
month, the county recorder or registrar of titles shall transmit
the well disclosure certificates to the commissioner of health.
By the tenth day after the end of each calendar quarter, the
county recorder or registrar of titles shall transmit to the
commissioner of health $27.50 $32.50 of the fee for each well
disclosure certificate received during the quarter. The
commissioner shall maintain the well disclosure certificate for
at least six years. The commissioner may store the certificate
as an electronic image. A copy of that image shall be as valid
as the original.
(j) No new well disclosure certificate is required under
this subdivision if the buyer or seller, or a person authorized
to act on behalf of the buyer or seller, certifies on the deed
or other instrument of conveyance that the status and number of
wells on the property have not changed since the last previously
filed well disclosure certificate. The following statement, if
followed by the signature of the person making the statement, is
sufficient to comply with the certification requirement of this
paragraph: "I am familiar with the property described in this
instrument and I certify that the status and number of wells on
the described real property have not changed since the last
previously filed well disclosure certificate." The
certification and signature may be on the front or back of the
deed or on an attached sheet and an acknowledgment of the
statement is not required for the deed or other instrument of
conveyance to be recordable.
(k) The commissioner in consultation with county recorders
shall prescribe the form for a well disclosure certificate and
provide well disclosure certificate forms to county recorders
and registrars of titles and other interested persons.
(l) Failure to comply with a requirement of this
subdivision does not impair:
(1) the validity of a deed or other instrument of
conveyance as between the parties to the deed or instrument or
as to any other person who otherwise would be bound by the deed
or instrument; or
(2) the record, as notice, of any deed or other instrument
of conveyance accepted for filing or recording contrary to the
provisions of this subdivision.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 6. Minnesota Statutes 2004, section 103I.601,
subdivision 2, is amended to read:
Subd. 2. [LICENSE REQUIRED TO MAKE BORINGS.] (a) Except as
provided in paragraph (b) (d), a person may must not make an
exploratory boring without an exploratory borer's explorer's
license. The fee for an explorer's license is $75. The
explorer's license is valid until the date prescribed in the
license by the commissioner.
(b) A person must file an application and renewal
application fee to renew the explorer's license by the date
stated in the license. The renewal application fee is $75.
(c) If the licensee submits an application fee after the
required renewal date, the licensee:
(1) must include a late fee of $75; and
(2) may not conduct activities authorized by an explorer's
license until the renewal application, renewal application fee,
late fee, and sealing reports required in subdivision 9 are
submitted.
(d) An explorer may must designate a responsible individual
to supervise and oversee the making of exploratory borings.
Before an individual supervises or oversees an exploratory
boring, the individual must file an application and application
fee of $75 to qualify as a responsible individual. The
individual must take and pass an examination relating to
construction, location, and sealing of exploratory borings. A
professional engineer registered or geoscientist licensed under
sections 326.02 to 326.15 or a certified professional geologist
certified by the American Institute of Professional Geologists
is not required to take the examination required in this
subdivision, but must be licensed certified as a responsible
individual to make supervise an exploratory boring.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 7. Minnesota Statutes 2004, section 144.122, as
amended by Laws 2005, chapter 85, section 1, is amended to read:
144.122 [LICENSE, PERMIT, AND SURVEY FEES.]
(a) The state commissioner of health, by rule, may
prescribe reasonable procedures and fees for filing with the
commissioner as prescribed by statute and for the issuance of
original and renewal permits, licenses, registrations, and
certifications issued under authority of the commissioner. The
expiration dates of the various licenses, permits,
registrations, and certifications as prescribed by the rules
shall be plainly marked thereon. Fees may include application
and examination fees and a penalty fee for renewal applications
submitted after the expiration date of the previously issued
permit, license, registration, and certification. The
commissioner may also prescribe, by rule, reduced fees for
permits, licenses, registrations, and certifications when the
application therefor is submitted during the last three months
of the permit, license, registration, or certification period.
Fees proposed to be prescribed in the rules shall be first
approved by the Department of Finance. All fees proposed to be
prescribed in rules shall be reasonable. The fees shall be in
an amount so that the total fees collected by the commissioner
will, where practical, approximate the cost to the commissioner
in administering the program. All fees collected shall be
deposited in the state treasury and credited to the state
government special revenue fund unless otherwise specifically
appropriated by law for specific purposes.
(b) The commissioner may charge a fee for voluntary
certification of medical laboratories and environmental
laboratories, and for environmental and medical laboratory
services provided by the department, without complying with
paragraph (a) or chapter 14. Fees charged for environment and
medical laboratory services provided by the department must be
approximately equal to the costs of providing the services.
(c) The commissioner may develop a schedule of fees for
diagnostic evaluations conducted at clinics held by the services
for children with handicaps program. All receipts generated by
the program are annually appropriated to the commissioner for
use in the maternal and child health program.
(d) The commissioner shall set license fees for hospitals
and nursing homes that are not boarding care homes at the
following levels:
Joint Commission on Accreditation of Healthcare
Organizations (JCAHO)
and American Osteopathic
Association (AOA) hospitals $7,055 $7,555 plus $13 per bed
Non-JCAHO and non-AOA hospitals $4,680 $5,180 plus $234
$247 per bed
Nursing home $183 plus $91 per bed
The commissioner shall set license fees for outpatient
surgical centers, boarding care homes, and supervised living
facilities at the following levels:
Outpatient surgical centers $1,512 $3,349
Boarding care homes $183 plus $91 per bed
Supervised living facilities $183 plus $91 per bed.
(e) Unless prohibited by federal law, the commissioner of
health shall charge applicants the following fees to cover the
cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or
Medicaid program:
Prospective payment surveys for $ 900
hospitals
Swing bed surveys for nursing homes $1,200
Psychiatric hospitals $1,400
Rural health facilities $1,100
Portable x-ray providers $ 500
Home health agencies $1,800
Outpatient therapy agencies $ 800
End stage renal dialysis providers $2,100
Independent therapists $ 800
Comprehensive rehabilitation $1,200
outpatient facilities
Hospice providers $1,700
Ambulatory surgical providers $1,800
Hospitals $4,200
Other provider categories or Actual surveyor costs:
additional resurveys required average surveyor cost x
to complete initial certification number of hours for the
survey process.
These fees shall be submitted at the time of the
application for federal certification and shall not be
refunded. All fees collected after the date that the imposition
of fees is not prohibited by federal law shall be deposited in
the state treasury and credited to the state government special
revenue fund.
(f) The commissioner shall charge the following fees for
examinations, registrations, licenses, and inspections:
Plumbing examination $ 50
Water conditioning examination $ 50
Plumbing bond registration fee $ 40
Water conditioning bond registration fee $ 40
Master plumber's license $120
Journeyman plumber's license $ 55
Apprentice registration $ 25
Water conditioning contractor license $ 70
Water conditioning installer license $ 35
Residential inspection fee (each visit) $ 50
Public, commercial, and Inspection fee
industrial inspections
25 or fewer drainage
fixture units $ 300
26 to 50 drainage
fixture units $ 900
51 to 150 drainage
fixture units $1,200
151 to 249 drainage
fixture units $1,500
250 or more drainage
fixture units $1,800
Callback fee (each visit) $ 100
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 8. Minnesota Statutes 2004, section 144.147,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] "Eligible rural hospital"
means any nonfederal, general acute care hospital that:
(1) is either located in a rural area, as defined in the
federal Medicare regulations, Code of Federal Regulations, title
42, section 405.1041, or located in a community with a
population of less than 10,000 15,000, according to United
States Census Bureau statistics, outside the seven-county
metropolitan area;
(2) has 50 or fewer beds; and
(3) is not for profit.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 9. Minnesota Statutes 2004, section 144.147,
subdivision 2, is amended to read:
Subd. 2. [GRANTS AUTHORIZED.] The commissioner shall
establish a program of grants to assist eligible rural
hospitals. The commissioner shall award grants to hospitals and
communities for the purposes set forth in paragraphs (a) and (b).
(a) Grants may be used by hospitals and their communities
to develop strategic plans for preserving or enhancing access to
health services. At a minimum, a strategic plan must consist of:
(1) a needs assessment to determine what health services
are needed and desired by the community. The assessment must
include interviews with or surveys of area health professionals,
local community leaders, and public hearings;
(2) an assessment of the feasibility of providing needed
health services that identifies priorities and timeliness for
potential changes; and
(3) an implementation plan.
The strategic plan must be developed by a committee that
includes representatives from the hospital, local public health
agencies, other health providers, and consumers from the
community.
(b) The grants may also be used by eligible rural hospitals
that have developed strategic plans to implement transition
projects to modify the type and extent of services provided, in
order to reflect the needs of that plan. Grants may be used by
hospitals under this paragraph to develop hospital-based
physician practices that integrate hospital and existing medical
practice facilities that agree to transfer their practices,
equipment, staffing, and administration to the hospital. The
grants may also be used by the hospital to establish a health
provider cooperative, a telemedicine system, an electronic
health records system, or a rural health care system or to cover
expenses associated with being designated as a critical access
hospital for the Medicare rural hospital flexibility program.
Not more than one-third of any grant shall be used to offset
losses incurred by physicians agreeing to transfer their
practices to hospitals.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 10. [144.1476] [RURAL PHARMACY PLANNING AND
TRANSITION GRANT PROGRAM.]
Subdivision 1. [DEFINITIONS.] (a) For the purposes of this
section, the following definitions apply.
(b) "Eligible rural community" means:
(1) a Minnesota community that is located in a rural area,
as defined in the federal Medicare regulations, Code of Federal
Regulations, title 42, section 405.1041; or
(2) a Minnesota community that has a population of less
than 10,000, according to the United States Bureau of
Statistics, and that is outside the seven-county metropolitan
area, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud.
(c) "Health care provider" means a hospital, clinic,
pharmacy, long-term care institution, or other health care
facility that is licensed, certified, or otherwise authorized by
the laws of this state to provide health care.
(d) "Pharmacist" means an individual with a valid license
issued under chapter 151 to practice pharmacy.
(e) "Pharmacy" has the meaning given under section 151.01,
subdivision 2.
Subd. 2. [GRANTS AUTHORIZED; ELIGIBILITY.] (a) The
commissioner of health shall establish a program to award grants
to eligible rural communities or health care providers in
eligible rural communities for planning, establishing, keeping
in operation, or providing health care services that preserve
access to prescription medications and the skills of a
pharmacist according to sections 151.01 to 151.40.
(b) To be eligible for a grant, an applicant must develop a
strategic plan for preserving or enhancing access to
prescription medications and the skills of a pharmacist. At a
minimum, a strategic plan must consist of:
(1) a needs assessment to determine what pharmacy services
are needed and desired by the community. The assessment must
include interviews with or surveys of area and local health
professionals, local community leaders, and public officials;
(2) an assessment of the feasibility of providing needed
pharmacy services that identifies priorities and timelines for
potential changes; and
(3) an implementation plan.
(c) A grant may be used by a recipient that has developed a
strategic plan to implement transition projects to modify the
type and extent of pharmacy services provided, in order to
reflect the needs of the community. Grants may also be used by
recipients:
(1) to develop pharmacy practices that integrate pharmacy
and existing health care provider facilities; or
(2) to establish a pharmacy provider cooperative or
initiatives that maintain local access to prescription
medications and the skills of a pharmacist.
Subd. 3. [CONSIDERATION OF GRANTS.] In determining which
applicants shall receive grants under this section, the
commissioner of health shall appoint a committee comprised of
members with experience and knowledge about rural pharmacy
issues including, but not limited to, two rural pharmacists with
a community pharmacy background, two health care providers from
rural communities, one representative from a statewide
pharmacist organization, and one representative of the Board of
Pharmacy. A representative of the commissioner may serve on the
committee in an ex officio status. In determining who shall
receive a grant, the committee shall take into account:
(1) improving or maintaining access to prescription
medications and the skills of a pharmacist;
(2) changes in service populations;
(3) the extent community pharmacy needs are not currently
met by other providers in the area;
(4) the financial condition of the applicant;
(5) the integration of pharmacy services into existing
health care services; and
(6) community support.
The commissioner may also take into account other relevant
factors.
Subd. 4. [ALLOCATION OF GRANTS.] (a) The commissioner
shall establish a deadline for receiving applications and must
make a final decision on the funding of each application within
60 days of the deadline. An applicant must apply no later than
March 1 of each fiscal year for grants awarded for that fiscal
year.
(b) Any grant awarded must not exceed $50,000 a year and
may not exceed a one-year term.
(c) Applicants may apply to the program each year they are
eligible.
(d) Project grants may not be used to retire debt incurred
with respect to any capital expenditure made prior to the date
on which the project is initiated.
Subd. 5. [EVALUATION.] The commissioner shall evaluate the
overall effectiveness of the grant program and may collect
progress reports and other information from grantees needed for
program evaluation. An academic institution that has the
expertise in evaluating rural pharmacy outcomes may participate
in the program evaluation if asked by a grantee or the
commissioner. The commissioner shall compile summaries of
successful grant projects and other model community efforts to
preserve access to prescription medications and the skills of a
pharmacist, and make this information available to Minnesota
communities seeking to address local pharmacy issues.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 11. Minnesota Statutes 2004, section 144.148,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] (a) For purposes of this
section, the following definitions apply.
(b) "Eligible rural hospital" means any nonfederal, general
acute care hospital that:
(1) is either located in a rural area, as defined in the
federal Medicare regulations, Code of Federal Regulations, title
42, section 405.1041, or located in a community with a
population of less than 10,000 15,000, according to United
States Census Bureau statistics, outside the seven-county
metropolitan area;
(2) has 50 or fewer beds; and
(3) is not for profit.
(c) "Eligible project" means a modernization project to
update, remodel, or replace aging hospital facilities and
equipment necessary to maintain the operations of a hospital,
including establishing an electronic health records system.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 12. Minnesota Statutes 2004, 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) 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;
(4) (3) develop a statewide, coordinated recruitment
strategy for health care personnel and maintain a database on
health care personnel as required under section 144.1485;
(5) (4) 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;
(6) (5) 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;
(7) (6) support efforts to ensure continued funding for
medical and nursing education programs that will increase the
number of health professionals serving in rural areas;
(8) (7) support efforts to secure higher reimbursement for
rural health care providers from the Medicare and medical
assistance programs;
(9) (8) coordinate the development of a statewide plan for
emergency medical services, in cooperation with the Emergency
Medical Services Advisory Council;
(10) (9) 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
(11) (10) carry out other activities necessary to address
rural health problems.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 13. Minnesota Statutes 2004, section 144.1501,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] (a) For purposes of this
section, the following definitions apply.
(b) "Dentist" means an individual who is licensed to
practice dentistry.
(c) "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) (d) "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) (e) "Medical resident" means an individual
participating in a medical residency in family practice,
internal medicine, obstetrics and gynecology, pediatrics, or
psychiatry.
(e) (f) "Midlevel practitioner" means a nurse practitioner,
nurse-midwife, nurse anesthetist, advanced clinical nurse
specialist, or physician assistant.
(f) (g) "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) (h) "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) (i) "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) (j) "Pharmacist" means an individual with a valid
license issued under chapter 151.
(k) "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) (l) "Physician assistant" means a person registered
under chapter 147A.
(k) (m) "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) (n) "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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 14. Minnesota Statutes 2004, section 144.1501,
subdivision 2, is amended to read:
Subd. 2. [CREATION OF ACCOUNT.] (a) 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:
(1) for medical residents agreeing to practice in
designated rural areas or underserved urban communities, or
specializing in the area of pediatric psychiatry;
(2) for midlevel practitioners agreeing to practice in
designated rural areas, and or to teach for at least 20 hours
per week in the nursing field in a postsecondary program;
(3) for nurses who agree to practice in a Minnesota nursing
home or intermediate care facility for persons with mental
retardation or related conditions or to teach for at least 20
hours per week in the nursing field in a postsecondary program;
(4) for other health care technicians agreeing to teach for
at least 20 hours per week in their designated field in a
postsecondary program. The commissioner, in consultation with
the Healthcare Education-Industry Partnership, shall determine
the health care fields where the need is the greatest,
including, but not limited to, respiratory therapy, clinical
laboratory technology, radiologic technology, and surgical
technology;
(5) for pharmacists who agree to practice in designated
rural areas; and
(6) for dentists agreeing to deliver at least 25 percent of
the dentist's yearly patient encounters to state public program
enrollees or patients receiving sliding fee schedule discounts
through a formal sliding fee schedule meeting the standards
established by the United States Department of Health and Human
Services under Code of Federal Regulations, title 42, section
51, chapter 303.
(b) 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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 15. Minnesota Statutes 2004, section 144.1501,
subdivision 3, is amended to read:
Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate
in the loan forgiveness program, an individual must:
(1) be a medical or dental resident, a licensed pharmacist
or be enrolled in a dentist, midlevel practitioner, registered
nurse, or a licensed practical nurse training program; and
(2) submit an application to the commissioner of
health. If fewer applications are submitted by dental students
or residents than there are dentist participant slots available,
the commissioner may consider applications submitted by dental
program graduates who are licensed dentists.
(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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 16. Minnesota Statutes 2004, section 144.1501,
subdivision 4, is amended to read:
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, teaching area,
patient group, or specialty 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 and
pediatric psychiatry loan forgiveness. If the commissioner does
not receive enough qualified applicants each year to use the
entire allocation of funds for urban underserved communities any
eligible profession, the remaining funds may be allocated for
rural physician loan forgiveness proportionally among the other
eligible professions according to the vacancy rate for each
profession in the required geographic area, patient group, or
facility type specified in subdivision 2. 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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 17. Minnesota Statutes 2004, section 144.226,
subdivision 1, as amended by Laws 2005, chapter 60, section 4,
is amended to read:
Subdivision 1. [WHICH SERVICES ARE FOR FEE.] The fees for
the following services shall be the following or an amount
prescribed by rule of the commissioner:
(a) The fee for the issuance of a certified vital record or
a certification that the vital record cannot be found is $8 $9.
No fee shall be charged for a certified birth, stillbirth, or
death record that is reissued within one year of the original
issue, if an amendment is made to the vital record and if the
previously issued vital record is surrendered. The fee is
nonrefundable.
(b) The fee for processing a request for the replacement of
a birth record for all events, except when filing a recognition
of parentage pursuant to section 257.73, subdivision 1,
is $20 $40. The fee is payable at the time of application and
is nonrefundable.
(c) The fee for processing a request for the filing of a
delayed registration of birth, stillbirth, or death is $20 $40.
The fee is payable at the time of application and is
nonrefundable. This fee includes one subsequent review of the
request if the request is not acceptable upon the initial
receipt.
(d) The fee for processing a request for the amendment of
any vital record when requested more than 45 days after the
filing of the vital record is $20 $40. No fee shall be charged
for an amendment requested within 45 days after the filing of
the vital record. The fee is payable at the time of application
and is nonrefundable. This fee includes one subsequent review
of the request if the request is not acceptable upon the initial
receipt.
(e) The fee for processing a request for the verification
of information from vital records is $8 $9 when the applicant
furnishes the specific information to locate the vital record.
When the applicant does not furnish specific information, the
fee is $20 per hour for staff time expended. Specific
information includes the correct date of the event and the
correct name of the registrant. Fees charged shall approximate
the costs incurred in searching and copying the vital records.
The fee shall be is payable at the time of application and is
nonrefundable.
(f) The fee for processing a request for the issuance of a
copy of any document on file pertaining to a vital record or
statement that a related document cannot be found is $8 $9. The
fee is payable at the time of application and is nonrefundable.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 18. Minnesota Statutes 2004, section 144.226,
subdivision 4, as amended by Laws 2005, chapter 60, section 6,
is amended to read:
Subd. 4. [VITAL RECORDS SURCHARGE.] (a) In addition to any
fee prescribed under subdivision 1, there is a nonrefundable
surcharge of $2 for each certified and noncertified birth,
stillbirth, or death record, and for a certification that the
record cannot be found. The local or state registrar shall
forward this amount to the commissioner of finance to be
deposited into the state government special revenue fund. This
surcharge shall not be charged under those circumstances in
which no fee for a birth, stillbirth, or death record is
permitted under subdivision 1, paragraph (a).
(b) Effective August 1, 2005, to June 30, 2009, the
surcharge in paragraph (a) shall be $4.
Sec. 19. Minnesota Statutes 2004, section 144.226, is
amended by adding a subdivision to read:
Subd. 5. [ELECTRONIC VERIFICATION.] A fee for the
electronic verification of a vital event, when the information
being verified is obtained from a certified birth or death
record, shall be established through contractual or interagency
agreements with interested local, state, or federal government
agencies.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 20. Minnesota Statutes 2004, section 144.226, is
amended by adding a subdivision to read:
Subd. 6. [ALTERNATIVE PAYMENT METHODS.] Notwithstanding
subdivision 1, alternative payment methods may be approved and
implemented by the state registrar or a local registrar.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 21. Minnesota Statutes 2004, section 144.3831,
subdivision 1, is amended to read:
Subdivision 1. [FEE SETTING.] The commissioner of health
may assess an annual fee of $5.21 $6.36 for every service
connection to a public water supply that is owned or operated by
a home rule charter city, a statutory city, a city of the first
class, or a town. The commissioner of health may also assess an
annual fee for every service connection served by a water user
district defined in section 110A.02.
[EFFECTIVE DATE.] This section is effective July 1, 2006.
Sec. 22. Minnesota Statutes 2004, 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,
notwithstanding section 144.552, 27 beds, of which 12 serve
mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;
(13) a construction project involving the addition of up to
31 new beds in an existing nonfederal hospital in Beltrami
County;
(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;
(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;
(17) a project involving the addition of 14 new hospital
beds to be used for rehabilitation services in an existing
hospital in Itasca County; or
(18) a project to add 20 licensed beds in existing space at
a hospital in Hennepin County that closed 20 rehabilitation beds
in 2002, provided that the beds are used only for rehabilitation
in the hospital's current rehabilitation building. If the beds
are used for another purpose or moved to another location, the
hospital's licensed capacity is reduced by 20 beds; or
(19) a critical access hospital established under section
144.1483, clause (9), and section 1820 of the federal Social
Security Act, United States Code, title 42, section 1395i-4,
that delicensed beds since enactment of the Balanced Budget Act
of 1997, Public Law 105-33, to the extent that the critical
access hospital does not seek to exceed the maximum number of
beds permitted such hospital under federal law.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 23. Minnesota Statutes 2004, section 144.562,
subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY FOR LICENSE CONDITION.] (a) A
hospital is not eligible to receive a license condition for
swing beds unless (1) it either has a licensed bed capacity of
less than 50 beds defined in the federal Medicare regulations,
Code of Federal Regulations, title 42, section 482.66, or it has
a licensed bed capacity of 50 beds or more and has swing beds
that were approved for Medicare reimbursement before May 1,
1985, or it has a licensed bed capacity of less than 65 beds and
the available nursing homes within 50 miles have had, in the
aggregate, an average occupancy rate of 96 percent or higher in
the most recent two years as documented on the statistical
reports to the Department of Health; and (2) it is located in a
rural area as defined in the federal Medicare regulations, Code
of Federal Regulations, title 42, section 482.66.
(b) Except for those critical access hospitals established
under section 144.1483, clause (9), and section 1820 of the
federal Social Security Act, United States Code, title 42,
section 1395i-4, that have an attached nursing home or that
owned a nursing home located in the same municipality as of May
1, 2005, eligible hospitals are allowed a total of 1,460 2,000
days of swing bed use per year, provided that no more than ten
hospital beds are used as swing beds at any one time. Critical
access hospitals that have an attached nursing home or that
owned a nursing home located in the same municipality as of May
1, 2005, are allowed swing bed use as provided in federal law.
(c) Except for critical access hospitals that have an
attached nursing home or that owned a nursing home located in
the same municipality as of May 1, 2005, the commissioner of
health must may approve swing bed use beyond 1,460 2,000 days as
long as there are no Medicare certified skilled nursing facility
beds available within 25 miles of that hospital that are willing
to admit the patient. Critical access hospitals exceeding 2,000
swing bed days must maintain documentation that they have
contacted skilled nursing facilities within 25 miles to
determine if any skilled nursing facility beds are available
that are willing to admit the patient.
(d) After reaching 2,000 days of swing bed use in a year,
an eligible hospital to which this limit applies may admit six
additional patients to swing beds each year without seeking
approval from the commissioner or being in violation of this
subdivision. These six swing bed admissions are exempt from the
limit of 2,000 annual swing bed days for hospitals subject to
this limit.
(e) A health care system that is in full compliance with
this subdivision may allocate its total limit of swing bed days
among the hospitals within the system, provided that no hospital
in the system without an attached nursing home may exceed 2,000
swing bed days per year.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 24. [144.574] [EDUCATION ABOUT THE DANGERS OF SHAKING
INFANTS AND YOUNG CHILDREN.]
Subdivision 1. [EDUCATION BY HOSPITALS.] (a) A hospital
licensed under sections 144.50 to 144.56 shall make available
for viewing by the parents of each newborn baby delivered in the
hospital a video presentation on the dangers associated with
shaking infants and young children.
(b) A hospital shall use a video obtained from the
commissioner or approved by the commissioner. The commissioner
shall provide to a hospital and any interested individuals, at
cost, copies of an approved video. The commissioner shall
review other video presentations for possible approval upon the
request of a hospital. The commissioner shall not require a
hospital to use videos that would require the hospital to pay
royalties for use of the video, restrict viewing in order to
comply with public viewing or other restrictions, or be subject
to other costs or restrictions associated with copyrights.
(c) A hospital shall, whenever possible, request both
parents to view the video.
(d) The showing or distribution of the video shall not
subject any person or facility to any action for damages or
other relief provided the person or facility acted in good faith.
Subd. 2. [EDUCATION BY HEALTH CARE PROVIDERS.] The
commissioner shall establish a protocol for health care
providers to educate parents and primary caregivers about the
dangers associated with shaking infants and young children. The
commissioner shall request family practice physicians,
pediatricians, and other pediatric health care providers to
review these dangers with the parents and primary caregivers of
infants and young children up to the age of three at each
well-baby visit.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 25. [144.602] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] For purposes of sections
144.601 to 144.608, the terms defined in this section have the
meanings given them.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of health.
Subd. 3. [MAJOR TRAUMA.] "Major trauma" means a sudden
severe injury or damage to the body caused by an external force
that results in potentially life-threatening injuries or that
could result in the following disabilities:
(1) impairment of cognitive or mental abilities;
(2) impairment of physical functioning; or
(3) disturbance of behavioral or emotional functioning.
Subd. 4. [TRAUMA HOSPITAL.] "Trauma hospital" means a
hospital that voluntarily meets the commissioner's criteria
under section 144.603 and that has been designated as a trauma
hospital under section 144.605.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 26. [144.603] [STATEWIDE TRAUMA SYSTEM CRITERIA.]
Subdivision 1. [CRITERIA ESTABLISHED.] The commissioner
shall adopt criteria to ensure that severely injured people are
promptly transported and treated at trauma hospitals appropriate
to the severity of injury. Minimum criteria shall address
emergency medical service trauma triage and transportation
guidelines as approved under section 144E.101, subdivision 14,
designation of hospitals as trauma hospitals, interhospital
transfers, a trauma registry, and a trauma system governance
structure.
Subd. 2. [BASIS; VERIFICATION.] The commissioner shall
base the establishment, implementation, and modifications to the
criteria under subdivision 1 on the department-published
Minnesota comprehensive statewide trauma system plan. The
commissioner shall seek the advice of the Trauma Advisory
Council in implementing and updating the criteria, using
accepted and prevailing trauma transport, treatment, and
referral standards of the American College of Surgeons, the
American College of Emergency Physicians, the Minnesota
Emergency Medical Services Regulatory Board, the national Trauma
Resources Network, and other widely recognized trauma experts.
The commissioner shall adapt and modify the standards as
appropriate to accommodate Minnesota's unique geography and the
state's hospital and health professional distribution and shall
verify that the criteria are met by each hospital voluntarily
participating in the statewide trauma system.
Subd. 3. [RULE EXEMPTION AND REPORT TO THE
LEGISLATURE.] In developing and adopting the criteria under this
section, the commissioner of health is exempt from chapter 14,
including section 14.386. By September 1, 2009, the
commissioner must report to the legislature on implementation of
the voluntary trauma system, including recommendations on the
need for including the trauma system criteria in rule.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 27. [144.604] [TRAUMA TRIAGE AND TRANSPORTATION.]
Subdivision 1. [TRANSPORT REQUIREMENT.] Unless the
Emergency Medical Services Regulatory Board has approved a
licensed ambulance service's deviation from the guidelines under
section 144E.101, subdivision 14, the ambulance service must
transport major trauma patients from the scene to the highest
state-designated trauma hospital within 30 minutes' transport
time.
Subd. 2. [GROUND AMBULANCE EXCEPTIONS.] Notwithstanding
subdivision 1, ground ambulances must comply with the following:
(1) patients with compromised airways must be transported
immediately to the nearest designated trauma hospital; and
(2) level II trauma hospitals capable of providing
definitive trauma care must not be bypassed to reach a level I
trauma hospital.
Subd. 3. [UNDESIGNATED HOSPITALS.] No major trauma patient
shall be transported to a hospital not participating in the
statewide trauma system unless no trauma hospital is available
within 30 minutes' transport time.
[EFFECTIVE DATE.] This section is effective July 1, 2009.
Sec. 28. [144.605] [DESIGNATING TRAUMA HOSPITALS.]
Subdivision 1. [NAMING PRIVILEGES.] Unless it has been
designated a trauma hospital by the commissioner, no hospital
shall use the term trauma center or trauma hospital in its name
or its advertising or shall otherwise indicate it has trauma
treatment capabilities.
Subd. 2. [DESIGNATION; REVERIFICATION.] The commissioner
shall designate four levels of trauma hospitals. A hospital
that voluntarily meets the criteria for a particular level of
trauma hospital shall apply to the commissioner for designation
and, upon the commissioner's verifying the hospital meets the
criteria, be designated a trauma hospital at the appropriate
level for a three-year period. Prior to the expiration of the
three-year designation, a hospital seeking to remain part of the
voluntary system must apply for and successfully complete a
reverification process, be awaiting the site visit for the
reverification, or be awaiting the results of the site visit.
The commissioner may extend a hospital's existing designation
for up to 18 months on a provisional basis if the hospital has
applied for reverification in a timely manner but has not yet
completed the reverification process within the expiration of
the three-year designation and the extension is in the best
interest of trauma system patient safety. To be granted a
provisional extension, the hospital must be:
(1) scheduled and awaiting the site visit for
reverification;
(2) awaiting the results of the site visit; or
(3) responding to and correcting identified deficiencies
identified in the site visit.
Subd. 3. [ACS VERIFICATION.] The commissioner shall grant
the appropriate level I, II, or III trauma hospital designation
to a hospital that successfully completes and passes the
American College of Surgeons (ACS) verification standards at the
hospital's cost, submits verification documentation to the
Trauma Advisory Council, and formally notifies the Trauma
Advisory Council of ACS verification.
Subd. 4. [LEVEL III DESIGNATION; NOT ACS VERIFIED.] (a)
The commissioner shall grant the appropriate level III trauma
hospital designation to a hospital that is not ACS verified but
that successfully completes the designation process under
paragraph (b).
(b) The hospital must complete and submit a self-reported
survey and application to the Trauma Advisory Council for
review, verifying that the hospital meets the criteria as a
level III trauma hospital. When the Trauma Advisory Council is
satisfied the application is complete, the commissioner shall
arrange a site review visit. Upon successful completion of the
site review, the review team shall make written recommendations
to the Trauma Advisory Council. If approved by the Trauma
Advisory Council, a letter of recommendation shall be sent to
the commissioner for final approval and designation.
Subd. 5. [LEVEL IV DESIGNATION.] (a) The commissioner
shall grant the appropriate level IV trauma hospital designation
to a hospital that successfully completes the designation
process under paragraph (b).
(b) The hospital must complete and submit a self-reported
survey and application to the Trauma Advisory Council for
review, verifying that the hospital meets the criteria as a
level IV trauma hospital. When the Trauma Advisory Council is
satisfied the application is complete, the council shall review
the application and, if the council approves the application,
send a letter of recommendation to the commissioner for final
approval and designation. The commissioner shall grant a level
IV designation and shall arrange a site review visit within
three years of the designation and every three years thereafter,
to coincide with the three-year reverification process.
Subd. 6. [CHANGES IN DESIGNATION.] Changes in a trauma
hospital's ability to meet the criteria for the hospital's level
of designation must be self-reported to the Trauma Advisory
Council and to other regional hospitals and local emergency
medical services providers and authorities. If the hospital
cannot correct its ability to meet the criteria for its level
within six months, the hospital may apply for redesignation at a
different level.
Subd. 7. [HIGHER DESIGNATION.] A trauma hospital may apply
for a higher trauma hospital designation one time during the
hospital's three-year designation by completing the designation
process for that level of trauma hospital.
Subd. 8. [LOSS OF DESIGNATION.] The commissioner may
refuse to designate or redesignate or may revoke a previously
issued trauma hospital designation if a hospital does not meet
the criteria of the statewide trauma plan, in the interests of
patient safety, or if a hospital denies or refuses a reasonable
request by the commissioner or the commissioner's designee to
verify information by correspondence or an on-site visit.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 29. [144.606] [INTERHOSPITAL TRANSFERS.]
Subdivision 1. [WRITTEN PROCEDURES REQUIRED.] A level III
or IV trauma hospital must have predetermined, written
procedures that direct the internal process for rapidly and
efficiently transferring a major trauma patient to definitive
care, including:
(1) clearly identified anatomic and physiologic criteria
that, if met, will immediately initiate transfer to definitive
care;
(2) a listing of appropriate ground and air transport
services, including primary and secondary telephone contact
numbers; and
(3) immediately available supplies, records, or other
necessary resources that will accompany a patient.
Subd. 2. [TRANSFER AGREEMENTS.] (a) A level III or IV
trauma hospital may transfer patients to a hospital with which
the trauma hospital has a written transfer agreement.
(b) Each agreement must be current and with a trauma
hospital or trauma hospitals capable of caring for major trauma
injuries.
(c) A level III or IV trauma hospital must have a current
transfer agreement with a hospital that has special capabilities
in the treatment of burn injuries and a transfer agreement with
a second hospital that has special capabilities in the treatment
of burn injuries, should the primary transfer hospital be unable
to accept a burn patient.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 30. [144.607] [TRAUMA REGISTRY.]
Subdivision 1. [REGISTRY PARTICIPATION REQUIRED.] A trauma
hospital must participate in the statewide trauma registry.
Subd. 2. [TRAUMA REPORTING.] A trauma hospital must report
major trauma injuries as part of the reporting for the traumatic
brain injury and spinal cord injury registry required in
sections 144.661 to 144.665.
Subd. 3. [APPLICATION OF OTHER LAW.] Sections 144.661 to
144.665 apply to a major trauma reported to the statewide trauma
registry, with the exception of sections 144.662, clause (2),
and 144.664, subdivision 3.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 31. [144.608] [TRAUMA ADVISORY COUNCIL.]
Subdivision 1. [TRAUMA ADVISORY COUNCIL ESTABLISHED.] (a)
A Trauma Advisory Council is established to advise, consult
with, and make recommendations to the commissioner on the
development, maintenance, and improvement of a statewide trauma
system.
(b) The council shall consist of the following members:
(1) a trauma surgeon certified by the American College of
Surgeons who practices in a level I or II trauma hospital;
(2) a general surgeon certified by the American College of
Surgeons whose practice includes trauma and who practices in a
designated rural area as defined under section 144.1501,
subdivision 1, paragraph (b);
(3) a neurosurgeon certified by the American Board of
Neurological Surgery who practices in a level I or II trauma
hospital;
(4) a trauma program nurse manager or coordinator
practicing in a level I or II trauma hospital;
(5) an emergency physician certified by the American
College of Emergency Physicians whose practice includes
emergency room care in a level I, II, III, or IV trauma
hospital;
(6) an emergency room nurse manager who practices in a
level III or IV trauma hospital;
(7) a family practice physician whose practice includes
emergency room care in a level III or IV trauma hospital located
in a designated rural area as defined under section 144.1501,
subdivision 1, paragraph (b);
(8) a nurse practitioner, as defined under section
144.1501, subdivision 1, paragraph (h), or a physician
assistant, as defined under section 144.1501, subdivision 1,
paragraph (j), whose practice includes emergency room care in a
level IV trauma hospital located in a designated rural area as
defined under section 144.1501, subdivision 1, paragraph (b);
(9) a pediatrician certified by the American Academy of
Pediatrics whose practice includes emergency room care in a
level I, II, III, or IV trauma hospital;
(10) an orthopedic surgeon certified by the American Board
of Orthopaedic Surgery whose practice includes trauma and who
practices in a level I, II, or III trauma hospital;
(11) the state emergency medical services medical director
appointed by the Emergency Medical Services Regulatory Board;
(12) a hospital administrator of a level III or IV trauma
hospital located in a designated rural area as defined under
section 144.1501, subdivision 1, paragraph (b);
(13) a rehabilitation specialist whose practice includes
rehabilitation of patients with major trauma injuries or
traumatic brain injuries and spinal cord injuries as defined
under section 144.661;
(14) an attendant or ambulance director who is an EMT,
EMT-I, or EMT-P within the meaning of section 144E.001 and who
actively practices with a licensed ambulance service in a
primary service area located in a designated rural area as
defined under section 144.1501, subdivision 1, paragraph (b);
and
(15) the commissioner of public safety or the
commissioner's designee.
(c) Council members whose appointment is dependent on
practice in a level III or IV trauma hospital may be appointed
to an initial term based upon their statements that the hospital
intends to become a level III or IV facility by July 1, 2009.
Subd. 2. [COUNCIL ADMINISTRATION.] (a) The council must
meet at least twice a year but may meet more frequently at the
call of the chair, a majority of the council members, or the
commissioner.
(b) The terms, compensation, and removal of members of the
council are governed by section 15.059, except that the council
expires June 30, 2015.
(c) The council may appoint subcommittees and workgroups.
Subcommittees shall consist of council members. Workgroups may
include noncouncil members. Noncouncil members shall be
compensated for workgroup activities under section 15.059,
subdivision 3, but shall receive expenses only.
Subd. 3. [REGIONAL TRAUMA ADVISORY COUNCILS.] (a) Up to
eight regional trauma advisory councils may be formed as needed.
(b) Regional trauma advisory councils shall advise, consult
with, and make recommendation to the state Trauma Advisory
Council on suggested regional modifications to the statewide
trauma criteria that will improve patient care and accommodate
specific regional needs.
(c) Each regional advisory council must have no more than
15 members. The commissioner, in consultation with the
Emergency Medical Services Regulatory Board, shall name the
council members.
(d) Regional council members may receive expenses in the
same manner and amount as authorized by the plan adopted under
section 43A.18, subdivision 2.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 32. Minnesota Statutes 2004, section 144.9504,
subdivision 2, is amended to read:
Subd. 2. [LEAD RISK ASSESSMENT.] (a) An assessing agency
shall conduct a lead risk assessment of a residence according to
the venous blood lead level and time frame set forth in clauses
(1) to (5) (4) for purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than 70 60 micrograms of
lead per deciliter of whole blood;
(2) within five working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 45 micrograms
of lead per deciliter of whole blood;
(3) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead
level equal to or greater than 20 15 micrograms of lead per
deciliter of whole blood; or
(4) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead
level that persists in the range of 15 to 19 micrograms of lead
per deciliter of whole blood for 90 days after initial
identification; or
(5) within ten working days of a pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than ten micrograms of lead
per deciliter of whole blood.
(b) Within the limits of available local, state, and
federal appropriations, an assessing agency may also conduct a
lead risk assessment for children with any elevated blood lead
level.
(c) In a building with two or more dwelling units, an
assessing agency shall assess the individual unit in which the
conditions of this section are met and shall inspect all common
areas accessible to a child. If a child visits one or more
other sites such as another residence, or a residential or
commercial child care facility, playground, or school, the
assessing agency shall also inspect the other sites. The
assessing agency shall have one additional day added to the time
frame set forth in this subdivision to complete the lead risk
assessment for each additional site.
(d) Within the limits of appropriations, the assessing
agency shall identify the known addresses for the previous 12
months of the child or pregnant female with venous blood lead
levels of at least 20 15 micrograms per deciliter for the child
or at least ten micrograms per deciliter for the pregnant
female; notify the property owners, landlords, and tenants at
those addresses that an elevated blood lead level was found in a
person who resided at the property; and give them primary
prevention information. Within the limits of appropriations,
the assessing agency may perform a risk assessment and issue
corrective orders in the properties, if it is likely that the
previous address contributed to the child's or pregnant female's
blood lead level. The assessing agency shall provide the notice
required by this subdivision without identifying the child or
pregnant female with the elevated blood lead level. The
assessing agency is not required to obtain the consent of the
child's parent or guardian or the consent of the pregnant female
for purposes of this subdivision. This information shall be
classified as private data on individuals as defined under
section 13.02, subdivision 12.
(e) The assessing agency shall conduct the lead risk
assessment according to rules adopted by the commissioner under
section 144.9508. An assessing agency shall have lead risk
assessments performed by lead risk assessors licensed by the
commissioner according to rules adopted under section 144.9508.
If a property owner refuses to allow a lead risk assessment, the
assessing agency shall begin legal proceedings to gain entry to
the property and the time frame for conducting a lead risk
assessment set forth in this subdivision no longer applies. A
lead risk assessor or assessing agency may observe the
performance of lead hazard reduction in progress and shall
enforce the provisions of this section under section 144.9509.
Deteriorated painted surfaces, bare soil, and dust must be
tested with appropriate analytical equipment to determine the
lead content, except that deteriorated painted surfaces or bare
soil need not be tested if the property owner agrees to engage
in lead hazard reduction on those surfaces. The lead content of
drinking water must be measured if another probable source of
lead exposure is not identified. Within a standard metropolitan
statistical area, an assessing agency may order lead hazard
reduction of bare soil without measuring the lead content of the
bare soil if the property is in a census tract in which soil
sampling has been performed according to rules established by
the commissioner and at least 25 percent of the soil samples
contain lead concentrations above the standard in section
144.9508.
(f) Each assessing agency shall establish an administrative
appeal procedure which allows a property owner to contest the
nature and conditions of any lead order issued by the assessing
agency. Assessing agencies must consider appeals that propose
lower cost methods that make the residence lead safe. The
commissioner shall use the authority and appeal procedure
granted under sections 144.989 to 144.993.
(g) Sections 144.9501 to 144.9509 neither authorize nor
prohibit an assessing agency from charging a property owner for
the cost of a lead risk assessment.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 33. Minnesota Statutes 2004, section 144.98,
subdivision 3, is amended to read:
Subd. 3. [FEES.] (a) An application for certification
under subdivision 1 must be accompanied by the biennial fee
specified in this subdivision. The fees are for:
(1) nonrefundable base certification fee, $1,200
$1,600; and
(2) sample preparation techniques fees, $100 per technique;
and
(3) test category certification fees:
Test Category Certification Fee
Clean water program bacteriology $600 $800
Safe drinking water program bacteriology $600 $800
Clean water program inorganic chemistry $600 $800
Safe drinking water program inorganic chemistry $600 $800
Clean water program chemistry metals $800 $1,200
Safe drinking water program chemistry metals $800 $1,200
Resource conservation and recovery program
chemistry metals $800 $1,200
Clean water program volatile organic compounds $1,200 $1,500
Safe drinking water program
volatile organic compounds $1,200 $1,500
Resource conservation and recovery program
volatile organic compounds $1,200 $1,500
Underground storage tank program
volatile organic compounds $1,200 $1,500
Clean water program other organic compounds $1,200 $1,500
Safe drinking water program other organic compounds $1,200 $1,500
Resource conservation and recovery program
other organic compounds $1,200 $1,500
Clean water program radiochemistry $2,500
Safe drinking water program radiochemistry $2,500
Resource conservation and recovery program
agricultural contaminants $2,500
Resource conservation and recovery program
emerging contaminants $2,500
(b) The total biennial certification fee is the base fee
plus the applicable test category fees.
(c) Laboratories located outside of this state that require
an on-site survey will inspection shall be assessed an
additional $2,500 $3,750 fee.
(c) The total biennial certification fee includes the base
fee, the sample preparation techniques fees, the test category
fees, and, when applicable, the on-site inspection fee.
(d) Fees must be set so that the total fees support the
laboratory certification program. Direct costs of the
certification service include program administration,
inspections, the agency's general support costs, and attorney
general costs attributable to the fee function.
(e) A change fee shall be assessed if a laboratory requests
additional analytes or methods at any time other than when
applying for or renewing its certification. The change fee is
equal to the test category certification fee for the analyte.
(f) A variance fee shall be assessed if a laboratory
requests and is granted a variance from a rule adopted under
this section. The variance fee is $500 per variance.
(g) Refunds or credits shall not be made for analytes or
methods requested but not approved.
(h) Certification of a laboratory shall not be awarded
until all fees are paid.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 34. Minnesota Statutes 2004, section 144E.101, is
amended by adding a subdivision to read:
Subd. 14. [TRAUMA TRIAGE AND TRANSPORT GUIDELINES.] By
July 1, 2009, a licensee shall have written age appropriate
trauma triage and transport guidelines consistent with the
criteria issued by the Trauma Advisory Council established under
section 144.608 and approved by the board. The board may
approve a licensee's requested deviations to the guidelines due
to the availability of local or regional trauma resources if the
changes are in the best interest of the patient's health.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 35. Minnesota Statutes 2004, section 145.4242, is
amended to read:
145.4242 [INFORMED CONSENT.]
(a) No abortion shall be performed in this state except
with the voluntary and informed consent of the female upon whom
the abortion is to be performed. Except in the case of a
medical emergency, consent to an abortion is voluntary and
informed only if:
(1) the female is told the following, by telephone or in
person, by the physician who is to perform the abortion or by a
referring physician, at least 24 hours before the abortion:
(i) the particular medical risks associated with the
particular abortion procedure to be employed including, when
medically accurate, the risks of infection, hemorrhage, breast
cancer, danger to subsequent pregnancies, and infertility;
(ii) the probable gestational age of the unborn child at
the time the abortion is to be performed; and
(iii) the medical risks associated with carrying her child
to term; and
(iv) for abortions after 20 weeks gestational, whether or
not an anesthetic or analgesic would eliminate or alleviate
organic pain to the unborn child caused by the particular method
of abortion to be employed and the particular medical benefits
and risks associated with the particular anesthetic or analgesic.
The information required by this clause may be provided by
telephone without conducting a physical examination or tests of
the patient, in which case the information required to be
provided may be based on facts supplied to the physician by the
female and whatever other relevant information is reasonably
available to the physician. It may not be provided by a tape
recording, but must be provided during a consultation in which
the physician is able to ask questions of the female and the
female is able to ask questions of the physician. If a physical
examination, tests, or the availability of other information to
the physician subsequently indicate, in the medical judgment of
the physician, a revision of the information previously supplied
to the patient, that revised information may be communicated to
the patient at any time prior to the performance of the
abortion. Nothing in this section may be construed to preclude
provision of required information in a language understood by
the patient through a translator;
(2) the female is informed, by telephone or in person, by
the physician who is to perform the abortion, by a referring
physician, or by an agent of either physician at least 24 hours
before the abortion:
(i) that medical assistance benefits may be available for
prenatal care, childbirth, and neonatal care;
(ii) that the father is liable to assist in the support of
her child, even in instances when the father has offered to pay
for the abortion; and
(iii) that she has the right to review the printed
materials described in section 145.4243, that these materials
are available on a state-sponsored Web site, and what the Web
site address is. The physician or the physician's agent shall
orally inform the female that the materials have been provided
by the state of Minnesota and that they describe the unborn
child, list agencies that offer alternatives to abortion, and
contain information on fetal pain. If the female chooses to
view the materials other than on the Web site, they shall either
be given to her at least 24 hours before the abortion or mailed
to her at least 72 hours before the abortion by certified mail,
restricted delivery to addressee, which means the postal
employee can only deliver the mail to the addressee.
The information required by this clause may be provided by
a tape recording if provision is made to record or otherwise
register specifically whether the female does or does not choose
to have the printed materials given or mailed to her;
(3) the female certifies in writing, prior to the abortion,
that the information described in clauses (1) and (2) has been
furnished to her and that she has been informed of her
opportunity to review the information referred to in clause (2),
subclause (iii); and
(4) prior to the performance of the abortion, the physician
who is to perform the abortion or the physician's agent obtains
a copy of the written certification prescribed by clause (3) and
retains it on file with the female's medical record for at least
three years following the date of receipt.
(b) Prior to administering the anesthetic or analgesic as
described in paragraph (a), clause (1), item (iv), the physician
must disclose to the woman any additional cost of the procedure
for the administration of the anesthetic or analgesic. If the
woman consents to the administration of the anesthetic or
analgesic, the physician shall administer the anesthetic or
analgesic or arrange to have the anesthetic or analgesic
administered.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 36. Minnesota Statutes 2004, section 145.56,
subdivision 2, is amended to read:
Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) To the extent
funds are appropriated for the purposes of this subdivision, the
commissioner shall establish a grant program to fund:
(1) community-based programs to provide education,
outreach, and advocacy services to populations who may be at
risk for suicide;
(2) community-based programs that educate community helpers
and gatekeepers, such as family members, spiritual leaders,
coaches, and business owners, employers, and coworkers on how to
prevent suicide by encouraging help-seeking behaviors;
(3) community-based programs that educate populations at
risk for suicide and community helpers and gatekeepers that must
include information on the symptoms of depression and other
psychiatric illnesses, the warning signs of suicide, skills for
preventing suicides, and making or seeking effective referrals
to intervention and community resources; and
(4) community-based programs to provide evidence-based
suicide prevention and intervention education to school staff,
parents, and students in grades kindergarten through 12.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 37. Minnesota Statutes 2004, section 145.56,
subdivision 5, is amended to read:
Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] To the
extent funds are appropriated for the purposes of this
subdivision, the commissioner shall conduct periodic evaluations
of the impact of and outcomes from implementation of the state's
suicide prevention plan and each of the activities specified in
this section. By July 1, 2002, and July 1 of each even-numbered
year thereafter, the commissioner shall report the results of
these evaluations to the chairs of the policy and finance
committees in the house and senate with jurisdiction over health
and human services issues.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 38. [145.906] [POSTPARTUM DEPRESSION EDUCATION AND
INFORMATION.]
(a) The commissioner of health shall work with health care
facilities, licensed health and mental health care
professionals, mental health advocates, consumers, and families
in the state to develop materials and information about
postpartum depression, including treatment resources, and
develop policies and procedures to comply with this section.
(b) Physicians, traditional midwives, and other licensed
health care professionals providing prenatal care to women must
have available to women and their families information about
postpartum depression.
(c) Hospitals and other health care facilities in the state
must provide departing new mothers and fathers and other family
members, as appropriate, with written information about
postpartum depression, including its symptoms, methods of coping
with the illness, and treatment resources.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 39. Minnesota Statutes 2004, section 145.9268, is
amended to read:
145.9268 [COMMUNITY CLINIC GRANTS.]
Subdivision 1. [DEFINITION.] For purposes of this section,
"eligible community clinic" means:
(1) a nonprofit clinic that provides is established to
provide health services under conditions as defined in Minnesota
Rules, part 9505.0255, to low income or rural population groups;
provides medical, preventive, dental, or mental health primary
care services; and utilizes a sliding fee scale or other
procedure to determine eligibility for charity care or to ensure
that no person will be denied services because of inability to
pay;
(2) a governmental entity or an Indian tribal government or
Indian health service unit that provides services and utilizes a
sliding fee scale or other procedure as described under clause
(1); or
(3) a consortium of clinics comprised of entities under
clause (1) or (2); or
(4) a nonprofit, tribal, or governmental entity proposing
the establishment of a clinic that will provide services and
utilize a sliding fee scale or other procedure as described
under clause (1).
Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health
shall award grants to eligible community clinics to plan,
establish, or operate services to improve the ongoing viability
of Minnesota's clinic-based safety net providers. Grants shall
be awarded to support the capacity of eligible community clinics
to serve low-income populations, reduce current or future
uncompensated care burdens, or provide for improved care
delivery infrastructure. The commissioner shall award grants to
community clinics in metropolitan and rural areas of the state,
and shall ensure geographic representation in grant awards among
all regions of the state.
Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant
under this section, an eligible community clinic must submit an
application to the commissioner of health by the deadline
established by the commissioner. A grant may be awarded upon
the signing of a grant contract. Community clinics may apply
for and the commissioner may award grants for one-year or
two-year periods.
(b) An application must be on a form and contain
information as specified by the commissioner but at a minimum
must contain:
(1) a description of the purpose or project for which grant
funds will be used;
(2) a description of the problem or problems the grant
funds will be used to address; and
(3) a description of achievable objectives, a workplan, and
a timeline for implementation and completion of processes or
projects enabled by the grant; and
(4) a process for documenting and evaluating results of the
grant.
(c) The commissioner shall review each application to
determine whether the application is complete and whether the
applicant and the project are eligible for a grant. In
evaluating applications according to paragraph (d), the
commissioner shall establish criteria including, but not limited
to: the priority level eligibility of the project; the
applicant's thoroughness and clarity in describing the problem
grant funds are intended to address; a description of the
applicant's proposed project; a description of the population
demographics and service area of the proposed project; the
manner in which the applicant will demonstrate the effectiveness
of any projects undertaken; and evidence of efficiencies and
effectiveness gained through collaborative efforts. The
commissioner may also take into account other relevant factors,
including, but not limited to, the percentage for which
uninsured patients represent the applicant's patient base and
the degree to which grant funds will be used to support services
increasing or maintaining access to health care services.
During application review, the commissioner may request
additional information about a proposed project, including
information on project cost. Failure to provide the information
requested disqualifies an applicant. The commissioner has
discretion over the number of grants awarded.
(d) In determining which eligible community clinics will
receive grants under this section, the commissioner shall give
preference to those grant applications that show evidence of
collaboration with other eligible community clinics, hospitals,
health care providers, or community organizations. In addition,
the commissioner shall give priority, in declining order, to
grant applications for projects that:
Subd. 3a. [AWARDING GRANTS.] (a) The commissioner may
award grants for activities to:
(1) provide a direct offset to expenses incurred for
services provided to the clinic's target population;
(2) establish, update, or improve information, data
collection, or billing systems, including electronic health
records systems;
(3) procure, modernize, remodel, or replace equipment used
in the delivery of direct patient care at a clinic;
(4) provide improvements for care delivery, such as
increased translation and interpretation services; or
(5) build a new clinic or expand an existing facility; or
(6) other projects determined by the commissioner to
improve the ability of applicants to provide care to the
vulnerable populations they serve.
(e) (b) A grant awarded to an eligible community clinic may
not exceed $300,000 per eligible community clinic. For an
applicant applying as a consortium of clinics, a grant may not
exceed $300,000 per clinic included in the consortium. The
commissioner has discretion over the number of grants awarded.
Subd. 4. [EVALUATION AND REPORT.] The commissioner of
health shall evaluate the overall effectiveness of the grant
program. The commissioner shall collect progress reports to
evaluate the grant program from the eligible community clinics
receiving grants. Every two years, as part of this evaluation,
the commissioner shall report to the legislature on priority
areas for grants set under subdivision 3 the needs of community
clinics and provide any recommendations for adding or
changing priority areas eligible activities.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 40. Minnesota Statutes 2004, 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 144.1501, subdivision 1, paragraphs
(e) (f), (g) (h), and (h) (i).
(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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 41. Minnesota Statutes 2004, section 150A.22, is
amended to read:
150A.22 [DONATED DENTAL SERVICES.]
(a) The Board of Dentistry commissioner of health shall
contract with the Minnesota Dental Association, or another
appropriate and qualified organization to develop and operate a
donated dental services program to provide dental care to public
program recipients and the uninsured through dentists who
volunteer their services without compensation. As part of the
contract, the board commissioner shall include specific
performance and outcome measures that the contracting
organization must meet. The donated dental services program
shall:
(1) establish a network of volunteer dentists, including
dental specialties, to donate dental services to eligible
individuals;
(2) establish a system to refer eligible individuals to the
appropriate volunteer dentists; and
(3) develop and implement a public awareness campaign to
educate eligible individuals about the availability of the
program.
(b) Funding for the program may be used for administrative
or technical support. The organization contracting with the
board commissioner shall provide an annual report that accounts
for funding appropriated to the program by the state, documents
the number of individuals served by the program and the number
of dentists participating as program providers, and provides
data on meeting the specific performance and outcome measures
identified by the board commissioner.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 42. Minnesota Statutes 2004, section 157.011, is
amended by adding a subdivision to read:
Subd. 3. [RULE EXEMPTION.] Notwithstanding any rule to the
contrary, no food establishment shall be required to acquire
equipment or change construction solely because ownership of the
food establishment has been transferred.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 43. Minnesota Statutes 2004, section 157.15, is
amended by adding a subdivision to read:
Subd. 19. [STATEWIDE HOSPITALITY FEE.] "Statewide
hospitality fee" means a fee to fund statewide food, beverage,
and lodging program development activities, including training
for inspection staff, technical assistance, maintenance of a
statewide integrated food safety and security information
system, and other related statewide activities that support the
food, beverage, and lodging program activities.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 44. Minnesota Statutes 2004, section 157.16,
subdivision 2, is amended to read:
Subd. 2. [LICENSE RENEWAL.] Initial and renewal licenses
for all food and beverage service establishments, hotels,
motels, lodging establishments, and resorts shall be issued for
the calendar year for which application is made and shall expire
on December 31 of such year. Any person who operates a place of
business after the expiration date of a license or without
having submitted an application and paid the fee shall be deemed
to have violated the provisions of this chapter and shall be
subject to enforcement action, as provided in the Health
Enforcement Consolidation Act, sections 144.989 to 144.993. In
addition, a penalty of $25 $50 shall be added to the total of
the license fee for any food and beverage service establishment
operating without a license as a mobile food unit, a seasonal
temporary or seasonal permanent food stand, or a special event
food stand, and a penalty of $50 $100 shall be added to the
total of the license fee for all restaurants, food carts,
hotels, motels, lodging establishments, and resorts operating
without a license for a period of up to 30 days. A late fee of
$300 shall be added to the license fee for establishments
operating more than 30 days without a license.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 45. Minnesota Statutes 2004, section 157.16, is
amended by adding a subdivision to read:
Subd. 2a. [FOOD MANAGER CERTIFICATION.] An applicant for
certification or certification renewal as a food manager must
submit to the commissioner a $28 nonrefundable certification fee
payable to the Department of Health.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 46. Minnesota Statutes 2004, section 157.16,
subdivision 3, is amended to read:
Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The
following fees are required for food and beverage service
establishments, hotels, motels, lodging establishments, and
resorts licensed under this chapter. Food and beverage service
establishments must pay the highest applicable fee under
paragraph (e) (d), clause (1), (2), (3), or (4), and
establishments serving alcohol must pay the highest applicable
fee under paragraph (e) (d), clause (6) or (7). The license fee
for new operators previously licensed under this chapter for the
same calendar year is one-half of the appropriate annual license
fee, plus any penalty that may be required. The license fee for
operators opening on or after October 1 is one-half of the
appropriate annual license fee, plus any penalty that may be
required.
(b) All food and beverage service establishments, except
special event food stands, and all hotels, motels, lodging
establishments, and resorts shall pay an annual base fee of
$145 $150.
(c) A special event food stand shall pay a flat fee
of $35 $40 annually. "Special event food stand" means a fee
category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special
event food stand as defined in section 157.15.
(d) In addition to the base fee in paragraph (b), each food
and beverage service establishment, other than a special event
food stand, and each hotel, motel, lodging establishment, and
resort shall pay an additional annual fee for each fee category
as, additional food service, or required additional inspection
specified in this paragraph:
(1) Limited food menu selection, $40 $50. "Limited food
menu selection" means a fee category that provides one or more
of the following:
(i) prepackaged food that receives heat treatment and is
served in the package;
(ii) frozen pizza that is heated and served;
(iii) a continental breakfast such as rolls, coffee, juice,
milk, and cold cereal;
(iv) soft drinks, coffee, or nonalcoholic beverages; or
(v) cleaning for eating, drinking, or cooking utensils,
when the only food served is prepared off site.
(2) Small establishment, including boarding establishments,
$75 $100. "Small establishment" means a fee category that has
no salad bar and meets one or more of the following:
(i) possesses food service equipment that consists of no
more than a deep fat fryer, a grill, two hot holding containers,
and one or more microwave ovens;
(ii) serves dipped ice cream or soft serve frozen desserts;
(iii) serves breakfast in an owner-occupied bed and
breakfast establishment;
(iv) is a boarding establishment; or
(v) meets the equipment criteria in clause (3), item (i) or
(ii), and has a maximum patron seating capacity of not more than
50.
(3) Medium establishment, $210 $260. "Medium establishment"
means a fee category that meets one or more of the following:
(i) possesses food service equipment that includes a range,
oven, steam table, salad bar, or salad preparation area;
(ii) possesses food service equipment that includes more
than one deep fat fryer, one grill, or two hot holding
containers; or
(iii) is an establishment where food is prepared at one
location and served at one or more separate locations.
Establishments meeting criteria in clause (2), item (v),
are not included in this fee category.
(4) Large establishment, $350 $460. "Large establishment"
means either:
(i) a fee category that (A) meets the criteria in clause
(3), items (i) or (ii), for a medium establishment, (B) seats
more than 175 people, and (C) offers the full menu selection an
average of five or more days a week during the weeks of
operation; or
(ii) a fee category that (A) meets the criteria in clause
(3), item (iii), for a medium establishment, and (B) prepares
and serves 500 or more meals per day.
(5) Other food and beverage service, including food carts,
mobile food units, seasonal temporary food stands, and seasonal
permanent food stands, $40 $50.
(6) Beer or wine table service, $40 $50. "Beer or wine
table service" means a fee category where the only alcoholic
beverage service is beer or wine, served to customers seated at
tables.
(7) Alcoholic beverage service, other than beer or wine
table service, $105 $135.
"Alcohol beverage service, other than beer or wine table
service" means a fee category where alcoholic mixed drinks are
served or where beer or wine are served from a bar.
(8) Lodging per sleeping accommodation unit, $6 $8,
including hotels, motels, lodging establishments, and resorts,
up to a maximum of $600 $800. "Lodging per sleeping
accommodation unit" means a fee category including the number of
guest rooms, cottages, or other rental units of a hotel, motel,
lodging establishment, or resort; or the number of beds in a
dormitory.
(9) First public swimming pool, $140 $180; each additional
public swimming pool, $80 $100. "Public swimming pool" means a
fee category that has the meaning given in Minnesota Rules, part
4717.0250, subpart 8.
(10) First spa, $80 $110; each additional spa, $40 $50.
"Spa pool" means a fee category that has the meaning given in
Minnesota Rules, part 4717.0250, subpart 9.
(11) Private sewer or water, $40 $50. "Individual private
water" means a fee category with a water supply other than a
community public water supply as defined in Minnesota Rules,
chapter 4720. "Individual private sewer" means a fee category
with an individual sewage treatment system which uses subsurface
treatment and disposal.
(12) Additional food service, $130. "Additional food
service" means a location at a food service establishment, other
than the primary food preparation and service area, used to
prepare or serve food to the public.
(13) Additional inspection fee, $300. "Additional
inspection fee" means a fee to conduct the second inspection
each year for elementary and secondary education facility school
lunch programs when required by the Richard B. Russell National
School Lunch Act.
(e) A fee of $150 $350 for review of the construction plans
must accompany the initial license application for food and
beverage service establishments restaurants, hotels, motels,
lodging establishments, or resorts with five or more sleeping
units.
(f) When existing food and beverage service establishments,
hotels, motels, lodging establishments, or resorts are
extensively remodeled, a fee of $150 $250 must be submitted with
the remodeling plans. A fee of $250 must be submitted for new
construction or remodeling for a restaurant with a limited food
menu selection, a seasonal permanent food stand, a mobile food
unit, or a food cart, or for a hotel, motel, resort, or lodging
establishment addition of less than five sleeping units.
(g) Seasonal temporary food stands and special event food
stands are not required to submit construction or remodeling
plans for review.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 47. Minnesota Statutes 2004, section 157.16, is
amended by adding a subdivision to read:
Subd. 3a. [STATEWIDE HOSPITALITY FEE.] Every person, firm,
or corporation that operates a licensed boarding establishment,
food and beverage service establishment, seasonal temporary or
permanent food stand, special event food stand, mobile food
unit, food cart, resort, hotel, motel, or lodging establishment
in Minnesota must submit to the commissioner a $35 annual
statewide hospitality fee for each licensed activity. The fee
for establishments licensed by the Department of Health is
required at the same time the licensure fee is due. For
establishments licensed by local governments, the fee is due by
July 1 of each year.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 48. Minnesota Statutes 2004, section 157.20,
subdivision 2, is amended to read:
Subd. 2. [INSPECTION FREQUENCY.] The frequency of
inspections of the establishments shall be based on the degree
of health risk.
(a) High-risk establishments must be inspected at least
once a year every 12 months.
(b) Medium-risk establishments must be inspected at least
once every 18 months.
(c) Low-risk establishments must be inspected at least once
every two years 24 months.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 49. Minnesota Statutes 2004, section 157.20,
subdivision 2a, is amended to read:
Subd. 2a. [RISK CATEGORIES.] (a) [HIGH-RISK
ESTABLISHMENT.] "High-risk establishment" means any food and
beverage service establishment, hotel, motel, lodging
establishment, or resort that:
(1) serves potentially hazardous foods that require
extensive processing on the premises, including manual handling,
cooling, reheating, or holding for service;
(2) prepares foods several hours or days before service;
(3) serves menu items that epidemiologic experience has
demonstrated to be common vehicles of food-borne illness;
(4) has a public swimming pool; or
(5) draws its drinking water from a surface water supply.
(b) [MEDIUM-RISK ESTABLISHMENT.] "Medium-risk
establishment" means a food and beverage service establishment,
hotel, motel, lodging establishment, or resort that:
(1) serves potentially hazardous foods but with minimal
holding between preparation and service; or
(2) serves foods, such as pizza, that require extensive
handling followed by heat treatment.
(c) [LOW-RISK ESTABLISHMENT.] "Low-risk establishment"
means a food and beverage service establishment, hotel, motel,
lodging establishment, or resort that is not a high-risk or
medium-risk establishment.
(d) [RISK EXCEPTIONS.] Mobile food units, seasonal
permanent and seasonal temporary food stands, food carts, and
special event food stands are not inspected on an established
schedule and therefore are not defined as high-risk,
medium-risk, or low-risk establishments.
(e) [SCHOOL INSPECTION FREQUENCY.] Elementary and
secondary school food service establishments must be inspected
according to the assigned risk category or by the frequency
required in the Richard B. Russell National School Lunch Act,
whichever frequency is more restrictive.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 50. Minnesota Statutes 2004, section 326.42,
subdivision 2, is amended to read:
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 design;
(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 design;
(6) manufactured home park or campground, one 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 51. Laws 2005, chapter 107, article 1, section 6, is
amended to read:
Sec. 6. COMMISSIONER OF HEALTH 95,000 155,000
To the commissioner of health to
implement new Minnesota Statutes,
section 144.1498 144.1501.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 52. [CERVICAL CANCER ELIMINATION STUDY.]
(a) The commissioner of health shall develop a statewide
integrated and comprehensive cervical cancer prevention plan,
including strategies for promoting and implementing the plan.
The plan must include activities that identify and implement
methods to improve the cervical cancer screening rates in
Minnesota, including, but not limited to:
(1) identifying and disseminating appropriate
evidence-based cervical cancer screening guidelines to be used
in Minnesota;
(2) increasing the use of appropriate screening based on
these guidelines for patients seen by medical groups in
Minnesota and monitoring results of these medical groups; and
(3) reducing the number of women who should but have not
been screened.
(b) In developing the plan, the commissioner shall also
identify and examine limitations and barriers in providing
cervical cancer screening, diagnosis tools, and treatment,
including, but not limited to, medical care reimbursement,
treatment costs, and the availability of insurance coverage.
(c) The commissioner may work with one or more nonprofit
quality improvement organizations in Minnesota to identify
evidence-based guidelines for cervical cancer screening and to
identify methods to improve the cervical cancer screening rates
among medical groups; and may work with one or more nonprofit
health care result reporting organizations to monitor results by
medical groups in Minnesota.
(d) The commissioner may convene an advisory committee that
includes representatives of health care providers, the American
Cancer Society, health plan companies, the University of
Minnesota Academic Health Center, community health boards, and
the general public.
(e) The commissioner shall submit a report to the
legislature by January 15, 2006, on:
(1) the statewide cervical cancer prevention plan,
including a description of the plan activities and strategies
developed for promoting and implementing the plan;
(2) methods for monitoring the results by medical groups
and by the entire state of cervical cancer screening improvement
activities; and
(3) recommended changes to existing laws, programs, or
services in terms of reducing the occurrence of cervical cancer
by improving insurance coverage for the prevention, diagnosis,
and treatment for cervical cancer.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 53. [PUBLIC HEALTH INFORMATION NETWORK.]
(a) The commissioner of health shall work with local public
health departments to develop a public health information
network. The development of the network must be consistent with
the recommendations, goals, and strategies of the Minnesota
public health information network report to the 2005 legislature
and the e-health initiative.
(b) The commissioner of health shall work with the
commissioner of human services to determine how data from care
systems can be utilized to assist with population health needs
assessments and targeted prevention efforts.
(c) Before the next biennium, the commissioner of health
shall submit to the legislature a status report on the progress
of the information network and the e-health initiative.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 54. [REPORT TO LEGISLATURE ON SWING BED USAGE.]
The commissioner of health shall review swing bed and
related data reported under Minnesota Statutes, sections
144.562, subdivision 3, paragraph (f); 144.564; and 144.698.
The commissioner shall report and make any appropriate
recommendations to the legislature by January 31, 2007, on:
(1) the use of swing bed days by all hospitals and by
critical access hospitals;
(2) occupancy rates in skilled nursing facilities within 25
miles of hospitals with swing beds; and
(3) information provided by rural providers on the use of
swing beds and the adequacy of rural services across the
continuum of care.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 55. [IMPLEMENTATION OF AN ELECTRONIC HEALTH RECORDS
SYSTEM.]
The commissioner of health, in consultation with the
electronic health record planning work group established in Laws
2004, chapter 288, article 7, section 7, shall develop a
statewide plan for all hospitals and physician group practices
to have in place an interoperable electronic health records
system by January 1, 2015. In developing the plan, the
commissioner shall consider:
(1) creating financial assistance to hospitals and
providers for implementing or updating an electronic health
records system, including, but not limited to, the establishment
of grants, financial incentives, or low-interest loans;
(2) addressing specific needs and concerns of safety-net
hospitals, community health clinics, and other health care
providers who serve low-income patients in implementing an
electronic records system within the hospital or practice; and
(3) providing assistance in the development of possible
alliances or collaborations among providers.
The commissioner shall provide preliminary reports to the
chairs of the senate and house committees with jurisdiction over
health care policy and finance biennially beginning January 15,
2007, on the status of reaching the goal for all hospitals and
physician group practices to have an interoperable electronic
health records system in place by January 1, 2015. The reports
shall include recommendations on statutory language necessary to
implement the plan, including possible financing options.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 56. [RULE AMENDMENT.]
The commissioner of health shall amend Minnesota Rules,
part 4626.2015, subparts 3, item C; and 6, item B, to conform
with Minnesota Statutes, section 157.16, subdivision 2a. The
commissioner may use the good cause exemption under Minnesota
Statutes, section 14.388, subdivision 1, clause (3). Minnesota
Statutes, section 14.386, does not apply, except to the extent
provided under Minnesota Statutes, section 14.388.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 57. [DIRECTION TO COMMISSIONER; DENTAL REVIEW.]
The commissioner of health, in consultation with the
relevant dental associations, licensed dental and public health
professionals, and others, shall review the leadership and
advisory role of the Department of Health relative to dental
health including the usefulness of utilizing a dental director.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 58. [REPEALER.]
(a) Minnesota Statutes 2004, sections 144.1486; 144.1502;
and 157.215, are repealed effective the day following final
enactment.
(b) Laws 2005, chapter 107, article 2, section 51, is
repealed effective the day following final enactment.
ARTICLE 7
LONG-TERM CARE AND CONTINUING CARE
Section 1. Minnesota Statutes 2004, section 144A.073, is
amended by adding a subdivision to read:
Subd. 3d. [PROJECT AMENDMENT AUTHORIZED.] Notwithstanding
the provisions of subdivision 3b:
(1) the commissioner may approve a request by a nursing
facility located in the city of Duluth with 48 licensed beds as
of January 1, 2005, that received approval under this section in
2002 for a moratorium exception project for amendment of the
project design that:
(i) reduces the total amount of common space devoted to
resident and family uses by more than five percent if the total
amount of common space in the facility, including that added by
the project, is at least 175 percent of the state requirement
for common space; and
(ii) reduces the space for no more than two residents'
living areas by increasing the size of a majority of the
single-bed rooms from the size in the project design as
originally approved and converting two single-bed rooms in the
project design as originally approved to one semi-private room;
and
(2) the commissioner may approve a request by a nursing
facility located in the city of Duluth with 129 licensed beds as
of January 1, 2005, that received approval under this section in
2002 for a moratorium exception project for amendment of the
project design that:
(i) reduces the total amount of common space devoted to
resident and family uses by more than five percent if the total
amount of common space in the facility, including that added by
the project, is at least 175 percent of the state requirement
for common space; and
(ii) reduces the space for no more than four residents'
living areas by increasing the size of a majority of the
single-bed rooms from the size in the project design as
originally approved and converting four single-bed rooms in the
project design as originally approved to two semi-private rooms;
and
(3) the amended project designs in clauses (1) and (2) must
provide solutions to all of the problems addressed by the
original application that are at least as effective as the
original solutions.
Sec. 2. Minnesota Statutes 2004, section 144A.073,
subdivision 10, is amended to read:
Subd. 10. [EXTENSION OF APPROVAL OF MORATORIUM EXCEPTION.]
Notwithstanding subdivision 3, the commissioner of health shall
extend project approval for an additional 18 36 months for any
proposed exception to the nursing home licensure and
certification moratorium if the proposal was approved under this
section between July 1, 2001, and June 30, 2003.
Sec. 3. [256B.0185] [REQUIRED REPORT.]
Subdivision 1. [PENDING APPLICATION.] By December 15 of
both 2005 and 2006, the commissioner must deliver to the
legislature a report that identifies:
(1) each county in which an application for medical
assistance from a person identified as residing in a long-term
care facility is or was pending, at any time between January 1
and December 1 of the calendar year to which the report relates,
for more than 60 days in the case of a person who is disabled,
or for more than 45 days in the case of a person who is age 65
or older; and
(2) for each of the identified counties: the number of
applications described in clause (1), the average number of days
the applications were pending, the distribution of days for
applications that were pending, and what percentage of the
applications, respectively, the county approved and denied.
Subd. 2. [TIME TO PROCESS APPLICATION.] The report must
include specific recommendations for how counties, as a group,
could shorten the time it takes to act on the applications
described in subdivision 1, clause (1).
Sec. 4. Minnesota Statutes 2004, 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 and other
obligations under paragraph (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).
(5) 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.
(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.
(f) Any required premium shall be determined at application
and redetermined at the enrollee's six-month income review or
when a change in income or household size 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.
(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.
(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.
Sec. 5. [256B.0571] [LONG-TERM CARE PARTNERSHIP.]
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them.
Subd. 2. [HOME CARE SERVICE.] "Home care service" means
care described in section 144A.43.
Subd. 3. [LONG-TERM CARE INSURANCE.] "Long-term care
insurance" means a policy described in section 62S.01.
Subd. 4. [MEDICAL ASSISTANCE.] "Medical assistance" means
the program of medical assistance established under section
256B.01.
Subd. 5. [NURSING HOME.] "Nursing home" means a nursing
home as described in section 144A.01.
Subd. 6. [PARTNERSHIP POLICY.] "Partnership policy" means
a long-term care insurance policy that meets the requirements
under subdivision 10 or 11, regardless of when the policy was
first issued.
Subd. 7. [PARTNERSHIP PROGRAM.] "Partnership program"
means the Minnesota partnership for long-term care program
established under this section.
Subd. 8. [PROGRAM ESTABLISHED.] (a) The commissioner, in
cooperation with the commissioner of commerce, shall establish
the Minnesota partnership for long-term care program to provide
for the financing of long-term care through a combination of
private insurance and medical assistance.
(b) An individual who meets the requirements in this
paragraph is eligible to participate in the partnership
program. The individual must:
(1) be a Minnesota resident;
(2) purchase a partnership policy that is delivered, issued
for delivery, or renewed on or after the effective date of
this section, and
maintain the partnership policy in effect
throughout the period of participation in the partnership
program; and
(3) exhaust the minimum benefits under the partnership
policy as described in this section. Benefits received under a
long-term care insurance policy before the effective date of
this section do
not count toward the exhaustion of benefits
required in this subdivision.
Subd. 9. [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon
application of an individual who meets the requirements
described in subdivision 8, the commissioner shall determine the
individual's eligibility for medical assistance according to
paragraphs (b) and (c).
(b) After disregarding financial assets exempted under
medical assistance eligibility requirements, the commissioner
shall disregard an additional amount of financial assets equal
to the dollar amount of coverage utilized under the partnership
policy.
(c) The commissioner shall consider the individual's income
according to medical assistance eligibility requirements.
Subd. 10. [DOLLAR-FOR-DOLLAR ASSET PROTECTION
POLICIES.] (a) A dollar-for-dollar asset protection policy must
meet all of the requirements in paragraphs (b) to (e).
(b) The policy must satisfy the requirements of chapter 62S.
(c) The policy must offer an elimination period of not more
than 180 days for an adjusted premium.
(d) The policy must satisfy the requirements established by
the commissioner of human services under subdivision 14.
(e) Minimum daily benefits shall be $130 for nursing home
care or $65 for home care, with inflation protection provided in
the policy as described in section 62S.23, subdivision 1, clause
(1). These minimum daily benefit amounts shall be adjusted by
the commissioner on October 1 of each year by a percentage equal
to the inflation protection feature described in section 62S.23,
subdivision 1, clause (1), for purposes of setting minimum
requirements that a policy must meet in future years in order to
initially qualify as an approved policy under this subdivision.
Adjusted minimum daily benefit amounts shall be rounded to the
nearest whole dollar.
Subd. 11. [TOTAL ASSET PROTECTION POLICIES.] (a) A total
asset protection policy must meet all of the requirements in
subdivision 10, paragraphs (b) to (d), and this subdivision.
(b) Minimum coverage shall be for a period of not less than
three years and for a dollar amount equal to 36 months of
nursing home care at the minimum daily benefit rate determined
and adjusted under paragraph (c).
(c) Minimum daily benefits shall be $150 for nursing home
care or $75 for home care, with inflation protection provided in
the policy as described in section 62S.23, subdivision 1, clause
(1). These minimum daily benefit amounts shall also be adjusted
by the commissioner on October 1 of each year by a percentage
equal to the inflation protection feature described in section
62S.23, subdivision 1, clause (1), for purposes of setting
minimum requirements that a policy must meet in future years in
order to initially qualify as an approved policy under this
subdivision. Adjusted minimum daily benefit amounts shall be
rounded to the nearest whole dollar.
(d) The policy must cover all of the following services:
(1) nursing home stay;
(2) home care service; and
(3) care management.
Subd. 12. [COMPLIANCE WITH FEDERAL LAW.] An issuer of a
partnership policy must comply with any federal law authorizing
partnership policies in Minnesota, including any federal
regulations, as amended, adopted under that law. This paragraph
does not require compliance with any provision of this federal
law until the date upon which the law requires compliance with
the provision. The commissioner has authority to enforce this
paragraph.
Subd. 13. [LIMITATIONS ON ESTATE RECOVERY.] (a) For an
individual who exhausts the minimum benefits of a
dollar-for-dollar asset protection policy under subdivision 10,
and is determined eligible for medical assistance under
subdivision 9, the state shall limit recovery under the
provisions of section 256B.15 against the estate of the
individual or individual's spouse for medical assistance
benefits received by that individual to an amount that exceeds
the dollar amount of coverage utilized under the partnership
policy.
(b) For an individual who exhausts the minimum benefits of
a total asset protection policy under subdivision 11, and is
determined eligible for medical assistance under subdivision 9,
the state shall not seek recovery under the provisions of
section 256B.15 against the estate of the individual or
individual's spouse for medical assistance benefits received by
that individual.
Subd. 14. [IMPLEMENTATION.] (a) If federal law is amended
or a federal waiver is granted to permit implementation of this
section, the commissioner, in consultation with the commissioner
of commerce, may alter the requirements of subdivisions 10 and
11, and may establish additional requirements for approved
policies in order to conform with federal law or waiver
authority. In establishing these requirements, the commissioner
shall seek to maximize purchase of qualifying policies by
Minnesota residents while controlling medical assistance costs.
(b) The commissioner is authorized to suspend
implementation of this section until the next session of the
legislature if the commissioner, in consultation with the
commissioner of commerce, determines that the federal
legislation or federal waiver authorizing a partnership program
in Minnesota is likely to impose substantial unforeseen costs on
the state budget.
(c) The commissioner must take action under paragraph (a)
or (b) within 45 days of final federal action authorizing a
partnership policy in Minnesota.
(d) The commissioner must notify the appropriate
legislative committees of action taken under this subdivision
within 50 days of final federal action authorizing a partnership
policy in Minnesota.
(e) The commissioner must publish a notice in the State
Register of implementation decisions made under this subdivision
as soon as practicable.
[EFFECTIVE DATE.] (a) If any provision of this section is
prohibited by federal law, no provision shall become effective
until federal law is changed to permit its full implementation.
The commissioner of human services shall notify the revisor of
statutes when federal law is enacted 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 federal law is changed to permit a waiver of any
provisions prohibited by federal law, the commissioner of human
services shall apply to the federal government 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.
Sec. 6. Minnesota Statutes 2004, section 256B.0621,
subdivision 2, is amended to read:
Subd. 2. [TARGETED CASE MANAGEMENT; DEFINITIONS.] For
purposes of subdivisions 3 to 10, the following terms have the
meanings given them:
(1) "home care service recipients" means those individuals
receiving the following services under section 256B.0627:
skilled nursing visits, home health aide visits, private duty
nursing, personal care assistants, or therapies provided through
a home health agency;
(2) "home care targeted case management" means the
provision of targeted case management services for the purpose
of assisting home care service recipients to gain access to
needed services and supports so that they may remain in the
community;
(3) "institutions" means hospitals, consistent with Code of
Federal Regulations, title 42, section 440.10; regional
treatment center inpatient services, consistent with section
245.474; nursing facilities; and intermediate care facilities
for persons with mental retardation;
(4) "relocation targeted case management" means includes
the provision of both county targeted case management and public
or private vendor service coordination services for the purpose
of assisting recipients to gain access to needed services and
supports if they choose to move from an institution to the
community. Relocation targeted case management may be provided
during the last 180 consecutive days of an eligible recipient's
institutional stay; and
(5) "targeted case management" means case management
services provided to help recipients gain access to needed
medical, social, educational, and other services and supports.
Sec. 7. Minnesota Statutes 2004, section 256B.0621,
subdivision 3, is amended to read:
Subd. 3. [ELIGIBILITY.] The following persons are eligible
for relocation targeted case management or home care-targeted
care targeted case management:
(1) medical assistance eligible persons residing in
institutions who choose to move into the community are eligible
for relocation targeted case management services; and
(2) medical assistance eligible persons receiving home care
services, who are not eligible for any other medical assistance
reimbursable case management service, are eligible for home
care-targeted care targeted case management services beginning
January 1, 2003 July 1, 2005.
Sec. 8. Minnesota Statutes 2004, section 256B.0621,
subdivision 4, is amended to read:
Subd. 4. [RELOCATION TARGETED COUNTY CASE MANAGEMENT
PROVIDER QUALIFICATIONS.] (a) A relocation targeted county 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 county 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. Counties must require that contracted
providers must provide information on all conflicts of interest
and obtain the recipient's informed consent or provide the
recipient with alternatives.
Sec. 9. Minnesota Statutes 2004, section 256B.0621,
subdivision 5, is amended to read:
Subd. 5. [HOME CARE TARGETED CASE MANAGEMENT AND
RELOCATION SERVICE COORDINATION PROVIDER QUALIFICATIONS.] The
following qualifications and certification standards must be met
by Providers of home care targeted case management and
relocation service coordination must meet the qualifications
under subdivision 4 for county vendors or the qualifications and
certification standards under paragraphs (a) and (b) for private
vendors.
(a) The commissioner must certify each provider of home
care targeted case management and relocation service
coordination before enrollment. The certification process shall
examine the provider's ability to meet the requirements in this
subdivision and other state and federal requirements of this
service.
(b) A Both home care targeted case management provider is
an providers and relocation service coordination providers are
enrolled medical assistance provider providers who has have a
minimum of a bachelor's degree or a license in a health or human
services field, comparable training and two years of experience
in human services, or who have been credentialed by an American
Indian tribe under section 256B.02, subdivision 7, and is have
been determined by the commissioner to have all of the following
characteristics:
(1) the demonstrated capacity and experience to provide the
components of case management to coordinate and link community
resources needed by the eligible population;
(2) 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;
(3) a financial management system that provides accurate
documentation of services and costs under state and federal
requirements;
(4) the capacity to document and maintain individual case
records under state and federal requirements; and
(5) the capacity to coordinate with county administrative
functions;
(6) have no financial interest in the provision of
out-of-home residential services to persons for whom home care
targeted case management or relocation service coordination is
provided; and
(7) if a provider has a financial interest in services
other than out-of-home residential services provided to persons
for whom home care targeted case management or relocation
service coordination is also provided, the county must determine
each year that:
(i) any possible conflict of interest is explained annually
at a face-to-face meeting and in writing and the person provides
written informed consent consistent with section 256B.77,
subdivision 2, paragraph (p); and
(ii) information on a range of other feasible service
provider options has been provided.
(c) The state of Minnesota, a county board, or agency
acting on behalf of a county board shall not be liable for
damages, injuries, or liabilities sustained because of services
provided to a client by a private service coordination vendor.
Sec. 10. Minnesota Statutes 2004, section 256B.0621,
subdivision 6, is amended to read:
Subd. 6. [ELIGIBLE SERVICES.] (a) Services eligible for
medical assistance reimbursement as targeted case management
include:
(1) assessment of the recipient's need for targeted case
management services and for persons choosing to relocate, the
county must provide service coordination provider options at the
first contact and upon request;
(2) development, completion, and regular review of a
written individual service plan, which is based upon the
assessment of the recipient's needs and choices, and which will
ensure access to medical, social, educational, and other related
services and supports;
(3) routine contact or communication with the recipient,
recipient's family, primary caregiver, legal representative,
substitute care provider, service providers, or other relevant
persons identified as necessary to the development or
implementation of the goals of the individual service plan;
(4) coordinating referrals for, and the provision of, case
management services for the recipient with appropriate service
providers, consistent with section 1902(a)(23) of the Social
Security Act;
(5) coordinating and monitoring the overall service
delivery and engaging in advocacy as needed to ensure quality of
services, appropriateness, and continued need;
(6) completing and maintaining necessary documentation that
supports and verifies the activities in this subdivision;
(7) traveling assisting individuals in order to access
needed services, including travel to conduct a visit with the
recipient or other relevant person necessary to develop or
implement the goals of the individual service plan; and
(8) coordinating with the institution discharge planner in
the 180-day period before the recipient's discharge.
(b) Relocation targeted county case management includes
services under paragraph (a), clauses (1), (2), and (4).
Relocation service coordination includes services under
paragraph (a), clauses (3) and (5) to (8). Home care targeted
case management includes services under paragraph (a), clauses
(1) to (8).
Sec. 11. Minnesota Statutes 2004, 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:
(a) For relocation targeted case management, an eligible
recipient must be assigned a county 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 obtain targeted relocation case
management services relocation service coordination from an
alternative a provider of targeted case management services
enrolled by the commissioner qualified under subdivision 5.
(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.
Sec. 12. Minnesota Statutes 2004, section 256B.0621, is
amended by adding a subdivision to read:
Subd. 11. [DATA USE AGREEMENT AND NOTICE OF RELOCATION
TARGETED CASE MANAGEMENT AVAILABILITY.] The commissioner shall
execute a data use agreement with the Centers for Medicare and
Medicaid Services to obtain the long-term care minimum data set
data to assist residents of nursing facilities who have
indicated a desire to live in the community. The commissioner
shall in turn enter into agreements with the Centers for
Independent Living to provide information about assistance for
persons who want to move to the community. The commissioner
shall work with the Centers for Independent Living on both the
content of the information to be provided and privacy
protections for the individual residents.
Sec. 13. Minnesota Statutes 2004, section 256B.0625,
subdivision 2, is amended to read:
Subd. 2. [SKILLED AND INTERMEDIATE NURSING CARE.] Medical
assistance covers skilled nursing home services and services of
intermediate care facilities, including training and
habilitation services, as defined in section 252.41, subdivision
3, for persons with mental retardation or related conditions who
are residing in intermediate care facilities for persons with
mental retardation or related conditions. Medical assistance
must not be used to pay the costs of nursing care provided to a
patient in a swing bed as defined in section 144.562, unless (a)
the facility in which the swing bed is located is eligible as a
sole community provider, as defined in Code of Federal
Regulations, title 42, section 412.92, or the facility is a
public hospital owned by a governmental entity with 15 or fewer
licensed acute care beds; (b) the Centers for Medicare and
Medicaid Services approves the necessary state plan amendments;
(c) the patient was screened as provided by law; (d) the patient
no longer requires acute care services; and (e) no nursing home
beds are available within 25 miles of the facility. The
commissioner shall exempt a facility from compliance with the
sole community provider requirement in clause (a) if, as of
January 1, 2004, the facility had an agreement with the
commissioner to provide medical assistance swing bed services.
Medical assistance also covers up to ten days of nursing care
provided to a patient in a swing bed if: (1) the patient's
physician certifies that the patient has a terminal illness or
condition that is likely to result in death within 30 days and
that moving the patient would not be in the best interests of
the patient and patient's family; (2) no open nursing home beds
are available within 25 miles of the facility; and (3) no open
beds are available in any Medicare hospice program within 50
miles of the facility. The daily medical assistance payment for
nursing care for the patient in the swing bed is the statewide
average medical assistance skilled nursing care per diem as
computed annually by the commissioner on July 1 of each year.
[EFFECTIVE DATE.] This section is effective the day
following final enactment and applies to medical assistance
payments for swing bed services provided on or after July 1,
2005.
Sec. 14. Minnesota Statutes 2004, 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
have a statement of need by a physician, provided in accordance
with a plan of treatment, and are supervised by the recipient or
a qualified professional. The physician's statement of need for
personal care assistant services shall be documented on a form
approved by the commissioner and include the diagnosis or
condition of the person that results in a need for personal care
assistant services and be updated when the person's medical
condition requires a change, but at least annually if the need
for personal care assistant services is ongoing.
"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. 15. Minnesota Statutes 2004, section 256B.0627,
subdivision 1, as amended by Laws 2005, chapter 10, article 1,
section 49, 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 assistant.
(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) maintains daily written records detailing:
(i) the actual services provided to the recipient; and
(ii) the amount of time spent providing the services; and
(7) is subject to criminal background checks and procedures
specified in chapter 245C.
(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 chapter 245C. 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 chapter 245C, or a comparable crime in
another jurisdiction, unless the owner or managerial official
meets the reconsideration criteria specified in chapter 245C;
(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;
(3) the organization must maintain documentation and a
recipient file and satisfy communication requirements in
subdivision 4, paragraph (f); and
(4) the organization must comply with all laws and rules
governing the provision of personal care assistant services.
(k) "Responsible party" means an individual who is capable
of providing the 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 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 who is not the
personal care assistant 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. The delegated responsible party is not
required to reside with the recipient while serving as the
responsible party if competent supervision to ensure the health
and safety of the recipient and monitoring of services provided
are stated as part of the person's individual service plan under
a home care service or home and community-based waiver program
or in conjunction with a home care targeted case management
service provider or other case manager. 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. 16. Minnesota Statutes 2004, 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 provided without
a physician's statement of need as required by section
256B.0625, subdivision 19c, and included in the personal care
provider agency's file for the recipient;
(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) homemaker services that are not an integral part of a
personal care assistant services;
(11) home maintenance or chore services;
(12) services not specified under paragraph (a); and
(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.
(f) In order to be paid for personal care assistant
services, personal care provider organizations, and personal
care assistant choice providers are required:
(1) to maintain a recipient file for each recipient for
whom services are being billed that contains:
(i) the current physician's statement of need as required
by section 256B.0625, subdivision 19c;
(ii) the service plan, including the monthly authorized
hours, or flexible use plan;
(iii) the care plan, signed by the recipient and the
qualified professional, if required or designated, detailing the
personal care assistant services to be provided;
(iv) documentation, on a form approved by the commissioner
and signed by the personal care assistant, specifying the day,
month, year, arrival, and departure times, with AM and PM
notation, for all services provided to the recipient. The form
must include a notice that it is a federal crime to provide
false information on personal care service billings for medical
assistance payment; and
(v) all notices to the recipient regarding personal care
service use exceeding authorized hours; and
(2) to communicate, by telephone if available, and in
writing, with the recipient or the responsible party about the
schedule for use of authorized hours and to notify the recipient
and the county public health nurse in advance and as soon as
possible, on a form approved by the commissioner, if the monthly
number of hours authorized is likely to be exceeded for the
month.
(g) The commissioner shall establish an ongoing audit
process for potential fraud and abuse for personal care
assistant services. The audit process must include, at a
minimum, a requirement that the documentation of hours of care
provided be on a form approved by the commissioner and include
the personal care assistant's signature attesting that the hours
shown on each bill were provided by the personal care assistant
on the dates and the times specified.
Sec. 17. Minnesota Statutes 2004, section 256B.0627,
subdivision 5, as amended by Laws 2005, chapter 10, article 1,
section 50, is amended to read:
Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance
payments for home care services shall be limited according to
this subdivision.
(a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
recipient may receive the following home care services during a
calendar year:
(1) up to two face-to-face assessments to determine a
recipient's need for personal care assistant services;
(2) one service update done to determine a recipient's need
for personal care assistant services; and
(3) up to nine skilled nurse visits.
(b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
services above the limits in paragraph (a) must receive the
commissioner's prior authorization, except when:
(1) the home care services were required to treat an
emergency medical condition that if not immediately treated
could cause a recipient serious physical or mental disability,
continuation of severe pain, or death. The provider must
request retroactive authorization no later than five working
days after giving the initial service. The provider must be
able to substantiate the emergency by documentation such as
reports, notes, and admission or discharge histories;
(2) the home care services were provided on or after the
date on which the recipient's eligibility began, but before the
date on which the recipient was notified that the case was
opened. Authorization will be considered if the request is
submitted by the provider within 20 working days of the date the
recipient was notified that the case was opened;
(3) a third-party payor for home care services has denied
or adjusted a payment. Authorization requests must be submitted
by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the
request;
(4) the commissioner has determined that a county or state
human services agency has made an error; or
(5) the professional nurse determines an immediate need for
up to 40 skilled nursing or home health aide visits per calendar
year and submits a request for authorization within 20 working
days of the initial service date, and medical assistance is
determined to be the appropriate payer.
(c) [RETROACTIVE AUTHORIZATION.] A request for retroactive
authorization will be evaluated according to the same criteria
applied to prior authorization requests.
(d) [ASSESSMENT AND SERVICE PLAN.] Assessments under
section 256B.0627, subdivision 1, paragraph (b), shall be
conducted initially, and at least annually thereafter, in person
with the recipient and result in a completed service plan using
forms specified by the commissioner. Within 30 days of
recipient or responsible party request for home care services,
the assessment, the service plan, and other information
necessary to determine medical necessity such as diagnostic or
testing information, social or medical histories, and hospital
or facility discharge summaries shall be submitted to the
commissioner. Notwithstanding the provisions of section
256B.0627, subdivision 12, the commissioner shall maximize
federal financial participation to pay for public health nurse
assessments for personal care services. For personal care
assistant services:
(1) The amount and type of service authorized based upon
the assessment and service plan will follow the recipient if the
recipient chooses to change providers.
(2) If the recipient's medical need changes, the
recipient's provider may assess the need for a change in service
authorization and request the change from the county public
health nurse. Within 30 days of the request, the public health
nurse will determine whether to request the change in services
based upon the provider assessment, or conduct a home visit to
assess the need and determine whether the change is
appropriate. If the change in service need is due to a change
in medical condition, a new physician's statement of need
required by section 256B.0625, subdivision 19c, must be obtained.
(3) To continue to receive personal care assistant services
after the first year, the recipient or the responsible party, in
conjunction with the public health nurse, may complete a service
update on forms developed by the commissioner according to
criteria and procedures in subdivision 1.
(e) [PRIOR AUTHORIZATION.] The commissioner, or the
commissioner's designee, shall review the assessment, service
update, request for temporary services, request for flexible use
option, service plan, and any additional information that is
submitted. The commissioner shall, within 30 days after
receiving a complete request, assessment, and service plan,
authorize home care services as follows:
(1) [HOME HEALTH SERVICES.] All home health services
provided by a home health aide must be prior authorized by the
commissioner or the commissioner's designee. Prior
authorization must be based on medical necessity and
cost-effectiveness when compared with other care options. When
home health services are used in combination with personal care
and private duty nursing, the cost of all home care services
shall be considered for cost-effectiveness. The commissioner
shall limit home health aide visits to no more than one visit
each per day. The commissioner, or the commissioner's designee,
may authorize up to two skilled nurse visits per day.
(2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal
care assistant services and supervision by a qualified
professional, if requested by the recipient, must be prior
authorized by the commissioner or the commissioner's designee
except for the assessments established in paragraph (a). The
amount of personal care assistant services authorized must be
based on the recipient's home care rating. A child may not be
found to be dependent in an activity of daily living if because
of the child's age an adult would either perform the activity
for the child or assist the child with the activity and the
amount of assistance needed is similar to the assistance
appropriate for a typical child of the same age. Based on
medical necessity, the commissioner may authorize:
(A) up to two times the average number of direct care hours
provided in nursing facilities for the recipient's comparable
case mix level; or
(B) up to three times the average number of direct care
hours provided in nursing facilities for recipients who have
complex medical needs or are dependent in at least seven
activities of daily living and need physical assistance with
eating or have a neurological diagnosis; or
(C) up to 60 percent of the average reimbursement rate, as
of July 1, 1991, for care provided in a regional treatment
center for recipients who have Level I behavior, plus any
inflation adjustment as provided by the legislature for personal
care service; or
(D) up to the amount the commissioner would pay, as of July
1, 1991, plus any inflation adjustment provided for home care
services, for care provided in a regional treatment center for
recipients referred to the commissioner by a regional treatment
center preadmission evaluation team. For purposes of this
clause, home care services means all services provided in the
home or community that would be included in the payment to a
regional treatment center; or
(E) up to the amount medical assistance would reimburse for
facility care for recipients referred to the commissioner by a
preadmission screening team established under section 256B.0911
or 256B.092; and
(F) a reasonable amount of time for the provision of
supervision by a qualified professional of personal care
assistant services, if a qualified professional is requested by
the recipient or responsible party.
(ii) The number of direct care hours shall be determined
according to the annual cost report submitted to the department
by nursing facilities. The average number of direct care hours,
as established by May 1, 1992, shall be calculated and
incorporated into the home care limits on July 1, 1992. These
limits shall be calculated to the nearest quarter hour.
(iii) The home care rating shall be determined by the
commissioner or the commissioner's designee based on information
submitted to the commissioner by the county public health nurse
on forms specified by the commissioner. The home care rating
shall be a combination of current assessment tools developed
under sections 256B.0911 and 256B.501 with an addition for
seizure activity that will assess the frequency and severity of
seizure activity and with adjustments, additions, and
clarifications that are necessary to reflect the needs and
conditions of recipients who need home care including children
and adults under 65 years of age. The commissioner shall
establish these forms and protocols under this section and shall
use an advisory group, including representatives of recipients,
providers, and counties, for consultation in establishing and
revising the forms and protocols.
(iv) A recipient shall qualify as having complex medical
needs if the care required is difficult to perform and because
of recipient's medical condition requires more time than
community-based standards allow or requires more skill than
would ordinarily be required and the recipient needs or has one
or more of the following:
(A) daily tube feedings;
(B) daily parenteral therapy;
(C) wound or decubiti care;
(D) postural drainage, percussion, nebulizer treatments,
suctioning, tracheotomy care, oxygen, mechanical ventilation;
(E) catheterization;
(F) ostomy care;
(G) quadriplegia; or
(H) other comparable medical conditions or treatments the
commissioner determines would otherwise require institutional
care.
(v) A recipient shall qualify as having Level I behavior if
there is reasonable supporting evidence that the recipient
exhibits, or that without supervision, observation, or
redirection would exhibit, one or more of the following
behaviors that cause, or have the potential to cause:
(A) injury to the recipient's own body;
(B) physical injury to other people; or
(C) destruction of property.
(vi) Time authorized for personal care relating to Level I
behavior in subclause (v), items (A) to (C), shall be based on
the predictability, frequency, and amount of intervention
required.
(vii) A recipient shall qualify as having Level II behavior
if the recipient exhibits on a daily basis one or more of the
following behaviors that interfere with the completion of
personal care assistant services under subdivision 4, paragraph
(a):
(A) unusual or repetitive habits;
(B) withdrawn behavior; or
(C) offensive behavior.
(viii) A recipient with a home care rating of Level II
behavior in subclause (vii), items (A) to (C), shall be rated as
comparable to a recipient with complex medical needs under
subclause (iv). If a recipient has both complex medical needs
and Level II behavior, the home care rating shall be the next
complex category up to the maximum rating under subclause (i),
item (B).
(3) [PRIVATE DUTY NURSING SERVICES.] All private duty
nursing services shall be prior authorized by the commissioner
or the commissioner's designee. Prior authorization for private
duty nursing services shall be based on medical necessity and
cost-effectiveness when compared with alternative care options.
The commissioner may authorize medically necessary private duty
nursing services in quarter-hour units when:
(i) the recipient requires more individual and continuous
care than can be provided during a nurse visit; or
(ii) the cares are outside of the scope of services that
can be provided by a home health aide or personal care assistant.
The commissioner may authorize:
(A) up to two times the average amount of direct care hours
provided in nursing facilities statewide for case mix
classification "K" as established by the annual cost report
submitted to the department by nursing facilities in May 1992;
(B) private duty nursing in combination with other home
care services up to the total cost allowed under clause (2);
(C) up to 16 hours per day if the recipient requires more
nursing than the maximum number of direct care hours as
established in item (A) and the recipient meets the hospital
admission criteria established under Minnesota Rules, parts
9505.0501 to 9505.0540.
The commissioner may authorize up to 16 hours per day of
medically necessary private duty nursing services or up to 24
hours per day of medically necessary private duty nursing
services until such time as the commissioner is able to make a
determination of eligibility for recipients who are
cooperatively applying for home care services under the
community alternative care program developed under section
256B.49, or until it is determined by the appropriate regulatory
agency that a health benefit plan is or is not required to pay
for appropriate medically necessary health care services.
Recipients or their representatives must cooperatively assist
the commissioner in obtaining this determination. Recipients
who are eligible for the community alternative care program may
not receive more hours of nursing under this section than would
otherwise be authorized under section 256B.49.
(4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is
ventilator-dependent, the monthly medical assistance
authorization for home care services shall not exceed what the
commissioner would pay for care at the highest cost hospital
designated as a long-term hospital under the Medicare program.
For purposes of this clause, home care services means all
services provided in the home that would be included in the
payment for care at the long-term hospital.
"Ventilator-dependent" means an individual who receives
mechanical ventilation for life support at least six hours per
day and is expected to be or has been dependent for at least 30
consecutive days.
(f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
or the commissioner's designee shall determine the time period
for which a prior authorization shall be effective and, if
flexible use has been requested, whether to allow the flexible
use option. If the recipient continues to require home care
services beyond the duration of the prior authorization, the
home care provider must request a new prior authorization.
Under no circumstances, other than the exceptions in paragraph
(b), shall a prior authorization be valid prior to the date the
commissioner receives the request or for more than 12 months. A
recipient who appeals a reduction in previously authorized home
care services may continue previously authorized services, other
than temporary services under paragraph (h), pending an appeal
under section 256.045. The commissioner must provide a detailed
explanation of why the authorized services are reduced in amount
from those requested by the home care provider.
(g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or
the commissioner's designee shall determine the medical
necessity of home care services, the level of caregiver
according to subdivision 2, and the institutional comparison
according to this subdivision, the cost-effectiveness of
services, and the amount, scope, and duration of home care
services reimbursable by medical assistance, based on the
assessment, primary payer coverage determination information as
required, the service plan, the recipient's age, the cost of
services, the recipient's medical condition, and diagnosis or
disability. The commissioner may publish additional criteria
for determining medical necessity according to section 256B.04.
(h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
The agency nurse, the independently enrolled private duty nurse,
or county public health nurse may request a temporary
authorization for home care services by telephone. The
commissioner may approve a temporary level of home care services
based on the assessment, and service or care plan information,
and primary payer coverage determination information as required.
Authorization for a temporary level of home care services
including nurse supervision is limited to the time specified by
the commissioner, but shall not exceed 45 days, unless extended
because the county public health nurse has not completed the
required assessment and service plan, or the commissioner's
determination has not been made. The level of services
authorized under this provision shall have no bearing on a
future prior authorization.
(i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.]
Home care services provided in an adult or child foster care
setting must receive prior authorization by the department
according to the limits established in paragraph (a).
The commissioner may not authorize:
(1) home care services that are the responsibility of the
foster care provider under the terms of the foster care
placement agreement and administrative rules;
(2) personal care assistant services when the foster care
license holder is also the personal care provider or personal
care assistant unless the recipient can direct the recipient's
own care, or case management is provided as required in section
256B.0625, subdivision 19a;
(3) personal care assistant services when the responsible
party is an employee of, or under contract with, or has any
direct or indirect financial relationship with the personal care
provider or personal care assistant, unless case management is
provided as required in section 256B.0625, subdivision 19a; or
(4) personal care assistant and private duty nursing
services when the number of foster care residents is greater
than four unless the county responsible for the recipient's
foster placement made the placement prior to April 1, 1992,
requests that personal care assistant and private duty nursing
services be provided, and case management is provided as
required in section 256B.0625, subdivision 19a.
Sec. 18. Minnesota Statutes 2004, section 256B.0627,
subdivision 9, is amended to read:
Subd. 9. [OPTION FOR FLEXIBLE USE OF PERSONAL CARE
ASSISTANT HOURS.] (a) "Flexible use option" means the scheduled
use of authorized hours of personal care assistant services,
which vary within the length of the a service authorization
period covering no more than six months, in order to more
effectively meet the needs and schedule of the
recipient. Authorized hours not used within the six-month
period may not be carried over to another time period. The
flexible use of personal care assistant hours for a six-month
period must be prior authorized by the commissioner, based on a
request submitted on a form approved by the commissioner. The
request must include the assessment and the annual service plan
prepared by the county public health nurse.
(b) The recipient or responsible party, together with the
case manager, if the recipient has case management services, and
the county public health nurse, shall determine whether flexible
use is an appropriate option based on the needs, abilities,
preferences, and history of service use of the recipient or
responsible party, and if appropriate, must ensure that the
allocation of hours covers the ongoing needs of the recipient
over an entire year divided into two six-month periods of
flexible use. A recipient who has terminated personal care
assistant services before the end of the 12-month authorization
period shall not receive additional hours upon reapplying during
the same 12-month authorization period, except if a change in
condition is documented. Services shall be prorated for the
remainder of the 12-month authorization period based on earlier
assessment.
(c) If prior authorized, 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) (d) The personal care provider organization and the
recipient or responsible party, together with the provider, or
the personal care assistant choice 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. 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 develop a written month-to-month plan of
the projected use of personal care assistant services that is
part of the care plan and ensures:
(1) that the health and safety needs of the recipient will
be met;
(2) that the total annual authorization will not be used
before the end of the authorization period; and
(3) monthly monitoring will be conducted of hours used as a
percentage of the authorized amount.
(e) The provider shall notify the recipient or responsible
party, any case manager for the recipient, and the county public
health nurse in advance and as soon as possible, on a form
approved by the commissioner, if the monthly amount of hours
authorized is likely to be exceeded for the month.
(f) The commissioner shall provide written notice to the
provider, the recipient or responsible party, any case manager
for the recipient, and the county public health nurse, when a
flexible use recipient exceeds the personal care assistant
service authorization for the month by an amount determined by
the commissioner. If the use of hours exceeds the monthly
service authorization by the amount determined by the
commissioner for two months during any three-month period, the
commissioner shall notify the recipient and the county public
health nurse that the flexible use authorization will be revoked
beginning the following month. The revocation will not become
effective if, within ten working days of the commissioner's
notice of flexible use revocation, the county public health
nurse requests prior authorization for an increase in the
service authorization or continuation of the flexible use
option, or the recipient appeals and assistance pending appeal
is ordered. The commissioner shall determine whether to approve
the increase and continued flexible use.
(g) The recipient or responsible party may stop the
flexible use of hours by notifying the personal care provider
organization or the personal care assistance choice provider and
county public health nurse in writing.
(h) The recipient or responsible party may appeal the
commissioner's action according to section 256.045. The denial
or revocation of the flexible use option shall not affect the
recipient's authorized level of personal care assistant services
as determined under subdivision 5.
Sec. 19. Minnesota Statutes 2004, section 256B.0627, is
amended by adding a subdivision to read:
Subd. 18. [OVERSIGHT OF ENROLLED PERSONAL CARE ASSISTANT
SERVICES PROVIDERS.] The commissioner may request from providers
documentation of compliance with laws, rules, and policies
governing the provision of personal care assistant services. A
personal care assistant service provider must provide the
requested documentation to the commissioner within ten business
days of the request. Failure to provide information to
demonstrate substantial compliance with laws, rules, or policies
may result in suspension, denial, or termination of the provider
agreement.
Sec. 20. Minnesota Statutes 2004, 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 would
be eligible for medical assistance within 180 135 days of
admission to a nursing facility and subject to subdivisions 4 to
13.
Sec. 21. Minnesota Statutes 2004, 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 180 135 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;
(6) the monthly cost of the alternative care services
funded by the program for this person does not exceed 75 percent
of the 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, alternative care funds may not
be used to pay for any service the cost of which: (i) is
payable by medical assistance; (ii) is used by a recipient to
meet a 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 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. 22. Minnesota Statutes 2004, section 256B.0913,
subdivision 5, is amended to read:
Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.]
Alternative care funding may be used for payment of costs of:
(1) adult foster care;
(2) adult day care;
(3) (2) home health aide;
(4) (3) homemaker services;
(5) (4) personal care;
(6) (5) case management;
(7) (6) respite care;
(8) assisted living;
(9) residential care services;
(10) (7) care-related supplies and equipment;
(11) (8) meals delivered to the home;
(12) (9) transportation;
(13) (10) nursing services;
(14) (11) chore services;
(15) (12) companion services;
(16) (13) nutrition services;
(17) (14) training for direct informal caregivers;
(18) (15) telehome care to provide services in their own
homes in conjunction with in-home visits;
(19) (16) discretionary 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;
(20) (17) environmental modifications; and
(21) (18) 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.
Sec. 23. Minnesota Statutes 2004, section 256B.0913,
subdivision 5a, is amended to read:
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, assisted living
services, adult foster care services, and residential care
services.
(b) The county agency must ensure that the funds are not
used to supplant services available through other public
assistance or services programs. 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.
Sec. 24. Minnesota Statutes 2004, section 256B.095, is
amended to read:
256B.095 [QUALITY ASSURANCE SYSTEM ESTABLISHED.]
(a) Effective July 1, 1998, a quality assurance system for
persons with developmental disabilities, which includes an
alternative quality assurance licensing system for programs, 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 or may continue
regulation of these programs under the licensing system operated
by the commissioner. The project expires on June 30, 2007 2009.
(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 retroactively
from July 1, 2005.
Sec. 25. Minnesota Statutes 2004, section 256B.0951,
subdivision 1, is amended to read:
Subdivision 1. [MEMBERSHIP.] The 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. 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, 2007 2009.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 26. Minnesota Statutes 2004, section 256B.0952,
subdivision 5, is amended to read:
Subd. 5. [QUALITY ASSURANCE TEAMS.] Quality assurance
teams shall be comprised of county staff; providers; consumers,
families, and their legal representatives; members of advocacy
organizations; and other involved community members. Team
members must satisfactorily complete the training program
approved by the commission and must demonstrate
performance-based competency. Team members are not considered
to be county employees for purposes of workers' compensation,
unemployment insurance, or state retirement laws solely on the
basis of participation on a quality assurance team. The county
may pay a per diem to team members who do not receive a salary
or wages from an employer for time spent on alternative quality
assurance process matters. All team members may be reimbursed
for expenses related to their participation in the alternative
process.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 27. Minnesota Statutes 2004, section 256B.0953,
subdivision 1, is amended to read:
Subdivision 1. [PROCESS COMPONENTS.] (a) The quality
assurance licensing process consists of an evaluation by a
quality assurance team of the facility, program, or service
according to outcome-based measurements. The process must
include an evaluation of a random sample of program consumers.
The sample must be representative of each service provided. The
sample size must be at least five percent of consumers but not
less than three two consumers.
(b) All consumers must be given the opportunity to be
included in the quality assurance process in addition to those
chosen for the random sample.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 28. Minnesota Statutes 2004, 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
and alternative care for nonmedical assistance recipients under
section 256B.0913.
(c) All provisions in this subdivision, and subdivisions
1d, 1f, 1g, 1h, 1i, and 1j, related to the continuation of a
recipient's life estate or joint tenancy interests in real
property after the recipient's death for the purpose of
recovering medical assistance, are effective only for life
estates and joint tenancy interests established on or after
August 1, 2003. For purposes of this paragraph, medical
assistance does not include alternative care.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 29. Minnesota Statutes 2004, 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 payable first from 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, 2005,
and applies to persons dying on and after that date and to
probates commenced on and after that date.
Sec. 30. Minnesota Statutes 2004, section 256B.15, is
amended by adding a subdivision to read:
Subd. 6. [ESTABLISHMENT OF LIFE ESTATE OR JOINT TENANCY
INTEREST.] For purposes of subdivision 1 and section 514.981,
subdivision 6, a life estate or joint tenancy interest is
established upon the earlier of:
(1) the date the instrument creating the interest is
recorded or filed in the office of the county recorder or
registrar of titles where the real estate interest it describes
is located;
(2) the date of delivery by the grantor to the grantee of
the signed instrument as stated in an affidavit made by a person
with knowledge of the facts;
(3) the date on which the judicial order creating the
interest was issued by the court; or
(4) the date upon which the interest devolves under section
524.3-101.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 31. Minnesota Statutes 2004, section 256B.15, is
amended by adding a subdivision to read:
Subd. 7. [LIEN NOTICES.] Medical assistance liens and
liens under notices of potential claims that are of record
against life estate or joint tenancy interests established prior
to August 1, 2003, shall end, become unenforceable, and cease to
be liens on those interests upon the death of the person named
in the lien or notice of potential claim, shall be disregarded
by examiners of title after the death of the life tenant or
joint tenant, and shall not be carried forward to a subsequent
certificate of title. This subdivision shall not apply to life
estates that continue to exist after the death of the person
named in the lien or notice of potential claim under the terms
of the instrument creating or reserving the life estate until
the life estate ends as provided for in the instrument.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 32. Minnesota Statutes 2004, section 256B.15, is
amended by adding a subdivision to read:
Subd. 8. [IMMUNITY.] The commissioner of human services,
county agencies, and elected officials and their employees are
immune from all liability for any action taken implementing Laws
2003, First Special Session chapter 14, article 12, sections 40
to 52 and 90, as those laws existed at the time the action was
taken, and section 514.981, subdivision 6.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 33. Minnesota Statutes 2004, section 256B.431, is
amended by adding a subdivision to read:
Subd. 41. [NURSING FACILITY RATE INCREASES FOR OCTOBER 1,
2005, AND OCTOBER 1, 2006.] (a) For the rate period beginning
October 1, 2005, the commissioner shall make available to each
nursing facility reimbursed under this section or section
256B.434 an adjustment equal to 2.2553 percent of the total
operating payment rate, and for the rate year beginning October
1, 2006, the commissioner shall make available to each nursing
facility reimbursed under this section or section 256B.434 an
adjustment equal to 1.2553 percent of the total operating
payment rate.
(b) 75 percent of the money resulting from the rate
adjustment under paragraph (a) must be used to increase wages
and benefits and pay associated costs for all employees, except
management fees, the administrator, and central office staff.
Except as provided in paragraph (c), 75 percent of the money
received by a facility as a result of the rate adjustment
provided in paragraph (a) must be used only for wage, benefit,
and staff increases implemented on or after the effective date
of the rate increase each year, and must not be used for
increases implemented prior to that date.
(c) With respect only to the October 1, 2005, rate
increase, a nursing facility that incurred costs for salary and
employee benefit increases first provided after July 1, 2003,
may count those costs towards the amount required to be spent on
salaries and benefits under paragraph (b). These costs must be
reported to the commissioner in the form and manner specified by
the commissioner.
(d) Nursing facilities may apply for the portion of the
rate adjustment under paragraph (a) for employee wages and
benefits and associated costs. The application must be made to
the commissioner and contain a plan by which the nursing
facility will distribute the funds according to paragraph (b).
For nursing facilities in which the employees are represented by
an exclusive bargaining representative, an agreement negotiated
and agreed to by the employer and the exclusive bargaining
representative constitutes the plan. A negotiated agreement may
constitute the plan only if the agreement is finalized after the
date of enactment of all increases for the rate year and signed
by both parties prior to submission to the commissioner. The
commissioner shall review the plan to ensure that the rate
adjustments are used as provided in paragraph (b). To be
eligible, a facility must submit its distribution plan by March
31, 2006, and March 31, 2007, respectively. The commissioner
may approve distribution plans on or before June 30, 2006, and
June 30, 2007, respectively. If a facility's distribution plan
is effective after the first day of the applicable rate period
that the funds are available, the rate adjustments are effective
the same date as the facility's plan.
(e) A copy of the approved distribution plan must be made
available to all employees by giving each employee a copy or by
posting a copy in an area of the nursing facility to which all
employees have access. If an employee does not receive the wage
and benefit adjustment described in the facility's approved plan
and is unable to resolve the problem with the facility's
management or through the employee's union representative, the
employee may contact the commissioner at an address or telephone
number provided by the commissioner and included in the approved
plan.
Sec. 34. Minnesota Statutes 2004, section 256B.431, is
amended by adding a subdivision to read:
Subd. 42. [INCENTIVE TO ESTABLISH SINGLE-BED ROOMS.] (a)
Beginning July 1, 2005, the operating payment rate for nursing
facilities reimbursed under this section, section 256B.434, or
256B.441 shall be increased by 20 percent multiplied by the
ratio of the number of new single-bed rooms created divided by
the number of active beds on July 1, 2005, for each bed closure
that results in the creation of a single-bed room after July 1,
2005. The commissioner may implement rate adjustments for up to
3,000 new single-bed rooms each year. For eligible bed closures
for which the commissioner receives a notice from a facility
during a calendar quarter that a bed has been delicensed and a
new single-bed room has been established, the rate adjustment in
this paragraph shall be effective on the first day of the second
month following that calendar quarter.
(b) A nursing facility is prohibited from discharging
residents for purposes of establishing single-bed rooms. A
nursing facility must submit documentation to the commissioner
in a form prescribed by the commissioner, certifying the
occupancy status of beds closed to create single-bed rooms. In
the event that the commissioner determines that a facility has
discharged a resident for purposes of establishing a single-bed
room, the commissioner shall not provide a rate adjustment under
paragraph (a).
(c) If after the date of enactment of this section and
before December 31, 2007, more than 4,000 nursing home beds are
removed from service, a portion of the appropriation for nursing
homes shall be transferred to the alternative care program. The
amount of this transfer shall equal the number of beds removed
from service less 4,000, multiplied by the average monthly
per-person cost for alternative care, multiplied by 12, and
further multiplied by 0.3.
Sec. 35. Minnesota Statutes 2004, section 256B.432,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following terms have the meanings given them.
(a) "Management agreement" means an agreement in which one
or more of the following criteria exist:
(1) the central, affiliated, or corporate office has or is
authorized to assume day-to-day operational control of the
nursing facility for any six-month period within a 24-month
period. "Day-to-day operational control" means that the
central, affiliated, or corporate office has the authority to
require, mandate, direct, or compel the employees of the nursing
facility to perform or refrain from performing certain acts, or
to supplant or take the place of the top management of the
nursing facility. "Day-to-day operational control" includes the
authority to hire or terminate employees or to provide an
employee of the central, affiliated, or corporate office to
serve as administrator of the nursing facility;
(2) the central, affiliated, or corporate office performs
or is authorized to perform two or more of the following: the
execution of contracts; authorization of purchase orders;
signature authority for checks, notes, or other financial
instruments; requiring the nursing facility to use the group or
volume purchasing services of the central, affiliated, or
corporate office; or the authority to make annual capital
expenditures for the nursing facility exceeding $50,000, or $500
per licensed bed, whichever is less, without first securing the
approval of the nursing facility board of directors;
(3) the central, affiliated, or corporate office becomes or
is required to become the licensee under applicable state law;
(4) the agreement provides that the compensation for
services provided under the agreement is directly related to any
profits made by the nursing facility; or
(5) the nursing facility entering into the agreement is
governed by a governing body that meets fewer than four times a
year, that does not publish notice of its meetings, or that does
not keep formal records of its proceedings.
(b) "Consulting agreement" means any agreement the purpose
of which is for a central, affiliated, or corporate office to
advise, counsel, recommend, or suggest to the owner or operator
of the nonrelated nursing facility measures and methods for
improving the operations of the nursing facility.
(c) "Nursing facility" means a nursing facility whose
medical assistance rates are determined according to section
256B.431 with a medical assistance provider agreement that is
licensed as a nursing home under chapter 144A or as a boarding
care home under sections 144.50 to 144.56.
Sec. 36. Minnesota Statutes 2004, section 256B.432,
subdivision 2, is amended to read:
Subd. 2. [EFFECTIVE DATE.] For rate years beginning on or
after July 1, 1990, the central, affiliated, or corporate office
cost allocations in subdivisions 3 to 6 must be used when
determining medical assistance rates under section 256B.431,
256B.434, or 256B.441.
Sec. 37. Minnesota Statutes 2004, section 256B.432, is
amended by adding a subdivision to read:
Subd. 4a. [ALLOCATION; COSTS ALLOCABLE ON A FUNCTIONAL
BASIS.] (a) Costs that have not been directly identified must be
allocated to nursing facilities on a basis designed to equitably
allocate the costs to the nursing facilities or activities
receiving the benefits of the costs. This allocation must be
made in a manner reasonably related to the services received by
the nursing facilities. Where practical and the amounts are
material, these costs must be allocated on a functional basis.
The functions, or cost centers used to allocate central office
costs, and the unit bases used to allocate the costs, including
those central office costs allocated according to subdivision 5,
must be used consistently from one central office accounting
period to another.
(b) If the central office wishes to change its allocation
bases and believes the change will result in more appropriate
and more accurate allocations, the central office must make a
written request, with its justification, to the commissioner for
approval of the change no later than 120 days after the
beginning of the central office accounting period to which the
change is to apply. The commissioner's approval of a central
office request will be furnished to the central office in
writing. Where the commissioner approves the central office
request, the change must be applied to the accounting period for
which the request was made, and to all subsequent central office
accounting periods unless the commissioner approves a subsequent
request for change by the central office. The effective date of
the change will be the beginning of the accounting period for
which the request was made.
Sec. 38. Minnesota Statutes 2004, section 256B.432,
subdivision 5, is amended to read:
Subd. 5. [ALLOCATION OF REMAINING COSTS; ALLOCATION
RATIO.] (a) After the costs that can be directly identified
according to subdivisions 3 and 4 have been allocated, the
remaining central, affiliated, or corporate office costs must be
allocated between the nursing facility operations and the other
activities or facilities unrelated to the nursing facility
operations based on the ratio of total operating
costs. However, in the event that these remaining costs are
partially attributable to the start-up of home and
community-based services intended to fill a gap identified by
the local agency, the facility may assign these remaining costs
to the appropriate cost category of the facility for a period
not to exceed two years.
(b) For purposes of allocating these remaining central,
affiliated, or corporate office costs, the numerator for the
allocation ratio shall be determined as follows:
(1) for nursing facilities that are related organizations
or are controlled by a central, affiliated, or corporate office
under a management agreement, the numerator of the allocation
ratio shall be equal to the sum of the total operating costs
incurred by each related organization or controlled nursing
facility;
(2) for a central, affiliated, or corporate office
providing goods or services to related organizations that are
not nursing facilities, the numerator of the allocation ratio
shall be equal to the sum of the total operating costs incurred
by the nonnursing facility related organizations;
(3) for a central, affiliated, or corporate office
providing goods or services to unrelated nursing facilities
under a consulting agreement, the numerator of the allocation
ratio shall be equal to the greater of directly identified
central, affiliated, or corporate costs or the contracted
amount; or
(4) for business activities that involve the providing of
goods or services to unrelated parties which are not nursing
facilities, the numerator of the allocation ratio shall be equal
to the greater of directly identified costs or revenues
generated by the activity or function.
(c) The denominator for the allocation ratio is the sum of
the numerators in paragraph (b), clauses (1) to (4).
Sec. 39. Minnesota Statutes 2004, section 256B.432, is
amended by adding a subdivision to read:
Subd. 6a. [RELATED ORGANIZATION COSTS.] (a) Costs
applicable to services, capital assets, and supplies directly or
indirectly furnished to the nursing facility by any related
organization are includable in the allowable cost of the nursing
facility at the purchase price paid by the related organization
for capital assets or supplies and at the cost incurred by the
related organization for the provision of services to the
nursing facility if these prices or costs do not exceed the
price of comparable services, capital assets, or supplies that
could be purchased elsewhere. For this purpose, the related
organization's costs must not include an amount for markup or
profit.
(b) If the related organization in the normal course of
business sells services, capital assets, or supplies to
nonrelated organizations, the cost to the nursing facility shall
be the nonrelated organization's price provided that sales to
nonrelated organizations constitute at least 50 percent of total
annual sales of similar services, capital assets, or supplies.
Sec. 40. Minnesota Statutes 2004, section 256B.434,
subdivision 3, is amended to read:
Subd. 3. [DURATION AND TERMINATION OF CONTRACTS.] (a)
Subject to available resources, the commissioner may begin to
execute contracts with nursing facilities November 1, 1995.
(b) All contracts entered into under this section are for a
term of one year not to exceed four years. Either party may
terminate a contract at any time without cause by providing 90
calendar days advance written notice to the other party. The
decision to terminate a contract is not appealable.
Notwithstanding section 16C.05, subdivision 2, paragraph (a),
clause (5), the contract shall be renegotiated for
additional one-year terms of up to four years, unless either
party provides written notice of termination. The provisions of
the contract shall be renegotiated annually at a minimum of
every four years by the parties prior to the expiration date of
the contract. The parties may voluntarily renegotiate the terms
of the contract at any time by mutual agreement.
(c) If a nursing facility fails to comply with the terms of
a contract, the commissioner shall provide reasonable notice
regarding the breach of contract and a reasonable opportunity
for the facility to come into compliance. If the facility fails
to come into compliance or to remain in compliance, the
commissioner may terminate the contract. If a contract is
terminated, the contract payment remains in effect for the
remainder of the rate year in which the contract was terminated,
but in all other respects the provisions of this section do not
apply to that facility effective the date the contract is
terminated. The contract shall contain a provision governing
the transition back to the cost-based reimbursement system
established under section 256B.431 and Minnesota Rules, parts
9549.0010 to 9549.0080. A contract entered into under this
section may be amended by mutual agreement of the parties.
Sec. 41. Minnesota Statutes 2004, 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 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, July 1, 2002, July 1,
2003, and July 1, 2004, July 1, 2005, July 1, 2006, July 1,
2007, and July 1, 2008, 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.
Beginning in 2005, adjustment to the property payment rate under
this section and section 256B.431 shall be effective on October
1. 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. Beginning October 1, 2006, facilities reimbursed under
this section shall be allowed to receive a property rate
adjustment for building projects under section 144A.071,
subdivision 2.
(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.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 42. Minnesota Statutes 2004, section 256B.434, is
amended by adding a subdivision to read:
Subd. 18. [FACILITIES WITHOUT APS CONTRACTS AS OF OCTOBER
1, 2006.] Effective October 1, 2006, payment rates for property
shall no longer be determined under section 256B.431. A
facility that does not have a contract with the commissioner
under this section shall not be eligible for a rate increase.
Sec. 43. [256B.441] [NURSING FACILITY REIMBURSEMENT SYSTEM
EFFECTIVE OCTOBER 1, 2007.]
Subdivision 1. [IN GENERAL.] (a) The commissioner shall
establish a value-based nursing facility reimbursement system
which will provide facility-specific, prospective rates for
nursing facilities participating in the medical assistance
program. The rates shall be determined using an annual
statistical and cost report filed by each nursing facility. The
total payment rate shall be composed of four rate components:
direct care services, support services, external fixed, and
property-related rate components. The payment rate shall be
derived from statistical measures of actual costs incurred in
facility operation of nursing facilities. From this cost basis,
the components of the total payment rate shall be adjusted for
quality of services provided, recognition of staffing levels,
geographic variation in labor costs, and resident acuity.
(b) Rates shall be rebased annually. Each cost reporting
year shall begin on October 1 and end on the following September
30. Beginning in 2006, a statistical and cost report shall be
filed by each nursing facility by January 15. Notice of rates
shall be distributed by August 15 and the rates shall go into
effect on October 1 for one year.
(c) The commissioner shall begin to phase in the new
reimbursement system beginning October 1, 2007. Full phase-in
shall be completed by October 1, 2011.
Subd. 2. [DEFINITIONS.] For purposes of this section, the
terms in subdivisions 3 to 42 have the meanings given unless
otherwise provided for in this section.
Subd. 3. [ACTIVE BEDS.] "Active beds" means licensed beds
that are not currently in layaway status.
Subd. 4. [ACTIVITIES COSTS.] "Activities costs" means the
costs for the salaries and wages of the supervisor and other
activities workers, associated fringe benefits and payroll
taxes, supplies, services, and consultants.
Subd. 5. [ADMINISTRATIVE COSTS.] "Administrative costs"
means the direct costs for administering the overall activities
of the nursing home. These costs include salaries and wages of
the administrator, assistant administrator, business office
employees, security guards, and associated fringe benefits and
payroll taxes, fees, contracts, or purchases related to business
office functions, licenses, and permits except as provided in
the external fixed costs category, employee recognition, travel
including meals and lodging, training, voice and data
communication or transmission, office supplies, liability
insurance and other forms of insurance not designated to other
areas, personnel recruitment, legal services, accounting
services, management or business consultants, data processing,
central or home office costs, business meetings and seminars,
postage, fees for professional organizations, subscriptions,
security services, advertising, board of director's fees,
working capital interest expense, and bad debts and bad debt
collection fees.
Subd. 6. [ALLOWED COSTS.] "Allowed costs" means the
amounts reported by the facility which are necessary for the
operation of the facility and the care of residents and which
are reviewed by the department for accuracy, reasonableness, and
compliance with this section and generally accepted accounting
principles.
Subd. 7. [CENTER FOR MEDICARE AND MEDICAID
SERVICES.] "Center for Medicare and Medicaid services" means the
federal agency, in the United States Department of Health and
Human Services that administers Medicaid, also referred to as
"CMS."
Subd. 8. [COMMISSIONER.] "Commissioner" means the
commissioner of human services unless specified otherwise.
Subd. 9. [DESK AUDIT.] "Desk audit" means the
establishment of the payment rate based on the commissioner's
review and analysis of required reports, supporting
documentation, and work sheets submitted by the nursing facility.
Subd. 10. [DIETARY COSTS.] "Dietary costs" means the costs
for the salaries and wages of the dietary supervisor,
dietitians, chefs, cooks, dishwashers, and other employees
assigned to the kitchen and dining room, and associated fringe
benefits and payroll taxes. Dietary costs also includes the
salaries or fees of dietary consultants, direct costs of raw
food (both normal and special diet food), dietary supplies, and
food preparation and serving. Also included are special dietary
supplements used for tube feeding or oral feeding, such as
elemental high nitrogen diet, even if written as a prescription
item by a physician.
Subd. 11. [DIRECT CARE COSTS CATEGORY.] "Direct care costs
category" means costs for nursing services, activities, and
social services.
Subd. 12. [ECONOMIC DEVELOPMENT REGIONS.] "Economic
development regions" are as defined in section 462.385,
subdivision 1.
Subd. 13. [EXTERNAL FIXED COSTS CATEGORY.] "External fixed
costs category" means costs related to the nursing home
surcharge under section 256.9657, subdivision 1; licensure fees
under section 144.122; long-term care consultation fees under
section 256B.0911, subdivision 6; family advisory council fee
under section 144A.35; scholarships under section 256B.431,
subdivision 36; planned closure rate adjustments under section
256B.437; property taxes and property insurance; and PERA.
Subd. 14. [FACILITY AVERAGE CASE MIX INDEX
(CMI).] "Facility average case mix index" or "CMI" means a
numerical value score that describes the relative resource use
for all residents within the groups under the resource
utilization group (RUG-III) classification system prescribed by
the commissioner based on an assessment of each resident. The
facility average CMI shall be computed as the standardized days
divided by total days for all residents in the facility.
Subd. 15. [FIELD AUDIT.] "Field audit" means the
examination, verification, and review of the financial records,
statistical records, and related supporting documentation on the
nursing home and any related organization.
Subd. 16. [FINAL RATE.] "Final rate" means the rate
established after any adjustment by the commissioner, including,
but not limited to, adjustments resulting from audits.
Subd. 17. [FRINGE BENEFIT COSTS.] "Fringe benefit costs"
means the costs for group life, health, dental, workers'
compensation, and other employee insurances and pension,
profit-sharing, and retirement plans for which the employer pays
all or a portion of the costs and that are available to at least
all employees who work at least 20 hours per week.
Subd. 18. [GENERALLY ACCEPTED ACCOUNTING PRINCIPLES.]
"Generally Accepted Accounting Principles" means the body of
pronouncements adopted by the American Institute of Certified
Public Accountants regarding proper accounting procedures,
guidelines, and rules.
Subd. 19. [HOSPITAL-ATTACHED NURSING FACILITY STATUS.] (a)
For the purpose of setting rates under this section, for rate
years beginning after September 30, 2006, "hospital-attached
nursing facility" means a nursing facility which meets the
requirements of clauses (1) and (2); or (3); or (4), or had
hospital-attached status prior to January 1, 1995, and has been
recognized as having hospital-attached status by CMS
continuously since that date:
(1) the nursing facility is recognized by the federal
Medicare program to be a hospital-based nursing facility;
(2) the hospital and nursing facility are physically
attached or connected by a corridor;
(3) a nursing facility and hospital, which have applied for
hospital-based nursing facility status under the federal
Medicare program during the reporting year, shall be considered
a hospital-attached nursing facility for purposes of setting
payment rates under this section. The nursing facility must
file its cost report for that reporting year using Medicare
principles and Medicare's recommended cost allocation methods
had the Medicare program's hospital-based nursing facility
status been granted to the nursing facility. For each
subsequent rate year, the nursing facility must meet the
definition requirements in clauses (1) and (2). If the nursing
facility is denied hospital-based nursing facility status under
the Medicare program, the nursing facility's payment rates for
the rate years the nursing facility was considered to be a
hospital-attached nursing facility according to this paragraph
shall be recalculated treating the nursing facility as a
non-hospital-attached nursing facility;
(4) if a nonprofit or community-operated hospital and
attached nursing facility suspend operation of the hospital, the
remaining nursing facility must be allowed to continue its
status as hospital-attached for rate calculations in the three
rate years subsequent to the one in which the hospital ceased
operations.
(b) The nursing facility's cost report filed as
hospital-attached facility shall use the same cost allocation
principles and methods used in the reports filed for the
Medicare program. Direct identification of costs to the nursing
facility cost center will be permitted only when the comparable
hospital costs have also been directly identified to a cost
center which is not allocated to the nursing facility.
Subd. 20. [HOUSEKEEPING COSTS.] "Housekeeping costs" means
the costs for the salaries and wages of the housekeeping
supervisor, housekeepers, and other cleaning employees and
associated fringe benefits and payroll taxes. It also includes
the cost of housekeeping supplies, including cleaning and
lavatory supplies and contract services.
Subd. 21. [LABOR-RELATED PORTION.] The "labor-related
portion" of direct care costs and of support service costs shall
be that portion of costs that is attributable to wages for all
compensated hours, payroll taxes, and fringe benefits.
Subd. 22. [LAUNDRY COSTS.] "Laundry costs" means the costs
for the salaries and wages of the laundry supervisor and other
laundry employees, associated fringe benefits, and payroll
taxes. It also includes the costs of linen and bedding, the
laundering of resident clothing, laundry supplies, and contract
services.
Subd. 23. [LICENSEE.] "Licensee" means the individual or
organization listed on the form issued by the Minnesota
Department of Health under chapter 144A or sections 144.50 to
144.56.
Subd. 24. [MAINTENANCE AND PLANT OPERATIONS
COSTS.] "Maintenance and plant operations costs" means the costs
for the salaries and wages of the maintenance supervisor,
engineers, heating-plant employees, and other maintenance
employees and associated fringe benefits and payroll taxes. It
also includes direct costs for maintenance and operation of the
building and grounds, including fuel, electricity, medical waste
and garbage removal, water, sewer, supplies, tools, and repairs.
Subd. 25. [NORMALIZED DIRECT CARE COSTS PER
DAY.] "Normalized direct care costs per day" means direct care
costs divided by standardized days. It is the costs per day for
direct care services associated with a RUG's index of 1.00.
Subd. 26. [NURSING COSTS.] "Nursing costs" means the costs
for the wages of nursing administration, staff education, and
direct care registered nurses, licensed practical nurses,
certified nursing assistants, and trained medication aides;
mental health workers and other direct care employees, and
associated fringe benefits and payroll taxes; services from a
supplemental nursing services agency and supplies that are
stocked at nursing stations or on the floor and distributed or
used individually, including: alcohol, applicators, cotton
balls, incontinence pads, disposable ice bags, dressings,
bandages, water pitchers, tongue depressors, disposable gloves,
enemas, enema equipment, soap, medication cups, diapers, plastic
waste bags, sanitary products, thermometers, hypodermic needles
and syringes, and clinical reagents or similar diagnostic
agents, and drugs which are not paid on a separate fee schedule
by the medical assistance program or any other payer.
Subd. 27. [NURSING FACILITY.] "Nursing facility" means a
facility with a medical assistance provider agreement that is
licensed as a nursing home under chapter 144A or as a boarding
care home under sections 144.50 to 144.56.
Subd. 28. [OPERATING COSTS.] "Operating costs" means costs
associated with the direct care costs category and the support
services costs category.
Subd. 29. [PAYROLL TAXES.] "Payroll taxes" means the costs
for the employer's share of the FICA and Medicare withholding
tax, and state and federal unemployment compensation taxes.
Subd. 30. [PEER GROUPS.] Facilities shall be classified
into three groups, called "peer groups," which shall consist of:
(1) C&NC/Short Stay/R80 - facilities that have three or
more admissions per bed per year, are hospital-attached, or are
licensed under Minnesota Rules, parts 9570.2000 to 9570.3600;
(2) boarding care homes - facilities that have more than 50
percent of their beds licensed as boarding care homes; and
(3) standard - all other facilities.
Subd. 31. [PRIOR RATE-SETTING METHOD.] "Prior rate-setting
method" means the rate determination process in effect prior to
October 1, 2006, under Minnesota Rules and Minnesota Statutes.
Subd. 32. [PRIVATE PAYING RESIDENT.] "Private paying
resident" means a nursing facility resident who is not a medical
assistance recipient and whose payment rate is not established
by another third party, including the veterans administration or
Medicare.
Subd. 33. [RATE YEAR.] "Rate year" means the 12-month
period beginning on October 1 following the second most recent
reporting year.
Subd. 34. [RELATED ORGANIZATION.] "Related organization"
means a person that furnishes goods or services to a nursing
facility and that is a close relative of a nursing facility, an
affiliate of a nursing facility, a close relative of an
affiliate of a nursing facility, or an affiliate of a close
relative of an affiliate of a nursing facility. As used in this
subdivision, paragraphs (a) to (d) apply:
(a) "Affiliate" means a person that directly, or indirectly
through one or more intermediaries, controls or is controlled
by, or is under common control with another person.
(b) "Person" means an individual, a corporation, a
partnership, an association, a trust, an unincorporated
organization, or a government or political subdivision.
(c) "Close relative of an affiliate of a nursing facility"
means an individual whose relationship by blood, marriage, or
adoption to an individual who is an affiliate of a nursing
facility is no more remote than first cousin.
(d) "Control" including the terms "controlling,"
"controlled by," and "under common control with" means the
possession, direct or indirect, of the power to direct or cause
the direction of the management, operations, or policies of a
person, whether through the ownership of voting securities, by
contract, or otherwise, or to influence in any manner other than
through an arms length, legal transaction.
Subd. 35. [REPORTING PERIOD.] "Reporting period" means the
one-year period beginning on October 1 and ending on the
following September 30 during which incurred costs are
accumulated and then reported on the statistical and cost report.
Subd. 36. [RESIDENT DAY OR ACTUAL RESIDENT DAY.] "Resident
day" or "actual resident day" means a day for which nursing
services are rendered and billable, or a day for which a bed is
held and billed. The day of admission is considered a resident
day, regardless of the time of admission. The day of discharge
is not considered a resident day, regardless of the time of
discharge.
Subd. 37. [SALARIES AND WAGES.] "Salaries and wages" means
amounts earned by and paid to employees or on behalf of
employees to compensate for necessary services provided.
Salaries and wages include accrued vested vacation and accrued
vested sick leave pay. Salaries and wages must be paid within
30 days of the end of the reporting period in order to be
allowable costs of the reporting period.
Subd. 38. [SOCIAL SERVICES COSTS.] "Social services costs"
means the costs for the salaries and wages of the supervisor and
other social work employees, associated fringe benefits and
payroll taxes, supplies, services, and consultants.
Subd. 39. [STAKEHOLDERS.] "Stakeholders" means individuals
and representatives of organizations interested in long-term
care, including nursing homes, consumers, and labor unions.
Subd. 40. [STANDARDIZED DAYS.] "Standardized days" means
the sum of resident days by case mix category multiplied by the
RUG index for each category.
Subd. 41. [STATISTICAL AND COST REPORT.] "Statistical and
cost report" means the forms supplied by the commissioner for
annual reporting of nursing facility expenses and statistics,
including instructions and definitions of items in the report.
Subd. 42. [SUPPORT SERVICES COSTS CATEGORY.] "Support
services costs category" means the costs for dietary,
housekeeping, laundry, maintenance, and administration.
Subd. 43. [REPORTING OF STATISTICAL AND COST
INFORMATION.] (a) Beginning in 2006, all nursing facilities
shall provide information annually to the commissioner on a form
and in a manner determined by the commissioner. The
commissioner may also require nursing facilities to provide
statistical and cost information for a subset of the items in
the annual report on a semiannual basis. Nursing facilities
shall report only costs directly related to the operation of the
nursing facility. The facility shall not include costs which
are separately reimbursed by residents, medical assistance, or
other payors. Allocations of costs from central, affiliated, or
corporate office and related organization transactions shall be
reported according to section 256B.432. The commissioner may
grant to facilities one extension of up to 15 days for the
filing of this report if the extension is requested by December
15 and the commissioner determines that the extension will not
prevent the commissioner from establishing rates in a timely
manner required by law. The commissioner may separately require
facilities to submit in a manner specified by the commissioner
documentation of statistical and cost information included in
the report to ensure accuracy in establishing payment rates and
to perform audit and appeal review functions under this section.
Facilities shall retain all records necessary to document
statistical and cost information on the report for a period of
no less than seven years. The commissioner may amend
information in the report according to subdivision 47. The
commissioner may reject a report filed by a nursing facility
under this section if the commissioner determines that the
report has been filed in a form that is incomplete or inaccurate
and the information is insufficient to establish accurate
payment rates. In the event that a complete report is not
submitted in a timely manner, the commissioner shall reduce the
reimbursement payments to a nursing facility to 85 percent of
amounts due until the information is filed. The release of
withheld payments shall be retroactive for no more than 90
days. A nursing facility that does not submit a report or whose
report is filed in a timely manner but determined to be
incomplete shall be given written notice that a payment
reduction is to be implemented and allowed ten days to complete
the report prior to any payment reduction. The commissioner may
delay the payment withhold under exceptional circumstances to be
determined at the sole discretion of the commissioner.
(b) Nursing facilities may, within 12 months of the due
date of a statistical and cost report, file an amendment when
errors or omissions in the annual statistical and cost report
are discovered and an amendment would result in a rate increase
of at least 0.15 percent of the statewide weighted average
operating payment rate and shall, at any time, file an amendment
which would result in a rate reduction of at least 0.15 percent
of the statewide weighted average operating payment rate. The
commissioner shall make retroactive adjustments to the total
payment rate of a nursing facility if an amendment is accepted.
Where a retroactive adjustment is to be made as a result of an
amended report, audit findings, or other determination of an
incorrect payment rate, the commissioner may settle the payment
error through a negotiated agreement with the facility and a
gross adjustment of the payments to the facility. Retroactive
adjustments shall not be applied to private pay residents. An
error or omission for purposes of this item does not include a
nursing facility's determination that an election between
permissible alternatives was not advantageous and should be
changed.
(c) If the commissioner determines that a nursing facility
knowingly supplied inaccurate or false information or failed to
file an amendment to a statistical and cost report that resulted
in or would result in an overpayment, the commissioner shall
immediately adjust the nursing facility's payment rate and
recover the entire overpayment. The commissioner may also
terminate the commissioner's agreement with the nursing facility
and prosecute under applicable state or federal law.
Subd. 44. [CALCULATION OF A QUALITY SCORE.] (a) The
commissioner shall determine a quality score for each nursing
facility using quality measures established in section 256B.439,
according to methods determined by the commissioner in
consultation with stakeholders and experts. These methods shall
be exempt from the rulemaking requirements under chapter 14.
(b) For each quality measure, a score shall be determined
with a maximum number of points available and number of points
assigned as determined by the commissioner using the methodology
established according to this subdivision. The scores
determined for all quality measures shall be totaled. The
determination of the quality measures to be used and the methods
of calculating scores may be revised annually by the
commissioner.
(c) For the initial rate year under the new payment system,
the quality measures shall include:
(1) staff turnover;
(2) staff retention;
(3) use of pool staff;
(4) quality indicators from the minimum data set; and
(5) survey deficiencies.
(d) For rate years beginning after October 1, 2006, when
making revisions to the quality measures or method for
calculating scores, the commissioner shall publish the
methodology in the State Register at least 15 months prior to
the start of the rate year for which the revised methodology is
to be used for rate-setting purposes. The quality score used to
determine payment rates shall be established for a rate year
using data submitted in the statistical and cost report from the
associated reporting year, and using data from other sources
related to a period beginning no more than six months prior to
the associated reporting year.
Subd. 45. [CALCULATION OF OPERATING PAYMENT RATE FOR
DIRECT CARE AND SUPPORT SERVICES.] The commissioner shall
provide recommendations to the legislature by February 15, 2006,
on specific methodology for the establishment of the operating
payment rate for direct care and support services under the new
system. The recommendations must not increase expenditures for
the new payment system beyond the limits of the appropriation.
The commissioner shall include recommendations on options for
recognizing changes in staffing and services that may require a
supplemental appropriation in the future.
Subd. 46. [CALCULATION OF QUALITY ADD-ON.] The payment
rate for the quality add-on shall be a variable amount based on
each facility's quality score.
(a) For the rate year beginning October 1, 2006, the
maximum quality add-on percent shall be 2.4 percent and this
add-on shall not be subject to a phase-in. The determination of
the quality score to be used in calculating the quality add-on
for October 1, 2006, shall be based on a report which must be
filed with the commissioner, according to the requirements in
subdivision 43, for a six-month period ending January 31, 2006.
This report shall be filed with the commissioner by February 28,
2006. The commissioner shall prorate the six months of data to
a full year. When new quality measures are incorporated into
the quality score methodology and when existing quality measures
are updated or improved, the commissioner may increase the
maximum quality add-on percent.
(b) For each facility, determine the operating payment rate.
(c) For each facility determine a ratio of the quality
score of the facility determined in subdivision 44, less 40 and
then divided by 60. If this value is less than zero, use the
value zero.
(d) For each facility, the quality add-on shall be the
value determined in paragraph (b) times the value determined in
paragraph (c) times the maximum quality add-on percent.
Subd. 47. [AUDIT AUTHORITY.] (a) The commissioner may
subject reports and supporting documentation to desk and field
audits to determine compliance with this section. Retroactive
adjustments shall be made as a result of desk or field audit
findings if the cumulative impact of the finding would result in
a rate adjustment of at least 0.15 percent of the statewide
weighted average operating payment rate. If a field audit
reveals inadequacies in a nursing facility's record keeping or
accounting practices, the commissioner may require the nursing
facility to engage competent professional assistance to correct
those inadequacies within 90 days so that the field audit may
proceed.
(b) Field audits may cover the four most recent annual
statistical and cost reports for which desk audits have been
completed and payment rates have been established. The field
audit must be an independent review of the nursing facility's
statistical and cost report. All transactions, invoices, or
other documentation that support or relate to the statistics and
costs claimed on the annual statistical and cost reports are
subject to review by the field auditor. If the provider fails
to provide the field auditor access to supporting documentation
related to the information reported on the statistical and cost
report within the time period specified by the commissioner, the
commissioner shall calculate the total payment rate by
disallowing the cost of the items for which access to the
supporting documentation is not provided.
(c) Changes in the total payment rate which result from
desk or field audit adjustments to statistical and cost reports
for reporting years earlier than the four most recent annual
cost reports must be made to the four most recent annual
statistical and cost reports, the current statistical and cost
report, and future statistical and cost reports to the extent
that those adjustments affect the total payment rate established
by those reporting years.
(d) The commissioner shall extend the period for retention
of records under subdivision 43 for purposes of performing field
audits as necessary to enforce section 256B.48 with written
notice to the facility postmarked no later than 90 days prior to
the expiration of the record retention requirement.
Sec. 44. Minnesota Statutes 2004, section 256B.49,
subdivision 16, is amended to read:
Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and
supports included in the home and community-based waivers for
persons with disabilities shall meet the requirements set out in
United States Code, title 42, section 1396n. The services and
supports, which are offered as alternatives to institutional
care, shall promote consumer choice, community inclusion,
self-sufficiency, and self-determination.
(b) Beginning January 1, 2003, the commissioner shall
simplify and improve access to home and community-based waivered
services, to the extent possible, through the establishment of a
common service menu that is available to eligible recipients
regardless of age, disability type, or waiver program.
(c) Consumer directed community support services shall be
offered as an option to all persons eligible for services under
subdivision 11, by January 1, 2002.
(d) Services and supports shall be arranged and provided
consistent with individualized written plans of care for
eligible waiver recipients.
(e) A transitional supports allowance shall be available to
all persons under a home and community-based waiver who are
moving from a licensed setting to a community setting.
"Transitional supports allowance" means a onetime payment of up
to $3,000, to cover the costs, not covered by other sources,
associated with moving from a licensed setting to a community
setting. Covered costs include:
(1) lease or rent deposits;
(2) security deposits;
(3) utilities set-up costs, including telephone;
(4) essential furnishings and supplies; and
(5) personal supports and transports needed to locate and
transition to community settings.
(f) The state of Minnesota and county agencies that
administer home and community-based waivered services for
persons with disabilities, shall not be liable for damages,
injuries, or liabilities sustained through the purchase of
supports by the individual, the individual's family, legal
representative, or the authorized representative with funds
received through the consumer-directed community support service
under this section. Liabilities include but are not limited
to: workers' compensation liability, the Federal Insurance
Contributions Act (FICA), or the Federal Unemployment Tax Act
(FUTA).
[EFFECTIVE DATE.] This section is effective upon federal
approval and to the extent approved as a federal waiver
amendment.
Sec. 45. Minnesota Statutes 2004, section 256B.5012, is
amended by adding a subdivision to read:
Subd. 6. [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 2005,
AND OCTOBER 1, 2006.] (a) For the rate periods beginning October
1, 2005, and October 1, 2006, the commissioner shall make
available to each facility reimbursed under this section an
adjustment to the total operating payment rate of 2.2553 percent.
(b) 75 percent of the money resulting from the rate
adjustment under paragraph (a) must be used to increase wages
and benefits and pay associated costs for all employees, except
for administrative and central office employees. 75 percent of
the money received by a facility as a result of the rate
adjustment provided in paragraph (a) must be used only for wage,
benefit, and staff increases implemented on or after the
effective date of the rate increase each year, and must not be
used for increases implemented prior to that date.
(c) For each facility, the commissioner shall make
available an adjustment using the percentage specified in
paragraph (a) multiplied by the total payment rate, excluding
the property-related payment rate, in effect on the preceding
day. The total payment rate shall include the adjustment
provided in section 256B.501, subdivision 12.
(d) A facility whose payment rates are governed by closure
agreements, receivership agreements, or Minnesota Rules, part
9553.0075, is not eligible for an adjustment otherwise granted
under this subdivision.
(e) A facility may apply for the portion of the payment
rate adjustment provided under paragraph (a) for employee wages
and benefits and associated costs. The application must be made
to the commissioner and contain a plan by which the facility
will distribute the funds according to paragraph (b). For
facilities in which the employees are represented by an
exclusive bargaining representative, an agreement negotiated and
agreed to by the employer and the exclusive bargaining
representative constitutes the plan. A negotiated agreement may
constitute the plan only if the agreement is finalized after the
date of enactment of all rate increases for the rate year. The
commissioner shall review the plan to ensure that the payment
rate adjustment per diem is used as provided in this
subdivision. To be eligible, a facility must submit its plan by
March 31, 2006, and December 31, 2006, respectively. If a
facility's plan is effective for its employees after the first
day of the applicable rate period that the funds are available,
the payment rate adjustment per diem is effective the same date
as its plan.
(f) A copy of the approved distribution plan must be made
available to all employees by giving each employee a copy or by
posting it in an area of the facility to which all employees
have access. If an employee does not receive the wage and
benefit adjustment described in the facility's approved plan and
is unable to resolve the problem with the facility's management
or through the employee's union representative, the employee may
contact the commissioner at an address or telephone number
provided by the commissioner and included in the approved plan.
Sec. 46. Minnesota Statutes 2004, section 256B.69,
subdivision 23, is amended to read:
Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES;
ELDERLY AND DISABLED PERSONS.] (a) The commissioner may
implement demonstration projects to create alternative
integrated delivery systems for acute and long-term care
services to elderly persons and persons with disabilities as
defined in section 256B.77, subdivision 7a, that provide
increased coordination, improve access to quality services, and
mitigate future cost increases. The commissioner may seek
federal authority to combine Medicare and Medicaid capitation
payments for the purpose of such demonstrations. Medicare funds
and services shall be administered according to the terms and
conditions of the federal waiver and demonstration provisions.
For the purpose of administering medical assistance funds,
demonstrations under this subdivision are subject to
subdivisions 1 to 22. The provisions of Minnesota Rules, parts
9500.1450 to 9500.1464, apply to these demonstrations, with the
exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
subpart 1, items B and C, which do not apply to persons
enrolling in demonstrations under this section. An initial open
enrollment period may be provided. Persons who disenroll from
demonstrations under this subdivision remain subject to
Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is
enrolled in a health plan under these demonstrations and the
health plan's participation is subsequently terminated for any
reason, the person shall be provided an opportunity to select a
new health plan and shall have the right to change health plans
within the first 60 days of enrollment in the second health
plan. Persons required to participate in health plans under
this section who fail to make a choice of health plan shall not
be randomly assigned to health plans under these demonstrations.
Notwithstanding section 256L.12, subdivision 5, and Minnesota
Rules, part 9505.5220, subpart 1, item A, if adopted, for the
purpose of demonstrations under this subdivision, the
commissioner may contract with managed care organizations,
including counties, to serve only elderly persons eligible for
medical assistance, elderly and disabled persons, or disabled
persons only. For persons with primary diagnoses of mental
retardation or a related condition, serious and persistent
mental illness, or serious emotional disturbance, the
commissioner must ensure that the county authority has approved
the demonstration and contracting design. Enrollment in these
projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under
this subdivision for persons with primary diagnoses of mental
retardation or a related condition, serious and persistent
mental illness, or serious emotional disturbance, without
approval of the county board of the county in which the
demonstration is being implemented.
(b) Notwithstanding chapter 245B, sections 252.40 to
252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules,
parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580,
and 9525.1800 to 9525.1930, the commissioner may implement under
this section projects for persons with developmental
disabilities. The commissioner may capitate payments for ICF/MR
services, waivered services for mental retardation or related
conditions, including case management services, day training and
habilitation and alternative active treatment services, and
other services as approved by the state and by the federal
government. Case management and active treatment must be
individualized and developed in accordance with a
person-centered plan. Costs under these projects may not exceed
costs that would have been incurred under fee-for-service.
Beginning July 1, 2003, and until two years after the pilot
project implementation date, subcontractor participation in the
long-term care developmental disability pilot is limited to a
nonprofit long-term care system providing ICF/MR services, home
and community-based waiver services, and in-home services to no
more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall
report to the legislature prior to expansion of the
developmental disability pilot project. This paragraph expires
two years after the implementation date of the pilot project.
(c) Before implementation of a demonstration project for
disabled persons, the commissioner must provide information to
appropriate committees of the house of representatives and
senate and must involve representatives of affected disability
groups in the design of the demonstration projects.
(d) A nursing facility reimbursed under the alternative
reimbursement methodology in section 256B.434 may, in
collaboration with a hospital, clinic, or other health care
entity provide services under paragraph (a). The commissioner
shall amend the state plan and seek any federal waivers
necessary to implement this paragraph.
(e) The commissioner, in consultation with the
commissioners of commerce and health, may approve and implement
programs for all-inclusive care for the elderly (PACE) according
to federal laws and regulations governing that program and state
laws or rules applicable to participating providers. The
process for approval of these programs shall begin only after
the commissioner receives grant money in an amount sufficient to
cover the state share of the administrative and actuarial costs
to implement the programs during state fiscal years 2006 and
2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the
commissioner to be used solely for the purpose of PACE
administrative and actuarial costs. A PACE provider is not
required to be licensed or certified as a health plan company as
defined in section 62Q.01, subdivision 4. Persons age 55 and
older who have been screened by the county and found to be
eligible for services under the elderly waiver or community
alternatives for disabled individuals or who are already
eligible for Medicaid but meet level of care criteria for
receipt of waiver services may choose to enroll in the PACE
program. Medicare and Medicaid services will be provided
according to this subdivision and federal Medicare and Medicaid
requirements governing PACE providers and programs. PACE
enrollees will receive Medicaid home and community-based
services through the PACE provider as an alternative to services
for which they would otherwise be eligible through home and
community-based waiver programs and Medicaid State Plan
Services. The commissioner shall establish Medicaid rates for
PACE providers that do not exceed costs that would have been
incurred under fee-for-service or other relevant managed care
programs operated by the state.
(f) The commissioner shall seek federal approval to expand
the Minnesota disability health options (MnDHO) program
established under this subdivision in stages, first to regional
population centers outside the seven-county metro area and then
to all areas of the state.
(g) Notwithstanding section 256B.0261, health plans
providing services under this section are responsible for home
care targeted case management and relocation targeted case
management. Services must be provided according to the terms of
the waivers and contracts approved by the federal government.
Sec. 47. [256B.762] [REIMBURSEMENT FOR HEALTH CARE
SERVICES.]
Effective for services provided on or after October 1,
2005, payment rates for the following services shall be
increased by five percent over the rates in effect on September
30, 2005, when these services are provided as home health
services under section 256B.0625, subdivision 6a:
(1) skilled nursing visit;
(2) physical therapy visit;
(3) occupational therapy visit;
(4) speech therapy visit; and
(5) home health aide visit.
Sec. 48. Minnesota Statutes 2004, section 256I.06, is
amended by adding a subdivision to read:
Subd. 9. [COMMUNITY LIVING ADJUSTMENT.] Effective August
1, 2005, persons eligible for and residing in group residential
housing under section 256I.04 shall receive a group residential
housing community living adjustment of $12 per month.
Sec. 49. Minnesota Statutes 2004, 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, paragraph (a), clause (4), paragraph
(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.
All provisions in this paragraph related to the continuation of
a recipient's life estate or joint tenancy interests in real
property after the recipient's death, for the purpose of
recovering medical assistance but not alternative care, are
effective only for life estates and joint tenancy interests
established on or after August 1, 2003.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 50. [CONSUMER-DIRECTED COMMUNITY SUPPORTS
METHODOLOGY.]
(a) Effective upon federal approval, for persons using the
home and community-based waiver for persons with developmental
disabilities whose consumer-directed community supports budgets
were reduced by the October 2004, state-set budget methodology,
the commissioner of human services must allow exceptions to
exceed the state-set budget formula up to the daily average cost
during calendar year 2004 or for persons who graduated from
school during 2004, the average daily cost during July through
December 2004, less one-half of case management and home
modifications over $5,000 when the individual's county of
financial responsibility determines that:
(1) necessary alternative services will cost the same or
more than the person's current budget; and
(2) administrative expenses or provider rates will result
in fewer hours of needed staffing for the person than under the
consumer-directed community supports option. Any exceptions the
county grants must be within the county's allowable aggregate
amount for the home and community-based waiver for persons with
developmental disabilities.
(b) This section expires on the date the commissioner of
human services implements a new consumer-directed community
supports budget methodology that is based on information about
the services and supports intensity needs of persons using the
option and that adequately accounts for the increased costs of
adults who graduate from school and need services funded by the
waiver during the day.
Sec. 51. [COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES.]
Effective upon federal approval, the expenses allowed for
adults under the consumer-directed community supports option
shall include the costs at the lowest rate available considering
daily, monthly, semi-annual, annual, or membership rates,
including transportation, associated with physical exercise or
other physical activities to maintain or improve the person's
health and functioning.
Sec. 52. [WAIVER AMENDMENT.]
The commissioner of human services shall submit an
amendment to the Centers for Medicare and Medicaid Services
consistent with sections 50 and 51 by October 1, 2005.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 53. [INDEPENDENT EVALUATION AND REVIEW OF UNALLOWABLE
ITEMS.]
The commissioner of human services shall include in the
independent evaluation of the consumer-directed community
supports option provided through the home and community-based
services waivers for persons with disabilities under 65 years of
age:
(1) provision for ongoing, regular participation by
stakeholder representatives through June 30, 2007;
(2) recommendations on whether changes to the unallowable
items should be made to meet the health, safety, or welfare
needs of participants in the consumer-directed community
supports option within the allowed budget amounts. The
recommendations on allowable items shall be provided to the
senate and house of representatives committees with jurisdiction
over human services policy and finance issues by January 15,
2006; and
(3) a review of the statewide caseload changes for the
disability waiver programs for persons under 65 years of age
that occurred since the state-set budget methodology
implementation on October 1, 2004, and recommendations on the
fiscal impact of the budget methodology on use of the
consumer-directed community supports option.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 54. [FEDERAL APPROVAL.]
By October 1, 2005, the commissioner of human services
shall request any federal approval and plan amendments necessary
to implement (1) the transitional supports allowance under
Minnesota Statutes, sections 256B.0916, subdivision 10, and
256B.49, subdivision 16; and (2) the choice of case management
service coordination provisions under Minnesota Statutes,
section 256B.0621, subdivisions 4, 5, 6, and 7.
Sec. 55. [COMMUNITY SERVICES PROVIDER RATE INCREASES.]
(a) The commissioner of human services shall increase
reimbursement rates or rate limits, as applicable, by 2.2553
percent for the rate period beginning October 1, 2005, and the
rate period beginning October 1, 2006, effective for services
rendered on or after those dates.
(b) The 2.2553 percent annual rate increase described in
this section must be provided to:
(1) home and community-based waivered services for persons
with mental retardation or related conditions under Minnesota
Statutes, section 256B.501;
(2) home and community-based waivered services for the
elderly under Minnesota Statutes, section 256B.0915;
(3) waivered services under community alternatives for
disabled individuals under Minnesota Statutes, section 256B.49;
(4) community alternative care waivered services under
Minnesota Statutes, section 256B.49;
(5) traumatic brain injury waivered services under
Minnesota Statutes, section 256B.49;
(6) nursing services and home health services under
Minnesota Statutes, section 256B.0625, subdivision 6a;
(7) personal care services and nursing supervision of
personal care services under Minnesota Statutes, section
256B.0625, subdivision 19a;
(8) private duty nursing services under Minnesota Statutes,
section 256B.0625, subdivision 7;
(9) day training and habilitation services for adults with
mental retardation or related conditions under Minnesota
Statutes, sections 252.40 to 252.46;
(10) alternative care services under Minnesota Statutes,
section 256B.0913;
(11) adult residential program grants under Minnesota
Rules, parts 9535.2000 to 9535.3000;
(12) adult and family community support grants under
Minnesota Rules, parts 9535.1700 to 9535.1760;
(13) the group residential housing supplementary service
rate under Minnesota Statutes, section 256I.05, subdivision 1a;
(14) adult mental health integrated fund grants under
Minnesota Statutes, section 245.4661;
(15) semi-independent living services under Minnesota
Statutes, section 252.275, including SILS funding under county
social services grants formerly funded under Minnesota Statutes,
chapter 256I;
(16) community support services for deaf and
hard-of-hearing adults with mental illness who use or wish to
use sign language as their primary means of communication;
(17) living skills training programs for persons with
intractable epilepsy who need assistance in the transition to
independent living;
(18) physical therapy services under sections 256B.0625,
subdivision 8, and 256D.03, subdivision 4;
(19) occupational therapy services under sections
256B.0625, subdivision 8a, and 256D.03, subdivision 4;
(20) speech-language therapy services under section
256D.03, subdivision 4, and Minnesota Rules, part 9505.0390; and
(21) respiratory therapy services under section 256D.03,
subdivision 4, and Minnesota Rules, part 9505.0295.
(c) Providers that receive a rate increase under this
section shall use 75 percent of the additional revenue to
increase wages and benefits and pay associated costs for all
employees, except for management fees, the administrator, and
central office staffs.
(d) For public employees, the increase for wages and
benefits for certain staff is available and pay rates shall be
increased only to the extent that they comply with laws
governing public employees collective bargaining. Money
received by a provider for pay increases under this section may
be used only for increases implemented on or after the first day
of the rate period in which the increase is available and must
not be used for increases implemented prior to that date.
(e) A copy of the provider's plan for complying with
paragraph (c) must be made available to all employees by giving
each employee a copy or by posting a copy in an area of the
provider's operation to which all employees have access. If an
employee does not receive the adjustment, if any, described in
the plan and is unable to resolve the problem with the provider,
the employee may contact the employee's union representative.
If the employee is not covered by a collective bargaining
agreement, the employee may contact the commissioner at a
telephone number provided by the commissioner and included in
the provider's plan.
Sec. 56. [COMMISSIONER'S DUTIES RELATED TO CHANGE IN
EFFECTIVE DATE FOR LIFE ESTATE AND JOINT TENANCY INTEREST
PROVISIONS.]
(a) The commissioner of human services or a county agency
that has recovered medical assistance or alternative care
payments for recipients after they die from their life estates
or jointly owned interests in real property that were
established prior to August 1, 2003, and that were continued in
existence or merged into another interest in real property after
their death due solely to the provisions of section 256B.15 or
514.981, subdivision 6, paragraph (c), as those provisions
existed prior to the amendments in this act, shall refund those
recoveries, without interest. The refunds shall be paid to the
surviving record owners of the real property in which the
recipient had a life estate or a jointly owned interest on the
date of the recipient's death in proportion to their record
interests on that date. The commissioner and a county agency
are not required to refund any other recoveries attributable to
any other interests or assets of the deceased recipient. For
purposes of this paragraph, a life estate or jointly owned
interest in real property is established as of the date provided
for in Minnesota Statutes, section 256B.15, subdivision 6.
(b) If the commissioner of human services or a county
agency determines a person entitled to any refund under this act
is dead, they may pay the refund due that person to their estate
if it is still open. If the person's estate is closed or if a
court has entered a decree of distribution for that person under
section 525.312 that is a final decree, the commissioner or the
county agency may, in their absolute discretion, pay the
person's refund to their heirs or devisees as finally determined
in any completed probate or under any final decree of
distribution. In all other cases including, but not limited to,
those in which the commissioner or a county agency determines
they cannot identify or locate a person entitled to a refund
under this section, they may, at their discretion, declare such
person's refund to be abandoned property and pay and deliver it
to the commissioner of commerce. The commissioner of commerce
shall administer and dispose of the refunds according to
sections 345.31 to 345.60. Neither the commissioner of human
services, the Department of Human Services, a county agency, or
the employees of the department or agency, shall be liable to
anyone with respect to the refund after paying or delivering the
refund as provided for in this section.
[EFFECTIVE DATE.] This section is effective retroactively
from August 1, 2003.
Sec. 57. [DIRECTION TO THE COMMISSIONER; LICENSING AND
ALTERNATIVE QUALITY ASSURANCE STUDY.]
The commissioner of human services shall arrange for a
study, including recommendations for statewide development and
implementation of regional or local quality assurance models for
disability services. The study shall include a review of
current projects or models; make findings regarding the best
components, role, and function of such models within a statewide
quality assurance system; and shall estimate the cost and
sources of funding for regional and local quality assurance
models on a statewide basis. The study shall be done in
consultation with counties, consumers of service, providers, and
representatives of the Quality Assurance Commission under
Minnesota Statutes, section 256B.0951, subdivision 1.
The study shall be submitted to the chairs of the
legislative committees with jurisdiction over health and human
services with recommendations on implementation of a statewide
system of quality assurance and licensing by July 1, 2006. The
commissioner shall submit proposed legislation for
implementation of a statewide system of quality assurance to the
chairs of the legislative committees with jurisdiction over
health and human services by December 15, 2006.
Sec. 58. [DISABILITY SERVICES INTERAGENCY WORK GROUP.]
Subdivision 1. [MEMBERSHIP.] The Department of Human
Services, the Minnesota Housing Finance Agency, and the
Minnesota State Council on Disability shall convene an
interagency work group which includes interested stakeholders
including other state agencies, counties, public housing
authorities, the Metropolitan Council, disability service
providers, and representatives from disability advocacy
organizations to identify barriers, strengthen coordination,
recommend policy and funding changes, and pursue federal
financing that will assist Minnesotans with disabilities who are
attempting to relocate from or avoid placement in institutional
settings.
Subd. 2. [WORK GROUP ACTIVITIES.] The work group shall
make recommendations to the state agencies and the legislature
related to:
(1) coordinating the availability of housing,
transportation, and support services needed to discharge persons
with disabilities from institutions;
(2) improving information and assistance needed to make an
informed choice about relocating from an institutional placement
to community-based services;
(3) identifying gaps in human services, transportation, or
housing access which are barriers to moving to community
services;
(4) identifying strategies which would result in earlier
identification of persons most at risk of institutional
placement in order to promote diversion to community service or
reduce length of stay in an institutional facility;
(5) identifying funding mechanisms and financial strategies
to assure a financially sustainable community support system
that diverts and relocates individuals from institutional
placement; and
(6) identifying state changes needed to address any federal
changes affecting policies, benefits, or funding used to support
persons with disabilities to avoid institutional placement.
Subd. 3. [RECOMMENDATIONS.] Recommendations of the work
group will be submitted to each participating state agency and
to the chairs of the health and human services policy and
finance committees of the senate and house of representatives by
October 15, 2006. This section expires October 15, 2006.
Sec. 59. [REPORT TO LEGISLATURE.]
The commissioner shall report to the legislature by
December 15, 2006, 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).
Sec. 60. [RECOMMENDATIONS FOR PROPERTY PAYMENT SYSTEM FOR
NURSING FACILITIES.]
The commissioner of human services shall provide
recommendations to the legislature by February 15, 2007, on
changes to the current nursing facility property payment system.
Sec. 61. [REPEALER.]
Minnesota Statutes 2004, sections 514.991; 514.992;
514.993; 514.994; and 514.995, are repealed retroactively from
July 1, 2005. On and after the repeal date all alternative care
liens of record shall be of no force and effect, shall not be
liens on real property, and examiners of title shall disregard
these liens and shall not carry them forward to subsequent
certificates of title.
Sec. 62. [EFFECTIVE DATE.]
The sections in this article are effective August 1, 2005,
unless another date is specified.
ARTICLE 8
HEALTH CARE - DEPARTMENT
OF HUMAN SERVICES
Section 1. Minnesota Statutes 2004, section 16A.724, is
amended to read:
16A.724 [HEALTH CARE ACCESS FUND.]
Subdivision 1. [CREATION OF FUND.] A health care access
fund is created in the state treasury. The fund is a direct
appropriated special revenue fund. The commissioner shall
deposit to the credit of the fund money made available to the
fund. Notwithstanding section 11A.20, after June 30, 1997, all
investment income and all investment losses attributable to the
investment of the health care access fund not currently needed
shall be credited to the health care access fund.
Subd. 2. [TRANSFERS.] (a) Notwithstanding section 295.581,
to the extent available resources in the health care access fund
exceed expenditures in that fund, effective with the biennium
beginning July 1, 2007, the commissioner of finance shall
transfer the excess funds from the health care access fund to
the general fund on June 30 of each year, provided that the
amount transferred in any fiscal biennium shall not exceed
$96,000,000.
(b) For fiscal years 2006 to 2009, MinnesotaCare shall be a
forecasted program, and, if necessary, the commissioner shall
reduce these transfers from the health care access fund to the
general fund to meet annual MinnesotaCare expenditures or, if
necessary, transfer sufficient funds from the general fund to
the health care access fund to meet annual MinnesotaCare
expenditures.
Sec. 2. [62J.82] [HOSPITAL CHARGE DISCLOSURE.]
The Minnesota Hospital Association shall develop a
Web-based system, available to the public free of charge, for
reporting charge information, for Minnesota residents,
including, but not limited to, number of discharges, average
length of stay, average charge, average charge per day, and
median charge, for each of the 50 most common inpatient
diagnosis-related groups and the 25 most common outpatient
surgical procedures as specified by the Minnesota Hospital
Association. The Web site must provide information that
compares hospital-specific data to hospital statewide data. The
Web site must be established by October 1, 2006, and must be
updated annually. If a hospital does not provide this
information to the Minnesota Hospital Association, the
commissioner may require the hospital to do so. The
commissioner shall provide a link to this information on the
department's Web site.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 3. Minnesota Statutes 2004, section 62Q.251, as added
by Laws 2005, chapter 147, article 11, section 3, is amended to
read:
62Q.251 [DISCOUNTED PAYMENTS.]
(a) Notwithstanding any other provision of law, a health
care provider may provide care to a patient at a discounted
payment amount, provided that the discount does not reduce the
payment below the Medicare-approved payment level.
(b) A health plan company or other insurer must not
consider, in determining a provider's usual and customary
payment, standard payment, or allowable payment used as a basis
for determining the provider's payment by the health plan
company or other insurer, the following discounted payment
situations:
(1) care provided to relatives of the provider; and
(2) care for which a discount is given for hardship
situations; and
(3) care for which a discount is given in exchange for cash
payment.
(c) This section does not disallow Nothing in this section
shall prohibit a provider from providing charity care for
hardship situations in which the care is provided for free.
(d) A provider may not charge an uninsured person more than
the provider charges a health plan company or other insurer.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 4. Minnesota Statutes 2004, section 62Q.37,
subdivision 7, is amended to read:
Subd. 7. [HUMAN SERVICES.] (a) The commissioner of human
services shall implement this section in a manner that is
consistent with applicable federal laws and regulations and that
avoids the duplication of review activities performed by a
nationally recognized independent organization.
(b) By December 31 of each year, the commissioner shall
submit to the legislature a written report identifying the
number of audits performed by a nationally recognized
independent organization that were accepted, partially accepted,
or rejected by the commissioner under this section. The
commissioner shall provide the rationale for partial acceptance
or rejection. If the rationale for the partial acceptance or
rejection was based on the commissioner's determination that the
standards used in the audit were not equivalent to state law,
regulation, or contract requirement, the report must document
the variances between the audit standards and the applicable
state requirements.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 5. Minnesota Statutes 2004, 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 carry out the specific duties in paragraphs (a)
through (aa) (cc):
(a) 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:
(1) require county agency participation in training and
technical assistance programs to promote compliance with
statutes, rules, federal laws, regulations, and policies
governing human services;
(2) 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;
(3) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit
determinations;
(4) 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;
(5) 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;
(6) make contracts with and grants to public and private
agencies and organizations, both profit and nonprofit, and
individuals, using appropriated funds; and
(7) 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.
(b) 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.
(c) 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.
(d) 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.
(e) 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.
(f) 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.
(g) Establish and maintain any administrative units
reasonably necessary for the performance of administrative
functions common to all divisions of the department.
(h) 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.
(i) Act as coordinating referral and informational center
on requests for service for newly arrived immigrants coming to
Minnesota.
(j) 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.
(k) 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.
(l) 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:
(1) 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; and
(2) a comprehensive plan, including estimated project
costs, shall be approved by the Legislative Advisory Commission
and filed with the commissioner of administration.
(m) 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.
(n) 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:
(1) 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; and
(2) notwithstanding the provisions of clause (1), 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 clause (1), 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 clause (1).
(o) 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.
(p) 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.
(q) Have the authority to establish and enforce the
following county reporting requirements:
(1) 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;
(2) 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;
(3) if the required reports are not received by the
deadlines established in clause (2), 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;
(4) 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;
(5) 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;
(6) the commissioner may not delay payments, withhold
funds, or require repayment under clause (3) or (5) 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 clause (3) or (5), the county board may appeal the action
according to sections 14.57 to 14.69; and
(7) counties subject to withholding of funds under clause
(3) or forfeiture or repayment of funds under clause (5) shall
not reduce or withhold benefits or services to clients to cover
costs incurred due to actions taken by the commissioner under
clause (3) or (5).
(r) 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.
(s) 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.
(t) 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.
(u) 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 rebate as defined for purposes of the
federal rebate program in United States Code, title 42, section
1396r-8. 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.
(v) 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.
(w) 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.
(x) 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.
(y) 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.
(z) Designate community information and referral call
centers and incorporate cost reimbursement claims from the
designated community information and referral call centers into
the federal cost reimbursement claiming processes of the
department according to federal law, rule, and regulations.
Existing information and referral centers provided by Greater
Twin Cities United Way or existing call centers for which
Greater Twin Cities United Way has legal authority to represent,
shall be included in these designations upon review by the
commissioner and assurance that these services are accredited
and in compliance with national standards. Any reimbursement is
appropriated to the commissioner and all designated information
and referral centers shall receive payments according to normal
department schedules established by the commissioner upon final
approval of allocation methodologies from the United States
Department of Health and Human Services Division of Cost
Allocation or other appropriate authorities.
(aa) 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.
(bb) Have the authority to administer a drug rebate program
for drugs purchased for persons eligible for general assistance
medical care under section 256D.03, subdivision 3. For
manufacturers that agree to participate in the general
assistance medical care rebate program, the commissioner shall
enter into a rebate agreement for covered drugs as defined in
section 256B.0625, subdivisions 13 and 13d. 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 manufacturers must provide
payment within the terms and conditions used for the federal
rebate program established under section 1927 of title XIX of
the Social Security Act. The rebate program shall utilize the
terms and conditions used for the federal rebate program
established under section 1927 of title XIX of the Social
Security Act.
Effective January 1, 2006, drug coverage under general
assistance medical care shall be limited to those prescription
drugs that:
(1) are covered under the medical assistance program as
described in section 256B.0625, subdivisions 13 and 13d; and
(2) are provided by manufacturers that have fully executed
general assistance medical care rebate agreements with the
commissioner and comply with such agreements. Prescription drug
coverage under general assistance medical care shall conform to
coverage under the medical assistance program according to
section 256B.0625, subdivisions 13 to 13g.
The rebate revenues collected under the drug rebate program
are deposited in the general fund.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 6. Minnesota Statutes 2004, section 256.01, is
amended by adding a subdivision to read:
Subd. 2a. [AUTHORIZATION FOR TEST SITES FOR HEALTH CARE
PROGRAMS.] In coordination with the development and
implementation of HealthMatch, an automated eligibility system
for medical assistance, general assistance medical care, and
MinnesotaCare, the commissioner, in cooperation with county
agencies, is authorized to test and compare a variety of
administrative models to demonstrate and evaluate outcomes of
integrating health care program business processes and points of
access. The models will be evaluated for ease of enrollment for
health care program applicants and recipients and administrative
efficiencies. Test sites will combine the administration of all
three programs and will include both local county and
centralized statewide customer assistance. The duration of each
approved test site shall be no more than one year. Based on the
evaluation, the commissioner shall recommend the most efficient
and effective administrative model for statewide implementation.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 7. Minnesota Statutes 2004, section 256.019,
subdivision 1, is amended to read:
Subdivision 1. [RETENTION RATES.] When an assistance
recovery amount is collected and posted by a county agency under
the provisions governing public assistance programs including
general assistance medical care, general assistance, and
Minnesota supplemental aid, the county may keep one-half of the
recovery made by the county agency using any method other than
recoupment. For medical assistance, if the recovery is made by
a county agency using any method other than recoupment, the
county may keep one-half of the nonfederal share of the recovery.
For MinnesotaCare, if the recovery is collected and posted by
the county agency, the county may keep one-half of the
nonfederal share of the recovery.
This does not apply to recoveries from medical providers or
to recoveries begun by the Department of Human Services'
Surveillance and Utilization Review Division, State Hospital
Collections Unit, and the Benefit Recoveries Division or, by the
attorney general's office, or child support collections. In the
food stamp or food support program, the nonfederal share of
recoveries in the federal tax offset program only will be
divided equally between the state agency and the involved county
agency.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 8. Minnesota Statutes 2004, section 256.045,
subdivision 3, as amended by Laws 2005, chapter 98, article 3,
section 18, is amended to read:
Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency
hearings are available for the following: (1) any person
applying for, receiving or having received public assistance,
medical care, or a program of social services granted by the
state agency or a county agency or the federal Food Stamp Act
whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended,
reduced, terminated, or claimed to have been incorrectly paid;
(2) any patient or relative aggrieved by an order of the
commissioner under section 252.27; (3) a party aggrieved by a
ruling of a prepaid health plan; (4) except as provided under
chapter 245C, any individual or facility determined by a lead
agency to have maltreated a vulnerable adult under section
626.557 after they have exercised their right to administrative
reconsideration under section 626.557; (5) any person whose
claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section
626.556 is denied or not acted upon with reasonable promptness,
regardless of funding source; (6) any person to whom a right of
appeal according to this section is given by other provision of
law; (7) an applicant aggrieved by an adverse decision to an
application for a hardship waiver under section 256B.15; (8) an
applicant aggrieved by an adverse decision to an application or
redetermination for a Medicare Part D prescription drug subsidy
under section 256B.04, subdivision 4a; (9) except as provided
under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual
or facility has exercised the right to administrative
reconsideration under section 626.556; or (9) (10) except as
provided under chapter 245C, an individual disqualified under
sections 245C.14 and 245C.15, on the basis of serious or
recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition
of any of the crimes listed in section 245C.15, subdivisions 1
to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings
regarding a maltreatment determination under clause (4)
or (8) (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring
maltreatment, which has not been set aside under sections
245C.22 and 245C.23, shall be consolidated into a single fair
hearing. In such cases, the scope of review by the human
services referee shall include both the maltreatment
determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a
bar to a hearing under this section if federal law provides an
individual the right to a hearing to dispute a finding of
maltreatment. Individuals and organizations specified in this
section may contest the specified action, decision, or final
disposition before the state agency by submitting a written
request for a hearing to the state agency within 30 days after
receiving written notice of the action, decision, or final
disposition, or within 90 days of such written notice if the
applicant, recipient, patient, or relative shows good cause why
the request was not submitted within the 30-day time limit.
The hearing for an individual or facility under clause (4),
(8) (9), or (9) (10) is the only administrative appeal to the
final agency determination specifically, including a challenge
to the accuracy and completeness of data under section 13.04.
Hearings requested under clause (4) apply only to incidents of
maltreatment that occur on or after October 1, 1995. Hearings
requested by nursing assistants in nursing homes alleged to have
maltreated a resident prior to October 1, 1995, shall be held as
a contested case proceeding under the provisions of chapter 14.
Hearings requested under clause (8) (9) apply only to incidents
of maltreatment that occur on or after July 1, 1997. A hearing
for an individual or facility under clause (8) (9) is only
available when there is no juvenile court or adult criminal
action pending. If such action is filed in either court while
an administrative review is pending, the administrative review
must be suspended until the judicial actions are completed. If
the juvenile court action or criminal charge is dismissed or the
criminal action overturned, the matter may be considered in an
administrative hearing.
For purposes of this section, bargaining unit grievance
procedures are not an administrative appeal.
The scope of hearings involving claims to foster care
payments under clause (5) shall be limited to the issue of
whether the county is legally responsible for a child's
placement under court order or voluntary placement agreement
and, if so, the correct amount of foster care payment to be made
on the child's behalf and shall not include review of the
propriety of the county's child protection determination or
child placement decision.
(b) A vendor of medical care as defined in section 256B.02,
subdivision 7, or a vendor under contract with a county agency
to provide social services is not a party and may not request a
hearing under this section, except if assisting a recipient as
provided in subdivision 4.
(c) An applicant or recipient is not entitled to receive
social services beyond the services prescribed under chapter
256M or other social services the person is eligible for under
state law.
(d) The commissioner may summarily affirm the county or
state agency's proposed action without a hearing when the sole
issue is an automatic change due to a change in state or federal
law.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 9. Minnesota Statutes 2004, section 256.045,
subdivision 3a, is amended to read:
Subd. 3a. [PREPAID HEALTH PLAN APPEALS.] (a) All prepaid
health plans under contract to the commissioner under chapter
256B or 256D must provide for a complaint system according to
section 62D.11. When a prepaid health plan denies, reduces, or
terminates a health service or denies a request to authorize a
previously authorized health service, the prepaid health plan
must notify the recipient of the right to file a complaint or an
appeal. The notice must include the name and telephone number
of the ombudsman and notice of the recipient's right to request
a hearing under paragraph (b). When a complaint is filed, the
prepaid health plan must notify the ombudsman within three
working days. Recipients may request the assistance of the
ombudsman in the complaint system process. The prepaid health
plan must issue a written resolution of the complaint to the
recipient within 30 days after the complaint is filed with the
prepaid health plan. A recipient is not required to exhaust the
complaint system procedures in order to request a hearing under
paragraph (b).
(b) Recipients enrolled in a prepaid health plan under
chapter 256B or 256D may contest a prepaid health plan's denial,
reduction, or termination of health services, a prepaid health
plan's denial of a request to authorize a previously authorized
health service, or the prepaid health plan's written resolution
of a complaint by submitting a written request for a hearing
according to subdivision 3. A state human services referee
shall conduct a hearing on the matter and shall recommend an
order to the commissioner of human services. The commissioner
need not grant a hearing if the sole issue raised by a recipient
is the commissioner's authority to require mandatory enrollment
in a prepaid health plan in a county where prepaid health plans
are under contract with the commissioner. The state human
services referee may order a second medical opinion from the
prepaid health plan or may order a second medical opinion from a
nonprepaid health plan provider at the expense of the prepaid
health plan. Recipients may request the assistance of the
ombudsman in the appeal process.
(c) In the written request for a hearing to appeal from a
prepaid health plan's denial, reduction, or termination of a
health service, a prepaid health plan's denial of a request to
authorize a previously authorized service, or the prepaid health
plan's written resolution to a complaint, a recipient may
request an expedited hearing. If an expedited appeal is
warranted, the state human services referee shall hear the
appeal and render a decision within a time commensurate with the
level of urgency involved, based on the individual circumstances
of the case.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 10. Minnesota Statutes 2004, 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, the diversionary work program,
child care assistance programs, general assistance, family
general assistance program formerly codified in section 256D.05,
subdivision 1, clause (15), Minnesota supplemental aid, 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
Department of Human Services, in lieu of a local agency, may
initiate an administrative fraud disqualification hearing when
the state agency is directly responsible for administration of
the health care program for which benefits were wrongfully
obtained. 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, medical care programs, and child care assistance under
chapter 119B.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 11. Minnesota Statutes 2004, section 256.9657, is
amended by adding a subdivision to read:
Subd. 7a. [WITHHOLDING.] If any provider obligated to pay
an annual surcharge under this section is more than two months
delinquent in the timely payment of a monthly surcharge
installment payment, the provisions in paragraphs (a) to (f)
apply.
(a) The department may withhold some or all of the amount
of the delinquent surcharge, together with any interest and
penalties due and owing on those amounts, from any money the
department owes to the provider. The department may, at its
discretion, also withhold future surcharge installment payments
from any money the department owes the provider as those
installments become due and owing. The department may continue
this withholding until the department determines there is no
longer any need to do so.
(b) The department shall give prior notice of the
department's intention to withhold by mailing a written notice
to the provider at the address to which remittance advices are
mailed or faxing a copy of the notice to the provider at least
ten business days before the date of the first payment period
for which the withholding begins. The notice may be sent by
ordinary or certified mail, or facsimile, and shall be deemed
received as of the date of mailing or receipt of the facsimile.
The notice shall:
(i) state the amount of the delinquent surcharge;
(ii) state the amount of the withholding per payment
period;
(iii) state the date on which the withholding is to begin;
(iv) state whether the department intends to withhold
future installments of the provider's surcharge payments;
(v) inform the provider of their rights to informally
object to the proposed withholding and to appeal the withholding
as provided for in this subdivision;
(vi) state that the provider may prevent the withholding
during the pendency of their appeal by posting a bond; and
(vii) state other contents as the department deems
appropriate.
(c) The provider may informally object to the withholding
in writing anytime before the withholding begins. An informal
objection shall not stay or delay the commencement of the
withholding. The department may postpone the commencement of
the withholding as deemed appropriate and shall not be required
to give another notice at the end of the postponement and before
commencing the withholding. The provider shall have the right
to appeal any withholding from remittances by filing an appeal
with Ramsey County District Court and serving notice of the
appeal on the department within 30 days of the date of the
written notice of the withholding. Notice shall be given and
the appeal shall be heard no later than 45 days after the appeal
is filed. In a hearing of the appeal, the department's action
shall be sustained if the department proves the amount of the
delinquent surcharges or overpayment the provider owes, plus any
accrued interest and penalties, has not been repaid. The
department may continue withholding for delinquent and current
surcharge installment payments during the pendency of an appeal
unless the provider posts a bond from a surety company licensed
to do business in Minnesota in favor of the department in an
amount equal to two times the provider's total annual surcharge
payment for the fiscal year in which the appeal is filed with
the department.
(d) The department shall refund any amounts due to the
provider under any final administrative or judicial order or
decree which fully and finally resolves the appeal together with
interest on those amounts at the rate of three percent per annum
simple interest computed from the date of each withholding, as
soon as practical after entry of the order or decree.
(e) The commissioner, or the commissioner's designee, may
enter into written settlement agreements with a provider to
resolve disputes and other matters involving unpaid surcharge
installment payments or future surcharge installment payments.
(f) Notwithstanding any law to the contrary, all unpaid
surcharges, plus any accrued interest and penalties, shall be
overpayments for purposes of section 256B.0641.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 12. Minnesota Statutes 2004, 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.
(d) In addition to the reduction in paragraphs (b) and (c),
the total payment for fee-for-service admissions occurring on or
after July 1, 2005, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced 6.0
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. Notwithstanding section 256.9686, subdivision 7, for
purposes of this paragraph, medical assistance does not include
general assistance medical care. Payments made to managed care
plans shall be reduced for services provided on or after January
1, 2006, to reflect this reduction.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 13. Minnesota Statutes 2004, section 256.969,
subdivision 9, is amended to read:
Subd. 9. [DISPROPORTIONATE NUMBERS OF LOW-INCOME PATIENTS
SERVED.] (a) For admissions occurring on or after October 1,
1992, through December 31, 1992, the medical assistance
disproportionate population adjustment shall comply with federal
law and shall be paid to a hospital, excluding regional
treatment centers and facilities of the federal Indian Health
Service, with a medical assistance inpatient utilization rate in
excess of the arithmetic mean. The adjustment must be
determined as follows:
(1) for a hospital with a medical assistance inpatient
utilization rate above the arithmetic mean for all hospitals
excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one
standard deviation above the mean, the adjustment must be
determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's
actual medical assistance inpatient utilization rate and the
arithmetic mean for all hospitals excluding regional treatment
centers and facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient
utilization rate above one standard deviation above the mean,
the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by
1.1. If federal matching funds are not available for all
adjustments under this subdivision, the commissioner shall
reduce payments on a pro rata basis so that all adjustments
qualify for federal match. The commissioner may establish a
separate disproportionate population operating payment rate
adjustment under the general assistance medical care program.
For purposes of this subdivision medical assistance does not
include general assistance medical care. The commissioner shall
report annually on the number of hospitals likely to receive the
adjustment authorized by this paragraph. The commissioner shall
specifically report on the adjustments received by public
hospitals and public hospital corporations located in cities of
the first class.
(b) For admissions occurring on or after July 1, 1993, the
medical assistance disproportionate population adjustment shall
comply with federal law and shall be paid to a hospital,
excluding regional treatment centers and facilities of the
federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean.
The adjustment must be determined as follows:
(1) for a hospital with a medical assistance inpatient
utilization rate above the arithmetic mean for all hospitals
excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one
standard deviation above the mean, the adjustment must be
determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's
actual medical assistance inpatient utilization rate and the
arithmetic mean for all hospitals excluding regional treatment
centers and facilities of the federal Indian Health Service;
(2) for a hospital with a medical assistance inpatient
utilization rate above one standard deviation above the mean,
the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by
1.1. The commissioner may establish a separate disproportionate
population operating payment rate adjustment under the general
assistance medical care program. For purposes of this
subdivision, medical assistance does not include general
assistance medical care. The commissioner shall report annually
on the number of hospitals likely to receive the adjustment
authorized by this paragraph. The commissioner shall
specifically report on the adjustments received by public
hospitals and public hospital corporations located in cities of
the first class; and
(3) for a hospital that had medical assistance
fee-for-service payment volume during calendar year 1991 in
excess of 13 percent of total medical assistance fee-for-service
payment volume, a medical assistance disproportionate population
adjustment shall be paid in addition to any other
disproportionate payment due under this subdivision as follows:
$1,515,000 due on the 15th of each month after noon, beginning
July 15, 1995. For a hospital that had medical assistance
fee-for-service payment volume during calendar year 1991 in
excess of eight percent of total medical assistance
fee-for-service payment volume and was the primary hospital
affiliated with the University of Minnesota, a medical
assistance disproportionate population adjustment shall be paid
in addition to any other disproportionate payment due under this
subdivision as follows: $505,000 due on the 15th of each month
after noon, beginning July 15, 1995; and
(4) effective August 1, 2005, the payments in paragraph
(b), clause (3), shall be reduced to zero.
(c) The commissioner shall adjust rates paid to a health
maintenance organization under contract with the commissioner to
reflect rate increases provided in paragraph (b), clauses (1)
and (2), on a nondiscounted hospital-specific basis but shall
not adjust those rates to reflect payments provided in clause
(3).
(d) If federal matching funds are not available for all
adjustments under paragraph (b), the commissioner shall reduce
payments under paragraph (b), clauses (1) and (2), on a pro rata
basis so that all adjustments under paragraph (b) qualify for
federal match.
(e) For purposes of this subdivision, medical assistance
does not include general assistance medical care.
(f) For hospital services occurring on or after July 1,
2005, to June 30, 2007, general assistance medical care
expenditures made by the department and by prepaid health plans
participating in general assistance medical care shall be
considered Medicaid disproportionate share hospital payments,
except as limited below:
(1) only the portion of Minnesota's disproportionate share
hospital allotment under section 1923(f) of the Social Security
Act that is not spent on the disproportionate population
adjustments in paragraph (b), clauses (1) and (2), may be used
for general assistance medical care expenditures;
(2) only those general assistance medical care expenditures
made to hospitals that qualify for disproportionate share
payments under section 1923 of the Social Security Act and the
Medicaid state plan may be considered disproportionate share
hospital payments;
(3) only those general assistance medical care expenditures
made to an individual hospital that would not cause the hospital
to exceed its individual hospital limits under section 1923 of
the Social Security Act may be considered; and
(4) general assistance medical care expenditures may be
considered only to the extent of Minnesota's aggregate allotment
under section 1923 of the Social Security Act.
All hospitals and prepaid health plans participating in general
assistance medical care must provide any necessary expenditure,
cost, and revenue information required by the commissioner as
necessary for purposes of obtaining federal Medicaid matching
funds for general assistance medical care expenditures.
[EFFECTIVE DATE.] Upon federal approval of the related
state plan amendment, paragraph (f) is effective retroactively
from July 1, 2005, or the earliest effective date approved by
the Centers for Medicare and Medicaid Services.
Sec. 14. Minnesota Statutes 2004, section 256.969,
subdivision 26, is amended to read:
Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE
30, 2001.] (a) For admissions occurring after June 30, 2001, the
commissioner shall pay fee-for-service inpatient admissions for
the diagnosis-related groups specified in paragraph (b) at
hospitals located outside of the seven-county metropolitan area
at the higher of:
(1) the hospital's current payment rate for the diagnostic
category to which the diagnosis-related group belongs, exclusive
of disproportionate population adjustments received under
subdivision 9 and hospital payment adjustments received under
subdivision 23; or
(2) 90 percent of the average payment rate for that
diagnostic category for hospitals located within the
seven-county metropolitan area, exclusive of disproportionate
population adjustments received under subdivision 9 and hospital
payment adjustments received under subdivisions 20 and 23. The
commissioner may adjust this percentage each year so that the
estimated payment increases under this paragraph are equal to
the funding provided under section 256B.195 for this purpose.
(b) The payment increases provided in paragraph (a) apply
to the following diagnosis-related groups, as they fall within
the diagnostic categories:
(1) 370 cesarean section with complicating diagnosis;
(2) 371 cesarean section without complicating diagnosis;
(3) 372 vaginal delivery with complicating diagnosis;
(4) 373 vaginal delivery without complicating diagnosis;
(5) 386 extreme immaturity and respiratory distress
syndrome, neonate;
(6) 388 full-term neonates with other problems;
(7) 390 prematurity without major problems;
(8) 391 normal newborn;
(9) 385 neonate, died or transferred to another acute care
facility;
(10) 425 acute adjustment reaction and psychosocial
dysfunction;
(11) 430 psychoses;
(12) 431 childhood mental disorders; and
(13) 164-167 appendectomy.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 15. Minnesota Statutes 2004, section 256.969, is
amended by adding a subdivision to read:
Subd. 27. [QUARTERLY PAYMENT ADJUSTMENT.] (a) In addition
to any other payment under this section, the commissioner shall
make the following payments effective July 1, 2007:
(1) for a hospital located in Minnesota and not eligible
for payments under subdivision 20, with a medical assistance
inpatient utilization rate greater than 17.8 percent of total
patient days as of the base year in effect on July 1, 2005, a
payment equal to 13 percent of the total of the operating and
property payment rates;
(2) for a hospital located in Minnesota in a specified
urban area outside of the seven-county metropolitan area and not
eligible for payments under subdivision 20, with a medical
assistance inpatient utilization rate less than or equal to 17.8
percent of total patient days as of the base year in effect on
July 1, 2005, a payment equal to ten percent of the total of the
operating and property payment rates. For purposes of this
clause, the following cities are specified urban areas: Detroit
Lakes, Rochester, Willmar, Alexandria, Austin, Cambridge,
Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River
Falls, and Wadena; and
(3) for a hospital located in Minnesota but not located in
a specified urban area under clause (2), with a medical
assistance inpatient utilization rate less than or equal to 17.8
percent of total patient days as of the base year in effect on
July 1, 2005, a payment equal to four percent of the total of
the operating and property payment rates. A hospital located in
Woodbury and not in existence during the base year shall be
reimbursed under this clause.
(b) The state share of payments under paragraph (a) shall
be equal to federal reimbursements to the commissioner to
reimburse nonstate expenditures reported under section
256B.199. The commissioner shall ratably reduce or increase
payments under this subdivision in order to ensure that these
payments equal the amount of reimbursement received by the
commissioner under section 256B.199, except that payments shall
be ratably reduced by an amount equivalent to the state share of
a four percent reduction in MinnesotaCare and medical assistance
payments for inpatient hospital services.
(c) The payments under paragraph (a) shall be paid
quarterly beginning on July 15, 2007, or upon federal approval
of federal reimbursements under section 256B.199, whichever
occurs later.
(d) The commissioner shall not adjust rates paid to a
prepaid health plan under contract with the commissioner to
reflect payments provided in paragraph (a).
(e) The commissioner shall maximize the use of available
federal money for disproportionate share hospital payments and
shall maximize payments to qualifying hospitals. In order to
accomplish these purposes, the commissioner may, in consultation
with the nonstate entities identified in section 256B.199,
adjust, on a pro rata basis if feasible, the amounts reported by
nonstate entities under section 256B.199 when application for
reimbursement is made to the federal government, and otherwise
adjust the provisions of this subdivision.
(f) By January 15 of each year, beginning January 15, 2006,
the commissioner shall report to the chairs of the house and
senate finance committees and divisions with jurisdiction over
funding for the Department of Human Services the following
estimates for the current and upcoming federal and state fiscal
years:
(1) the difference between the Medicare upper payment limit
and actual or anticipated medical assistance payments for
hospital services;
(2) the amount of federal disproportionate share hospital
funding available to Minnesota and the amount expected to be
claimed by the state; and
(3) the methodology used to calculate the results reported
for clauses (1) and (2).
(g) For purposes of this subdivision, medical assistance
does not include general assistance medical care.
(h) This section sunsets on June 30, 2009. The
commissioner shall report to the legislature by December 15,
2008, with recommendations for maximizing federal
disproportionate share hospital payments after June 30, 2009.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 16. Minnesota Statutes 2004, section 256.975,
subdivision 9, is amended 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.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 17. Minnesota Statutes 2004, section 256B.02,
subdivision 12, is amended to read:
Subd. 12. [THIRD-PARTY PAYER.] "Third-party payer" means a
person, entity, or agency or government program that has a
probable obligation to pay all or part of the costs of a medical
assistance recipient's health services. Third-party payer
includes an entity under contract with the recipient to cover
all or part of the recipient's medical costs.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 18. Minnesota Statutes 2004, section 256B.04, is
amended by adding a subdivision to read:
Subd. 4a. [MEDICARE PRESCRIPTION DRUG SUBSIDY.] The
commissioner shall perform all duties necessary to administer
eligibility determinations for the Medicare Part D prescription
drug subsidy and facilitate the enrollment of eligible medical
assistance recipients into Medicare prescription drug plans as
required by the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA), Public Law 108-173, and Code of
Federal Regulations, title 42, sections 423.30 to 423.56 and
423.771 to 423.800.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 19. Minnesota Statutes 2004, section 256B.055, is
amended by adding a subdivision to read:
Subd. 14. [PERSONS DETAINED BY LAW.] (a) Medical
assistance may be paid for an inmate of a correctional facility
who is conditionally released as authorized under section
241.26, 244.065, or 631.425, if the individual does not require
the security of a public detention facility and is housed in a
halfway house or community correction center, or under house
arrest and monitored by electronic surveillance in a residence
approved by the commissioner of corrections, and if the
individual meets the other eligibility requirements of this
chapter.
(b) An individual, regardless of age, who is considered an
inmate of a public institution as defined in Code of Federal
Regulations, title 42, section 435.1009, is not eligible for
medical assistance.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 20. Minnesota Statutes 2004, section 256B.056, is
amended by adding a subdivision to read:
Subd. 3d. [REDUCTION OF EXCESS ASSETS.] Assets in excess
of the limits in subdivisions 3 to 3c may be reduced to
allowable limits as follows:
(a) Assets may be reduced in any of the three calendar
months before the month of application in which the applicant
seeks coverage by:
(1) designating burial funds up to $1,500 for each
applicant, spouse, and MA-eligible dependent child; and
(2) paying health service bills incurred in the retroactive
period for which the applicant seeks eligibility, starting with
the oldest bill. After assets are reduced to allowable limits,
eligibility begins with the next dollar of MA-covered health
services incurred in the retroactive period. Applicants
reducing assets under this subdivision who also have excess
income shall first spend excess assets to pay health service
bills and may meet the income spenddown on remaining bills.
(b) Assets may be reduced beginning the month of
application by:
(1) paying bills for health services that would otherwise
be paid by medical assistance; and
(2) using any means other than a transfer of assets for
less than fair market value as defined in section 256B.0595,
subdivision 1, paragraph (b).
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 21. Minnesota Statutes 2004, section 256B.056,
subdivision 5, is amended to read:
Subd. 5. [EXCESS INCOME.] A person who has excess income
is eligible for medical assistance if the person has expenses
for medical care that are more than the amount of the person's
excess income, computed by deducting incurred medical expenses
from the excess income to reduce the excess to the income
standard specified in subdivision 5c. The person shall elect to
have the medical expenses deducted at the beginning of a
one-month budget period or at the beginning of a six-month
budget period. The commissioner shall allow persons eligible
for assistance on a one-month spenddown basis under this
subdivision to elect to pay the monthly spenddown amount in
advance of the month of eligibility to the state agency in order
to maintain eligibility on a continuous basis. If the recipient
does not pay the spenddown amount on or before the 20th last
business day of the month, the recipient is ineligible for this
option for the following month. The local agency shall code the
Medicaid Management Information System (MMIS) to indicate that
the recipient has elected this option. The state agency shall
convey recipient eligibility information relative to the
collection of the spenddown to providers through the Electronic
Verification System (EVS). A recipient electing advance payment
must pay the state agency the monthly spenddown amount on or
before noon on the 20th last business day of the month in order
to be eligible for this option in the following month.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 22. Minnesota Statutes 2004, section 256B.056,
subdivision 5a, is amended to read:
Subd. 5a. [INDIVIDUALS ON FIXED OR EXCLUDED INCOME.]
Recipients of medical assistance who receive only fixed unearned
or excluded income, when that income is excluded from
consideration as income or unvarying in amount and timing of
receipt throughout the year, shall report and verify their
income annually every 12 months. The 12-month period begins
with the month of application.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 23. Minnesota Statutes 2004, section 256B.056,
subdivision 5b, is amended to read:
Subd. 5b. [INDIVIDUALS WITH LOW INCOME.] Recipients of
medical assistance not residing in a long-term care facility who
have slightly fluctuating income which is below the medical
assistance income limit shall report and verify their income on
a semiannual basis every six months. The six-month period
begins the month of application.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 24. Minnesota Statutes 2004, section 256B.056,
subdivision 7, is amended to read:
Subd. 7. [PERIOD OF ELIGIBILITY.] Eligibility is available
for the month of application and for three months prior to
application if the person was eligible in those prior
months. Eligibility for months prior to application is
determined independently from eligibility for the month of
application and future months. A redetermination of eligibility
must occur every 12 months. The 12-month period begins with the
month of application.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 25. Minnesota Statutes 2004, section 256B.056, is
amended by adding a subdivision to read:
Subd. 9. [NOTICE.] The state agency must be given notice
of monetary claims against a person, entity, or corporation that
may be liable to pay all or part of the cost of medical care
when the state agency has paid or becomes liable for the cost of
that care. Notice must be given according to paragraphs (a) to
(d).
(a) An applicant for medical assistance shall notify the
state or local agency of any possible claims when the applicant
submits the application. A recipient of medical assistance
shall notify the state or local agency of any possible claims
when those claims arise.
(b) A person providing medical care services to a recipient
of medical assistance shall notify the state agency when the
person has reason to believe that a third party may be liable
for payment of the cost of medical care.
(c) A party to a claim that may be assigned to the state
agency under this section shall notify the state agency of its
potential assignment claim in writing at each of the following
stages of a claim:
(1) when a claim is filed;
(2) when an action is commenced; and
(3) when a claim is concluded by payment, award, judgment,
settlement, or otherwise.
(d) Every party involved in any stage of a claim under this
subdivision is required to provide notice to the state agency at
that stage of the claim. However, when one of the parties to
the claim provides notice at that stage, every other party to
the claim is deemed to have provided the required notice for
that stage of the claim. If the required notice under this
paragraph is not provided to the state agency, all parties to
the claim are deemed to have failed to provide the required
notice. A party to the claim includes the injured person or the
person's legal representative, the plaintiff, the defendants, or
persons alleged to be responsible for compensating the injured
person or plaintiff, and any other party to the cause of action
or claim, regardless of whether the party knows the state agency
has a potential or actual assignment claim.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 26. Minnesota Statutes 2004, section 256B.056, is
amended by adding a subdivision to read:
Subd. 10. [ELIGIBILITY VERIFICATION.] (a) The commissioner
shall require women who are applying for the continuation of
medical assistance coverage following the end of the 60-day
postpartum period to update their income and asset information
and to submit any required income or asset verification.
(b) The commissioner shall determine the eligibility of
private-sector health care coverage for infants less than one
year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (d), and shall pay for
private-sector coverage if this is determined to be
cost-effective.
(c) The commissioner shall modify the application for
Minnesota health care programs to require more detailed
information related to verification of assets and income, and
shall verify assets and income for all applicants, and for all
recipients upon renewal.
(d) The commissioner shall require Minnesota health care
program recipients to report new or an increase in earned income
within ten days of the change, and to verify new or an increase
in earned income that affects eligibility within ten days of
notification by the agency that the new or increased earned
income affects eligibility. Recipients who fail to verify new
or an increase in earned income that affects eligibility shall
be disenrolled.
[EFFECTIVE DATE.] This section is effective September 1,
2005, except that paragraph (a) is effective September 1, 2005,
or upon federal approval, whichever is later. Prior to the
implementation of HealthMatch, the commissioner shall implement
this section to the fullest extent possible, including the use
of manual processing. Upon implementation of HealthMatch, the
commissioner shall implement this section in a manner consistent
with the procedures and requirements of HealthMatch.
Sec. 27. Minnesota Statutes 2004, section 256B.0575, is
amended to read:
256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
PERSONS.]
When an institutionalized person is determined eligible for
medical assistance, the income that exceeds the deductions in
paragraphs (a) and (b) must be applied to the cost of
institutional care.
(a) The following amounts must be deducted from the
institutionalized person's income in the following order:
(1) the personal needs allowance under section 256B.35 or,
for a veteran who does not have a spouse or child, or a
surviving spouse of a veteran having no child, the amount of an
improved pension received from the veteran's administration not
exceeding $90 per month;
(2) the personal allowance for disabled individuals under
section 256B.36;
(3) if the institutionalized person has a legally appointed
guardian or conservator, five percent of the recipient's gross
monthly income up to $100 as reimbursement for guardianship or
conservatorship services;
(4) a monthly income allowance determined under section
256B.058, subdivision 2, but only to the extent income of the
institutionalized spouse is made available to the community
spouse;
(5) a monthly allowance for children under age 18 which,
together with the net income of the children, would provide
income equal to the medical assistance standard for families and
children according to section 256B.056, subdivision 4, for a
family size that includes only the minor children. This
deduction applies only if the children do not live with the
community spouse and only to the extent that the deduction is
not included in the personal needs allowance under section
256B.35, subdivision 1, as child support garnished under a court
order;
(6) a monthly family allowance for other family members,
equal to one-third of the difference between 122 percent of the
federal poverty guidelines and the monthly income for that
family member;
(7) reparations payments made by the Federal Republic of
Germany and reparations payments made by the Netherlands for
victims of Nazi persecution between 1940 and 1945;
(8) all other exclusions from income for institutionalized
persons as mandated by federal law; and
(9) amounts for reasonable expenses incurred for necessary
medical or remedial care for the institutionalized person that
are not medical assistance covered expenses and that are not
subject to payment by a third party.
Reasonable expenses are limited to expenses that have not
been previously used as a deduction from income and are incurred
during the enrollee's current period of eligibility, including
retroactive months associated with the current period of
eligibility, for medical assistance payment of long-term care
services.
For purposes of clause (6), "other family member" means a
person who resides with the community spouse and who is a minor
or dependent child, dependent parent, or dependent sibling of
either spouse. "Dependent" means a person who could be claimed
as a dependent for federal income tax purposes under the
Internal Revenue Code.
(b) Income shall be allocated to an institutionalized
person for a period of up to three calendar months, in an amount
equal to the medical assistance standard for a family size of
one if:
(1) a physician certifies that the person is expected to
reside in the long-term care facility for three calendar months
or less;
(2) if the person has expenses of maintaining a residence
in the community; and
(3) if one of the following circumstances apply:
(i) the person was not living together with a spouse or a
family member as defined in paragraph (a) when the person
entered a long-term care facility; or
(ii) the person and the person's spouse become
institutionalized on the same date, in which case the allocation
shall be applied to the income of one of the spouses.
For purposes of this paragraph, a person is determined to be
residing in a licensed nursing home, regional treatment center,
or medical institution if the person is expected to remain for a
period of one full calendar month or more.
[EFFECTIVE DATE.] This section is effective retroactively
from July 1, 2005.
Sec. 28. Minnesota Statutes 2004, 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 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 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined
in section 501(e) of Public Law 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 this chapter, 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 this chapter, 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 this chapter 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 this chapter, 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 this chapter 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 this chapter,
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, or eligible for medical assistance as described
in paragraph (j), and who are not covered by a group health plan
or health insurance coverage according to Code of Federal
Regulations, title 42, section 457.310, and who otherwise meet
the eligibility requirements of this chapter, are eligible for
medical assistance payment without federal financial
participation for care and services through the period of
pregnancy, and including labor and delivery, to the extent
federal funds are available under Title XXI of the Social
Security Act, and the state children's health insurance program,
followed by 60 days postpartum, except for labor and
delivery without federal financial participation.
(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) 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 this chapter 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 paragraph shall not be
required to participate in prepaid medical assistance.
[EFFECTIVE DATE.] This section is effective September 1,
2005.
Sec. 29. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 1a. [SERVICES PROVIDED IN A HOSPITAL EMERGENCY
ROOM.] Medical assistance does not cover visits to a hospital
emergency room that are not for emergency and emergency
poststabilization care or urgent care, and does not pay for any
services provided in a hospital emergency room that are not for
emergency and emergency poststabilization care or urgent care.
[EFFECTIVE DATE.] This section is effective October 1, 2005.
Sec. 30. Minnesota Statutes 2004, section 256B.0625,
subdivision 3a, is amended to read:
Subd. 3a. [GENDER SEX REASSIGNMENT SURGERY.] Gender Sex
reassignment surgery and other gender reassignment medical
procedures including drug therapy for gender reassignment are is
not covered unless the individual began receiving gender
reassignment services prior to July 1, 1998.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 31. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 3f. [CIRCUMCISION FOR NEWBORNS.] Newborn
circumcision is not covered, unless the procedure is medically
necessary or required because of a well-established religious
practice.
[EFFECTIVE DATE.] This section is effective September 1,
2005, and applies to services provided on or after that date.
Sec. 32. Minnesota Statutes 2004, 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) restorative services; and
(3) emergency services.
Emergency services, dentures, and extractions related to
dentures are not included in the $500 annual benefit limit.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 33. Minnesota Statutes 2004, 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.
(d) Effective January 1, 2006, medical assistance shall not
cover drugs that are coverable under Medicare Part D as defined
in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section
1860D-2(e), for individuals eligible for drug coverage as
defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section
1860D-1(a)(3)(A). For these individuals, medical assistance may
cover drugs from the drug classes listed in United States Code,
title 42, section 1396r-8(d)(2), subject to this subdivision and
subdivisions 13a to 13g, except that drugs listed in United
States Code, title 42, section 1396r-8(d)(2)(E), shall not be
covered.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 34. Minnesota Statutes 2004, section 256B.0625,
subdivision 13a, is amended to read:
Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] The
commissioner, after receiving recommendations from professional
medical associations, professional pharmacy associations, and
consumer groups shall designate a nine-member Drug Utilization
Review Board is established. The board is shall be comprised of
at least three but no more than four licensed physicians
actively engaged in the practice of medicine in Minnesota; 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. The
board shall be staffed by an employee of the department who
shall serve as an ex officio nonvoting member of the board. The
department's medical director shall also serve as an ex officio,
nonvoting member of the board. The members of the board shall
be appointed by the commissioner and shall serve three-year
terms. The members shall be selected from lists submitted by
professional associations. The commissioner shall appoint the
initial members of the board for terms expiring as follows:
three members for terms expiring June 30, 1996; three members
for terms expiring June 30, 1997; and three members for terms
expiring June 30, 1998. Members may be reappointed once by the
commissioner. The board shall annually elect a chair from among
the members.
The commissioner shall, with the advice of the board:
(1) implement a medical assistance retrospective and
prospective drug utilization review program as required by
United States Code, title 42, section 1396r-8(g)(3);
(2) develop and implement the predetermined criteria and
practice parameters for appropriate prescribing to be used in
retrospective and prospective drug utilization review;
(3) develop, select, implement, and assess interventions
for physicians, pharmacists, and patients that are educational
and not punitive in nature;
(4) establish a grievance and appeals process for
physicians and pharmacists under this section;
(5) publish and disseminate educational information to
physicians and pharmacists regarding the board and the review
program;
(6) adopt and implement procedures designed to ensure the
confidentiality of any information collected, stored, retrieved,
assessed, or analyzed by the board, staff to the board, or
contractors to the review program that identifies individual
physicians, pharmacists, or recipients;
(7) establish and implement an ongoing process to (i)
receive public comment regarding drug utilization review
criteria and standards, and (ii) consider the comments along
with other scientific and clinical information in order to
revise criteria and standards on a timely basis; and
(8) adopt any rules necessary to carry out this section.
The board may establish advisory committees. The
commissioner may contract with appropriate organizations to
assist the board in carrying out the board's duties. The
commissioner may enter into contracts for services to develop
and implement a retrospective and prospective review program.
The board shall report to the commissioner annually on the
date the Drug Utilization Review Annual Report is due to the
Centers for Medicare and Medicaid Services. This report is to
cover the preceding federal fiscal year. The commissioner shall
make the report available to the public upon request. The
report must include information on the activities of the board
and the program; the effectiveness of implemented interventions;
administrative costs; and any fiscal impact resulting from the
program. An honorarium of $100 per meeting and reimbursement
for mileage shall be paid to each board member in attendance.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 35. Minnesota Statutes 2004, section 256B.0625,
subdivision 13c, is amended to read:
Subd. 13c. [FORMULARY COMMITTEE.] The commissioner, after
receiving recommendations from professional medical associations
and professional pharmacy associations, and consumer groups
shall designate a Formulary Committee to 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, but the committee shall be staffed
by an employee of the department who shall serve as an ex
officio, nonvoting member of the board. The department's
medical director shall also serve as an ex officio, nonvoting
member for the committee. Committee members shall serve
three-year terms and may be reappointed 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.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 36. Minnesota Statutes 2004, section 256B.0625,
subdivision 13d, is amended to read:
Subd. 13d. [DRUG FORMULARY.] 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:
(1) drugs or products for which there is no federal
funding;
(2) over-the-counter drugs, except as provided in
subdivision 13;
(3) drugs used for weight loss, except that medically
necessary lipase inhibitors may be covered for a recipient with
type II diabetes;
(4) drugs when used for the treatment of impotence or
erectile dysfunction;
(5) drugs for which medical value has not been established;
and
(5) (6) 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.
[EFFECTIVE DATE.] This section is effective September 1,
2005.
Sec. 37. Minnesota Statutes 2004, section 256B.0625,
subdivision 13e, as amended by Laws 2005, chapter 155, article
3, section 5, is amended to read:
Subd. 13e. [PAYMENT RATES.] (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 11.5 12 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 11.5 percent deduction. The actual
acquisition cost of antihemophilic factor drugs shall be
estimated at the average wholesale price minus 30 percent. The
maximum allowable cost of a multisource drug may be set by the
commissioner and it shall be comparable to, but no higher than,
the maximum amount paid by other third-party payors in this
state who have maximum allowable cost programs. Establishment
of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.
(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, or on the maximum allowable cost established
by the commissioner.
(d) 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 or the
amount established for Medicare by the United States Department
of Health and Human Services pursuant to title XVIII, section
1847a of the federal Social Security Act.
(e) The commissioner may negotiate lower reimbursement
rates for specialty pharmacy products than the rates specified
in paragraph (a). The commissioner may require individuals
enrolled in the health care programs administered by the
department to obtain specialty pharmacy products from providers
with whom the commissioner has negotiated lower reimbursement
rates. Specialty pharmacy products are defined as those used by
a small number of recipients or recipients with complex and
chronic diseases that require expensive and challenging drug
regimens. Examples of these conditions include, but are not
limited to: multiple sclerosis, HIV/AIDS, transplantation,
hepatitis C, growth hormone deficiency, Crohn's Disease,
rheumatoid arthritis, and certain forms of cancer. Specialty
pharmaceutical products include injectable and infusion
therapies, biotechnology drugs, high-cost therapies, and
therapies that require complex care. The commissioner shall
consult with the formulary committee to develop a list of
specialty pharmacy products subject to this paragraph. In
consulting with the formulary committee in developing this list,
the commissioner shall take into consideration the population
served by specialty pharmacy products, the current delivery
system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust
the reimbursement rate to prevent access to care issues.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 38. Minnesota Statutes 2004, section 256B.0625,
subdivision 13f, as amended by Laws 2005, chapter 155, article
3, section 6, is amended to read:
Subd. 13f. [PRIOR AUTHORIZATION.] (a) The Formulary
Committee shall review and recommend drugs which require prior
authorization. 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. Prior authorization shall automatically be
granted for 60 days for brand name drugs prescribed for
treatment of mental illness within 60 days of when a generically
equivalent drug becomes available, provided that the brand name
drug was part of the recipient's course of treatment at the time
the generically equivalent drug became available.
(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 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, 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.
(f) Notwithstanding this subdivision, the commissioner may
automatically require prior authorization, for a period not to
exceed 180 days, for any drug that is approved by the United
States Food and Drug Administration on or after July 1, 2005.
The 180-day period begins no later than the first day that a
drug is available for shipment to pharmacies within the state.
The Formulary Committee shall recommend to the commissioner
general criteria to be used for the prior authorization of the
drugs, but the committee is not required to review each
individual drug. In order to continue prior authorizations for
a drug after the 180-day period has expired, the commissioner
must follow the provisions of this subdivision.
[EFFECTIVE DATE.] Paragraph (c) is effective August 1,
2005, and paragraph (d) is effective retroactively from June 30,
2005.
Sec. 39. Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 13h. [MEDICATION THERAPY MANAGEMENT CARE.] (a)
Medical assistance and general assistance medical care cover
medication therapy management services for a recipient taking
four or more prescriptions to treat or prevent two or more
chronic medical conditions, or a recipient with a drug therapy
problem that is identified or prior authorized by the
commissioner that has resulted or is likely to result in
significant nondrug program costs. The commissioner may cover
medical therapy management services under MinnesotaCare if the
commissioner determines this is cost-effective. For purposes of
this subdivision, "medication therapy management" means the
provision of the following pharmaceutical care services by a
licensed pharmacist to optimize the therapeutic outcomes of the
patient's medications:
(1) performing or obtaining necessary assessments of the
patient's health status;
(2) formulating a medication treatment plan;
(3) monitoring and evaluating the patient's response to
therapy, including safety and effectiveness;
(4) performing a comprehensive medication review to
identify, resolve, and prevent medication-related problems,
including adverse drug events;
(5) documenting the care delivered and communicating
essential information to the patient's other primary care
providers;
(6) providing verbal education and training designed to
enhance patient understanding and appropriate use of the
patient's medications;
(7) providing information, support services, and resources
designed to enhance patient adherence with the patient's
therapeutic regimens; and
(8) coordinating and integrating medication therapy
management services within the broader health care management
services being provided to the patient.
Nothing in this subdivision shall be construed to expand or
modify the scope of practice of the pharmacist as defined in
section 151.01, subdivision 27.
(b) To be eligible for reimbursement for services under
this subdivision, a pharmacist must meet the following
requirements:
(1) have a valid license issued under chapter 151;
(2) have graduated from an accredited college of pharmacy
on or after May 1996, or completed a structured and
comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education
for the provision and documentation of pharmaceutical care
management services that has both clinical and didactic
elements;
(3) be practicing in an ambulatory care setting as part of
a multidisciplinary team or have developed a structured patient
care process that is offered in a private or semiprivate patient
care area that is separate from the commercial business that
also occurs in the setting; and
(4) make use of an electronic patient record system that
meets state standards.
(c) For purposes of reimbursement for medication therapy
management services, the commissioner may enroll individual
pharmacists as medical assistance and general assistance medical
care providers. The commissioner may also establish contact
requirements between the pharmacist and recipient, including
limiting the number of reimbursable consultations per recipient.
(d) The commissioner, after receiving recommendations from
professional medical associations, professional pharmacy
associations, and consumer groups, shall convene an 11-member
Medication Therapy Management Advisory Committee to advise the
commissioner on the implementation and administration of
medication therapy management services. The committee shall be
comprised of: two licensed physicians; two licensed
pharmacists; two consumer representatives; two health plan
company representatives; and three members with expertise in the
area of medication therapy management, who may be licensed
physicians or licensed pharmacists. The committee is governed
by section 15.059, except that committee members do not receive
compensation or reimbursement for expenses. The advisory
committee expires on June 30, 2007.
(e) The commissioner shall evaluate the effect of
medication therapy management on quality of care, patient
outcomes, and program costs, and shall include a description of
any savings generated in the medical assistance and general
assistance medical care programs that can be attributable to
this coverage. The evaluation shall be submitted to the
legislature by December 15, 2007. The commissioner may contract
with a vendor or an academic institution that has expertise in
evaluating health care outcomes for the purpose of completing
the evaluation.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 40. Minnesota Statutes 2004, 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
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.
(b) Medical assistance covers special transportation, as
defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
if 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. 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 $17 for the base rate and $1.40 $1.35 per mile for
services to eligible persons who need a wheelchair-accessible
van;
(2) $12 $11.50 for the base rate and $1.35 $1.30 per mile
for services to eligible persons who do not need a
wheelchair-accessible van; and
(3) $36 $60 for the base rate and $1.40 $2.40 per mile, and
an attendant rate of $9 per trip, for services to eligible
persons who need a stretcher-accessible vehicle.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 41. Minnesota Statutes 2004, section 256B.0631,
subdivision 1, is amended to read:
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 $12 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.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 42. Minnesota Statutes 2004, section 256B.0631,
subdivision 3, is amended to read:
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 $12
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.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 43. [256B.072] [PERFORMANCE REPORTING AND QUALITY
IMPROVEMENT SYSTEM.]
(a) The commissioner of human services shall establish a
performance reporting system for health care providers who
provide health care services to public program recipients
covered under chapters 256B, 256D, and 256L, reporting
separately for managed care and fee-for-service recipients.
(b) The measures used for the performance reporting system
for medical groups shall include measures of care for asthma,
diabetes, hypertension, and coronary artery disease and measures
of preventive care services. The measures used for the
performance reporting system for inpatient hospitals shall
include measures of care for acute myocardial infarction, heart
failure, and pneumonia, and measures of care and prevention of
surgical infections. In the case of a medical group, the
measures used shall be consistent with measures published by
nonprofit Minnesota or national organizations that produce and
disseminate health care quality measures or evidence-based
health care guidelines. In the case of inpatient hospital
measures, the commissioner shall appoint the Minnesota Hospital
Association and Stratis Health to advise on the development of
the performance measures to be used for hospital reporting. To
enable a consistent measurement process across the community,
the commissioner may use measures of care provided for patients
in addition to those identified in paragraph (a). The
commissioner shall ensure collaboration with other health care
reporting organizations so that the measures described in this
section are consistent with those reported by those
organizations and used by other purchasers in Minnesota.
(c) The commissioner may require providers to submit
information in a required format to a health care reporting
organization or to cooperate with the information collection
procedures of that organization. The commissioner may
collaborate with a reporting organization to collect information
reported and to prevent duplication of reporting.
(d) By October 1, 2007, and annually thereafter, the
commissioner shall report through a public Web site the results
by medical groups and hospitals, where possible, of the measures
under this section, and shall compare the results by medical
groups and hospitals for patients enrolled in public programs to
patients enrolled in private health plans. To achieve this
reporting, the commissioner may collaborate with a health care
reporting organization that operates a Web site suitable for
this purpose.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 44. Minnesota Statutes 2004, section 256B.075,
subdivision 2, is amended to read:
Subd. 2. [FEE-FOR-SERVICE.] (a) The commissioner shall
develop and implement a disease management program for medical
assistance and general assistance medical care recipients who
are not enrolled in the prepaid medical assistance or prepaid
general assistance medical care programs and who are receiving
services on a fee-for-service basis. The commissioner may
contract with an outside organization to provide these services.
(b) The commissioner shall seek any federal approval
necessary to implement this section and to obtain federal
matching funds.
(c) The commissioner shall develop and implement a pilot
intensive care management program for medical assistance
children with complex and chronic medical issues who are not
able to participate in the metro-based U Special Kids program
due to geographic distance.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 45. Minnesota Statutes 2004, section 256B.0911,
subdivision 1a, is amended to read:
Subd. 1a. [DEFINITIONS.] For purposes of this section, the
following definitions apply:
(a) "Long-term care consultation services" means:
(1) providing information and education to the general
public regarding availability of the services authorized under
this section;
(2) an intake process that provides access to the services
described in this section;
(3) assessment of the health, psychological, and social
needs of referred individuals;
(4) assistance in identifying services needed to maintain
an individual in the least restrictive environment;
(5) providing recommendations on cost-effective community
services that are available to the individual;
(6) development of an individual's community support plan;
(7) providing information regarding eligibility for
Minnesota health care programs;
(8) preadmission screening to determine the need for a
nursing facility level of care;
(9) preliminary determination of Minnesota health care
programs eligibility for individuals who need a nursing facility
level of care, with appropriate referrals for final
determination;
(10) providing recommendations for nursing facility
placement when there are no cost-effective community services
available; and
(11) assistance to transition people back to community
settings after facility admission.
(b) "Minnesota health care programs" means the medical
assistance program under chapter 256B, and the alternative care
program under section 256B.0913, and the prescription drug
program under section 256.955.
[EFFECTIVE DATE.] This section is effective January 1, 2006.
Sec. 46. Minnesota Statutes 2004, section 256B.0916, is
amended by adding a subdivision to read:
Subd. 10. [TRANSITIONAL SUPPORTS ALLOWANCE.] A
transitional supports allowance shall be available to all
persons under a home and community-based waiver who are moving
from a licensed setting to a community setting. "Transitional
supports allowance" means a onetime payment of up to $3,000, to
cover the costs, not covered by other sources, associated with
moving from a licensed setting to a community setting. Covered
costs include:
(1) lease or rent deposits;
(2) security deposits;
(3) utilities set-up costs, including telephone;
(4) essential furnishings and supplies; and
(5) personal supports and transports needed to locate and
transition to community settings.
[EFFECTIVE DATE.] This section is effective upon federal
approval and to the extent approved as a federal waiver
amendment.
Sec. 47. [256B.0918] [EMPLOYEE SCHOLARSHIP COSTS.]
Subdivision 1. [PROGRAM CRITERIA.] Beginning on or after
October 1, 2005, within the limits of appropriations
specifically available for this purpose, the commissioner shall
provide funding to qualified provider applicants for employee
scholarships for education in nursing and other health care
fields. Employee scholarships must be for a course of study
that is expected to lead to career advancement with the provider
or in the field of long-term care, including home care or care
of persons with disabilities, or nursing. Providers that secure
this funding must use it to award scholarships to employees who
work an average of at least 20 hours per week for the provider.
Management staff, registered nurses, and therapists are not
eligible to receive scholarships under this section.
Subd. 2. [PARTICIPATING PROVIDERS.] The commissioner shall
publish a request for proposals in the State Register by August
15, 2005, specifying provider eligibility requirements, provider
selection criteria, program specifics, funding mechanism, and
methods of evaluation. The commissioner may publish additional
requests for proposals in subsequent years. Providers who
provide services funded through the following programs are
eligible to apply to participate in the scholarship program:
home and community-based waivered services for persons with
mental retardation or related conditions under section 256B.501;
home and community-based waivered services for the elderly under
section 256B.0915; waivered services under community
alternatives for disabled individuals under section 256B.49;
community alternative care waivered services under section
256B.49; traumatic brain injury waivered services under section
256B.49; nursing services and home health services under section
256B.0625, subdivision 6a; personal care services and nursing
supervision of personal care services under section 256B.0625,
subdivision 19a; private duty nursing services under section
256B.0625, subdivision 7; day training and habilitation services
for adults with mental retardation or related conditions under
sections 252.40 to 252.46; and intermediate care facilities for
persons with mental retardation under section 256B.5012.
Subd. 3. [PROVIDER SELECTION CRITERIA.] To be considered
for scholarship funding, the provider shall submit a completed
application within the time frame specified by the
commissioner. In awarding funding, the commissioner shall
consider the following:
(1) the size of the provider as measured in annual billing
to the medical assistance program. To be eligible, a provider
must receive at least $500,000 annually in medical assistance
payments;
(2) the percentage of employees meeting the scholarship
program recipient requirements;
(3) staff retention rates for paraprofessionals; and
(4) other criteria determined by the commissioner.
Subd. 4. [FUNDING SPECIFICS.] Within the limits of
appropriations specifically available for this purpose, for the
rate period beginning on or after October 1, 2005, to September
30, 2007, the commissioner shall provide to each provider listed
in subdivision 2 and awarded funds under subdivision 3 a medical
assistance rate increase to fund scholarships up to two-tenths
percent of the medical assistance reimbursement rate. The
commissioner shall require providers to repay any portion of
funds awarded under subdivision 3 that is not used to fund
scholarships. If applications exceed available funding, funding
shall be targeted to providers that employ a higher percentage
of paraprofessional staff or have lower rates of turnover of
paraprofessional staff. During the subsequent years of the
program, the rate adjustment may be recalculated, at the
discretion of the commissioner. In making a recalculation the
commissioner may consider the provider's success at granting
scholarships based on the amount spent during the previous year
and the availability of appropriations to continue the program.
Subd. 5. [REPORTING REQUIREMENTS.] Participating providers
shall report to the commissioner on a schedule determined by the
commissioner and on a form supplied by the commissioner for a
scholarship rate for rate periods beginning October 1, 2007.
The report shall include the amount spent during the reporting
period on eligible scholarships, and, for each scholarship
recipient, the name of the recipient, the amount awarded, the
educational institution attended, the nature of the educational
program, the expected or actual program completion date, and a
determination of the amount spent as a percentage of the
provider's reimbursement. The commissioner shall require
providers to repay all of the funds awarded under subdivision 3
if the report required in this subdivision is not filled
according to the schedule determined by the commissioner.
Subd. 6. [EVALUATION.] The commissioner shall report to
the legislature annually, beginning March 15, 2007, on the use
of these funds.
Sec. 48. Minnesota Statutes 2004, section 256B.19,
subdivision 1c, is amended to read:
Subd. 1c. [ADDITIONAL PORTION OF NONFEDERAL SHARE.] (a)
Hennepin County shall be responsible for a monthly transfer
payment of $1,500,000, due before noon on the 15th of each month
and the University of Minnesota shall be responsible for a
monthly transfer payment of $500,000 due before noon on the 15th
of each month, beginning July 15, 1995. These sums shall be
part of the designated governmental unit's portion of the
nonfederal share of medical assistance costs.
(b) Beginning July 1, 2001, Hennepin county's payment under
paragraph (a) shall be $2,066,000 each month.
(c) Beginning July 1, 2001, the commissioner shall increase
annual capitation payments to the metropolitan health plan under
section 256B.69 for the prepaid medical assistance program by
approximately $3,400,000, plus any available federal matching
funds, to recognize higher than average medical education costs.
(d) Effective August 1, 2005, Hennepin County's payment
under paragraphs (a) and (b) shall be reduced to $566,000, and
the University of Minnesota's payment under paragraph (a) shall
be reduced to zero.
Sec. 49. Minnesota Statutes 2004, 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. The allocation in
paragraph (b), clause (1), item (ii), to increase hospital
payments under section 256.969, subdivision 26, shall not limit
payments under that section.
(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.
[EFFECTIVE DATE.] This section is effective August 1, 2005.
Sec. 50. [256B.199] [PAYMENTS REPORTED BY GOVERNMENTAL
ENTITIES.]
(a) Hennepin County, Hennepin County Medical Center, Ramsey
County, Regions Hospital, the University of Minnesota, and
Fairview-University Medical Center shall report quarterly to the
commissioner beginning June 1, 2007, payments made during the
second previous quarter that may qualify for reimbursement under
federal law.
(b) Based on these reports, the commissioner shall apply
for federal matching funds. These funds are appropriated to the
commissioner for the payments under section 256.969, subdivision
27.
(c) By May 1 of each year, beginning May 1, 2007, the
commissioner shall inform the nonstate entities listed in
paragraph (a) of the amount of federal disproportionate share
hospital payment money expected to be available in the current
federal fiscal year.
(d) This section sunsets on June 30, 2009. The
commissioner shall report to the legislature by December 15,
2008, with recommendations for maximizing federal
disproportionate share hospital payments after June 30, 2009.
Sec. 51. Minnesota Statutes 2004, 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;
(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 non-Medicare 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 (1), (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.
(f) An infant born to a woman who is eligible for and
receiving medical assistance and who is enrolled in the prepaid
medical assistance program shall be retroactively enrolled to
the month of birth in the same managed care plan as the mother
once the child is enrolled in medical assistance unless the
child is determined to be excluded from enrollment in a prepaid
plan under this section.
[EFFECTIVE DATE.] This section is effective September 1,
2005.
Sec. 52. Minnesota Statutes 2004, section 256D.03,
subdivision 3, as amended by Laws 2005, chapter 98, article 2,
section 14, 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
(2) 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 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;
(ii) who has gross countable income above 75 percent of 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; or
(iii) the commissioner shall adjust the income standards
under this section each July 1 by the annual update of the
federal poverty guidelines following publication by the United
States Department of Health and Human Services.
(b) Effective for applications and renewals processed on or
after September 1, 2006, 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 adults with dependent children under 21 whose
gross family income is equal to or less than 275 percent of the
federal poverty guidelines who are not described in paragraph
(e).
(c) Effective for applications and renewals processed on or
after September 1, 2006, general assistance medical care may be
paid for applicants and recipients who meet all eligibility
requirements of paragraph (a), clause (2), item (i), for a
temporary period beginning the date of application. Immediately
following approval of general assistance medical care, enrollees
shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section
256L.03 for the rest of the six-month eligibility period, until
their six-month renewal.
(d) To be eligible for general assistance medical care
following enrollment in MinnesotaCare as required by paragraph
(c), an individual must complete a new application.
(e) Applicants and recipients eligible under paragraph (a),
clause (1), or who have applied for and are awaiting a
determination of blindness or disability by the state medical
review team or a determination of eligibility for Supplemental
Security Income or Social Security Disability Insurance by the
Social Security Administration, or who fail to meet the
requirements of section 256L.09, subdivision 2, are exempt from
the MinnesotaCare enrollment requirements of this subdivision.
(c) (f) For 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.
(g) Beginning January September 1, 2000 2006, Minnesota
health care program applications and renewals completed by
recipients and applicants who are persons described in
paragraph (b), may be returned (c) and submitted 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 shall be determined for MinnesotaCare
eligibility by the county agency. 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 is 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) paragraphs (c), (e),
and (f).
(d) (h) 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 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 an applicant's behalf to 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.
(e) (i) 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) (j) 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) (k) 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.
(h) (l) 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) (m) 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
104-193, sections 421 and 422, and subsequently set out in
federal rules.
(j) (n) Undocumented noncitizens and nonimmigrants are
ineligible for general assistance medical care. 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.
(k) (o) 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) (p) Effective July 1, 2003, general assistance medical
care emergency services end.
[EFFECTIVE DATE.] This section is effective September 1,
2006.
Sec. 53. Minnesota Statutes 2004, 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 (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 as
covered under the medical assistance program;
(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) Gender Effective August 1, 2005, sex reassignment
surgery and related services are is not covered services under
this subdivision unless the individual began receiving gender
reassignment services prior to July 1, 1995.
(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.
(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, advanced practice nurse, audiologist,
optician, or optometrist;
(2) $25 for eyeglasses;
(3) (2) $25 for nonemergency visits to a hospital-based
emergency room;
(4) (3) $3 per brand-name drug prescription and $1 per
generic drug prescription, subject to a $20 $12 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) (4) 50 percent coinsurance on restorative dental
services.
(e) Co-payments shall be limited to one per day per
provider for nonpreventive visits, eyeglasses, and nonemergency
visits to a hospital-based emergency room. 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 $12 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.
(g) Any county may, from its own resources, provide medical
payments for which state payments are not made.
(h) Chemical dependency services that are reimbursed under
chapter 254B must not be reimbursed under general assistance
medical care.
(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.
(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.
(o) Fee-for-service payments for nonpreventive visits shall
be reduced by $3 for services provided on or after January 1,
2006. 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, advance practice nurse,
audiologist, optician, or optometrist.
(p) Payments to managed care plans shall not be increased
as a result of the removal of the $3 nonpreventive visit
co-payment effective January 1, 2006.
[EFFECTIVE DATE.] Paragraph (b) is effective August 1,
2005, and paragraph (d) is effective January 1, 2006.
Sec. 54. Minnesota Statutes 2004, section 256D.045, is
amended to read:
256D.045 [SOCIAL SECURITY NUMBER REQUIRED.]
To be eligible for general assistance under sections
256D.01 to 256D.21, an individual must provide the individual's
Social Security number to the county agency or submit proof that
an application has been made. An individual who refuses to
provide a Social Security number because of a well-established
religious objection as described in Code of Federal Regulations,
title 42, section 435.910, may be eligible for general
assistance medical care under section 256D.03. The provisions
of this section do not apply to the determination of eligibility
for emergency general assistance under section 256D.06,
subdivision 2. This provision applies to eligible children
under the age of 18 effective July 1, 1997.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 55. Minnesota Statutes 2004, section 256L.01,
subdivision 4, is amended to read:
Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] (a)
"Gross individual or gross family income" for nonfarm
self-employed means income calculated for the six-month period
of eligibility using as the baseline the adjusted gross income
the net profit or loss reported on the applicant's federal
income tax form for the previous year and adding back in
reported depreciation, carryover loss, and net operating loss
amounts that apply to the business in which the family is
currently engaged using the medical assistance families with
children methodology for determining allowable and nonallowable
self-employment expenses and countable income.
(b) "Gross individual or gross family income" for farm
self-employed means income calculated for the six-month period
of eligibility using as the baseline the adjusted gross income
reported on the applicant's federal income tax form for the
previous year and adding back in reported depreciation amounts
that apply to the business in which the family is currently
engaged.
(c) Applicants shall report the most recent financial
situation of the family if it has changed from the period of
time covered by the federal income tax form. The report may be
in the form of percentage increase or decrease "Gross individual
or gross family income" means the total income for all family
members, calculated for the six-month period of eligibility.
[EFFECTIVE DATE.] This section is effective August 1, 2007,
or upon HealthMatch implementation, whichever is later.
Sec. 56. Minnesota Statutes 2004, section 256L.01,
subdivision 5, is amended to read: