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1991 Minnesota Session Laws

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    Laws of Minnesota 1991 

                        CHAPTER 292-H.F.No. 719 
           An act relating to the organization and operation of 
          state government; appropriating money for human 
          services, jobs and training, corrections, health, 
          human rights, housing finance, and other purposes with 
          certain conditions; amending Minnesota Statutes 1990, 
          sections 3.922, subdivisions 3 and 8; 3.9223, 
          subdivision 1; 3.9225, subdivision 1; 3.9226, 
          subdivision 1; 3.98, subdivision 1; 3.982; 13.46, 
          subdivision 2; 15.46; 103I.235; 116C.04, by adding a 
          subdivision; 136A.121, subdivision 2; 136A.162; 
          144.335, subdivision 1; 144.871, subdivisions 2 and 7; 
          144.873, subdivision 1; 144.874, subdivisions 1, 2, 3, 
          and by adding subdivisions; 144A.071, subdivision 3, 
          and by adding a subdivision; 144A.10, subdivision 4; 
          144A.31; 144A.46, subdivisions 1 and 4; 144A.49; 
          144A.51, subdivision 5; 144A.53, subdivision 1; 
          145.924; 145.925, by adding a subdivision; 148B.01, 
          subdivision 7; 148B.03; 148B.04, subdivisions 3 and 4; 
          148B.05, subdivision 1; 148B.06, subdivisions 1 and 3; 
          148B.07; 148B.08; 148B.12; 148B.13; 148B.17; 148B.18, 
          subdivision 10; 148B.23, subdivision 1; 148B.33, 
          subdivision 1; 148B.38, subdivision 3; 157.031, 
          subdivisions 2, 3, 4, and 9; 171.29, subdivision 2; 
          176.104, subdivision 1; 198.007; 214.04, subdivision 
          3; 237.70, subdivision 7; 241.022; 244.16; 245.461, 
          subdivision 3, and by adding a subdivision; 245.462, 
          subdivisions 6 and 18; 245.465; 245.4711, by adding a 
          subdivision; 245.472, subdivision 2, and by adding a 
          subdivision; 245.473, by adding subdivisions; 245.484; 
          245.487, subdivision 4, and by adding a subdivision; 
          245.4871, subdivisions 27, 31, and by adding a 
          subdivision; 245.4873, subdivision 6; 245.4874; 
          245.4881, subdivision 1; 245.4882, by adding 
          subdivisions; 245.4884, subdivision 1; 245.4885, 
          subdivisions 1, 2, and by adding a subdivision; 
          245.697, subdivision 1; 246.18, subdivision 4, and by 
          adding a subdivision; 246.23; 246.64, subdivision 3; 
          251.011, subdivisions 3 and 4a; 252.24, by adding a 
          subdivision; 252.27, subdivisions 1a and 2a; 252.275; 
          252.28, subdivisions 1, 3, and by adding a 
          subdivision; 252.32; 252.46, subdivisions 3, 6, 14, 
          and by adding a subdivision; 252.478, subdivisions 1 
          and 3; 252.50, subdivision 2; 253.015, subdivision 2; 
          253C.01, subdivisions 1 and 2; 254A.17, subdivision 3; 
          254B.04, subdivision 1; 254B.05, by adding a 
          subdivision; 256.01, subdivisions 2, 11, and by adding 
          a subdivision; 256.025, subdivisions 1, 2, 3, and 4; 
          256.031; 256.032; 256.033; 256.034; 256.035; 256.036, 
          subdivisions 1, 2, 4, and 5; 256.045, subdivision 10; 
          256.482, subdivision 1; 256.736, subdivision 3a; 
          256.82, subdivision 1; 256.871, subdivision 6; 
          256.935, subdivision 1; 256.936, by adding a 
          subdivision; 256.9365, subdivisions 1 and 3; 256.9685, 
          subdivision 1; 256.9686, subdivisions 1 and 6; 
          256.969, subdivisions 1, 2, 2c, 3a, and 6a; 256.9695, 
          subdivision 1; 256.98, by adding a subdivision; 
          256.983; 256B.031, subdivision 4, and by adding a 
          subdivision; 256B.04, subdivision 16; 256B.055, 
          subdivisions 10 and 12; 256B.057, subdivisions 1, 2, 
          3, 4, and by adding a subdivision; 256B.0575; 
          256B.0625, subdivisions 2, 4, 7, 13, 17, 19, 20, 24, 
          25, 28, 30, and by adding subdivisions; 256B.0627; 
          256B.064, subdivision 2; 256B.0641, by adding a 
          subdivision; 256B.08, by adding a subdivision; 
          256B.092; 256B.093; 256B.19, subdivision 1, and by 
          adding subdivisions; 256B.431, subdivisions 2l, 3e, 
          3f, and by adding subdivisions; 256B.48, subdivision 
          1; 256B.49, by adding a subdivision; 256B.491, by 
          adding a subdivision; 256B.50, subdivision 1d; 
          256B.501, subdivisions 8, 11, and by adding a 
          subdivision; 256B.64; 256C.24, subdivision 2; 256C.25; 
          256D.03, subdivisions 2, 2a, 3, and 4; 256D.05, 
          subdivisions 1, 2, 6, and by adding a subdivision; 
          256D.051, subdivisions 1, 1a, 2, 3, 3a, 6, and 8; 
          256D.052, subdivisions 3 and 4; 256D.06, subdivision 
          1b; 256D.07; 256D.10; 256D.101, subdivisions 1 and 3; 
          256D.111; 256D.36, subdivision 1; 256D.44, by adding a 
          subdivision; 256F.01; 256F.02; 256F.03, subdivision 5; 
          256F.04; 256F.05; 256F.06; 256F.07, subdivisions 1, 2, 
          and 3; 256H.02; 256H.03; 256H.05; 256H.08; 256H.15, 
          subdivisions 1, 2, and by adding a subdivision; 
          256H.18; 256H.20, subdivision 3a; 256H.21, subdivision 
          10; 256H.22, subdivision 2, and by adding a 
          subdivision; 256I.04, by adding a subdivision; 
          256I.05, subdivision 2, and by adding subdivisions; 
          257.071, subdivision 1a; 257.352, subdivision 2; 
          257.57, subdivision 2; 260.165, by adding a 
          subdivision; 261.035; 268.022, subdivision 2; 268.39; 
          268.914; 268.975, subdivision 3, and by adding a 
          subdivision; 268.977; 268.98; 268A.03; 268A.06, by 
          adding a subdivision; 270A.04, subdivision 2; 270A.08, 
          subdivision 2; 273.1398, subdivision 1; 299A.21, 
          subdivision 6; 299A.23, subdivision 2; 299A.27; 
          393.07, subdivisions 10 and 10a; 401.13; 462A.02, 
          subdivision 13; 462A.03, subdivisions 10, 13, 16, and 
          by adding a subdivision; 462A.05, subdivisions 14, 20, 
          and by adding subdivisions; 462A.08, subdivision 2; 
          462A.21, subdivisions 4k, 12a, 14, and by adding a 
          subdivision; 462A.22, subdivision 9; 462A.222, 
          subdivision 3; 471.705, subdivision 1; 474A.048, 
          subdivision 2; 518.551, subdivision 5, and by adding 
          subdivisions; 518.64; 609.52, by adding a subdivision; 
          631.425, subdivisions 3 and 7; 638.04; 638.05; 638.06; 
          643.29, subdivision 1; Laws 1987, chapter 404, section 
          28, subdivision 1; Laws 1988, chapter 689, article 2, 
          section 256, subdivision 1; Laws 1989, chapters 290, 
          article 1, section 3, subdivision 2; and 335, article 
          1, section 27, subdivision 1, as amended; proposing 
          coding for new law in Minnesota Statutes, chapters 
          144; 148B; 214; 241; 245; 252; 256; 256B; 256D; 256H; 
          257; 462A; proposing coding for new law as Minnesota 
          Statutes, chapter 144B; repealing Minnesota Statutes 
          1990, sections 144A.31, subdivisions 2 and 3; 148B.01, 
          subdivisions 2, 5, and 6; 148B.02; 148B.16; 148B.171; 
          148B.40; 148B.41; 148B.42; 148B.43; 148B.44; 148B.45; 
          148B.46; 148B.47; 148B.48; 157.031, subdivision 5; 
          245.476, subdivisions 1, 2, and 3; 246.18, 
          subdivisions 3 and 3a; 252.275, subdivision 2; 
          256.032, subdivisions 5 and 9; 256.035, subdivisions 6 
          and 7; 256.036, subdivision 10; 256B.0625, 
          subdivisions 6 and 19; 256B.0627, subdivision 3; 
          256B.091; 256B.431, subdivision 6; 256B.71, 
          subdivision 5; 256D.051, subdivisions 1b, 3c, and 16; 
          256D.09, subdivision 4; 256D.101, subdivision 2; 
          256H.25; 256H.26; 268A.05, subdivision 2; 462A.05, 
          subdivisions 28 and 29; and Laws 1990, chapter 568, 
          article 6, section 4.  
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 

                                ARTICLE 1

                             APPROPRIATIONS 
    Section 1.  [HUMAN RESOURCES; APPROPRIATIONS.] 
    The sums shown in the columns marked "APPROPRIATIONS" are 
appropriated from the general fund, or any other fund named, to 
the agencies and for the purposes specified in the following 
sections of this act, to be available for the fiscal years 
indicated for each purpose.  The figures "1992" and "1993" where 
used in this act, mean that the appropriation or appropriations 
listed under them are available for the year ending June 30, 
1992, or June 30, 1993, respectively.  

                             SUMMARY BY FUND
                          1992          1993           TOTAL
General          $1,786,990,000 $1,894,841,000 $3,681,831,000
State Government 
Special Revenue       6,314,000      6,462,000     12,776,000 
Metropolitan
Landfill                168,000        168,000        336,000 
Trunk Highway         1,487,000      1,486,000      2,973,000 
Total             1,794,959,000  1,902,957,000  3,697,916,000 
                                           APPROPRIATIONS 
                                       Available for the Year 
                                           Ending June 30 
                                          1992         1993 
Sec. 2.  COMMISSIONER OF HUMAN 
SERVICES 
Subdivision 1.  Appropriation by 
Fund 
General Fund                       1,496,147,000  1,596,183,000 
 The amounts that may be spent from this 
appropriation for each program and 
activity are more specifically 
described in the following subdivisions.
 Federal money received in excess of the 
estimates shown in the 1991-1993 
department of human services budget 
document reduces the state 
appropriation by the amount of the 
excess receipts, unless otherwise 
directed by the governor, after 
consulting with the legislative 
advisory commission.  
 For the biennium ending June 30, 1993, 
federal receipts as shown in the 
biennial budget document to be used for 
financing activities, programs, and 
projects under the supervision and 
jurisdiction of the commissioner must 
be credited to and become a part of the 
appropriations provided for in this 
section. 
 If federal money anticipated is less 
than that shown in the biennial budget 
document, the commissioner of finance 
shall reduce the amount available from 
the direct appropriation a 
corresponding amount.  The reductions 
must be noted in the budget document 
submitted to the 78th legislature in 
addition to an estimate of similar 
federal money anticipated for the 
biennium ending June 30, 1995. 
 The commissioner of human services, 
with the approval of the commissioner 
of finance and by direction of the 
governor after consulting with the 
legislative advisory commission, may 
transfer unencumbered appropriation 
balances among the aid to families with 
dependent children, AFDC child care, 
general assistance, general assistance 
medical care, medical assistance, 
Minnesota supplemental aid, and work 
readiness programs, and the entitlement 
portion of the chemical dependency 
consolidated treatment fund, and 
between fiscal years of the biennium. 
 Effective the day following final 
enactment, the commissioner may 
transfer unencumbered appropriation 
balances for fiscal year 1991 among the 
aid to families with dependent 
children, general assistance, general 
assistance medical care, medical 
assistance, Minnesota supplemental aid, 
and work readiness programs with the 
approval of the commissioner of finance 
after notification of the chairs of the 
health and human services divisions of 
the senate finance committee and the 
house appropriations committee. 
 For the biennium ending June 30, 1993, 
information system project 
appropriations for development and 
federal receipts for the alien 
verification entitlement system must be 
deposited in the special systems 
account authorized in Minnesota 
Statutes, section 256.014.  Money 
appropriated for computer projects 
approved by the Information Policy 
Office, funded by the legislature, and 
approved by the commissioner of finance 
may be transferred from one project to 
another and from development to 
operations as the commissioner 
considers necessary.  Any unexpended 
balance in the appropriation for these 
projects does not cancel in the first 
year but is available for the second 
year of the biennium. 
Subd. 2.  Human Services 
Administration
     12,194,000     11,665,000
Subd. 3.  Legal and 
Intergovernmental Programs 
      4,351,000      4,340,000
Subd. 4.  Economic Support and 
Transition Services for Families  
and Individuals
    255,051,000    253,960,000
 During the biennium ending June 30, 
1993, the commissioner of human 
services shall provide supplementary 
grants not to exceed $200,000 a year 
for aid to families with dependent 
children and include the following 
costs in determining the amount of the 
supplementary grants:  major home 
repairs; repair of major home 
appliances; utility recaps; 
supplementary dietary needs not covered 
by medical assistance; and replacement 
of essential household furnishings and 
essential major appliances.  
 For the biennium ending June 30, 1993, 
any federal money remaining from 
receipt of state legalization impact 
assistance grants, after reimbursing 
the department of education for actual 
expenditures, must be deposited in the 
aid to families with dependent children 
account. 
 The money appropriated from federal 
child care funds received by the 
department of human services and 
allocated to the Minnesota early 
childhood care and education council 
for the biennium ending June 30, 1993, 
for general operation of the council is 
to enable the council to provide 
coordination, training outreach, and 
technical assistance to child care 
providers. 
 The commissioner shall set the monthly 
standard of assistance for general 
assistance and work readiness 
assistance units consisting of an adult 
recipient who is childless and 
unmarried or living apart from his or 
her parents or a legal guardian at $203.
 Money appropriated for fiscal year 1991 
for general assistance may be used to 
reimburse fiscal year 1990 and fiscal 
year 1991 county refugee cash 
assistance expenditures that were not 
reimbursed by the federal government, 
to the extent that unreimbursed refugee 
cash assistance payments do not exceed 
$140,000. 
 Chisago and Isanti counties shall be 
added to the list of counties in which 
the commissioner shall require 
establishment and operation of fraud 
prevention investigation programs. 
 By January 1, 1993, the commissioner 
shall report to the legislature on the 
fraud prevention investigation 
projects.  The report shall include a 
comparison of the effectiveness of the 
fraud prevention investigation projects 
with other proposals to reduce fraud in 
public income assistance programs, 
including client reporting requirements.
 Money appropriated for the AFDC child 
care program and the basic sliding fee 
program for the first year does not 
cancel but is available for the second 
year.  Money carried forward does not 
become part of the base level funding 
for these programs for purposes of the 
1993-1995 biennial budget. 
 For the biennium ending June 30, 1993, 
federal food stamp employment and 
training funds received for the work 
readiness program are appropriated to 
the commissioner to reimburse counties 
for work readiness service expenditures.
 For the biennium ending June 30, 1993, 
federal job opportunity and basic 
skills (JOBS) funds received for direct 
employment services provided to 
refugees and immigrants is appropriated 
to the commissioner to provide 
bicultural employment service case 
managers to STRIDE-eligible refugees 
and immigrants.  The commissioner of 
human services shall review 
expenditures of bilingual case 
management funds at the end of the 
third quarter of the second year of the 
biennium and may reallocate 
unencumbered funds to those counties 
that can demonstrate a need for 
additional funds.  Funds shall be 
reallocated according to the same 
formula used initially to allocate 
funds to counties. 
 By October 1, 1991, the commissioner 
shall submit to the secretary of health 
and human services an amendment to the 
state JOBS plan to secure federal 
reimbursement for child care for AFDC 
caretakers who are not eligible for 
STRIDE, but who are engaged in 
education or training or job search.  
The state plan amendment shall provide 
that the activities required of a 
non-STRIDE caretaker and the 
administrative services provided are 
the minimum necessary to secure federal 
reimbursement for child care 
assistance.  Upon federal approval of 
the amendment, the commissioner shall 
submit to the legislature a proposal to 
transfer money from the basic sliding 
fee child care program to fund the 
state share of child care services 
under the state plan amendment. 
 Any balance remaining in the first year 
for the Minnesota family investment 
plan appropriation does not cancel but 
is available for the second year of the 
biennium. 
 Any balance remaining in the first year 
for the fraud prevention initiative 
appropriation does not cancel but is 
available for the second year of the 
biennium. 
 Any balance remaining in the first year 
for the job opportunities and basic 
skills (JOBS) automated system 
appropriation does not cancel but is 
available for the second year of the 
biennium. 
 For the biennium ending June 30, 1993, 
the commissioner of jobs and training 
shall certify as STRIDE employment and 
training service providers under 
Minnesota Statutes, section 268.871, 
the providers who provided services 
under the AFDC self-employment 
demonstration project.  The 
commissioner of human services shall 
seek federal authority to renew or 
extend the waivers that are necessary 
to continue the demonstration project. 
 For the child support enforcement 
activity, during the biennium ending 
June 30, 1993, money received from the 
counties for providing data processing 
services must be deposited in that 
activity's account.  The money is 
appropriated to the commissioner for 
the purposes of the child support 
enforcement activity. 
 A county, or the commissioner of human 
services with the consent of affected 
counties, may contract with the 
commissioner of revenue to collect 
child support obligations.  The county 
and the commissioner of human services 
may furnish the data necessary for the 
collections to the commissioner of 
revenue.  The commissioner of revenue 
is subject to the same laws governing 
the data that apply to the commissioner 
of human services and the county.  The 
county or the commissioner of human 
services may provide an advance payment 
to the commissioner of revenue for 
collection services, to be repaid out 
of subsequent collections. 
 For the biennium ending June 30, 1993, 
federal money received for the 
operating costs of the statewide MAXIS 
automated eligibility information 
system is appropriated to the 
commissioner to pay for the development 
and operation of the MAXIS system and 
the counties' share of the operating 
costs.  
 Notwithstanding Minnesota Statutes, 
section 237.701, subdivision 1, the 
reimbursement of telephone assistance 
plan administrative expenses incurred 
shall not exceed $422,000 in the first 
year of the biennium. 
Subd. 5.  Economic Support and 
Services to Elderly
    24,776,000     30,082,000
 The increased funding to the area 
agencies on aging shall be distributed 
by the agencies to nutrition programs 
serving counties where congregate and 
home delivered meals were locally 
financed prior to participation in the 
nutrition program of the Older 
Americans Act.  Supplemental funds for 
affected areas may be awarded in 
amounts up to the level of prior county 
financial participation less any local 
match as required by the Older 
Americans Act. 
 The Minnesota board on aging shall 
appoint an advisory task force 
consisting of Indian elders and 
representatives from the area agencies 
on aging, counties, and other 
interested parties to make 
recommendations on how Indian elder 
access to services can be improved.  
Compensation, terms, and removal of 
members shall be as provided in 
Minnesota Statutes, section 15.059.  
The Minnesota board on aging shall 
report its recommendations to the 
legislature by February 1, 1992. 
 For the biennium ending June 30, 1993, 
any money allocated to the alternative 
care grants program that is not spent 
for the purposes indicated does not 
cancel but shall be transferred to the 
medical assistance account. 
Subd. 6.  Services to Special 
Needs Adults
   121,283,000    124,166,000
 Money is appropriated from the mental 
health special project account for 
adults with mental illness from across 
the state, for a camping program which 
utilizes the BWCA and is cooperatively 
sponsored by client advocacy, mental 
health treatment, and outdoor 
recreation agencies.  
 Money is appropriated from the mental 
health special projects fund for grants 
to two nonprofit charitable mental 
health self-help groups.  One grant 
shall be used to provide support 
services to people with major 
depression.  The other grant shall 
provide employability support services 
to people with mental illness delivered 
by people who have or have had a mental 
illness. 
 All of the fees paid to the 
commissioner for interpreter referral 
services for people with hearing 
impairments shall be used for direct 
client referral activities.  None of 
the fees shall be used to pay for state 
agency administrative and support costs.
 For the biennium ending June 30, 1993, 
if a facility's residents continue to 
be served in the same location, the 
commissioner of human services may 
continue the operating cost payment 
rate, including any program operating 
cost adjustments and special operating 
costs, of an intermediate care facility 
for persons with mental retardation 
under receivership pursuant to 
Minnesota Statutes, section 245A.12 or 
245A.13, beyond the receivership period 
in order that this portion of the 
payment rate remain in effect for one 
full calendar year plus the following 
nine months.  The allowable property- 
related costs of the previous operator 
before the receivership shall be the 
basis for establishing the property- 
related payment rate for rate periods 
following the end of the receivership 
period.  
 During the biennium ending June 30, 
1993, the commissioner may transfer 
money from rule 12 residential program 
grants to rule 14 housing support 
program grants.  Funds shall be 
transferred only if agreement is 
reached between the participating 
county and rule 12 provider 
volunteering to convert to rule 14 
services.  The commissioner shall 
consider past utilization of the 
residential program in determining 
which counties to include in the 
transferred housing support funding. 
 Any unspent money appropriated in the 
first year for the nonentitlement 
portion of the consolidated chemical 
dependency treatment fund shall be 
carried forward to the second year of 
the biennium for that purpose. 
 Money appropriated in fiscal year 1992 
for the Dakota county mental health 
pilot planning grant is available until 
spent. 
 By January 31, 1992, the commissioner 
of human services shall present to the 
legislature a report, prepared in 
cooperation with the commissioner of 
health, containing recommendations on 
the standards and procedures to be used 
in the licensing or credentialing of 
chemical dependency professionals.  In 
preparing this report, the 
commissioners shall consult with an 
advisory group that includes a 
representative of each of the boards 
established under Minnesota Statutes, 
chapter 148B and at least six 
individuals representing chemical 
dependency professionals and service 
providers.  
 Of the funds appropriated above the 
base level for family preservation 
grants for the biennium ending June 30, 
1993, 45 percent must be provided to 
counties for purposes of providing 
bonus incentives for early intervention 
services under Minnesota Statutes, 
section 256F.05, subdivision 4a. 
 The amount of money from the 
consolidated chemical dependency 
treatment fund that, on April 1, 1991, 
the department of human services 
projected would be received by the 
regional treatment center chemical 
dependency units each year of the 
biennium is transferred from the 
consolidated chemical dependency 
treatment fund to the appropriation for 
the regional treatment centers to fund 
the chemical dependency units. * (The 
preceding paragraph beginning "The 
amount" was vetoed by the governor.) 
 The regional treatment centers are not 
required to repay any advances received 
in fiscal years 1990 and 1991 from the 
consolidated chemical dependency 
treatment fund in accordance with the 
provisions of Minnesota Statutes, 
section 246.18, subdivision 3, for 
chemical dependency services delivered 
under Minnesota Statutes, sections 
254B.01 to 254B.09. 
 The commissioner of human services, 
after consultation with professional 
treatment experts, service providers, 
and the families of victims, shall 
develop recommendations on special 
residential and other treatment 
programs for persons suffering from 
Prader-Willi syndrome.  A report with 
the recommendations shall be provided 
to the legislature by January 15, 1992. 
 Notwithstanding Minnesota Statutes, 
section 256I.04 or any other law to the 
contrary, the commissioner shall allow 
up to eight additional general 
assistance or Minnesota supplemental 
aid negotiated rate facility beds for 
adult foster homes licensed under 
Minnesota Rules, parts 9555.5105 to 
9555.6265, provided the beds serve 
persons with developmental disabilities 
and are located in Todd county.  
Agreements for new beds are subject to 
the approval of the commissioner.  
Subd. 7.  Services to Special 
Needs Children
    15,167,000     17,075,000
 The department of human services shall 
develop recommended standards for 
counties to use when conducting child 
protection investigations of child care 
providers.  The standards, while 
maintaining the safety of children as a 
first priority, shall also ensure that 
child care providers under 
investigation are accorded adequate due 
process protections.  The agency shall 
develop the recommendations through a 
process of public hearings and report 
back to the legislature by January 1992.
 Money appropriated for child care 
incentive grants in the first year does 
not cancel but is available for the 
second year of the biennium. 
 Money is appropriated each year to 
provide a grant to the New Chance 
demonstration project that provides 
comprehensive services to young AFDC 
recipients who became pregnant as 
teenagers and dropped out of high 
school.  The commissioner of human 
services shall provide an annual report 
on the progress of the demonstration 
project, including specific data on 
participant outcomes in comparison to a 
control group that received no 
services.  The commissioner shall also 
include recommendations on whether 
strategies or methods that have proven 
successful in the demonstration project 
should be incorporated into the STRIDE 
employment program for AFDC recipients. 
Subd. 8.  State-Operated 
Residential Care For Special 
Needs Populations
   240,717,000    236,416,000
 During the biennium ending June 30, 
1993, the commissioner may determine 
the need for conversion of a 
state-operated home- and 
community-based service program to an 
intermediate care facility for persons 
with mental retardation if the 
conversion will produce a net savings 
to the state general fund and the 
persons receiving home- and 
community-based services choose to 
receive services in an intermediate 
care facility for persons with mental 
retardation.  After the commissioner 
has determined the need to convert the 
program, the commissioner of health 
shall certify the program as an 
intermediate care facility for persons 
with mental retardation if the program 
meets applicable certification 
standards.  Notwithstanding the 
provisions of Minnesota Statutes, 
section 246.18, receipts collected for 
state-operated community-based services 
are appropriated to the commissioner 
and are dedicated to the operation of 
state-operated community-based services 
which are converted in this section or 
which were authorized in Laws 1988, 
chapter 689, article 1, section 2, 
subdivision 5.  Any balance remaining 
in this account at the end of the 
fiscal year does not cancel and is 
available for the second year of the 
biennium.  The commissioner may, upon 
approval of the governor after 
consultation with the legislative 
advisory commission, transfer funds 
from the Minnesota supplemental aid 
program to the medical assistance 
program to fund services converted 
under this section. 
 Receipts received for the 
state-operated community services 
program are appropriated to the 
commissioner for that purpose. 
 During the biennium ending June 30, 
1993, the commissioner of human 
services shall establish an on-site 
child care facility at the 
Ah-Gwah-Ching state nursing home.  
State employees must receive priority 
for child care services at the 
Ah-Gwah-Ching site.  The commissioner 
shall contract with a nonprofit child 
care provider by August 1, 1991, that 
can demonstrate knowledge of the child 
care needs at the site and that has a 
commitment to maximizing the salaries 
and benefits of its direct child care 
workers.  The commissioner shall 
provide support to the center, 
including renovation expenses to meet 
and maintain all relevant building 
codes and ongoing building expenses 
including rent, maintenance, and 
utilities.  The commissioner shall 
consult with the commissioner of 
administration regarding the 
establishment and operation of the 
on-site program.  The child care 
contractor chosen by the commissioner 
shall become accredited by the National 
Academy of Early Childhood Programs 
within one year of beginning 
operation.  The commissioner shall 
report to the chairs of the human 
resources division of the house 
appropriations committee and the senate 
finance committee on the status of the 
Ah-Gwah-Ching child care center by 
September 1, 1991. 
 During the biennium ending June 30, 
1993, regional treatment center and 
state-operated nursing home employees, 
except temporary or emergency 
employees, affected by changes in the 
department of human services delivery 
system must receive, along with other 
options, priority consideration in 
order to transfer to vacant or newly 
created positions at the Minneapolis 
and Hastings veterans homes and at 
facilities operated by the commissioner 
of corrections.  The veterans homes 
board, in cooperation with the 
commissioners of human services and 
corrections, shall develop procedures 
to facilitate these transfers. 
 Transfer of facilities at Faribault RTC:
The legislature recognizes that the 
orderly transfer of some buildings at 
the Faribault regional treatment center 
from the department of human services 
to the department of corrections is 
necessary in order to develop a shared 
campus and to abide by legislated 
policies concerning the future of the 
regional treatment center.  If the 
transfer of the infirmary, the skilled 
nursing facility, the Osage, Willow, or 
Birch buildings, or any other building 
on the campus of the Faribault regional 
treatment center requires the transfer 
of developmentally disabled residents 
to community residential facilities, 
the commissioner of human services 
shall accomplish this transfer 
according to the following schedule: 
 (1) the commissioner of human services 
shall maintain the 35 skilled nursing 
facility beds for developmentally 
disabled residents and an infirmary at 
the Faribault regional treatment 
center; 
 (2) the transfer of the hospital 
building at the Faribault regional 
treatment center to the department of 
corrections may take place only after 
alternative, state-operated, skilled 
nursing facility and infirmary space 
has been developed for residents on the 
campus of the Faribault regional 
treatment center; 
 (3) the transfer of the Osage facility 
to the department of corrections may 
not occur before December 31, 1992.  
Residents affected by the transfer of 
the Osage building shall not be 
transferred to another regional 
treatment center or state nursing home 
but must either be housed at the 
Faribault regional treatment center or 
placed in appropriate community-based 
facilities.  At least 60 percent of the 
community-based facility beds to which 
affected regional center residents are 
transferred must be state-operated 
community services (SOCS) beds; 
 (4) the transfer of the Willow and 
Birch facilities to the department of 
corrections must not occur before June 
30, 1993.  Residents affected by the 
transfer of the Willow or Birch 
facilities shall not be transferred to 
another regional treatment center or 
state nursing home but must either be 
housed at the Faribault regional 
treatment center or placed in 
appropriate community-based 
facilities.  At least 60 percent of the 
community-based facility beds to which 
affected regional treatment center 
residents are transferred must be 
state-operated community services 
(SOCS) beds. 
 Notwithstanding Minnesota Statutes, 
section 144A.071, the commissioner of 
health shall license and certify 
nursing home beds to be operated by the 
commissioner of human services in new 
or existing buildings if the following 
conditions are met:  (1) the number of 
licensed and certified beds shall not 
exceed the number of beds that were 
operated by the commissioner of human 
services at the Oak Terrace nursing 
home; and (2) the beds will be located 
as follows:  105 at Brainerd in 
addition to the existing 28 beds at 
Brainerd; 70 beds at Cambridge; 85 beds 
at Fergus Falls; and up to 62 
additional beds as needed at these or 
other regional treatment centers. 
 Any portion of the appropriation to 
remodel, set up, and operate state 
nursing home beds at the Fergus Falls 
and Cambridge regional treatment 
centers and state nursing home beds and 
security hospital beds at the Brainerd 
regional treatment center that is not 
spent in fiscal year 1992 does not 
cancel and shall be available for 
fiscal year 1993. 
 For the biennium ending June 30, 1993, 
savings realized from holding vacancies 
open at the regional treatment centers 
may only be used to pay negotiated 
salary increases for regional treatment 
center employees.  The commissioner 
shall hold positions vacant in the 
general professional, supervisory, and 
managerial units at the regional 
treatment centers for the purpose of 
funding negotiated salary increases.  
Positions in other units shall not be 
held vacant for this purpose. 
 The appropriation for fiscal 1992 to 
improve property at regional treatment 
centers and state nursing homes to 
prepare the property for lease does not 
cancel but is available for fiscal 
1993.  For the biennium ending June 30, 
1993, money collected as rent under 
Minnesota Statutes, section 16B.24, 
subdivision 5, for state property at 
any of the regional treatment centers 
or state nursing homes administered by 
the commissioner of human services is 
dedicated to the facility generating 
the rental income and is appropriated 
for the express purpose of maintaining 
the property.  Any balance remaining at 
the end of the fiscal year shall not 
and is available until expended. * (The 
preceding paragraph beginning "The 
appropriation" was vetoed by the 
governor.) 
 If the resident population at the 
regional treatment centers is projected 
to be higher than the estimates upon 
which the medical assistance forecast 
and budget recommendations were based, 
the amount of the medical assistance 
appropriation that is attributable to 
the cost of services that would have 
been provided as an alternative to 
regional treatment center services is 
transferred to the residential 
facilities appropriation. 
 For purposes of restructuring the 
chemical dependency and developmental 
disabilities programs at the regional 
treatment centers during the biennium 
ending June 30, 1993, any regional 
treatment center employee whose 
position is to be eliminated shall be 
afforded the options provided in 
applicable collective bargaining 
agreements.  Provided there is no 
conflict with any collective bargaining 
agreement, any regional treatment 
center position reduction must only be 
accomplished through mitigation, 
attrition, transfer, and other measures 
as provided in state or applicable 
collective bargaining agreements and 
Minnesota Statutes, section 252.50, 
subdivision 11, and not through layoff. 
However, if the commissioner proceeds 
with construction of 10 additional 
state-operated community residences for 
persons with developmental disabilities 
and 84 additional state nursing home 
beds during the biennium ending June 
30, 1993, and begins siting and 
constructing 24 additional 
state-operated community residential 
facilities for persons with 
developmental disabilities, then the 
commissioner may use a mitigated layoff 
procedure to reduce unnecessary staff 
at the regional treatment centers, as 
negotiated with respective collective 
bargaining agents.  Affected employees 
must be offered alternative employment, 
severance pay, retraining, transfers, 
and other options that do not conflict 
with collective bargaining agreements.  
All of the 24 additional state-operated 
community facilities shall be sited 
within a reasonable distance of a 
regional treatment center.  Community 
facilities shall be allocated to these 
sites based on the proportionate number 
of developmentally disabled clients 
that have been discharged from the area 
regional treatment center in the period 
1980 to 1990. 
 The commissioner shall consolidate both 
program and support functions at each 
of the regional centers and state 
nursing homes to ensure efficient and 
effective space utilization that is 
consistent with applicable licensing 
and certification standards.  The 
commissioner may transfer residents and 
positions between the regional center 
and state nursing home system as 
necessary to promote the most efficient 
use of available state buildings.  
Surplus buildings shall be reported to 
the commissioner of administration for 
appropriate disposition according to 
Minnesota Statutes, section 16B.24. 
 Any unencumbered balances in special 
equipment and repairs and betterments 
remaining in the first year do not 
cancel but are available for the second 
year of the biennium.  
Subd. 9.  Health Care for   
Families and Individuals
   822,608,000    918,479,000
 For the biennium ending June 30, 1993, 
medical assistance and general 
assistance medical care payments for 
mental health services provided by 
masters-prepared mental health 
practitioners and practitioners 
licensed at the masters level, except 
services provided by community mental 
health centers, shall be 65 percent of 
the rate paid to doctoral-prepared 
practitioners. 
 Notwithstanding Minnesota Statutes, 
section 252.46, subdivision 3, the 
commissioner shall increase 
reimbursement rates for day training 
and habilitation services by two 
percent, effective January 1, 1992. 
 Notwithstanding Minnesota Statutes, 
section 252.46, subdivision 12, payment 
rates established by a county board to 
be paid to a vendor for day training 
and habilitation services after July 1, 
1993, must be determined under 
permanent rule adopted by the 
commissioner. 
 By October 1, 1991, the drug formulary 
committee shall review legend and 
nonlegend drug classes and advise the 
commissioner of formulary changes and 
prior authorization requirements 
necessary to provide a $1,300,000 
savings in medical assistance and 
general assistance medical care drug 
expenditures for the biennium ending 
June 30, 1993.  
 The drug formulary committee shall 
review the department of human services 
drug utilization review program and 
drug utilization review programs that 
are available from other vendors to 
determine which program best ensures 
the appropriate use of pharmaceutical 
products for quality medical care for 
persons in the medical assistance, 
GAMC, and children's health plan 
programs.  The committee shall report 
its findings to the commissioner by 
December 31, 1991. 
 Rates paid for anesthesiology services 
provided by physicians and certified 
registered nurse anesthetists (CRNAs) 
shall be according to the formula 
utilized in the Medicare program.  For 
physicians, a conversion factor "at 
percentile of calendar year set by 
legislature" shall be used.  For CRNAs, 
the conversion factor shall be that 
used by Medicare. 
 Implementation of the reduced rate for 
therapy services provided by a physical 
or occupational therapy assistant, to 
65 percent of the rate paid for 
services provided by a physical or 
occupational therapist, will be 
implemented in conjunction with the 
department's complete therapy code 
conversion project, or January 1, 1992, 
whichever occurs first. 
 For the biennium ending June 30, 1993, 
all receipts for services provided by 
community health clinics operated by 
the department of human services in 
accordance with Minnesota Statutes, 
sections 256B.04, subdivision 2, and 
256B.0625, subdivision 4, and as 
enrolled medical assistance providers 
under Minnesota Rules, part 9505.0255, 
shall be dedicated to the commissioner 
of human services for operation and 
expansion of the clinics.  Any balances 
remaining in the clinic accounts at the 
end of the first year do not cancel but 
are available until spent. 
 Notwithstanding Minnesota Statutes, 
section 13.03, subdivision 5, the rate 
setting computer program except the 
edits and screens for nursing home 
payment rates is not trade secret 
information and is public data not on 
individuals.  If a person requests this 
data, the commissioner of human 
services shall require the requesting 
person to pay no more than the actual 
costs of searching for and retrieving 
the data, including the cost of 
employee time, and for making, 
certifying, compiling, and 
electronically transmitting the copies 
of the data or the data, but may not 
charge for separating public data from 
not public data.  
 Notwithstanding Minnesota Statutes, 
section 256B.0641, and Minnesota Rules, 
part 9505.0465, the commissioner of 
human services shall not be required to 
recover nonallowable federal medical 
assistance payments made between 
October 1, 1986, and December 31, 1988, 
from nursing facilities declared on 
January 1, 1989, as institutions for 
mental diseases. 
 Notwithstanding Minnesota Statutes, 
section 256B.431 or any other 
provision, the commissioner of human 
services shall postpone the seventh 
year catch-up reappraisals until the 
ninth year after the initial appraisal 
of all nursing homes. 
 Up to $260,000 of the appropriation for 
administration of the medical 
assistance provider surcharge program 
may be used in fiscal year 1991 to 
implement computer system changes 
necessary to begin operation on July 1, 
1991. 
 The nonfederal share of the costs of 
case management services provided to 
persons with mental retardation or 
related conditions relocated from 
nursing homes as required by federal 
law and receiving home and 
community-based services funded through 
the waiver granted under section 
1915(c)(7)(B) of the Social Security 
Act shall be provided from 
state-appropriated medical assistance 
grant funds for the biennium ending 
June 30, 1993.  The division of cost is 
subject to Minnesota Statutes, section 
256B.19, and the services are included 
as covered programs and services under 
Minnesota Statutes, section 256.025, 
subdivision 2. 
 For the biennium ending June 30, 1993, 
the money transferred from the special 
project account created in Minnesota 
Statutes, section 256.01, subdivision 
2, paragraph (15), to the attorney 
general is for costs incurred in the 
resolution of long-term care appeals.  
 Money is appropriated the first year 
for a regional demonstration project 
under Minnesota Statutes, section 
256B.73, to provide health coverage to 
uninsured persons.  The commissioner 
shall contract with the coalition 
formed for the nine counties named in 
Minnesota Statutes, section 256B.73, 
subdivision 2. * (The preceding 
paragraph beginning "Money" was vetoed 
by the governor.) 
 The commissioner shall postpone the 
implementation of the new client based 
reimbursement system for the program 
operating cost payment rates as 
provided in Minnesota Statutes, section 
256B.501, subdivision 3g, until October 
1, 1993.  Each facility's 
interdisciplinary team shall continue 
to assess each new admission to the 
facility.  The quality assurance and 
review teams in the department of 
health shall continue to assess all 
residents annually.  The quality 
assurance and review teams and the 
interdisciplinary team shall assess all 
residents using a uniform assessment 
instrument developed by the 
commissioner and the ICF-MR 
reimbursement and quality assurance and 
review manual.  Beginning with the 
reporting year which ends December 31, 
1991, the commissioner shall annually 
collect client statistical data based 
on assessments performed by the quality 
assurance and review teams and by the 
interdisciplinary team on annual cost 
reports submitted by the facility and 
may use this data in the calculation of 
program operating cost payment rates 
after October 1, 1993. 
 Recoveries obtained by the provider 
appeals unit shall be dedicated to the 
medical assistance account during the 
biennium ending June 30, 1993. 
 The commissioner shall study the need 
for enhanced reimbursement for the 
special Huntington's disease unit at 
Metro Health Care and shall make 
recommendations to the legislature by 
January 1, 1992. 
Sec. 3.  OMBUDSMAN FOR MENTAL 
HEALTH AND MENTAL RETARDATION          1,033,000      1,031,000
Sec. 4.  VETERANS NURSING   
HOMES BOARD                           24,363,000     26,330,000
 The amounts that may be spent from this 
appropriation for each program are more 
specifically described in the following 
subdivisions. 
Subdivision 1.  Veterans Nursing Homes  
    23,811,000     25,929,000
 Any unencumbered balances in the first 
year do not cancel but are available 
for the second year of the biennium 
within the programs overseen by the 
veterans homes board of directors. 
 Notwithstanding Laws 1989, chapter 282, 
article 1, section 12, for the biennium 
ending June 30, 1991, the veterans 
homes and the veterans nursing homes 
board, with the approval of the 
commissioner of finance, may transfer 
money to the object of expenditure 
"personal services" in order to pay 
workers' compensation costs.  
 The systemwide reductions shall be 
prorated against the appropriations for 
the veterans nursing homes board and 
the facilities operated by the board. 
 For the biennium ending June 30, 1993, 
the veterans homes board of directors 
may transfer unencumbered appropriation 
balances and positions from Luverne and 
Silver Bay nursing homes among all 
programs.  
 For the biennium ending June 30, 1993, 
the board may set costs of care at the 
Silver Bay and Luverne facilities based 
on costs of average skilled nursing 
care provided to residents of the 
Minneapolis veterans home. 
 Until June 30, 1993, the commissioner 
of health shall not apply the 
provisions of Minnesota Statutes, 
section 144.55, subdivision 6, 
paragraph (b), to the Minnesota 
veterans home at Hastings. 
 The department of health shall not 
reduce the licensed bed capacity for 
the Minneapolis veterans home for the 
biennium ending June 30, 1993, in lieu 
of presentation to the legislature of 
building needs and options by the 
veterans nursing homes board. 
 Any funds encumbered for use in 
repairing building 6 are available for 
unrestricted use in the fiscal year 
1991 operations for the Minneapolis 
veterans home.  
Subd. 2.  Veterans Nursing  
Homes Board  
       552,000        401,000
 The veterans nursing homes board and 
the department of veterans affairs 
shall review current alternatives to 
long-term care for veterans and report 
to the legislature by February 15, 
1992, with their review and proposals 
to enhance the availability and use of 
these options by veterans.  This study 
must be done with existing resources.  
 For the biennium ending June 30, 1991, 
the veterans nursing homes board, with 
the approval of the commissioner of 
finance, may transfer seven positions 
and unencumbered appropriation balances 
between the veterans nursing homes and 
the veterans nursing homes board.  
Sec. 5.  COMMISSIONER OF JOBS 
AND TRAINING                          36,170,000     35,307,000
 The amounts that may be spent from this 
appropriation for each program are more 
specifically described in the following 
subdivisions. 
Subdivision 1.  Rehabilitation Services    
    18,923,000     18,923,000
 For the biennium ending June 30, 1993, 
at least 35 percent in the first year 
and 38 percent in the second year of 
the vocational rehabilitation activity 
budget must be directed toward grants, 
which are budgeted as aid to 
individuals and local assistance 
categories of expense. 
 The amount of the appropriation for 
vocational rehabilitation services that 
is designated for mental illness 
demonstration grants may be used for 
innovative programs to serve persons 
with serious and persistent mental 
illness, but only if this use of the 
money will satisfy federal maintenance 
of effort requirements.  If this use 
will not satisfy the maintenance of 
effort requirements, the money must be 
added to the base appropriation for 
vocational rehabilitation services.  
 The commissioner of jobs and training 
shall develop a plan for staffing 
adjustments and organizational 
restructuring in the vocational 
rehabilitation activity.  The goal of 
the plan must be to lower 
administrative costs and redirect 
resources to direct services to 
clients.  The commissioner shall 
present the plan to the legislature by 
February 15, 1992. 
 Money is appropriated to be directed 
toward developing a plan for 
rehabilitation services programs 
provided by the state departments of 
jobs and training and human services.  
The plan shall be directed toward the 
goals of supporting the delivery of 
services to citizens with disabilities 
through a single point of entry at the 
community level, allowing greater 
consumer control, and ensuring greater 
coordination of services among the 
public and private agencies currently 
involved in providing services.  The 
development of this plan shall be done 
in cooperation with centers for 
independent living. * (The preceding 
paragraph beginning "Money" was vetoed 
by the governor.) 
 The money appropriated for a 
rehabilitation special project grant is 
transferred to the commissioner of 
labor and industry along with the 
workers' compensation program of the 
rehabilitation services division of the 
department of jobs and training, as 
provided in article 10. * (The 
preceding paragraph beginning "The 
money" was vetoed by the governor.) 
Subd. 2.  Services for the Blind 
     3,636,000      3,626,000
 This appropriation may be supplemented 
by funds provided by the Friends of the 
Communication Center, for support of 
Services for the Blind's Communication 
Center which serves all blind and 
visually handicapped Minnesotans.  The 
commissioner shall report to the 
legislature on a biennial basis the 
funds provided by the Friends of the 
Communication Center. 
Subd. 3.  Economic Opportunity Office 
     8,539,000      8,537,000
 For the biennium ending June 30, 1993, 
the commissioner shall transfer to the 
community services block grant program 
ten percent of the money received under 
the low-income home energy assistance 
block grant in each year of the 
biennium and shall spend all of the 
transferred money during the year of 
the transfer or the year following the 
transfer.  Up to 3.75 percent of the 
transferred money may be used by the 
commissioner for administrative 
purposes. 
 For the biennium ending June 30, 1993, 
the commissioner shall transfer to the 
low-income home weatherization program 
at least five percent of money received 
under the low-income home energy 
assistance block grant in each year of 
the biennium and shall spend all of the 
transferred money during the year of 
the transfer or the year following the 
transfer.  Up to 1.63 percent of the 
transferred money may be used by the 
commissioner for administrative 
purposes. 
 For the biennium ending June 30, 1993, 
no more than 1.63 percent of money 
remaining under the low-income home 
energy assistance program after 
transfers to the community services 
block grant program and the 
weatherization program may be used by 
the commissioner for administrative 
purposes. 
 For the biennium ending June 30, 1993, 
discretionary money from the community 
services block grant program (regular) 
must be used to supplement the 
appropriation for local storage, 
transportation, processing, and 
distribution of United States 
Department of Agriculture surplus 
commodities to the extent supplemental 
funding is required.  Any remaining 
money must be allocated to 
state-designated and state-recognized 
community action agencies, Indian 
reservations, and the Minnesota migrant 
council. 
 The state appropriation for the 
temporary emergency food assistance 
program may be used to meet the federal 
match requirements. 
Subd. 4.  Employment and Training 
     5,072,000      4,221,000
 Of the money appropriated for the 
summer youth employment programs for 
fiscal year 1992, $750,000 is 
immediately available.  Any remaining 
balance of the immediately available 
money is available for the year in 
which it is appropriated.  If the 
appropriation for either year of the 
biennium is insufficient, money may be 
transferred from the appropriation for 
the other year. 
 Notwithstanding Minnesota Statutes, 
section 268.022, subdivision 2, the 
commissioner of finance shall transfer 
in each year of the biennium ending 
June 30, 1993, from the dislocated 
worker fund to the general fund $5 
million of the money collected through 
the special assessment established in 
Minnesota Statutes, section 268.022, 
subdivision 1. 
 MEED service providers may retain 75 
percent of outstanding payback funds 
they collect to be used for the cost of 
collection and for program closeout 
activities without regard to existing 
cost category requirements.  MEED 
service providers may continue to 
operate the program until all 
activities are closed out, financial 
reports are finalized, and participants 
are terminated. 
 For the biennium ending June 30, 1993, 
the commissioner shall hold harmless 
the allocations to any program 
receiving funding for the displaced 
homemaker program that would be reduced 
due to any change in funding formula.  
In the event of increased 
appropriations, increases may be used 
in accordance with a needs-based 
formula. 
Sec. 6.  COMMISSIONER OF    
CORRECTIONS                          162,057,000    168,978,000
 The amounts that may be spent from the 
appropriation for each program and 
activity are more specifically 
described in the following subdivisions.
 Positions and administrative money may 
be transferred within the department of 
corrections as the commissioner 
considers necessary, upon the advance 
approval of the commissioner of finance.
 Any unencumbered balances remaining 
from fiscal year 1992 do not cancel but 
are available for the second year of 
the biennium. 
 For the biennium ending June 30, 1993, 
the commissioner of corrections may, 
with the approval of the commissioner 
of finance and upon notification of the 
chairs of the human resources division 
of the house appropriations committee 
and the human development division of 
the senate finance committee, transfer 
funds to or from salaries. 
 For the biennium ending June 30, 1993, 
and notwithstanding Minnesota Statutes, 
section 243.51, the commissioner of 
corrections may enter into agreements 
with the appropriate officials of any 
state, political subdivision, or the 
United States, for housing prisoners in 
Minnesota correctional facilities.  
Money received under the agreements is 
appropriated to the commissioner for 
correctional purposes. 
 The commissioner of corrections may 
transfer to the commissioner of human 
services unencumbered funds from fiscal 
year 1991 to accomplish the conversion 
of the Faribault regional treatment 
center to a shared campus with the 
department of corrections for a medium 
security correctional facility.  The 
commissioner of corrections may use any 
additional unencumbered funds from 
fiscal year 1991 to renovate buildings 
at Faribault for the correctional 
facility.  These funds do not cancel 
but are available to the commissioners 
of corrections and human services for 
both years of the biennium. 
Subdivision 1.  Correctional 
Institutions  
   111,632,000    118,292,000
Subd. 2.  Community Services 
    40,043,000     40,329,000
 The commissioner of finance shall 
adjust the base for the county 
probation reimbursement program, 
described in Minnesota Statutes, 
section 260.311, subdivision 5, to a 
level that allows the state to maintain 
a 50 percent reimbursement level to 
counties for the biennium beginning 
July 1, 1993. 
 During the biennium ending June 30, 
1993, whenever offenders are assigned 
for the purpose of work under agreement 
with a state department or agency, 
local unit of government, or other 
government subdivision, the state 
department or agency, local unit of 
government, or other government 
subdivision must certify to the 
appropriate bargaining agent that the 
work performed by inmates will not 
result in the displacement of currently 
employed workers or workers on seasonal 
layoff or layoff from a substantially 
equivalent position, including partial 
displacement such as reduction in hours 
of nonovertime work, wages, or other 
employment benefits. 
 Notwithstanding Minnesota Statutes, 
section 609.105 or any other provision 
of law to the contrary, a felony 
offender sentenced in a community 
corrections act county may not be 
committed to the custody of the 
commissioner of corrections under an 
executed sentence of imprisonment if 
the time remaining in the offender's 
sentence, minus credit for prior 
imprisonment, is 60 days or less unless 
the offender's sentence was 
presumptively executed under the 
sentencing guidelines.  Notwithstanding 
any provision of law to the contrary, 
these offenders may be sentenced to 
imprisonment in a local jail or 
workhouse.  This does not apply to 
offenders whose sentences were executed 
at the time of sentencing and to 
offenders whose sentences were executed 
after revocation of a stayed felony 
sentence. 
Subd. 3.  Management Services  
    10,382,000     10,357,000
Sec. 7.  SENTENCING GUIDELINES 
COMMISSION                               248,000        254,000
Sec. 8.  CORRECTIONS OMBUDSMAN           419,000        441,000
Sec. 9.  COMMISSIONER OF HEALTH 
Subdivision 1.  Appropriation 
by Fund 
General Fund                          47,610,000     47,337,000
Metropolitan Landfill 
Contingency Fund                         168,000        168,000
State Government Special 
Revenue Fund                             455,000        513,000
Trunk Highway Fund                     1,487,000      1,486,000
 The appropriation from the metropolitan 
landfill contingency fund is for 
monitoring well water supplies and 
conducting health assessments in the 
metropolitan area. 
 The appropriation from the trunk 
highway fund is for emergency medical 
services activities. 
 The commissioner of health, with the 
approval of the commissioner of 
finance, may transfer appropriated 
funds between fiscal years and from 
supply and expense categories to the 
salary account in order to avoid 
layoffs.  
 The amounts that may be spent from this 
appropriation for each program and 
activity are more specifically 
described in the following subdivisions.
Subd. 2.  Protective Health 
Services 
General Fund  
    16,064,000     16,218,000
Metropolitan Landfill 
Contingency Fund  
       146,000        146,000
Subd. 3.  Health Delivery Systems 
General Fund 
    27,544,000     27,068,000
State Government Special 
Revenue Fund  
       455,000        513,000
Trunk Highway Fund 
     1,401,000      1,400,000
 General fund appropriations for the 
women, infants and children food 
supplement program (WIC) are available 
for either year of the biennium.  
Transfers of appropriations between 
fiscal years must be for the purpose of 
maximizing federal funds or minimizing 
fluctuations in the number of 
participants.  
 When cost effective, the commissioner 
may use money received for the services 
for children with handicaps program to 
purchase health coverage for eligible 
children. 
 Minnesota Rules, parts 4655.1070 to 
4655.1098, as in effect on September 1, 
1989, are adopted as an emergency rule 
of the department of health.  The 
commissioner of health shall publish in 
the State Register a notice of intent 
to adopt Minnesota Rules, parts 
4655.1070 to 4655.1098 [Emergency].  
The same notice shall be mailed to all 
persons registered with the agency to 
receive notice of any rulemaking 
proceedings.  The emergency rule is 
exempt from the requirements of 
Minnesota Statutes, sections 14.32 to 
14.35, and shall take effect five 
working days after publication in the 
State Register.  Those rules shall 
govern the process for granting 
exceptions to the moratorium on nursing 
homes under Minnesota Statutes, section 
144A.073, during the biennium. 
 In the event that Minnesota is required 
to comply with the provision in the 
federal maternal and child health block 
grant law, which requires 30 percent of 
the allocation to be spent on primary 
services for children, federal funds 
allocated to the commissioner of health 
under Minnesota Statutes, section 
145.882, subdivision 2, may be 
transferred to the commissioner of 
human services for the purchase of 
primary services for children covered 
by the children's health plan.  The 
commissioner of human services shall 
transfer an equal amount of the money 
appropriated for the children's health 
plan to the commissioner of health to 
assure access to quality child health 
services under Minnesota Statutes, 
section 145.88. 
 General fund appropriations for 
treatment services in the services for 
children with handicaps program are 
available for either year of the 
biennium. 
 During the biennium ending June 30, 
1993, and notwithstanding Minnesota 
Statutes, section 144A.48, subdivision 
2, clause (9), the commissioner of 
health may issue a hospice license to a 
freestanding residential facility that 
was registered and was providing 
hospice services as of March 1, 1990, 
if that facility is licensed as a board 
and lodging facility, provides services 
to no more than six residents, meets 
group R, division 3 occupancy 
requirements and meets the fire 
protection provisions of chapter 21 of 
the 1985 Life Safety Code, NFPA 101, of 
the National Fire Protection 
Association, for facilities housing 
persons with impractical evacuation 
capabilities.  Continued licensure as a 
hospice must be contingent on the 
facility's compliance with the 
department of health rules for hospices 
and for residential care facilities 
upon adoption of those rules. 
 The commissioner shall fund a statewide 
family planning hotline grant and shall 
allocate remaining family planning 
special project grant funds to eight 
regions according to a needs-based 
distribution formula. 
 The funding for family planning special 
project grants shall be awarded through 
the criteria established in Minnesota 
Rules.  Notwithstanding any rule to the 
contrary, an organization shall not be 
excluded or reduced in priority for 
funding because the organization does 
not make available, directly or through 
referral, all methods of contraceptives 
for reasons of conscience.  The 
commissioner of health shall develop 
procedures for establishing a 
conscience clause in the grant 
application process. 
 For the purpose of conducting a 
comprehensive review of nursing home 
licensure laws and regulations the 
commissioner may assess a licensing fee 
surcharge on nursing home beds and 
boarding care beds for which an initial 
or renewal license is issued during 
fiscal year 1992 and fiscal year 1993.  
The surcharge shall be $2.12 per bed in 
fiscal 1992 and $2.73 per bed in fiscal 
1993.  The surcharge shall not continue 
beyond fiscal 1993. 
Subd. 4.  Health Support Services 
General Fund  
     4,002,000      4,051,000
Metropolitan Landfill 
Contingency Fund  
        22,000         22,000
Trunk Highway Fund 
        86,000         86,000
Sec. 10.  HEALTH-RELATED BOARDS  
Subdivision 1.  Total 
Appropriation 
State Government Special    
Revenue Fund                           5,859,000      5,949,000
 Fees generated by the health-related 
licensing boards or the commissioner of 
health under Minnesota Statutes, 
section 214.06, must be credited to the 
health occupations licensing account 
within the state government special 
revenue fund. 
 The commissioner of finance shall not 
permit the allotment, encumbrance, or 
expenditure of money appropriated in 
this section in excess of the 
anticipated biennial revenues from fees 
collected by the boards.  Neither this 
provision nor Minnesota Statutes, 
section 214.06, applies to transfers 
from the general contingent account, if 
the amount transferred does not exceed 
the amount of surplus revenue 
accumulated by the transferee during 
the previous five years. 
 Unless otherwise designated, all 
appropriations in this section are from 
the state government special revenue 
fund. 
Subd. 2.  Board of Chiropractic 
Examiners                                283,000        291,000
Subd. 3.  Board of Dentistry             586,000        586,000
Subd. 4.  Board of Medical  
Examiners                              1,958,000      1,951,000
 For the biennium ending June 30, 1993, 
fees set by the board of medical 
examiners pursuant to Minnesota 
Statutes, section 214.06, must be fixed 
by rule.  The procedure for 
noncontroversial rules in Minnesota 
Statutes, sections 14.22 to 14.28 may 
be used except that, notwithstanding 
the requirements of Minnesota Statutes, 
section 14.22, paragraph (3), no public 
hearing may be held.  The notice of 
intention to adopt the rules must state 
that no hearing will be held.  This 
procedure may be used only when the 
total fees estimated for the biennium 
do not exceed the sum of direct 
appropriations, indirect costs, 
transfers in, and salary supplements 
for that purpose.  A public hearing is 
required for adjustments of fees spent 
under open appropriations of dedicated 
receipts. 
Subd. 5.  Board of Nursing             1,375,000      1,412,000
Subd. 6.  Board of Examiners for 
Nursing Home Administrators              165,000        193,000
Subd. 7.  Board of Optometry              69,000         71,000
Subd. 8.  Board of Pharmacy              544,000        599,000
 Deficiency:  $16,000 is appropriated 
for fiscal year 1991 to the board of 
pharmacy from the state government 
special revenue fund. 
Subd. 9.  Board of Podiatry               28,000         28,000
Subd. 10.  Board of Psychology           237,000        206,000
 Deficiency:  $30,000 is appropriated 
for fiscal year 1991 to the board of 
psychology from the state government 
special revenue fund. 
Subd. 11.  Board of Marriage and 
Family Therapy                            94,000         94,000
Subd. 12.  Board of Social Work          410,000        410,000
Subd. 13.  Board of Veterinary 
Medicine                                 110,000        108,000
Sec. 11.  COUNCIL ON DISABILITY          568,000        583,000
Sec. 12.  COUNCIL ON BLACK  
MINNESOTANS                              195,000        200,000
Sec. 13.  COUNCIL ON AFFAIRS 
OF SPANISH-SPEAKING PEOPLE               213,000        220,000
 During the biennium ending June 30, 
1993, council publications may contain 
advertising.  Funds derived from 
advertising are appropriated to the 
council for purposes of council 
publications. 
 For the biennium ending June 30, 1993, 
the council shall report to the 
legislature on the revenues and 
expenditures from advertising by 
February 15 each year. 
Sec. 14.  COUNCIL ON ASIAN- 
PACIFIC MINNESOTANS                      170,000        174,000
Sec. 15.  INDIAN AFFAIRS COUNCIL         444,000        455,000
 For the biennium ending June 30, 1993, 
federal money received for the Indian 
affairs council is appropriated to the 
council and added to this appropriation.
Sec. 16.  COMMISSIONER OF
HUMAN RIGHTS                           3,194,000      3,189,000
 The department of human rights may not 
be charged by the attorney general for 
legal representation on behalf of 
complaining parties who have filed a 
charge of discrimination with the 
department.  This provision is 
effective retroactive to July 1, 1989.  
The department does not have an 
obligation to pay for any services 
rendered by the attorney general since 
July 1, 1985, in excess of the amounts 
already paid for those services. 
Sec. 17.  COMMISSIONER OF HOUSING
FINANCE AGENCY  
Subdivision 1.  Total 
Appropriation                         14,159,000     14,159,000
Approved Complement - 140 
 Spending limit on cost of general 
administration of agency programs:  
      1992           1993
     8,305,000      8,686,000
 This appropriation is for transfer to 
the housing development fund for the 
programs specified in the working 
documents of the conferees.  
 Money is appropriated from the housing 
development fund to be used to provide 
housing for chronic chemically 
dependent adults under Minnesota 
Statutes, section 462A.05, subdivision 
20.  Money is appropriated from the 
housing development fund to be used to 
make planning grants to nonprofit 
organizations to develop coordinated 
training and housing programs for 
homeless adults under Minnesota 
Statutes, section 462A.05, subdivision 
20. 
 Any state appropriations used to meet 
match requirements under Title II of 
the National Affordable Housing Act of 
1990, Public Law Number 101-625, 104 
Stat. 4079, must be repaid, to the 
extent required by federal law, to the 
HOME Investment Trust Fund established 
by the department of housing and urban 
development pursuant to Title II of the 
National Affordable Housing Act of 1990 
for the state of Minnesota or for the 
appropriate participating jurisdiction. 
 State appropriations to the Minnesota 
housing finance agency may be granted 
by the agency to cities or nonprofit 
organizations to the extent necessary 
to meet match requirements under Title 
II of the National Affordable Housing 
Act of 1990, Public Law Number 101-625, 
104 Stat. 4079, provided that other 
program requirements are met. 
Sec. 18.  ALLOCATIONS
 All appropriations in this article 
shall be allocated according to the 
working documents of the conferees.  
Sec. 19  CARRYOVER LIMITATION 
 None of the appropriations in this act 
which are allowed to be carried forward 
from fiscal year 1992 to fiscal year 
1993 shall become part of the base 
level funding for the 1993-1995 
biennial budget. 
Sec. 20  UNCODIFIED LANGUAGE
 All uncodified language contained in 
this article expires on June 30, 1993, 
unless a different expiration is 
explicit. 
 Sec. 21.  TRANSFERS 
 Subdivision 1.  Approval Required 
 Transfers may be made by the 
commissioners of human services, 
corrections, jobs and training, health, 
human rights, and housing finance, the 
councils listed in sections 11 to 15, 
and the veterans nursing homes board to 
salary accounts and unencumbered salary 
money may be transferred to the next 
fiscal year in order to avoid layoffs 
with the advance approval of the 
commissioner of finance and upon 
notification of the chairs of the 
health and human services divisions of 
the senate finance committee and the 
house appropriations committee.  
Amounts transferred to fiscal 1993 
shall not increase the base funding 
level for the 1994-1995 appropriation.  
The commissioners and the board shall 
not transfer money to or from the 
object of expenditure "grants and aid" 
without the written approval of the 
governor after consulting with the 
legislative advisory commission, except 
for transfers in the services for the 
blind and rehabilitation services 
programs, which may be made with the 
approval of the commissioner of finance.
 Subd. 2.  Transfers of Unencumbered 
Appropriations 
 For the biennium ending June 30, 1993, 
the commissioners of human services, 
human rights, corrections, health, and 
jobs and training, the housing finance 
agency, the councils listed in sections 
11 to 15, and the veterans nursing 
homes board, by direction of the 
governor after consulting with the 
legislative advisory commission, may 
transfer unencumbered appropriation 
balances and positions among all 
programs. 
Sec. 22  PROJECT LABOR
 For the biennium ending June 30, 1993, 
wages for project labor may be paid by 
the commissioners of human services and 
corrections out of repairs and 
betterment funds if the individual is 
to be engaged in a construction project 
or repair project of a short-term and 
nonrecurring nature.  Compensation for 
project labor shall be based on the 
prevailing wage rates, as defined in 
Minnesota Statutes, section 177.42, 
subdivision 6.  Project laborers are 
excluded from the provisions of 
Minnesota Statutes, sections 43A.22 to 
43A.30, and shall not be eligible for 
state-paid insurance and benefits. 
 Sec. 23.  PROVISIONS 
 For the biennium ending June 30, 1993, 
money appropriated to the commissioner 
of corrections, the commissioner of 
human services, and the veterans 
nursing homes board in this act for the 
purchase of provisions within the item 
"current expense" must be used solely 
for that purpose.  Money provided and 
not used for purchase of provisions 
must be canceled into the fund from 
which appropriated, except that money 
provided and not used for the purchase 
of provisions because of population 
decreases may be transferred and used 
for the purchase of medical and 
hospital supplies with the written 
approval of the governor after 
consulting with the legislative 
advisory commission. 
 The allowance for food may be adjusted 
annually according to the United States 
Department of Labor, Bureau of Labor 
Statistics publication, producer price 
index, with the approval of the 
commissioner of finance.  Adjustments 
for fiscal year 1992 and fiscal year 
1993 must be based on the June 1991 and 
June 1992 producer price index 
respectively, but the adjustment must 
be prorated if the wholesale food price 
index adjustment would require money in 
excess of this appropriation. 
Sec. 24.  SALES, LEASES AND TRANSFERS 
 The commissioner of human services 
shall not sell, lease, or otherwise 
transfer the ownership, management, or 
operation of a state-operated 
community-based group home or other 
state operated community facility 
authorized and funded by the 
legislature. 
Sec. 25.  EFFECTIVE DATE 
 Section 24 is effective the day 
following final enactment. 

                               ARTICLE 2 

                           HEALTH DEPARTMENT 
    Section 1.  Minnesota Statutes 1990, section 15.46, is 
amended to read: 
     15.46 [PREVENTIVE HEALTH SERVICES FOR STATE EMPLOYEES.] 
     The commissioner of the department of employee relations 
may establish and operate a program of preventive health 
services for state employees, and shall provide such staff, 
equipment, and facilities as are necessary therefor.  The 
commissioner shall develop these services in accordance with the 
accepted practices of and standards for occupational preventive 
health services in the state of Minnesota.  Specific services 
shall be directed to the work environment and to the health of 
the employee in relation to the job.  The commissioner shall 
cooperate with the department of health as well as other private 
and public community agencies providing health, safety, 
employment, and welfare services.  A county may establish and 
operate a program of preventive health and employee recognition 
services for county employees and may provide necessary staff, 
equipment, and facilities and may expend funds as necessary to 
achieve the objectives of the program. 
    Sec. 2.  Minnesota Statutes 1990, section 103I.235, is 
amended to read: 
    103I.235 [SALE OF PROPERTY WHERE WELLS ARE LOCATED.] 
    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 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.  A well certificate 
need not be provided If the closing occurs before November 1, 
1990, or the seller does not know of any wells on the property 
and, a well disclosure certificate is not required; however, the 
deed or other instrument of conveyance contains must contain the 
statement:  "The Seller certifies that the Seller does not know 
of any wells on the described real property."  
    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; however, the deed 
or other instrument of conveyance must contain the statement:  
"The purchaser certifies the purchaser does not know of any 
wells on the property."  
    (c) 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 515A. 
    (d) For an area owned in common under chapter 515 or 515A 
the association or other responsible person must report to the 
commissioner by January 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. 
    (c) (e) 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.
    (d) (f) 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 either contains the statement 
"The Seller certifies that the Seller does not know of any wells 
on the described real property," or is accompanied by the well 
disclosure certificate required by this subdivision.  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 well disclosure certificate shall not be filed or recorded 
in the records maintained by the county recorder or registrar of 
titles.  The county recorder or registrar of titles shall 
transmit the well disclosure certificate to the commissioner of 
health within 15 days after receiving the well disclosure 
certificate.  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.  The commissioner 
shall charge the buyer of the property a fee of $10 for the 
processing of the well disclosure certificate. 
    (e) (g) 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. 
    (f) (h) 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.  
    Subd. 2.  [LIABILITY FOR FAILURE TO DISCLOSE.] Unless the 
buyer and seller agree to the contrary, in writing, before the 
closing of the sale, a seller who fails to disclose the 
existence or known status of a well at the time of sale and knew 
or had reason to know of the existence or known status of the 
well, is liable to the buyer for costs relating to sealing of 
the well and reasonable attorney fees for collection of costs 
from the seller, if the action is commenced within six years 
after the date the buyer closed the purchase of the real 
property where the well is located. 
    Sec. 3.  Minnesota Statutes 1990, section 144.335, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DEFINITIONS.] For the purposes of this 
section, the following terms have the meanings given them: 
    (a) "Patient" means a natural person who has received 
health care services from a provider for treatment or 
examination of a medical, psychiatric, or mental condition, the 
surviving spouse and parents of a deceased patient, or a person 
the patient designates in writing as a representative.  Except 
for minors who have received health care services pursuant to 
sections 144.341 to 144.347, in the case of a minor, patient 
includes a parent or guardian, or a person acting as a parent or 
guardian in the absence of a parent or guardian. 
    (b) "Provider" means (1) any person who furnishes health 
care services and is licensed to furnish the services pursuant 
to chapter 147, 148, 148B, 150A, 151, or 153; (2) a home care 
provider licensed under section 144A.46; and (3) a health care 
facility licensed pursuant to this chapter or chapter 144A; and 
(4) an unlicensed mental health practitioner regulated pursuant 
to sections 148B.60 to 148B.71. 
    Sec. 4.  [144.401] [COMMUNITY PREVENTION GRANTS.] 
    Subdivision 1.  [GRANTS MAY BE AWARDED TO COMMUNITY HEALTH 
BOARDS AND INDIAN RESERVATIONS.] Within the limits of funding 
provided by the legislature, the federal government, or public 
or private grants, the commissioner shall award grants to 
community health boards and the federally recognized Indian 
reservations to plan, develop, and implement community alcohol 
and drug use and abuse prevention programs.  To be considered 
for a grant, a health board or Indian reservation must submit an 
application to the commissioner of health that includes a 
description of the planning process used, a description of 
community needs and existing resources, a description of the 
program activities to be implemented with grant money, and a 
list of the agencies and organizations with whom the board or 
Indian reservation intends to contract.  
    Subd. 2.  [LOCAL PLANNING REQUIREMENTS.] To be eligible for 
a prevention grant, a community health board or Indian 
reservation must conduct a communitywide planning process that 
allows full participation of all agencies, organizations, and 
individuals interested in alcohol and drug use and abuse 
issues.  This process must include at least an assessment of 
community needs, an inventory of existing resources, 
identification of prevention program activities that will be 
implemented, and a description of how the program will work 
collaboratively with programs in existence.  A health board may 
comply with the planning requirements of this subdivision by 
expanding the community needs assessment process used to develop 
its community health plan under section 145A.10, subdivision 5. 
    Subd. 3.  [USE OF GRANT MONEY.] Grant money may be used to 
plan, develop, and implement communitywide primary prevention 
programs relating to alcohol and other drug use and abuse.  
Programs may include specific components to address related 
health risk behaviors involving use of tobacco, poor nutrition, 
limited exercise or physical activity, and behaviors that create 
a risk of serious injury.  Grantees may contract with other 
agencies and organizations to implement the program activities 
identified in the grant application.  Special consideration for 
contracts must be given to local agencies and organizations with 
previous successful experience conducting alcohol and other drug 
prevention programs.  Grant money must not be used for alcohol 
and other drug testing, treatment, or law enforcement 
activities.  Grant money must not be used to supplant or replace 
funding provided from other sources.  
    Subd. 4.  [LOCAL MATCH.] Prevention grant money provided by 
the commissioner must not exceed 75 percent of the estimated 
cost of the eligible prevention program activities for the 
fiscal year for which the grant is awarded.  Local funding of 
the remainder of the costs may be provided from the sources 
specified in section 145A.13, subdivision 2, paragraph (a). 
    Subd. 5.  [TRANSFER OF FUNDS.] Federal money provided to 
the commissioner of education for community prevention grants 
through the federal Drug Free Schools and Communities Act is 
transferred to the commissioner of health for prevention grants 
under this section. 
    Sec. 5.  [144.661] [DEFINITIONS.] 
    Subdivision 1.  [APPLICABILITY.] For purposes of sections 
144.661 to 144.665, the following terms have the meanings given 
them.  
    Subd. 2.  [TRAUMATIC BRAIN INJURY.] "Traumatic brain injury"
means a sudden insult or damage to the brain or its coverings 
caused by an external physical force which may produce a 
diminished or altered state of consciousness and which results 
in the following disabilities:  
    (1) impairment of cognitive or mental abilities; 
    (2) impairment of physical functioning; or 
    (3) disturbance of behavioral or emotional functioning. 
These disabilities may be temporary or permanent and may result 
in partial or total loss of function.  "Traumatic brain injury" 
does not include injuries of a degenerative or congenital nature.
    Subd. 3.  [SPINAL CORD INJURY.] "Spinal cord injury" means 
an injury that occurs as a result of trauma which may involve 
spinal vertebral fracture and where the injured person suffers 
an acute, traumatic lesion of neural elements in the spinal 
canal, resulting in any degree of temporary or permanent sensory 
deficit, motor deficit, or bladder or bowel dysfunction.  
"Spinal cord injury" does not include intervertebral disc 
disease.  
    Sec. 6.  [144.662] [TRAUMATIC BRAIN INJURY AND SPINAL CORD 
INJURY REGISTRY; PURPOSE.] 
    The commissioner of health shall establish and maintain a 
central registry of persons who sustain traumatic brain injury 
or spinal cord injury.  The purpose of the registry is to:  
    (1) collect information to facilitate the development of 
injury prevention, treatment, and rehabilitation programs; and 
    (2) ensure the provision to persons with traumatic brain 
injury or spinal cord injury of information regarding 
appropriate public or private agencies that provide 
rehabilitative services so that injured persons may obtain 
needed services to alleviate injuries and avoid secondary 
problems, such as mental illness and chemical dependency.  
    Sec. 7.  [144.663] [DUTY TO REPORT.] 
    Subdivision 1.  [ESTABLISHMENT OF REPORTING SYSTEM.] The 
commissioner shall design and establish a reporting system which 
designates either the treating hospital, medical facility, or 
physician to report to the department within a reasonable period 
of time after the identification of a person with traumatic 
brain injury or spinal cord injury.  The consent of the injured 
person is not required. 
    Subd. 2.  [INFORMATION.] The report must be submitted on 
forms provided by the department and must include the following 
information:  
    (1) the name, age, and residence of the injured person; 
    (2) the date and cause of the injury; 
    (3) the initial diagnosis; and 
    (4) other information required by the commissioner.  
    Subd. 3.  [REPORTING WITHOUT LIABILITY.] The furnishing of 
information required by the commissioner shall not subject any 
person or facility required to report to any action for damages 
or other relief, provided that the person or facility is acting 
in good faith.  
    Sec. 8.  [144.664] [DUTIES OF COMMISSIONER.] 
    Subdivision 1.  [STUDIES.] The commissioner shall collect 
injury incidence information, analyze the information, and 
conduct special studies regarding traumatic brain injury and 
spinal cord injury.  
    Subd. 2.  [PROVISION OF DATA.] The commissioner shall 
provide summary registry data to public and private entities to 
conduct studies using data collected by the registry.  The 
commissioner may charge a fee under section 13.03, subdivision 
3, for all out-of-pocket expenses associated with the provision 
of data or data analysis.  
    Subd. 3.  [NOTIFICATION.] Within five days of receiving a 
report of traumatic brain injury or spinal cord injury, the 
commissioner shall notify the commissioner of jobs and 
training.  The notification shall include the person's name and 
other identifying information. 
    Subd. 4.  [REVIEW COMMITTEE.] The commissioner shall 
establish a committee to assist the commissioner in the adoption 
of rules under subdivision 5 and in the review of registry 
activities.  The committee expires as provided in section 
15.059, subdivision 5.  
    Subd. 5.  [RULES.] The commissioner shall adopt rules to 
administer the registry, collect information, and distribute 
data.  The rules must include, but are not limited to, the 
following:  
    (1) the specific ICD-9 procedure codes included in the 
definitions of "traumatic brain injury" and "spinal cord 
injury"; 
    (2) the type of data to be reported; 
    (3) standards for reporting specific types of data; 
    (4) the persons and facilities required to report and the 
time period in which reports must be submitted; 
    (5) criteria relating to the use of registry data by public 
and private entities engaged in research; and 
    (6) specification of fees to be charged under section 
13.03, subdivision 3, for out-of-pocket expenses.  
    Sec. 9.  [144.665] [TRAUMATIC BRAIN INJURY AND SPINAL CORD 
INJURY DATA.] 
    Data on individuals collected by the commissioner of health 
under sections 144.662 to 144.664 or provided to the 
commissioner of jobs and training under section 144.664 are 
private data on individuals as defined in section 13.02, 
subdivision 12, and may be used only for the purposes set forth 
in sections 144.662 to 144.664 in accordance with the rules 
adopted by the commissioner. 
    Sec. 10.  Minnesota Statutes 1990, section 144A.46, 
subdivision 1, is amended to read: 
    Subdivision 1.  [LICENSE REQUIRED.] (a) A home care 
provider may not operate in the state without a current license 
issued by the commissioner of health. 
    (b) Within ten days after receiving an application for a 
license, the commissioner shall acknowledge receipt of the 
application in writing.  The acknowledgment must indicate 
whether the application appears to be complete or whether 
additional information is required before the application will 
be considered complete.  Within 90 days after receiving a 
complete application, the commissioner shall either grant or 
deny the license.  If an applicant is not granted or denied a 
license within 90 days after submitting a complete application, 
the license must be deemed granted.  An applicant whose license 
has been deemed granted must provide written notice to the 
commissioner before providing a home care service. 
    (c) Each application for a home care provider license, or 
for a renewal of a license, shall be accompanied by a fee to be 
set by the commissioner under section 144.122, except that the 
commissioner shall not charge a licensure fee to a home care 
provider operated by a statutory or home rule charter city, 
county, town, or other governmental entity. 
    Sec. 11.  Minnesota Statutes 1990, section 144A.49, is 
amended to read: 
    144A.49 [TEMPORARY PROCEDURES.] 
    For purposes of this section, "home care providers" shall 
mean the providers described in section 144A.43, subdivision 4, 
including hospice programs described in section 144A.48.  Home 
care providers are exempt from the licensure requirement in 
section 144A.46, subdivision 1, until 90 days after the 
effective date of the licensure rules.  Beginning July 1, 1987, 
no home care provider, as defined in section 144A.43, 
subdivision 4, except a provider exempt from licensure under 
section 144A.46, subdivision 2, may provide home care services 
in this state without registering with the commissioner.  A home 
care provider is registered with the commissioner when the 
commissioner has received in writing the provider's name; the 
name of its parent corporation or sponsoring organization, if 
any; the street address and telephone number of its principal 
place of business; the street address and telephone number of 
its principal place of business in Minnesota; the counties in 
Minnesota in which it may render services; the street address 
and telephone number of all other offices in Minnesota; and the 
name, educational background, and ten-year employment history of 
the person responsible for the management of the agency.  A 
registration fee must be submitted with the application for 
registration, except that the commissioner shall not collect a 
registration fee from a home care provider operated by a 
statutory or home rule charter city, county, town, or other 
governmental entity.  The fee must be established pursuant to 
section 144.122 and must be based on a consideration of the 
following factors:  the number of clients served by the home 
care provider, the number of employees, the number of services 
offered, and annual revenues of the provider.  The registration 
is effective until 90 days after licensure rules are effective.  
In order to maintain its registration and provide services in 
Minnesota, a home care provider must comply with section 144A.44 
and comply with requests for information under section 144A.47.  
A registered home care provider is subject to sections 144A.51 
to 144A.54.  Registration under this section does not exempt a 
home care provider from the licensure and other requirements 
later adopted by the commissioner. 
    Within 90 days after the effective date of the licensure 
rules under section 144A.45, the commissioner of health shall 
issue provisional licenses to all home care providers registered 
with the department as of that date.  The provisional license 
shall be valid until superseded by a license issued under 
section 144A.46 or for a period of one year, whichever is 
shorter.  Applications for licensure as a home care provider 
received on or after the effective date of the home care 
licensure rules, shall be issued under section 144A.46, 
subdivision 1. 
    Sec. 12.  Minnesota Statutes 1990, section 144A.51, 
subdivision 5, is amended to read: 
    Subd. 5.  "Health facility" means a facility or that part 
of a facility which is required to be licensed pursuant to 
sections 144.50 to 144.58, and a facility or that part of a 
facility which is required to be licensed under any law of this 
state which provides for the licensure of nursing homes, and a 
residential care home licensed under sections 144B.10 to 144B.17.
    Sec. 13.  Minnesota Statutes 1990, section 144A.53, 
subdivision 1, is amended to read: 
    Subdivision 1.  [POWERS.] The director may: 
    (a) Promulgate by rule, pursuant to chapter 14, and within 
the limits set forth in subdivision 2, the methods by which 
complaints against health facilities, health care providers, 
home care providers, or administrative agencies are to be made, 
reviewed, investigated, and acted upon; provided, however, that 
a fee may not be charged for filing a complaint. 
    (b) Recommend legislation and changes in rules to the state 
commissioner of health, legislature, governor, administrative 
agencies or the federal government. 
    (c) Investigate, upon a complaint or upon initiative of the 
director, any action or failure to act by a health care 
provider, home care provider, or a health facility. 
     (d) Request and receive access to relevant information, 
records, incident reports, or documents in the possession of an 
administrative agency, a health care provider, a home care 
provider, or a health facility, and issue investigative 
subpoenas to individuals and facilities for oral information and 
written information, including privileged information which the 
director deems necessary for the discharge of responsibilities.  
For purposes of investigation and securing information to 
determine violations, the director need not present a release, 
waiver, or consent of an individual.  The identities of patients 
or residents must be kept private as defined by section 13.02, 
subdivision 12. 
    (e) Enter and inspect, at any time, a health facility and 
be permitted to interview staff; provided that the director 
shall not unduly interfere with or disturb the provision of care 
and services within the facility or the activities of a patient 
or resident unless the patient or resident consents.  
    (f) Issue a correction order pursuant to section 144.653 or 
any other law which provides for the issuance of correction 
orders to health care facilities or home care provider, or under 
section 144A.45.  A facility's refusal to cooperate in providing 
lawfully requested information may also be grounds for a 
correction order. 
    (g) Recommend the certification or decertification of 
health facilities pursuant to Title XVIII or XIX of the United 
States Social Security Act. 
    (h) Assist patients or residents of health facilities in 
the enforcement of their rights under Minnesota law.  
    (i) Work with administrative agencies, health facilities, 
home care providers, and health care providers and organizations 
representing consumers on programs designed to provide 
information about health facilities to the public and to health 
facility residents.  
    Sec. 14.  [144B.01] [DEFINITIONS.] 
    Subdivision 1.  [SCOPE.] As used in sections 144B.01 to 
144B.17, the following terms have the meanings given them in 
this section. 
    Subd. 2.  [ADULT.] "Adult" means a person who has attained 
the age of 18 years.  
    Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
commissioner of health or the commissioner's designee.  
    Subd. 4.  [DEPARTMENT.] "Department" means the Minnesota 
department of health. 
    Subd. 5.  [RESIDENTIAL CARE HOME OR HOME.] "Residential 
care home" or "home" means an establishment with a minimum of 
five beds, where adult residents are provided sleeping 
accommodations and two or more meals per day and where 
supportive services are provided or offered to all residents by 
the facility.  A "residential care home" does not include: 
    (1) a board and lodging establishment licensed under 
chapter 157 and also licensed by the commissioner of human 
services under chapter 245A; 
    (2) a boarding care home or a supervised living facility 
licensed under chapter 144; 
    (3) a home care provider licensed under chapter 144A; and 
    (4) any housing arrangement which consists of apartments 
containing a separate kitchen or kitchen equipment that will 
allow residents to prepare meals and where supportive services 
may be provided, on an individual basis, to residents in their 
living units either by the management of the residential care 
home or by home care providers under contract with the home's 
management. 
    Subd. 6.  [SUPPORTIVE SERVICES.] "Supportive services" 
means the provision of supervision and minimal assistance with 
independent living skills.  Supportive services include 
assistance with transportation, arranging for meetings and 
appointments, arranging for medical and social services, help 
with laundry, managing money, and personal shopping assistance.  
In addition, supportive services include, if needed, assistance 
with walking, grooming, dressing, eating, bathing, toileting, 
and providing reminders to residents to take medications.  
Supportive services also include other health-related support 
services identified by the commissioner in rule.  
    Sec. 15.  [144B.02] [LICENSE REQUIRED.] 
    No person, partnership, association, or corporation, nor 
any state, county, or local governmental units, nor any 
division, department, board, or agency shall establish, operate, 
conduct, or maintain in the state any residential care home 
without first obtaining a license as required in sections 
144B.01 to 144B.17.  No person or entity shall advertise a home 
providing services required to be licensed under sections 
144B.01 to 144B.17 without first obtaining a license.  A 
violation of this section is a misdemeanor punishable by a fine 
of not more than $300.  The commissioner may seek an injunction 
in the district court against the continuing operation of the 
unlicensed home.  Proceedings for securing an injunction may be 
brought by the attorney general or by the appropriate county 
attorney.  The sanctions in this section do not restrict other 
available sanctions.  
    Sec. 16.  [144B.03] [LICENSE APPLICATION.] 
    Subdivision 1.  [LICENSE PROCEDURES.] The commissioner 
shall by rule establish forms and procedures for processing 
residential care home license applications.  An application for 
a residential care home license shall include: 
    (1) the name and address of the licensee and the manager of 
the home to be licensed; 
    (2) the address of the home; and 
    (3) any other relevant information which the commissioner 
by rule may determine is necessary to properly evaluate an 
application for license.  
    An applicant for licensure which is a corporation shall 
submit copies of its articles of incorporation and bylaws and 
any amendments as they occur, together with the names and 
addresses of its officers and directors.  An applicant for 
licensure which is a foreign corporation shall furnish the 
commissioner with a copy of its certificate of authority to do 
business in this state.  The application of a corporation, 
association, or a governmental unit or instrumentality shall be 
signed by at least two officers or managing agents of that 
entity.  
    Subd. 2.  [AGENTS IDENTIFIED.] Each application for a 
residential care home license or for renewal of a residential 
care home license shall specify one or more individuals or 
employees as agents: 
    (1) who shall be responsible for dealing with the 
commissioner on all matters provided for in sections 144B.01 to 
144B.17; and 
    (2) on whom personal service of all notices and orders 
shall be made, and who shall be authorized to accept service on 
behalf of the licensee. 
    Notwithstanding any law to the contrary, personal service 
on the designated person or persons named in an application 
shall be deemed to be service on the licensee, and it shall not 
be a defense to any action arising, that personal service was 
not made on each individual.  The designation of one or more 
individuals pursuant to this subdivision shall not affect the 
legal responsibility of the licensee under sections 144B.01 to 
144B.17. 
    Sec. 17.  [144B.04] [FEES.] 
    Each application for a license to operate a residential 
care home, or for a renewal of license, shall be accompanied by 
a fee established by the commissioner according to section 
144.122.  No fee shall be refunded.  The fee established must 
include an amount necessary to recover, over a five-year period, 
the commissioner's direct expenditures for adoption of the 
residential care home rules. 
    Sec. 18.  [144B.05] [QUALIFICATIONS FOR LICENSE.] 
    Subdivision 1.  [COMPLIANCE REQUIRED.] No license shall be 
issued to a home unless the commissioner of health determines 
that the home complies with the requirements of this chapter.  
    Subd. 2.  [APPLICATION REQUIRED.] The applicant for a 
license under sections 144B.01 to 144B.17 must comply with the 
application requirements specified by section 144B.03.  
    Subd. 3.  [HEALTH; SAFETY STANDARDS.] The home must meet 
the minimum health, safety, comfort, and well-being standards 
prescribed by the rules of the commissioner with respect to the 
construction, equipment, maintenance, and operation of a 
residential care home. 
    Subd. 4.  [LICENSURE CONDITIONS OR LIMITATIONS.] The 
commissioner may attach to the license any conditions or 
limitations necessary to assure compliance with the laws or 
rules governing the operation of the home or to protect the 
health, safety, comfort, or well-being of the residents.  A 
condition or limitation may be attached to the license when 
first issued, when renewed, or during the course of the 
licensure year.  The commissioner shall adopt rules governing 
the procedures for issuing conditions or limitations. 
    Sec. 19.  [144B.06] [LICENSE RENEWAL.] 
    Unless the license is suspended or revoked according to 
section 144B.08, a residential care home license is effective 
for one year from the date of its issuance.  The commissioner 
shall by rule establish forms and procedures for the processing 
of license renewals.  The commissioner shall approve a license 
renewal application if the home continues to satisfy the 
requirements, standards, and conditions of sections 144B.01 to 
144B.17, and the rules adopted under those sections. 
    Sec. 20.  [144B.07] [TRANSFERABILITY OF LICENSE.] 
    Subdivision 1.  [TRANSFERS PROHIBITED; CHANGE OF 
OWNERSHIP.] A license shall be issued only for the premise 
identified in the application for license and may not be 
transferred or assigned to another party.  Prior to any change 
of licensee of a home, the prospective licensee must apply for a 
license according to subdivision 2.  "Change of licensee" means 
a transfer of the legal responsibility to operate the home to a 
different individual or entity.  
    Subd. 2.  [NOTIFICATION.] At least 60 days prior to the 
final change of license, the prospective licensee shall notify 
the department of the intended change of licensee and shall file 
an application for a license.  The original licensee shall 
notify the department of the intended change at least 90 days 
prior to the change.  The original licensee remains responsible 
for the operation of the home until the date a new license is 
issued by the department.  The original licensee is liable for 
all penalties assessed against the home and for all violations 
occurring prior to the transfer of operation.  The commissioner 
may not issue a license to the prospective licensee if, at the 
time of the requested transfer, there are any uncorrected 
violations of sections 144B.01 to 144B.17 or rules adopted under 
those sections unless the commissioner determines that the 
violations will not create an imminent risk of harm to the 
residents and that the prospective licensee has submitted an 
acceptable plan of correction to the commissioner.  
    Sec. 21.  [144B.08] [LICENSE SUSPENSION, REVOCATION, OR 
REFUSAL TO ISSUE; HEARING; RELICENSING.] 
    Subdivision 1.  [PROCEEDINGS.] The commissioner may 
institute proceedings to suspend or revoke a residential care 
home license, or may refuse to grant or renew the license of a 
residential care home if any action by a licensee or employee of 
the residential care home: 
    (1) violates any of the provisions of sections 144B.01 to 
144B.17, or the rules adopted under those sections; 
    (2) permits, aids, or abets the commission of any illegal 
act in the residential care home or relating to the operation of 
the home; 
    (3) performs any act contrary to the welfare of the 
residential care home; or 
    (4) obtains, or attempts to obtain, a license by fraudulent 
means or misrepresentation. 
    Subd. 2.  [HEARING.] No residential care home license may 
be suspended or revoked, and renewal may not be denied, without 
a hearing held as a contested case in accordance with chapter 14.
If the individual designated under section 144B.03, subdivision 
2, as an agent to accept service on behalf of the licensee has 
been notified by the commissioner that the home will not receive 
an initial license or that a license renewal has been denied, 
the licensee or a legal representative on behalf of the 
residential care home may request and receive a hearing on the 
denial.  This hearing shall be held as a contested case in 
accordance with chapter 14. 
    Subd. 3.  [MANDATORY REVOCATION OR REFUSAL TO ISSUE A 
LICENSE.] Notwithstanding subdivision 2, the commissioner shall 
revoke or refuse to issue a residential care home license if the 
applicant, licensee, or manager of the licensed home is 
convicted of a felony or gross misdemeanor that is punishable by 
a term of imprisonment of not more than 90 days and that relates 
to operation of the residential care home or directly affects 
resident safety or care.  The commissioner shall notify the 
residential care home 30 days before the date of revocation. 
    Subd. 4.  [RELICENSING.] If a residential care home license 
is revoked, a new application for license may be considered by 
the commissioner when the conditions upon which revocation was 
based have been corrected and satisfactory evidence of this fact 
has been furnished to the commissioner.  A new license may be 
granted after an inspection has been made and the home has been 
found to comply with all provisions of sections 144B.01 to 
144B.17, and the rules adopted under those sections. 
    Sec. 22.  [144B.09] [RULES.] 
    The commissioner shall establish by rule minimum standards 
for the construction, maintenance, equipping, and operation of 
residential care homes.  To the extent possible, the rules shall 
assure the health, safety, comfort, and well-being of 
residential care home residents.  The rules shall include, but 
not be limited to the following provisions: 
    (1) the supportive services that can be provided; 
    (2) special service permit requirements for medication or 
other supportive services; 
    (3) staffing requirements; 
    (4) training and qualifications of staff; 
    (5) criteria for admission and continued stay of a 
resident; 
    (6) resident rights; 
    (7) fire safety and physical plant requirements that are 
based on the size of the home, and the resident's ability to 
ambulate, taking into consideration the need for differing 
standards for existing physical plants and for new construction; 
and 
    (8) procedures for granting variances or waivers from the 
rules.  
    Sec. 23.  [144B.10] [INSPECTIONS; ENFORCEMENT.] 
    Subdivision 1.  [ENFORCEMENT.] The department is the 
exclusive state agency charged with the responsibility and duty 
of inspecting all homes required to be licensed under sections 
144B.01 to 144B.17.  The commissioner shall enforce its rules 
subject only to the authority of the department of public safety 
respecting the enforcement of fire and safety standards in 
licensed residential care homes. 
    Subd. 2.  [PERIODIC INSPECTION.] (a) All homes required to 
be licensed under sections 144B.01 to 144B.17 shall be 
periodically inspected by the commissioner to ensure compliance 
with rules and standards.  Inspections shall occur at different 
times throughout the calendar year.  
    (b) Within the limits of the resources available to the 
commissioner, the commissioner shall conduct inspections and 
reinspections with a frequency and in a manner calculated to 
produce the greatest benefit to residents.  In performing this 
function, the commissioner may devote proportionately more 
resources to the inspection of those homes in which conditions 
present the most serious concerns with respect to resident 
health, safety, comfort, and well-being, including:  (1) change 
in ownership; (2) frequent change in management or staff; (3) 
complaints about care, safety, or rights; (4) previous 
inspections or reinspections which have resulted in correction 
orders related to care, safety, or rights; and (5) indictment of 
persons involved in ownership or operation of the home for 
alleged criminal activity.  
    (c) A home that does not have any of the conditions in 
paragraph (b) or any other condition established by the 
commissioner that poses a risk to resident care, safety, or 
rights shall be inspected once every two years. 
    Subd. 3.  [AUTHORITY.] The commissioner may request and 
must be given access to relevant information, records, incident 
reports, or other documents in the possession of a home if the 
commissioner considers them necessary for the discharge of 
responsibilities.  For the purposes of inspections and securing 
information to determine compliance with the licensure laws and 
rules, the commissioner need not present a release, waiver, or 
consent of the individual.  The identities of patients or 
residents must be kept private as defined by section 13.02, 
subdivision 12. 
    Subd. 4.  [INSPECTIONS WITHOUT NOTICE.] No prior notice 
shall be given of an inspection or reinspection conducted under 
this section. 
    Subd. 5.  [CORRECTION ORDERS.] Whenever a duly authorized 
representative of the commissioner determines that a home is not 
in compliance with the provisions of this chapter or the rules 
adopted under it, a correction order shall be issued to the 
home.  The correction order shall state the deficiency, cite the 
specific law or rule violated, and specify the time allowed for 
correction. 
    Subd. 6.  [REINSPECTIONS; FINES.] If, upon reinspection, it 
is found that the home has not corrected deficiencies specified 
in the correction order, a notice of noncompliance shall be 
issued stating all deficiencies not corrected.  Unless a hearing 
is requested under subdivision 8, the home shall forfeit to the 
state, within 15 days after receiving the notice of 
noncompliance, up to $1,000 for each deficiency not corrected.  
For each subsequent reinspection, the home may be fined an 
additional amount for each deficiency which has not been 
corrected.  All forfeitures shall be paid into the general fund. 
The commissioner shall adopt by rule a schedule of fines 
applicable for each type of uncorrected deficiency.  
    Subd. 7.  [RECOVERY.] Any unpaid forfeitures may be 
recovered by the attorney general. 
    Subd. 8.  [HEARINGS.] A licensee is entitled to a hearing 
on any notice of noncompliance provided that the licensee makes 
a written request within 15 days after receiving the notice of 
noncompliance.  Failure to request a hearing shall result in the 
forfeiture of a penalty as determined by the commissioner 
according to subdivision 6.  During the hearing and review 
process a request for a hearing shall operate as a stay of the 
payment of any forfeiture provided for in this section.  The 
hearing shall be conducted as a contested case proceeding under 
the provisions of chapter 14.  
    Subd. 9.  [RECORDS OF INSPECTIONS.] After each inspection 
or reinspection required or authorized by this section, the 
commissioner shall, by certified mail, send copies of any 
correction order or notice of noncompliance to the home.  A copy 
of each correction order and notice of noncompliance shall be 
kept on file at the home and shall be made available for viewing 
by any person upon request.  
    Subd. 10.  [POWERS NOT LIMITED.] Nothing in this section 
shall be construed to limit the powers granted to the 
commissioner in this chapter.  
    Sec. 24.  [144B.11] [INJUNCTIVE RELIEF; SUBPOENAS.] 
    Subdivision 1.  [INJUNCTIVE RELIEF.] In addition to any 
other remedy provided by law, the commissioner may bring an 
action in the district court in Ramsey or Hennepin county or in 
the district in which a home is located to enjoin the licensee 
or an employee of the home from illegally engaging in activities 
regulated by sections 144B.01 to 144B.17.  A temporary 
restraining order may be granted by the court in the proceeding 
if continued activity by the licensee or employee would create 
an imminent risk of harm to a resident of the facility. 
    Subd. 2.  [SUBPOENAS.] In all matters pending before the 
commissioner under sections 144B.01 to 144B.17, the commissioner 
shall have the power to issue subpoenas, and to compel the 
attendance of witnesses and the production of all necessary 
papers, books, records, documents, and other evidentiary 
material.  Any person failing or refusing to appear or testify 
regarding any matter about which that person may be lawfully 
questioned or refusing to produce any papers, books, records, 
documents, or evidentiary materials in the matter to be heard, 
after having been required by order of the commissioner or by a 
subpoena of the commissioner to do so may, upon application by 
the commissioner to the district court in any district, be 
ordered by the court to comply with the subpoena or order.  The 
commissioner may issue subpoenas and may administer oaths to 
witnesses, or take their affirmation.  Depositions may be taken 
within or without the state in the manner provided by law for 
the taking of depositions in civil actions, with the same fees 
and mileage and in the same manner as prescribed by law for 
process issued out of the district court of this state.  Fees 
and mileage and other costs for persons subpoenaed by the 
commissioner shall be paid in the same manner as for proceedings 
in district court.  
    Sec. 25.  [144B.12] [PLACEMENT OF A MONITOR.] 
    Subdivision 1.  [AUTHORITY.] The commissioner may place a 
person to act as a monitor in a residential care home when the 
commissioner determines that violations of this chapter, or the 
rules adopted under it, require extended surveillance to enforce 
compliance or to protect the health, safety, or welfare of the 
residents. 
    Subd. 2.  [DUTIES OF THE MONITOR.] The monitor shall 
observe the operation of the home, provide advice to the home on 
methods of complying with state law and rules, where documented 
deficiencies for the regulations exist, and periodically shall 
submit a written report to the commissioner on the ways in which 
the home meets or fails to meet state rules.  
    Subd. 3.  [SELECTION OF THE MONITOR.] The commissioner may 
select as monitor an employee of the department or may contract 
with any other individual to serve as a monitor.  The 
commissioner shall publish a notice in the State Register that 
requests proposals from individuals who wish to be considered 
for placement as monitors and that sets forth the criteria for 
selecting individuals as monitors.  The commissioner shall 
maintain a list of individuals who are not employees of the 
department who are interested in serving as monitors.  The 
commissioner may contract with those individuals determined to 
be qualified. 
    Subd. 4.  [PAYMENT OF THE MONITOR.] A residential care home 
in which a monitor is placed shall pay to the department the 
actual costs associated with the placement, unless the payment 
would create an undue hardship for the home.  
    Sec. 26.  [144B.13] [FREEDOM FROM ABUSE AND NEGLECT.] 
    Residents shall be free from abuse and neglect as defined 
in section 626.557, subdivision 2.  The commissioner shall by 
rule develop procedures for the reporting of alleged incidents 
of abuse or neglect in residential care homes.  The office of 
health facility complaints shall investigate reports of alleged 
abuse or neglect according to sections 144A.51 to 144A.54. 
    Sec. 27.  [144B.14] [CESSATION OF OPERATIONS.] 
    If a residential care home voluntarily plans to cease 
operations or to curtail operations to the extent that 
relocation of residents is necessary, the licensee of the home 
shall notify the commissioner at least 90 days prior to the 
scheduled cessation or curtailment.  The commissioner shall 
cooperate with and advise the licensee of the home in the 
resettlement of residents.  Failure to comply with this section 
shall be subject to the issuance of a correction order and fine 
under section 144B.10.  
    Sec. 28.  [144B.15] [HUMAN SERVICES LICENSURE EXCLUSION.] 
    Notwithstanding section 245A.03, subdivision 2, board and 
lodging establishments licensed by the commissioner and 
registered under section 157.031, subdivision 2, that provide 
services for five or more persons whose primary diagnosis is 
mental illness and who have refused a residential program 
offered by a county agency are exempt from licensure under 
sections 245A.01 to 245A.16, until one year after the 
residential care home licensure rules required under sections 
144B.01 to 144B.17 are adopted by the commissioner of health.  
At that time, these establishments shall be licensed under 
sections 245A.01 to 245A.16, or as residential care homes.  
    Sec. 29.  [144B.16] [TRANSITIONAL PERIOD.] 
    Except as provided for in section 157.031, subdivision 4, 
the requirement to obtain a residential care home license is 
effective as of the effective date of the rules adopted by the 
commissioner.  Until that time, board and lodging establishments 
that are required to be registered under the provisions of 
section 157.031 shall continue to meet the requirements 
contained in that section. 
    Sec. 30.  [144B.17] [ADVISORY WORK GROUP.] 
    The commissioner shall convene a work group to advise, 
consult with, and make recommendations to the commissioner 
regarding the development of rules required under sections 
144B.01 to 144B.16.  The work group must include consumers and 
providers of the services described in sections 144B.01 to 
144B.16 and other interested parties. 
    Sec. 31.  Minnesota Statutes 1990, section 145.924, is 
amended to read: 
    145.924 [AIDS PREVENTION GRANTS.] 
    (a) The commissioner may award grants to boards of health 
as defined in section 145A.02, subdivision 2, state agencies, 
state councils, or nonprofit corporations to provide evaluation 
and counseling services to populations at risk for acquiring 
human immunodeficiency virus infection, including, but not 
limited to, minorities, adolescents, intravenous drug users, and 
homosexual men. 
    (b) The commissioner may award grants to agencies 
experienced in providing services to communities of color, for 
the design of innovative outreach and education programs for 
targeted groups within the community who may be at risk of 
acquiring the human immunodeficiency virus infection, including 
intravenous drug users and their partners, adolescents, gay and 
bisexual individuals and women.  Grants shall be awarded on a 
request for proposal basis and shall include funds for 
administrative costs.  Priority for grants shall be given to 
agencies or organizations that have experience in providing 
service to the particular community which the grantee proposes 
to serve; that have policymakers representative of the targeted 
population; that have experience in dealing with issues relating 
to HIV/AIDS; and that have the capacity to deal effectively with 
persons of differing sexual orientations.  For purposes of this 
paragraph, the "communities of color" are:  the American-Indian 
community; the Hispanic community; the African-American 
community; and the Asian-Pacific community. 
    Sec. 32.  Minnesota Statutes 1990, section 145.925, is 
amended by adding a subdivision to read: 
    Subd. 9.  Notwithstanding any rules to the contrary, 
including rules proposed in the State Register on April 1, 1991, 
the commissioner, in allocating grant funds for family planning 
special projects, shall not limit the total amount of funds that 
can be allocated to an organization that has submitted 
applications from more than one region, except that no more than 
$75,000 may be allocated to any grantee within a single region.  
For two or more organizations who have submitted a joint 
application, that limit is $75,000 for each organization.  This 
subdivision does not affect any procedure established in rule 
for allocating special project money to the different regions.  
The commissioner shall revise the rules for family planning 
special project grants so that they conform to the requirements 
of this subdivision.  In adopting these revisions, the 
commissioner is not subject to the rulemaking provisions of 
chapter 14, but is bound by section 14.38, subdivision 7. 
    Sec. 33.  Minnesota Statutes 1990, section 148B.01, 
subdivision 7, is amended to read: 
    Subd. 7.  [REGULATED INDIVIDUAL LICENSEE.] "Regulated 
individual Licensee" means a person licensed by the board of 
social work or the board of marriage and family therapy, or 
required to file with the board of unlicensed mental health 
service providers. 
    Sec. 34.  Minnesota Statutes 1990, section 148B.03, is 
amended to read: 
    148B.03 [APPLICABILITY.] 
    Sections 148B.04 to 148B.17 apply to all of the social work 
and mental health boards the board of social work and the board 
of marriage and family therapy, and the regulated 
individuals licensees within their respective jurisdictions, 
unless superseded by an inconsistent law that relates 
specifically to a particular board. 
    Sec. 35.  Minnesota Statutes 1990, section 148B.04, 
subdivision 3, is amended to read: 
    Subd. 3.  [INFORMATION ON ADVERSE DISCIPLINARY ACTIONS.] If 
a board imposes disciplinary measures or takes adverse 
disciplinary action of any kind, the name and business address 
of the regulated individual licensee, the nature of the 
misconduct, and the action taken by the board are public data. 
    Sec. 36.  Minnesota Statutes 1990, section 148B.04, 
subdivision 4, is amended to read: 
    Subd. 4.  [EXCHANGE OF INFORMATION.] The boards shall 
exchange information with other boards, agencies, or departments 
within the state, as required under section 214.10, subdivision 
8, paragraph (d), and may release information in the reports 
required under section 148B.02. 
    Sec. 37.  Minnesota Statutes 1990, section 148B.05, 
subdivision 1, is amended to read: 
    Subdivision 1.  [ADVERSE DISCIPLINARY ACTION BY A BOARD.] A 
suspension, revocation, condition, limitation, qualification, or 
restriction of a regulated an individual's license, filing, or 
right to practice is in effect pending determination of an 
appeal unless the court, upon petition and for good cause shown, 
orders otherwise.  The right to provide services is 
automatically suspended if (1) a guardian of the person of 
a regulated individual licensee is appointed by order of a 
probate court pursuant to sections 525.54 to 525.61, for reasons 
other than the minority of the individual licensee, or (2) 
the individual licensee is committed by order of a probate court 
pursuant to chapter 253B or sections 526.09 to 526.11.  The 
right to provide services remains suspended until the individual 
licensee is restored to capacity by a court and, upon petition 
by the individual licensee, the suspension is terminated by the 
board after a hearing.  In its discretion, a board may restore 
and reissue permission to provide services, but as a condition 
thereof may impose any disciplinary or corrective measure that 
it might originally have imposed.  
    Sec. 38.  Minnesota Statutes 1990, section 148B.06, 
subdivision 1, is amended to read: 
    Subdivision 1.  [CERTIFICATE REQUIRED.] A board may not 
issue or renew a filing license if the commissioner of revenue 
notifies the board and the regulated individual licensee or 
applicant for a license or filing that the individual licensee 
or applicant owes the state delinquent taxes in the amount of 
$500 or more.  A board may issue or renew a license or filing 
only if the commissioner of revenue issues a tax clearance 
certificate and the commissioner of revenue or the individual 
licensee or applicant forwards a copy of the clearance to the 
board.  The commissioner of revenue may issue a clearance 
certificate only if the individual licensee or applicant does 
not owe the state any uncontested delinquent taxes.  For 
purposes of this section, "taxes" means all taxes payable to the 
commissioner of revenue, including penalties and interest due on 
those taxes.  "Delinquent taxes" do not include a tax liability 
if (i) an administrative or court action that contests the 
amount or validity of the liability has been filed or served, 
(ii) the appeal period to contest the tax liability has not 
expired, or (iii) the regulated individual licensee or applicant 
has entered into a payment agreement to pay the liability and is 
current with the payments. 
     Sec. 39.  Minnesota Statutes 1990, section 148B.06, 
subdivision 3, is amended to read: 
    Subd. 3.  [INFORMATION REQUIRED.] The boards shall require 
all regulated individuals licensees or applicants to provide 
their social security number and Minnesota business 
identification number on all license or filing applications.  
Upon request of the commissioner of revenue, the board of social 
work and the board of marriage and family therapy must provide 
to the commissioner of revenue a list of all regulated 
individuals licensees and applicants, including the name and 
address, social security number, and business identification 
number.  The commissioner of revenue may request a list of 
the individuals licensees and applicants no more than once each 
calendar year.  
    Sec. 40.  Minnesota Statutes 1990, section 148B.07, is 
amended to read: 
    148B.07 [REPORTING OBLIGATIONS.] 
    Subdivision 1.  [PERMISSION TO REPORT.] A person who has 
knowledge of any conduct constituting grounds for discipline or 
adverse disciplinary action relating to licensure or filing 
unlicensed practice under this chapter may report the violation 
to the appropriate board.  
    Subd. 2.  [INSTITUTIONS.] A state agency, political 
subdivision, agency of a local unit of government, private 
agency, hospital, clinic, prepaid medical plan, or other health 
care institution or organization located in this state shall 
report to the appropriate board any action taken by the agency, 
institution, or organization or any of its administrators or 
medical or other committees to revoke, suspend, restrict, or 
condition a regulated individual's licensee's privilege to 
practice or treat patients or clients in the institution, or as 
part of the organization, any denial of privileges, or any other 
adverse action or disciplinary action for conduct that might 
constitute grounds for adverse action or disciplinary action by 
a board under this chapter.  The institution or organization 
shall also report the resignation of any regulated individuals 
licensees prior to the conclusion of any disciplinary or adverse 
action proceeding for conduct that might constitute grounds for 
disciplinary or adverse action under this chapter, or prior to 
the commencement of formal charges but after the individual 
licensee had knowledge that formal charges were contemplated or 
in preparation. 
    Subd. 3.  [PROFESSIONAL SOCIETIES.] A state or local 
professional society for regulated individuals licensees shall 
report to the appropriate board any termination, revocation, or 
suspension of membership or any other disciplinary or adverse 
action taken against a regulated individual licensee.  If the 
society has received a complaint that might be grounds for 
discipline under this chapter against a member on which it has 
not taken any disciplinary or adverse action, the society shall 
report the complaint and the reason why it has not taken action 
on it or shall direct the complainant to the appropriate board.  
    Subd. 4.  [REGULATED INDIVIDUALS AND LICENSED 
PROFESSIONALS.] A regulated individual or a licensed health 
professional shall report to the appropriate board personal 
knowledge of any conduct that the regulated individual or 
licensed health professional reasonably believes constitutes 
grounds for disciplinary or adverse action under this chapter by 
any regulated individual licensee, including conduct indicating 
that the individual licensee may be medically incompetent, or 
may be medically or physically unable to engage safely in the 
provision of services.  If the information was obtained in the 
course of a client relationship, the client is another regulated 
individual licensee, and the treating individual successfully 
counsels the other individual to limit or withdraw from practice 
to the extent required by the impairment, the board may deem 
this limitation of or withdrawal from practice to be sufficient 
disciplinary action. 
    Subd. 5.  [INSURERS.] Four times each year as prescribed by 
a board, each insurer authorized to sell insurance described in 
section 60A.06, subdivision 1, clause (13), and providing 
professional liability insurance to regulated 
individuals licensees, or the medical joint underwriting 
association under chapter 62F, shall submit to the appropriate 
board a report concerning the regulated individuals licensees 
against whom malpractice settlements or awards have been made to 
the plaintiff.  The report must contain at least the following 
information:  
    (1) the total number of malpractice settlements or awards 
made to the plaintiff; 
    (2) the date the malpractice settlements or awards to the 
plaintiff were made; 
    (3) the allegations contained in the claim or complaint 
leading to the settlements or awards made to the plaintiff; 
    (4) the dollar amount of each malpractice settlement or 
award; 
    (5) the regular address of the practice of the regulated 
individual licensee against whom an award was made or with whom 
a settlement was made; and 
    (6) the name of the regulated individual licensee against 
whom an award was made or with whom a settlement was made.  
    The insurance company shall, in addition to the above 
information, report to the board any information it possesses 
that tends to substantiate a charge that a regulated 
individual licensee may have engaged in conduct violating this 
chapter.  
    Subd. 6.  [COURTS.] The court administrator of district 
court or any other court of competent jurisdiction shall report 
to the board any judgment or other determination of the court 
that adjudges or includes a finding that a regulated individual 
licensee is mentally ill, mentally incompetent, guilty of a 
felony, guilty of a violation of federal or state narcotics laws 
or controlled substances act, or guilty of an abuse or fraud 
under Medicare or Medicaid; or that appoints a guardian of the 
regulated individual licensee pursuant to sections 525.54 to 
525.61 or commits a regulated individual licensee pursuant to 
chapter 253B or sections 526.09 to 526.11.  
    Subd. 7.  [SELF-REPORTING.] A regulated individual licensee 
shall report to the appropriate board or to the office of mental 
health practice any personal action that would require that a 
report be filed with the board by any person, health care 
facility, business, or organization pursuant to subdivisions 2 
to 6. 
    Subd. 8.  [DEADLINES; FORMS.] Reports required by 
subdivisions 2 to 7 must be submitted not later than 30 days 
after the occurrence of the reportable event or transaction.  
The boards and the office of mental health practice may provide 
forms for the submission of reports required by this section, 
may require that reports be submitted on the forms provided, and 
may adopt rules necessary to assure prompt and accurate 
reporting.  
    Subd. 9.  [SUBPOENAS.] The boards and the office of mental 
health practice may issue subpoenas for the production of any 
reports required by subdivisions 2 to 7 or any related documents.
    Sec. 41.  Minnesota Statutes 1990, section 148B.08, is 
amended to read: 
    148B.08 [IMMUNITY.] 
    Subdivision 1.  [REPORTING.] Any person, health care 
facility, business, or organization is immune from civil 
liability or criminal prosecution for submitting a report to a 
board under section 148B.07 or for otherwise reporting to the 
board violations or alleged violations of this chapter.  All the 
reports are confidential and absolutely privileged 
communications.  
    Subd. 2.  [INVESTIGATION.] Members of the boards of social 
work, and marriage and family therapy, and unlicensed mental 
health professionals, and persons employed by the office boards 
or engaged in the investigation of violations and in the 
preparation and management of charges of violations of this 
chapter on behalf of the office or boards, are immune from civil 
liability and criminal prosecution for any actions, 
transactions, or publications in the execution of, or relating 
to, their duties under this chapter.  
    Sec. 42.  Minnesota Statutes 1990, section 148B.12, is 
amended to read: 
    148B.12 [MALPRACTICE HISTORY.] 
    Subdivision 1.  [SUBMISSION.] Regulated individuals 
Licensees or applicants for licensure who have previously 
practiced in another state shall submit with their filing or 
application the following information:  
    (1) number, date, and disposition of any malpractice 
settlement or award made to the plaintiff or other claimant 
relating to the quality of services provided by the regulated 
individual licensee or applicant; and 
    (2) number, date, and disposition of any civil litigations 
or arbitrations relating to the quality of services provided by 
the regulated individual licensee or applicant in which the 
party complaining against the individual licensee or applicant 
prevailed or otherwise received a favorable decision or order.  
    Subd. 2.  [BOARD ACTION.] The board shall give due 
consideration to the information submitted under this section.  
A regulated individual licensee or applicant for licensure who 
willfully submits incorrect information is subject to 
disciplinary action under this chapter. 
    Sec. 43.  Minnesota Statutes 1990, section 148B.13, is 
amended to read: 
    148B.13 [PUBLICATION OF DISCIPLINARY ACTIONS.] 
    At least annually, each board shall publish and release to 
the public a description of all disciplinary measures or adverse 
actions taken by the board.  The publication must include, for 
each disciplinary measure or adverse action taken, the name and 
business address of the regulated individual licensee, the 
nature of the misconduct, and the measure or action taken by the 
board. 
    Sec. 44.  Minnesota Statutes 1990, section 148B.17, is 
amended to read: 
    148B.17 [FEES.] 
    Each board shall by rule establish fees, including late 
fees, for licenses or filings and renewals so that the total 
fees collected by the board will as closely as possible equal 
anticipated expenditures during the fiscal biennium, as provided 
in section 16A.128, plus the prorated costs of the office of 
social work and mental health boards.  Fees must be credited to 
accounts in the special revenue fund. 
    Sec. 45.  [148B.175] [COMPLAINTS; INVESTIGATION AND 
HEARING.] 
    Subdivision 1.  [DISCOVERY; SUBPOENAS.] In all matters 
relating to its lawful regulatory activities, a board may issue 
subpoenas and compel the attendance of witnesses and the 
production of all necessary papers, books, records, documents, 
and other evidentiary material.  Any person failing or refusing 
to appear to testify regarding any matter about which the person 
may be lawfully questioned or failing to produce any papers, 
books, records, documents, or other evidentiary materials in the 
matter to be heard, after having been required by order of the 
board or by a subpoena of the board to do so may, upon 
application to the district court in any district, be ordered to 
comply with the subpoena or order.  Any board member may 
administer oaths to witnesses or take their affirmation.  
Depositions may be taken within or without the state in the 
manner provided by law for the taking of depositions in civil 
actions.  A subpoena or other process or paper may be served 
upon a person it names anywhere within the state by any officer 
authorized to serve subpoenas or other process or paper in civil 
actions in the same manner as prescribed by law for service of 
process issued out of the district court of this state. 
    Subd. 2.  [CLASSIFICATION OF DATA.] The board shall 
maintain any records, other than client records, obtained as 
part of an investigation, as investigative data under section 
13.41.  Client records are classified as private under chapter 
13, and must be protected as such in the records of the board 
and in administrative or judicial proceeding unless the client 
authorizes the board in writing to make public the identity of 
the client or a portion or all of the client's records. 
    Subd. 3.  [EXAMINATION.] If a board has probable cause to 
believe that an applicant or licensee has engaged in conduct 
prohibited by section 214.10, it may issue an order directing 
the applicant or licensee to submit to a mental or physical 
examination or chemical dependency evaluation.  For the purpose 
of this section, every applicant or licensee is considered to 
have consented to submit to a mental or physical examination or 
chemical dependency evaluation when ordered to do so in writing 
by the board and to have waived all objections to the 
admissibility of the examiner's or evaluator's testimony or 
reports on the grounds that the testimony or reports constitute 
a privileged communication. 
    Subd. 4.  [FAILURE TO SUBMIT TO AN EXAMINATION.] Failure to 
submit to an examination or evaluation when ordered, unless the 
failure was due to circumstances beyond the control of the 
applicant or licensee, constitutes an admission that the 
applicant or licensee violated section 214.10, based on the 
factual specifications in the examination or evaluation order, 
and may result in an application being denied or a default and 
final disciplinary order being entered after a contested case 
hearing.  The only issues to be determined at the hearing are 
whether the designated board member had probable cause to issue 
the examination or evaluation order and whether the failure to 
submit was due to circumstances beyond the control of the 
applicant or licensee.  Neither the record of a proceeding under 
this subdivision nor the orders entered by the board are 
admissible, subject to subpoena, or to be used against the 
applicant or licensee in a proceeding in which the board is not 
a party or decision maker.  Information obtained under this 
subdivision is classified as private under chapter 13 and the 
orders issued by a board as the result of an applicant or 
licensee to submit to an examination or evaluation are 
classified as public. 
    Subd. 5.  [ACCESS TO DATA AND RECORDS.] In addition to 
ordering a physical or mental examination or chemical dependency 
evaluation and notwithstanding section 13.42, 144.651, 595.02, 
or any other law limiting access to medical or other health 
records, a board may obtain data and health records relating to 
an applicant or licensee without the applicant's or licensee's 
consent if the board has probable cause to believe that an 
applicant or licensee has engaged in conduct prohibited by 
section 214.10.  An applicant, licensee, insurance company, 
health care facility, provider as defined in section 144.335, 
subdivision 1, paragraph (b), or government agency shall comply 
with any written request of the board under this subdivision and 
is not liable in any action for damages for releasing the data 
requested by the board if the data are released in accordance 
with a written request made under this subdivision, unless the 
information is false and the person or entity giving the 
information knew or had reason to know that the information was 
false.  Information on individuals obtained under this section 
is investigative data under section 13.41. 
    Subd. 6.  [FORMS OF DISCIPLINARY ACTION.] When grounds for 
disciplinary action exist under section 214.10, or statute or 
rule enforced by the board, it may take one or more of the 
following disciplinary actions: 
    (1) deny the right to practice; 
    (2) revoke the right to practice; 
    (3) suspend the right to practice; 
    (4) impose limitations on the practice of the licensee; 
    (5) impose conditions on the practice of the licensee; 
    (6) impose a civil penalty not exceeding $10,000 for each 
separate violation, the amount of the civil penalty to be fixed 
so as to deprive the licensee of any economic advantage gained 
by reason of the violation charged, or to discourage repeated 
violations; 
    (7) impose a fee to reimburse the board for all or part of 
the cost of the proceedings resulting in disciplinary action 
including, but not limited to, the amount paid by the board for 
services from the office of administrative hearings, attorney 
fees, court reporters, witnesses, reproduction of records, board 
members' per diem compensation, board staff time, and expense 
incurred by board members and staff; 
    (8) censure or reprimand the licensee; or 
    (9) take any other action justified by the facts of the 
case. 
    Subd. 7.  [TEMPORARY SUSPENSION.] In addition to any other 
remedy provided by law, the board may, acting through its 
designated board member and without a hearing, temporarily 
suspend the right of a licensee to practice if the board member 
finds that the licensee has violated a statute or rule that the 
board is empowered to enforce and that continued practice by the 
licensee would create a serious risk of harm to others.  The 
suspension is in effect upon service of a written order on the 
licensee specifying the statute or rule violated.  The order 
remains in effect until the board issues a final order in the 
matter after a hearing or upon agreement between the board and 
the licensee.  Service of the order is effective if the order is 
served on the licensee or counsel of record personally or by 
first class mail to the most recent address provided to the 
board for the licensee or the counsel of record.  Within ten 
days of service of the order, the board shall hold a hearing 
before its own members on the sole issue of whether there is a 
reasonable basis to continue, modify, or lift the suspension.  
Evidence presented by the board or licensee may be in affidavit 
form only.  The licensee or the counsel of record may appear for 
oral argument.  Within five working days after the hearing, the 
board shall issue its order and, if the suspension is continued, 
schedule a contested case hearing within 45 days after issuance 
of the order.  The administrative law judge shall issue a report 
within 30 days after closing of the contested case hearing 
record.  The board shall issue a final order within 30 days 
after receipt of that report. 
    Subd. 8.  [AUTOMATIC SUSPENSION.] The right to practice is 
automatically suspended if (1) a guardian of a licensee is 
appointed by order of a probate court under sections 525.54 to 
525.61, or (2) the licensee is committed by order of a probate 
court pursuant to chapter 253B or sections 526.09 to 526.11.  
The right to practice remains suspended until the licensee is 
restored to capacity by a court and, upon petition by the 
licensee, the suspension is terminated by the board after a 
hearing or upon agreement between the board and the licensee. 
    Subd. 9.  [ADDITIONAL REMEDIES.] The board may in its own 
name issue a cease and desist order to stop a person from 
engaging in an unauthorized practice or violating or threatening 
to violate a statute, rule, or order which the board has issued 
or is empowered to enforce.  The cease and desist order must 
state the reason for its issuance and give notice of the 
person's right to request a hearing under sections 14.57 to 
14.62.  If, within 15 days of service of the order, the subject 
of the order fails to request a hearing in writing, the order is 
the final order of the board and is not reviewable by a court or 
agency. 
    A hearing must be initiated by the board not later than 30 
days from the date of the board's receipt of a written hearing 
request.  Within 30 days of receipt of the administrative law 
judge's report, the board shall issue a final order modifying, 
vacating, or making permanent the cease and desist order as the 
facts require.  The final order remains in effect until modified 
or vacated by the board. 
    When a request for a stay accompanies a timely hearing 
request, the board may, in its discretion, grant the stay.  If 
the board does not grant a requested stay, it shall refer the 
request to the office of administrative hearings within three 
working days of receipt of the request.  Within ten days after 
receiving the request from the board, an administrative law 
judge shall issue a recommendation to grant or deny the stay.  
The board shall grant or deny the stay within five days of 
receiving the administrative law judge's recommendation. 
    In the event of noncompliance with a cease and desist 
order, the board may institute a proceeding in Ramsey county 
district court to obtain injunctive relief or other appropriate 
relief, including a civil penalty payable to the board not 
exceeding $10,000 for each separate violation. 
    Subd. 10.  [INJUNCTIVE RELIEF.] In addition to any other 
remedy provided by law, including the issuance of a cease and 
desist order under subdivision 1, a board may in its own name 
bring an action in Ramsey county district court for injunctive 
relief to restrain any unauthorized practice or violation or 
threatened violation of any statute, rule, or order which the 
board is empowered to regulate, enforce, or issue.  A temporary 
restraining order must be granted in the proceeding if continued 
activity by a licensee would create a serious risk of harm to 
others.  The board need not show irreparable harm. 
    Subd. 11.  [ADDITIONAL POWERS.] The issuance of a cease and 
desist order or injunctive relief granted under this section 
does not relieve a licensee from criminal prosecution by a 
competent authority or from disciplinary action by the board.  
Nothing in this section limits the board's authority to seek 
injunctive relief under section 214.11. 
    Sec. 46.  Minnesota Statutes 1990, section 148B.18, 
subdivision 10, is amended to read: 
    Subd. 10.  [QUALIFIED MENTAL HEALTH PROFESSIONAL.] 
"Qualified mental health professional" means a psychiatrist, 
board-certified or eligible for board certification, and 
licensed under chapter 147; a psychologist licensed under 
sections 148.88 to 148.98; an independent clinical social worker 
who has the qualifications in section 148B.21, subdivision 6; or 
a psychiatric registered nurse with a master's degree from an 
accredited school of nursing, licensed under section 148.211, 
with at least two years of postmaster's supervised experience in 
direct clinical practice; or a marriage and family therapist who 
is licensed under sections 148B.29 to 148B.39. 
    Sec. 47.  Minnesota Statutes 1990, section 148B.23, 
subdivision 1, is amended to read: 
    Subdivision 1.  [EXEMPTION FROM EXAMINATION.] (a) For two 
years from July 1, 1987, the board shall issue a license without 
examination to an applicant: 
    (1) for a licensed social worker, if the board determines 
that the applicant has received a baccalaureate degree from an 
accredited program of social work, or that the applicant has at 
least a baccalaureate degree from an accredited college or 
university and two years in full-time employment or 4,000 hours 
of experience in the supervised practice of social work within 
the five years before July 1, 1989, or within a longer time 
period as specified by the board; 
    (2) for a licensed graduate social worker, if the board 
determines that the applicant has received a master's degree 
from an accredited program of social work or doctoral degree in 
social work; or a master's or doctoral degree from a graduate 
program in a human service discipline, as approved by the board; 
    (3) for a licensed independent social worker, if the board 
determines that the applicant has received a master's degree 
from an accredited program of social work or doctoral degree in 
social work; or a master's or doctoral degree from a graduate 
program in a human service discipline, as approved by the board; 
and, after receiving the degree, has practiced social work for 
at least two years in full-time employment or 4,000 hours under 
the supervision of a social worker meeting these requirements, 
or of another qualified professional; and 
    (4) for a licensed independent clinical social worker, if 
the board determines that the applicant has received a master's 
degree from an accredited program of social work or doctoral 
degree in social work; or a master's or doctoral degree from a 
graduate program in a human service discipline as approved by 
the board; and, after receiving the degree, has practiced 
clinical social work for at least two years in full-time 
employment or 4,000 hours under the supervision of a clinical 
social worker meeting these requirements, or of another 
qualified mental health professional. 
    (b) During the period beginning August 1, 1991, and ending 
September 30, 1991, the board shall issue a license without 
examination to an applicant who was licensed as a school social 
worker by the board of teaching between July 1, 1987, and July 
1, 1989.  To qualify for a license under this paragraph, the 
applicant must: 
     (1) provide evidence, as determined by the board, of 
meeting all other licensure requirements under paragraph (a); 
     (2) provide evidence, as determined by the board, of 
practicing social work between July 1, 1987, and July 1, 1989, 
at the level of licensure being applied for; 
    (3) provide verification, on a form provided by the board, 
that the license held with the board of teaching was in good 
standing while licensed under their jurisdiction; and 
    (4) provide a completed application, including all 
information required in this paragraph, by September 30, 1991. 
    (c) The board shall allow an applicant who became licensed 
as a school social worker by the board of teaching between July 
1, 1989, and July 1, 1990, to take the social work licensure 
examination and, upon passing the examination, to receive a 
license.  To qualify for a license under this paragraph, the 
applicant must: 
    (1) take and pass one of the next two regularly scheduled 
social work licensure examinations administered after the 
effective date of this paragraph; 
    (2) provide verification, on a form provided by the board, 
that the license held with the board of teaching is in good 
standing; and 
    (3) provide a completed application, including all 
information required in this paragraph, by the board's 
examination application deadline for the February 1992 licensure 
examination. 
    Sec. 48.  Minnesota Statutes 1990, section 148B.33, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DOCUMENTARY EVIDENCE OF QUALIFICATIONS.] 
An applicant for a license shall furnish evidence that the 
applicant: 
    (1) has attained the age of majority; 
    (2) is of good moral character; 
    (3) is a citizen of the United States, or is lawfully 
entitled to remain and work in the United States; 
    (4) has at least two years of supervised postgraduate 
experience in marriage and family counseling therapy 
satisfactory to the board; 
    (5)(i) has completed a master's or doctoral degree in 
marriage and family therapy from a program in a regionally 
accredited educational institution or from a program accredited 
by the commissioner on accreditations for marriage and family 
therapy education of the American association for marriage and 
family therapists therapy; or (ii) has completed a master's or 
doctoral degree from a regionally accredited educational 
institution in a related field for which the course work is 
considered by the board to be equivalent to that provided in 
clause (5)(i); 
    (6) will agree to conduct all professional activities as a 
licensed marriage and family counselor therapist in accordance 
with a code of ethics for marriage and family therapists to be 
adopted by the board; and 
    (7) has passed an examination approved by the board by rule.
    Sec. 49.  Minnesota Statutes 1990, section 148B.38, 
subdivision 3, is amended to read: 
    Subd. 3.  [FEDERALLY RECOGNIZED TRIBES AND PRIVATE 
NONPROFIT AGENCIES WITH A MINORITY FOCUS.] The licensure of 
marriage and family therapists who are employed by federally 
recognized tribes and private nonprofit agency marriage and 
family therapists, whose primary service focus addresses ethnic 
minority populations and who are themselves members of ethnic 
minority populations within said agencies, shall be voluntary 
for a period of five years at which time the legislature will 
review the need for mandatory licensure for all marriage and 
family therapists under this subdivision. 
    Sec. 50.  [148B.60] [DEFINITIONS.] 
    Subdivision 1.  [TERMS.] As used in sections 148B.60 to 
148B.71, the following terms have the meanings given them in 
this section. 
    Subd. 2.  [OFFICE OF MENTAL HEALTH PRACTICE OR 
OFFICE.] "Office of mental health practice" or "office" means 
the office of mental health practice established in section 
148B.61. 
    Subd. 3.  [UNLICENSED MENTAL HEALTH PRACTITIONER OR 
PRACTITIONER.] "Unlicensed mental health practitioner" or 
"practitioner" means a person who provides or purports to 
provide, for remuneration, mental health services as defined in 
subdivision 4.  It does not include persons licensed by the 
board of medical examiners under chapter 147; the board of 
nursing under sections 148.171 to 148.285; the board of 
psychology under sections 148.88 to 148.98; the board of social 
work under sections 148B.18 to 148B.28; the board of marriage 
and family therapy under sections 148B.29 to 148B.39; or another 
licensing board if the person is practicing within the scope of 
the license; or members of the clergy who are providing pastoral 
services in the context of performing and fulfilling the 
salaried duties and obligations required of a member of the 
clergy by a religious congregation.  For the purposes of 
complaint investigation or disciplinary action relating to an 
individual practitioner, the term includes:  (1) hospital and 
nursing home social workers exempt from licensure by the board 
of social work under section 148B.28, subdivision 6, including 
hospital and nursing home social workers acting within the scope 
of their employment by the hospital or nursing home; (2) persons 
employed by a program licensed by the commissioner of human 
services who are acting as mental health practitioners within 
the scope of their employment; (3) persons employed by a program 
licensed by the commissioner of human services who are providing 
chemical dependency counseling services; persons who are 
providing chemical dependency counseling services in private 
practice; and (4) clergy who are providing mental health 
services that are equivalent to those defined in subdivision 4. 
    Subd. 4.  [MENTAL HEALTH SERVICES.] "Mental health services"
means psychotherapy and the professional assessment, treatment, 
or counseling of another person for a cognitive, behavioral, 
emotional, social, or mental condition, symptom, or dysfunction, 
including intrapersonal or interpersonal dysfunctions.  The term 
does not include pastoral services provided by members of the 
clergy to members of a religious congregation in the context of 
performing and fulfilling the salaried duties and obligations 
required of a member of the clergy by that religious 
congregation. 
    Subd. 5.  [MENTAL HEALTH CLIENT OR CLIENT.] "Mental health 
client" or "client" means a person who receives or pays for the 
services of a mental health practitioner. 
    Subd. 6.  [MENTAL HEALTH PRACTITIONER ADVISORY COUNCIL OR 
COUNCIL.] "Mental health practitioner advisory council" or 
"council" means the mental health practitioner advisory council 
established in section 148B.62. 
    Subd. 7.  [COMMISSIONER.] "Commissioner" means the 
commissioner of health or the commissioner's designee. 
    Subd. 8.  [DISCIPLINARY ACTION.] "Disciplinary action" 
means an adverse action taken by the commissioner against an 
unlicensed mental health practitioner relating to the person's 
right to provide mental health services. 
    Sec. 51.  [148B.61] [OFFICE OF MENTAL HEALTH PRACTICE.] 
    Subdivision 1.  [CREATION.] The office of mental health 
practice is created in the department of health to investigate 
complaints and take and enforce disciplinary actions against all 
unlicensed mental health practitioners for violations of 
prohibited conduct, as defined in section 148B.68.  The office 
shall also serve as a clearinghouse on mental health services 
and both licensed and unlicensed mental health professionals, 
through the dissemination of objective information to consumers 
and through the development and performance of public education 
activities, including outreach, regarding the provision of 
mental health services and both licensed and unlicensed mental 
health professionals who provide these services. 
    Subd. 2.  [RULEMAKING.] The commissioner of health shall 
adopt rules necessary to implement, administer, or enforce 
provisions of sections 148B.60 to 148B.71 pursuant to chapter 
14.  The commissioner may not adopt rules that restrict or 
prohibit persons from providing mental health services on the 
basis of education, training, experience, or supervision.  The 
commissioner may consult with the mental health practitioner 
advisory council, established in section 148B.62, during the 
rulemaking process.  Rules adopted pursuant to this authority 
are exempt from section 14.115. 
    Subd. 3.  [EMERGENCY RULES.] The commissioner may adopt 
emergency rules under sections 14.29 to 14.385 to carry out the 
provisions of sections 148B.60 to 148B.71. 
    Sec. 52.  [148B.62] [MENTAL HEALTH PRACTITIONER ADVISORY 
COUNCIL.] 
    Subdivision 1.  [CREATION.] The mental health practitioner 
advisory council is created to serve in an advisory capacity to 
the commissioner of health and staff of the office of mental 
health practice in the development of rules and procedures 
necessary to enforce sections 148B.60 to 148B.71 and in the 
enforcement of section 148B.68 on prohibited conduct and 
sections 148B.69 and 148B.70 on disciplinary action and remedies 
for violations of prohibited conduct.  The council shall also 
serve in an advisory capacity in the development of public 
education materials and activities, including outreach 
activities. 
    Subd. 2.  [COMPOSITION.] The advisory council consists of 
nine members, including six individuals who are providing mental 
health services and three public members, as defined in section 
214.02.  The initial appointments of the first members of the 
council must include at least four members who were members of 
the board of unlicensed mental health service providers on June 
30, 1991. 
    Subd. 3.  [APPOINTMENT.] Members of the advisory council 
are appointed by the commissioner of health and serve pursuant 
to requirements under section 15.059.  Members are appointed to 
serve terms of four years. 
    Subd. 4.  [COUNCIL ADMINISTRATION.] Members of the council 
shall elect from among its members a chair and a vice-chair to 
serve for one year or until a successor is elected and qualifies.
    Sec. 53.  [148B.63] [REPORTING OBLIGATIONS.] 
    Subdivision 1.  [PERMISSION TO REPORT.] A person who has 
knowledge of any conduct constituting grounds for disciplinary 
action relating to unlicensed practice under this chapter may 
report the violation to the office of mental health practice. 
    Subd. 2.  [INSTITUTIONS.] A state agency, political 
subdivision, agency of a local unit of government, private 
agency, hospital, clinic, prepaid medical plan, or other health 
care institution or organization located in this state shall 
report to the office of mental health practice any action taken 
by the agency, institution, or organization or any of its 
administrators or medical or other committees to revoke, 
suspend, restrict, or condition an unlicensed mental health 
practitioner's privilege to practice or treat patients or 
clients in the institution, or as part of the organization, any 
denial of privileges, or any other disciplinary action for 
conduct that might constitute grounds for disciplinary action by 
the office under this chapter.  The institution, organization, 
or governmental entity shall also report the resignation of any 
unlicensed mental health practitioners prior to the conclusion 
of any disciplinary action proceeding for conduct that might 
constitute grounds for disciplinary action under this chapter, 
or prior to the commencement of formal charges but after the 
practitioner had knowledge that formal charges were contemplated 
or were being prepared. 
    Subd. 3.  [PROFESSIONAL SOCIETIES.] A state or local 
professional society for unlicensed mental health practitioners 
shall report to the office of mental health practice any 
termination, revocation, or suspension of membership or any 
other disciplinary action taken against an unlicensed 
practitioner.  If the society has received a complaint that 
might be grounds for discipline under this chapter against a 
member on which it has not taken any disciplinary action, the 
society shall report the complaint and the reason why it has not 
taken action on it or shall direct the complainant to the office 
of mental health practice. 
    Subd. 4.  [LICENSED PROFESSIONALS.] A licensed health 
professional shall report to the office of mental health 
practice personal knowledge of any conduct that the licensed 
health professional reasonably believes constitutes grounds for 
disciplinary action under this chapter by any unlicensed mental 
health practitioner, including conduct indicating that the 
individual may be medically incompetent, or may be medically or 
physically unable to engage safely in the provision of 
services.  If the information was obtained in the course of a 
client relationship, the client is an unlicensed mental health 
practitioner, and the treating individual successfully counsels 
the other practitioner to limit or withdraw from practice to the 
extent required by the impairment, the office may deem this 
limitation of or withdrawal from practice to be sufficient 
disciplinary action. 
    Subd. 5.  [INSURERS.] Four times each year as prescribed by 
the commissioner, each insurer authorized to sell insurance 
described in section 60A.06, subdivision 1, clause (13), and 
providing professional liability insurance to unlicensed mental 
health practitioners or the medical joint underwriting 
association under chapter 62F, shall submit to the office of 
mental health practice a report concerning the unlicensed mental 
health practitioners against whom malpractice settlements or 
awards have been made.  The response must contain at least the 
following information: 
    (1) the total number of malpractice settlements or awards 
made; 
    (2) the date the malpractice settlements or awards were 
made; 
    (3) the allegations contained in the claim or complaint 
leading to the settlements or awards made; 
    (4) the dollar amount of each malpractice settlement or 
award; 
    (5) the regular address of the practice of the unlicensed 
practitioner against whom an award was made or with whom a 
settlement was made; and 
    (6) the name of the unlicensed practitioner against whom an 
award was made or with whom a settlement was made. 
    The insurance company shall, in addition to the above 
information, submit to the office of mental health practice any 
information, records, and files, including clients' charts and 
records, it possesses that tend to substantiate a charge that an 
unlicensed mental health practitioner may have engaged in 
conduct violating this chapter. 
    Subd. 6.  [COURTS.] The court administrator of district 
court or any other court of competent jurisdiction shall report 
to the office of mental health practice any judgment or other 
determination of the court that adjudges or includes a finding 
that an unlicensed mental health practitioner is mentally ill, 
mentally incompetent, guilty of a felony, guilty of a violation 
of federal or state narcotics laws or controlled substances act, 
or guilty of abuse or fraud under Medicare or Medicaid; or that 
appoints a guardian of the unlicensed mental health practitioner 
under sections 525.54 to 525.61 or commits an unlicensed mental 
practitioner under chapter 253B or sections 526.09 to 526.11. 
    Subd. 7.  [SELF-REPORTING.] An unlicensed mental health 
practitioner shall report to the office of mental health 
practice any personal action that would require that a report be 
filed with the office by any person, health care facility, 
business, or organization pursuant to subdivisions 2 to 5.  The 
practitioner shall also report the revocation, suspension, 
restriction, limitation, or other disciplinary action against 
the mental health practitioner's license, certificate, 
registration, or right of practice in another state or 
jurisdiction, for offenses that would be subject to disciplinary 
action in this state and also report the filing of charges 
regarding the practitioner's license, certificate, registration, 
or right of practice in another state or jurisdiction. 
    Subd. 8.  [DEADLINES; FORMS.] Reports required by 
subdivisions 2 to 7 must be submitted not later than 30 days 
after the reporter learns of the occurrence of the reportable 
event or transaction.  The office of mental health practice may 
provide forms for the submission of reports required by this 
section, may require that reports be submitted on the forms 
provided, and may adopt rules necessary to assure prompt and 
accurate reporting. 
    Sec. 54.  [148B.64] [IMMUNITY.] 
    Subdivision 1.  [REPORTING.] Any person, health care 
facility, business, or organization is immune from civil 
liability or criminal prosecution for submitting a report to the 
office of mental health practice, for otherwise reporting to the 
office violations or alleged violations of this chapter, or for 
cooperating with an investigation of a report, except as 
provided in this subdivision.  Any person who knowingly or 
recklessly makes a false report is liable in a civil suit for 
any actual damages suffered by the person or persons so reported 
and for any punitive damages set by the court or jury.  An 
action requires clear and convincing evidence that the defendant 
made the statement with knowledge of falsity or with reckless 
disregard for its truth or falsity.  The report or statement or 
any statement made in cooperation with an investigation or as 
part of a disciplinary proceeding is privileged except in an 
action brought under this subdivision. 
    Subd. 2.  [INVESTIGATION.] The commissioner and employees 
of the department of health, members of the advisory council on 
mental health practice, and other persons engaged in the 
investigation of violations and in the preparation, 
presentation, and management of and testimony pertaining to 
charges of violations of this chapter are absolutely immune from 
civil liability and criminal prosecution for any actions, 
transactions, or publications in the execution of, or relating 
to, their duties under this chapter. 
    Sec. 55.  [148B.65] [DISCIPLINARY RECORD ON JUDICIAL 
REVIEW.] 
    Upon judicial review of any disciplinary action taken by 
the commissioner under this chapter, the reviewing court shall 
seal the administrative record, except for the commissioner's 
final decision, and shall not make the administrative record 
available to the public. 
    Sec. 56.  [148B.66] [PROFESSIONAL COOPERATION.] 
    Subdivision 1.  [COOPERATION.] An unlicensed mental health 
practitioner who is the subject of an investigation, or who is 
questioned in connection with an investigation, by or on behalf 
of the office of mental health practice shall cooperate fully 
with the investigation.  Cooperation includes responding fully 
and promptly to any question raised by or on behalf of the 
office relating to the subject of the investigation and 
providing copies of client records, as reasonably requested by 
the office, to assist the office in its investigation, and 
appearing at conferences or hearings scheduled by the 
commissioner.  If the office does not have a written consent 
from a client permitting access to the client's records, the 
unlicensed mental health practitioner shall delete any data in 
the record that identifies the client before providing it to the 
board.  The office shall maintain any records obtained pursuant 
to this section as investigative data pursuant to section 
13.41.  If an unlicensed mental health practitioner refuses to 
give testimony or produce any documents, books, records, or 
correspondence on the basis of the fifth amendment to the 
Constitution of the United States, the commissioner may compel 
the unlicensed mental health practitioner to provide the 
testimony or information; however, the testimony or evidence may 
not be used against the practitioner in any criminal proceeding. 
Challenges to requests of the office may be brought before the 
appropriate agency or court. 
    Subd. 2.  [CLASSIFICATION OF DATA.] The commissioner shall 
maintain any records, other than client records, obtained as 
part of an investigation, as investigative data under section 
13.41.  Client records are classified as private under chapter 
13 and must be protected as such in the records of the office 
and in any administrative or judicial proceeding unless the 
client authorizes the office in writing to make public the 
identity of the client or a portion or all of the client's 
records. 
    Sec. 57.  [148B.67] [PROFESSIONAL ACCOUNTABILITY.] 
    The office of mental health practice shall maintain and 
keep current a file containing the reports and complaints filed 
against unlicensed mental health practitioners within the 
commissioner's jurisdiction.  Each complaint filed with the 
office must be investigated.  If the files maintained by the 
office show that a malpractice settlement or award has been made 
against an unlicensed mental health practitioner, as reported by 
insurers under section 148B.63, subdivision 5, the commissioner 
may authorize a review of the practitioner's practice by the 
staff of the office of mental health practice. 
    Sec. 58.  [148B.68] [PROHIBITED CONDUCT.] 
    Subdivision 1.  [PROHIBITED CONDUCT.] The commissioner may 
impose disciplinary action as described in section 148B.69 
against any unlicensed mental health practitioner.  The 
following conduct is prohibited and is grounds for disciplinary 
action: 
    (a) Conviction of a crime, including a finding or verdict 
of guilt, an admission of guilt, or a no contest plea, in any 
court in Minnesota or any other jurisdiction in the United 
States, reasonably related to the provision of mental health 
services.  Conviction, as used in this subdivision, includes a 
conviction of an offense which, if committed in this state, 
would be deemed a felony or gross misdemeanor without regard to 
its designation elsewhere, or a criminal proceeding where a 
finding or verdict of guilty is made or returned but the 
adjudication of guilt is either withheld or not entered. 
    (b) Conviction of crimes against persons.  For purposes of 
this chapter, a crime against a person means violations of the 
following:  sections 609.185; 609.19; 609.195; 609.20; 609.205; 
609.21; 609.215; 609.221; 609.222; 609.223; 609.224; 609.23; 
609.231; 609.235; 609.24; 609.245; 609.25; 609.255; 609.26, 
subdivision 1, clause (1) or (2); 609.265; 609.342; 609.343; 
609.344; 609.345; 609.365; 609.498, subdivision 1; 609.50, 
clause (1); 609.561; 609.562; and 609.595. 
    (c) Failure to comply with the self-reporting requirements 
of section 148B.63, subdivision 6. 
    (d) Engaging in sexual contact with a client or former 
client as defined in section 148A.01, or engaging in contact 
that may be reasonably interpreted by a client as sexual, or 
engaging in any verbal behavior that is seductive or sexually 
demeaning to the patient, or engaging in sexual exploitation of 
a client or former client. 
    (e) Advertising that is false, fraudulent, deceptive, or 
misleading. 
    (f) Conduct likely to deceive, defraud, or harm the public; 
or demonstrating a willful or careless disregard for the health, 
welfare, or safety of a client; or any other practice that may 
create unnecessary danger to any client's life, health, or 
safety, in any of which cases, proof of actual injury need not 
be established. 
    (g) Adjudication as mentally incompetent, or as a person 
who has a psychopathic personality as defined in section 526.09, 
or who is dangerous to self, or adjudication pursuant to chapter 
253B, as chemically dependent, mentally ill, mentally retarded, 
or mentally ill and dangerous to the public. 
    (h) Inability to provide mental health services with 
reasonable safety to clients. 
    (i) The habitual overindulgence in the use of or the 
dependence on intoxicating liquors. 
    (j) Improper or unauthorized personal or other use of any 
legend drugs as defined in chapter 151, any chemicals as defined 
in chapter 151, or any controlled substance as defined in 
chapter 152. 
    (k) Revealing a communication from, or relating to, a 
client except when otherwise required or permitted by law. 
    (l) Failure to comply with a client's request made under 
section 144.335, or to furnish a client record or report 
required by law. 
    (m) Splitting fees or promising to pay a portion of a fee 
to any other professional other than for services rendered by 
the other professional to the client. 
    (n) Engaging in abusive or fraudulent billing practices, 
including violations of the federal Medicare and Medicaid laws 
or state medical assistance laws. 
    (o) Failure to make reports as required by section 148B.63, 
or cooperate with an investigation of the office. 
    (p) Obtaining money, property, or services from a client, 
other than reasonable fees for services provided to the client, 
through the use of undue influence, harassment, duress, 
deception, or fraud. 
    (q) Undertaking or continuing a professional relationship 
with a client in which the objectivity of the professional would 
be impaired. 
    (r) Failure to provide the client with a copy of the client 
bill of rights or violation of any provision of the client bill 
of rights. 
    (s) Violating any order issued by the commissioner. 
    (t) Failure to comply with sections 148B.60 to 148B.71, and 
the rules adopted under those sections. 
    (u) Failure to comply with any additional disciplinary 
grounds established by the commissioner by rule. 
    Subd. 2.  [EVIDENCE.] In disciplinary actions alleging a 
violation of subdivision 1, paragraph (a), (b), (c), or (g), a 
copy of the judgment or proceeding under the seal of the court 
administrator or of the administrative agency that entered the 
same is admissible into evidence without further authentication 
and constitutes prima facie evidence of its contents. 
    Subd. 3.  [EXAMINATION; ACCESS TO MEDICAL DATA.] (a) If the 
commissioner has probable cause to believe that an unlicensed 
mental health practitioner has engaged in conduct prohibited by 
subdivision 1, paragraph (g), (h), (i), or (j), the commissioner 
may issue an order directing the practitioner to submit to a 
mental or physical examination or chemical dependency 
evaluation.  For the purpose of this subdivision, every 
unlicensed mental health practitioner is deemed to have 
consented to submit to a mental or physical examination or 
chemical dependency evaluation when ordered to do so in writing 
by the commissioner of health and further to have waived all 
objections to the admissibility of the testimony or examination 
reports of the health care provider performing the examination 
or evaluation on the grounds that the same constitute a 
privileged communication.  Failure of an unlicensed mental 
health practitioner to submit to an examination or evaluation 
when ordered, unless the failure was due to circumstances beyond 
the practitioner's control, constitutes an admission that the 
unlicensed mental health practitioner violated subdivision 1, 
paragraph (g), (h), (i), or (j), based on the factual 
specifications in the examination or evaluation order and may 
result in a default and final disciplinary order being entered 
after a contested case hearing.  An unlicensed mental health 
practitioner affected under this paragraph shall at reasonable 
intervals be given an opportunity to demonstrate that the 
practitioner can resume the provision of mental health services 
with reasonable safety to clients.  In any proceeding under this 
paragraph, neither the record of proceedings nor the orders 
entered by the commissioner shall be used against a mental 
health practitioner in any other proceeding. 
    (b) In addition to ordering a physical or mental 
examination or chemical dependency evaluation, the commissioner 
may, notwithstanding section 13.42, 144.651, 595.02, or any 
other law limiting access to medical or other health data, 
obtain medical data and health records relating to an unlicensed 
mental health practitioner without the practitioner's consent if 
the commissioner has probable cause to believe that a 
practitioner has engaged in conduct prohibited by subdivision 1, 
paragraph (g), (h), (i), or (j).  The medical data may be 
requested from a health care professional, as defined in section 
144.335, subdivision 1, paragraph (b), an insurance company, or 
a government agency, including the department of human 
services.  A health care professional, insurance company, or 
government agency shall comply with any written request of the 
commissioner under this subdivision and is not liable in any 
action for damages for releasing the data requested by the 
commissioner if the data are released pursuant to a written 
request under this subdivision, unless the information is false 
and the person or organization giving the information knew, or 
had reason to believe, the information was false.  Information 
obtained under this subdivision is private data under section 
13.41. 
    Sec. 59.  [148B.69] [DISCIPLINARY ACTIONS.] 
    Subdivision 1.  [FORMS OF DISCIPLINARY ACTION.] When the 
commissioner finds that an unlicensed mental health practitioner 
has violated a provision or provisions of this chapter, the 
commissioner may take one or more of the following actions, only 
against the individual practitioner: 
    (1) revoke the right to practice; 
    (2) suspend the right to practice; 
    (3) impose limitations or conditions on the practitioner's 
provision of mental health services, the imposition of 
rehabilitation requirements, or the requirement of practice 
under supervision; 
    (4) impose a civil penalty not exceeding $10,000 for each 
separate violation, the amount of the civil penalty to be fixed 
so as to deprive the practitioner of any economic advantage 
gained by reason of the violation charged or to reimburse the 
office of mental health practice for all costs of the 
investigation and proceeding; 
    (5) order the practitioner to provide unremunerated 
professional service under supervision at a designated public 
hospital, clinic, or other health care institution; 
    (6) censure or reprimand the practitioner; 
    (7) impose a fee on the practitioner to reimburse the 
office for all or part of the cost of the proceedings resulting 
in disciplinary action including, but not limited to, the amount 
paid by the office for services from the office of 
administrative hearings, attorney fees, court reports, 
witnesses, reproduction of records, advisory council members' 
per diem compensation, staff time, and expense incurred by 
advisory council members and staff of the office of mental 
health practice; or 
    (8) any other action justified by the case. 
    Subd. 2.  [DISCOVERY; SUBPOENAS.] In all matters relating 
to the lawful activities of the office of mental health 
practice, the commissioner of health may issue subpoenas and 
compel the attendance of witnesses and the production of all 
necessary papers, books, records, documents, and other 
evidentiary material.  Any person failing or refusing to appear 
or testify regarding any matter about which the person may be 
lawfully questioned or failing to produce any papers, books, 
records, documents, or other evidentiary materials in the matter 
to be heard, after having been required by order of the 
commissioner or by a subpoena of the commissioner to do so may, 
upon application to the district court in any district, be 
ordered to comply with the order or subpoena.  The commissioner 
of health may administer oaths to witnesses or take their 
affirmation.  Depositions may be taken within or without the 
state in the manner provided by law for the taking of 
depositions in civil actions.  A subpoena or other process or 
paper may be served upon a person it names anywhere within the 
state by any officer authorized to serve subpoenas or other 
process or paper in civil actions, in the same manner as 
prescribed by law for service of process issued out of the 
district court of this state. 
    Subd. 3.  [REINSTATEMENT.] The commissioner may at the 
commissioner's discretion reinstate the right to practice and 
may impose any disciplinary measure listed under subdivision 1. 
    Subd. 4.  [TEMPORARY SUSPENSION.] In addition to any other 
remedy provided by law, the commissioner may, acting through a 
person to whom the commissioner has delegated this authority and 
without a hearing, temporarily suspend the right of an 
unlicensed mental health practitioner to practice if the 
commissioner's delegate finds that the practitioner has violated 
a statute or rule that the commissioner is empowered to enforce 
and continued practice by the practitioner would create a 
serious risk of harm to others.  The suspension is in effect 
upon service of a written order on the practitioner specifying 
the statute or rule violated.  The order remains in effect until 
the commissioner issues a final order in the matter after a 
hearing or upon agreement between the commissioner and the 
practitioner.  Service of the order is effective if the order is 
served on the practitioner or counsel of record personally or by 
first class mail.  Within ten days of service of the order, the 
commissioner shall hold a hearing on the sole issue of whether 
there is a reasonable basis to continue, modify, or lift the 
suspension.  Evidence presented by the office or practitioner 
shall be in affidavit form only.  The practitioner or the 
counsel of record may appear for oral argument.  Within five 
working days after the hearing, the commissioner shall issue the 
commissioner's order and, if the suspension is continued, 
schedule a contested case hearing within 45 days after issuance 
of the order.  The administrative law judge shall issue a report 
within 30 days after closing of the contested case hearing 
record.  The commissioner shall issue a final order within 30 
days after receipt of that report. 
    Subd. 5.  [AUTOMATIC SUSPENSION.] The right to practice is 
automatically suspended if (1) a guardian of an unlicensed 
mental health practitioner is appointed by order of a probate 
court under sections 525.54 to 525.61, or (2) the practitioner 
is committed by order of a probate court pursuant to chapter 
253B or sections 526.09 to 526.11.  The right to practice 
remains suspended until the practitioner is restored to capacity 
by a court and, upon petition by the practitioner, the 
suspension is terminated by the commissioner after a hearing or 
upon agreement between the commissioner and the practitioner. 
    Subd. 6.  [PUBLIC EMPLOYEES.] Notwithstanding subdivision 
1, the commissioner must not take disciplinary action against an 
employee of the state or a political subdivision of the state.  
If, after an investigation conducted in compliance with and with 
the authority granted under sections 148B.60 to 148B.71, the 
commissioner determines that the employee violated a provision 
or provisions of this chapter, the commissioner shall report to 
the employee's employer the commissioner's findings and the 
actions the commissioner recommends that the employer take.  The 
commissioner's recommendations are not binding on the employer. 
    Sec. 60.  [148B.70] [ADDITIONAL REMEDIES.] 
    Subdivision 1.  [CEASE AND DESIST.] The commissioner of 
health may issue a cease and desist order to stop a person from 
violating or threatening to violate a statute, rule, or order 
which the office of mental health practice has issued or is 
empowered to enforce.  The cease and desist order must state the 
reason for its issuance and give notice of the person's right to 
request a hearing under sections 14.57 to 14.62.  If, within 15 
days of service of the order, the subject of the order fails to 
request a hearing in writing, the order is the final order of 
the commissioner and is not reviewable by a court or agency. 
    A hearing must be initiated by the office of mental health 
practice not later than 30 days from the date of the office's 
receipt of a written hearing request.  Within 30 days of receipt 
of the administrative law judge's report, the commissioner shall 
issue a final order modifying, vacating, or making permanent the 
cease and desist order as the facts require.  The final order 
remains in effect until modified or vacated by the commissioner. 
    When a request for a stay accompanies a timely hearing 
request, the commissioner may, in the commissioner's discretion, 
grant the stay.  If the commissioner does not grant a requested 
stay, the commissioner shall refer the request to the office of 
administrative hearings within three working days of receipt of 
the request.  Within ten days after receiving the request from 
the commissioner, an administrative law judge shall issue a 
recommendation to grant or deny the stay.  The commissioner 
shall grant or deny the stay within five days of receiving the 
administrative law judge's recommendation. 
    In the event of noncompliance with a cease and desist 
order, the commissioner may institute a proceeding in Hennepin 
county district court to obtain injunctive relief or other 
appropriate relief, including a civil penalty payable to the 
office of mental health practice not exceeding $10,000 for each 
separate violation. 
    Subd. 2.  [INJUNCTIVE RELIEF.] In addition to any other 
remedy provided by law, including the issuance of a cease and 
desist order under subdivision 1, the commissioner may in the 
commissioner's own name bring an action in Hennepin county 
district court for injunctive relief to restrain an unlicensed 
mental health practitioner from a violation or threatened 
violation of any statute, rule, or order which the commissioner 
is empowered to regulate, enforce, or issue.  A temporary 
restraining order must be granted in the proceeding if continued 
activity by a practitioner would create a serious risk of harm 
to others.  The commissioner need not show irreparable harm. 
    Subd. 3.  [ADDITIONAL POWERS.] The issuance of a cease and 
desist order or injunctive relief granted under this section 
does not relieve a practitioner from criminal prosecution by a 
competent authority or from disciplinary action by the 
commissioner. 
    Sec. 61.  [148B.71] [MENTAL HEALTH CLIENT BILL OF RIGHTS.] 
    Subdivision 1.  [SCOPE.] All unlicensed mental health 
practitioners other than those providing services in a facility 
regulated under section 144.651 or a government agency shall 
provide to each client prior to providing treatment a written 
copy of the mental health client bill of rights.  A copy must 
also be posted in a prominent location in the office of the 
mental health practitioner.  Reasonable accommodations shall be 
made for those clients who cannot read or who have communication 
impairments and those who do not read or speak English.  The 
mental health client bill of rights shall include the following: 
    (a) the name, title, business address, and telephone number 
of the practitioner; 
    (b) the degrees, training, experience, or other 
qualifications of the practitioner, followed by the following 
statement in bold print: 
    "THE STATE OF MINNESOTA HAS NOT ADOPTED UNIFORM EDUCATIONAL 
AND TRAINING STANDARDS FOR ALL MENTAL HEALTH PRACTITIONERS.  
THIS STATEMENT OF CREDENTIALS IS FOR INFORMATION PURPOSES ONLY." 
    (c) the name, business address, and telephone number of the 
practitioner's supervisor, if any; 
    (d) notice that a client has the right to file a complaint 
with the practitioner's supervisor, if any, and the procedure 
for filing complaints; 
    (e) the name, address, and telephone number of the office 
of mental health practice and notice that a client may file 
complaints with the office; 
    (f) the practitioner's fees per unit of service, the 
practitioner's method of billing for such fees, the names of any 
insurance companies that have agreed to reimburse the 
practitioner, or health maintenance organizations with whom the 
practitioner contracts to provide service, whether the 
practitioner accepts Medicare, medical assistance, or general 
assistance medical care, and whether the practitioner is willing 
to accept partial payment, or to waive payment, and in what 
circumstances; 
    (g) a statement that the client has a right to reasonable 
notice of changes in services or charges; 
    (h) a brief summary, in plain language, of the theoretical 
approach used by the practitioner in treating patients; 
    (i) notice that the client has a right to complete and 
current information concerning the practitioner's assessment and 
recommended course of treatment, including the expected duration 
of treatment; 
    (j) a statement that clients may expect courteous treatment 
and to be free from verbal, physical, or sexual abuse by the 
practitioner; 
    (k) a statement that client records and transactions with 
the practitioner are confidential, unless release of these 
records is authorized in writing by the client, or otherwise 
provided by law; 
    (l) a statement of the client's right to be allowed access 
to records and written information from records in accordance 
with section 144.335; 
    (m) a statement that other services may be available in the 
community, including where information concerning services is 
available; 
    (n) a statement that the client has the right to choose 
freely among available practitioners, and to change 
practitioners after services have begun, within the limits of 
health insurance, medical assistance, or other health programs; 
    (o) a statement that the client has a right to coordinated 
transfer when there will be a change in the provider of 
services; 
    (p) a statement that the client may refuse services or 
treatment, unless otherwise provided by law; and 
    (q) a statement that the client may assert the client's 
rights without retaliation. 
    Subd. 2.  [ACKNOWLEDGMENT BY CLIENT.] Prior to the 
provision of any service, the client must sign a written 
statement attesting that the client has received the client bill 
of rights. 
    Sec. 62.  [148B.72] [EXPENSES.] 
    The expenses of administering the office of mental health 
practice under sections 148B.60 to 148B.71 must be recovered by 
transferring to the commissioner a portion of the surplus of the 
fees collected by the health-related licensing boards and by 
assessing a fee surcharge on the indirect costs charged to each 
health-related licensing board.  At the end of each biennium, 
the commissioner of finance shall identify the amount of any 
surplus remaining in the state government special revenue fund 
of the license fees collected by the health-related licensing 
boards.  The commissioner of finance shall also determine a 
reasonable amount of the surplus that must remain in the state 
government special revenue fund as a cash flow reserve.  Any 
surplus remaining in the account in excess of the cash flow 
reserve that is attributable to health-related licensing board 
collections must be transferred to the commissioner of health 
for the office of mental health practice for the next biennium, 
not to exceed the amount of the legislative appropriation for 
the office.  At the end of each biennium, the commissioner of 
health shall determine the amount of the health-related 
licensing board surcharge for the next biennium that must be 
assessed in order to cover the costs of administering the office 
of mental health practice, after deducting the amount of any 
surplus transferred from the state government special revenue 
fund.  The fee surcharge must be based on a percentage of the 
indirect costs charged to each health-related licensing board.  
The total amount collected through the surcharge must not exceed 
the amount of the legislative appropriation from the state 
government special revenue fund minus any surplus transferred 
from the special revenue fund, except that the commissioner may 
recover the costs of initial rulemaking and other one-time 
expenses over a four-year period.  The commissioner of health 
and the commissioner of finance shall determine the amount of 
the surcharge without adopting rules.  
    Sec. 63.  Minnesota Statutes 1990, section 157.031, 
subdivision 2, is amended to read: 
    Subd. 2.  [REGISTRATION.] A board and lodging establishment 
that provides supportive services or health supervision services 
must register with the commissioner by September 1, 1989.  The 
registration must include the name, address, and telephone 
number of the establishment, the types of services that are 
being provided, a description of the residents being served, the 
type and qualifications of staff in the facility, and other 
information that is necessary to identify the needs of the 
residents and the types of services that are being provided.  
The commissioner shall develop and furnish to the board and 
lodging establishment the necessary form for submitting the 
registration.  The requirement for registration is effective 
until the special license rules required by subdivision 
5 sections 144B.01 to 144B.17 are effective. 
    Sec. 64.  Minnesota Statutes 1990, section 157.031, 
subdivision 3, is amended to read: 
    Subd. 3.  [RESTRICTION ON THE PROVISION OF SERVICES.] 
Effective September 1, 1989, and until one year after the rules 
required under subdivision 5 sections 144B.01 to 144B.17 are 
adopted, a board and lodging establishment registered under 
subdivision 2 may provide health supervision services only if a 
licensed nurse is on site in the facility for at least four 
hours a week to provide supervision and health monitoring of the 
residents.  A board and lodging facility that admits or retains 
residents using wheelchairs or walkers must have the necessary 
clearances from the office of the state fire marshal. 
    Sec. 65.  Minnesota Statutes 1990, section 157.031, 
subdivision 4, is amended to read: 
    Subd. 4.  [SPECIAL LICENSE RESIDENTIAL CARE HOME LICENSE 
REQUIRED.] Upon adoption of the rules required by subdivision 5 
sections 144B.01 to 144B.17, a board and lodging 
establishment registered under subdivision 2, that provides 
either supportive care or health supervision services must 
obtain a special residential care home license from the 
commissioner within one year from the adoption of those 
rules.  The special license is required until rules resulting 
from the recommendations made in accordance with Laws 1989, 
chapter 282, article 2, section 213, are implemented. 
    Sec. 66.  Minnesota Statutes 1990, section 157.031, 
subdivision 9, is amended to read: 
    Subd. 9.  [VIOLATIONS.] The commissioner may revoke both 
the special service license, when issued, and the establishment 
license, if the establishment is found to be in violation of 
this section.  Violation of this section is a gross misdemeanor. 
    Sec. 67.  Minnesota Statutes 1990, section 214.04, 
subdivision 3, is amended to read: 
    Subd. 3.  The executive director of each health-related 
board and the executive secretary of each non-health-related 
board shall be the chief administrative officer for the board 
but shall not be a member of the board.  The executive director 
or executive secretary shall maintain the records of the board, 
account for all fees received by it, supervise and direct 
employees servicing the board, and perform other services as 
directed by the board.  The executive directors, executive 
secretaries, and other employees of the following boards shall 
be hired by the board, and the executive directors or executive 
secretaries shall be in the unclassified civil service, except 
as provided in this subdivision:  
    (1) dentistry; 
    (2) medical examiners; 
    (3) nursing; 
    (4) pharmacy; 
    (5) accountancy; 
    (6) architecture, engineering, land surveying, and 
landscape architecture; 
    (7) barber examiners; 
    (8) cosmetology; 
    (9) electricity; 
    (10) teaching; 
    (11) peace officer standards and training; 
    (12) social work; and 
    (13) marriage and family therapy; 
    (14) unlicensed mental health service providers; and 
    (15) office of social work and mental health boards. 
    The executive directors or executive secretaries serving 
the boards are hired by those boards and are in the unclassified 
civil service, except for part-time executive directors or 
executive secretaries, who are not required to be in the 
unclassified service.  Boards not requiring full-time executive 
directors or executive secretaries may employ them on a 
part-time basis.  To the extent practicable, the sharing of 
part-time executive directors or executive secretaries by boards 
being serviced by the same department is encouraged.  Persons 
providing services to those boards not listed in this 
subdivision, except executive directors or executive secretaries 
of the boards and employees of the attorney general, are 
classified civil service employees of the department servicing 
the board.  To the extent practicable, the commissioner shall 
ensure that staff services are shared by the boards being 
serviced by the department.  If necessary, a board may hire 
part-time, temporary employees to administer and grade 
examinations. 
    Sec. 68.  Minnesota Statutes 1990, section 256I.04, is 
amended by adding a subdivision to read: 
    Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF NEGOTIATED RATE 
BEDS.] County agencies shall not enter into agreements for new 
general assistance or Minnesota supplemental aid negotiated rate 
beds except:  (1) for adult foster homes licensed by the 
commissioner of human services under Minnesota Rules, parts 
9555.5105 to 9555.6265; (2) for facilities licensed under 
Minnesota Rules, parts 9525.0215 to 9525.0355, provided the 
facility is needed to meet the census reduction targets for 
persons with mental retardation or related conditions at 
regional treatment centers; (3) to ensure compliance with the 
federal Omnibus Budget Reconciliation Act alternative 
disposition plan requirements for inappropriately placed persons 
with mental retardation or related conditions or mental illness; 
or (4) for up to five handicapped accessible beds in a facility 
that serves primarily persons with a mental illness or chemical 
dependency that began construction to add space for the new beds 
before April 1, 1991, and will complete construction or 
remodeling by December 1, 1991. 
    Sec. 69.  Minnesota Statutes 1990, section 268A.03, is 
amended to read: 
    268A.03 [POWERS AND DUTIES.] 
    The commissioner shall: 
    (a) certify the rehabilitation facilities to offer extended 
employment programs, grant funds to the extended employment 
programs, and perform the duties as specified in section 
268A.09; 
    (b) provide vocational rehabilitation services to persons 
with disabilities in accordance with the state plan for 
vocational rehabilitation.  These services include but are not 
limited to:  diagnostic and related services incidental to 
determination of eligibility for services to be provided, 
including medical diagnosis and vocational diagnosis; vocational 
counseling, training and instruction, including personal 
adjustment training; physical restoration, including corrective 
surgery, therapeutic treatment, hospitalization and prosthetic 
and orthotic devices, all of which shall be obtained from 
appropriate established agencies; transportation; occupational 
and business licenses or permits, customary tools and equipment; 
maintenance; books, supplies, and training materials; initial 
stocks and supplies; placement; on-the-job skill training and 
time-limited postemployment services leading to supported 
employment; acquisition of vending stands or other equipment, 
initial stocks and supplies for small business enterprises; 
supervision and management of small business enterprises, 
merchandising programs, or services rendered by severely 
disabled persons.  Persons with a disability are entitled to 
free choice of vendor for any medical, dental, prosthetic, or 
orthotic services provided under this paragraph; 
     (c) expend funds and provide technical assistance for the 
establishment, improvement, maintenance, or extension of public 
and other nonprofit rehabilitation facilities or centers; 
     (d) formulate plans of cooperation with the commissioner of 
labor and industry for providing services to workers covered 
under the workers' compensation act; 
     (e) maintain a contractual or regulatory relationship with 
the United States as authorized by the Social Security Act, as 
amended.  Under this relationship, the state will undertake to 
make determinations referred to in those public laws with 
respect to all individuals in Minnesota, or with respect to a 
class or classes of individuals in this state that is designated 
in the agreement at the state's request.  It is the purpose of 
this relationship to permit the citizens of this state to obtain 
all benefits available under federal law; 
     (f) provide an in-service training program for division of 
rehabilitation services employees by paying for its direct costs 
with state and federal funds; 
     (g) conduct research and demonstration projects; provide 
training and instruction, including establishment and 
maintenance of research fellowships and traineeships, along with 
all necessary stipends and allowances; disseminate information 
to persons with a disability and the general public; and provide 
technical assistance relating to vocational rehabilitation and 
independent living; 
     (h) receive and disburse pursuant to law money and gifts 
available from governmental and private sources including, but 
not limited to, the federal Department of Education and the 
Social Security Administration, for the purpose of vocational 
rehabilitation or independent living.  Money received from 
workers' compensation carriers for vocational rehabilitation 
services to injured workers must be deposited in the general 
fund; 
     (i) design all state plans for vocational rehabilitation or 
independent living services required as a condition to the 
receipt and disbursement of any money available from the federal 
government; 
     (j) cooperate with other public or private agencies or 
organizations for the purpose of vocational rehabilitation or 
independent living.  Money received from school districts, 
governmental subdivisions, mental health centers or boards, and 
private nonprofit organizations is appropriated to the 
commissioner for conducting joint or cooperative vocational 
rehabilitation or independent living programs; 
     (k) enter into contractual arrangements with 
instrumentalities of federal, state, or local government and 
with private individuals, organizations, agencies, or facilities 
with respect to providing vocational rehabilitation or 
independent living services; 
    (l) take other actions required by state and federal 
legislation relating to vocational rehabilitation, independent 
living, and disability determination programs; 
    (m) hire staff and arrange services and facilities 
necessary to perform the duties and powers specified in this 
section; and 
    (n) adopt, amend, suspend, or repeal rules necessary to 
implement or make specific programs that the commissioner by 
sections 268A.01 to 268A.10 is empowered to administer; and 
    (o) contact any person with traumatic brain injury or 
spinal cord injury reported by the commissioner of health under 
section 144.664, subdivision 3, and notify the person, or the 
person's parent or guardian if the person is a minor or is 
mentally incompetent, of services available to the person, 
eligibility requirements and application procedures for public 
programs, and other information the commissioner believes may be 
helpful to the person to make appropriate use of available 
rehabilitation services. 
    Sec. 70.  [TRANSFER OF JURISDICTION FOR DISCIPLINARY 
ACTIONS TAKEN AGAINST UNLICENSED MENTAL HEALTH PRACTITIONERS.] 
    Subdivision 1.  [COOPERATION.] During the transition period 
prior to the sunset of the board of unlicensed mental health 
service providers and the establishment of the office of mental 
health practice on July 1, 1991, members of the board, staff 
persons employed by the board, and the office of social work and 
mental health boards shall provide all necessary assistance to 
the office of the attorney general to complete as many 
investigations and disciplinary actions on pending complaints as 
possible prior to the sunset of the board.  The board members 
and staff of the board of unlicensed mental health service 
providers and the office of social work and mental health boards 
shall consult with and offer all necessary assistance to the 
commissioner of health in transferring pending complaints to the 
office of mental health practice and in implementing all other 
aspects of Minnesota Statutes, sections 148B.60 to 148B.71.  
Actions must be undertaken to ensure that complaints and 
investigations against unlicensed mental health practitioners 
pending before the board continue to receive attention during 
the transition period.  As of July 1, 1991, jurisdiction of all 
open complaints still pending before the board as of June 30, 
1991, is transferred to the commissioner of health who has the 
right to proceed on them under the authority granted to the 
commissioner in Minnesota Statutes, sections 148B.60 to 148B.71. 
Jurisdiction of all new complaints brought against unlicensed 
mental health practitioners on or after July 1, 1991, rests with 
the office of mental health practice, established under 
Minnesota Statutes, section 148B.61.  The transfer of records, 
pending complaints, and other data shall be completed no later 
than June 30, 1991. 
    Subd. 2.  [TRANSFER OF RULES.] The rules adopted by the 
board of unlicensed mental health service providers are 
transferred to the commissioner of health and must be used by 
the office of mental health practice until the commissioner 
adopts new rules. 
    Subd. 3.  [TRANSFER OF POWERS AND DUTIES.] The powers and 
duties of the board of unlicensed mental health service 
providers are transferred to the commissioner of health pursuant 
to Minnesota Statutes, section 15.039, effective July 1, 1991. 
    Sec. 71.  [FILING FEES NONREFUNDABLE.] 
    Filing fees paid to the board of unlicensed mental health 
service providers by unlicensed mental health service providers 
prior to June 30, 1991, are nonrefundable.  Any balance held by 
the board of unlicensed mental health service providers as of 
June 30, 1991, shall be transferred to the department of health 
for the operation of the office of mental health practice no 
later than June 30, 1991. 
    Sec. 72.  [TRANSFER OF DATA AND RECORDS.] 
    By June 30, 1992, the board of unlicensed mental health 
service providers shall transfer to the office of mental health 
practice all data and records obtained by the board as 
investigative data under Minnesota Statutes, section 148B.09, 
subdivision 1, and all other data gathered by the board. 
    Sec. 73.  [REPORT TO THE LEGISLATURE.] 
    By February 1, 1992, the commissioner shall report to the 
legislature on the implementation of Minnesota Statutes, 
sections 144B.01 to 144B.16.  This report must include a 
description of the provisions included in rules required under 
those sections and an estimate of the expected fiscal impact to 
the state of adopting those rules. 
    Sec. 74.  [REVISOR INSTRUCTION.] 
    In the next edition of Minnesota Statutes, the revisor 
shall delete the terms "individual," "individuals," "regulated 
individual," "regulated individuals," and "regulated 
individual's" wherever found in Minnesota Statutes, sections 
148B.04, subdivision 3; 148B.05, subdivision 2; 148B.06, 
subdivision 2; 148B.07, subdivisions 2, 3, 5, and 6; 148B.09; 
148B.11; 148B.13; and 148B.15, and insert the term "licensee," 
"licensees," or "licensee's" as appropriate. 
    Sec. 75.  [REPEALER.] 
    Subdivision 1.  [RESIDENTIAL CARE HOMES.] Minnesota 
Statutes 1990, section 157.031, subdivision 5, is repealed 
effective the day following final enactment. 
    Subd. 2.  [UNLICENSED MENTAL HEALTH 
PRACTITIONERS.] Minnesota Statutes 1990, sections 148B.01, 
subdivisions 2, 5, and 6; 148B.02; 148B.16; 148B.171; 148B.40; 
148B.41; 148B.42; 148B.43; 148B.44; 148B.45; 148B.46; 148B.47; 
and 148B.48, are repealed effective July 1, 1991. 
    Sec. 76.  [EFFECTIVE DATES.] 
    Sections 14 to 25, 27 to 30, 47, 63 to 66, 68, and 70 to 73 
are effective the day after final enactment.  Sections 12, 13, 
and 26 are effective upon the effective date of rules adopted by 
the commissioner of health for licensure of residential care 
homes. 

                                ARTICLE 3

                 MISCELLANEOUS SOCIAL SERVICES PROGRAMS
    Section 1.  Minnesota Statutes 1990, section 3.922, 
subdivision 3, is amended to read: 
    Subd. 3.  [COMPENSATION; EXPENSES; EXPIRATION.] 
Compensation of nonlegislator members is as provided in section 
15.059.  Expenses of the council shall be approved by two of any 
three members of the council designated by the council and then 
be paid in the same manner as other state expenses.  The 
executive secretary shall inform the commissioner of finance in 
writing of the names of the persons authorized to approve 
expenses.  The council expires on June 30, 1993.  
    Sec. 2.  Minnesota Statutes 1990, section 3.922, 
subdivision 8, is amended to read: 
    Subd. 8.  [ADVISORY COUNCIL.] An advisory council on urban 
Indians is created to advise the board on the unique problems 
and concerns of Minnesota Indians who reside in urban areas of 
the state.  The council shall be appointed by the board and 
consist of five Indians residing in the vicinity of Minneapolis, 
St. Paul, and Duluth.  At least one member of the council shall 
be a resident of each city.  The terms, compensation, and 
removal of members are as provided in section 15.059.  The 
council expires on June 30, 1993.  
    Sec. 3.  Minnesota Statutes 1990, section 3.9223, 
subdivision 1, is amended to read: 
    Subdivision 1.  [MEMBERSHIP.] A state council on affairs of 
Spanish-speaking people is created to consist of seven members 
appointed by the governor.  The demographic composition of the 
council members shall accurately reflect the demographic 
composition of Minnesota's Spanish-speaking community, including 
migrant workers, as determined by the state demographer.  
Membership, terms, removal of members and filling of vacancies 
are as provided in section 15.0575.  Compensation of members is 
as provided in section 15.059, subdivision 3.  The council shall 
annually elect from its membership a chair and other officers it 
deems necessary.  The council expires on June 30, 1993. 
    Sec. 4.  Minnesota Statutes 1990, section 3.9225, 
subdivision 1, is amended to read: 
    Subdivision 1.  [CREATION.] A state council on Black 
Minnesotans is created to consist of seven members appointed by 
the governor.  The members of the council shall be broadly 
representative of the Black community of the state and include 
at least three males and at least three females.  Membership 
terms, compensation, removal of members, and filling of 
vacancies for nonlegislative members are as provided in section 
15.059.  Two members of the house of representatives appointed 
by the speaker and two members of the senate appointed by the 
subcommittee on committees of the committee on rules and 
administration shall serve as ex officio, nonvoting members of 
the council.  The council shall annually elect from its 
membership a chair and other officers it deems necessary.  The 
council expires on June 30, 1993.  
    Sec. 5.  Minnesota Statutes 1990, section 3.9226, 
subdivision 1, is amended to read: 
    Subdivision 1.  [CREATION.] The state council on 
Asian-Pacific Minnesotans consists of 15 members.  Eleven 
members are appointed by the governor and must be broadly 
representative of the Asian-Pacific community of the state.  
Terms, compensation, removal, and filling of vacancies for 
appointed members are as provided in section 15.059.  Two 
members of the house of representatives appointed under the 
rules of the house of representatives and two members of the 
senate appointed under the rules of the senate shall serve as 
nonvoting members of the council.  The council shall annually 
elect from its membership a chair and other officers it deems 
necessary.  The council expires on June 30, 1993. 
    Sec. 6.  Minnesota Statutes 1990, section 256.01, 
subdivision 2, is amended to read: 
    Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
section 241.021, subdivision 2, the commissioner of human 
services shall: 
      (1) Administer and supervise all forms of public assistance 
provided for by state law and other welfare activities or 
services as are vested in the commissioner.  Administration and 
supervision of human services activities or services includes, 
but is not limited to, assuring timely and accurate distribution 
of benefits, completeness of service, and quality program 
management.  In addition to administering and supervising human 
services activities vested by law in the department, the 
commissioner shall have the authority to: 
    (a) require county agency participation in training and 
technical assistance programs to promote compliance with 
statutes, rules, federal laws, regulations, and policies 
governing human services; 
    (b) monitor, on an ongoing basis, the performance of county 
agencies in the operation and administration of human services, 
enforce compliance with statutes, rules, federal laws, 
regulations, and policies governing welfare services and promote 
excellence of administration and program operation; 
      (c) develop a quality control program or other monitoring 
program to review county performance and accuracy of benefit 
determinations; 
    (d) require county agencies to make an adjustment to the 
public assistance benefits issued to any individual consistent 
with federal law and regulation and state law and rule and to 
issue or recover benefits as appropriate; 
      (e) delay or deny payment of all or part of the state and 
federal share of benefits and administrative reimbursement 
according to the procedures set forth in section 256.017; and 
      (f) make contracts with and grants to public and private 
agencies and organizations, both profit and nonprofit, and 
individuals, using appropriated funds. 
    (2) Inform county agencies, on a timely basis, of changes 
in statute, rule, federal law, regulation, and policy necessary 
to county agency administration of the programs. 
      (3) Administer and supervise all child welfare activities; 
promote the enforcement of laws protecting handicapped, 
dependent, neglected and delinquent children, and children born 
to mothers who were not married to the children's fathers at the 
times of the conception nor at the births of the children; 
license and supervise child-caring and child-placing agencies 
and institutions; supervise the care of children in boarding and 
foster homes or in private institutions; and generally perform 
all functions relating to the field of child welfare now vested 
in the state board of control. 
      (4) Administer and supervise all noninstitutional service 
to handicapped persons, including those who are visually 
impaired, hearing impaired, or physically impaired or otherwise 
handicapped.  The commissioner may provide and contract for the 
care and treatment of qualified indigent children in facilities 
other than those located and available at state hospitals when 
it is not feasible to provide the service in state hospitals. 
      (5) Assist and actively cooperate with other departments, 
agencies and institutions, local, state, and federal, by 
performing services in conformity with the purposes of Laws 
1939, chapter 431. 
      (6) Act as the agent of and cooperate with the federal 
government in matters of mutual concern relative to and in 
conformity with the provisions of Laws 1939, chapter 431, 
including the administration of any federal funds granted to the 
state to aid in the performance of any functions of the 
commissioner as specified in Laws 1939, chapter 431, and 
including the promulgation of rules making uniformly available 
medical care benefits to all recipients of public assistance, at 
such times as the federal government increases its participation 
in assistance expenditures for medical care to recipients of 
public assistance, the cost thereof to be borne in the same 
proportion as are grants of aid to said recipients. 
      (7) Establish and maintain any administrative units 
reasonably necessary for the performance of administrative 
functions common to all divisions of the department. 
     (8) Act as designated guardian of both the estate and the 
person of all the wards of the state of Minnesota, whether by 
operation of law or by an order of court, without any further 
act or proceeding whatever, except as to persons committed as 
mentally retarded.  
     (9) Act as coordinating referral and informational center 
on requests for service for newly arrived immigrants coming to 
Minnesota. 
     (10) The specific enumeration of powers and duties as 
hereinabove set forth shall in no way be construed to be a 
limitation upon the general transfer of powers herein contained. 
     (11) Establish county, regional, or statewide schedules of 
maximum fees and charges which may be paid by county agencies 
for medical, dental, surgical, hospital, nursing and nursing 
home care and medicine and medical supplies under all programs 
of medical care provided by the state and for congregate living 
care under the income maintenance programs. 
     (12) Have the authority to conduct and administer 
experimental projects to test methods and procedures of 
administering assistance and services to recipients or potential 
recipients of public welfare.  To carry out such experimental 
projects, it is further provided that the commissioner of human 
services is authorized to waive the enforcement of existing 
specific statutory program requirements, rules, and standards in 
one or more counties.  The order establishing the waiver shall 
provide alternative methods and procedures of administration, 
shall not be in conflict with the basic purposes, coverage, or 
benefits provided by law, and in no event shall the duration of 
a project exceed four years.  It is further provided that no 
order establishing an experimental project as authorized by the 
provisions of this section shall become effective until the 
following conditions have been met: 
     (a) The proposed comprehensive plan, including estimated 
project costs and the proposed order establishing the waiver, 
shall be filed with the secretary of the senate and chief clerk 
of the house of representatives at least 60 days prior to its 
effective date. 
     (b) The secretary of health, education, and welfare of the 
United States has agreed, for the same project, to waive state 
plan requirements relative to statewide uniformity. 
     (c) A comprehensive plan, including estimated project 
costs, shall be approved by the legislative advisory commission 
and filed with the commissioner of administration.  
     (13) In accordance with federal requirements, establish 
procedures to be followed by local welfare boards in creating 
citizen advisory committees, including procedures for selection 
of committee members. 
     (14) Allocate federal fiscal disallowances or sanctions 
which are based on quality control error rates for the aid to 
families with dependent children, medical assistance, or food 
stamp program in the following manner:  
      (a) One-half of the total amount of the disallowance shall 
be borne by the county boards responsible for administering the 
programs.  For the medical assistance and AFDC programs, 
disallowances shall be shared by each county board in the same 
proportion as that county's expenditures for the sanctioned 
program are to the total of all counties' expenditures for the 
AFDC and medical assistance programs.  For the food stamp 
program, sanctions shall be shared by each county board, with 50 
percent of the sanction being distributed to each county in the 
same proportion as that county's administrative costs for food 
stamps are to the total of all food stamp administrative costs 
for all counties, and 50 percent of the sanctions being 
distributed to each county in the same proportion as that 
county's value of food stamp benefits issued are to the total of 
all benefits issued for all counties.  Each county shall pay its 
share of the disallowance to the state of Minnesota.  When a 
county fails to pay the amount due hereunder, the commissioner 
may deduct the amount from reimbursement otherwise due the 
county, or the attorney general, upon the request of the 
commissioner, may institute civil action to recover the amount 
due. 
      (b) Notwithstanding the provisions of paragraph (a), if the 
disallowance results from knowing noncompliance by one or more 
counties with a specific program instruction, and that knowing 
noncompliance is a matter of official county board record, the 
commissioner may require payment or recover from the county or 
counties, in the manner prescribed in paragraph (a), an amount 
equal to the portion of the total disallowance which resulted 
from the noncompliance, and may distribute the balance of the 
disallowance according to paragraph (a).  
    (15) Develop and implement special projects that maximize 
reimbursements and result in the recovery of money to the 
state.  For the purpose of recovering state money, the 
commissioner may enter into contracts with third parties.  Any 
recoveries that result from projects or contracts entered into 
under this paragraph shall be deposited in the state treasury 
and credited to a special account until the balance in the 
account reaches $400,000 $1,000,000.  When the balance in the 
account exceeds $400,000 $1,000,000, the excess shall be 
transferred and credited to the general fund.  All money in the 
account is appropriated to the commissioner for the purposes of 
this paragraph. 
    (16) Have the authority to make direct payments to 
facilities providing shelter to women and their children 
pursuant to section 256D.05, subdivision 3.  Upon the written 
request of a shelter facility that has been denied payments 
under section 256D.05, subdivision 3, the commissioner shall 
review all relevant evidence and make a determination within 30 
days of the request for review regarding issuance of direct 
payments to the shelter facility.  Failure to act within 30 days 
shall be considered a determination not to issue direct payments.
    (17) Have the authority to establish and enforce the 
following county reporting requirements:  
     (a) The commissioner shall establish fiscal and statistical 
reporting requirements necessary to account for the expenditure 
of funds allocated to counties for human services programs.  
When establishing financial and statistical reporting 
requirements, the commissioner shall evaluate all reports, in 
consultation with the counties, to determine if the reports can 
be simplified or the number of reports can be reduced. 
     (b) The county board shall submit monthly or quarterly 
reports to the department as required by the commissioner.  
Monthly reports are due no later than 15 working days after the 
end of the month.  Quarterly reports are due no later than 30 
calendar days after the end of the quarter, unless the 
commissioner determines that the deadline must be shortened to 
20 calendar days to avoid jeopardizing compliance with federal 
deadlines or risking a loss of federal funding.  Only reports 
that are complete, legible, and in the required format shall be 
accepted by the commissioner.  
     (c) If the required reports are not received by the 
deadlines established in clause (b), the commissioner may delay 
payments and withhold funds from the county board until the next 
reporting period.  When the report is needed to account for the 
use of federal funds and the late report results in a reduction 
in federal funding, the commissioner shall withhold from the 
county boards with late reports an amount equal to the reduction 
in federal funding until full federal funding is received.  
     (d) A county board that submits reports that are late, 
illegible, incomplete, or not in the required format for two out 
of three consecutive reporting periods is considered 
noncompliant.  When a county board is found to be noncompliant, 
the commissioner shall notify the county board of the reason the 
county board is considered noncompliant and request that the 
county board develop a corrective action plan stating how the 
county board plans to correct the problem.  The corrective 
action plan must be submitted to the commissioner within 45 days 
after the date the county board received notice of noncompliance.
     (e) The final deadline for fiscal reports or amendments to 
fiscal reports is one year after the date the report was 
originally due.  If the commissioner does not receive a report 
by the final deadline, the county board forfeits the funding 
associated with the report for that reporting period and the 
county board must repay any funds associated with the report 
received for that reporting period. 
     (f) The commissioner may not delay payments, withhold 
funds, or require repayment under paragraph (c) or (e) if the 
county demonstrates that the commissioner failed to provide 
appropriate forms, guidelines, and technical assistance to 
enable the county to comply with the requirements.  If the 
county board disagrees with an action taken by the commissioner 
under paragraph (c) or (e), the county board may appeal the 
action according to sections 14.57 to 14.69. 
      (g) Counties subject to withholding of funds under 
paragraph (c) or forfeiture or repayment of funds under 
paragraph (e) shall not reduce or withhold benefits or services 
to clients to cover costs incurred due to actions taken by the 
commissioner under paragraph (c) or (e). 
     (18) Allocate federal fiscal disallowances or sanctions for 
audit exceptions when federal fiscal disallowances or sanctions 
are based on a statewide random sample for the foster care 
program under title IV-E of the Social Security Act, United 
States Code, title 42, in direct proportion to each county's 
title IV-E foster care maintenance claim for that period. 
    Sec. 7.  Minnesota Statutes 1990, section 256.482, 
subdivision 1, is amended to read: 
    Subdivision 1.  [ESTABLISHMENT; MEMBERS.] There is hereby 
established the council on disability which shall consist of 21 
members appointed by the governor.  Members shall be appointed 
from the general public and from organizations which provide 
services for persons who have a disability.  A majority of 
council members shall be persons with a disability or parents or 
guardians of persons with a disability.  There shall be at least 
one member of the council appointed from each of the state 
development regions.  The commissioners of the departments of 
education, human services, health, jobs and training, and human 
rights and the directors of the division of rehabilitation 
services and state services for the blind or their designees 
shall serve as ex officio members of the council without vote.  
In addition, the council may appoint ex officio members from 
other bureaus, divisions, or sections of state departments which 
are directly concerned with the provision of services to persons 
with a disability.  
    Notwithstanding the provisions of section 15.059, each 
member of the council appointed by the governor shall serve a 
three-year term and until a successor is appointed and 
qualified.  The compensation and removal of all members shall be 
as provided in section 15.059.  The governor shall appoint a 
chair of the council from among the members appointed from the 
general public or who are persons with a disability or their 
parents or guardians.  Vacancies shall be filled by the 
authority for the remainder of the unexpired term.  The council 
expires on June 30, 1993. 
    Sec. 8.  Minnesota Statutes 1990, section 256C.24, 
subdivision 2, is amended to read: 
    Subd. 2.  [RESPONSIBILITIES.] The regional service center 
shall:  
    (a) serve as the central entry point for hearing impaired 
persons in need of human services and make referrals to the 
services needed; 
    (b) employ staff trained to work with hearing impaired 
persons; 
    (c) provide to all hearing impaired persons access to 
interpreter services which are necessary to help them obtain 
human services; 
    (d) assist the central interpreter referral agency with 
local and regional interpreter referrals; 
    (e) implement a plan to provide loan equipment and resource 
materials to hearing impaired persons; and 
    (f) (e) cooperate with responsible departments and 
administrative authorities to provide access for hearing 
impaired persons to services provided by state, county, and 
regional agencies.  
    Sec. 9.  Minnesota Statutes 1990, section 256C.25, is 
amended to read: 
    256C.25 [INTERPRETER SERVICES.] 
    Subdivision 1.  [ESTABLISHMENT.] The commissioner of human 
services shall supervise the development and implementation of a 
maintain and coordinate statewide interpreter referral service 
services for use by any public or private agency or individual 
in the state.  The commissioner of human services shall Within 
the seven-county metro area, the commissioner shall contract for 
these services; outside the metro area, the commissioner shall 
directly coordinate these services but may contract with an 
appropriate agency to provide this centralized service.  The 
commissioner may collect a $3 fee per referral for interpreter 
referral services and the actual costs of interpreter services 
provided by department staff.  Fees and payments collected shall 
be deposited in the general fund.  The $3 referral fee shall not 
be collected from state agencies or local units of government or 
hearing-impaired consumers or interpreters.  
    Subd. 2.  [DUTIES.] The central Interpreter referral agency 
shall services must include:  
    (a) Establish and maintain a statewide access to 
interpreter referral service services, maintain statistics 
related to interpreter referral services, and 
maintain coordinated with the regional service centers; 
    (b) maintenance of a statewide directory of qualified 
interpreters; 
    (b) Cooperate with the regional service centers in 
providing interpreter referral service; and 
    (c) Cooperate assessment of the present and projected 
supply and demand for interpreter services statewide; and 
    (d) coordination with the regional service centers on 
projects to train interpreters and advocate for and evaluate 
interpreter services. 
    Sec. 10.  Minnesota Statutes 1990, section 256F.01, is 
amended to read: 
    256F.01 [PUBLIC POLICY.] 
    It is the policy of this The public policy of this state is 
to assure that all children, regardless of minority racial or 
ethnic heritage, are entitled to live in families that offer a 
safe, permanent relationship with nurturing parents or 
caretakers and have.  To help assure children the opportunity to 
establish lifetime relationships.  To help assure this 
opportunity, public social services must be directed 
toward accomplishment of the following purposes: 
    (1) preventing the unnecessary separation of children from 
their families by identifying family problems, assisting 
families in resolving their problems, and preventing breakup of 
the family if the prevention of child removal it is desirable 
and possible; 
    (2) restoring to their families children who have been 
removed, by continuing to provide services to the reunited child 
and the families; 
    (3) placing children in suitable adoptive homes, in cases 
where restoration to the biological family is not possible or 
appropriate; and 
    (4) assuring adequate care of children away from their 
homes, in cases where the child cannot be returned home or 
cannot be placed for adoption. 
    Sec. 11.  Minnesota Statutes 1990, section 256F.02, is 
amended to read: 
    256F.02 [CITATION.] 
    Sections 256F.01 to 256F.07 may be cited as the "permanency 
planning grants to counties Minnesota family preservation act." 
    Sec. 12.  Minnesota Statutes 1990, section 256F.03, 
subdivision 5, is amended to read: 
    Subd. 5.  [FAMILY-BASED SERVICES.] "Family-based services" 
means intensive family-centered services to families primarily 
in their own home and for a limited time. one or more of the 
services described in paragraphs (a) to (f) provided to families 
primarily in their own home for a limited time.  Family-based 
services eligible for funding under the family preservation act 
are the services described in paragraphs (a) to (f). 
    (a) [CRISIS SERVICES.] "Crisis services" means professional 
services provided within 24 hours of referral to alleviate a 
family crisis and to offer an alternative to placing a child 
outside the family home.  The services are intensive and time 
limited.  The service may offer transition to other appropriate 
community-based services. 
    (b) [COUNSELING SERVICES.] "Counseling services" means 
professional family counseling provided to alleviate individual 
and family dysfunction; provide an alternative to placing a 
child outside the family home; or permit a child to return 
home.  The duration, frequency, and intensity of the service is 
determined in the individual or family service plan. 
    (c) [LIFE MANAGEMENT SKILLS SERVICES.] "Life management 
skills services" means paraprofessional services that teach 
family members skills in such areas as parenting, budgeting, 
home management, and communication.  The goal is to strengthen 
family skills as an alternative to placing a child outside the 
family home or to permit a child to return home.  A social 
worker shall coordinate these services within the family case 
plan. 
    (d) [CASE COORDINATION SERVICES.] "Case coordination 
services" means professional services provided to an individual, 
family, or caretaker as an alternative to placing a child 
outside the family home, to permit a child to return home, or to 
stabilize the long-term or permanent placement of a child.  
Coordinated services are provided directly, are arranged, or are 
monitored to meet the needs of a child and family.  The 
duration, frequency, and intensity of services is determined in 
the individual or family service plan. 
    (e) [MENTAL HEALTH SERVICES.] "Mental health services" 
means the professional services defined in section 245.4871, 
subdivision 31. 
    (f) [EARLY INTERVENTION SERVICES.] "Early intervention 
services" means family-based intervention services designed to 
help at-risk families avoid crisis situations. 
    Sec. 13.  Minnesota Statutes 1990, section 256F.04, is 
amended to read: 
    256F.04 [DUTIES OF COMMISSIONER OF HUMAN SERVICES.] 
    Subdivision 1.  [GRANT PROGRAM.] The commissioner shall 
establish a statewide permanency planning family preservation 
grant program to assist counties in providing placement 
prevention and family reunification services. 
    Subd. 2.  [FORMS AND INSTRUCTIONS.] The commissioner shall 
provide necessary forms and instructions to the counties for 
their community social services plan, as required in section 
256E.09, that incorporate the permanency plan format and 
information necessary to apply for a permanency planning family 
preservation grant.  For calendar year 1986, the local social 
services agency shall submit an amendment to their approved 
biennial community social services plan using the forms and 
instructions provided by the commissioner.  Beginning January 1, 
1986, the biennial community social services plan must include 
the permanency plan. 
    Subd. 3.  [MONITORING.] The commissioner shall design and 
implement methods for monitoring the delivery and evaluating the 
effectiveness of placement prevention and family reunification 
services including family-based services within the state 
according to section 256E.05, subdivision 3, paragraph (e).  An 
evaluation report describing program implementation, client 
outcomes, cost, and the effectiveness of those services in 
relation to measurable objectives and performance criteria to 
keep families unified and minimize the use of out-of-home 
placements for children must be prepared by the commissioner for 
the period from January 1, 1986 through June 30, 1988.  The 
commissioner shall monitor the provision of family-based 
services, conduct evaluations, and prepare and submit biannual 
reports to the legislature. 
    Subd. 4.  [TRAINING.] The commissioner shall provide 
training on family-based services. 
    Sec. 14.  Minnesota Statutes 1990, section 256F.05, is 
amended to read: 
    256F.05 [DISTRIBUTION OF GRANTS.] 
    Subd. 2.  [MONEY AVAILABLE.] Money appropriated for 
permanency planning family preservation grants to counties, 
together with an amount as determined by the commissioner of 
title IV-B funds distributed to Minnesota according to the 
Social Security Act, United States Code, title 42, section 621, 
must be distributed to counties on a calendar year basis 
according to the formula in subdivision 3. 
    Subd. 2a.  [DISTRIBUTION OF FUNDS.] Additional federal 
funds received by the commissioner, under title IV-E of the 
Social Security Act, as a direct result of revenue enhancement 
activities initiated subsequent to January 1, 1991, shall be 
allocated to counties.  One-half of the allocation is for family 
preservation services under this chapter to be allocated as 
follows:  
    (1) 50 percent based on a county's title IV-E earnings for 
family preservation services under this chapter during the 
previous calendar year; and 
    (2) 50 percent based on the formula set forth in 
subdivision 3. 
    Subd. 3.  [FORMULA.] The amount of money distributed 
allocated to counties under subdivision 2 must be based on the 
following two factors: 
    (1) the population of the county under age 19 years as 
compared to the state as a whole as determined by the most 
recent data from the state demographer's office; and 
    (2) the county's percentage share of the number of minority 
children in substitute care as determined by the most recent 
department of human services annual report on children in foster 
care. 
    The amount of money allocated according to formula factor 
(1) must not be less than 90 percent of the total distributed 
allocated under subdivision 2. 
    Subd. 4.  [PAYMENTS.] The commissioner shall make grant 
payments to each county whose biennial community social services 
plan includes a permanency plan under section 256F.04, 
subdivision 2.  The payment must be made in four installments 
per year.  The commissioner may certify the payments for the 
first three months of a calendar year.  Subsequent payments must 
be made on April 30 May 15, July 30 August 15, and October 30 
November 15, of each calendar year.  When an amount of title 
IV-B funds as determined by the commissioner is made available, 
it shall be reimbursed to counties on October 30 November 15. 
    Subd. 4a.  [SPECIAL INCENTIVE BONUS FOR EARLY INTERVENTION 
SERVICES.] In addition to the funds which are provided to 
counties under subdivision 2 and distributed according to the 
formula in subdivision 3, the commissioner, in consultation with 
persons knowledgeable in child abuse and neglect early 
intervention, shall, within the limits of appropriations made 
specifically for this purpose, and as part of each quarterly 
payment made under subdivision 4, provide an incentive bonus 
payment to counties as provided in this subdivision.  If a 
county, in submitting its application for funds under this 
section for a given calendar year, notifies the commissioner 
that the county will be increasing the amount of funds that will 
be allocated for counseling services under section 256F.03, 
subdivision 5, paragraph (b); life management skills under 
section 256F.03, subdivision 5, paragraph (c); and early 
intervention family-based services under section 256F.03, 
subdivision 5, paragraph (f), above the amount allocated in the 
previous calendar year, the commissioner shall provide the 
county with a bonus equal to 50 percent of the increased county 
allocation for the early intervention services.  If funds are 
insufficient to provide the full 50 percent bonus to all 
eligible counties, the funds shall be allocated 
proportionately.  A county may not reduce the amount of 
permanency planning grant funds which it makes available for 
other services, in order to earn the bonus incentive.  The 
special incentive bonus is subject to retroactive settle-up 
based on the actual county allocation. 
    Subd. 5.  [INAPPROPRIATE EXPENDITURES.] Permanency planning 
Family preservation grant money must not be used for: 
    (1) child day care necessary solely because of the 
employment or training to prepare for employment, of a parent or 
other relative with whom the child is living; 
    (2) residential facility payments; 
    (3) adoption assistance payments; 
    (4) public assistance payments for aid to families with 
dependent children, supplemental aid, medical assistance, 
general assistance, general assistance medical care, or 
community health services authorized by sections 145A.09 to 
145A.13; or 
    (5) administrative costs for local social services agency 
public assistance staff.  
    Subd. 6.  [TERMINATION OF GRANT.] A grant may be reduced or 
terminated by the commissioner when the county agency has failed 
to comply with the terms of the grant or sections 256F.01 to 
256F.07. 
    Subd. 7.  [TRANSFER OF FUNDS.] Notwithstanding subdivision 
1, the commissioner may transfer money from the appropriation 
for permanency planning family preservation grants to counties 
into the subsidized adoption account when a deficit in the 
subsidized adoption program occurs.  The amount of the transfer 
must not exceed five percent of the appropriation for permanency 
planning family preservation grants to counties.  
    Subd. 8.  [GRANTS FOR FAMILY-BASED CRISIS SERVICES.] Within 
the limits of appropriations made for this purpose, the 
commissioner may award grants for the families first program, 
including section 256F.08, to be distributed on a calendar year 
basis to counties to provide programs for family-based crisis 
services defined in section 256F.03, subdivision 5.  The 
commissioner shall ask counties to present proposals for the 
funding and shall award grants for the funding on a competitive 
basis.  Beginning January 1, 1993, the state share of the costs 
of the programs shall be 75 percent and the county share, 25 
percent. 
    Sec. 15.  Minnesota Statutes 1990, section 256F.06, is 
amended to read: 
    256F.06 [DUTIES OF COUNTY BOARDS.] 
    Subdivision 1.  [RESPONSIBILITIES.] A county board may, 
alone or in combination with other county boards, apply for a 
permanency planning family preservation grant as provided in 
section 256F.04, subdivision 2.  Upon approval of the permanency 
planning family preservation grant, the county board may 
contract for or directly provide placement prevention and family 
reunification services family-based services. 
    Subd. 2.  [USES OF GRANTS.] The grant must be used 
exclusively for placement prevention, family reunification 
services and training for family-based service and permanency 
planning services.  The grant may not be used as a match for 
other federal money or to meet the requirements of section 
256E.06, subdivision 5. 
    Subd. 3.  [DESCRIPTION OF FAMILY-BASED SERVICE.] When a 
county board elects to provide family-based service as a part of 
its permanency plan, its written description of family-based 
service must include the number of families to be served in each 
caseload, the provider of the service, the planned frequency of 
contacts with the families, and the maximum length of time 
family-based service will be provided to families. 
    Subd. 4.  [REPORTING.] The commissioner shall specify 
requirements for reports, including quarterly fiscal reports, 
according to section 256.01, subdivision 2, paragraph (17).  The 
reports must include: 
    (1) a detailed statement of expenses attributable to the 
grant during the preceding quarter; and 
    (2) a statement of the expenditure of money for placement 
prevention and family reunification family-based services by the 
county during the preceding quarter, including the number of 
clients served and the expenditures, by client, for each service 
provided.  
    Sec. 16.  Minnesota Statutes 1990, section 256F.07, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PREPLACEMENT REVIEW.] Each county board 
shall establish a preplacement procedure to review each request 
for substitute care placement and determine if appropriate 
community resources have been utilized before making a 
substitute care placement.  Emergency placements shall be 
reviewed to determine services necessary to allow a child to 
return home.  Placements shall be reviewed for compliance with 
the minority family heritage act, sections 257.072 and 259.255; 
the Minnesota minority family preservation act, section 260.181, 
subdivision 3; the Minnesota Indian family preservation act, 
sections 257.35 to 257.356; and the Indian Child Welfare Act of 
1978, United States Code, title 25, part 1901.  
    Sec. 17.  Minnesota Statutes 1990, section 256F.07, 
subdivision 2, is amended to read: 
    Subd. 2.  [PROCEDURE FOR PLACEMENT.] When the preplacement 
review has determined that a substitute care placement is 
required because the child is in imminent risk of abuse or 
neglect; or requires treatment of an emotional disorder, 
chemical dependency, or mental retardation; the agency shall 
determine the level of care most appropriate to meet the child's 
needs in the least restrictive setting and in closest proximity 
to the child's family; and estimate the length of time of the 
placement, project a placement goal, and provide a statement of 
the anticipated outcome of the placement. 
    Placements must be in compliance with the minority family 
heritage act, sections 257.071 and 259.255; the Minnesota 
minority family preservation act, section 260.181, subdivision 
3; the Minnesota Indian family preservation act, sections 257.35 
to 257.356; and the Indian Child Welfare Act of 1978, United 
States Code, title 25, part 1901. 
    Sec. 18.  Minnesota Statutes 1990, section 256F.07, 
subdivision 3, is amended to read: 
    Subd. 3.  [TYPES OF SERVICES.] Placement prevention and 
family reunification services include: 
    (1) family-based service; 
    (2) individual and family counseling; 
    (3) crisis intervention and crisis counseling; 
    (4) day care; 
    (5) 24-hour emergency caretaker and homemaker services; 
    (6) emergency shelter care up to 30 days in 12 months; 
    (7) access to emergency financial assistance; 
    (8) arrangements to provide temporary respite care to the 
family for up to 72 hours consecutively or 30 days in 12 months; 
and 
    (9) transportation services to the child and parents in 
order to prevent placement or accomplish reunification of the 
family family-based services as defined in section 256F.03, 
subdivision 5.  
    Family-based services must be coordinated with additional 
services identified and funded in the county social service act 
plan to provide a comprehensive placement prevention and family 
reunification services program. 
    Sec. 19.  Minnesota Statutes 1990, section 257.071, 
subdivision 1a, is amended to read: 
    Subd. 1a.  [PROTECTION OF HERITAGE OR BACKGROUND.] The 
authorized child placing agency shall ensure that the child's 
best interests are met by giving due consideration of the 
child's race or ethnic heritage in making a family foster care 
placement.  The authorized child placing agency shall place a 
child, released by court order or by voluntary release by the 
parent or parents, in a family foster home selected by following 
the preferences described in section 260.181, subdivision 3.  In 
instances where a child from a family of color is placed in a 
family foster home of a different racial or ethnic background, 
the local social service agency shall review the placement after 
30 days and each 30 days thereafter for the first six months to 
determine if there is another available placement that would 
better satisfy the requirements of this subdivision. 
    Sec. 20.  [257.0755] [OFFICE OF OMBUDSPERSON; CREATION; 
QUALIFICATIONS; FUNCTION.] 
    An ombudsperson for families shall be appointed to operate 
independently but under the auspices of each of the following 
groups:  the Indian Affairs Council, the Spanish-Speaking 
Affairs Council, the Council on Black Minnesotans, and the 
Council on Asian-Pacific Minnesotans.  Each of these groups 
shall select its own ombudsperson subject to final approval by 
the advisory board established under section 257.0768.  Each 
ombudsperson shall serve at the pleasure of the advisory board, 
shall be in the unclassified service, shall be selected without 
regard to political affiliation, and shall be a person highly 
competent and qualified to analyze questions of law, 
administration, and public policy regarding the protection and 
placement of children from families of color.  In addition, the 
ombudsperson must be experienced in dealing with communities of 
color and knowledgeable about the needs of those communities.  
No individual may serve as ombudsperson while holding any other 
public office.  The ombudsperson shall have the authority to 
investigate decisions, acts, and other matters of an agency, 
program, or facility providing protection or placement services 
to children of color. 
    Sec. 21.  [257.076] [DEFINITIONS.] 
    Subdivision 1.  [SCOPE.] For the purposes of sections 
257.0755 to 257.0768, the following terms shall have the 
meanings given them in this section. 
    Subd. 2.  [AGENCY.] "Agency" means the divisions, 
officials, or employees of the state departments of human 
services and health and local district courts or a designated 
county social service agency as defined in section 256G.02, 
subdivision 7, engaged in providing child protection and 
placement services for children.  "Agency" also means any 
individual, service, or program providing child protection or 
placement services in coordination with or under contract to any 
other entity specified in this subdivision. 
    Subd. 3.  [COMMUNITIES OF COLOR.] "Communities of color" 
means the following:  American Indian, Hispanic-Latino, 
Asian-Pacific, African, and African-American communities. 
    Subd. 4.  [COMPADRAZGO.] "Compadrazgo" is a kinship 
institution within the Hispanic-Latino community used as a means 
of parenting and caring for children from birth to adulthood. 
    Subd. 5.  [FAMILY OF COLOR.] "Family of color" means any 
family with a child under the age of 18 who is identified by one 
or both parents or another trusted adult to be of American 
Indian, Hispanic-Latino, Asian-Pacific, African, or 
African-American descent. 
    Subd. 6.  [FACILITY.] "Facility" means any entity required 
to be licensed under chapter 245A. 
    Subd. 7.  [TRUSTED ADULT.] "Trusted adult" means an 
individual recognized by the child's parent or legal guardian, 
the child's community, or both, as speaking for the child's best 
interest.  The term includes compadrazgo and other individuals 
with a kinship or community relationship with the child. 
    Sec. 22.  [257.0761] [ORGANIZATION OF OFFICE OF 
OMBUDSPERSON.] 
    Subdivision 1.  [STAFF; UNCLASSIFIED STATUS; 
RETIREMENT.] The ombudsperson for each group specified in 
section 257.0755 may select, appoint, and compensate out of 
available funds the assistants and employees as deemed necessary 
to discharge responsibilities.  All employees, except the 
secretarial and clerical staff, shall serve at the pleasure of 
the ombudsperson in the unclassified service.  The ombudsperson 
and full-time staff shall be members of the Minnesota state 
retirement association.  
    Subd. 2.  [DELEGATION TO STAFF.] The ombudsperson may 
delegate to staff members any of the ombudsperson's authority or 
duties except the duty of formally making recommendations to an 
administrative agency or reports to the office of the governor, 
or to the legislature.  
    Sec. 23.  [257.0762] [DUTIES AND POWERS.] 
    Subdivision 1.  [DUTIES.] (a) Each ombudsperson shall 
monitor agency compliance with all laws governing child 
protection and placement, as they impact on children of color.  
In particular, the ombudsperson shall monitor agency compliance 
with sections 256F.07, subdivision 3a; 256F.08; 257.072; 
257.075; 257.35 to 257.3579; and 260.181, subdivision 3. 
    (b) The ombudsperson shall work with local state courts to 
ensure that: 
    (1) court officials, public policymakers, and service 
providers are trained in cultural diversity.  The ombudsperson 
shall document and monitor court activities in order to heighten 
awareness of diverse belief systems and family relationships; 
    (2) experts from the appropriate community of color 
including tribal advocates are used as court advocates and are 
consulted in placement decisions that involve children of color; 
    (3) guardians ad litem and other individuals from 
communities of color are recruited, trained, and used in court 
proceedings to advocate on behalf of children of color; and 
    (4) training programs for bilingual workers are provided. 
    Subd. 2.  [POWERS.] In carrying out the duties in 
subdivision 1, each ombudsperson has the power to: 
    (1) prescribe the methods by which complaints are to be 
made, reviewed, and acted upon; 
    (2) determine the scope and manner of investigations to be 
made; 
    (3) investigate, upon a complaint or upon personal 
initiative, any action of any agency; 
    (4) request and be given access to any information in the 
possession of any agency deemed necessary for the discharge of 
responsibilities.  The ombudsperson is authorized to set 
reasonable deadlines within which an agency must respond to 
requests for information.  Data obtained from any agency under 
this clause shall retain the classification which it had under 
section 13.02 and shall be maintained and disseminated by the 
ombudsperson according to chapter 13; 
    (5) examine the records and documents of an agency; 
    (6) enter and inspect, during normal business hours, 
premises within the control of an agency; and 
    (7) subpoena any agency personnel to appear, testify, or 
produce documentary or other evidence which the ombudsperson 
deems relevant to a matter under inquiry, and may petition the 
appropriate state court to seek enforcement with the subpoena; 
provided, however, that any witness at a hearing or before an 
investigation as herein provided, shall possess the same 
privileges reserved to such a witness in the courts or under the 
laws of this state.  The ombudsperson may compel nonagency 
individuals to testify or produce evidence according to 
procedures developed by the advisory board. 
    Sec. 24.  [257.0763] [MATTERS APPROPRIATE FOR REVIEW.] 
    (a) In selecting matters for review, an ombudsperson should 
give particular attention to actions of an agency, facility, or 
program that: 
    (1) may be contrary to law or rule; 
    (2) may be unreasonable, unfair, oppressive, or 
inconsistent with a policy or order of an agency, facility, or 
program; 
    (3) may result in abuse or neglect of a child; 
    (4) may disregard the rights of a child or other individual 
served by an agency or facility; or 
    (5) may be unclear or inadequately explained, when reasons 
should have been revealed. 
    (b) An ombudsperson shall, in selecting matters for review, 
inform other interested agencies in order to avoid duplicating 
other investigations or regulatory efforts, including activities 
undertaken by a tribal organization under the authority of 
sections 257.35 to 257.3579. 
    Sec. 25.  [257.0764] [COMPLAINTS.] 
    An ombudsperson may receive a complaint from any source 
concerning an action of an agency, facility, or program.  After 
completing a review, the ombudsperson shall inform the 
complainant, agency, facility, or program.  Services to a child 
shall not be unfavorably altered as a result of an investigation 
or complaint.  An agency, facility, or program shall not 
retaliate or take adverse action, as defined in section 626.556, 
subdivision 4a, paragraph (c), against an individual who, in 
good faith, makes a complaint or assists in an investigation. 
    Sec. 26.  [257.0765] [RECOMMENDATIONS TO AGENCY.] 
    (a) If, after reviewing a complaint or conducting an 
investigation and considering the response of an agency, 
facility, or program and any other pertinent material, the 
ombudsperson determines that the complaint has merit or the 
investigation reveals a problem, the ombudsperson may recommend 
that the agency, facility, or program: 
    (1) consider the matter further; 
    (2) modify or cancel its actions; 
    (3) alter a rule, order, or internal policy; 
    (4) explain more fully the action in question; or 
    (5) take other action as authorized under section 257.0762. 
    (b) At the ombudsperson's request, the agency, facility, or 
program shall, within a reasonable time, inform the ombudsperson 
about the action taken on the recommendation or the reasons for 
not complying with it. 
    Sec. 27.  [257.0766] [RECOMMENDATIONS AND PUBLIC REPORTS.] 
    Subdivision 1.  [SPECIFIC REPORTS.] An ombudsperson may 
send conclusions and suggestions concerning any matter reviewed 
to the governor and shall provide copies of all reports to the 
advisory board and to the groups specified in section 257.0768, 
subdivision 1.  Before making public a conclusion or 
recommendation that expressly or implicitly criticizes an 
agency, facility, program, or any person, the ombudsperson shall 
inform the governor and the affected agency, facility, program, 
or person concerning the conclusion or recommendation.  When 
sending a conclusion or recommendation to the governor that is 
adverse to an agency, facility, program, or any person, the 
ombudsperson shall include any statement of reasonable length 
made by that agency, facility, program, or person in defense or 
mitigation of the ombudsperson's conclusion or recommendation. 
    Subd. 2.  [GENERAL REPORTS.] In addition to whatever 
conclusions or recommendations the ombudsperson may make to the 
governor on an ad hoc basis, the ombudsperson shall at the end 
of each year report to the governor concerning the exercise of 
the ombudsperson's functions during the preceding year. 
    Sec. 28.  [257.0767] [CIVIL ACTIONS.] 
    The ombudsperson and designees are not civilly liable for 
any action taken under sections 257.0755 to 257.0768 if the 
action was taken in good faith, was within the scope of the 
ombudsperson's authority, and did not constitute willful or 
reckless misconduct. 
    Sec. 29.  [257.0768] [OMBUDSPERSON'S ADVISORY COMMITTEE.] 
    Subdivision 1.  [MEMBERSHIP.] The appointment of each 
ombudsperson is subject to approval by an advisory committee 
consisting of no more than 17 members.  Members of the advisory 
committee shall be appointed by the following groups:  the 
Indian Affairs Council; the Spanish-Speaking Affairs Council; 
the Council on Black Minnesotans; and the Council on 
Asian-Pacific Minnesotans.  The committee shall provide advice 
and counsel to each ombudsperson. 
    Subd. 2.  [COMPENSATION; CHAIR.] Members do not receive 
compensation but are entitled to receive reimbursement for 
reasonable and necessary expenses incurred.  The members shall 
designate four rotating chairpersons to serve annually at the 
pleasure of the members. 
    Subd. 3.  [MEETINGS.] The committee shall meet at least 
four times a year at the request of its chair or the 
ombudspersons. 
    Subd. 4.  [DUTIES.] The committee shall advise and assist 
the ombudspersons in selecting matters for attention; developing 
policies, plans, and programs to carry out the ombudspersons' 
functions and powers; establishing protocols for working with 
the communities of color; developing procedures for the 
ombudspersons' use of the subpoena power to compel testimony and 
evidence from nonagency individuals; and making reports and 
recommendations for changes designed to improve standards of 
competence, efficiency, justice, and protection of rights.  The 
committee shall function as an advisory body. 
    Subd. 5.  [TERMS, COMPENSATION, REMOVAL, AND 
EXPIRATION.] The membership terms, compensation, and removal of 
members of the committee and the filling of membership vacancies 
are governed by section 15.0575. 
    Sec. 30.  [257.0769] [FUNDING FOR THE OMBUDSPERSON 
PROGRAM.] 
    (a) Money is appropriated from the special fund authorized 
by section 256.01, subdivision 2, clause (15), to the Indian 
Affairs Council for the purposes of sections 257.0755 to 
257.0768. 
    (b) Money is appropriated from the special fund authorized 
by section 256.01, subdivision 2, clause (15), to the 
Spanish-speaking Affairs Council for the purposes of sections 
257.0755 to 257.0768. 
    (c) Money is appropriated from the special fund authorized 
by section 256.01, subdivision 2, clause (15), to the Council of 
Black Minnesotans for the purposes of sections 257.0755 to 
257.0768. 
    (d) Money is appropriated from the special fund authorized 
by section 256.01, subdivision 2, clause (15), to the Council on 
Asian-Pacific Minnesotans for the purposes of sections 257.0755 
to 257.0768. 
    Sec. 31.  Minnesota Statutes 1990, section 257.352, 
subdivision 2, is amended to read: 
    Subd. 2.  [AGENCY NOTICE OF POTENTIAL OUT-OF-HOME 
PLACEMENT.] When a local social service agency or private child 
placing agency determines that an Indian child is in a dependent 
or other condition that could lead to an out-of-home placement 
and requires the continued involvement of the agency with the 
child for a period in excess of 30 days, the agency shall send 
notice of the condition and of the initial steps taken to remedy 
it to the Indian child's tribal social service agency within 
seven days of the determination.  At this and any subsequent 
stage of its involvement with an Indian child, the agency shall, 
upon request, give the tribal social service agency full 
cooperation including access to all files concerning the child.  
If the files contain confidential or private data, the agency 
may require execution of an agreement with the tribal social 
service agency that the tribal social service agency shall 
maintain the data according to statutory provisions applicable 
to the data.  This subdivision applies whenever the court 
transfers legal custody of an Indian child under section 
260.185, subdivision 1, paragraph (c), clause (1), (2), or (3) 
following an adjudication for a misdemeanor-level delinquent act.
     Sec. 32.  Minnesota Statutes 1990, section 261.035, is 
amended to read: 
    261.035 [BURIAL AT EXPENSE OF COUNTY.] 
    When a person dies in any county without apparent means to 
provide for burial and without relatives of sufficient ability 
to procure the burial, the county board shall first investigate 
to determine whether the person who has died has contracted for 
any prepaid burial arrangements.  If such arrangements have been 
made, the county shall authorize burial in accord with the 
written instructions of the deceased.  If it is determined that 
the person did not leave sufficient means to defray the 
necessary expenses of burial, nor any relatives therein of 
sufficient ability to procure the burial, the county board shall 
cause a decent burial or cremation of the person's remains to be 
made at the expense of the county.  Cremation shall not be used 
for persons who are known to be opposed to cremation because of 
religious affiliation or belief. 
    Sec. 33.  Minnesota Statutes 1990, section 268.022, 
subdivision 2, is amended to read: 
    Subd. 2.  [DISBURSEMENT OF SPECIAL ASSESSMENT FUNDS.] (a) 
The money collected under this section shall be deposited in the 
state treasury and credited to a dedicated fund to provide for 
the dislocated worker programs established under sections 
268.975 to 268.98; including vocational guidance, training, 
placement, and job development. 
    (b) All money in the dedicated fund is appropriated to the 
commissioner who must act as the fiscal agent for the money and 
must disburse the money for the purposes of this section, not 
allowing the money to be used for any other obligation of the 
state.  All money in the dedicated fund shall be deposited, 
administered, and disbursed in the same manner and under the 
same conditions and requirements as are provided by law for the 
other dedicated funds in the state treasury, except that all 
interest or net income resulting from the investment or deposit 
of money in the fund shall accrue to the fund for the purposes 
of the fund. 
    (c) No more than five percent of the dedicated funds 
collected in each fiscal year may be used by the department of 
jobs and training for its administrative costs. 
    (d) The dedicated funds, less amounts under paragraph (c), 
must be allocated as follows: 
    (1) 50 percent to be allocated according to paragraph (e) 
to the substate grantees under subchapter III of the Job 
Training Partnership Act, United States Code, title 29, section 
1661a in proportion to each substate area's share of the federal 
allocated funds, to be used to assist dislocated workers under 
the standards in section 268.98; 
    (2) 50 percent to fund specific programs proposed under the 
state plan request for proposal process and recommended by the 
governor's job training council.  This fund shall be used for 
state plan request for proposal programs addressing plant 
closings or layoffs regardless of size; and 
    (3) in fiscal years 1991, 1992, and 1993, any amounts 
transferred to the general fund or obligated before the 
effective date of this section shall be excluded from the 
calculation under this paragraph. 
    (e) In the event that a substate grantee has obligated 100 
percent of its formula allocated federal funds under subchapter 
III of the Job Training Partnership Act, United States Code, 
title 29, section 1651 et seq., and has demonstrated appropriate 
use of the funds to the governor's job training council, the 
substate grantee may request and the commissioner shall provide 
additional funds to the substate area in an amount equal to the 
federal formula allocated funds.  When a substate grantee has 
obligated 100 percent of the additional funds provided under 
this section, and has demonstrated appropriate use of the funds 
to the governor's job training council, the substate grantee may 
request and the commissioner shall provide further additional 
funds in amounts equal to the federal formula allocated funds 
until the substate area receives its proportionate share of 
funds under paragraph (d), clause (1). 
    (f) By December 31 of each fiscal year each substate 
grantee and the governor's job training council shall report to 
the commissioner on the extent to which funds under this section 
are committed and the anticipated demand for funds for the 
remainder of the fiscal year.  The commissioner shall reallocate 
those funds that the substate grantees and the council do not 
anticipate expending for the remainder of the fiscal year to be 
available for requests from other substate grantees or other 
dislocated worker projects proposed to the governor's job 
training council which demonstrate a need for additional funding.
    (g) Due to the anticipated quarterly variations in the 
amounts collected under this section, the amounts allocated 
under paragraph (d) must be based on collections for each 
quarter.  Any amount collected in the final two quarters of the 
fiscal year, but not allocated, obligated or expended in the 
fiscal year, shall be available for allocation, obligation and 
expenditure in the following fiscal year. 
    Sec. 34.  Minnesota Statutes 1990, section 268.914, is 
amended to read: 
    268.914 [DISTRIBUTION OF APPROPRIATION.] 
    Subdivision 1.  [STATE SUPPLEMENT FOR FEDERAL GRANTEES.] (a)
The commissioner of jobs and training shall distribute money 
appropriated for that purpose to head start program grantees to 
expand services to additional low-income children.  Money must 
be allocated to each project head start grantee in existence on 
the effective date of Laws 1989, chapter 282.  Migrant and 
Indian reservation grantees must be initially allocated money 
based on the grantees' share of federal funds.  The remaining 
money must be initially allocated to the remaining local 
agencies based equally on the agencies' share of federal funds 
and on the proportion of eligible children in the agencies' 
service area who are not currently being served.  A head start 
grantee must be funded at a per child rate equal to its 
contracted, federally funded base level for program accounts 20 
to 26 at the start of the fiscal year.  The commissioner may 
provide additional funding to grantees for start-up costs 
incurred by grantees due to the increased number of children to 
be served.  Before paying money to the grantees, the 
commissioner shall notify each grantee of its initial 
allocation, how the money must be used, and the number of 
low-income children that must be served with the allocation.  
Each grantee must notify the commissioner of the number of 
additional low-income children it will be able to serve.  For 
any grantee that cannot serve additional children to its full 
allocation, the commissioner shall reduce the allocation 
proportionately.  Money available after the initial allocations 
are reduced must be redistributed to eligible grantees. 
     (b) Up to 11 percent of the funds appropriated annually may 
be used to provide grants to local head start agencies to 
provide funds for innovative programs designed either to target 
head start resources to particular at-risk groups of children or 
to provide services in addition to those currently allowable 
under federal head start regulations.  The commissioner shall 
award funds for innovative programs under this paragraph on a 
competitive basis. 
    Subd. 2.  [SERVICE EXPANSION GRANTS.] One-third of any 
biennial increase in the state appropriations for head start 
programs shall be allocated by the commissioner of jobs and 
training, under a request for proposal system, to existing head 
start grantees for service expansion. 
    Priority for state-funded service expansion grants must be 
given to applicants who propose to: 
    (1) coordinate or co-locate the services through an 
existing community-based, family-oriented program such as a 
family resource center; 
    (2) minimize the amount of state funding that is needed for 
initial construction or remodeling costs by using an existing 
facility, by sharing a facility with a school or other program, 
or by obtaining contributions for these costs from private or 
local sources; 
    (3) reduce the costs and time of transportation by enabling 
children to attend a program closer to their home communities; 
    (4) increase services in an area where less than 15 percent 
of eligible children are enrolled; and 
    (5) expand programs within a city where no center-based 
program exists. 
    The additional funds provided to a grantee under this 
subdivision shall be considered part of the grantees funding 
base for future formula allocations of state or federal funds. 
    Sec. 35.  Minnesota Statutes 1990, section 268.975, 
subdivision 3, is amended to read: 
    Subd. 3.  [DISLOCATED WORKER.] "Dislocated worker" means an 
individual who: 
    (1) has been terminated or who has received a notice of 
termination of from employment as a result of a plant closing or 
any substantial layoff at a plant, facility, or enterprise 
located in the state, is eligible for or has exhausted 
entitlement to unemployment compensation, and is unlikely to 
return to the previous industry or occupation; 
    (2) was a resident of the state at the time has been 
terminated or has received a notice of termination of employment 
or at the time of receiving the notification of termination of 
employment as a result of any plant closing or any substantial 
layoff at a plant, facility, or enterprise; and 
    (3) is eligible for or has exhausted unemployment 
compensation and is unlikely to return to the previous industry 
or occupation has been long-term unemployed and has limited 
opportunities for employment or reemployment in the same or a 
similar occupation in the area in which the individual resides, 
including older individuals who may have substantial barriers to 
employment by reason of age; 
    (4) has been self-employed, including farmers and ranchers, 
and is unemployed as a result of general economic conditions in 
the community in which the individual resides or because of 
natural disasters, subject to rules to be adopted by the 
commissioner; or 
    (5) has been terminated or who has received a notice of 
termination from employment with a public or nonprofit employer. 
    A dislocated worker must have been working in Minnesota at 
the time employment ceased. 
    Sec. 36.  Minnesota Statutes 1990, section 268.975, is 
amended by adding a subdivision to read: 
    Subd. 3a.  [ADDITIONAL DISLOCATED WORKER.] "Additional 
dislocated worker" means an individual who was a full-time 
homemaker for a substantial number of years and derived the 
substantial share of his or her support from: 
    (1) a spouse and no longer receives such support due to the 
death, divorce, permanent disability of, or permanent separation 
from the spouse; or 
    (2) public assistance on account of dependents in the home 
and no longer receives such support. 
    An additional dislocated worker must have resided in 
Minnesota at the time the support ceased. 
    Sec. 37.  Minnesota Statutes 1990, section 268.977, is 
amended to read: 
    268.977 [RAPID RESPONSE PROGRAM.] 
    Subdivision 1.  [PROGRAM ESTABLISHMENT.] (a) The 
commissioner shall establish a rapid response program to (1) 
assist employees, employers, business organizations or 
associations, labor organizations, local government units, and 
community organizations to quickly and effectively respond to 
announced or actual plant closings and substantial layoffs and 
(2) assist dislocated workers and additional dislocated 
workers.  Grant recipients and substate grantees may, but shall 
not be required to, subcontract with the department for 
readjustment services. 
    (b) The program must include or address at least the 
following: 
    (1) within five working days after becoming aware of an 
announced or actual plant closing or substantial layoff, 
establish on-site contact with the employer, employees, labor 
organizations if there is one representing the employees, and 
leaders of the local government units and community 
organizations to provide coordination of efforts to formulate a 
communitywide response to the plant closing or substantial 
layoff, provide information on the public and private service 
and programs that might be available, inform the affected 
parties of the prefeasibility study grants under section 
268.978, and collect any information required by the 
commissioner to assist in responding to the plant closing or 
substantial layoff; 
    (2) provide ongoing technical assistance to employers, 
employees, business organizations or associations, labor 
organizations, local government units, and community 
organizations to assist them in reacting to or developing 
responses to plant closings or substantial layoffs; 
    (3) establish and administer the prefeasibility study grant 
program under section 268.978 to provide an initial assessment 
of the feasibility of alternatives to plant closings or 
substantial layoffs; 
    (4) work with employment and training service providers, 
employers, business organizations or associations, labor 
organizations, local government units, dislocated workers, and 
community organizations in providing training, education, 
community support service, job search programs, job clubs, and 
other services to address the needs of potential or actual 
dislocated workers; 
    (5) coordinate with providers of economic development 
related financial and technical assistance services so that 
communities that are experiencing plant closings or substantial 
layoffs have immediate access to economic development related 
services; and 
    (6) collect and make available information on programs that 
might assist dislocated workers and the communities affected by 
plant closings or substantial layoffs; and 
    (7) when they can be provided without adversely affecting 
delivery of services to all dislocated workers, the services 
under clause (4) shall be available to additional dislocated 
workers as defined in section 268.975, subdivision 3a. 
    Subd. 2.  [APPLICABILITY.] Notwithstanding section 268.975, 
subdivisions 6 and 8, the commissioner may waive the threshold 
requirements for finding a plant closing or substantial layoff 
in special cases where the governor's job training council 
recommends waiver to the commissioner following a finding by the 
council that the number of workers dislocated as a result of a 
plant closing or substantial layoff would have a substantial 
impact on the community or labor market where the closure or 
layoff occurs and, in the absence of intervention through the 
rapid response program, would overwhelm the capacity of other 
programs to provide effective assistance.  A proposal for a 
program recommended for funding by the governor's job training 
council shall not be denied based upon the increased funding and 
resources of substate areas. 
    Sec. 38.  Minnesota Statutes 1990, section 268.98, is 
amended to read: 
    268.98 [PERFORMANCE STANDARDS.] 
    (a) The commissioner shall establish performance standards 
for the programs and activities administered or funded through 
the rapid response program under section 268.977.  The 
commissioner may use existing federal performance standards or, 
if the commissioner determines that the federal standards are 
inadequate or not suitable, may formulate new performance 
standards to ensure that the programs and activities of the 
rapid response program are effectively administered. 
    (b) Not less than 20 percent of the funds expended under 
this section must be used to provide needs-related payments and 
other supportive services as those terms are used in subchapter 
III of the Job Training Partnership Act, United States Code, 
title 29, section 1661d(b).  This requirement does not apply to 
the extent that a program proposal requests less than 20 percent 
of such funds.  At the end of the fiscal year, each substate 
grantee and each grant recipient shall report to the 
commissioner on the types of services funded under this 
paragraph and the amounts expended for such services.  By 
January 15 of each year, the commissioner shall provide a 
summary report to the legislature.  
     Sec. 39.  Minnesota Statutes 1990, section 268A.06, is 
amended by adding a subdivision to read: 
    Subd. 3.  [REHABILITATION FACILITIES:  SALARY ADJUSTMENTS; 
GRANTS.] The commissioner shall increase grants, for the fiscal 
year beginning July 1, 1991, for each rehabilitation facility by 
a salary adjustment figured by multiplying the total salaries, 
payroll taxes, and fringe benefits for personnel below top 
management by three percent.  All increased revenue produced by 
this calculation must be used for salary and related costs of 
personnel in positions below top management.  The commissioner 
shall ensure that all increased revenue produced by this 
calculation is used for salary and related costs of personnel in 
positions below top management.  
    Sec. 40.  [LAND CONVEYANCE TO CITY OF CAMBRIDGE.] 
    Notwithstanding Minnesota Statutes, sections 94.09 to 
94.16; for the purposes of this section and Laws 1990, chapter 
610, article 1, section 12, subdivision 5; on behalf of the 
Cambridge regional human services center; and in cooperation 
with the city of Cambridge, the commissioner of administration 
may transfer to the city of Cambridge the real properties, 
consisting of 68 acres, more or less, described as follows: 
    Government Lot 2, Section 6, Township 35, Range 23, Isanti 
county, Minnesota. 
 ALSO:  that part of the West Half of the Northeast Quarter, 
that part of the East Half of the Northwest Quarter, that 
part of Government Lot 4, and that part of Government Lot 
5, all in Section 5, Township 35, Range 23, Isanti county, 
Minnesota, described jointly as follows: 
 Commencing at the intersection of the North line of the 
said Section 5 and the center line of state trunk highway 
No. 65 as laid out and constructed, said point being 786.27 
feet West from the northeast corner of said Section 5; 
thence South 15 degrees 39 minutes 50 seconds West, along 
the center line of said state trunk highway No. 65 and the 
tangent line of a curve to the right, a distance of 573.03 
feet; thence on a bearing of West, a distance of 80.63 feet 
to a point to be hereinafter known as point "A", said point 
being the intersection of the westerly right-of-way line of 
said state trunk highway No. 65 with a line drawn parallel 
with and distant 50 feet South, as measured at right angles 
thereto, from the center line of state highway No. 293, as 
laid out and constructed; thence continuing on a bearing of 
West and parallel with the center line of said state 
highway No. 293, said center line being parallel with the 
North line of said Section 5, a distance of 1484.50 feet to 
a point to be hereinafter known as point "B"; thence on a 
bearing of South, a distance of 714.00 feet; thence on a 
bearing of West, a distance of 545.64 feet; thence North 6 
degrees 13 minutes 06 seconds East, a distance of 591.12 
feet to the point of beginning of the land to be herein 
described; thence South 6 degrees 13 minutes 06 seconds 
West, retracing the last described course, a distance of 
591.12 feet; thence on a bearing of East, a distance of 
545.64 feet; thence on a bearing of South, a distance of 
70.57 feet; thence South 89 degrees 15 minutes 02 seconds 
West, a distance of 957.32 feet; thence South 1 degree 37 
minutes 42 seconds East, a distance of 133.27 feet to the 
south line of the North 102.5 feet of the Southeast Quarter 
of Northwest Quarter of Section 5, as measured along the 
west line of said Southeast Quarter of Northwest Quarter; 
thence South 89 degrees 24 minutes 15 seconds West, along 
said south line, a distance of 2040.05 feet to the west 
line of said Section 5; thence northerly, along said west 
line of Section 5 to the southerly shoreline of the Rum 
River; thence easterly and northeasterly along the 
southerly and southeasterly shoreline of the Rum River to 
the north line of the Northwest Quarter of said Section 5; 
thence North 89 degrees 47 minutes 10 seconds East, along 
said north line of the Northwest Quarter of Section 5 to a 
point distant 646.00 feet west of the northeast corner of 
said Northwest Quarter of Section 5, as measured along the 
north line of said Northwest Quarter; thence South 0 
degrees 03 minutes 35 seconds East, a distance of 134.02 
feet; thence North 89 degrees 56 minutes 25 seconds East, a 
distance of 238.29 feet to the westerly line of an easement 
for highway purposes for state highway No. 293, by Transfer 
of Custodial Control, dated June 15, 1959; thence South 0 
degrees 04 minutes 00 seconds East, along said westerly 
line, a distance of 7.77 feet; thence southeasterly along a 
tangential curve in the westerly line of said easement for 
highway purposes, said curve is concave to the northeast, 
radius 381.10 feet, central angle 58 degrees 44 minutes 37 
seconds, 390.73 feet to the point of intersection with a 
line that bears North 30 degrees 00 minutes 00 seconds East 
from the point of beginning; thence South 30 degrees 00 
minutes 00 seconds West, along said line, a distance of 
240.68 feet to the point of beginning. 
 That part of Lot 30 of Auditor's Subdivision No. 9, Isanti 
county, Minnesota, described as follows: 
Commencing at the East quarter corner of Section 32, 
Township 36, Range 23, Isanti county, Minnesota; thence 
South 89 degrees 44 minutes 35 seconds West, assumed 
bearing, along the east-west quarter line of said Section 
32, a distance of 2251.43 feet; thence South 1 degree 48 
minutes 40 seconds East, a distance of 344.47 feet to the 
south line of Lot 30 of Auditor's Subdivision No. 9; thence 
South 89 degrees 35 minutes 05 seconds West along said 
south line, a distance of 205.34 feet to the west line of 
the East 1098 feet of said Lot 30 and the point of 
beginning of the parcel to be herein described; thence 
continuing South 89 degrees 35 minutes 05 seconds West 
along the south line of said Lot 30, a distance of 534.66 
feet; thence North 45 degrees 24 minutes 55 seconds West, a 
distance of 180 feet, more or less, to the shoreline of the 
Rum River; thence northeasterly along said shoreline, a 
distance of 252 feet, more or less, to the east-west 
quarter line of said Section 32; thence North 89 degrees 44 
minutes 35 seconds East along said east-west quarter line, 
a distance of 524 feet, more or less, to the west line of 
the East 1098 feet of said Lot 30; thence South 2 degrees 
40 minutes 50 seconds East along said west line, a distance 
of 345.21 feet to the point of beginning. 
 That part of the North half of the Northeast Quarter and 
that part of the Northeast Quarter of the Northwest 
Quarter, both in said Section 5, lying northerly of the 
following described line "C" and lying southerly of a line 
drawn parallel with and distant 32 feet northerly of said 
line "C" (as measured at right angles to said line "C").  
Said line "C" is described as follows: 
 Beginning at the previously described point "A"; thence on 
a bearing of West, a distance of 1484.50 feet to the 
previously described point "B"; thence continuing on a 
bearing of West, a distance of 164.52 feet to a point to be 
hereinafter known as point "D". 
 The northerly line of the strip of land described herein is 
to extend easterly to terminate on the westerly 
right-of-way line of said state trunk highway No. 65. 
 That part of the Northeast Quarter of the Northwest Quarter 
of said Section 5, lying northerly of the following 
described line "E" and lying southerly of a line drawn 
parallel with and distant 27 feet northerly of said line 
"E" (as measured at right angles to said line "E").  Said 
line "E" is described as follows: 
 Beginning at the previously described point "D", said point 
is on a curve, the tangent of said curve bears East from 
said point; thence westerly, along said curve, concave to 
the north, radius 408.10 feet, central angle 31 degrees 02 
minutes 09 seconds, a distance of 221.06 feet and there 
terminating. 
    All of the land described herein is subject to easements, 
restrictions and reservations of record, if any. 
    In accordance with this section and Laws 1990, chapter 610, 
article 1, section 12, subdivision 5, the department of human 
services and the city may attach to the transfer the conditions 
that they agree are appropriate, including conditions that 
relate to water and sewer service at the center and in the 
city.  If the transfer requires the conveyance of any interest 
in real estate, the attorney general shall prepare appropriate 
instruments of conveyance.  The deeds to convey the properties 
must contain a clause that the property will revert to the state 
if the property ceases to be used for a public purpose. 
    The city of Cambridge shall use the land to preserve flood 
plain open space, to construct a wastewater treatment facility, 
to construct a trail system, to access the regional treatment 
center cemetery, to access existing infrastructure, and other 
public purposes.  Economic development is a public purpose 
within the meaning of the term in Laws 1990, chapter 610, 
article 1, section 12, subdivision 5, and sales or conveyances 
to private parties shall be deemed as economic development.  
Property conveyed by the state under this section shall not 
revert to the state if it is conveyed or otherwise encumbered by 
the city as part of a city economic development activity.  The 
appropriation in Laws 1990, chapter 610, article 1, section 12, 
subdivision 5, expires upon the accomplishment or abandonment of 
its purpose and the purposes of this section.  
    Sec. 41.  [REPEALER.] 
    Laws 1990, chapter 568, article 6, section 4, is repealed 
effective the day following final enactment.  
    Sec. 42.  [EFFECTIVE DATE.] 
    Sections 35 to 37 are effective the day following final 
enactment. 

                                ARTICLE 4

                               HEALTH CARE
    Section 1.  Minnesota Statutes 1990, section 144A.071, 
subdivision 3, is amended to read: 
    Subd. 3.  [EXCEPTIONS.] The commissioner of health, in 
coordination with the commissioner of human services, may 
approve the addition of a new certified bed or the addition of a 
new licensed nursing home bed, under the following conditions:  
    (a) to replace a bed decertified after May 23, 1983, or to 
address an extreme hardship situation, in a particular county 
that, together with all contiguous Minnesota counties, has fewer 
nursing home beds per 1,000 elderly than the number that is ten 
percent higher than the national average of nursing home beds 
per 1,000 elderly individuals.  For the purposes of this 
section, the national average of nursing home beds shall be the 
most recent figure that can be supplied by the federal health 
care financing administration and the number of elderly in the 
county or the nation shall be determined by the most recent 
federal census or the most recent estimate of the state 
demographer as of July 1, of each year of persons age 65 and 
older, whichever is the most recent at the time of the request 
for replacement.  In allowing replacement of a decertified bed, 
the commissioners shall ensure that the number of added or 
recertified beds does not exceed the total number of decertified 
beds in the state in that level of care.  An extreme hardship 
situation can only be found after the county documents the 
existence of unmet medical needs that cannot be addressed by any 
other alternatives; 
       (b) to certify a new bed in a facility that commenced 
construction before May 23, 1983.  For the purposes of this 
section, "commenced construction" means that all of the 
following conditions were met:  the final working drawings and 
specifications were approved by the commissioner of health; the 
construction contracts were let; a timely construction schedule 
was developed, stipulating dates for beginning, achieving 
various stages, and completing construction; and all zoning and 
building permits were secured; 
       (c) to certify beds in a new nursing home that is needed in 
order to meet the special dietary needs of its residents, if: 
the nursing home proves to the commissioner's satisfaction that 
the needs of its residents cannot otherwise be met; elements of 
the special diet are not available through most food 
distributors; and proper preparation of the special diet 
requires incurring various operating expenses, including extra 
food preparation or serving items, not incurred to a similar 
extent by most nursing homes; 
       (d) to license a new nursing home bed in a facility that 
meets one of the exceptions contained in clauses (a) to (c); 
       (e) to license nursing home beds in a facility that has 
submitted either a completed licensure application or a written 
request for licensure to the commissioner before March 1, 1985, 
and has either commenced any required construction as defined in 
clause (b) before May 1, 1985, or has, before May 1, 1985, 
received from the commissioner approval of plans for phased-in 
construction and written authorization to begin construction on 
a phased-in basis.  For the purpose of this clause, 
"construction" means any erection, building, alteration, 
reconstruction, modernization, or improvement necessary to 
comply with the nursing home licensure rules; 
       (f) to certify or license new beds in a new facility that 
is to be operated by the commissioner of veterans' affairs or 
when the costs of constructing and operating the new beds are to 
be reimbursed by the commissioner of veterans' affairs or the 
United States Veterans Administration; 
       (g) to license or certify beds in a new facility 
constructed to replace a facility that was destroyed after June 
30, 1987, by fire, lightning, or other hazard provided:  
       (1) destruction was not caused by the intentional act of or 
at the direction of a controlling person of the facility; 
       (2) at the time the facility was destroyed the controlling 
persons of the facility maintained insurance coverage for the 
type of hazard that occurred in an amount that a reasonable 
person would conclude was adequate; 
       (3) the net proceeds from an insurance settlement for the 
damages caused by the hazard are applied to the cost of the new 
facility; 
       (4) the new facility is constructed on the same site as the 
destroyed facility or on another site subject to the 
restrictions in section 144A.073, subdivision 5; and 
       (5) the number of licensed and certified beds in the new 
facility does not exceed the number of licensed and certified 
beds in the destroyed facility; 
       (h) to license or certify beds that are moved from one 
location to another within a nursing home facility, provided the 
total costs of remodeling performed in conjunction with the 
relocation of beds does not exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, or to 
license or certify beds in a facility for which the total costs 
of remodeling or renovation exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, if the 
facility makes a written commitment to the commissioner of human 
services that it will not seek to receive an increase in its 
property-related payment rate by reason of the remodeling or 
renovation; 
       (i) to license or certify beds in a facility that has been 
involuntarily delicensed or decertified for participation in the 
medical assistance program, provided that an application for 
relicensure or recertification is submitted to the commissioner 
within 120 days after delicensure or decertification; 
       (j) to license or certify beds in a project recommended for 
approval by the interagency board for quality assurance under 
section 144A.073; 
      (k) to license nursing home beds in a hospital facility 
that are relocated from a different hospital facility under 
common ownership or affiliation, provided:  (1) the nursing home 
beds are not certified for participation in the medical 
assistance program; and (2) the relocation of nursing home beds 
under this clause should not exceed a radius of six miles; 
       (1) to license or certify beds that are moved from one 
location to another within an existing identifiable complex of 
hospital buildings, from a hospital-attached nursing home to the 
hospital building, or from a separate nursing home to a building 
formerly used as a hospital, provided the original nursing home 
building will no longer be operated as a nursing home and the 
building to which the beds are moved will no longer be operated 
as a hospital.  As a condition of receiving a license or 
certification under this clause, the facility must make a 
written commitment to the commissioner of human services that it 
will not seek to receive an increase in its property-related 
payment rate as a result of the relocation.  At the time of the 
licensure and certification of the nursing home beds, the 
commissioner of health shall delicense the same number of acute 
care beds within the existing complex of hospital buildings or 
building.  Relocation of nursing home beds under this clause is 
subject to the limitations in section 144A.073, subdivision 5; 
       (m) to license or certify beds that are moved from an 
existing state nursing home to a different state facility, 
provided there is no net increase in the number of state nursing 
home beds.  The relocated beds need not be licensed and 
certified at the new location simultaneously with the 
delicensing and decertification of the old beds and may be 
licensed and certified at any time after the old beds are 
delicensed and decertified; 
    (n) to license new nursing home beds in a continuing care 
retirement community affiliated with 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 residents from outside 
the state for the purpose of meeting contractual obligations to 
residents of the retirement community, provided the facility 
makes a written commitment to the commissioner of human services 
that it will not seek medical assistance certification for the 
new beds; 
    (o) to certify or license new beds in a new facility on the 
Red Lake Indian Reservation for which payments will be made 
under the Indian Health Care Improvement Act, Public Law Number 
94-437, at the rates specified in United States Code, title 42, 
section 1396d(b); 
    (p) to certify and license as nursing home beds boarding 
care beds in a certified boarding care facility if the beds meet 
the standards for nursing home licensure and if the cost of any 
remodeling of the facility does not exceed ten percent of the 
appraised value of the facility or $200,000, whichever is less.  
If boarding care beds are licensed as nursing home beds, the 
number of boarding care beds in the facility must not increase 
in the future.  The provisions contained in section 144A.073 
regarding the upgrading of the facilities do not apply to 
facilities that satisfy these requirements; 
     (q) to license and certify up to 40 beds transferred from 
an existing facility owned and operated by the Amherst H. Wilder 
Foundation in the city of Saint Paul to a new unit at the same 
location as the existing facility that will serve persons with 
Alzheimer's disease and other related disorders.  The transfer 
of beds may occur gradually or in stages, provided the total 
number of beds transferred does not exceed 40.  At the time of 
licensure and certification of a bed or beds in the new unit, 
the commissioner of health shall delicense and decertify the 
same number of beds in the existing facility.  As a condition of 
receiving a license or certification under this clause, the 
facility must make a written commitment to the commissioner of 
human services that it will not seek to receive an increase in 
its property-related payment rate as a result of the transfers 
allowed under this clause; 
     (r) to license and certify nursing home beds to replace 
currently licensed and certified boarding care beds which may be 
located either in a remodeled or renovated boarding care or 
nursing home facility or in a remodeled, renovated, newly 
constructed, or replacement nursing home facility within the 
identifiable complex of health care facilities in which the 
currently licensed boarding care beds are presently located, 
provided that the number of boarding care beds in the facility 
or complex are decreased by the number to be licensed as nursing 
home beds and further provided that, if the total costs of new 
construction, replacement, remodeling, or renovation exceed ten 
percent of the appraised value of the facility or $200,000, 
whichever is less, the facility makes a written commitment to 
the commissioner of human services that it will not seek to 
receive an increase in its property-related payment rate by 
reason of the new construction, replacement, remodeling, or 
renovation.  The provisions contained in section 144A.073 
regarding the upgrading of facilities do not apply to facilities 
that satisfy these requirements; or 
    (s) to license or certify beds that are moved from a 
nursing home to a separate facility under common ownership or 
control that was formerly licensed as a hospital and is 
currently licensed as a nursing facility and that is located 
within eight miles of the original facility, provided the 
original nursing home building will no longer be operated as a 
nursing home.  As a condition of receiving a license or 
certification under this clause, the facility must make a 
written commitment to the commissioner of human services that it 
will not seek to receive an increase in its property-related 
payment rate as a result of the relocation; or 
    (t) to license as a nursing home and certify as a nursing 
facility a facility that is licensed as a boarding care facility 
but not certified under the medical assistance program, but only 
if the commissioner of human services certifies to the 
commissioner of health that licensing the facility as a nursing 
home and certifying the facility as a nursing facility will 
result in a net annual savings to the state general fund of 
$200,000 or more. 
    Sec. 2.  Minnesota Statutes 1990, section 144A.071, is 
amended by adding a subdivision to read: 
    Subd. 3a.  [CERTIFICATION OF LICENSED BEDS IN A CERTIFIED 
FACILITY.] Nothing in this section prohibits the commissioner of 
health from certifying licensed nursing home beds in a facility 
certified for medical assistance provided that these beds meet 
the certification requirements and the facility enters into a 
written agreement with the commissioner of human services 
specifying that medical assistance reimbursement shall not be 
requested for a greater number of residents than the facility 
had medical assistance certified beds on April 1, 1991. 
    Sec. 3.  Minnesota Statutes 1990, section 144A.10, 
subdivision 4, is amended to read: 
    Subd. 4.  [CORRECTION ORDERS.] Whenever a duly authorized 
representative of the commissioner of health finds upon 
inspection of a nursing home, that the facility or a controlling 
person or an employee of the facility is not in compliance with 
sections 144.651, 144A.01 to 144A.16, or 626.557 or the rules 
promulgated thereunder, a correction order shall be issued to 
the facility.  The correction order shall state the deficiency, 
cite the specific rule or statute violated, state the suggested 
method of correction, and specify the time allowed for 
correction.  If the commissioner finds that the nursing home had 
uncorrected or repeated violations which create a risk to 
resident care, safety, or rights, the commissioner shall notify 
the commissioner of human services who shall (1) review 
reimbursement to the nursing home to determine the extent to 
which the state has paid for substandard care and, (2) furnish 
the findings and disposition to the commissioner of health 
within 30 days of notification require the facility to use any 
efficiency incentive payments received under section 256B.431, 
subdivision 2b, paragraph (d), to correct the violations and 
shall require the facility to forfeit incentive payments for 
failure to correct the violations as provided in section 
256B.431, subdivision 2p.  The forfeiture shall not apply to 
correction orders issued for physical plant deficiencies. 
    Sec. 4.  Minnesota Statutes 1990, section 245.465, is 
amended to read: 
    245.465 [DUTIES OF COUNTY BOARD.] 
    Subdivision 1.  The county board in each county shall use 
its share of mental health and community social service act 
funds allocated by the commissioner according to a biennial 
local mental health service proposal approved by the 
commissioner.  The county board must: 
    (1) develop and coordinate a system of affordable and 
locally available adult mental health services in accordance 
with sections 245.461 to 245.486; 
    (2) provide for case management services to adults with 
serious and persistent mental illness in accordance with 
sections 245.462, subdivisions 3 and 4; 245.4711; and 245.486; 
    (3) provide for screening of adults specified in section 
245.476 upon admission to a residential treatment facility or 
acute care hospital inpatient, or informal admission to a 
regional treatment center; 
    (4) prudently administer grants and purchase-of-service 
contracts that the county board determines are necessary to 
fulfill its responsibilities under sections 245.461 to 245.486; 
and 
    (5) assure that mental health professionals, mental health 
practitioners, and case managers employed by or under contract 
with the county to provide mental health services have 
experience and training in working with adults with mental 
illness. 
    Subd. 2.  [RESIDENTIAL AND COMMUNITY SUPPORT PROGRAMS FOR 
PERSONS WITH MENTAL ILLNESS:  SALARY ADJUSTMENTS PER DIEM.] In 
establishing, operating, or contracting for the provision of 
programs licensed under Minnesota Rules, parts 9520.0500 to 
9520.0690 and programs funded under Minnesota Rules, parts 
9535.0100 to 9535.1600, for the fiscal year beginning July 1, 
1991, a county board's contract must reflect increased salaries 
by multiplying the total salaries, payroll taxes, and fringe 
benefits related to personnel below top management by three 
percent.  This increase shall remain in the base for purposes of 
wage determination in future contract years.  County boards 
shall verify in writing to the commissioner that each program 
has complied with this requirement.  If a county board 
determines that a program has not complied with this requirement 
for a specific contract period, the county board shall reduce 
the program's payment rates for the next contract period to 
reflect the amount of money not spent appropriately.  The 
commissioner shall modify reporting requirements for programs 
and counties as necessary to monitor compliance with this 
provision. 
    Sec. 5.  Minnesota Statutes 1990, section 246.23, is 
amended to read: 
    246.23 [PERSONS ADMISSIBLE TO REGIONAL TREATMENT CENTERS.] 
    Subdivision 1.  [RESIDENCE.] No person who has not a 
settlement in a county, as defined in section 256D.18, shall be 
admitted to a regional treatment center for persons with mental 
illness, mental retardation, or chemical dependency, except that 
the commissioner of human services may authorize admission 
thereto when the residence cannot be ascertained, or when the 
circumstances in the judgment of the commissioner make it 
advisable.  Except for emergency admissions under sections 
253B.05 and 253B.11, or when authorized by the commissioner, a 
chemical dependency program must not admit a chemically 
dependent person unless the cost of services will be paid for by 
private money or nongovernmental third-party payments, the 
person has been placed by a county or a federally recognized 
tribal unit that is responsible for payment, or the regional 
treatment center obtains approval of the admission from the 
county financially responsible for the person.  The commissioner 
shall maintain and enhance cooperative and effective 
relationships between counties and regional treatment centers 
and between the various regional treatment center chemical 
dependency programs.  In carrying out this responsibility.  The 
commissioner shall maintain a regionally based, state 
administered system of chemical dependency programs.  When 
application is made to a judge of probate for admission to any 
of the regional treatment centers above named for admission 
thereto, if the judge finds that the person for whom application 
is made has not such residence, or that residence cannot be 
ascertained, the judge shall so report to the commissioner; and 
may recommend that such person be admitted notwithstanding, 
giving reasons therefor.  The commissioner of human services 
shall thereupon investigate the question of residence and, if 
the commissioner finds that such person has not such residence 
and has a legal residence in another state or country, the 
commissioner may cause the person to be returned thereto at the 
expense of this state.  
    Subd. 2.  [CHEMICAL DEPENDENCY TREATMENT.] The commissioner 
shall maintain a regionally based, state-administered system of 
chemical dependency programs.  Counties may refer individuals 
who are eligible for services under chapter 254B to the chemical 
dependency units in the regional treatment centers.  A 15 
percent county share of the per diem cost of treatment is 
required for individuals served within the treatment capacity 
funded by direct legislative appropriation.  By July 1, 1991, 
the commissioner shall establish criteria for admission to the 
chemical dependency units that will maximize federal and private 
funding sources, fully utilize the regional treatment center 
capacity, and make state-funded treatment capacity available to 
counties on an equitable basis.  The admission criteria may be 
adopted without rulemaking.  Existing rules governing placements 
under chapters 254A and 254B do not apply to admissions to the 
capacity funded by direct appropriation.  Private and 
third-party collections and payments are appropriated to the 
commissioner for the operation of the chemical dependency 
units.  In addition to the chemical dependency treatment 
capacity funded by direct legislative appropriation, the 
regional treatment centers may provide treatment to additional 
individuals whose treatment is paid for out of the chemical 
dependency consolidated treatment fund under chapter 254B, in 
which case placement rules adopted under chapter 254B apply, or 
through other nonstate payment sources.  
    Sec. 6.  Minnesota Statutes 1990, section 246.64, 
subdivision 3, is amended to read: 
    Subd. 3.  [RESPONSIBILITIES OF COMMISSIONER.] The 
commissioner shall credit all receipts from billings for rates 
set in subdivision 1, except those credited according to 
subdivision 2, to the chemical dependency fund.  This money must 
not be used for a regional treatment center activity that is not 
a chemical dependency service or an allocation of expenditures 
that are included in the base for computation of the rates under 
subdivision 1.  The commissioner may expand chemical dependency 
services so long as expenditures are recovered by patient fees, 
transfer of funds, or supplementary appropriations.  The 
commissioner may expand or reduce chemical dependency staff 
complement as long as expenditures are recovered by patient 
fees, transfer of funds, or supplementary appropriations.  An 
increase or decrease in chemical dependency staff shall not 
result in an increase or decrease in staff in any facility or 
unit not providing chemical dependency services.  
Notwithstanding chapters 176 and 268, the commissioner shall 
provide for the self-insurance of regional treatment center 
chemical dependency programs for the costs of unemployment 
compensation and workers' compensation claims.  The commissioner 
shall provide a biennial report to the chairs of the senate 
finance subcommittee on health and human services, the house of 
representatives human services division of appropriations, and 
the senate and house of representatives health and human 
services committees.  
     Sec. 7.  Minnesota Statutes 1990, section 252.24, is 
amended by adding a subdivision to read: 
    Subd. 5.  [DAC'S:  SALARY ADJUSTMENT PER DIEM.] The 
commissioner shall approve a two percent increase in the payment 
rates for day training and habilitation services vendors 
effective July 1, 1991.  All revenue generated shall be used by 
vendors to increase salaries, fringe benefits, and payroll taxes 
by at least three percent for personnel below top management.  
County boards shall amend contracts with vendors to require that 
all revenue generated by this provision is expended on salary 
increases to staff below top management.  County boards shall 
verify in writing to the commissioner that each vendor has 
complied with this requirement.  If a county board determines 
that a vendor has not complied with this requirement for a 
specific contract period, the county board shall reduce the 
vendor's payment rates for the next contract period to reflect 
the amount of money not spent appropriately.  The commissioner 
shall modify reporting requirements for vendors and counties as 
necessary to monitor compliance with this provision. 
    Each county agency shall report to the commissioner by July 
30, 1991, its actual social service day training and 
habilitation expenditures for calendar year 1990.  The 
commissioner shall allocate the day habilitation service CSSA 
appropriation made available for this purpose to county agencies 
in proportion to these expenditures. 
    Sec. 8.  Minnesota Statutes 1990, section 252.275, is 
amended by adding a subdivision to read: 
    Subd. 10.  [SILS:  SALARY ADJUSTMENTS; RATES.] In 
establishing, operating, or contracting for the provision of 
semi-independent living services, for the fiscal year beginning 
July 1, 1991, a county board must contract at rates to pay for 
increased salaries by multiplying the total salaries, payroll 
taxes, and fringe benefits related to personnel below top 
management by three percent.  Any maximum rate limit shall be 
adjusted to provide for this provision.  The state shall provide 
counties with proper reimbursement to cover these increased 
costs.  County boards shall verify in writing to the 
commissioner that each semi-independent living service provider 
has complied with this requirement.  If a county board 
determines that a semi-independent living service provider has 
not complied with this requirement for a specific contract 
period, the county board shall reduce the provider's payment 
rates for the next contract period to reflect the amount of 
money not spent appropriately.  The commissioner shall modify 
reporting requirements for providers and counties as necessary 
to monitor compliance with this provision. 
    Sec. 9.  Minnesota Statutes 1990, section 252.46, 
subdivision 3, is amended to read: 
    Subd. 3.  [RATE MAXIMUM.] Unless a variance is granted 
under subdivision 6, the maximum payment rates for each vendor 
for a calendar year must be equal to the payment rates approved 
by the commissioner for that vendor in effect December 1 of the 
previous calendar year increased by no more than the projected 
percentage change in the urban consumer price index, all items, 
published by the United States Department of Labor, for the 
upcoming calendar year over the current calendar year.  The 
commissioner shall not provide an annual inflation adjustment 
for the biennium ending June 30, 1993. 
    Sec. 10.  Minnesota Statutes 1990, section 252.46, 
subdivision 6, is amended to read: 
    Subd. 6.  [VARIANCES.] A variance from the minimum or 
maximum payment rates in subdivisions 2 and 3 may be granted by 
the commissioner when the vendor requests and the county board 
submits to the commissioner a written variance request with the 
recommended payment rates.  The commissioner shall develop by 
October 1, 1989, a uniform format for submission of 
documentation for the variance requests.  This format shall be 
used by each vendor requesting a variance.  The form shall be 
developed by the commissioner and shall be reviewed by 
representatives of advocacy and provider groups and counties.  A 
variance may be utilized for costs associated with compliance 
with state administrative rules, compliance with court orders, 
capital costs required for continued licensure, increased 
insurance costs, start-up and conversion costs for supported 
employment, direct service staff salaries and benefits, and 
transportation.  The county board shall review all vendors' 
payment rates that are ten or more than ten percent lower than 
the statewide median payment rates.  If the county determines 
that the payment rates do not provide sufficient revenue to the 
vendor for authorized service delivery the county must recommend 
a variance under this section.  When the county board contracts 
for increased services from any vendor for some or all 
individuals receiving services from the vendor, the county board 
shall review the vendor's payment rates to determine whether the 
increase requires that a variance to the minimum rates be 
recommended under this section to reflect the vendor's lower per 
unit fixed costs.  The written variance request must include 
documentation that all the following criteria have been met: 
    (1) The commissioner and the county board have both 
conducted a review and have identified a need for a change in 
the payment rates and recommended an effective date for the 
change in the rate. 
    (2) The proposed changes are required for the vendor to 
deliver authorized individual services in an effective and 
efficient manner. 
    (3) The proposed changes are necessary to demonstrate 
compliance with minimum licensing standards, or to provide 
community-integrated and supported employment services after a 
change in the vendor's existing services has been approved as 
provided in section 252.28.  
    (4) The vendor documents that the changes cannot be 
achieved by reallocating current staff or by reallocating 
financial resources. 
    (5) The county board submits evidence that the need for 
additional staff cannot be met by using temporary special needs 
rate exceptions under Minnesota Rules, parts 9510.1020 to 
9510.1140. 
    (6) The county board submits a description of the nature 
and cost of the proposed changes, and how the county will 
monitor the use of money by the vendor to make necessary changes 
in services.  
    (7) The county board's recommended payment rates do not 
exceed 125 percent of the current calendar year's statewide 
median payment rates. 
    The commissioner shall have 60 calendar days from the date 
of the receipt of the complete request to accept or reject it, 
or the request shall be deemed to have been granted.  If the 
commissioner rejects the request, the commissioner shall state 
in writing the specific objections to the request and the 
reasons for its rejection. 
    Sec. 11.  Minnesota Statutes 1990, section 252.46, 
subdivision 14, is amended to read: 
    Subd. 14.  [PILOT STUDY.] The commissioner may initiate a 
pilot payment rate system under section 252.47.  The pilot 
project may establish training and demonstration sites.  The 
pilot payment rate system must include actual transfers of 
funds, not simulated transfers.  The pilot payment rate system 
may involve up to four counties and four vendors representing 
different geographic regions and rates of reimbursement.  
Participation in the pilot project is voluntary.  Selection of 
participants by the commissioner is based on the vendor's 
submission of a complete application form provided by the 
commissioner.  The application must include letters of agreement 
from the host county, counties of financial responsibility, and 
residential service providers.  Evaluation of the pilot project 
must include consideration of the effectiveness of procedures 
governing establishment of equitable payment rates.  
Implementation of the pilot payment rate system is contingent 
upon federal approval and systems feasibility.  The policies and 
procedures governing administration, participation, evaluation, 
service utilization, and payment for services under the pilot 
payment rate system are not subject to the rulemaking 
requirements of chapter 14.  
    Sec. 12.  Minnesota Statutes 1990, section 252.478, 
subdivision 1, is amended to read: 
    Subdivision 1.  [ESTABLISHMENT OF PROGRAM METRO 
TRANSPORTATION SUPPORT GRANTS.] The commissioner of human 
services shall establish and operate a metro transportation 
support grants program to provide reimbursement for client 
transportation by metro mobility, or cost-effective 
alternatives, to day training and habilitation services for 
which client transportation is a required and funded component, 
and to maximize use of federal funds for this reimbursement.  A 
metro transportation support grants account shall be established 
in the department of human services chart of accounts. 
    Sec. 13.  Minnesota Statutes 1990, section 252.478, 
subdivision 3, is amended to read: 
    Subd. 3.  [COUNTY SHARE.] The county share of the metro 
transportation support grants program costs will be distributed 
by the department to all metropolitan counties from the metro 
transportation support grants account.  For state fiscal year 
1991, the funds transferred from the regional transit board to 
this account shall be distributed to:  Ramsey county, 48 
percent; Hennepin county, 46 percent; Dakota county, five 
percent; and Anoka county, one percent.  For subsequent fiscal 
years, funds shall be distributed annually based on each 
county's percentage of total expenses incurred for trips 
provided on metro mobility to and from day training and 
habilitation services during the preceding 12-month period.  in 
amounts not to exceed those received by the counties and used 
for increased expenses incurred for trips provided on metro 
mobility during fiscal year 1991.  Counties must recommend 
decreases to the payment rates for vendors whose transportation 
costs decrease with use of cost-effective alternatives.  
Counties should deposit these funds into the program accounts 
that will incur the transportation expenses.  
    Sec. 14.  Minnesota Statutes 1990, section 254B.04, 
subdivision 1, is amended to read: 
    Subdivision 1.  [ELIGIBILITY.] (a) Persons eligible for 
benefits under Code of Federal Regulations, title 25, part 20, 
persons eligible for medical assistance benefits under sections 
256B.055 and 256B.056 or who meet the income standards of 
section 256B.056, subdivision 4, and persons eligible for 
general assistance medical care under section 256D.03, 
subdivision 3, are entitled to chemical dependency fund services.
State money appropriated for this paragraph must be placed in a 
separate account established for this purpose. 
    (b) A person not entitled to services under paragraph (a), 
but with family income that is less than 60 percent of the state 
median income for a family of like size and composition, shall 
be eligible to receive chemical dependency fund services within 
the limit of funds available after persons entitled to services 
under paragraph (a) have been served.  A county may spend money 
from its own sources to serve persons under this 
paragraph.  State money appropriated for this paragraph must be 
placed in a separate account established for this purpose. 
    (c) Persons whose income is between 60 percent and 115 
percent of the state median income shall be eligible for 
chemical dependency services on a sliding fee basis, within the 
limit of funds available, after persons entitled to services 
under paragraph (a) and persons eligible for services under 
paragraph (b) have been served.  Persons eligible under this 
paragraph must contribute to the cost of services according to 
the sliding fee scale established under subdivision 3.  A county 
may spend money from its own sources to provide services to 
persons under this paragraph.  State money appropriated for this 
paragraph must be placed in a separate account established for 
this purpose. 
    Sec. 15.  Minnesota Statutes 1990, section 254B.05, is 
amended by adding a subdivision to read: 
    Subd. 4.  [REGIONAL TREATMENT CENTERS.] Regional treatment 
center chemical dependency treatment units are eligible 
vendors.  The commissioner may expand the capacity of chemical 
dependency treatment units beyond the capacity funded by direct 
legislative appropriation to serve individuals who are referred 
for treatment by counties and whose treatment will be paid for 
with a county's allocation under section 254B.02 or other 
funding sources. 
    Sec. 16.  Minnesota Statutes 1990, section 256.045, 
subdivision 10, is amended to read: 
    Subd. 10.  [PAYMENTS PENDING APPEAL.] If the commissioner 
of human services or district court orders monthly assistance or 
aid or services paid or provided in any proceeding under this 
section, it shall be paid or provided pending appeal to the 
commissioner of human services, district court, court of 
appeals, or supreme court.  The human services referee may order 
the local human services agency to reduce or terminate medical 
assistance or general assistance medical care to a recipient 
before a final order is issued under this section if:  (1) the 
human services referee determines at the hearing that the sole 
issue on appeal is one of a change in state or federal law; and 
(2) the commissioner or the local agency notifies the recipient 
before the action.  The state or county agency has a claim for 
food stamps and, cash payments, medical assistance, and general 
assistance medical care made to or on behalf of a recipient or 
former recipient while an appeal is pending if the recipient or 
former recipient is determined ineligible for the food 
stamps and, cash payments, medical assistance, or general 
assistance medical care as a result of the appeal, except for 
medical assistance and general assistance medical care made on 
behalf of a recipient pursuant to a court order. 
    Sec. 17.  Minnesota Statutes 1990, section 256.936, is 
amended by adding a subdivision to read: 
    Subd. 5.  [APPEALS.] If the commissioner suspends, reduces, 
or terminates eligibility for the children's health plan, or 
services provided under the children's health plan, the 
commissioner must provide notification according to the laws and 
rules governing the medical assistance program.  A children's 
health plan applicant or enrollee aggrieved by a determination 
of the commissioner has the right to appeal the determination 
according to section 256.045. 
    Sec. 18.  Minnesota Statutes 1990, section 256.9365, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
human services shall establish a program to pay private health 
plan premiums for persons who have contracted human 
immunodeficiency virus (HIV) to enable them to continue coverage 
under a group or individual health plan.  If a person is 
determined to be eligible under subdivision 2, the commissioner 
shall:  (1) pay the eligible person's group plan continuation 
coverage premium for 18 months after termination of employment, 
or the period of continuation coverage provided in the 
Consolidated Omnibus Budget Reconciliation Act of 1985; or (2) 
pay the eligible person's individual plan premium for 24 months 
after initial application.  
    Sec. 19.  Minnesota Statutes 1990, section 256.9365, 
subdivision 3, is amended to read: 
    Subd. 3.  [RULES.] The commissioner shall establish rules 
as necessary to implement the program.  Special requirements for 
the payment of individual plan premiums under subdivision 2, 
clause (5), must be designed to ensure that the state cost of 
paying an individual plan premium over a two-year period does 
not exceed the estimated state cost that would otherwise be 
incurred in the medical assistance or general assistance medical 
care program. 
    Sec. 20.  [256.656] [DEPOSITS INTO THE GENERAL FUND.] 
    All money collected under section 256.9657 shall be 
deposited in the general fund and is appropriated to the 
commissioner of human services for the purposes of section 
256B.74.  Deposits do not cancel and are available until 
expended. 
    Sec. 21.  [256.9657] [PROVIDER SURCHARGES.] 
    Subdivision 1.  [NURSING FACILITY LICENSE 
SURCHARGE.] Effective July 1, 1991, each nursing facility 
subject to the reimbursement principles in Minnesota Rules, 
parts 9549.0010 to 9549.0080, shall pay to the commissioner an 
annual surcharge according to the schedule in subdivision 4.  
The surcharge shall be calculated as $500 per bed licensed on 
the previous April 1. 
    Subd. 2.  [HOSPITAL SURCHARGE.] (a) Effective July 1, 1991, 
each Minnesota and local trade area hospital except facilities 
of the federal Indian Health Service and regional treatment 
centers shall pay to the medical assistance account a surcharge 
equal to ten percent of medical assistance payments issued to 
that provider for inpatient services according to the schedule 
in subdivision 4.  Medicare crossovers and indigent care 
payments paid under section 256B.74 are excluded from the amount 
of medical assistance payments issued. 
    (b) Effective July 1, 1991, each Minnesota and local trade 
area hospital except facilities of the federal Indian Health 
Service and regional treatment centers shall pay to the medical 
assistance account a surcharge equal to five percent of medical 
assistance payments issued to that provider for outpatient 
services according to the schedule in subdivision 4.  Medicare 
crossovers are excluded from the amount of medical assistance 
payments issued. 
    Subd. 3.  [HEALTH PLAN SURCHARGE.] Effective July 1, 1991, 
each health plan under contract with the commissioner shall pay 
to the commissioner a surcharge equal to the equivalent value of 
the surcharges described in subdivision 2 for each medical 
assistance rate cell payment according to the schedule in 
subdivision 4.  The surcharge for each quarter or month of a 
fiscal year shall be calculated based on the payments due in 
September of the same fiscal year under subdivision 2. 
    Subd. 4.  [PAYMENTS INTO THE ACCOUNT.] Payments to the 
commissioner under subdivision 1 must be paid in monthly 
installments due on the 15th of the month beginning August 15, 
1991.  The monthly payment must be equal to the annual surcharge 
divided by 12.  Payments to the commissioner under subdivisions 
2 and 3 must be paid as follows:  the first payment is a 
quarterly payment due September 15, 1991, with subsequent 
payments due monthly on the fifteenth of each month.  The 
September 15, 1991, payment under subdivisions 2 and 3 shall be 
determined by taking the amount of medical assistance payments 
issued to each provider in the calendar quarter beginning six 
months prior to the quarter in which the payment is due 
multiplied by the percentage surcharge for each provider.  The 
subsequent monthly payments shall be determined by taking the 
amount of medical assistance payments issued to each provider in 
the month beginning six months prior to the month in which the 
payment is due multiplied by the percentage surcharge for each 
provider. 
    Subd. 5.  [NOT ALLOWABLE COST.] Provider payments to the 
commissioner under this section are not an allowable cost for 
purposes of the medical assistance program. 
    Subd. 6.  [NOTICE; APPEALS.] At least 30 days prior to the 
date the payment is due, the commissioner shall give each 
provider a written notice of each payment due.  A provider may 
request a contested case hearing under chapter 14 within 30 days 
of receipt of the notice.  The decision of the commissioner 
regarding the amount due stands until the appeal is decided.  
The provider shall pay the contested payment at the time of 
appeal with settle-up at the time of appeal resolution. 
    Subd. 7.  [ENFORCEMENT.] The commissioner shall bring 
action in district court to collect provider payments due under 
subdivisions 1 to 3 that are more than 30 days in arrears. 
    Sec. 22.  Minnesota Statutes 1990, section 256.9685, 
subdivision 1, is amended to read: 
    Subdivision 1.  [AUTHORITY.] The commissioner shall 
establish procedures for determining medical assistance and 
general assistance medical care payment rates under a 
prospective payment system for inpatient hospital services in 
hospitals that qualify as vendors of medical assistance.  The 
commissioner shall establish, by rule, procedures for 
implementing this section and sections 256.9686, 256.969, and 
256.9695.  The medical assistance payment rates must be based on 
methods and standards that the commissioner finds are adequate 
to provide for the costs that must be incurred for the care of 
recipients in efficiently and economically operated hospitals.  
Services must meet the requirements of section 256B.04, 
subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 
eligible for payment. 
    Sec. 23.  Minnesota Statutes 1990, section 256.9686, 
subdivision 1, is amended to read: 
    Subdivision 1.  [SCOPE.] For purposes of this section and 
sections 256.9685, 256.969, and 256.9695, the following terms 
and phrases have the meanings given. 
    Sec. 24.  Minnesota Statutes 1990, section 256.9686, 
subdivision 6, is amended to read: 
    Subd. 6.  [HOSPITAL.] "Hospital" means a facility licensed 
under sections 144.50 to 144.58 or, an out-of-state facility 
licensed to provide acute care under the requirements of that 
state in which it is located, or an Indian health service 
facility designated to provide acute care by the federal 
government. 
    Sec. 25.  Minnesota Statutes 1990, section 256.969, 
subdivision 1, is amended to read: 
    Subdivision 1.  [HOSPITAL COST INDEX.] The hospital cost 
index shall be obtained from an independent source and shall 
represent a weighted average of historical, as limited to 
statutory maximums, and projected cost change estimates 
determined for expense categories to include wages and salaries, 
employee benefits, medical and professional fees, raw food, 
utilities, insurance including malpractice insurance, and other 
applicable expenses as determined by the commissioner.  The 
index shall reflect Minnesota cost category weights.  Individual 
indices shall be specific to Minnesota if the commissioner 
determines that sufficient accuracy of the hospital cost index 
is achieved.  The hospital cost index shall be used to adjust 
the base year operating payment rate through the rate year on an 
annually compounded basis.  Notwithstanding section 256.9695, 
subdivision 3, paragraph (c), the hospital cost index shall not 
be effective under the general assistance medical care program 
for admissions occurring during the biennium ending June 30, 
1993.  
    Sec. 26.  Minnesota Statutes 1990, section 256.969, 
subdivision 2, is amended to read: 
    Subd. 2.  [DIAGNOSTIC CATEGORIES.] The commissioner shall 
use to the extent possible existing diagnostic classification 
systems, including the system used by the Medicare program to 
determine the relative values of inpatient services and case mix 
indices.  The commissioner may combine diagnostic 
classifications into diagnostic categories and may establish 
separate categories and numbers of categories based on program 
eligibility or hospital peer group.  Relative values shall be 
recalculated when the base year is changed and shall not be 
determined on a hospital specific basis.  Relative value 
determinations shall include paid claims for admissions during 
each hospital's base year.  The commissioner may extend the time 
period forward to obtain sufficiently valid information to 
establish relative values.  Relative value determinations shall 
not include property cost data, Medicare crossover data, and 
data from the transferring hospital on admissions that are paid 
a per day transfer discharges, except data on transfer 
discharges with a burn diagnostic classification or data on 
transfer discharges for the patient's convenience that have been 
reported by the hospital to the commissioner by the October 1 
preceding the rate year under subdivision 13.  The computation 
of the base year cost per admission must include identified 
outlier cases and their weighted costs up to the point that they 
become outlier cases, but must exclude costs recognized in 
outlier payments beyond that point.  The commissioner may 
recategorize the diagnostic classifications and recalculate 
relative values and case mix indices to reflect actual hospital 
practices, the specific character of specialty hospitals, or to 
reduce variances within the diagnostic categories after notice 
in the State Register and a 30-day comment period.  
    Sec. 27.  Minnesota Statutes 1990, section 256.969, 
subdivision 2c, is amended to read: 
    Subd. 2c.  [PROPERTY PAYMENT RATES.] For each hospital's 
first two consecutive fiscal years beginning on or after July 1, 
1988, the commissioner shall limit the annual increase in 
property payment rates for depreciation, rents and leases, and 
interest expense to the annual growth in the hospital cost index 
derived from the methodology in effect on the day before July 1, 
1989.  When computing budgeted and settlement property payment 
rates, the commissioner shall use the annual increase in the 
hospital cost index forecasted by Data Resources, Inc., 
consistent with the quarter of the hospital's fiscal year end.  
For admissions occurring on or after the rate year beginning 
January 1, 1991, the commissioner shall obtain property data 
from an updated base year and establish property payment rates 
per admission for each hospital.  Property payment rates shall 
be derived from data from the same base year that is used to 
establish operating payment rates.  The property information 
shall include cost categories not subject to the hospital cost 
index and shall reflect the cost-finding methods and allowable 
costs of the Medicare program in effect during the base year.  
The base year property payment rate per admission rates shall be 
adjusted for positive percentage change differences increases in 
the net book value of hospital property and equipment cost by 
increasing the base year property payment rate per admission 85 
percent of the percentage change from the base year through 
the most recent year ending prior to the rate year for 
which required information is available a Medicare cost report 
has been submitted to the Medicare program and filed with the 
department by the October 1 before the rate year.  The 
percentage change shall be derived from equivalent audited 
information in both years and shall be adjusted to account for 
changes in generally accepted accounting principles, 
reclassification of assets, allocations to nonhospital areas, 
and fiscal years.  The cost, audit, and charge data used to 
establish property rates shall only reflect inpatient services 
covered by medical assistance and shall not include operating 
cost information.  To be eligible for the property payment rate 
per admission adjustment, the hospital must provide the 
necessary information to the commissioner, in a format specified 
by the commissioner, by the October 1 preceding the rate year.  
The commissioner shall adjust rates for the rate year beginning 
January 1, 1991, to ensure that all hospitals are subject to the 
hospital cost index limitation for two complete years. 
    Sec. 28.  Minnesota Statutes 1990, section 256.969, 
subdivision 3a, is amended to read: 
    Subd. 3a.  [PAYMENTS.] 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.  To establish interim rates, the 
commissioner is exempt from the requirements of chapter 14.  
Medical assistance reimbursement for treatment of mental illness 
shall be reimbursed based on diagnostic classifications.  The 
commissioner may selectively contract with hospitals for 
services within the diagnostic categories relating to mental 
illness and chemical dependency under competitive bidding when 
reasonable geographic access by recipients can be assured.  No 
physician shall be denied the privilege of treating a recipient 
required to use a hospital under contract with the commissioner, 
as long as the physician meets credentialing standards of the 
individual hospital.  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 admissions 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 is not applicable and 
shall not be calculated to include 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 6a, paragraph (a), 
clause (5) or (6), 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. 
    Sec. 29.  Minnesota Statutes 1990, section 256.969, 
subdivision 6a, is amended to read: 
    Subd. 6a.  [SPECIAL CONSIDERATIONS.] (a) In determining the 
payment rates, the commissioner shall consider whether the 
following circumstances in subdivisions 7 to 14 exist:.  
    (1) Subd. 7.  [MINIMAL MEDICAL ASSISTANCE USE.] Minnesota 
hospitals with 30 or fewer annualized admissions of Minnesota 
medical assistance recipients in the base year, excluding 
Medicare crossover admissions, may have the base year operating 
rates, as adjusted by the case mix index, and property payment 
rates established at the 70th percentile of hospitals in the 
peer group in effect during the base year as established by the 
Minnesota department of health for use by the rate review 
program.  Rates within a peer group shall be adjusted for 
differences in fiscal years and outlier percentage payments 
before establishing the 70th percentile.  The operating payment 
rate portion of the 70th percentile shall be adjusted by the 
hospital cost index.  To have rates established under this 
paragraph, the hospital must notify the commissioner in writing 
by November 1 of the year preceding the rate year.  This 
paragraph shall be applied to all payment rates of the affected 
hospital. 
    (2) Subd. 8.  [UNUSUAL COST OR LENGTH OF STAY EXPERIENCE.] 
The commissioner shall establish day and cost outlier thresholds 
for each diagnostic category established under subdivision 2 at 
two standard deviations beyond the geometric mean length of stay 
or allowable cost.  Payment for the days and cost beyond the 
outlier threshold shall be in addition to the operating and 
property payment rates per admission established under 
subdivisions 2, 2b, and 2c.  Payment for outliers shall be at 70 
percent of the allowable operating cost calculated by dividing 
the operating payment rate per admission, after adjustment by 
the case mix index, hospital cost index, relative values and the 
disproportionate population adjustment, by the arithmetic mean 
length of stay for the diagnostic category.  The outlier 
threshold for neonatal and burn diagnostic categories shall be 
established at one standard deviation beyond the geometric mean 
length of stay or allowable cost, and payment shall be at 90 
percent of allowable operating cost calculated in the same 
manner as other outliers.  A hospital may choose an alternative 
percentage to the 70 percent outlier payment to that is at a 
minimum of 60 percent and a maximum of 80 percent if the 
commissioner is notified in writing of the request by October 1 
of the year preceding the rate year.  The chosen percentage 
applies to all diagnostic categories except burns and neonates.  
The percentage of allowable cost that is unrecognized by the 
outlier payment shall be added back to the base year operating 
payment rate per admission.  Cost outliers shall be calculated 
using hospital specific allowable cost data.  If a stay is both 
a day and a cost outlier, outlier payments shall be based on the 
higher outlier payment. 
    (3) Subd. 9.  [DISPROPORTIONATE NUMBERS OF LOW-INCOME 
PATIENTS SERVED.] For admissions occurring on or after July 1, 
1989, the medical assistance disproportionate population 
adjustment shall comply with federal law at fully implemented 
rates.  The commissioner may establish a separate 
disproportionate population operating payment rate adjustment 
under the general assistance medical care program.  For 
admissions occurring on or after the rate year beginning January 
1, 1991, the disproportionate population adjustment shall be 
derived from base year Medicare cost report data and may be 
adjusted by data reflecting actual claims paid by the department.
    (4) Subd. 10.  [SEPARATE BILLING BY CERTIFIED REGISTERED 
NURSE ANESTHETISTS.] Hospitals may exclude certified registered 
nurse anesthetist costs from the operating payment rate as 
allowed by section 256B.0625, subdivision 11.  To be eligible, a 
hospital must notify the commissioner in writing by October 1 of 
the year preceding the rate year of the request to exclude 
certified registered nurse anesthetist costs.  The hospital must 
agree that all hospital claims for the cost and charges of 
certified registered nurse anesthetist services will not be 
included as part of the rates for inpatient services provided 
during the rate year.  In this case, the operating payment rate 
shall be adjusted to exclude the cost of certified registered 
nurse anesthetist services.  Payments made through separate 
claims for certified registered nurse anesthetist services shall 
not be paid directly through the hospital provider number or 
indirectly by the certified registered nurse anesthetist to the 
hospital or related organizations. 
     For admissions occurring on or after July 1, 1991, and 
until the expiration date of section 256.9695, subdivision 3, 
services of certified registered nurse anesthetists provided on 
an inpatient basis may be paid as allowed by section 256B.0625, 
subdivision 11, when the hospital's base year did not include 
the cost of these services.  To be eligible, a hospital must 
notify the commissioner in writing by July 1, 1991, of the 
request and must comply with all other requirements of this 
subdivision. 
    (5) Subd. 11.  [SPECIAL RATES.] The commissioner may 
establish special rate-setting methodologies, including a per 
day operating and property payment system, for hospice, 
ventilator dependent, and other services on a hospital and 
recipient specific basis taking into consideration such 
variables as federal designation, program size, and admission 
from a medical assistance waiver or home care program.  The data 
and rate calculation method shall conform to the requirements of 
paragraph (7) subdivision 13, except that rates shall not be 
standardized by the case mix index or adjusted by relative 
values and hospice rates shall not exceed the amount allowed 
under federal law and payment shall be secondary to any other 
medical assistance hospice program.  Rates and payments 
established under this paragraph subdivision must meet the 
requirements of section 256.9685, subdivisions 1 and 2, and must 
not exceed payments that would otherwise be made to a hospital 
in total for rate year admissions under subdivisions 2, 2b, 2c, 
3, 4, 5, and 6.  The cost and charges used to establish rates 
shall only reflect inpatient medical assistance covered 
services.  Hospital and claims data that are used to establish 
rates under this paragraph subdivision shall not be used to 
establish payments or relative values under subdivisions 2, 2b, 
2c, 3, 4, 5 3a, 4a, 5a, and 6 7 to 14. 
    (6) Subd. 12.  [REHABILITATION DISTINCT PARTS.] Units of 
hospitals that are recognized as rehabilitation distinct parts 
by the Medicare program shall have separate provider numbers 
under the medical assistance program for rate establishment and 
billing purposes only.  These units shall also have operating 
and property payment rates and the disproportionate population 
adjustment, if allowed by federal law, established separately 
from other inpatient hospital services, based on the methods of 
subdivisions 2, 2b, 2c, 3, 4, 5, and 6.  The commissioner may 
establish separate relative values under subdivision 2 for 
rehabilitation hospitals and distinct parts as defined by the 
Medicare program.  For individual hospitals that did not have 
separate medical assistance rehabilitation provider numbers or 
rehabilitation distinct parts in the base year, hospitals shall 
provide the information needed to separate rehabilitation 
distinct part cost and claims data from other inpatient service 
data.  
    (7) Subd. 13.  [NEONATAL TRANSFERS.] For admissions 
occurring on or after July 1, 1989, neonatal diagnostic category 
transfers shall have operating and property payment rates 
established at receiving hospitals which have neonatal intensive 
care units on a per day payment system that is based on the cost 
finding methods and allowable costs of the Medicare program 
during the base year.  Other neonatal diagnostic category 
transfers shall have rates established according to paragraph 
(8) subdivision 14.  The rate per day for the neonatal service 
setting within the hospital shall be determined by dividing base 
year neonatal allowable costs by neonatal patient days.  The 
operating payment rate portion of the rate shall be adjusted by 
the hospital cost index and the disproportionate population 
adjustment.  For admissions occurring after the transition 
period specified in section 256.9695, subdivision 3, the 
operating payment rate portion of the rate shall be standardized 
by the case mix index and adjusted by relative values.  The cost 
and charges used to establish rates shall only reflect inpatient 
services covered by medical assistance.  Hospital and claims 
data used to establish rates under this paragraph subdivision 
shall not be used to establish payments or relative values rates 
under subdivisions 2, 2b, 2c, 3, 4, 5 3a, 4a, 5a, and 6 7 to 14. 
    (8) Subd. 14.  [TRANSFERS.] Except as provided 
in paragraphs (5) subdivisions 11 and (7) 13, operating and 
property payment rates for admissions that result in transfers 
and transfers shall be established on a per day payment system.  
The per day payment rate shall be the sum of the adjusted 
operating and property payment rates determined in under this 
subdivision and subdivisions 2, 2b and, 2c, 3a, 4a, 5a, and 7 
to 12, divided by the arithmetic mean length of stay for the 
diagnostic category.  Each admission that results in a transfer 
and each transfer is considered a separate admission to each 
hospital, and the total of the admission and transfer payments 
to each hospital must not exceed the total per admission payment 
that would otherwise be made to each hospital under paragraph 
(2) and this subdivision and subdivisions 2, 2b and, 2c, 3a, 
4a, 5a, and 7 to 13. 
    (b) Subd. 15.  [ROUTINE SERVICE COST LIMITATION; 
APPLICABILITY.] The computation of each hospital's payment rate 
and the relative values of the diagnostic categories are not 
subject to the routine service cost limitation imposed under the 
Medicare program. 
    (c) Subd. 16.  [INDIAN HEALTH SERVICE FACILITIES.] Indian 
health service facilities are exempt from the rate establishment 
methods required by this section and shall be reimbursed at the 
facility's usual and customary charges to the general public as 
limited to the amount allowed under federal law.  This exemption 
is not effective for payments under general assistance medical 
care. 
    (d) Subd. 17.  [OUT-OF-STATE HOSPITALS IN LOCAL TRADE 
AREAS.] Except as provided in paragraph (a), clauses (1) and 
(3), Out-of-state hospitals that are located within a Minnesota 
local trade area shall have rates established using the same 
procedures and methods that apply to Minnesota hospitals.  For 
this subdivision and subdivision 18, local trade area means a 
county contiguous to Minnesota.  Hospitals that are not required 
by law to file information in a format necessary to establish 
rates shall have rates established based on the commissioner's 
estimates of the information.  Relative values of the diagnostic 
categories shall not be redetermined under this paragraph 
subdivision until required by rule.  Hospitals affected by 
this paragraph subdivision shall then be included in determining 
relative values.  However, hospitals that have rates established 
based upon the commissioner's estimates of information shall not 
be included in determining relative values.  This paragraph 
subdivision is effective for hospital fiscal years beginning on 
or after July 1, 1988.  A hospital shall provide the information 
necessary to establish rates under this paragraph subdivision at 
least 90 days before the start of the hospital's fiscal year. 
    (e) Subd. 18.  [OUT-OF-STATE HOSPITALS OUTSIDE LOCAL TRADE 
AREAS.] Hospitals that are not located within Minnesota or a 
Minnesota local trade area shall have operating and property 
rates established at the average of statewide and local trade 
area rates or, at the commissioner's discretion, at an amount 
negotiated by the commissioner.  Relative values shall not 
include data from hospitals that have rates established under 
this paragraph subdivision.  Payments, including third party and 
recipient liability, established under this paragraph 
subdivision may not exceed the charges on a claim specific basis 
for inpatient services that are covered by medical assistance.  
    (f) Subd. 19.  [METABOLIC DISORDER TESTING OF MEDICAL 
ASSISTANCE RECIPIENTS.] Medical assistance inpatient payment 
rates must include the cost incurred by hospitals to pay the 
department of health for metabolic disorder testing of newborns 
who are medical assistance recipients, if the cost is not 
recognized by another payment source. 
    (g) Subd. 20.  [INCREASES IN MEDICAL ASSISTANCE INPATIENT 
PAYMENTS; CONDITIONS.] (a) Medical assistance inpatient payments 
shall increase 20 percent for inpatient hospital originally paid 
admissions, excluding Medicare crossovers, that occurred between 
July 1, 1988, and December 31, 1990, if:  (i) the hospital had 
100 or fewer Minnesota medical assistance annualized paid 
admissions, excluding Medicare crossovers, that were paid by 
March 1, 1988, for the period January 1, 1987, to June 30, 1987; 
(ii) the hospital had 100 or fewer licensed beds on March 1, 
1988; (iii) the hospital is located in Minnesota; and (iv) the 
hospital is not located in a city of the first class as defined 
in section 410.01.  For this paragraph, medical assistance does 
not include general assistance medical care. 
    (h) (b) Medical assistance inpatient payments shall 
increase 15 percent for inpatient hospital originally paid 
admissions, excluding Medicare crossovers, that occurred between 
July 1, 1988, and December 31, 1990, if:  (i) the hospital had 
more than 100 but fewer than 250 Minnesota medical assistance 
annualized paid admissions, excluding Medicare crossovers, that 
were paid by March 1, 1988, for the period January 1, 1987, to 
June 30, 1987; (ii) the hospital had 100 or fewer licensed beds 
on March 1, 1988; (iii) the hospital is located in Minnesota; 
and (iv) the hospital is not located in a city of the first 
class as defined in section 410.01.  For this paragraph, medical 
assistance does not include general assistance medical care. 
    (i) Subd. 21.  [MENTAL HEALTH OR CHEMICAL DEPENDENCY 
ADMISSIONS; RATES.] Admissions occurring on or after July 1, 
1990, that are classified to a diagnostic category of mental 
health or chemical dependency shall have rates established 
according to the methods of paragraph (a), clause 
(8) subdivision 14, except the per day rate shall be multiplied 
by a factor of 2, provided that the total of the per day rates 
shall not exceed the per admission rate.  This methodology shall 
also apply when a hold or commitment is ordered by the court for 
the days that inpatient hospital services are medically 
necessary.  Stays which are medically necessary for inpatient 
hospital services and covered by medical assistance shall not be 
billable to any other governmental entity.  Medical necessity 
shall be determined under criteria established to meet the 
requirements of section 256B.04, subdivision 15, or 256D.03, 
subdivision 7, paragraph (b). 
    Sec. 30.  Minnesota Statutes 1990, section 256.9695, 
subdivision 1, is amended to read: 
    Subdivision 1.  [APPEALS.] A hospital may appeal a decision 
arising from the application of standards or methods under 
section 256.9685, 256.9686, or 256.969, if an appeal would 
result in a change to the hospital's payment rate or payments.  
Both overpayments and underpayments that result from the 
submission of appeals shall be implemented.  Regardless of any 
appeal outcome, relative values shall not be recalculated.  The 
appeal shall be heard by an administrative law judge according 
to sections 14.48 14.57 to 14.56 14.62, or upon agreement by 
both parties, according to a modified appeals procedure 
established by the commissioner and the office of administrative 
hearings.  In any proceeding under this section, the appealing 
party must demonstrate by a preponderance of the evidence that 
the commissioner's determination is incorrect or not according 
to law. 
    (a) To appeal a payment rate or payment determination or a 
determination made from base year information, the hospital 
shall file a written appeal request to the commissioner within 
60 days of the date the payment rate determination was mailed.  
The appeal request shall specify:  (i) the disputed items; (ii) 
the authority in federal or state statute or rule upon which the 
hospital relies for each disputed item; and (iii) the name and 
address of the person to contact regarding the appeal.  A change 
to a payment rate or payments that results from a successful 
appeal to the Medicare program of the base year information 
establishing rates for the rate year beginning in 1991 and after 
is a prospective adjustment to subsequent rate years.  After 
December 31, 1990, payment rates shall not be adjusted for 
appeals of base year information that affect years prior to the 
rate year beginning January 1, 1991.  Facts to be considered in 
any appeal of base year information are limited to those in 
existence at the time the payment rates of the first rate year 
were established from the base year information.  In the case of 
Medicare settled appeals, the 60-day appeal period shall begin 
on the mailing date of the notice by the Medicare program or the 
date the medical assistance payment rate determination notice is 
mailed, whichever is later. 
    (b) To appeal a payment rate or payment change that results 
from a difference in case mix between the base year and a rate 
year, the procedures and requirements of paragraph (a) apply.  
However, the appeal must be filed with the commissioner within 
120 days after the end of a rate year.  A case mix appeal must 
apply to the cost of services to all medical assistance patients 
that received inpatient services from the hospital during the 
rate year appealed.  
    Sec. 31.  Minnesota Statutes 1990, section 256B.031, 
subdivision 4, is amended to read: 
    Subd. 4.  [PREPAID HEALTH PLAN RATES.] For payments made 
during calendar year 1988, the monthly maximum allowable rate 
established by the commissioner of human services for payment to 
prepaid health plans must not exceed 90 percent of the projected 
average monthly per capita fee-for-service medical assistance 
costs for state fiscal year 1988 for recipients of aid to 
families with dependent children.  The base year for projecting 
the average monthly per capita fee-for-service medical 
assistance costs is state fiscal year 1986.  A maximum allowable 
per capita rate must be established collectively for Anoka, 
Carver, Dakota, Hennepin, Ramsey, St. Louis, Scott, and 
Washington counties.  A separate maximum allowable per capita 
rate must be established collectively for all other counties.  
The maximum allowable per capita rate may be adjusted to reflect 
utilization differences among eligible classes of recipients.  
For payments made during calendar year 1989, the maximum 
allowable rate must be calculated in the same way as 1988 rates, 
except the base year is state fiscal year 1987.  For payments 
made during calendar year 1990 and later years, the commissioner 
shall contract consult with an independent actuary to establish 
in establishing prepayment rates, but shall retain final control 
over the rate methodology.  Rates established for prepaid health 
plans must be based on the services that the prepaid health plan 
provides under contract with the commissioner.  
    Sec. 32.  Minnesota Statutes 1990, section 256B.031, is 
amended by adding a subdivision to read: 
    Subd. 11.  [LIMITATION ON REIMBURSEMENT TO PROVIDERS NOT 
AFFILIATED WITH A PREPAID HEALTH PLAN.] A prepaid health plan 
may limit any reimbursement it may be required to pay to 
providers not employed by or under contract with the prepaid 
health plan to the medical assistance rates for medical 
assistance enrollees, and the general assistance medical care 
rates for general assistance medical care enrollees, paid by the 
commissioner of human services to providers for services to 
recipients not enrolled in a prepaid health plan. 
    Sec. 33.  Minnesota Statutes 1990, section 256B.055, 
subdivision 10, is amended to read: 
    Subd. 10.  [INFANTS.] Medical assistance may be paid for an 
infant less than one year of age born on or after October 1, 
1984, whose mother was eligible for and receiving medical 
assistance at the time of birth and who remains in the mother's 
household or who is in a family with countable income that is 
equal to or less than the income standard established under 
section 256B.057, subdivision 1.  Eligibility under this 
subdivision is concurrent with the mother's and does not depend 
on the father's income except as the income affects the mother's 
eligibility.  
    Sec. 34.  Minnesota Statutes 1990, section 256B.055, 
subdivision 12, is amended to read: 
    Subd. 12.  [DISABLED CHILDREN.] (a) A person is eligible 
for medical assistance if the person is under age 19 and 
qualifies as a disabled individual under United States Code, 
title 42, section 1382c(a), and would be eligible for medical 
assistance under the state plan if residing in a medical 
institution, and who requires a level of care provided in a 
hospital, skilled nursing facility, intermediate care facility, 
or intermediate care facility for persons with mental 
retardation or related conditions, for whom home care is 
appropriate, provided that the cost to medical assistance for 
home care services is not more than the amount that medical 
assistance would pay for appropriate institutional care. 
      (b) For purposes of this subdivision, "hospital" means an 
acute care institution as defined in section 144.696, 
subdivision 3, licensed pursuant to sections 144.50 to 144.58, 
which is appropriate if a person is technology dependent or has 
a chronic health condition which requires frequent intervention 
by a health care professional to avoid death. 
     (c) For purposes of this subdivision, "skilled nursing 
facility" and "intermediate care facility" means a facility 
which provides nursing care as defined in section 144A.01, 
subdivision 5, licensed pursuant to sections 144A.02 to 144A.10, 
which is appropriate if a person is in active restorative 
treatment; is in need of special treatments provided or 
supervised by a licensed nurse; or has unpredictable episodes of 
active disease processes requiring immediate judgment by a 
licensed nurse.  
    (d) For purposes of this subdivision, "intermediate care 
facility for the mentally retarded" or "ICF/MR" means a program 
licensed to provide services to persons with mental retardation 
under section 252.28, and chapter 245A, and a physical plant 
licensed as a supervised living facility under chapter 144, 
which together are certified by the Minnesota department of 
health as meeting the standards in Code of Federal Regulations, 
title 42, part 483, for an intermediate care facility which 
provides services for persons with mental retardation or persons 
with related conditions who require 24-hour supervision and 
active treatment for medical, behavioral, or habilitation needs. 
    (e) For purposes of this subdivision, a person "requires a 
level of care provided in a hospital, skilled nursing facility, 
intermediate care facility, or intermediate care facility for 
persons with mental retardation or related conditions" if the 
person requires 24-hour supervision because the person exhibits 
suicidal or homicidal ideation or behavior, psychosomatic 
disorders or somatopsychic disorders that may become life 
threatening, severe socially unacceptable behavior associated 
with psychiatric disorder, psychosis or severe developmental 
problems requiring continuous skilled observation, or disabling 
symptoms that do not respond to office-centered outpatient 
treatment. 
    The determination of the level of care needed by the child 
shall be made by the commissioner based on information supplied 
to the commissioner by the case manager if the child has one, 
the parent or guardian, the child's physician or physicians or, 
if available, the screening information obtained under section 
256B.092. 
    Sec. 35.  Minnesota Statutes 1990, section 256B.057, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] An infant 
less than one year of age or a pregnant woman who has written 
verification of a positive pregnancy test from a physician or 
licensed registered nurse, is eligible for medical assistance if 
countable family income is equal to or less than 185 percent of 
the federal poverty guideline for the same family size.  
Eligibility for a pregnant woman or infant less than one year of 
age under this subdivision must be determined without regard to 
asset standards established in section 256B.056, subdivision 3.  
Adjustments in the income limits due to annual changes in the 
federal poverty guidelines shall be implemented the first day of 
July following publication of the changes. 
    An infant born on or after January 1, 1991, to a woman who 
was eligible for and receiving medical assistance on the date of 
the child's birth shall continue to be eligible for medical 
assistance without redetermination until the child's first 
birthday, as long as the child remains in the woman's household. 
    Sec. 36.  Minnesota Statutes 1990, section 256B.057, 
subdivision 2, is amended to read: 
    Subd. 2.  [CHILDREN.] A child one through five years of age 
in a family whose countable income is less than 133 percent of 
the federal poverty guidelines for the same family size, is 
eligible for medical assistance.  A child six through seven 18 
years of age, who was born after September 30, 1983, in a family 
whose countable income is less than 100 percent of the federal 
poverty guidelines for the same family size is eligible for 
medical assistance.  Eligibility for children under this 
subdivision must be determined without regard to asset standards 
established in section 256B.056, subdivision 3.  Adjustments in 
the income limits due to annual changes in the federal poverty 
guidelines shall be implemented the first day of July following 
publication of the changes.  
    Sec. 37.  Minnesota Statutes 1990, section 256B.057, 
subdivision 3, is amended to read: 
    Subd. 3.  [QUALIFIED MEDICARE BENEFICIARIES.] A person who 
is entitled to Part A Medicare benefits, whose income is equal 
to or less than 85 percent of the federal poverty guidelines, 
and whose assets are no more than twice the asset limit used to 
determine eligibility for the supplemental security income 
program, is eligible for medical assistance reimbursement of 
Part A and Part B premiums, Part A and Part B coinsurance and 
deductibles, and cost-effective premiums for enrollment with a 
health maintenance organization or a competitive medical plan 
under section 1876 of the Social Security Act.  The income limit 
shall be increased to 90 percent of the federal poverty 
guidelines on January 1, 1990; and to 95 100 percent on January 
1, 1991; and to 100 percent on January 1, 1992.  Reimbursement 
of the Medicare coinsurance and deductibles, when added to the 
amount paid by Medicare, must not exceed the total rate the 
provider would have received for the same service or services if 
the person were a medical assistance recipient with Medicare 
coverage.  Adjustments in the income limits due to annual 
changes in the federal poverty guidelines shall be implemented 
the first day of July following publication of the 
changes.  Increases in benefits under Title II of the Social 
Security Act shall not be counted as income for purposes of this 
subdivision until the first day of the second full month 
following publication of the change in the federal poverty 
guidelines. 
    Sec. 38.  Minnesota Statutes 1990, section 256B.057, 
subdivision 4, is amended to read: 
    Subd. 4.  [QUALIFIED WORKING DISABLED ADULTS.] A person who 
is entitled to Medicare Part A benefits under section 1818A of 
the Social Security Act; whose income does not exceed 200 
percent of the federal poverty guidelines for the applicable 
family size; whose nonexempt assets do not exceed twice the 
maximum amount allowable under the supplemental security income 
program, according to family size; and who is not otherwise 
eligible for medical assistance, is eligible for medical 
assistance reimbursement of the Medicare Part A premium.  
Adjustments in the income limits due to annual changes in the 
federal poverty guidelines shall be implemented the first day of 
July following publication of the changes. 
    Sec. 39.  Minnesota Statutes 1990, section 256B.057, is 
amended by adding a subdivision to read: 
    Subd. 6.  [DISABLED WIDOWS AND WIDOWERS.] A person who is 
at least 50 years old who is entitled to disabled widow's or 
widower's benefits under United States Code, title 42, section 
402(e) or (f), who is not entitled to Medicare Part A, and who 
received supplemental security income or Minnesota supplemental 
aid in the month before the month the widow's or widower's 
benefits began, is eligible for medical assistance as long as 
the person would be entitled to supplemental security income or 
Minnesota supplemental aid in the absence of the widow's or 
widower's benefits. 
    Sec. 40.  Minnesota Statutes 1990, 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, the amount of 
his or her veteran's pension 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 if the children resided with the 
institutionalized person immediately prior to admission; 
    (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; and 
    (7) reparations payments made by the Federal Republic of 
Germany; and 
     (8) amounts for reasonable expenses incurred for necessary 
medical or remedial care for the institutionalized spouse that 
are not medical assistance covered expenses and that are not 
subject to payment by a third party.  
    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. 
    Sec. 41.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 4, is amended to read: 
    Subd. 4.  [OUTPATIENT AND PHYSICIAN-DIRECTED CLINIC 
SERVICES.] Medical assistance covers outpatient hospital or 
physician-directed clinic services.  The physician-directed 
clinic staff shall include at least two physicians and all 
services shall be provided under the direct supervision of a 
physician.  Hospital outpatient departments are subject to the 
same limitations and reimbursements as other enrolled vendors 
for all services, except initial triage, emergency services, and 
services not provided or immediately available in clinics, 
physicians' offices, or by other enrolled providers.  A second 
medical opinion is required before reimbursement for elective 
surgeries requiring a second opinion.  The commissioner shall 
publish in the State Register a list of elective surgeries that 
require a second medical opinion before reimbursement and the 
criteria and standards for deciding whether an elective surgery 
should require a second surgical opinion.  The list and the 
criteria and standards are not subject to the requirements of 
sections 14.001 to 14.69.  The commissioner's decision whether a 
second medical opinion is required, made in accordance with 
rules governing that decision, is not subject to administrative 
appeal.  "Emergency services" means those medical services 
required for the immediate diagnosis and treatment of medical 
conditions that, if not immediately diagnosed and treated, could 
lead to serious physical or mental disability or death or are 
necessary to alleviate severe pain.  Neither the hospital, its 
employees, nor any physician or dentist, shall be liable in any 
action arising out of a determination not to render emergency 
services or care if reasonable care is exercised in determining 
the condition of the person, or in determining the 
appropriateness of the facilities, or the qualifications and 
availability of personnel to render these services consistent 
with this section.  
    Sec. 42.  Minnesota Statutes 1990, section 256B.0625, is 
amended by adding a subdivision to read: 
    Subd. 4a.  [SECOND MEDICAL OPINION FOR SURGERY.] Certain 
surgeries require a second medical opinion to confirm the 
necessity of the procedure, in order for reimbursement to be 
made.  The commissioner shall publish in the State Register a 
list of surgeries that require a second medical opinion and the 
criteria and standards for deciding whether a surgery should 
require a second medical opinion.  The list and the criteria and 
standards are not subject to the requirements of sections 14.01 
to 14.69.  The commissioner's decision about whether a second 
medical opinion is required, made according to rules governing 
that decision, is not subject to administrative appeal. 
    Sec. 43.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 13, is amended to read: 
    Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs if 
prescribed by a licensed practitioner and dispensed by a 
licensed pharmacist, or by a physician enrolled in the medical 
assistance program as a dispensing physician.  The commissioner 
shall designate a formulary committee to advise the commissioner 
on the names of drugs for which payment is made, recommend a 
system for reimbursing providers on a set fee or charge basis 
rather than the present system, and develop methods encouraging 
use of generic drugs when they are less expensive and equally 
effective as trademark drugs.  The commissioner shall appoint 
the formulary committee members no later than 30 days following 
July 1, 1981.  The formulary committee shall consist of nine 
members, four of whom shall be physicians who are not employed 
by the department of human services, and a majority of whose 
practice is for persons paying privately or through health 
insurance, three of whom shall be pharmacists who are not 
employed by the department of human services, and a majority of 
whose practice is for persons paying privately or through health 
insurance, a consumer representative, and a nursing home 
representative.  Committee members shall serve two-year terms 
and shall serve without compensation.  The commissioner may 
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 
committee shall review and recommend drugs which require prior 
authorization.  Prior authorization may be required by the 
commissioner, with the consent of the drug formulary committee, 
before certain formulary drugs are eligible for payment.  The 
formulary shall not include:  drugs or products for which there 
is no federal funding; over-the-counter drugs, except for 
antacids, acetaminophen, family planning products, aspirin, 
insulin, products for the treatment of lice, and vitamins for 
children under the age of seven and pregnant or nursing women; 
or any other over-the-counter drug identified by the 
commissioner, in consultation with the appropriate professional 
consultants under contract with or employed by the state agency, 
drug formulary committee as necessary, appropriate and cost 
effective for the treatment of certain specified chronic 
diseases, conditions or disorders, and this determination shall 
not be subject to the requirements of chapter 14, the 
administrative procedure act; nutritional products, except for 
those products needed for treatment of phenylketonuria, 
hyperlysinemia, maple syrup urine disease, a combined allergy to 
human milk, cow milk, and soy formula, or any other childhood or 
adult diseases, conditions, or disorders identified by the 
commissioner as requiring a similarly necessary nutritional 
product; anorectics; and drugs for which medical value has not 
been established.  Separate payment shall not be made for 
nutritional products for residents of long-term care facilities; 
payment for dietary requirements is a component of the per diem 
rate paid to these facilities.  Payment to drug vendors shall 
not be modified before the formulary is established except that 
the commissioner shall not permit payment for any drugs which 
may not by law be included in the formulary, and the 
commissioner's determination shall not be subject to chapter 14, 
the administrative procedure act.  The commissioner shall 
publish conditions for prohibiting payment for specific drugs 
after considering the formulary committee's recommendations.  
    (b) 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 established by the commissioner, 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.  Actual acquisition cost 
includes quantity and other special discounts except time and 
cash discounts.  The actual acquisition cost of a drug may be 
estimated by the commissioner.  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.  An additional dispensing fee of 
$.30 may be added to the dispensing fee paid to pharmacists for 
legend drug prescriptions dispensed to residents of long-term 
care facilities when a unit dose blister card system, approved 
by the department, is used.  Under this type of dispensing 
system, the pharmacist must dispense a 30-day supply of drug.  
The National Drug Code (NDC) from the drug container used to 
fill the blister card must be identified on the claim to the 
department.  The unit dose blister card containing the drug must 
meet the packaging standards set forth in Minnesota Rules, part 
6800.2700, that govern the return of unused drugs to the 
pharmacy for reuse.  The pharmacy provider will be required to 
credit the department for the actual acquisition cost of all 
unused drugs that are eligible for reuse.  Over-the-counter 
medications must be dispensed in the manufacturer's unopened 
package.  The commissioner may permit the drug clozapine to be 
dispensed in a quantity that is less than a 30-day supply.  
Whenever a generically equivalent product is available, payment 
shall be on the basis of the actual acquisition cost of the 
generic drug, unless the prescriber specifically indicates 
"dispense as written - brand necessary" on the prescription as 
required by section 151.21, subdivision 2.  Implementation of 
any change in the fixed dispensing fee that has not been subject 
to the administrative procedure act is limited to not more than 
180 days, unless, during that time, the commissioner initiates 
rulemaking through the administrative procedure act. 
    Sec. 44.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 17, is amended to read: 
    Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
covers transportation costs incurred solely for obtaining 
emergency medical care or transportation costs incurred by 
nonambulatory persons in obtaining emergency or nonemergency 
medical care when paid directly to an ambulance company, common 
carrier, or other recognized providers of transportation 
services.  For the purpose of this subdivision, a person who is 
incapable of transport by taxicab or bus shall be considered to 
be nonambulatory. 
    (b) Medical assistance covers special transportation, as 
defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
if the provider receives and maintains a current physician's 
order by the recipient's attending physician.  The commissioner 
shall establish maximum medical assistance reimbursement rates 
for special transportation services for persons who need a 
wheelchair lift van or stretcher-equipped vehicle and for those 
who do not need a wheelchair lift van or stretcher-equipped 
vehicle.  The average of these two rates must not exceed $12.50 
for the base rate and $1 per mile.  Special transportation 
provided to nonambulatory persons who do not need a wheelchair 
lift van or stretcher-equipped vehicle, may be reimbursed at a 
lower rate than special transportation provided to persons who 
need a wheelchair lift van or stretcher-equipped vehicle. 
    Sec. 45.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 19, is amended to read: 
    Subd. 19.  [PERSONAL CARE ASSISTANTS.] Medical assistance 
covers personal care assistant services provided by an 
individual, not a relative, who is qualified to provide the 
services, where the services are prescribed by a physician in 
accordance with a plan of treatment and are supervised by a 
registered nurse.  Payments to personal care assistants shall be 
adjusted annually to reflect changes in the cost of living or of 
providing services by the average annual adjustment granted to 
vendors such as nursing homes and home health agencies.  The 
commissioner shall not provide an annual inflation adjustment 
for the fiscal year ending June 30, 1993. 
    Sec. 46.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 24, is amended to read: 
    Subd. 24.  [OTHER MEDICAL OR REMEDIAL CARE.] Medical 
assistance covers any other medical or remedial care licensed 
and recognized under state law unless otherwise prohibited by 
law, except licensed chemical dependency treatment programs or 
primary treatment or extended care treatment units in hospitals 
that are covered under Laws 1986, chapter 394, sections 8 to 
20 chapter 254B.  The commissioner shall include chemical 
dependency services in the state medical assistance plan for 
federal reporting purposes, but payment must be made under Laws 
1986, chapter 394, sections 8 to 20 chapter 254B.  The 
commissioner shall publish in the State Register a list of 
elective surgeries that require a second medical opinion before 
medical assistance reimbursement, and the criteria and standards 
for deciding whether an elective surgery should require a second 
medical opinion.  The list and criteria and standards are not 
subject to the requirements of sections 14.01 to 14.69.  
    Sec. 47.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 25, is amended to read: 
    Subd. 25.  [SECOND OPINION OR PRIOR AUTHORIZATION 
REQUIRED.] The commissioner shall publish in the State Register 
a list of health services that require prior authorization, as 
well as the criteria and standards used to select health 
services on the list.  The list and the criteria and standards 
used to formulate it are not subject to the requirements of 
sections 14.001 to 14.69.  The commissioner's decision whether 
prior authorization is required for a health service or a second 
medical opinion is required for an elective surgery is not 
subject to administrative appeal. 
    Sec. 48.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 28, is amended to read: 
    Subd. 28.  [CERTIFIED PEDIATRIC OR FAMILY NURSE 
PRACTITIONER SERVICES.] Medical assistance covers services 
performed by a certified pediatric nurse practitioner or, a 
certified family nurse practitioner, a certified adult nurse 
practitioner, or a certified geriatric nurse practitioner in 
independent practice, if the services are otherwise covered 
under this chapter as a physician service, and if the service is 
within the scope of practice of the nurse practitioner's license 
as a registered nurse, as defined in section 148.171. 
    Sec. 49.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 30, is amended to read: 
    Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
covers rural health clinic services, federally qualified health 
center services, and nonprofit community health clinic services, 
public health clinic services, and the services of a clinic 
meeting the criteria established in rule by the commissioner.  
Rural health clinic services and federally qualified health 
center services mean services defined in United States Code, 
title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
health clinic and federally qualified health center services 
shall be made according to applicable federal law and regulation.
    (b) A federally qualified health center that is beginning 
initial operation shall submit an estimate of budgeted costs and 
visits for the initial reporting period in the form and detail 
required by the commissioner.  A federally qualified health 
center that is already in operation shall submit an initial 
report using actual costs and visits for the initial reporting 
period.  Within 90 days of the end of its reporting period, a 
federally qualified health center shall submit, in the form and 
detail required by the commissioner, a report of its operations, 
including allowable costs actually incurred for the period and 
the actual number of visits for services furnished during the 
period, and other information required by the commissioner.  
Federally qualified health centers that file Medicare cost 
reports shall provide the commissioner with a copy of the most 
recent Medicare cost report filed with the Medicare program 
intermediary for the reporting year which support the costs 
claimed on their cost report to the state. 
    Sec. 50.  Minnesota Statutes 1990, section 256B.08, is 
amended by adding a subdivision to read: 
    Subd. 3.  [OUTREACH LOCATIONS.] The local agency must 
establish locations, other than those used to process 
applications for cash assistance, to receive and perform initial 
processing of applications for pregnant women and children who 
want medical assistance only.  At a minimum, these locations 
must be in federally qualified health centers and in hospitals 
that receive disproportionate share adjustments under section 
256.969, subdivision 8, except that hospitals located outside of 
this state that receive the disproportionate share adjustment 
are not included.  Initial processing of the application need 
not include a final determination of eligibility.  Local 
agencies shall designate a person or persons within the agency 
who will receive the applications taken at an outreach location 
and the local agency will be responsible for timely 
determination of eligibility. 
    Sec. 51.  Minnesota Statutes 1990, section 256B.19, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DIVISION OF COST.] The cost state and 
county share of medical assistance paid by each county of 
financial responsibility costs not paid by federal funds shall 
be borne as follows:  
    (1) ninety percent of the expense of assistance not paid by 
federal funds available for that purpose shall be paid by the 
state funds and ten percent shall be paid by the county of 
financial responsibility funds, unless otherwise provided below; 
    (2) beginning January 1, 1992, 50 percent state funds and 
50 percent county funds for the cost of placement of severely 
emotionally disturbed children in regional treatment centers.  
    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.  
    Beginning July 1, 1991, the state will reimburse counties 
according to the payment schedule in section 256.025 for the 
county share of costs incurred under this subdivision from 
January 1, 1991, on.  Payment to counties under this subdivision 
is subject to the provisions of section 256.017. 
    In counties where prepaid health plans are under contract 
to the commissioner to provide services to medical assistance 
recipients, the cost of court ordered treatment ordered without 
consulting the prepaid health plan that does not include 
diagnostic evaluation, recommendation, and referral for 
treatment by the prepaid health plan is the responsibility of 
the county of financial responsibility.  
    Sec. 52.  Minnesota Statutes 1990, section 256B.19, is 
amended by adding a subdivision to read: 
    Subd. 1a.  [STATE REIMBURSEMENT OF COUNTIES.] Beginning 
July 1, 1991, the state will reimburse counties according to the 
payment schedule in section 256.025 for the county share of 
costs incurred under this subdivision on and after January 1, 
1991, except for costs described in subdivision 1, clause (2).  
Payment to counties under this subdivision is subject to the 
provisions of section 256.017. 
    Sec. 53.  Minnesota Statutes 1990, section 256B.19, is 
amended by adding a subdivision to read: 
    Subd. 2c.  [OBLIGATION OF LOCAL AGENCY TO INVESTIGATE AND 
DETERMINE ELIGIBILITY FOR MEDICAL ASSISTANCE.] (a) When the 
commissioner receives information that indicates that a general 
assistance medical care recipient or children's health plan 
enrollee may be eligible for medical assistance, the 
commissioner may notify the appropriate local agency of that 
fact.  The local agency must investigate eligibility for medical 
assistance and take appropriate action and notify the 
commissioner of that action within 90 days from the date notice 
is issued.  If the person is eligible for medical assistance, 
the local agency must find eligibility retroactively to the date 
on which the person met all eligibility requirements. 
    (b) When a prepaid health plan under a contract with the 
state to provide medical assistance services notifies the 
commissioner that an infant has been or will be born to an 
enrollee under the contract, the commissioner may notify the 
appropriate local agency of that fact.  The local agency must 
investigate eligibility for medical assistance for the infant, 
take appropriate action, and notify the commissioner of that 
action within 90 days from the date notice is issued.  If the 
infant would have been eligible on the date of birth, the local 
agency must establish eligibility retroactively to that month. 
    (c) For general assistance medical care recipients and 
children's health plan enrollees, if the local agency fails to 
comply with paragraph (a), the local agency is responsible for 
the entire cost of general assistance medical care or children's 
health plan services provided from the date the commissioner 
issues the notice until the date the local agency takes 
appropriate action on the case and notifies the commissioner of 
the action.  For infants, if the local agency fails to comply 
with paragraph (b), the commissioner may determine eligibility 
for medical assistance for the infant for a period of two 
months, and the local agency shall be responsible for the entire 
cost of medical assistance services provided for that infant, in 
addition to a fee of $100 for processing the case.  The 
commissioner shall deduct any obligation incurred under this 
paragraph from the amount due to the local agency under 
subdivision 1. 
    Sec. 54.  Minnesota Statutes 1990, section 256B.431, 
subdivision 2l, is amended to read: 
    Subd. 2l.  [INFLATION ADJUSTMENTS AFTER JULY 1, 1990.] (a) 
For rate years beginning on or after July 1, 1990, the 
forecasted composite price index for a nursing home's allowable 
operating cost per diems shall be determined using Data 
Resources, Inc., forecast for change in the Nursing Home Market 
Basket.  The commissioner of human services shall use the 
indices as forecasted by Data Resources, Inc., in the fourth 
quarter of the calendar year preceding the rate year. 
    (b) For rate years beginning on or after July 1, 1992, the 
commissioner shall index the prior year's operating cost limits 
by the percentage change in the Data Resources, Inc., nursing 
home market basket between the midpoint of the current reporting 
year and the midpoint of the previous reporting year.  The 
commissioner shall use the indices as forecasted by Data 
Resources, Inc., in the fourth quarter of the calendar year 
preceding the rate year. 
    Sec. 55.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2m.  [NURSING HOMES SPECIALIZING IN THE TREATMENT OF 
HUNTINGTON'S DISEASE.] For the rate year beginning July 1, 1991, 
the commissioner shall reimburse nursing homes that specialize 
in the treatment of Huntington's disease using the case mix per 
diem limit that applies to nursing homes licensed under the 
department of human services' rules governing residential 
services for physically handicapped persons to establish rates 
for up to 35 persons with Huntington's disease.  For purposes of 
this subdivision, a nursing home specializes in the treatment of 
Huntington's disease if more than 25 percent of its licensed 
capacity is used for residents with Huntington's disease.  
    Sec. 56.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2n.  [EFFICIENCY INCENTIVE REDUCTIONS FOR SUBSTANDARD 
CARE.] For rate years beginning on or after July 1, 1991, the 
efficiency incentive established under subdivision 2b, paragraph 
(d), shall be reduced or eliminated for nursing homes determined 
by the commissioner of health under section 144A.10, subdivision 
4, to have uncorrected or repeated violations which create a 
risk to resident care, safety, or rights, except for uncorrected 
or repeated violations relating to a facility's physical plant.  
Upon being notified by the commissioner of health of uncorrected 
or repeated violations, the commissioner of human services shall 
require the nursing home to use efficiency incentive payments to 
correct the violations.  The commissioner of human services 
shall require the nursing home to forfeit efficiency incentive 
payments for failure to correct the violations.  Any forfeiture 
shall be limited to the amount necessary to correct the 
violation.  
    Sec. 57.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2o.  [SPECIAL PAYMENT RATES FOR SHORT-STAY NURSING 
HOMES.] Notwithstanding contrary provisions of this section and 
rules adopted by the commissioner, for the rate year beginning 
July 1, 1992, a nursing home whose average length of stay for 
the rate year beginning July 1, 1991, is less than 180 days must 
be reimbursed for allowable costs up to 125 percent of the total 
care-related limit and 105 percent of the other-operating-cost 
limit for hospital-attached nursing facilities.  The nursing 
home continues to receive this rate even if the home's average 
length of stay is more than 180 days in the rate year subsequent 
to the rate year beginning July 1, 1991. 
    Sec. 58.  Minnesota Statutes 1990, section 256B.431, 
subdivision 3e, is amended to read: 
    Subd. 3e.  [HOSPITAL-ATTACHED CONVALESCENT AND NURSING CARE 
FACILITIES.] If a nonprofit or community-operated hospital and 
attached convalescent and nursing care facility suspend 
operation of the hospital, the surviving nursing care facility 
must be allowed to continue its status as a hospital-attached 
convalescent and nursing care facility for reimbursement 
purposes in three five subsequent rate years.  In the fourth 
year the facility shall receive 60 percent of the difference 
between the hospital-attached limit and the freestanding nursing 
facility limit, and in the fifth year the facility shall receive 
30 percent of the difference.  
    Sec. 59.  Minnesota Statutes 1990, section 256B.431, 
subdivision 3f, is amended to read: 
    Subd. 3f.  [PROPERTY COSTS AFTER JULY 1, 1988.] (a) [ 
INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 
1988, the replacement-cost-new per bed limit must be $32,571 per 
licensed bed in multiple bedrooms and $48,857 per licensed bed 
in a single bedroom.  For the rate year beginning July 1, 1989, 
the replacement-cost-new per bed limit for a single bedroom must 
be $49,907 adjusted according to Minnesota Rules, part 
9549.0060, subpart 4, item A, subitem (1).  Beginning January 1, 
1990, the replacement-cost-new per bed limits must be adjusted 
annually as specified in Minnesota Rules, part 9549.0060, 
subpart 4, item A, subitem (1).  Beginning January 1, 1991, the 
replacement-cost-new per bed limits will be adjusted annually as 
specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 
subitem (1), except that the index utilized will be the Bureau 
of the Census:  Composite fixed-weighted price index as 
published in the Survey of Current Business. 
    Sec. 60.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 12.  [INTERIM PROPERTY-RELATED PAYMENT RATES.] For 
the rate period July 1, 1991, to June 30, 1993, the commissioner 
shall continue the property-related payment rate in effect on 
June 30, 1991, for each nursing facility, except as provided in 
section 256B.431, subdivision 3i, paragraphs (f) and (g), and 
subdivision 11, except that: 
    (1) A chain organization consisting of 28 nursing 
facilities which has a majority of owners beyond the retirement 
age of 62 and that has a change in ownership or reorganization 
of provider entity between July 1, 1991, and June 30, 1993, or 
until the property reimbursement system is changed, shall 
receive the property-related payment rate in effect at the time 
of the sale or reorganization.  This exception is not effective 
until the commissioner has received approval of its state plan 
from the federal government; and 
    (2) If the property-related payment rate in effect on June 
30, 1991, is later adjusted by the commissioner, the 
property-related payment rate for the rate period July 1, 1991, 
to July 1, 1993, shall also be adjusted correspondingly. 
    Sec. 61.  Minnesota Statutes 1990, section 256B.49, is 
amended by adding a subdivision to read: 
    Subd. 4.  [INFLATION ADJUSTMENT.] For the biennium ending 
June 30, 1993, the commissioner of human services shall not 
provide an annual inflation adjustment for home and 
community-based waivered services, except as provided in section 
256B.491, subdivision 3, and except that the commissioner shall 
provide an inflation adjustment for the community alternatives 
for disabled individuals (CADI) and community alternative care 
(CAC) waivered services programs for the fiscal year beginning 
July 1, 1991. 
    Sec. 62.  Minnesota Statutes 1990, section 256B.491, is 
amended by adding a subdivision to read: 
    Subd. 3.  [WAIVERED SERVICES; SALARY ADJUSTMENTS.] For the 
fiscal year beginning July 1, 1991, the commissioner of human 
services shall increase the statewide reimbursement rates for 
home and community-based waivered services for persons with 
developmental disabilities to reflect a three percent increase 
in salaries, payroll taxes, and fringe benefits of personnel 
below top management employed by agencies under contract with 
the county board to provide these services.  The specific rate 
increase made available to county boards shall be calculated 
based on the estimated portion of the fiscal year 1991 
reimbursement rate that is attributable to these costs.  County 
boards shall verify in writing to the commissioner that each 
waivered service provider has complied with this requirement.  
If a county board determines that a waivered service provider 
has not complied with this requirement for a specific contract 
period, the county board shall reduce the provider's payment 
rates for the next contract period to reflect the amount of 
money not spent appropriately.  The commissioner shall modify 
reporting requirements for vendors and counties as necessary to 
monitor compliance with this provision. 
    Sec. 63.  Minnesota Statutes 1990, section 256B.50, 
subdivision 1d, is amended to read: 
    Subd. 1d.  [EXPEDITED APPEAL REVIEW PROCESS.] (a) Within 
120 days of the date an appeal is due according to subdivision 
1b, the department shall review an appealed adjustment equal to 
or less than $100 annually per licensed bed of the provider, 
make a determination concerning the adjustment, and notify the 
provider of the determination.  Except as allowed in paragraph 
(g), this review does not apply to an appeal of an adjustment 
made to, or proposed on, an amount already paid to the 
provider.  In this subdivision, an adjustment is each separate 
disallowance, allocation, or adjustment of a cost item or part 
of a cost item as submitted by a provider according to forms 
required by the commissioner. 
    (b) For an item on which the provider disagrees with the 
results of the determination of the department made under 
paragraph (a), the provider may, within 60 days of the date of 
the review notice, file with both the office of administrative 
hearings and the department its written argument and documents, 
information, or affidavits in support of its appeal.  If the 
provider fails to make a submission timely submissions in 
accordance with this paragraph, the department's determinations 
on the disputed items must be upheld. 
     (c) Within 60 days of the date the department received the 
provider's submission under paragraph (b), the department may 
file with the office of administrative hearings and serve upon 
the provider its written argument and documents, information, 
and affidavits in support of its determination.  If the 
department fails to make a submission in accordance with this 
paragraph, the administrative law judge shall proceed pursuant 
to paragraph (d) based on the provider's submission. 
     (d) Upon receipt by the office of administrative hearings 
of the department's submission made under paragraph (c) or upon 
the expiration of the 60-day filing period, whichever is 
earlier, the chief administrative law judge shall assign the 
matter to an administrative law judge.  The administrative law 
judge shall consider the submissions of the parties and all 
relevant rules, statutes, and case law.  The administrative law 
judge may request additional argument from the parties if it is 
deemed necessary to reach a final decision, but shall not allow 
witnesses to be presented or discovery to be made in the 
proceeding.  Within 60 days of receipt by the office of 
administrative hearings of the department's submission or the 
expiration of the 60-day filing period in paragraph (c), 
whichever is earlier, the administrative law judge shall make a 
final decision on the items in issue, and shall notify the 
provider and the department by first-class mail of the decision 
on each item.  The decision of the administrative law judge is 
the final administrative decision, is not appealable, and does 
not create legal precedent, except that the department may make 
an adjustment contrary to the decision of the administrative law 
judge based upon a subsequent cost report amendment or field 
audit that reveals information relating to the adjustment that 
was not known to the department at the time of the final 
decision. 
    (e) For a disputed item otherwise subject to the review set 
forth in this subdivision, the department and the provider may 
mutually agree to bypass the expedited review process and 
proceed to a contested case hearing at any time prior to the 
time for the department's submission under paragraph (c). 
    (f) When the department determines that the appeals of two 
or more providers otherwise an appeal item subject to the review 
set forth in this subdivision present presents the same or 
substantially the same adjustment, presented in another appeal 
filed pursuant to this chapter, the department may remove the 
disputed items from the review in this subdivision, and the 
disputed items shall proceed in accordance with subdivision 1c.  
The department's decision to remove the appealed adjustments to 
contested case proceeding is final and is not reviewable. 
    (g) For a disputed item otherwise subject to the review in 
this subdivision, the department or a provider may petition the 
chief administrative law judge to issue an order allowing the 
petitioning party to bypass the expedited review process.  If 
the petition is granted, the disputed item must proceed in 
accordance with subdivision 1c.  In making the determination, 
the chief administrative law judge shall consider the potential 
impact and precedential and monetary value of the disputed 
item.  A petition for removal to contested case hearing must be 
filed with the chief administrative law judge and the opposing 
party on or before the date on which its submission is due under 
paragraph (b) or (c).  Within 20 days of receipt of the 
petition, the opposing party may submit its argument opposing 
the petition.  Within 20 days of receipt of the argument 
opposing the petition, or if no argument is received, within 20 
days of the date on which the argument was due, the chief 
administrative law judge shall issue a decision granting or 
denying the petition.  If the petition is denied, the 
petitioning party has 60 days from the date of the denial to 
make a submission under paragraph (b) or (c). 
    (h) The department and a provider may mutually agree to use 
the procedures set forth in this subdivision for any disputed 
item not otherwise subject to this subdivision. 
    (i) Nothing shall prevent either party from making its 
submissions and arguments under this subdivision through a 
person who is not an attorney. 
    (j) This subdivision applies to all appeals for rate years 
beginning after June 30, 1988. 
    Sec. 64.  Minnesota Statutes 1990, section 256B.501, 
subdivision 8, is amended to read: 
    Subd. 8.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS.] The 
commissioner shall establish by December 31, 1983, procedures to 
be followed by the counties to seek authorization from the 
commissioner for medical assistance reimbursement for very 
dependent persons with special needs in an amount in excess of 
the rates allowed pursuant to subdivisions 2 and 4, including 
rates established under section 252.46 when they apply to 
services provided to residents of intermediate care facilities 
for persons with mental retardation or related conditions, and 
procedures to be followed for rate limitation exemptions for 
intermediate care facilities for persons with mental retardation 
or related conditions.  No excess payment or limitation 
exemption approved by the commissioner after June 30, 1991, 
shall be authorized unless the need for the service is 
documented in the individual service plan of the person or 
persons to be served, the type and duration of the services 
needed are stated, and there is a basis for estimated cost of 
the services.: 
    (1) the need for specific level of service is documented in 
the individual service plan of the person to be served; 
    (2) the level of service needed can be provided within the 
rates established under section 252.46 and Minnesota Rules, 
parts 9553.0010 to 9553.0080, without a rate exception within 12 
months; 
    (3) staff hours beyond those available under the rates 
established under section 252.46 and Minnesota Rules, parts 
9553.0010 to 9553.0080, necessary to deliver services do not 
exceed 720 hours within six months; 
    (4) there is a basis for the estimated cost of services; 
    (5) the provider requesting the exception documents that 
current per diem rates are insufficient to support needed 
services; 
    (6) estimated costs, when added to the costs of current 
medical assistance-funded residential and day training and 
habilitation services and calculated as a per diem, do not 
exceed the per diem established for the regional treatment 
centers for persons with mental retardation and related 
conditions on July 1, 1990, indexed annually by the urban 
consumer price index, all items, published by the United States 
Department of Labor, for the next fiscal year over the current 
fiscal year; 
    (7) any contingencies for an approval as outlined in 
writing by the commissioner are met; and 
    (8) any commissioner orders for use of preferred providers 
are met. 
    The commissioner shall evaluate the services provided 
pursuant to this subdivision through program and fiscal audits.  
    The commissioner may terminate the rate exception at any 
time under any of the conditions outlined in Minnesota Rules, 
part 9510.1120, subpart 3, for county termination, or by reason 
of information obtained through program and fiscal audits which 
indicate the criteria outlined in this subdivision have not 
been, or are no longer being, met. 
    The commissioner may approve no more than two consecutive 
six-month rate exceptions for an eligible client whose first 
application for funding occurs after June 30, 1991. 
    Sec. 65.  Minnesota Statutes 1990, section 256B.501, 
subdivision 11, is amended to read: 
    Subd. 11.  [INVESTMENT PER BED LIMITS, INTEREST EXPENSE 
LIMITATIONS, AND ARMS-LENGTH LEASES.] (a) The provisions of 
Minnesota Rules, part 9553.0075, except as modified under this 
subdivision, shall apply to newly constructed or established 
facilities that are certified for medical assistance on or after 
May 1, 1990.  
     (b) For purposes of establishing payment rates under this 
subdivision and Minnesota Rules, parts 9553.0010 to 9553.0080, 
the term "newly constructed or newly established" means a 
facility (1) for which a need determination has been approved by 
the commissioner under sections 252.28 and 252.291; (2) whose 
program is newly licensed under Minnesota Rules, parts 9525.0215 
to 9525.0355, and certified under Code of Federal Regulations, 
title 42, section 442.400, et seq.; and (3) that is part of a 
proposal that meets the requirements of section 252.291, 
subdivision 2, paragraph (2).  The term does not include a 
facility for which a need determination was granted solely for 
other reasons such as the relocation of a facility; a change in 
the facility's name, program, number of beds, type of beds, or 
ownership; or the sale of a facility, unless the relocation of a 
facility to one or more service sites is the result of a closure 
of a facility under section 252.292, in which case clause (3) 
shall not apply.  The term does include a facility that converts 
more than 50 percent of its licensed beds from class A to class 
B residential or class B institutional to serve persons 
discharged from state regional treatment centers on or after May 
1, 1990, in which case clause (3) does not apply.  
     (c) Newly constructed or newly established facilities that 
are certified for medical assistance on or after May 1, 1990, 
shall be allowed the capital asset investment per bed limits as 
provided in clauses (1) to (4).  
     (1) The 1990 calendar year investment per bed limit for a 
facility's land must not exceed $5,700 per bed for newly 
constructed or newly established facilities in Hennepin, Ramsey, 
Anoka, Washington, Dakota, Scott, Carver, Chisago, Isanti, 
Wright, Benton, Sherburne, Stearns, St. Louis, Clay, and Olmsted 
counties, and must not exceed $3,000 per bed for newly 
constructed or newly established facilities in other counties.  
     (2) The 1990 calendar year investment per bed limit for a 
facility's depreciable capital assets must not exceed $44,800 
for class B residential beds, and $45,200 for class B 
institutional beds.  
     (3) The investment per bed limit in clause (2) must not be 
used in determining the three-year average percentage increase 
adjustment in Minnesota Rules, part 9553.0060, subpart 1, item 
C, subitem (4), for facilities that were newly constructed or 
newly established before May 1, 1990.  
    (4) The investment per bed limits in clause (2) and 
Minnesota Rules, part 9553.0060, subpart 1, item C, subitem (2) 
shall be adjusted annually beginning January 1, 1991, and each 
January 1 following, as provided in Minnesota Rules, part 
9553.0060, subpart 1, item C, subitem (2), except that the index 
utilized will be the Bureau of the Census:  Composite 
fixed-weighted price index as published in the Survey of Current 
Business.  
     (d) A newly constructed or newly established facility's 
interest expense limitation as provided for in Minnesota Rules, 
part 9553.0060, subpart 3, item F, on capital debt for capital 
assets acquired during the interim or settle-up period, shall be 
increased by 2.5 percentage points for each full .25 percentage 
points that the facility's interest rate on its mortgage is 
below the maximum interest rate as established in Minnesota 
Rules, part 9553.0060, subpart 2, item A, subitem (2).  For all 
following rate periods, the interest expense limitation on 
capital debt in Minnesota Rules, part 9553.0060, subpart 3, item 
F, shall apply to the facility's capital assets acquired, 
leased, or constructed after the interim or settle-up period.  
If a newly constructed or newly established facility is acquired 
by the state, the limitations of this paragraph and Minnesota 
Rules, part 9553.0060, subpart 3, item F, shall not apply.  
     (e) If a newly constructed or newly established facility is 
leased with an arms-length lease as provided for in Minnesota 
Rules, part 9553.0060, subpart 7, the lease agreement shall be 
subject to the following conditions:  
     (1) the term of the lease, including option periods, must 
not be less than 20 years; 
     (2) the maximum interest rate used in determining the 
present value of the lease must not exceed the lesser of the 
interest rate limitation in Minnesota Rules, part 9553.0060, 
subpart 2, item A, subitem (2), or 16 percent; and 
     (3) the residual value used in determining the net present 
value of the lease must be established using the provisions of 
Minnesota Rules, part 9553.0060.  
     (f) All leases of the physical plant of an intermediate 
care facility for the mentally retarded shall contain a clause 
that requires the owner to give the commissioner notice of any 
requests or orders to vacate the premises 90 days before such 
vacation of the premises is to take place.  In the case of 
unlawful detainer actions, the owner shall notify the 
commissioner within three days of notice of an unlawful detainer 
action being served upon the tenant.  The only exception to this 
notice requirement is in the case of emergencies where immediate 
vacation of the premises is necessary to assure the safety and 
welfare of the residents.  In such an emergency situation, the 
owner shall give the commissioner notice of the request to 
vacate at the time the owner of the property is aware that the 
vacating of the premises is necessary.  This section applies to 
all leases entered into after May 1, 1990. Rentals set in leases 
entered into after that date that do not contain this clause are 
not allowable costs for purposes of medical assistance 
reimbursement.  
    (g) A newly constructed or newly established facility's 
preopening costs are subject to the provisions of Minnesota 
Rules, part 9553.0035, subpart 12, and must be limited to only 
those costs incurred during one of the following periods, 
whichever is shorter:  
    (1) between the date the commissioner approves the 
facility's need determination and 30 days before the date the 
facility is certified for medical assistance; or 
    (2) the 12-month period immediately preceding the 30 days 
before the date the facility is certified for medical assistance.
    (h) The development of any newly constructed or newly 
established facility as defined in this subdivision and 
projected to be operational after July 1, 1991, by the 
commissioner of human services shall be delayed until July 1, 
1993, except for those facilities authorized by the commissioner 
as a result of a closure of a facility according to section 
252.292 prior to January 1, 1991, or those facilities developed 
as a result of a receivership of a facility according to section 
245A.12.  This paragraph does not apply to state-operated 
community facilities authorized in section 252.50. 
     Sec. 66.  Minnesota Statutes 1990, section 256B.501, is 
amended by adding a subdivision to read: 
    Subd. 12.  [ICF/MR SALARY ADJUSTMENTS.] For the rate period 
beginning January 1, 1992, and ending September 30, 1993, the 
commissioner shall add the appropriate salary adjustment cost 
per diem calculated in paragraphs (a) to (d) to the total 
operating cost payment rate of each facility.  The salary 
adjustment cost per diem must be determined as follows: 
    (a) [COMPUTATION AND REVIEW GUIDELINES.  Except as provided 
in paragraph (c), a state-operated community service, and any 
facility whose payment rates are governed by closure agreements, 
receivership agreements, or Minnesota Rules, part 9553.0075, are 
not eligible for a salary adjustment otherwise granted under 
this subdivision.  For purposes of the salary adjustment per 
diem computation and reviews in this subdivision, the term 
"salary adjustment cost" means the facility's allowable program 
operating cost category employee training expenses, and the 
facility's allowable salaries, payroll taxes, and fringe 
benefits.  The term does not include these same salary-related 
costs for both administrative or central office employees. 
    For the purpose of determining the amount of salary 
adjustment to be granted under this subdivision, the 
commissioner must use the reporting year ending December 31, 
1990, as the base year for the salary adjustment per diem 
computation.  For the purpose of each year's salary adjustment 
cost review, the commissioner must use the facility's salary 
adjustment cost for the reporting year ending December 31, 1991, 
as the base year.  If the base year and the reporting year 
subject to review include salary cost reclassifications made by 
the department, the commissioner must reconcile those 
differences before completing the salary adjustment per diem 
review. 
    (b) [SALARY ADJUSTMENT PER DIEM COMPUTATION.] For the rate 
period beginning January 1, 1992, each facility shall receive a 
salary adjustment cost per diem equal to its salary adjustment 
costs multiplied by 1-1/2 percent, and then divided by the 
facility's resident days.  
    (c) [ADJUSTMENTS FOR NEW FACILITIES.] For newly constructed 
or newly established facilities, except for state-operated 
community services, whose payment rates are governed by 
Minnesota Rules, part 9553.0075, if the settle-up cost report 
includes a reporting year which is subject to review under this 
subdivision, the commissioner shall adjust the rule provision 
governing the maximum settle-up payment rate by increasing the 
.4166 percent for each full month of the settle-up cost report 
to .7083.  For any subsequent rate period which is authorized 
for salary adjustments under this subdivision, the commissioner 
shall compute salary adjustment cost per diems by annualizing 
the salary adjustment costs for the settle-up cost report period 
and treat that period as the base year for purposes of reviewing 
salary adjustment cost per diems. 
    (d)  [SALARY ADJUSTMENT PER DIEM REVIEW.] The commissioner 
shall review the implementation of the salary adjustments on a 
per diem basis.  For reporting years ending December 31, 1992, 
and December 31, 1993, the commissioner must review and 
determine the amount of change in salary adjustment costs in 
each of the above reporting years over the base year.  In the 
case of each review, the commissioner must inflate the base 
year's salary adjustment costs by the cumulative percentage 
increase granted in paragraph (b), plus three percentage points 
for each of the two years reviewed.  The commissioner must then 
compare each facility's salary adjustment costs for the 
reporting year divided by the facility's resident days for that 
reporting year to the base year's inflated salary adjustment 
cost divided by the facility's resident days for the base year.  
If the facility has had a one-time program operating cost 
adjustment settle-up during any of the reporting years subject 
to review, the commissioner must remove the per diem effect of 
the one-time program adjustment before completing the review and 
per diem comparison. 
    The review and per diem comparison must be done by the 
commissioner each year following the reporting years subject to 
review.  If the salary adjustment cost per diem for the 
reporting year being reviewed is less than the base year's 
inflated salary adjustment cost per diem, the commissioner must 
recover the difference within 120 days after the date of written 
notice.  The amount of the recovery shall be equal to the per 
diem difference multiplied by the facility's resident days in 
the reporting year being reviewed.  Written notice of the amount 
subject to recovery must be given by the commissioner following 
each reporting year reviewed.  Interest charges must be assessed 
by the commissioner after the 120th day of that notice at the 
same interest rate the commissioner assesses for other balance 
outstanding. 
    Sec. 67.  [256B.74] [SPECIAL PAYMENTS.] 
    Subdivision 1.  [HOSPITAL REIMBURSEMENT.] (a) Effective for 
admissions occurring on or after July 1, 1991, the commissioner 
shall make an indigent care payment to Minnesota and local trade 
area hospitals except facilities of the federal Indian Health 
Service and regional treatment centers, in addition to all other 
payment to hospitals for inpatient services.  The indigent care 
payment shall be ten percent of the amount of medical assistance 
payments issued to that provider for inpatient services in a 
given calendar quarter or month, excluding indigent care 
payments paid under this section, divided by the number of 
related admissions, or patient days if applicable, and 
multiplying the result by 111 percent.  The indigent care 
payment is added to each admission, or patient day if 
applicable, occurring (1) in the second calendar quarter 
beginning after the quarter on which the September 15, 1991, 
indigent care payment amount is based and (2) in the month 
beginning six months after the month on which the subsequent 
monthly indigent care payment amount is based.  Medicare 
crossovers are excluded from indigent care payments and from the 
payments and admissions on which the indigent care payment is 
based.  The commissioner may issue indigent care payments as 
disproportionate population adjustments for eligible hospitals. 
    (b) Effective for services rendered on or after July 1, 
1991, the commissioner shall reimburse outpatient hospital 
facility fees at 80 percent of calendar year 1990 submitted 
charges, not to exceed the medicare upper payment limit.  
Services excepted from this payment methodology are emergency 
room facility fees, clinic facility fees, and those services for 
which there is a federal maximum allowable payment. 
    Subd. 2.  [PHYSICIAN REIMBURSEMENT.] The commissioner shall 
make payments for physician services rendered on or after July 
1, 1992, as follows: 
    (a) Payments for level one Health Care Finance 
Administration's common procedural coding system (HCPCS) codes 
titled "office and other outpatient medical services," 
"preventive medicine new and established patient," "delivery, 
antepartum and postpartum care," caesarean delivery, and 
pharmacologic management provided to psychiatric patients and 
HCPCS level three codes for enhanced services for prenatal high 
risk shall be calculated at the lower of (1) submitted charges, 
or (2) the median charges in 1989 minus 20 percent.  If the 
median minus 20 percent results in a decrease to rates in effect 
June 30, 1991, for obstetrical and prenatal services, the rate 
on those codes in effect on June 30, 1991, shall be increased by 
an additional five percent. 
    (b) Payments for level one HCPCS codes titled "critical 
care" initial or subsequent visits only shall be calculated at 
the lower of (1) submitted charges, or (2) the median charges in 
1989 minus 30 percent. 
    (c) Payments for all other services shall be calculated at 
the lower of (1) submitted charges, or (2) the median charges in 
1989 minus 40 percent. 
    (d) In addition to the payment rates in paragraphs (a) to 
(c), rates for obstetrical services shall be adjusted by the ten 
percent increase in Laws 1989, chapter 689, article 1, section 
2, subdivision 5, and rates for obstetrical and pediatric 
services shall be adjusted by the 15 percent increase in Laws 
1990, chapter 568, article 1, section 2, subdivision 7. 
    Subd. 3.  [NURSING FACILITY REIMBURSEMENT.] For rate years 
beginning on or after July 1, 1991, the commissioner shall 
reimburse nursing facilities participating in the medical 
assistance program as follows: 
    (1) a capital allowance of $1.44 per resident day shall be 
paid.  For a licensed provider with an operating lease on the 
nursing facility, the capital equipment allowance shall not be 
the property of the lessor but shall be the property of the 
licensed provider for the duration of the operating lease or any 
renewal or extension of the operating lease; and 
    (2) the maximum efficiency incentive per diem payment 
established annually under section 256B.431, subdivision 2b, 
paragraph (d), shall be increased to $2.10 effective July 1, 
1991, and $2.20 effective July 1, 1992. 
    Subd. 4.  [PERSONAL NEEDS ALLOWANCE.] The commissioner 
shall provide cost of living increases in the personal needs 
allowance under section 256B.35, subdivision 1. 
    Subd. 5.  [DENTISTS.] The commissioner shall increase 
reimbursement to dentists for services rendered on or after July 
1, 1992, by 20 percent for preventative services and five 
percent for all other services. 
    Subd. 6.  [HEALTH PLANS.] Effective for services rendered 
after July 1, 1991, the commissioner shall adjust the monthly 
medical assistance capitation rate cell established in contract 
by the amount necessary to accommodate the equivalent value of 
the reimbursement increase established under subdivisions 1, 2, 
and 5. 
    Subd. 7.  [ADMINISTRATIVE COST.] The commissioner may 
expend up to $1,700,000 for the administrative costs associated 
with sections 256.9657 and 256B.74. 
    Subd. 8.  [CONTINGENT ON FEDERAL FINANCIAL PARTICIPATION.] 
The provisions of this section and section 256.9657 apply only 
as long as federal financial participation under Title XIX of 
the Social Security Act is available for medical assistance 
payments made under this section.  In the event federal 
financial participation is denied for payments under this 
section, the commissioner shall discontinue collections from 
providers under section 256.9657, eliminate payments to 
providers and recipients under this section, and implement the 
contingent budget reductions in section 77, effective 
immediately. 
    Subd. 9.  [NO ADJUSTMENTS WHILE FEES IN EFFECT.] The 
commissioner shall not adjust the payments under this section as 
long as the surcharges under section 256.9657 remain in effect.  
The commissioner shall report to the legislature when submitting 
the budget forecast regarding the amount of actual and 
anticipated surcharge collections and provider payments.  The 
report must include recommendations for improving the operation 
of this section and section 256.9657, including any changes in 
surcharges or payments necessary to ensure that payments under 
this section do not exceed collections under section 256.9657.  
    Subd. 10.  [IMPLEMENTATION; RULEMAKING.] The commissioner 
shall implement sections 256.9657 and 256B.74 on July 1, 1991, 
without complying with the rulemaking requirements of the 
administrative procedure act.  The commissioner shall begin to 
adopt emergency rules to implement this article within 30 days, 
and may adopt permanent rules to implement this article. 
Emergency and permanent rules adopted to implement this article 
supersede any provisions adopted under the exemption from 
rulemaking requirements in this section.  
    Sec. 68.  Minnesota Statutes 1990, section 256D.03, 
subdivision 3, is amended to read: 
    Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
(a) General assistance medical care may be paid for any 
person who is age 18 or older and who is not eligible for 
medical assistance under chapter 256B, including eligibility for 
medical assistance based on a spend-down of excess income 
according to section 256B.056, subdivision 5, and: 
    (1) who is receiving assistance under section 256D.05 or 
256D.051 and is not eligible for medical assistance under 
chapter 256B including eligibility for medical assistance based 
on a spend-down of excess income according to section 256B.056, 
subdivision 5; or 
    (2)(i) who is a resident of Minnesota; and whose equity in 
assets is not in excess of $1,000 per assistance unit.  Exempt 
assets, the reduction of excess assets, and the waiver of excess 
assets must conform to the medical assistance program in chapter 
256B; and 
    (ii) who has countable income not in excess of the 
assistance standards established in section 256B.056, 
subdivision 4, or whose excess income is spent down pursuant to 
section 256B.056, subdivision 5, using a six-month budget 
period, except that a one-month budget period must be used for 
recipients residing in a long-term care facility.  The method 
for calculating earned income disregards and deductions for a 
person who resides with a dependent child under age 21 shall be 
as specified in section 256.74, subdivision 1.  However, if a 
disregard of $30 and one-third of the remainder described in 
section 256.74, subdivision 1, clause (4), has been applied to 
the wage earner's income, the disregard shall not be applied 
again until the wage earner's income has not been considered in 
an eligibility determination for general assistance, general 
assistance medical care, medical assistance, or aid to families 
with dependent children for 12 consecutive months.  The earned 
income and work expense deductions for a person who does not 
reside with a dependent child under age 21 shall be the same as 
the method used to determine eligibility for a person under 
section 256D.06, subdivision 1, except the disregard of the 
first $50 of earned income is not allowed; or 
    (3) who is over age 18 and who would be eligible for 
medical assistance except that the person resides in a facility 
that is determined by the commissioner or the federal health 
care financing administration to be an institution for mental 
diseases. 
    (b) Eligibility is available for the month of application, 
and for three months prior to application if the person was 
eligible in those prior months.  A redetermination of 
eligibility must occur every 12 months. 
    (c) General assistance medical care may be paid for a 
person, regardless of age, who 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, 
if 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.  
     (d) 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. 
     (e) In determining the amount of assets of an individual, 
there shall be included any asset or interest in an asset, 
including an asset excluded under paragraph (a), that was given 
away, sold, or disposed of for less than fair market value 
within the 30 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. 
    Sec. 69.  Minnesota Statutes 1990, section 256D.03, 
subdivision 4, is amended to read: 
    Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
Reimbursement under the general assistance medical care program 
shall be limited to the following categories of service For a 
person who is eligible under subdivision 3, paragraph (a), 
clause (3), general assistance medical care covers: 
    (1) inpatient hospital care, services; 
    (2) outpatient hospital care, services; 
    (3) services provided by Medicare certified rehabilitation 
agencies,; 
    (4) prescription drugs, and other products recommended 
through the process established in section 256B.0625, 
subdivision 13; 
    (5) equipment necessary to administer insulin and 
diagnostic supplies and equipment for diabetics to monitor blood 
sugar level,; 
    (6) eyeglasses and eye examinations provided by a physician 
or optometrist,; 
    (7) hearing aids,; 
    (8) prosthetic devices,; 
    (9) laboratory and X-ray services,; 
    (10) physician's services,; 
    (11) medical transportation,; 
    (12) chiropractic services as covered under the medical 
assistance program,; 
    (13) podiatric services, and; 
    (14) dental care.  In addition, payments of state aid shall 
be made for: services; 
    (1) (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; 
    (2) (16) day treatment services for mental illness provided 
under contract with the county board; 
    (3) (17) prescribed medications for persons who have been 
diagnosed as mentally ill as necessary to prevent more 
restrictive institutionalization; 
    (4) (18) case management services for a person with serious 
and persistent mental illness who would be eligible for medical 
assistance except that the person resides in an institution for 
mental diseases; 
    (5) (19) psychological services, medical supplies and 
equipment, and Medicare premiums, coinsurance and deductible 
payments for a person who would be eligible for medical 
assistance except that the person resides in an institution for 
mental diseases; and 
    (6) (20) 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. 
    (b) For a recipient who is eligible under subdivision 3, 
paragraph (a), clause (1) or (2), general assistance medical 
care covers the services listed in paragraph (a) with the 
exception of special transportation services. 
    (b) (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 contract 
consult with an independent actuary to establish in establishing 
prepayment rates, but shall retain final control over the rate 
methodology. 
    (c) (d) The commissioner of human services may reduce 
payments provided under sections 256D.01 to 256D.21 and 261.23 
in order to remain within the amount appropriated for general 
assistance medical care, within the following restrictions. 
    For the period July 1, 1985, to December 31, 1985, 
reductions below the cost per service unit allowable under 
section 256.966, are permitted only as follows:  payments for 
inpatient and outpatient hospital care provided in response to a 
primary diagnosis of chemical dependency or mental illness may 
be reduced no more than 30 percent; payments for all other 
inpatient hospital care may be reduced no more than 20 percent.  
Reductions below the payments allowable under general assistance 
medical care for the remaining general assistance medical care 
services allowable under this subdivision may be reduced no more 
than ten percent. 
    For the period January 1, 1986, to December 31, 1986, 
reductions below the cost per service unit allowable under 
section 256.966 are permitted only as follows:  payments for 
inpatient and outpatient hospital care provided in response to a 
primary diagnosis of chemical dependency or mental illness may 
be reduced no more than 20 percent; payments for all other 
inpatient hospital care may be reduced no more than 15 percent.  
Reductions below the payments allowable under general assistance 
medical care for the remaining general assistance medical care 
services allowable under this subdivision may be reduced no more 
than five percent. 
      For the period January 1, 1987, to June 30, 1987, 
reductions below the cost per service unit allowable under 
section 256.966 are permitted only as follows:  payments for 
inpatient and outpatient hospital care provided in response to a 
primary diagnosis of chemical dependency or mental illness may 
be reduced no more than 15 percent; payments for all other 
inpatient hospital care may be reduced no more than ten 
percent.  Reductions below the payments allowable under medical 
assistance for the remaining general assistance medical care 
services allowable under this subdivision may be reduced no more 
than five percent.  
      For the period July 1, 1987, to June 30, 1988, reductions 
below the cost per service unit allowable under section 256.966 
are permitted only as follows:  payments for inpatient and 
outpatient hospital care provided in response to a primary 
diagnosis of chemical dependency or mental illness may be 
reduced no more than 15 percent; payments for all other 
inpatient hospital care may be reduced no more than five percent.
Reductions below the payments allowable under medical assistance 
for the remaining general assistance medical care services 
allowable under this subdivision may be reduced no more than 
five percent. 
    For the period July 1, 1988, to June 30, 1989, reductions 
below the cost per service unit allowable under section 256.966 
are permitted only as follows:  payments for inpatient and 
outpatient hospital care provided in response to a primary 
diagnosis of chemical dependency or mental illness may be 
reduced no more than 15 percent; payments for all other 
inpatient hospital care may not be reduced.  Reductions below 
the payments allowable under medical assistance for the 
remaining general assistance medical care services allowable 
under this subdivision may be reduced no more than five percent. 
    There shall be no copayment required of any recipient of 
benefits for any services provided under this subdivision.  A 
hospital receiving a reduced payment as a result of this section 
may apply the unpaid balance toward satisfaction of the 
hospital's bad debts. 
    (d) (e) Any county may, from its own resources, provide 
medical payments for which state payments are not made. 
    (e) (f) Chemical dependency services that are reimbursed 
under Laws 1986, chapter 394, sections 8 to 20, chapter 254B 
must not be reimbursed under general assistance medical care. 
    (f) (g) 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. 
    (g) (h) The conditions of payment for services under this 
subdivision are the same as the conditions specified in rules 
adopted under chapter 256B governing the medical assistance 
program, unless otherwise provided by statute or rule. 
    Sec. 70.  Minnesota Statutes 1990, section 256D.06, 
subdivision 1b, is amended to read: 
    Subd. 1b.  [EARNED INCOME SAVINGS ACCOUNT.] In addition to 
the $50 disregard required under subdivision 1, the county 
agency shall disregard an additional earned income up to a 
maximum of $150 per month for:  (1) persons residing in 
facilities licensed under Minnesota Rules, parts 9520.0500 to 
9520.0690 and 9530.2500 to 9530.4000, and for whom discharge and 
work are part of a treatment plan and for; (2) persons living in 
supervised apartments with services funded under Minnesota 
Rules, parts 9535.0100 to 9535.1600, and for whom discharge and 
work are part of a treatment plan; and (3) persons residing in a 
negotiated rate residence, as that term is defined in section 
256I.03, subdivision 3, for whom the county agency has approved 
a discharge plan which includes work.  The additional amount 
disregarded must be placed in a separate savings account by the 
eligible individual, to be used upon discharge from the 
residential facility into the community.  A maximum of $1,000, 
including interest, of the money in the savings account must be 
excluded from the resource limits established by section 
256D.08, subdivision 1, clause (1). Amounts in that account in 
excess of $1,000 must be applied to the resident's cost of 
care.  If excluded money is removed from the savings account by 
the eligible individual at any time before the individual is 
discharged from the facility into the community, the money is 
income to the individual in the month of receipt and a resource 
in subsequent months.  If an eligible individual moves from a 
community facility to an inpatient hospital setting, the 
separate savings account is an excluded asset for up to 18 
months.  During that time, amounts that accumulate in excess of 
the $1,000 savings limit must be applied to the patient's cost 
of care.  If the patient continues to be hospitalized at the 
conclusion of the 18-month period, the entire account must be 
applied to the patient's cost of care. 
    Sec. 71.  Minnesota Statutes 1990, section 256I.05, is 
amended by adding a subdivision to read: 
    Subd. 1a.  [LOWER MAXIMUM RATE.] The maximum monthly rate 
for a general assistance or Minnesota supplemental aid 
negotiated rate residence that enters into an initial negotiated 
rate agreement with a county agency on or after June 1, 1989, 
may not exceed 90 percent of the maximum rate established under 
subdivision 1.  This is effective until June 30, 1993, or until 
the statewide system authorized under subdivision 6 is 
established, whichever occurs first. 
    Sec. 72.  Minnesota Statutes 1990, section 256I.05, is 
amended by adding a subdivision to read: 
    Subd. 1b.  [RATES FOR UNCERTIFIED BOARDING CARE 
HOMES.] Effective July 1, 1992, the maximum rate for a boarding 
care home not certified to receive medical assistance is equal 
to 65 percent of the average nursing home level "A" rate in 
effect for the geographic area in which the boarding care home 
is located, except that a facility's rate must not be reduced by 
more than ten percent for the year ending June 30, 1992.  This 
is effective until June 30, 1993.  A noncertified boarding care 
home licensed under Minnesota Rules, parts 9520.0500 to 
9520.0690, is exempt from this rate limit.  The commissioner 
shall study the numbers of facilities and residents that will be 
affected by the limit in this subdivision, the number of 
facilities likely to close because of the limit, the available 
alternatives for affected residents, methods of relocating or 
securing alternative placements for residents, and other effects 
of the limit.  The commissioner shall provide a report to the 
legislature by January 1, 1992, on the commissioner's findings 
and recommendations relating to the rate limit.  
    Sec. 73.  Minnesota Statutes 1990, section 256I.05, 
subdivision 2, is amended to read: 
    Subd. 2.  [MONTHLY RATES; EXEMPTIONS.] (a) The maximum 
negotiated rate does not apply to a residence that on August 1, 
1984, was licensed by the commissioner of health only as a 
boarding care home, certified by the commissioner of health as 
an intermediate care facility, and licensed by the commissioner 
of human services under Minnesota Rules, parts 9520.0500 to 
9520.0690.  For residences in this clause that have less than 
five percent of their licensed boarding care capacity reimbursed 
by the medical assistance program, rate increases shall be 
provided according to section 256B.431, subdivision 4, paragraph 
(c). 
    (b) The maximum negotiated rate does not apply to a 
residence that on August 1, 1984, was licensed by the 
commissioner of human services under Minnesota Rules, parts 
9525.0520 to 9525.0660, but funded as a negotiated rate 
residence under general assistance or Minnesota supplemental aid.
Rate increases for these residences are subject to the 
provisions of subdivision 7.  
    (c) The following residences are exempt from the limit on 
negotiated rates and must be reimbursed for documented actual 
costs, until an alternative reimbursement system covering 
services excluding room and board maintenance services is 
developed by the commissioner: 
    (1) a residence that is not certified to participate in the 
medical assistance program, that was licensed as a boarding care 
facility by March 1, 1985, and does not receive supplemental 
program funding under Minnesota Rules, parts 9535.2000 to 
9535.3000 or 9553.0010 to 9553.0080; 
    (2) The maximum negotiated rate does not apply to a 
residence certified to participate in the medical assistance 
program, licensed as a boarding care facility or a nursing home, 
and declared to be an institution for mental disease by January 
1, 1989.  Effective January 1, 1989, the actual documented 
cost rate for these residences is the individual's appropriate 
medical assistance case mix rate until the commissioner develops 
a comprehensive system of rates and payments for persons in all 
negotiated rate residences.  The exclusion from the rate limit 
for residences under this clause expires July 1, 1991 continues 
until June 30, 1992.  The commissioner of human services, in 
consultation with the counties in which these residences are 
located, shall review the status of each certified nursing home 
and board and care facility declared to be an institution for 
mental disease.  This review shall include the cost 
effectiveness of continued payment for residents through general 
assistance or Minnesota supplemental aid; the appropriateness of 
placement of general assistance or supplemental aid clients in 
these facilities; the effects of Public Law Number 100-203 on 
these facilities; and the role of these facilities in the mental 
health service delivery system.  The commissioner shall make 
recommendations to the legislature by January 1, 1990, regarding 
the need to continue the exclusion of these facilities from the 
negotiated rate maximum and the future role of these facilities 
in serving persons with mental illness.  
    (d) The commissioner of human services shall take the 
following action in relation to certified boarding care 
facilities and nursing homes that have been declared 
institutions for mental diseases, excluding those facilities 
exempt under paragraph (a): 
    (1) All mental health and placement screenings and 
diagnostic assessments required under the federal Omnibus Budget 
Reconciliation Act (OBRA) must be completed by July 1, 1991, for 
all residents in institutions for mental diseases admitted 
before June 1, 1991.  Residents determined to need relocation 
under the preadmission screening and annual resident review must 
be relocated to a more appropriate placement in accordance with 
the timelines established in the state's alternative disposition 
plan. 
    (2) By October 1, 1991, all institutions for mental 
diseases must be reviewed again by the commissioner to determine 
if they are still institutions for mental diseases, and the 
commissioner shall immediately revoke a declaration that a 
facility is an institution for mental diseases if the 
commissioner determines that the facility is not an institution 
for mental diseases. 
    (3) The commissioner shall provide to institutions for 
mental diseases training in the criteria used in assessing 
residents for determination of institutions for mental diseases 
status and the numbers of residents in each category. 
    (4) For facilities whose status as an institution for 
mental diseases is not revoked by the commissioner by October 1, 
1991, a facility-specific plan must be developed by the 
commissioner and the facility, in consultation with the 
appropriate consumer groups, to offer alternative services to 
enough residents by July 1, 1992, to allow the commissioner to 
revoke the facility's status as an institution for mental 
diseases. 
    Sec. 74.  Minnesota Statutes 1990, section 256I.05, is 
amended by adding a subdivision to read: 
    Subd. 7a.  [RATE INCREASES FOR THE 1991-1993 BIENNIUM.] For 
the biennium ending June 30, 1993, no inflationary increases 
shall be provided in rates for negotiated rate settings under 
subdivision 7. 
    Sec. 75.  [REGULATORY REVIEW.] 
    The commissioner of health shall study the regulation of 
long-term care facilities and report to the legislature by 
January 15, 1992, with any recommendations for changes in the 
current regulatory structure.  The study must address at least 
the following issues: 
    (1) the possibility of unifying the federal and state 
enforcement systems; 
    (2) the effectiveness of existing enforcement tools; 
    (3) the appropriateness of current licensure standards; and 
    (4) alternative mechanisms for dispute resolution. 
    Sec. 76.  [NURSING HOME FINANCIAL PERFORMANCE MONITORING.] 
    The commissioners of health and human services shall 
recommend to the legislature by January 15, 1992, a system to 
monitor the financial performance of nursing homes on an ongoing 
basis.  The system may provide for the inclusion of nursing 
homes in the health care cost information act of 1984 or for 
another method to obtain, analyze, and report financial data.  
The system must be coordinated with existing nursing home 
financial reporting requirements and must provide for periodic 
reports to the legislature on the financial condition of nursing 
homes. 
    Sec. 77.  [CONTINGENT BUDGET REDUCTIONS.] 
    Subdivision 1.  [CONTINGENT MEDICAL ASSISTANCE PROVIDER 
REDUCTIONS.] This section is effective only if federal financial 
participation under Title XIX of the Social Security Act is not 
available for payments under Minnesota Statutes, section 
256B.74.  This section is effective on the date the commissioner 
of human services receives an official denial of federal 
financial participation or an official communication from the 
federal government stating that federal financial participation 
will not be available, or on the effective date of a federal law 
that specifically prohibits federal financial participation. 
    Subd. 2.  [HOSPITAL PEER GROUPS.] (a) For admissions 
occurring after the transition period specified in Minnesota 
Statutes, section 256.9695, subdivision 3, operating payment 
rates of each hospital shall be limited to the operating payment 
rates within its peer group so that the statewide operating 
payment level is reduced by 4.5 percent.  For subsequent rate 
years, the limits shall be adjusted by the hospital cost index.  
The commissioner shall contract for the development of criteria 
for and the establishment of the peer groups.  Peer groups must 
be established based on variables that affect medical assistance 
cost such as scope and intensity of services, acuity of 
patients, location, and capacity.  Rates shall be standardized 
by the case mix index and adjusted, if applicable, for the 
variable outlier percentage.  The peer groups may exclude and 
have separate limits or be standardized for operating cost 
differences that are not common to all hospitals in order to 
establish a minimum number of groups.  The criteria and 
establishment of the peer groups is not subject to the 
requirements of Minnesota Statutes, chapter 14, the 
administrative procedure act. 
    (b) The commissioner shall not implement section 67, 
subdivision 1, paragraph (b). 
    Subd. 3.  [MEDICAL ASSISTANCE COVERAGE OF DENTAL SERVICES.] 
Notwithstanding Minnesota Statutes, section 256B.0625, 
subdivision 9, medical assistance only covers dental services 
for children under age 18, and dental services not to exceed 
$150 annually for adults.  The commissioner shall not implement 
section 67, subdivision 5. 
    Subd. 4.  [MEDICAL ASSISTANCE COVERAGE OF SPECIAL 
TRANSPORTATION.] For medical assistance coverage of special 
transportation under Minnesota Statutes, section 256B.0625, 
subdivision 17, the commissioner of human services shall 
establish maximum medical assistance reimbursement rates for 
special transportation services for persons who need a 
wheelchair lift van or stretcher-equipped vehicle and for those 
who do not need a wheelchair lift van or stretcher-equipped 
vehicle.  The average of these two rates must not exceed $12.50 
for the base rate and 60 cents per mile. 
    Subd. 5.  [NURSING HOME WORKERS' COMPENSATION 
COSTS.] Notwithstanding contrary provisions of Minnesota 
Statutes, section 256B.431, in determining medical assistance 
payments to nursing facilities, the commissioner must reduce the 
workers' compensation cost during the reporting year for each 
nursing facility to account for any savings in workers' 
compensation costs that result from actions of the 1991 
legislature for the purposes of computing the payment rates for 
the rate year beginning July 1, 1991, and for the first nine 
months of the rate year beginning July 1, 1992.  For any nursing 
facility that cannot separately report the workers' compensation 
costs, the commissioner shall determine the amount of the 
workers' compensation costs to be reduced by identifying the 
nursing facility's portion of total workers' compensation costs 
by applying the individual Medicare stepdowns which the nursing 
facility used to allocate its payroll taxes and fringe benefits 
and multiplying that amount by 16 percent.  
    Subd. 6.  [NURSING HOME COST LIMITS.] (a) [NURSING HOME 
RATES.] The provisions in paragraphs (b) to (e) apply to medical 
assistance payments to nursing facilities and supersede any 
inconsistent provisions in Minnesota Statutes, section 256B.431. 
    (b) [OTHER OPERATING COST LIMITS.] For the rate year 
beginning July 1, 1991, the commissioner, in conjunction with 
the rebasing for the reporting year September 30, 1990, shall 
establish the other operating cost limits in Minnesota Rules, 
part 9549.0055, subpart 2, item E, at 108 percent of the median 
of the array of allowable historical other operating cost per 
diems.  The limits must be established according to Minnesota 
Statutes, section 256B.431, subdivision 2b, paragraph (d).  For 
rate years beginning on or after July 1, 1992, the adjusted 
other operating cost limits must be indexed as in subdivision 2l.
    (c) [CARE-RELATED OPERATING COST LIMITS.] For the rate year 
beginning July 1, 1991, the commissioner, in conjunction with 
the rebasing for the reporting year September 30, 1990, shall 
establish the care-related operating cost limits in Minnesota 
Rules, part 9549.0055, subpart 2, items A and B, at 122 percent 
of the median of the array of the allowable historical case mix 
operating cost standardized per diems and the allowable 
historical other care-related operating cost per diems.  The 
limits must be established according to Minnesota Statutes, 
section 256B.431, subdivision 2b, paragraph (d).  For rate years 
beginning on or after July 1, 1992, the adjusted care-related 
limits must be indexed as in Minnesota Statutes, section 
256B.431, subdivision 2l. 
    (d) [ADMINISTRATIVE COST LIMITS.] For rate years beginning 
on or after July 1, 1991, the cost limitation for costs in the 
general and administrative cost category in Minnesota Rules, 
part 9549.0055, subpart 2, item D, shall be modified as in 
clauses (1) to (4): 
    (1) the percentage limitation for nursing homes with 60 or 
fewer licensed beds shall be 14 percent; 
    (2) the percentage limitation for nursing homes with 61 to 
100 licensed beds shall be 13 percent; 
    (3) the percentage limitation for nursing homes with 101 to 
200 licensed beds shall be 12 percent; and 
    (4) the percentage limitation for nursing homes with more 
than 200 licensed beds shall be 11 percent. 
    (e) [EFFICIENCY INCENTIVE.] For rate years beginning on or 
after July 1, 1991, a nursing home's maximum efficiency 
incentive shall be $1. 
    Subd. 7.  [NURSING HOME PROPERTY COSTS.] (a) The provisions 
of paragraphs (b) to (d) apply to medical assistance payments to 
nursing facilities and supersede any inconsistent provisions of 
Minnesota Statutes, section 256B.431.  
    (b) For the rate year beginning July 1, 1991, the 
property-related payment rate for a nursing home classified as a 
group A nursing home under Minnesota Statutes, section 256B.431, 
subdivision 3i, shall be the lesser of the nursing home's 
property-related payment rate in effect on July 1, 1990; or the 
sum of 115 percent of the nursing home's allowable principal and 
interest expense, plus its equipment allowance multiplied by the 
resident days for the reporting year ending September 30, 1990, 
divided by the nursing home's capacity days as determined under 
Minnesota Rules, part 9549.0060, subpart 11, as modified by 
Minnesota Statutes, section 256B.431, subdivision 3f, paragraph 
(c); but not less than the lesser of $3.25 or the nursing home's 
July 1, 1990, property-related payment rate.  
    (c) For the rate year beginning July 1, 1991, a nursing 
home classified as a group B nursing home under Minnesota 
Statutes, section 256B.431, subdivision 3i, shall receive the 
greater of 90 percent of its property-related payment rate in 
effect on July 1, 1990; or the sum of 115 percent of the nursing 
home's allowable principal and interest expense, plus its 
equipment allowance multiplied by the resident days for the 
reporting year ending September 30, 1990, divided by the nursing 
home's capacity days as determined under Minnesota Rules, part 
9549.0060, subpart 11, as modified by Minnesota Statutes, 
section 256B.431, subdivision 3f, paragraph (c); except that the 
nursing home's property-related payment rate must not exceed the 
property-related payment rate in effect on July 1, 1990. 
    (d) For the rate year beginning July 1, 1991, a nursing 
home classified as a group C nursing home under Minnesota 
Statutes, section 256B.431, subdivision 3i, shall receive the 
greater of 85 percent of its property-related payment rate in 
effect on July 1, 1990; or the sum of 115 percent of the nursing 
home's allowable principal and interest expense, plus its 
equipment allowance multiplied by the resident days for the 
reporting year ending September 30, 1990, divided by the nursing 
home's capacity days as determined under Minnesota Rules, part 
9549.0060, subpart 11, as modified by Minnesota Statutes, 
section 256B.431, subdivision 3f, paragraph (c); except that the 
nursing home's property-related payment rate must not exceed the 
property-related payment rate in effect on July 1, 1990. 
    Subd. 8.  [PERSONAL NEEDS ALLOWANCE 
INFLATION.] Notwithstanding Minnesota Statutes, section 256B.35, 
subdivision 1, no increase for inflation may be provided to the 
personal needs allowance for persons receiving medical 
assistance. 
    Subd. 9.  [NURSING HOME MORATORIUM EXCEPTIONS.] The 
commissioner of health shall not authorize exceptions to the 
nursing home moratorium under Minnesota Statutes, section 
144A.073. 
    Subd. 10.  [NURSING HOMES TREATING HUNTINGTON'S.] The 
commissioner shall not implement section 55. 
    Subd. 11.  [EXTENSION OF HOSPITAL-ATTACHED STATUS.] The 
commissioner shall not implement section 58. 
    Subd. 12.  [EFFICIENCY INCENTIVE INCREASE.] The 
commissioner shall not implement section 67, subdivision 3, 
clause (2). 
    Subd. 13.  [ICF/MR WORKERS' COMPENSATION.] The commissioner 
shall adjust reimbursement rates for intermediate care 
facilities for persons with mental retardation and related 
conditions to account for any savings in workers' compensation 
costs that results from actions of the 1991 legislature. 
    Subd. 14.  [ICF/MR EFFICIENCY INCENTIVE.] The commissioner 
shall reduce the maximum efficiency incentive for intermediate 
care facilities for persons with mental retardation to $1. 
     Subd. 15.  [INFLATION ADJUSTMENTS.] The commissioner shall 
not provide inflationary increases for fiscal year 1992 for the 
medical assistance alternative care grants program, the 
community alternatives for disabled individuals (CADI) program, 
the community alternative care (CAC) waiver, and for personal 
care attendant and private duty nursing services. 
    Subd. 16.  [DAY TRAINING INFLATION.] The commissioner shall 
not provide the two percent inflation adjustment authorized 
under article 1 for day training and habilitation services for 
the fiscal year beginning July 1, 1991. 
    Subd. 17.  [CHIROPRACTIC SERVICES.] The commissioner shall 
limit chiropractic services under medical assistance to 18 
visits per year. 
    Subd. 18.  [PHYSICIAN REIMBURSEMENT.] The commissioner 
shall not implement section 67, subdivision 2. 
    Subd. 19.  [MASTERS-LEVEL PSYCHOLOGISTS.] The commissioner 
shall reimburse masters-prepared mental health practitioners and 
practitioners licensed at the masters level providing services 
through community mental health centers at 65 percent of the 
level for doctoral-prepared practitioners. 
    Subd. 20.  [GENERAL ASSISTANCE MEDICAL CARE.] The 
commissioner shall: 
    (1) reduce retroactive eligibility for general assistance 
medical care recipients who are not residents of institutions 
for mental diseases from three months to one month; 
    (2) limit coverage for over the counter drugs for general 
assistance medical care recipients residing in institutions for 
mental diseases to insulin, aspirin, antacids, products for the 
treatment of lice, and acetaminophen, and limit coverage for 
dental services to $150 a year; and 
    (3) establish the following coverage limitations for 
general assistance medical care recipients who are not residents 
in institutions for mental diseases: 
    (i) chiropractic services, vision care, podiatry services, 
allergy testing, special transportation, case management for 
persons with serious and persistent mental illness, and Medicare 
premiums, coinsurance, and deductibles are not covered; 
    (ii) audiology, occupational therapy, and speech therapy 
are not covered, regardless of provider type; 
    (iii) physical therapy is limited to five treatment 
modalities, regardless of provider type; 
    (iv) services of a Medicare-certified rehabilitation 
agency, except physical therapy services under item (iii), are 
not covered; 
    (v) coverage for dental services is limited to $100 
annually; 
    (vi) coverage for physician services is limited to 14 
physician visits; 
    (vii) coverage for mental health therapy, including 
psychological services and diagnostic services is limited to ten 
hours annually.  For purposes of this clause, two hours of group 
therapy count as one hour; 
    (viii) coverage for legend drugs is limited to those 
prescribed by a physician and contained in a general assistance 
medical care drug formulary established by the commissioner in 
the manner used to establish and publish the formulary in 
section 256B.0625, subdivision 13; 
    (ix) outpatient hospital services are covered to the extent 
otherwise provided under this paragraph; and 
    (x) for an emergency room visit that does not result in an 
inpatient admission, reimbursement for the emergency room visit 
shall be reduced by $5 and the hospital may collect that amount 
from the recipient.  The hospital may not deny services to the 
recipient for failure to pay the copayment amount.  
    Contracts with prepaid health plans to provide health care 
services to recipients of general assistance medical care may 
include, without limitation, the services set forth in clause 
(3), items (iii), (v), (vi), (viii), and (x).  The commissioner 
may seek a waiver according to Minnesota Statutes, section 
62D.30, in order to execute contracts for the benefit package in 
this subdivision. 
    Subd. 21.  [REIMBURSEMENT FOR SHORT STAY FACILITIES.] The 
commissioner shall not implement section 57. 
    Sec. 78.  [INSTRUCTION TO REVISOR.] 
    In each section of Minnesota Statutes referred to in column 
A, the revisor of statutes shall delete the reference in column 
B and insert the reference in column C.  The revisor shall also 
correct any cross-references to Minnesota Statutes, section 
256.969, subdivision 6a, that appear in Minnesota Rules. 
    Column A            Column B                Column C
  256.969, subd. 3a   256.969, subd. 6a,      256.969, subds. 10
                      paragraph (a), clause   and 11
                      (5) or (6)
  256.9695, subd. 3   256.969, subd. 6a,      256.969, subd. 8
                      paragraph (a), clause
                      (3)
  256.9695, subd. 3,  256.969, subd. 6a,      256.969, subds. 7,
  paragraph (a)       paragraph (a), clauses  9, 10, 11, and 13
                      (1), (2), (4), (5), 
                      (6), and (8)
  256.9695, subd. 3,  256.969, subd. 6a,      256.969, subds. 12
  paragraph (a)       paragraph (a), clause   and 20
                      (7), and paragraph (i)
  256.9695, subd. 3,  256.969, subd. 6a,      256.969, subd. 19,
  paragraph (c)       paragraphs (g) and (h)  paragraphs (a) and
                                              (b)
    Sec. 79.  [REPEALER.] 
    Subdivision 1.  [CONTINGENT MEDICAL ASSISTANCE REDUCTIONS.] 
Section 77 is repealed effective July 1, 1993.  
    Subd. 2.  [REGIONAL TREATMENT CENTER CHEMICAL DEPENDENCY 
UNIT FUNDING.] Minnesota Statutes 1990, section 246.18, 
subdivisions 3 and 3a, are repealed. 
    Sec. 80.  [EFFECTIVE DATES.] 
    Subdivision 1.  [SPECIAL CATEGORIES OF ELIGIBILITY.] (a) 
Those portions of sections 35, 36, and 38 regarding publication 
of federal poverty guidelines are effective retroactive to the 
date the 1991 change in the federal poverty guidelines became 
effective. 
    (b) Sections 37 and 39 are effective retroactive to January 
1, 1991. 
    Subd. 2.  [ADMISSION CRITERIA.] That portion of section 5 
requiring the commissioner of human services to establish 
criteria for admission to chemical dependency units is effective 
the day following final enactment. 
    Subd. 3.  [AVAILABILITY OF INCOME.] The deduction for 
reparation payments in section 40 is effective retroactive to 
January 1, 1991.  The deduction for veterans pensions in section 
40 is effective the month in which the Veteran's Administration 
implements the change at section 8003 of the Omnibus Budget 
Reconciliation Act of 1990. 
    Subd. 4.  [HOSPITAL-ATTACHED CONVALESCENT AND NURSING CARE 
FACILITIES.] Section 58 takes effect the day after its final 
enactment and applies to facilities whose attached hospitals 
suspend operation before or after its effective date. 
    Subd. 5.  [FEDERALLY QUALIFIED HEALTH CENTER.] Section 49, 
paragraph (b), is effective retroactive to July 1, 1990. 

                                ARTICLE 5

                           ASSISTANCE PAYMENTS
    Section 1.  Minnesota Statutes 1990, section 13.46, 
subdivision 2, is amended to read: 
    Subd. 2.  [GENERAL.] (a) Unless the data is summary data or 
a statute specifically provides a different classification, data 
on individuals collected, maintained, used, or disseminated by 
the welfare system is private data on individuals, and shall not 
be disclosed except:  
    (1) pursuant to section 13.05; 
    (2) pursuant to court order; 
    (3) pursuant to a statute specifically authorizing access 
to the private data; 
    (4) to an agent of the welfare system, including a law 
enforcement person, attorney, or investigator acting for it in 
the investigation or prosecution of a criminal or civil 
proceeding relating to the administration of a program; 
    (5) to personnel of the welfare system who require the data 
to determine eligibility, amount of assistance, and the need to 
provide services of additional programs to the individual; 
    (6) to administer federal funds or programs; 
    (7) between personnel of the welfare system working in the 
same program; 
    (8) the amounts of cash public assistance and relief paid 
to welfare recipients in this state, including their names and 
social security numbers, upon request by the department of 
revenue to administer the property tax refund law, supplemental 
housing allowance, and the income tax; 
    (9) to the Minnesota department of jobs and training for 
the purpose of monitoring the eligibility of the data subject 
for unemployment compensation, for any employment or training 
program administered, supervised, or certified by that agency, 
or for the purpose of administering any rehabilitation program, 
whether alone or in conjunction with the welfare system, and to 
verify receipt of energy assistance for the telephone assistance 
plan; 
    (10) to appropriate parties in connection with an emergency 
if knowledge of the information is necessary to protect the 
health or safety of the individual or other individuals or 
persons; 
    (11) data maintained by residential facilities as defined 
in section 245A.02 may be disclosed to the protection and 
advocacy system established in this state pursuant to Part C of 
Public Law Number 98-527 to protect the legal and human rights 
of persons with mental retardation or other related conditions 
who live in residential facilities for these persons if the 
protection and advocacy system receives a complaint by or on 
behalf of that person and the person does not have a legal 
guardian or the state or a designee of the state is the legal 
guardian of the person; or 
    (12) to the county medical examiner or the county coroner 
for identifying or locating relatives or friends of a deceased 
person; or 
     (13) data on a child support obligor who makes payments to 
the public agency may be disclosed to the higher education 
coordinating board to the extent necessary to determine 
eligibility under section 136A.121, subdivision 2, clause (5). 
    (b) Mental health data shall be treated as provided in 
subdivisions 7, 8, and 9, but is not subject to the access 
provisions of subdivision 10, paragraph (b).  
    Sec. 2.  Minnesota Statutes 1990, section 136A.121, 
subdivision 2, is amended to read: 
    Subd. 2.  [ELIGIBILITY FOR GRANTS.] An applicant is 
eligible to be considered for a grant, regardless of the 
applicant's sex, creed, race, color, national origin, or 
ancestry, under sections 136A.095 to 136A.131 if the board finds 
that the applicant: 
    (1) is a resident of the state of Minnesota; 
    (2) is a graduate of a secondary school or its equivalent, 
or is 17 years of age or over, and has met all requirements for 
admission as a student to an eligible college or technical 
college of choice as defined in sections 136A.095 to 136A.131; 
    (3) has met the financial need criteria established in 
Minnesota Rules; and 
    (4) is not in default, as defined by the board, of any 
federal or state student educational loan; and 
    (5) is not more than 30 days in arrears for any child 
support payments owed to a public agency responsible for child 
support enforcement or, if the applicant is more than 30 days in 
arrears, is complying with a payment plan for arrearages. 
    The director and the commissioner of human services shall 
develop procedures to implement clause (5).  
    Sec. 3.  Minnesota Statutes 1990, section 136A.162, is 
amended to read: 
    136A.162 [CLASSIFICATION OF DATA.] 
    All data on applicants for financial assistance collected 
and used by the higher education coordinating board for student 
financial aid programs administered by that board shall be 
classified as private data on individuals under section 13.02, 
subdivision 12.  Exceptions to this classification are that:  
    (a) the names and addresses of program recipients or 
participants are public data; and 
    (b) data on applicants may be disclosed to the commissioner 
of human services to the extent necessary to determine 
eligibility under section 136A.121, subdivision 2, clause (5); 
and 
    (b) (c) the following data collected in the Minnesota 
supplemental loan program under section 136A.1701 may be 
disclosed to a consumer credit reporting agency only if the 
borrower and the cosigner give informed consent, according to 
section 13.05, subdivision 4, at the time of application for a 
loan: 
    (1) the lender-assigned borrower identification number; 
    (2) the name and address of borrower; 
    (3) the name and address of cosigner; 
    (4) the date the account is opened; 
    (5) the outstanding account balance; 
    (6) the dollar amount past due; 
    (7) the number of payments past due; 
    (8) the number of late payments in previous 12 months; 
    (9) the type of account; 
    (10) the responsibility for the account; and 
    (11) the status or remarks code. 
    Sec. 4.  [214.101] [CHILD SUPPORT; SUSPENSION OF LICENSE.] 
    Subdivision 1.  [COURT ORDER; HEARING ON SUSPENSION.] If a 
licensing board receives an order from a court under section 
518.551, subdivision 12, dealing with suspension of a license of 
a person found by the court to be in arrears in child support 
payments, the board shall, within 30 days of receipt of the 
court order, provide notice to the licensee and hold a hearing.  
If the board finds that the person is licensed by the board and 
evidence of full payment of arrearages found to be due by the 
court is not presented at the hearing, the board shall suspend 
the license unless it determines that probation is appropriate 
under subdivision 2.  The only issues to be determined by the 
board are whether the person named in the court order is a 
licensee, whether the arrearages have been paid, and whether 
suspension or probation is appropriate.  The board may not 
consider evidence with respect to the appropriateness of the 
court order or the ability of the person to comply with the 
order.  The board may not lift the suspension until the licensee 
files with the board proof showing that the licensee is current 
in child support payments. 
    Subd. 2.  [PROBATION.] If the board determines that the 
suspension of the license would create an extreme hardship to 
either the licensee or to persons whom the licensee serves, the 
board may, in lieu of suspension, allow the licensee to continue 
to practice the occupation on probation.  Probation must be 
conditioned upon full compliance with the court order that 
referred the matter to the board.  The probation period may not 
exceed two years, and the terms of probation must provide for 
automatic suspension of the license if the licensee does not 
provide monthly proof to the board of full compliance with the 
court order that referred the matter to the board or a further 
court order if the original order is modified by the court. 
    Subd. 3.  [REVOCATION OR REINSTATEMENT OF PROBATION.] If 
the licensee has a modification petition pending before the 
court, the board may, without a hearing, defer a revocation of 
probation and institution of suspension until receipt of the 
court's ruling on the modification order.  A licensee who was 
placed on probation and then automatically suspended may be 
automatically reinstated upon providing proof to the board that 
the licensee is currently in compliance with the court order. 
    Subd. 4.  [VERIFICATION OF PAYMENTS.] Before a board may 
terminate probation, remove a suspension, issue, or renew a 
license of a person who has been suspended or placed on 
probation under this section, it shall contact the court that 
referred the matter to the board to determine that the applicant 
is not in arrears for child support.  The board may not issue or 
renew a license until the applicant proves to the board's 
satisfaction that the applicant is current in support payments. 
    Subd. 5.  [APPLICATION.] This section applies to support 
obligations ordered by any state, territory, or district of the 
United States. 
    Sec. 5.  Minnesota Statutes 1990, section 237.70, 
subdivision 7, is amended to read: 
    Subd. 7.  [ADMINISTRATION.] The telephone assistance plan 
must be administered jointly by the commission, the department 
of human services, and the telephone companies in accordance 
with the following guidelines: 
    (a) The commission and the department of human services 
shall develop an application form that must be completed by the 
subscriber for the purpose of certifying eligibility for 
telephone assistance plan credits to the telephone 
companies department of human services.  The application must 
contain the applicant's social security number.  Applications 
without Applicants who refuse to provide a social security 
number will be denied telephone assistance plan credits.  The 
application form must include provisions for the applicant to 
show the name of the applicant's telephone company.  The 
application must also advise the applicant to submit the 
required proof of age or disability, and income and must provide 
examples of acceptable proof.  The application must state that 
failure to submit proof with the application will result in the 
applicant being found ineligible.  Each telephone company shall 
annually mail a notice of the availability of the telephone 
assistance plan to each residential subscriber in a regular 
billing and shall mail the application form to customers when 
requested.  
    The notice must state the following: 
    YOU MAY BE ELIGIBLE FOR ASSISTANCE IN PAYING YOUR TELEPHONE 
BILL IF YOU MEET CERTAIN HOUSEHOLD INCOME LIMITS, AND YOU ARE 65 
YEARS OF AGE OR OLDER OR ARE DISABLED AND IF YOU MEET CERTAIN 
HOUSEHOLD INCOME LIMITS.  FOR MORE INFORMATION OR AN APPLICATION 
FORM PLEASE CONTACT ......... 
    (b) The department of human services shall determine the 
eligibility for telephone assistance plan credits at least 
annually according to the criteria contained in subdivision 4a.  
    (c) Each telephone company shall provide telephone 
assistance plan credits against monthly charges in the earliest 
possible month following receipt of an application form and 
shall continue to provide credits unless notified that the 
subscriber is ineligible.  The company shall cease granting 
credits at the earliest possible billing cycle when notified by 
the department of human services that the subscriber is 
ineligible.  An application may be made by the subscriber, the 
subscriber's spouse, or a person authorized by the subscriber to 
act on the subscriber's behalf.  On completing the application 
certifying that the statutory criteria for eligibility are 
satisfied, the applicant must return the application to an 
office of the department of human services specially designated 
to process telephone assistance plan applications.  On receiving 
a completed application from an applicant, the department of 
human services shall determine the applicant's eligibility or 
ineligibility within 120 days.  If the department fails to do 
so, it shall within three working days provide written notice to 
the applicant's telephone company that the company shall provide 
telephone assistance plan credits against monthly charges in the 
earliest possible month following receipt of the written 
notice.  The applicant must receive telephone assistance plan 
credits until the earliest possible month following the 
company's receipt of notice from the department that the 
applicant is ineligible. 
    If the department of human services determines that an 
applicant is not eligible to receive telephone assistance plan 
credits, it shall notify the applicant within ten working days 
of that determination. 
    Within ten working days of determining that an applicant is 
eligible to receive telephone assistance plan credits, the 
department of human services shall provide written notification 
to the telephone company that serves the applicant.  The notice 
must include the applicant's name, address, and telephone number.
    Each telephone company shall provide telephone assistance 
plan credits against monthly charges in the earliest possible 
month following receipt of notice from the department of human 
services. 
    By December 31 of each year, the department of human 
services shall redetermine eligibility of each person receiving 
telephone assistance plan credits, as required in paragraph (b). 
The department of human services shall submit an annual report 
to the legislature and the commission by January 15 of each year 
showing that the department has determined the eligibility for 
telephone assistance plan credits of each person receiving the 
credits or explaining why the determination has not been made 
and showing how and when the determination will be completed.  
    If the department of human services determines that a 
current recipient of telephone assistance plan credits is not 
eligible to receive the credits, it shall notify, in writing, 
the recipient within ten working days and the telephone company 
serving the recipient within 20 working days of the 
determination.  The notice must include the recipient's name, 
address, and telephone number. 
    Each telephone company shall remove telephone assistance 
plan credits against monthly charges in the earliest possible 
month following receipt of notice from the department of human 
services. 
    Each telephone company that disconnects a subscriber 
receiving the telephone assistance plan credit shall report the 
disconnection to the department of human services.  The reports 
must be submitted monthly, identifying the subscribers 
disconnected.  Telephone companies that do not disconnect a 
subscriber receiving the telephone assistance plan credit are 
not required to report.  
    If the telephone assistance plan credit is not itemized on 
the subscriber's monthly charges bill for local telephone 
service, the telephone company must notify the subscriber of the 
approval for the telephone assistance plan credit. 
    (d) The commission shall serve as the coordinator of the 
telephone assistance plan and be reimbursed for its 
administrative expenses from the surcharge revenue pool.  As the 
coordinator, the commission shall: 
    (1) establish a uniform statewide surcharge in accordance 
with subdivision 6; 
    (2) establish a uniform statewide level of telephone 
assistance plan credit that each telephone company shall extend 
to each eligible household in its service area; 
    (3) require each telephone company to account to the 
commission on a periodic basis for surcharge revenues collected 
by the company, expenses incurred by the company, not to include 
expenses of collecting surcharges, and credits extended by the 
company under the telephone assistance plan; 
    (4) require each telephone company to remit surcharge 
revenues to the department of administration for deposit in the 
fund; and 
    (5) remit to each telephone company from the surcharge 
revenue pool the amount necessary to compensate the company for 
expenses, not including expenses of collecting the surcharges, 
and telephone assistance plan credits.  When it appears that the 
revenue generated by the maximum surcharge permitted under 
subdivision 6 will be inadequate to fund any particular 
established level of telephone assistance plan credits, the 
commission shall reduce the credits to a level that can be 
adequately funded by the maximum surcharge.  Similarly, the 
commission may increase the level of the telephone assistance 
plan credit that is available or reduce the surcharge to a level 
and for a period of time that will prevent an unreasonable 
overcollection of surcharge revenues. 
    (e) Each telephone company shall maintain adequate records 
of surcharge revenues, expenses, and credits related to the 
telephone assistance plan and shall, as part of its annual 
report or separately, provide the commission and the department 
of public service with a financial report of its experience 
under the telephone assistance plan for the previous year.  That 
report must also be adequate to satisfy the reporting 
requirements of the federal matching plan.  
    (f) The department of public service shall investigate 
complaints against telephone companies with regard to the 
telephone assistance plan and shall report the results of its 
investigation to the commission.  
    Sec. 6.  Minnesota Statutes 1990, section 256.01, 
subdivision 11, is amended to read: 
    Subd. 11.  [CENTRALIZED DISBURSEMENT SYSTEM.] The state 
agency may establish a system for the centralized disbursement 
of (1) assistance payments to recipients of aid to families with 
dependent children, (2) emergency assistance payments to needy 
families with dependent children as defined in Minnesota 
Statutes 1976, section 256.12, and (3) the benefit documents for 
food stamp recipients food coupons, assistance payments, and 
related documents.  The state agency shall adopt rules and set 
guidelines for the operation of the statewide system.  If 
required by federal law or regulations promulgated thereunder, 
or by state law, or by rule of the state agency, each county 
shall pay to the state treasurer that portion of assistance for 
which the county is responsible.  Benefits shall be issued by 
the state or county and funded under this section according to 
section 256.025, subdivision 3, and subject to section 256.017.  
    Sec. 7.  Minnesota Statutes 1990, section 256.01 is amended 
by adding a subdivision to read: 
    Subd. 11a.  [CONTRACTING WITH FINANCIAL INSTITUTIONS.] The 
state agency may contract with banks or other financial 
institutions to provide services associated with the processing 
of public assistance checks and may pay a service fee for these 
services, provided the fee charged does not exceed the fee 
charged to other customers of the institution for similar 
services.  
    Sec. 8.  [256.023] [ONE HUNDRED PERCENT COUNTY ASSISTANCE.] 
    The commissioner of human services may maintain client 
records and issue public assistance benefits that are over state 
and federal standards or that are not required by state or 
federal law, providing the cost of benefits is paid by the 
counties to the department of human services.  Payment methods 
for this section shall be according to section 256.025, 
subdivision 3. 
    Sec. 9.  Minnesota Statutes 1990, section 256.025, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
section, the following terms have the meanings given them.  
    (b) "Base amount" means the calendar year 1990 county share 
of county agency expenditures for all of the programs specified 
in subdivision 2.  
    (c) "County agency expenditure" means the total expenditure 
or cost incurred by the county of financial responsibility for 
the benefits and services for each of the programs specified in 
subdivision 2.  The term includes the federal, state, and county 
share of costs for programs in which there is federal financial 
participation.  For programs in which there is no federal 
financial participation, the term includes the state and county 
share of costs.  The term excludes county administrative costs, 
unless otherwise specified.  
    (d) "Nonfederal share" means the sum of state and county 
shares of costs of the programs specified in subdivision 2. 
    (e) The "county share of county agency expenditures growth 
amount" is the amount by which the county share of county agency 
expenditures in calendar years 1991 to 1997 2000 has increased 
over the base amount. 
    Sec. 10.  Minnesota Statutes 1990, section 256.025, 
subdivision 3, is amended to read: 
    Subd. 3.  [PAYMENT METHODS.] The state shall pay counties, 
according to the reporting cycle established by the 
commissioner, all federal funds available for the services and 
benefits distributed under subdivision 2 together with an amount 
of state funds equal to the state share of expenditures, except 
as provided for in section 256.017.  (a) Beginning July 1, 1991, 
the state will reimburse counties for the county share of county 
agency expenditures for benefits and services distributed under 
subdivision 2 and funded by the human services account 
established under section 273.1392., except as follows: 
    (1) beginning July 1, 1992, the county shall pay 25 percent 
of the costs of the growth in emergency general assistance 
payments which exceed expenditures during the base year of 
calendar year 1990; 
    (2) beginning July 1, 1992, the county shall pay 25 percent 
of the costs of the growth in eligible general assistance 
negotiated rate payments which exceed expenditures during the 
base year of calendar year 1990; 
    (3) beginning July 1, 1992, the county shall pay 15 percent 
of the costs of the growth in Minnesota supplemental aid 
negotiated rate payments made which exceed expenditures during 
the base year of calendar year 1990; 
    (4) beginning July 1, 1992, the county shall pay 50 percent 
of the nonfederal portion of the growth in emergency assistance 
payments made which exceed expenditures during the base year of 
calendar year 1990. 
    (b) Payments under subdivision 4 are only for client 
benefits and services distributed under subdivision 2 and do not 
include reimbursement for county administrative expenses. 
    (c) The state and the county agencies shall pay for 
assistance programs as follows: 
    (1) Where the state issues payments for the programs, the 
county shall monthly advance to the state, as required by the 
department of human services, the portion of program costs not 
met by federal and state funds.  The advance shall be an 
estimate that is based on actual expenditures from the prior 
period and that is sufficient to compensate for the county share 
of disbursements as well as state and federal shares of 
recoveries; 
    (2) Where the county agencies issue payments for the 
programs, the state shall monthly advance to counties all 
federal funds available for those programs together with an 
amount of state funds equal to the state share of expenditures; 
and 
    (3) Payments made under this paragraph are subject to 
section 256.017.  Adjustment of any overestimate or 
underestimate in advances shall be made by the state agency in 
any succeeding month. 
    Sec. 11.  Minnesota Statutes 1990, section 256.025, 
subdivision 4, is amended to read: 
    Subd. 4.  [PAYMENT SCHEDULE.] Except as provided for in 
subdivision 3, beginning July 1, 1991, the state will reimburse 
counties, according to the following payment schedule, for the 
county share of county agency expenditures for the programs 
specified in subdivision 2. 
    (a) Beginning July 1, 1991, the state will reimburse or pay 
the county share of county agency expenditures according to the 
reporting cycle as established by the commissioner, for the 
programs identified in subdivision 2.  Payments for the period 
of January 1 through July 31, for calendar years 1991, 1992, and 
1993 shall be made on or before July 10 in each of those years.  
Payments for the period August through December for calendar 
years 1991, 1992, and 1993 shall be made on or before the third 
of each month thereafter through December 31 in each of those 
years. 
    (b) Payment for 1/24 of the base amount and the January 
1994 county share of county agency expenditures growth amount 
for the programs identified in subdivision 2 shall be made on or 
before January 3, 1994.  For the period of February 1, 1994, 
through July 31, 1994, payment of the base amount shall be made 
on or before July 10, 1994, and payment of the growth amount 
over the base amount shall be made on or before the third of 
each month.  Payments for the period August 1994 through 
December 1994 shall be made on or before the third of each month 
thereafter through December 31, 1994. 
    (c) Payment for the county share of county agency 
expenditures during January 1995 shall be made on or before 
January 3, 1995.  Payment for 1/24 of the base amount and the 
February 1995 county share of county agency expenditures growth 
amount for the programs identified in subdivision 2 shall be 
made on or before February 3, 1995.  For the period of March 1, 
1995, through July 31, 1995, payment of the base amount shall be 
made on or before July 10, 1995, and payment of the growth 
amount over the base amount shall be made on or before the third 
of each month.  Payments for the period August 1995 through 
December 1995 shall be made on or before the third of each month 
thereafter through December 31, 1995. 
    (d) Monthly payments for the county share of county agency 
expenditures from January 1996 through February 1996 shall be 
made on or before the third of each month through February 
1996.  Payment for 1/24 of the base amount and the March 1996 
county share of county agency expenditures growth amount for the 
programs identified in subdivision 2 shall be made on or before 
March 1996.  For the period of April 1, 1996, through July 31, 
1996, payment of the base amount shall be made on or before July 
10, 1996, and payment of the growth amount over the base amount 
shall be made on or before the third of each month.  Payments 
for the period August 1996 through December 1996 shall be made 
on or before the third of each month thereafter through December 
31, 1996. 
    (e) Monthly payments for the county share of county agency 
expenditures from January 1997 through March 1997 shall be made 
on or before the third of each month through March 1997.  
Payment for 1/24 of the base amount and the April 1997 county 
share of county agency expenditures growth amount for the 
programs identified in subdivision 2 shall be made on or before 
April 3, 1997.  For the period of May 1, 1997, through July 31, 
1997, payment of the base amount shall be made on or before July 
10, 1997, and payment of the growth amount over the base amount 
shall be made on or before the third of each month.  Payments 
for the period August 1997 through December 1997 shall be made 
on or before the third of each month thereafter through December 
31, 1997. 
    (f) Monthly payments for the county share of county agency 
expenditures from January 1998 through April 1998 shall be made 
on or before the third of each month through April 1998.  
Payment for 1/24 of the base amount and the May 1998 county 
share of county agency expenditures growth amount for the 
programs identified in subdivision 2 shall be made on or before 
May 3, 1998.  For the period of June 1, 1998, through July 31, 
1998, payment of the base amount shall be made on or before July 
10, 1998, and payment of the growth amount over the base amount 
shall be made on or before the third of each month.  Payments 
for the period August 1998 through December 1998 shall be made 
on or before the third of each month thereafter through December 
31, 1998. 
    (g) Monthly payments for the county share of county agency 
expenditures from January 1999 through May 1999 shall be made on 
or before the third of each month through May 1999.  Payment for 
1/24 of the base amount and the June 1999 county share of county 
agency expenditures growth amount for the programs identified in 
subdivision 2 shall be made on or before June 3, 1999.  For the 
period of June 1, 1999, through July 31, 1999, payment shall be 
made on or before July 10, 1999.  Payments for the period August 
1999 through December 1999 shall be made on or before the third 
of each month thereafter through December 31, 1999. 
    (h) Effective January 1, 2000, monthly payments for the 
county share of county agency expenditures shall be made 
subsequent to the first of each month. 
    Payments under this subdivision are subject to the 
provisions of section 256.017.  
    Sec. 12.  Minnesota Statutes 1990, section 256.031, is 
amended to read: 
    256.031 [MINNESOTA FAMILY INVESTMENT PLAN.] 
    Subdivision 1.  [CITATION.] Sections 256.031 to 256.036 
256.0361 may be cited as the Minnesota family investment plan. 
    Subd. 2.  [LEGISLATIVE FINDINGS.] The legislature 
recognizes the need to fundamentally change the way government 
supports families.  The legislature finds that many features of 
the current system of public assistance do not help families 
carry out their two basic functions:  the economic support of 
the family unit and the care and nurturing of children.  The 
legislature recognizes that the Minnesota family investment plan 
is an investment strategy that will support and strengthen the 
family's social and financial functions.  This investment in 
families will provide long-term benefits through stronger and 
more independent families. 
    Subd. 3.  [AUTHORIZATION FOR THE DEMONSTRATION.] (a) The 
commissioner of human services, in consultation with the 
commissioners of education, finance, jobs and training, health, 
and planning, and the directors director of the higher education 
coordinating board and the office of jobs policy, is authorized 
to proceed with the planning and designing of the Minnesota 
family investment plan and to implement the plan to test 
policies, methods, and cost impact on an experimental basis by 
using field trials.  The commissioner, under the authority in 
section 256.01, subdivision 2, shall implement the plan 
according to sections 256.031 to 256.033 describe the basic 
principles of the program. Sections 256.034 to 256.036 provide a 
basis for congressional action.  Using sections 256.031 to 
256.036, the commissioner shall seek congressional authority to 
implement the program in field trials After obtaining 
congressional authority to implement the Minnesota family 
investment plan in field trials, the commissioner shall request 
specific appropriations from the legislature to implement field 
trials 256.0361 and Public Law Numbers 101-202 and 101-239, 
section 8015, as amended.  If major and unpredicted costs to the 
program occur, the commissioner may take corrective action 
consistent with Public Law Numbers 101-202 and 101-239, which 
may include termination of the program.  Before taking such 
corrective action, the commissioner shall consult with the 
chairs of the senate health and human services committee, the 
house health and human services committee, the health and human 
services division of the senate finance committee and the human 
resources division of the house appropriations committee, or, if 
the legislature is not in session, consult with the legislative 
advisory commission.  
    (b) The field trials must shall be conducted as permitted 
under federal law, for as many years as necessary, and in 
different geographical settings, to provide reliable instruction 
about the desirability of expanding the program statewide. 
    (c) The commissioner shall select the counties which shall 
serve as field trial or control sites based on criteria which 
ensure reliable evaluation of the program.  
    (d) The commissioner is authorized to determine the number 
of families and characteristics of subgroups to be included in 
the evaluation.  
    (i) A family that applies for or is currently receiving 
financial assistance from aid to families with dependent 
children; family general assistance or work readiness; or food 
stamps may be assigned by the commissioner to an experimental or 
a control group for the purposes of evaluating the family 
investment plan.  Families assigned to an experimental group 
receive benefits and services through the family investment 
plan.  Families assigned to a control group receive benefits and 
services through existing programs.  A family may not select the 
group to which it is assigned.  Once assigned to a group, a 
family must remain in that group for the duration of the project.
    (ii) To evaluate the effectiveness of the family investment 
plan, the commissioner may designate a subgroup of families from 
the experimental group who shall be exempt from section 256.035, 
subdivision 1, and shall not receive case management services 
under section 256.035, subdivision 6a.  Families are eligible 
for services under section 256.736 to the same extent as 
families receiving AFDC.  
    Subd. 4.  [GOALS OF THE MINNESOTA FAMILY INVESTMENT PLAN.] 
The commissioner shall design the program to meet the following 
goals: 
    (1) to support families' transition to financial 
independence by emphasizing options, removing barriers to work 
and education, providing necessary support services, and 
building a supportive network of education, employment and 
training, health, social, counseling, and family-based services; 
    (2) to allow resources to be more effectively and 
efficiently focused on investing in families by removing the 
complexity of current rules and procedures and consolidating 
public assistance programs; 
    (3) to prevent long-term dependence on public assistance 
through paternity establishment, child support enforcement, 
emphasis on education and training, and early intervention with 
minor parents; and 
     (4) to provide families with an opportunity to increase 
their living standard by rewarding efforts aimed at transition 
to employment and by allowing families to keep a greater portion 
of earnings when they become employed. 
    Subd. 5.  [FEDERAL WAIVERS.] The commissioner of human 
services shall seek authority from Congress to implement the 
Minnesota family investment plan on a demonstration basis.  If 
necessary In accordance with sections 256.031 to 256.0361 and 
federal laws authorizing the program, the commissioner shall 
seek waivers of compliance with federal requirements for 
of:  aid to families with dependent children under United States 
Code, title 42, sections section 601 to 679a, as amended; 
medical assistance under United States Code, title 42, sections 
1396 to 1396s, as amended; food stamps under et seq., and United 
States Code, title 7, sections section 2011 to 2030, as amended; 
and other federal requirements that would inhibit implementation 
of et seq., needed to implement the Minnesota family investment 
plan in a manner consistent with the goals and objectives of the 
program.  The commissioner shall seek terms from the federal 
government that are consistent with the goals of the Minnesota 
family investment plan.  The commissioner shall also seek terms 
from the federal government that will maximize federal financial 
participation so that the extra costs to the state of 
implementing the program are minimized, to the extent that those 
terms are consistent with the goals of the Minnesota family 
investment plan.  An agreement with the federal government under 
this section shall provide that the agreements may be canceled 
by the state or federal government upon six months' 180 days' 
notice or immediately upon mutual agreement.  If the agreements 
are agreement is canceled, families which cease receiving 
assistance under the Minnesota family investment plan who are 
eligible for the aid to families with dependent children, 
general assistance, medical assistance, general assistance 
medical care, and or the food stamp programs program must be 
placed with their consent on those the programs for which they 
are eligible. 
    Sec. 13.  Minnesota Statutes 1990, section 256.032, is 
amended to read: 
    256.032 [DEFINITIONS.] 
    Subdivision 1.  [SCOPE OF DEFINITIONS.] The terms used in 
sections 256.031 to 256.036 256.0361 have the meanings given 
them unless otherwise provided or indicated by the context. 
    Subd. 1a.  [ASSISTANCE UNIT.] (a) "Assistance unit" means 
the following individuals when they are living together:  a 
minor child; the minor child's blood-related siblings; and the 
minor child's natural and adoptive parents.  The income and 
assets of members of the assistance unit must be considered in 
determining eligibility for the family investment plan.  
    (b) A nonparental caregiver, as defined in subdivision 2, 
may elect to be included in the assistance unit.  A nonparental 
caregiver who does not elect to be included under this paragraph 
must apply for assistance with the minor child. 
    (c) A stepparent of the minor child may elect to be 
included in the assistance unit.  If the stepparent does not 
choose to be included, the county agency shall not count the 
stepparent's resources or income, if the stepparent's income is 
less than 275 percent of the federal poverty guidelines for a 
family of one.  If the stepparent's income is more than 275 
percent of the federal poverty guidelines for a family of one 
and the stepparent does not choose to be included, the county 
agency shall not count the stepparent's resources, but shall 
count the stepparent's income in accordance with section 
256.033, subdivision 2, clause (5).  
    (d) A stepsibling of the minor child may elect to be 
included in the assistance unit. 
    (e) A parent of a minor caregiver may elect to be included 
in the minor caregiver's assistance unit.  If the parent of the 
minor caregiver does not choose to be included, the county 
agency shall not count the resources of the parent of the minor 
caregiver, but shall count the income of the parent of the minor 
caregiver, in accordance with section 256.033, subdivision 2, 
clause (5). 
    Subd. 2.  [CAREGIVER.] "Caregiver" means a minor child's 
natural or adoptive parent or parents who live in the home with 
the minor child.  For purposes of determining eligibility for 
this program, "caregiver" also means any of the following 
individuals, if adults, who live with and provide care and 
support to a minor child when the minor child's natural or 
adoptive parent or parents do not reside in the same home:  
grandfather, grandmother, brother, sister, stepfather, 
stepmother, stepbrother, stepsister, uncle, aunt, first cousin, 
nephew, niece, persons of preceding generations as denoted by 
prefixes of "great" or "great-great," or a spouse of any person 
named in the above groups even after the marriage ends by death 
or divorce. 
    Subd. 3.  [CASE MANAGEMENT.] "Case management" means the 
assessment of family needs and, the development of the 
employability plan and family support agreement, and the 
coordination of services necessary to support the family in its 
social and economic roles, in addition to the services described 
in according to section 256.736 256.035, subdivision 11 6a. 
    Subd. 4.  [COMMISSIONER.] "Commissioner" means the 
commissioner of human services or a designee. 
    Subd. 5.  [CONTRACT.] "Contract" means a family 
self-sufficiency plan, described in section 256.035, subdivision 
7, based on the case manager's assessment of the family's needs 
and abilities and developed, together with a parental caregiver, 
by a county agency or its designee.  
    Subd. 5a.  [COUNTY AGENCY.] "County agency" means the 
agency designated by the county board to implement financial 
assistance for current programs and for the Minnesota family 
investment plan and the agency responsible for enforcement of 
child support collection. 
    Subd. 5b.  [COUNTY BOARD.] "County board" means the county 
board of commissioners; a county welfare board as defined in 
chapter 393; a board established under the joint powers act, 
section 471.59; or a human services board under chapter 402. 
    Subd. 6.  [DEPARTMENT.] "Department" means the department 
of human services. 
    Subd. 6a.  [EMPLOYABILITY PLAN.] "Employability plan" means 
the plan developed by the case manager and the caregiver 
according to section 256.035, subdivision 6b, which meets the 
requirements for an employability development plan under section 
256.736, subdivision 10, paragraph (a), clause (15). 
    Subd. 7.  [FAMILY.] For purposes of determining eligibility 
for this program, "Family" includes the following individuals 
who live together:  a minor child or a group of minor children 
related to each other as siblings, half siblings, stepsiblings, 
or adopted siblings, together with their natural or adoptive 
parents, or their caregiver as defined in subdivision 2.  
"Family" also includes a pregnant woman in the third trimester 
of pregnancy with no children. 
    Subd. 7a.  [FAMILY SUPPORT AGREEMENT.] "Family support 
agreement" means the agreement developed by the case manager and 
the caregiver under section 256.035, subdivision 6c.  
    Subd. 8.  [FAMILY WAGE LEVEL.] "Family wage level" means 
120 percent of the transitional standard, as defined in 
subdivision 13. 
    Subd. 8a.  [MINOR CHILD.] "Minor child" means a child who 
is living in the same home of a parent or other caregiver, who 
is in financial need, and who is either less than 18 years of 
age or is under the age of 19 years and is regularly attending 
as a full-time student and is expected to complete a high school 
or a secondary level course of vocational or technical training 
designed to fit students for gainful employment before reaching 
age 19.  
    Subd. 9.  [ORIENTATION.] "Orientation" means a presentation 
that meets the requirements of section 256.736, subdivision 10a, 
provides information to caregivers about the Minnesota family 
investment plan, and encourages parental caregivers to engage in 
activities that will stabilize the family and lead to 
self-sufficiency. 
    Subd. 10.  [PROGRAM.] "Program" means the Minnesota family 
investment plan.  
    Subd. 11.  [SIGNIFICANT CHANGE.] "Significant change" means 
a change of ten percent or $50, whichever is less, in monthly 
gross family earned income, or a change in family composition in 
income available to the family so that the sum of the income and 
the grant for the current month would be less than the 
transitional standard as defined in subdivision 13. 
    Subd. 11a.  [SUITABLE EMPLOYMENT.] "Suitable employment" 
has the meaning given in section 256.736, subdivision 1a, 
paragraph (h). 
    Subd. 12.  [TRANSITIONAL STATUS.] "Transitional status" 
means the status of caregivers who are independently pursuing 
self-sufficiency or caregivers who are complying with the terms 
of a contract family support agreement with a county agency or 
its designee. 
    Subd. 13.  [TRANSITIONAL STANDARD.] "Transitional standard" 
means the sum of the AFDC standard of assistance and the full 
cash value of food stamps for a family of the same size and 
composition in effect when for the remainder of the state during 
implementation of the Minnesota family investment plan begins 
field trials.  This standard applies only to families in which 
the parental caregiver is in transitional status and to families 
in which the caregiver is exempt from having a contract or is 
exempt from developing or has good cause for not complying with 
the terms of the contract family support agreement.  Full cash 
value of food stamps is the amount of the cash value of food 
stamps to which a family of a given size would be entitled for a 
month, determined by assuming unearned income equal to the AFDC 
standard for a family of that size and composition and 
subtracting the standard deduction and maximum shelter deduction 
from gross family income, as allowed under the Food Stamp Act of 
1977, as amended, and Public Law Number 100-435.  The assistance 
standard for a family consisting of a pregnant woman in the 
third trimester of pregnancy with no children must equal the 
assistance standard for one adult and one child. 
    Sec. 14.  Minnesota Statutes 1990, section 256.033, is 
amended to read: 
    256.033 [ELIGIBILITY FOR THE MINNESOTA FAMILY INVESTMENT 
PLAN.] 
    Subdivision 1.  [ELIGIBILITY CONDITIONS.] (a) A family is 
eligible for and entitled to assistance under the Minnesota 
family investment plan if: 
    (1) the family's net income, after deducting an amount to 
cover taxes and actual dependent care costs up to the maximum 
disregarded under United States Code, title 42, section 
602(a)(8)(A)(iii), does not exceed the applicable standard of 
assistance for that family as defined under section 256.032, 
subdivision 13; and the family meets the definition of 
assistance unit under section 256.032, subdivision 1a; 
    (2) the family's nonexcluded resources not excluded under 
subdivision 3 do not exceed $2,000.; 
    (3) the family can verify citizenship or lawful resident 
alien status; 
    (4) the family provides or applies for a social security 
number for each member of the family receiving assistance under 
the family investment plan; and 
    (5) the family assigns child support collection to the 
county agency. 
    (b) A family is eligible for the family investment plan if 
the net income is less than the transitional standard as defined 
in section 256.032, subdivision 13, for that size and 
composition of family.  In determining available net income, the 
provisions in subdivision 2 shall apply. 
    (c) Upon application, a family is initially eligible for 
the family investment plan if the family's gross income does not 
exceed the applicable transitional standard of assistance for 
that family as defined under section 256.032, subdivision 13, 
after deducting: 
    (1) 18 percent to cover taxes; 
    (2) actual dependent care costs up to the maximum 
disregarded under United States Code, title 42, section 
602(a)(8)(A)(iii); and 
    (3) $50 of child support collected in that month. 
    (d) A family can remain eligible for the program if: 
    (1) it meets the conditions in section 256.035, subdivision 
4; and 
    (2) its income is below the transitional standard in 
section 256.032, subdivision 13, allowing for income exclusions 
in subdivision 2 and after applying the family investment plan 
treatment of earnings under section 256.035, subdivision 4. 
    Subd. 2.  [DETERMINATION OF FAMILY INCOME.] The aid to 
families with dependent children income exclusions listed in 
Code of Federal Regulations, title 45, sections 233.20(a)(3) and 
233.20(a)(4), must be used when determining a family's available 
income, except that:  
    (1) the disregard of the first $75 of gross earned income 
is replaced with a single disregard described in section 
256.035, subdivision 4, paragraph (a); 
    (2) all earned income of a minor child receiving assistance 
through the Minnesota family investment plan is excluded when 
the child is attending school at least half-time; 
    (3) (2) all earned income tax credit payments received by 
the family as a refund of federal income taxes or made as 
advance payments are excluded in accordance with United States 
Code, title 42, section 602(a)(8)(A)(viii); 
    (4) (3) educational grants and loans as provided in section 
256.74, subdivision 1, clause (2), are excluded; and 
    (5) (4) all other income listed in Minnesota Rules, part 
9500.2380, subpart 2, is excluded.; and 
    (5) when determining income available from members of the 
family who do not elect to be included in the assistance unit 
under section 256.032, subdivision 1a, paragraphs (c) and (e), 
the county agency shall count the remaining income after 
disregarding: 
    (i) the first 18 percent of the excluded family member's 
gross earned income; 
    (ii) an amount for the support of the stepparent and any 
other individuals whom the stepparent claims as dependents for 
determining federal personal income tax liability and who live 
in the same household but whose needs are not considered in 
determining eligibility for assistance under sections 256.031 to 
256.033.  The amount equals the transitional standard in section 
256.032, subdivision 13, for a family of the same size and 
composition; 
     (iii) amounts the stepparent actually paid to individuals 
not living in the same household but whom the stepparent claims 
as dependents for determining federal personal income tax 
liability; and 
     (iv) alimony or child support, or both, paid by the 
stepparent for individuals not living in the same household. 
    Subd. 3.  [DETERMINATION OF FAMILY RESOURCES.] When 
determining a family's resources, the following are excluded:  
    (1) the family's home, together with the surrounding 
property that does not exceed ten acres and that is not 
separated from the home by intervening property owned by others; 
    (2) one burial plot for each family member; 
    (3) one prepaid burial contract with an equity value of no 
more than $1,500 for each member of the family; 
    (4) licensed automobiles, trucks, or vans up to a total 
equity value of $4,500; 
    (5) the value of personal property needed to produce earned 
income, including tools, implements, farm animals, and 
inventory; 
    (6) the entire equity value of a motor vehicle determined 
to be necessary for the operation of a self-employment business; 
and 
    (7) clothing, necessary household furniture, equipment, and 
other basic maintenance items essential for daily living. 
    Subd. 4.  [TREATMENT OF SSI AND MSA.] The monthly benefits 
and any other income received through the supplemental security 
income or Minnesota supplemental aid programs program and any 
real or personal property of a person receiving an assistance 
unit member who receives supplemental security income or 
Minnesota supplemental aid must be excluded in determining the 
family's eligibility for the Minnesota family investment plan 
and the amount of assistance.  In determining the amount of 
assistance to be paid to the family, the needs of the person 
receiving supplemental security income or Minnesota supplemental 
aid must not be taken into account. 
     Subd. 5.  [ABILITY TO APPLY FOR FOOD STAMPS.] A family that 
is ineligible for assistance through the Minnesota family 
investment plan due to income or resources may apply for, and if 
eligible receive, benefits under the food stamp program. 
    Sec. 15.  Minnesota Statutes 1990, section 256.034, is 
amended to read: 
    256.034 [PROGRAM SIMPLIFICATION.] 
    Subdivision 1.  [CONSOLIDATION OF TYPES OF ASSISTANCE.] 
Under the Minnesota family investment plan, assistance 
previously provided to families through the AFDC, food stamp, 
and general assistance programs must be combined into a single 
cash assistance program.  If As authorized by Congress, families 
receiving assistance through the Minnesota family investment 
plan are automatically eligible for and entitled to medical 
assistance under chapter 256B.  Federal, state, and local funds 
that would otherwise be allocated for assistance to families 
under the AFDC, food stamp, and general assistance programs must 
be transferred to the Minnesota family investment plan.  The 
provisions of the Minnesota family investment plan prevail over 
any provisions of sections 256.72 to 256.87 or 256D.01 to 
256D.21 and any rules implementing those sections with which 
they are irreconcilable.  The food stamp, general assistance, 
and work readiness programs for single persons and couples who 
are not responsible for the care of children are not replaced by 
the Minnesota family investment plan. 
    Subd. 2.  [COUPON OPTION.] Families have the option to 
receive a portion of their assistance standardized amount of 
assistance as described in Public Law Number 101-202, section 
22(a)(3)(D), designated by the commissioner, in the form of food 
coupons or vendor payments. 
    Subd. 3.  [MODIFICATION OF ELIGIBILITY TESTS.] (a) A needy 
family is eligible and entitled to receive assistance under the 
program even if its children are not found to be deprived of 
parental support or care by reason of death, continued absence 
from the home, physical or mental incapacity of a parent, or 
unemployment of a parent, provided the family's income and 
resources do not exceed the eligibility requirements in section 
256.033.  In addition, a family member caregiver who is in the 
assistance unit who is physically and mentally fit, who is 
between the ages of 18 and 60 years, who is enrolled at least 
half time in an institution of higher education, and whose 
family income and resources do not exceed the eligibility 
requirements in section 256.033, is eligible for assistance 
under the Minnesota family investment plan even if the 
conditions for eligibility as prescribed under the federal Food 
Stamp Act of 1977, as amended, are not met. 
    (b) An applicant for, or a person receiving, assistance 
under the Minnesota family investment plan is considered to have 
assigned to the public agency responsible for child support 
enforcement at the time of application all rights to child 
support, health care benefits coverage, and maintenance from any 
other person the applicant may have in the applicant's own 
behalf or on behalf of any other family member for whom 
application is made under the Minnesota family investment plan.  
The provisions of section 256.74, subdivision 5, govern the 
assignment.  An applicant for, or a person receiving, assistance 
under the Minnesota family investment plan shall cooperate with 
the efforts of the county agency to collect child and spousal 
support.  The county agency is entitled to any child support and 
maintenance received by or on behalf of the person receiving 
assistance or another member of the family for which the person 
receiving assistance is responsible.  Failure by an applicant or 
a person receiving assistance to cooperate with the efforts of 
the county agency to collect child and spousal support without 
good cause must be sanctioned according to section 256.035, 
subdivision 3.  
    (c) An applicant for, or a person receiving, assistance 
under the Minnesota family investment plan is not required to 
comply with the employment and training requirements prescribed 
under sections 256.736, subdivisions 3, 3a, and 14; and 256D.05, 
subdivision 1; section 402(a)(19) of the Social Security Act; 
the federal Food Stamp Act of 1977, as amended; Public Law 
Number 100-485; or any other state or federal employment and 
training program, unless and to the extent compliance is 
specifically required in a contract family support agreement 
with the county agency or its designee. 
    Subd. 4.  [SIMPLIFICATION OF BUDGETING PROCEDURES.] The 
monthly amount of assistance provided by the Minnesota family 
investment plan must be calculated on a prospective basis by 
taking into account actual income or circumstances that existed 
in a previous month and other relevant information to predict 
income and circumstances for the next month or months.  When a 
family has a significant change in circumstances, the budgeting 
cycle must be interrupted and the amount of assistance for the 
payment month must be based on the county agency's best estimate 
of the family's income and circumstances for that month.  
Families may be required to report their income monthly, but 
income may be averaged over a period of more than one month.  
    Subd. 5.  [SIMPLIFICATION OF VERIFICATION PROCEDURES.] 
Verification procedures must be reduced to the minimum that is 
workable and consistent with the goals and requirements of the 
Minnesota family investment plan as determined by the 
commissioner. 
    Sec. 16.  Minnesota Statutes 1990, section 256.035, is 
amended to read: 
    256.035 [INCOME SUPPORT AND TRANSITION.] 
    Subdivision 1.  [EXPECTATIONS.] All families eligible for 
assistance under the family investment plan are expected to be 
in transitional status as defined in section 256.032, 
subdivision 12.  To be considered in transitional status, 
families must meet the following expectations: 
    (a) For a family headed by a single adult parent parental 
caregiver, the expectation is that the parent parental caregiver 
will independently pursue self-sufficiency until the family has 
received assistance for 24 months within the preceding 36 
months.  Beginning with the 25th month of assistance, the parent 
must be developing or have a contract and comply complying with 
the terms of the contract with the county agency or its designee 
family support agreement.  
    (b) For a family with a minor parent parental caregiver or 
a family whose parental caregiver is 18 or 19 years of age and 
does not have a high school diploma or its equivalent, the 
expectation is that, concurrent with the receipt of assistance, 
the minor parent parental caregiver must be developing or have a 
contract with the county agency complying with a family support 
agreement.  The terms of the contract family support agreement 
must include compliance with section 256.736, subdivision 
3b.  However, if the assistance unit does not comply with 
section 256.736, subdivision 3b, the sanctions in subdivision 3 
apply.  
    (c) For a family with two adult parents parental 
caregivers, the expectation is that at least one or both parents 
parent will independently pursue self-sufficiency until the 
family has received assistance for six months within the 
preceding 12 months.  Beginning with the seventh month of 
assistance, one parent must be developing or have a contract and 
comply complying with the terms of the contract with the county 
agency or its designee family support agreement.  
    Subd. 2.  [EXEMPTIONS.] (a) A caregiver is exempt from the 
requirement of developing a contract and complying with the 
terms of the contract developed with the county agency family 
support agreement, or engaging in transitional activities, if:  
    (1) the caregiver is not the natural or adoptive parent of 
a minor child; or 
    (2) in the case of a parental caregiver, the county agency 
determines that: 
    (i) individual circumstances prevent compliance; 
    (ii) support services necessary to enable compliance are 
not available; 
    (iii) activities identified in the contract are not 
available; or 
    (iv) a parental caregiver is willing to accept suitable 
employment but employment is not available. the caregiver is 
exempt under United States Code, title 7, section 
2031(c)(1)(A)(B)(C)(D)(E) or (F); 
    (b) A parental caregiver exempt under paragraph (a), clause 
(2), may meet with a case manager and develop an employability 
plan if the parental caregiver fits one of the categories of 
expectations in subdivision 1, and may receive support services 
including child care if needed to participate in activities 
identified in the employability plan.  
    Subd. 2a.  [GOOD CAUSE.] The county agency shall not impose 
the sanction in subdivision 3 if it determines that the parental 
caregiver has good cause for not meeting the expectations of 
developing and complying with the terms of a family support 
agreement developed with the county agency.  Good cause exists 
when: 
    (1) needed child care is not available; 
    (2) the job does not meet the definition of suitable 
employment in section 256.032, subdivision 11a; 
    (3) the parental caregiver is ill or injured; 
    (4) a family member is ill and needs care by the parental 
caregiver that prevents the parental caregiver from complying 
with the family support agreement; 
    (5) the parental caregiver is unable to secure the 
necessary transportation; 
    (6) the parental caregiver is in an emergency situation 
which prevents compliance with the family support agreement; 
    (7) the schedule of compliance with the family support 
agreement conflicts with judicial proceedings; 
    (8) the parental caregiver is already participating in 
acceptable activities; 
    (9) the family support agreement requires an educational 
program for a parent under age 20, but the educational program 
is not offered in the school district; 
    (10) activities identified in the family support agreement 
are not available; 
    (11) the parental caregiver is willing to accept suitable 
employment as defined in section 256.032, subdivision 11a, but 
employment is not available; or 
    (12) the parental caregiver documents other verifiable 
impediments to compliance with the family support agreement 
beyond the parental caregiver's control. 
    Subd. 3.  [SANCTIONS.] A family whose parental caregiver is 
not exempt from the expectations in subdivision 1 and who is not 
complying with those expectations by developing or complying 
with the family support agreement must have assistance reduced 
by a value equal to ten percent of the transitional standard as 
defined in section 256.032, subdivision 13.  This reduction is 
effective with the month following the finding of noncompliance 
and continues until the beginning of the month after failure to 
comply ceases.  The county agency must notify provide written 
notice to the parental caregiver of its intent to implement this 
sanction and the opportunity to have a conciliation conference, 
upon request, before the sanctions are sanction is implemented.  
Implementation of the sanction shall be postponed pending 
resolution of the conciliation conference under section 256.036, 
subdivision 5, or hearing under section 256.045. 
    Subd. 4.  [TREATMENT OF INCOME FOR THE PURPOSES OF 
CONTINUED ELIGIBILITY.] To help families during their transition 
from the Minnesota family investment plan to self-sufficiency, 
the following income supports are available: 
    (a) The $30 and one-third and $75 $90 disregards allowed 
under section 256.74, subdivision 1, and the 20 percent earned 
income deduction allowed under the federal Food Stamp Act of 
1977, as amended, are replaced with a single disregard of not 
less than 35 percent of gross earned income to cover taxes and 
other work-related expenses and to reward the earning of 
income.  This single disregard is available for the entire time 
a family receives assistance through the Minnesota family 
investment plan. 
    (b) The dependent care deduction, as prescribed under 
section 256.74, subdivision 1, and United States Code, title 7, 
section 2014(e), is replaced for families with earned income who 
need assistance with dependent care with an entitlement to a 
dependent care subsidy from money earmarked appropriated for the 
Minnesota family investment plan. 
    (c) The family wage level, as defined in section 256.032, 
subdivision 8, allows families to supplement earned income with 
assistance received through the Minnesota family investment 
plan.  If, after earnings are adjusted according to the 
disregard described in paragraph (a), earnings have raised 
family income to a level equal to or greater than the family 
wage level, the amount of assistance received through the 
Minnesota family investment plan must be reduced. 
    (d) The first $50 of any timely support payment for a month 
received by the public agency responsible for child support 
enforcement shall be paid to the family and disregarded in 
determining eligibility and the amount of assistance in 
accordance with United States Code, title 42, sections 
602(a)(8)(A)(vi) and 657(b)(1).  This paragraph applies 
regardless of whether the caregiver is in transitional status, 
is exempt from having developing or complying with the terms of 
a contract family support agreement, or has had a sanction 
imposed under subdivision 3.  
    Subd. 5.  [ORIENTATION.] All caregivers receiving 
assistance through the Minnesota family investment plan must 
attend orientation The county agency must provide orientation 
which supplies information to caregivers about the Minnesota 
family investment plan, and must encourage parental caregivers 
to engage in activities to stabilize the family and lead to 
employment and self-support. 
    Subd. 6.  [CONTRACT.] (a) To receive the transitional 
standard of assistance, a single adult parent who is a member of 
a family that has received assistance through the Minnesota 
family investment plan for 24 months within the preceding 36 
months, a minor parent receiving assistance through the 
Minnesota family investment plan, and one parent in a two-parent 
family that has received assistance through the Minnesota family 
investment plan for six months within the preceding 12 months, 
must comply with the terms of a contract with the county agency 
or its designee unless exempt under subdivision 2.  Case 
management must be provided to a caregiver who is a parent to 
assist the caregiver in meeting established goals and to monitor 
the caregiver's progress toward achieving those goals.  The 
parental caregiver and the county agency must finalize the 
contract as soon as possible, but in any event within a 
reasonable period of time after the deadline specified in 
subdivision 1, paragraph (a), (b), or (c), whichever applies.  
    (b) A contract must identify the parental caregiver's 
employment goal and explain what steps the family must take to 
pursue self-sufficiency.  Activities may include: 
    (1) orientation; 
    (2) employment; 
    (3) employment and training services as defined under 
section 256.736, subdivision 1a, paragraph (d); 
    (4) preemployment activities; 
   (5) participation in an educational program leading to a 
high school or general equivalency diploma and post-secondary 
education programs, excluding postbaccalaureate degrees as 
provided in section 256.736, subdivision 1a, paragraph (d); 
    (6) case management; 
    (7) social services; or 
    (8) other programs or services leading to self-sufficiency. 
The contract must also identify the services that the county 
agency will provide to the family that the family needs to 
enable the parental caregiver to comply with the contract, 
including support services such as transportation and child care.
    Subd. 6a.  [CASE MANAGEMENT SERVICES.] (a) The county 
agency will provide case management services to caregivers 
required to develop and comply with a family support agreement 
as provided in subdivision 1.  For minor parents, the 
responsibility of the case manager shall be as defined in 
section 256.736, subdivision 3b.  Sanctions for failing to 
develop or comply with the terms of a family support agreement 
shall be imposed according to subdivision 3.  When a minor 
parent reaches age 17, or earlier if determined necessary by the 
social service agency, the minor parent shall be referred for 
case management services.  
    (b) Case managers shall provide the following services: 
    (1) the case manager shall provide or arrange for an 
assessment of the family and caregiver's needs, interests, and 
abilities according to section 256.736, subdivision 11, 
paragraph (a), clause (1); 
    (2) the case manager shall coordinate services according to 
section 256.736, subdivision 11, paragraph (a), clause (3); 
    (3) the case manager shall develop an employability plan 
according to subdivision 6b; 
    (4) the case manager shall develop a family support 
agreement according to subdivision 6c; and 
    (5) the case manager shall monitor the caregiver's 
compliance with the employability plan and the family support 
agreement as required by the commissioner.  
    (c) Case management may continue for up to six months 
following the caregiver's achievement of employment goals. 
    Subd. 6b.  [EMPLOYABILITY PLAN.] (a) The case manager shall 
develop an employability plan with the caregiver according to 
this subdivision and section 256.736, subdivision 11, paragraph 
(a), clause (2), which will be based on the assessment in 
subdivision 6a of the caregiver's needs, interests, and 
abilities. 
    (b) An employability plan must identify the caregiver's 
employment goal or goals and explain what steps the family must 
take to pursue self-sufficiency.  
    (c) Activities in the employability plan may include 
preemployment activities such as:  programs, activities, and 
services related to job training and job placement.  These 
preemployment activities may include, based on availability and 
resources, participation in dislocated worker services, chemical 
dependency treatment, mental health services, self-esteem 
enhancement activities, peer group networks, displaced homemaker 
programs, education programs leading toward the employment goal, 
parenting education, and other programs to help the families 
reach their employment goals and enhance their ability to care 
for their children. 
    Subd. 6c.  [FAMILY SUPPORT AGREEMENT.] (a) The family 
support agreement is the enforceable component of the 
employability plan as described in subdivision 6b and section 
256.736, subdivision 10, paragraph (a), clause (15).  A parental 
caregiver's failure to comply with any part of the family 
support agreement without good cause as provided in subdivision 
2a is subject to sanction as provided in subdivision 3. 
    (b) A family support agreement must identify the parental 
caregiver's employment goal or goals and outline the steps which 
the parental caregiver and case manager mutually determined are 
necessary to achieve each goal.  Activities are limited to: 
    (1) employment; 
    (2) employment and training activities; or 
    (3) education up to a baccalaureate degree. 
    (c) A family support agreement shall include only those 
activities described in paragraph (b).  Social services or 
activities, such as mental health or chemical dependency 
services, parenting education, or budget management, can be 
included in the employability plan and not in the family support 
agreement and are not subject to a sanction under subdivision 3. 
    (d) For a parental caregiver whose employability plan is 
composed entirely of services described in paragraph (c), the 
family support agreement shall designate a date for reassessment 
of the activities needed to reach the parental caregiver's 
employment goal and this date shall be considered as the content 
of the family support agreement.  The parental caregiver and 
case manager shall meet at least semiannually to review and 
revise the family support agreement. 
    (e) The family support agreement must identify the services 
that the county agency will provide to the family to enable the 
parental caregiver to comply with the family support agreement, 
including support services such as transportation and child care.
    (f) The family support agreement must state the parental 
caregiver's obligations and the conditions under which the 
county agency will recommend a sanction be applied to the grant 
and withdraw the services. 
     (g) The family support agreement will specify a date for 
completion of activities leading to the employment goal.  
    (h) The family support agreement must be signed and dated 
by the case manager and parental caregiver.  In all cases, the 
case manager must assist the parental caregiver in reviewing and 
understanding the family support agreement and must assist the 
caregiver in setting realistic goals in the agreement which are 
consistent with the ultimate goal of financial support for the 
caregiver's family.  The case manager must inform the caregiver 
of the right to seek conciliation as provided in subdivision 6e. 
    (i) The caregiver may revise the family support agreement 
with the case manager when good cause indicates revision is 
warranted.  Revisions for reasons other than good cause to 
employment goals or steps toward self-support may be made in the 
first six months after the signing of the family support 
agreement with the approval of the case manager.  After that, 
the revision must be approved by the case management supervisor 
or other persons responsible for review of case management 
decisions. 
    Subd. 6d.  [LENGTH OF JOB SEARCH.] When the family support 
agreement specifies a date when job search should begin, the 
parental caregiver must participate in employment search 
activities.  If, after three months of search, the parental 
caregiver does not find a job that is consistent with the 
parental caregiver's employment goal, the parent must accept any 
suitable employment.  The search may be extended for up to three 
months if the parental caregiver seeks and needs additional job 
search assistance. 
    Subd. 6e.  [CONCILIATION.] A conciliation procedure shall 
be available as provided in section 256.736, subdivision 11, 
paragraph (c).  The conciliation conference will be available to 
parental caregivers who cannot reach agreement with the case 
manager about the contents or interpretation of the family 
support agreement, or who have received a notice of intent to 
implement a sanction as required under subdivision 3.  
Implementation of the sanction will be postponed pending the 
outcome of conciliation.  The conciliation conference will be 
facilitated by a neutral mediator, and the goal will be to 
achieve mutual agreement between the parental caregiver and case 
manager.  The conciliation conference is an optional procedure 
preceding the hearing process under section 256.045. 
    Subd. 7.  [EMPLOYMENT BONUS.] A family leaving the program 
as a result of increased earnings through employment is entitled 
to an employment bonus.  This bonus is a one-time cash 
incentive, not more than the family's monthly payment standard, 
to cover initial expenses incurred by the family leaving the 
Minnesota family investment plan. 
    Subd. 8.  [CHILD CARE.] The commissioner shall ensure that 
each Minnesota family investment plan caregiver who is a parent 
in transitional status employed or is developing or is engaged 
in activities identified in an employability plan under 
subdivision 6b and who needs assistance with child care costs to 
independently pursue self-sufficiency be employed or to develop 
or comply with the terms of a contract with the county agency an 
employability plan receives a child care subsidy through child 
care money earmarked appropriated for the Minnesota family 
investment plan.  The subsidy must cover all actual child care 
costs for eligible hours up to the maximum rate allowed 
under sections section 256H.15 and 256H.16.  A caregiver who 
is a parent in the assistance unit who leaves the program as a 
result of increased earnings from employment and who needs child 
care assistance to remain employed is entitled to extended child 
care assistance as provided under United States Code, title 42, 
section 602(g)(1)(A)(ii) on a copayment basis. 
    Subd. 9.  [HEALTH CARE.] A family leaving the program as a 
result of increased earnings from employment is eligible for 
extended medical assistance as provided under Public Law Number 
100-485, section 303, as amended and Public Law Number 101-239, 
section 8015(b)(7). 
    Sec. 17.  Minnesota Statutes 1990, section 256.036, 
subdivision 1, is amended to read: 
    Subdivision 1.  [SUPPORT SERVICES.] If assistance with 
child care or transportation is necessary to enable a parental 
caregiver who is a parent to work, obtain training or education, 
attend orientation, or comply with the terms of a contract 
family support agreement with the county agency, and the 
county agency determines that child care or transportation is 
not available, the family's applicable standard of assistance 
continues to be the transitional standard. 
    Sec. 18.  Minnesota Statutes 1990, section 256.036, 
subdivision 2, is amended to read: 
    Subd. 2.  [VOLUNTEERS.] For caregivers receiving assistance 
under the Minnesota family investment plan who are not currently 
employed but who are independently pursuing self-sufficiency, 
case management and, support services other than, and child care 
are available to the extent that resources permit.  A caregiver 
who volunteers is not subject to a sanction under section 
256.035, subdivision 3.  
    Sec. 19.  Minnesota Statutes 1990, section 256.036, 
subdivision 4, is amended to read: 
    Subd. 4.  [TIMELY ASSISTANCE.] Applications must be 
processed in a timely manner according to the processing 
standards of the federal Food Stamp Act of 1977, as amended, and 
no later than 30 days following the date of application, unless 
the county agency has requested information that the applicant 
has not yet supplied.  Financial assistance must be provided on 
no less than a at least monthly basis to eligible families. 
    Sec. 20.  Minnesota Statutes 1990, section 256.036, 
subdivision 5, is amended to read: 
    Subd. 5.  [DUE PROCESS.] Any family that applies for or 
receives assistance under the Minnesota family investment plan 
whose application for assistance is denied or not acted upon 
with reasonable promptness, or whose assistance is suspended, 
reduced, terminated, or claimed to have been incorrectly paid, 
is entitled, upon request, to a hearing under section 256.045.  
A parental caregiver may request a conciliation conference, as 
provided under section 256.736 256.035, subdivisions 4a and 
11 subdivision 6e, when the caregiver disputes the contents 
terms of a contract family support agreement developed under the 
Minnesota family investment plan or disputes a decision 
regarding failure or refusal to cooperate comply with the terms 
of a contract family support agreement.  The disputes are not 
subject to administrative review under section 256.045, unless 
they result in a denial, suspension, reduction, or termination, 
and the parental caregiver complies with section 256.045.  A 
caregiver need not request a conciliation conference to request 
a hearing according to section 256.045. 
    Sec. 21.  [256.0361] [FIELD TRIAL OPERATION.] 
    Subdivision 1.  [LOCAL PLAN.] A county that is selected to 
serve as a field trial or control site shall carry out the 
activities necessary to perform the evaluation for the duration 
of the field trials. 
    Subd. 2.  [FINANCIAL REIMBURSEMENT.] (a) Up to the limit of 
the state appropriation, a county selected by the commissioner 
to serve as a field trial or a control site for the Minnesota 
family investment plan shall be reimbursed by the state for the 
nonfederal share of administrative costs that were incurred 
during the development, implementation, and operation of the 
program and that exceed the administrative costs that would have 
been incurred in the absence of the program. 
     (b) Minnesota family investment plan assistance is included 
as covered programs and services under section 256.025, 
subdivision 2. 
    Sec. 22.  Minnesota Statutes 1990, section 256.736, 
subdivision 3a, is amended to read: 
    Subd. 3a.  [PARTICIPATION.] (a) Except as provided under 
paragraphs (b) and (c), participation in employment and training 
services under this section is limited to the following 
recipients:  
    (1) caretakers who are required to participate in a job 
search under subdivision 14; 
    (2) custodial parents who are subject to the school 
attendance or case management participation requirements under 
subdivision 3b; 
    (3) caretakers whose participation in employment and 
training services began prior to May 1, 1990, if the caretaker's 
AFDC eligibility has not been interrupted for 30 days or more 
and the caretaker's employability development plan has not been 
completed; 
    (4) recipients who are members of a family in which the 
youngest child is within two years of being ineligible for AFDC 
due to age; 
    (5) effective September 1, 1990, custodial parents under 
the age of 22 24 who:  (i) have not completed a high school 
education and who, at the time of application for AFDC, were not 
enrolled in high school or in a high school equivalency program; 
or (ii) have had little or no work experience in the preceding 
year; 
    (6) recipients who have received AFDC for 48 36 or more 
months out of the last 60 months; 
    (7) recipients who are participants in the self-employment 
investment demonstration project under section 268.95; and 
    (8) recipients who participate in the new chance research 
and demonstration project under contract with the department of 
human services. 
    (b) If the commissioner determines that participation of 
persons listed in paragraph (a) in employment and training 
services is insufficient either to meet federal performance 
targets or to fully utilize funds appropriated under this 
section, the commissioner may, after notifying the chairs of the 
senate and house health and human services committees, the 
health and human services division of the senate finance 
committee, and the health and human services division of the 
house appropriations committee, permit additional groups of 
recipients to participate until the next meeting of the 
legislative advisory commission, after which the additional 
groups may continue to enroll for participation unless the 
legislative advisory commission disapproves the continued 
enrollment.  The commissioner shall allow participation of 
additional groups in the following order only as needed to meet 
performance targets or fully utilize funding for employment and 
training services under this section: 
    (1) recipients who have received at least 42 months of AFDC 
out of the previous 60 months; 
    (2) custodial parents under the age of 24 who meet the 
criteria in paragraph (a), clause (5), subclause (i) or (ii); 
    (3) recipients who have received at least 36 months of AFDC 
out of the previous 60 months; 
    (4) recipients who have received 24 or more months of AFDC 
out of the previous 48 months; and 
    (5) (2) recipients who have not completed a high school 
education or a high school equivalency program. 
    (c) To the extent of money appropriated specifically for 
this paragraph, the commissioner may permit AFDC caretakers who 
are not eligible for participation in employment and training 
services under the provisions of paragraph (a) or (b) to 
participate.  Money must be allocated to county agencies based 
on the county's percentage of participants statewide in services 
under this section in the prior calendar year.  Counties must 
provide equal or greater services to participants enrolled under 
this paragraph, as measured in average per client expenditures, 
as provided to other participants in employment and training 
services under this section.  Caretakers must be selected on a 
first-come, first-served basis from a waiting list of caretakers 
who volunteer to participate.  The commissioner may, on a 
quarterly basis, reallocate unused allocations to county 
agencies that have sufficient volunteers.  If funding under this 
paragraph is discontinued in future fiscal years, caretakers who 
began participating under this paragraph must be deemed eligible 
under paragraph (a), clause (3). 
    Sec. 23.  Minnesota Statutes 1990, section 256.82, 
subdivision 1, is amended to read: 
    Subdivision 1.  [MONTHLY DIVISION OF COSTS AND PAYMENTS.] 
Based upon estimates submitted by the county agency to the state 
agency, which shall state the estimated required expenditures 
for the succeeding month, upon the direction of the state 
agency, payment shall be made monthly in advance by the state to 
the counties of all federal funds available for that purpose for 
such succeeding month.  The state share of the nonfederal 
portion of county agency expenditures shall be 85 percent and 
the county share shall be 15 percent.  Payments to counties for 
costs incurred shall include an amount of state funds equal to 
85 percent of the difference between the total estimated cost 
and the federal funds so available for payments made.  Benefits 
shall be issued to recipients by the state or county and funded 
according to section 256.025, subdivision 3, subject to 
provisions of section 256.017.  Beginning July 1, 1991, the 
state will reimburse counties according to the payment schedule 
in section 256.025 for the county share of county agency 
expenditures under this subdivision from January 1, 1991, on.  
Payment to counties under this subdivision is subject to the 
provisions of section 256.017.  Adjustment of any overestimate 
or underestimate made by any county shall be paid upon the 
direction of the state agency in any succeeding month.  
    Sec. 24.  Minnesota Statutes 1990, section 256.871, 
subdivision 6, is amended to read: 
    Subd. 6.  [REPORTS OF ESTIMATED EXPENDITURES; PAYMENTS.] 
The county agency shall submit to the state agency reports 
required under section 256.01, subdivision 2, paragraph (17).  
Fiscal reports shall estimate expenditures for each succeeding 
month in such form as required by the state agency.  Payment 
shall be made monthly in advance by the state agency to the 
counties, of federal funds available for that purpose for each 
succeeding month.  The state share of the nonfederal portion of 
county agency expenditures shall be ten percent and the county 
share shall be 90 percent.  Payments to counties for costs 
incurred shall include an amount of state funds equal to ten 
percent of the difference between the total estimated cost and 
the federal funds available.  The state share of the nonfederal 
portion of eligible expenditures shall be ten percent and the 
county share shall be 90 percent.  Benefits shall be issued to 
recipients by the state or county and funded according to 
section 256.025, subdivision 3, subject to provisions of section 
256.017.  Beginning July 1, 1991, the state will reimburse 
counties according to the payment schedule set forth in section 
256.025 for the county share of county agency expenditures made 
under this subdivision from January 1, 1991, on.  Payment to 
counties under this subdivision is subject to the provisions of 
section 256.017.  Adjustment of any overestimate or 
underestimate made by any county shall be paid upon the 
direction of the state agency in any succeeding month. 
    Sec. 25.  Minnesota Statutes 1990, section 256.935, 
subdivision 1, is amended to read: 
    Subdivision 1.  On the death of any person receiving public 
assistance through aid to dependent children, the county agency 
shall pay an amount for funeral expenses not exceeding $370 and 
actual cemetery charges.  No funeral expenses shall be paid if 
the estate of the deceased is sufficient to pay such expenses or 
if the children, or spouse, who were legally responsible for the 
support of the deceased while living, are able to pay such 
expenses; provided, that the additional payment or donation of 
the cost of cemetery lot, interment, religious service, or for 
the transportation of the body into or out of the community in 
which the deceased resided, shall not limit payment by the 
county agency as herein authorized.  Freedom of choice in the 
selection of a funeral director shall be granted to persons 
lawfully authorized to make arrangements for the burial of any 
such deceased recipient.  In determining the sufficiency of such 
estate, due regard shall be had for the nature and marketability 
of the assets of the estate.  The county agency may grant 
funeral expenses where the sale would cause undue loss to the 
estate.  Any amount paid for funeral expenses shall be a prior 
claim against the estate, as provided in section 524.3-805, and 
any amount recovered shall be reimbursed to the agency which 
paid the expenses.  The commissioner shall specify requirements 
for reports, including fiscal reports, according to section 
256.01, subdivision 2, paragraph (17).  The state share of 
county agency expenditures shall be 50 percent and the county 
share shall be 50 percent.  The state shall reimburse the county 
for 50 percent of county agency expenditures made for funeral 
expenses.  Benefits shall be issued to recipients by the state 
or county and funded according to section 256.025, subdivision 
3, subject to provisions of section 256.017. 
    Beginning July 1, 1991, the state will reimburse counties 
according to the payment schedule set forth in section 256.025 
for the county share of county agency expenditures made under 
this subdivision from January 1, 1991, on.  Payment to counties 
under this subdivision is subject to the provisions of section 
256.017. 
    Sec. 26.  Minnesota Statutes 1990, section 256.98, is 
amended by adding a subdivision to read: 
    Subd. 8.  [DISQUALIFICATION FROM PROGRAM.] Any person found 
to be guilty of wrongfully obtaining assistance by a federal or 
state court, in either the aid to families with dependent 
children program or the food stamp program, shall be 
disqualified from that program.  The needs of that individual 
shall not be taken into consideration in determining the grant 
level for that assistance unit:  
    (1) for six months after the first conviction; 
    (2) for 12 months after the second conviction; and 
    (3) permanently after the third or subsequent conviction.  
    Any period for which sanctions are imposed is effective, 
without possibility of administrative stay, until the findings 
upon which the sanctions were imposed are reversed by a court of 
competent jurisdiction.  The period for which sanctions are 
imposed is not subject to review.  The sanctions provided under 
this subdivision are in addition to, and not in substitution 
for, any other sanctions that may be provided for by law for the 
offense involved.  When the disqualified individual is a 
caretaker relative, the remainder of the aid to families with 
dependent children grant payable to the other eligible 
assistance unit members must be provided in the form of 
protective payments.  These payments may be made to the 
disqualified individual only if, after reasonable efforts, the 
county agency documents that it cannot locate an appropriate 
protective payee.  Protective payments must continue until the 
disqualification period ends. 
    Sec. 27.  Minnesota Statutes 1990, section 256.983, is 
amended to read: 
    256.983 [FRAUD PREVENTION INVESTIGATIONS.] 
    Subdivision 1.  [PROGRAMS ESTABLISHED.] (a) Within the 
limits of available appropriations, and to the extent either 
required or authorized by applicable federal regulations, the 
commissioner of human services shall select and fund not less 
than four pilot projects for a two-year period to test the 
effectiveness of fraud prevention investigations conducted at 
the point of application for assistance.  County agencies must 
be selected to be involved in the pilot projects based on their 
response to requests for proposals issued by the commissioner.  
One of the county agencies selected must be located in either 
Hennepin or Ramsey county, one must be from a county in the 
seven-county metropolitan area other than Hennepin and Ramsey 
counties, and two must be located outside the metropolitan area. 
    (b) If proposals are not submitted, the commissioner may 
select the county agencies to be involved.  The county agencies 
must be selected from the locations described in paragraph (a). 
Within the limits of available appropriations, and to the extent 
required or authorized by applicable federal regulations, the 
commissioner of human services shall require the establishment 
of fraud prevention investigation programs in the seven counties 
participating in the fraud prevention investigation pilot 
project established under Laws 1989, chapter 282, article 5, 
section 41, and in 11 additional Minnesota counties with the 
largest aid to families with dependent children program 
caseloads as of July 1, 1991.  If funds are sufficient, the 
commissioner may also extend fraud prevention investigation 
programs to other counties that have welfare fraud control 
programs already in place based on enhanced funding contracts 
covering the fraud investigation function.  
    Subd. 2.  [COUNTY PROPOSALS.] Each participating county 
agency shall develop and submit an annual staffing and funding 
proposal to the commissioner no later than April 30 of each 
year.  Each proposal shall include, but not be limited to, the 
staffing and funding of the fraud prevention investigation 
program, a job description for investigators involved in the 
fraud prevention investigation program, and the organizational 
structure of the county agency unit, training programs for case 
workers, and the operational requirements which may be directed 
by the commissioner.  The proposal shall be approved, to include 
any changes directed or negotiated by the commissioner, no later 
than June 30 of each year. 
    Subd. 3.  [DEPARTMENT RESPONSIBILITIES.] The commissioner 
shall establish training programs which shall be attended by all 
investigative and supervisory staff of the involved county 
agencies.  The commissioner shall also develop the necessary 
operational guidelines, forms, and reporting mechanisms, which 
shall be used by the involved county agencies.  
    Subd. 4.  [FUNDING.] Every involved county agency shall 
either have in place or obtain an approved contract which meets 
all federal requirements necessary to obtain enhanced federal 
funding for its welfare fraud control and fraud prevention 
investigation programs.  County agency reimbursement shall be 
made through the settlement provisions applicable to the aid to 
families with dependent children and food stamp programs.  
    Sec. 28.  [256.984] [DECLARATION AND PENALTY.] 
    Subdivision 1.  [DECLARATION.] Every application for food 
stamps under chapter 393 shall be in writing or reduced to 
writing as prescribed by the state agency and shall contain the 
following declaration which shall be signed by the applicant: 
"I declare under the penalties of perjury that this 
application has been examined by me and to the best of my 
knowledge is a true and correct statement of every material 
point.  I understand that a person convicted of perjury may 
be sentenced to imprisonment of not more than five years or 
to payment of a fine of not more than $10,000, or both." 
    Subd. 2.  [PENALTY.] Any person who willfully and falsely 
makes the declaration in subdivision 1 is guilty of perjury and 
shall be subject to the penalties prescribed in section 609.48. 
    Sec. 29.  Minnesota Statutes 1990, section 256B.064, 
subdivision 2, is amended to read: 
    Subd. 2.  The commissioner shall determine monetary amounts 
to be recovered and the sanction to be imposed upon a vendor of 
medical care for conduct described by subdivision 1a.  Neither a 
monetary recovery nor a sanction will be sought by the 
commissioner without prior notice and an opportunity for a 
hearing, pursuant to chapter 14, on the commissioner's proposed 
action, provided that the commissioner may suspend or reduce 
payment to a vendor of medical care, except a nursing home or 
convalescent care facility, prior to the hearing if in the 
commissioner's opinion that action is necessary to protect the 
public welfare and the interests of the program.  
    Upon receipt of a notice that a monetary recovery or 
sanction is to be imposed, a vendor may request a contested 
case, as defined in section 14.02, subdivision 3, by filing with 
the commissioner a written request of appeal.  The appeal 
request must be received by the commissioner no later than 30 
days after the date the notification of monetary recovery or 
sanction was mailed to the vendor.  The appeal request must 
specify: 
    (1) each disputed item, the reason for the dispute, and an 
estimate of the dollar amount involved for each disputed item; 
    (2) the computation that the vendor believes is correct; 
    (3) the authority in statute or rule upon which the vendor 
relies for each disputed item; 
    (4) the name and address of the person or entity with whom 
contacts may be made regarding the appeal; and 
    (5) other information required by the commissioner. 
    Sec. 30.  Minnesota Statutes 1990, section 256D.03, 
subdivision 2, is amended to read: 
    Subd. 2.  After December 31, 1980, state aid shall be paid 
to county agencies for 75 percent of all general assistance and 
work readiness grants up to the standards of sections 256D.01, 
subdivision 1a, and 256D.051, and according to procedures 
established by the commissioner, except as provided for under 
section 256.017 and except that, until January 1, 1991, state 
aid is reduced to 65 percent of all work readiness assistance if 
the county agency does not make occupational or vocational 
literacy training available and accessible to recipients who are 
eligible for assistance under section 256D.051.  Benefits shall 
be issued to recipients by the state or county and funded 
according to section 256.025, subdivision 3.  
    Beginning July 1, 1991, the state will reimburse counties 
according to the payment schedule in section 256.025 for the 
county share of county agency expenditures made under this 
subdivision from January 1, 1991, on.  Payment to counties under 
this subdivision is subject to the provisions of section 256.017.
    Sec. 31.  Minnesota Statutes 1990, section 256D.03, 
subdivision 2a, is amended to read: 
    Subd. 2a.  [COUNTY AGENCY OPTIONS.] Any county agency may, 
from its own resources, make payments of general assistance and 
work readiness assistance:  (a) at a standard higher than that 
established by the commissioner without reference to the 
standards of section 256D.01, subdivision 1; or (b) to persons 
not meeting the eligibility standards set forth in section 
256D.05, subdivision 1, or 256D.051 but for whom the aid would 
further the purposes established in the general assistance or 
work readiness program in accordance with rules adopted by the 
commissioner pursuant to the administrative procedure act.  The 
Minnesota department of human services may maintain client 
records and issue these payments, providing the cost of benefits 
is paid by the counties to the department of human services in 
accordance with sections 256.01 and 256.025, subdivision 3. 
    Sec. 32.  Minnesota Statutes 1990, section 256D.05, 
subdivision 1, is amended to read: 
    Subdivision 1.  [ELIGIBILITY.] (a) Each person or family 
whose income and resources are less than the standard of 
assistance established by the commissioner and who is a resident 
of the state shall be eligible for and entitled to general 
assistance if the person or family is: 
    (1) a person who is suffering from a professionally 
certified permanent or temporary illness, injury, or incapacity 
which is expected to continue for more than 30 days and which 
prevents the person from obtaining or retaining employment; 
    (2) a person whose presence in the home on a substantially 
continuous basis is required because of the professionally 
certified illness, injury, incapacity, or the age of another 
member of the household; 
     (3) a person who has been placed in, and is residing in, a 
licensed or certified facility for purposes of physical or 
mental health or rehabilitation, or in an approved chemical 
dependency domiciliary facility, if the placement is based on 
illness or incapacity and is pursuant to a plan developed or 
approved by the county agency through its director or designated 
representative; 
     (4) a person who resides in a shelter facility described in 
subdivision 3; 
     (5) a person not described in clause (1) or (3) who is 
diagnosed by a licensed physician, licensed psychologist, or 
other qualified professional, as mentally retarded or mentally 
ill, and that condition prevents the person from obtaining or 
retaining employment; 
    (6) a person who has an application pending for the social 
security disability program or the program of supplemental 
security income for the aged, blind, and disabled, provided that 
within 60 days of the initial denial of the application by the 
social security administration, the person produces medical 
evidence in support of the person's application; or a person who 
has been terminated from either program and has an appeal from 
that termination pending.  A person whose benefits are 
terminated for failure to produce any medical evidence within 60 
days of the denial of the application, is eligible as soon as 
medical evidence in support of the application for the social 
security disability program or the program of supplemental 
security income for the aged, blind, and disabled is produced.  
Except for a person whose application is based in whole or in 
part on mental illness or chemical dependency, a person whose 
application for either program is denied and who does not pursue 
an appeal is eligible under this paragraph based on a new 
application only if the new application concerns a different 
disability or alleges new or aggravated symptoms of the original 
disability a person who has an application pending for, or is 
appealing termination of benefits from, the social security 
disability program or the program of supplemental security 
income for the aged, blind, and disabled, provided the person 
has a professionally certified permanent or temporary illness, 
injury, or incapacity which is expected to continue for more 
than 30 days and which prevents the person from obtaining or 
retaining employment; 
    (7) a person who is unable to obtain or retain employment 
because advanced age significantly affects the person's ability 
to seek or engage in substantial work; 
    (8) a person who has been assessed by a qualified 
professional or a vocational specialist as not being likely to 
obtain permanent employment.  The assessment must consider the 
recipient's age, physical and mental health, education, 
trainability, prior work experience, and the local labor market; 
, following participation in the work readiness program, 
completion of an individualized employability assessment by the 
work readiness service provider, and consultation between the 
county agency and the work readiness service provider, the 
county agency determines is not employable.  For purposes of 
this item, a person is considered employable if the county 
agency determines that there exist positions of employment in 
the local labor market, regardless of the current availability 
of openings for those positions, that the person is capable of 
performing.  Eligibility under this category must be reassessed 
at least annually by the county agency and must be based upon 
the results of a new individualized employability assessment 
completed by the work readiness service provider.  The recipient 
shall, if otherwise eligible, continue to receive general 
assistance while the annual individualized employability 
assessment is completed by the work readiness service provider, 
rather than receive work readiness payments under section 
256D.051.  Subsequent eligibility for general assistance is 
dependent upon the county agency determining, following 
consultation with the work readiness service provider, that the 
person is not employable, or the person meeting the requirements 
of another general assistance category of eligibility; 
    (9) a person who is determined by the county agency, in 
accordance with emergency and permanent rules adopted by the 
commissioner, to be learning disabled, provided that if a 
rehabilitation plan for the person is developed or approved by 
the county agency, the person is following the plan; 
    (10) a child under the age of 18 who is not living with a 
parent, stepparent, or legal custodian, but only if:  the child 
is legally emancipated or living with an adult with the consent 
of an agency acting as a legal custodian; the child is at least 
16 years of age and the general assistance grant is approved by 
the director of the county agency or a designated representative 
as a component of a social services case plan for the child; or 
the child is living with an adult with the consent of the 
child's legal custodian and the county agency.  For purposes of 
this clause, "legally emancipated" means a person under the age 
of 18 years who:  (i) has been married; (ii) is on active duty 
in the uniformed services of the United States; (iii) has been 
emancipated by a court of competent jurisdiction; or (iv) is 
otherwise considered emancipated under Minnesota law, and for 
whom county social services has not determined that a social 
services case plan is necessary, for reasons other than that the 
child has failed or refuses to cooperate with the county agency 
in developing the plan; 
    (11) a woman in the last trimester of pregnancy who does 
not qualify for aid to families with dependent children.  A 
woman who is in the last trimester of pregnancy who is currently 
receiving aid to families with dependent children may be granted 
emergency general assistance to meet emergency needs; 
    (12) a person whose need for general assistance will not 
exceed 30 days who is eligible for displaced homemaker services, 
programs, or assistance under section 268.96, but only if that 
person is enrolled as a full-time student; 
    (13) a person who lives more than two hours round-trip 
traveling time from any potential suitable employment; and 
    (14) a person who is involved with protective or 
court-ordered services that prevent the applicant or recipient 
from working at least four hours per day.; and 
    (15) a family as defined in section 256D.02, subdivision 5, 
which is ineligible for the aid to families with dependent 
children program.  If all children in the family are six years 
of age or older, or if suitable child care is available for 
children under age six at no cost to the family, all the adult 
members of the family must register for and cooperate in the 
work readiness program under section 256D.051.  If one or more 
of the children is under the age of six and suitable child care 
is not available without cost to the family, all the adult 
members except one adult member must register for and cooperate 
with the work readiness program under section 256D.051.  The 
adult member who must participate in the work readiness program 
is the one having earned the greater of the incomes, excluding 
in-kind income, during the 24-month period immediately preceding 
the month of application for assistance.  When there are no 
earnings or when earnings are identical for each adult, the 
applicant must designate the adult who must participate in work 
readiness and that designation must not be transferred or 
changed after program eligibility is determined as long as 
program eligibility continues without an interruption of 30 days 
or more.  The adult members required to register for and 
cooperate with the work readiness program are not eligible for 
financial assistance under section 256D.051, except as provided 
in section 256D.051, subdivision 6, and shall be included in the 
general assistance grant.  If an adult member fails to cooperate 
with requirements of section 256D.051, the local agency shall 
not take that member's needs into account in making the grant 
determination as provided by the termination provisions of 
section 256D.051, subdivision 1a, paragraph (b).  The time 
limits of section 256D.051, subdivision 1, do not apply to 
persons eligible under this clause. 
    (b) Persons or families who are not state residents but who 
are otherwise eligible for general assistance may receive 
emergency general assistance to meet emergency needs. 
    (c) As a condition of eligibility under paragraph (a), 
clauses (1), (3), (5), (8), and (9), the recipient must complete 
an interim assistance agreement and must apply for other 
maintenance benefits as specified in section 256D.06, 
subdivision 5, and must comply with efforts to determine the 
recipient's eligibility for those other maintenance benefits.  
    (d) The burden of providing documentation for a county 
agency to use to verify eligibility for general assistance or 
work readiness is upon the applicant or recipient.  The county 
agency shall use documents already in its possession to verify 
eligibility, and shall help the applicant or recipient obtain 
other existing verification necessary to determine eligibility 
which the applicant or recipient does not have and is unable to 
obtain. 
    Sec. 33.  Minnesota Statutes 1990, section 256D.05, 
subdivision 2, is amended to read: 
    Subd. 2.  [USE OF FEDERAL FUNDS.] Notwithstanding any law 
to the contrary, if any person otherwise eligible for general 
assistance would, but for state statutory restriction or 
limitation, be eligible for a funded federally aided assistance 
program providing benefits equal to or greater than those of 
general assistance, the person shall be eligible for that 
federally aided program and ineligible for general assistance; 
provided, however, that (a) nothing in this section shall be 
construed to extend eligibility for federally aided programs to 
persons not otherwise eligible for general assistance; (b) this 
section shall not be effective to the extent that federal law or 
regulation require new eligibility for federal programs to 
persons not otherwise eligible for general assistance; and (c) 
nothing in this section shall deny general assistance to a 
person otherwise eligible who is determined ineligible for a 
substitute federally aided program. 
    Sec. 34.  Minnesota Statutes 1990, section 256D.05, 
subdivision 6, is amended to read: 
    Subd. 6.  [ASSISTANCE FOR PERSONS WITHOUT A VERIFIED 
RESIDENCE.] (a) For applicants or recipients of general 
assistance, emergency general assistance, or work readiness 
assistance who do not have a verified residence address, the 
county agency may provide assistance using one or more of the 
following methods: 
    (1) the county agency may provide assistance in the form of 
vouchers or vendor payments and provide separate vouchers or 
vendor payments for food, shelter, and other needs; 
    (2) the county agency may divide the monthly assistance 
standard into weekly payments, whether in cash or by voucher or 
vendor payment; or, if actual need is greater than the standards 
of assistance established under section 256D.01, subdivision 1a, 
issue assistance based on actual need.  Nothing in this clause 
prevents the county agency from issuing voucher or vendor 
payments for emergency general assistance in an amount less than 
the standards of assistance; and 
    (3) the county agency may determine eligibility and provide 
assistance on a weekly basis.  Weekly assistance can be issued 
in cash or by voucher or vendor payment and can be determined 
either on the basis of actual need or by prorating the monthly 
assistance standard.  
    (b) An individual may verify a residence address by 
providing a driver's license; a state identification card; a 
statement by the landlord, apartment manager, or homeowner 
verifying that the individual is residing at the address; or 
other written documentation approved by the commissioner. 
    (c) Notwithstanding the provisions of section 256D.06, 
subdivision 1, if the county agency elects to provide assistance 
on a weekly payment basis, the agency may not provide assistance 
for a period during which no need is claimed by the individual 
unless the individual has good cause for failing to claim need.  
The individual must be notified, each time weekly assistance is 
provided, that subsequent weekly assistance will not be issued 
unless the individual claims need.  The advance notice required 
under section 256D.10 does not apply to weekly assistance issued 
under this paragraph that is withheld because the individual 
failed to claim need without good cause.  
    (d) The county agency may not issue assistance on a weekly 
basis to an applicant or recipient who has professionally 
certified mental illness or mental retardation or a related 
condition, or to an assistance unit that includes minor 
children, unless requested by the assistance unit. 
    Sec. 35.  Minnesota Statutes 1990, section 256D.05, is 
amended by adding a subdivision to read: 
    Subd. 7.  [INELIGIBILITY FOR GENERAL ASSISTANCE.] No person 
disqualified from any federally aided assistance program shall 
be eligible for general assistance during the period covered by 
the disqualification sanction.  
    Sec. 36.  Minnesota Statutes 1990, section 256D.051, 
subdivision 1, is amended to read: 
    Subdivision 1.  [WORK REGISTRATION.] (a) A person, family, 
or married couple Except as provided in this subdivision, 
persons who are residents of the state and whose income and 
resources are less than the standard of assistance established 
by the commissioner, but who are not categorically eligible 
under section 256D.05, subdivision 1, are eligible for the work 
readiness program for a maximum period of five consecutive 
calendar months during any 12 consecutive calendar month period, 
subject to the provisions of paragraph (d), subdivision 3, and 
section 256D.052, subdivision 4.  The person's five-month 
eligibility period begins on the first day of the calendar month 
following the date of application for assistance or following 
the date all eligibility factors are met, whichever is later, 
and ends on the last day of the fifth consecutive calendar 
month, whether or not the person has received benefits for all 
five months.  The person is not eligible to receive work 
readiness benefits during the seven calendar months immediately 
following the five-month eligibility period; however, the person 
may voluntarily continue to participate in work readiness 
services for up to three additional consecutive months 
immediately following the last month of benefits to complete the 
provisions of the person's employability development plan.  
Prior to terminating work readiness assistance the county agency 
must advise the person of his or her eligibility for general 
assistance medical care and must assess the person's eligibility 
for general assistance under section 256D.05 to the extent 
possible, using information in the case file, and determine the 
person's eligibility for general assistance.  A determination 
that the person is not eligible for general assistance must be 
stated in the notice of termination of work readiness benefits. 
    (b) Persons, families, and married couples who are not 
state residents but who are otherwise eligible for work 
readiness assistance may receive emergency assistance to meet 
emergency needs. 
    (c) Except for family members who must participate in work 
readiness services under the provisions of section 256D.05, 
subdivision 1, clause (14), any person who would be defined for 
purposes of the food stamp program as being enrolled at least 
half-time in an institution of higher education is ineligible 
for the work readiness program. 
    (d) Notwithstanding the provisions of sections 256.045 and 
256D.10, during the pendency of an appeal, work readiness 
payments and services shall not continue to a person who appeals 
the termination of benefits due to exhaustion of the period of 
eligibility specified in paragraph (a) or (d). 
    Sec. 37.  Minnesota Statutes 1990, section 256D.051, 
subdivision 1a, is amended to read: 
    Subd. 1a.  [WORK READINESS PAYMENTS.] (a) Except as 
provided in this subdivision, grants of work readiness shall be 
determined using the standards of assistance, exclusions, 
disregards, and procedures which are used in the general 
assistance program.  Work readiness shall be granted in an 
amount that, when added to the nonexempt income actually 
available to the assistance unit, the total amount equals the 
applicable standard of assistance.  
    (b) Work readiness payments must be provided to persons 
determined eligible for the work readiness program as provided 
in this subdivision except when the special payment provisions 
in subdivision 1b are utilized.  The initial payment must be 
prorated to provide assistance for the period beginning with the 
date the completed application is received by the county agency 
or the date the assistance unit meets all work readiness 
eligibility factors, whichever is later, and ending on the final 
day of that month.  The amount of the first payment must be 
determined by dividing the number of days to be covered under 
the payment by the number of days in the month, to determine the 
percentage of days in the month that are covered by the payment, 
and multiplying the monthly payment amount by this percentage.  
Subsequent payments must be paid monthly on the first day of 
each month.  Except as provided in section 256D.05, subdivision 
6, work readiness assistance must be paid on the first day of 
each month. 
    At the time the county agency notifies the assistance unit 
that it is eligible for family general assistance or work 
readiness assistance and by the first day of each month of 
services, the county agency must inform all mandatory 
registrants in the assistance unit that they must attend an 
orientation within 30 days comply with all work readiness 
requirements that month, and that work readiness eligibility 
will end at the end of the month in which the orientation is 
scheduled unless the registrants attend orientation comply with 
work readiness requirements specified in the notice.  A 
registrant who fails, without good cause, to comply with 
requirements during this time period, including attendance at 
orientation, will lose family general assistance or work 
readiness eligibility without notice under section 256D.101, 
subdivision 1, paragraph (b).  The registrant shall, however, be 
sent a notice, on or before the date that no later than five 
days after eligibility ends, which informs the registrant 
that family general assistance or work readiness eligibility has 
ended in accordance with this section for failure to comply with 
work readiness requirements.  The notice shall set forth the 
factual basis for such determination and advises advise the 
registrant of the right to reinstate eligibility upon a showing 
of good cause for the failure to meet the requirements.  
Subsequent assistance must not be issued unless the person 
completes an application, is determined eligible, and attends an 
orientation complies with the work readiness requirements that 
had not been complied with, or demonstrates that the person had 
good cause for failing to comply with the requirement.  The time 
during which the person is ineligible under these provisions is 
counted as part of the person's period of eligibility under 
subdivision 1.  
    (c) Notwithstanding the provisions of section 256D.01, 
subdivision 1a, paragraph (d), when one member of a married 
couple has exhausted the five months of work readiness 
eligibility in a 12-month period and the other member has one or 
more months of eligibility remaining within the same 12-month 
period, the standard of assistance applicable to the member who 
remains eligible is the first adult standard in the aid to 
families with dependent children program. 
    (d) Notwithstanding sections 256.045 and 256D.10, during 
the pendency of an appeal, work readiness payments and services 
shall not continue to a person who appeals the termination of 
benefits under paragraph (b).  
    Sec. 38.  Minnesota Statutes 1990, section 256D.051, 
subdivision 2, is amended to read: 
    Subd. 2.  [COUNTY AGENCY DUTIES.] (a) The county agency 
shall provide to registrants a work readiness program.  The work 
readiness program must include: 
    (1) orientation to the work readiness program; 
    (2) an individualized employability assessment and an 
individualized employability development plan that includes 
assessment of literacy, ability to communicate in the English 
language, eligibility for displaced homemaker services under 
section 268.96, educational and employment history, and that 
estimates the length of time it will take the registrant to 
obtain employment.  The employability assessment and development 
plan must be completed in consultation with the registrant, must 
assess the registrant's assets, barriers, and strengths, and 
must identify steps necessary to overcome barriers to 
employment.  A copy of the employability development plan must 
be provided to the registrant; 
    (3) referral to available accredited remedial or skills 
training programs designed to address registrant's barriers to 
employment; 
    (4) referral to available programs including the Minnesota 
employment and economic development program; 
    (5) a job search program, including job seeking skills 
training; and 
    (6) other activities, to the extent of available resources 
designed by the county agency to prepare the registrant for 
permanent employment. 
    The work readiness program may include a public sector or 
nonprofit work experience component only if the component is 
established according to section 268.90. 
    In order to allow time for job search, the county agency 
may not require an individual to participate in the work 
readiness program for more than 32 hours a week.  The county 
agency shall require an individual to spend at least eight hours 
a week in job search or other work readiness program activities. 
    (b) The county agency shall prepare an annual plan for the 
operation of its work readiness program.  The plan must be 
submitted to and approved by the commissioner of jobs and 
training.  The plan must include: 
    (1) a description of the services to be offered by the 
county agency; 
    (2) a plan to coordinate the activities of all public 
entities providing employment-related services in order to avoid 
duplication of effort and to provide services more efficiently; 
    (3) a description of the factors that will be taken into 
account when determining a client's employability development 
plan; and 
    (4) provisions to assure that applicants and recipients are 
evaluated for eligibility for general assistance prior to 
termination from the work readiness program; and 
    (5) provisions to ensure that the county agency's 
employment and training service provider provides each recipient 
with an orientation, employability assessment, and employability 
development plan as specified in paragraph (a), clauses (1) and 
(2), within 30 days of the recipient's application for 
assistance. 
    Sec. 39.  Minnesota Statutes 1990, section 256D.051, 
subdivision 3, is amended to read: 
    Subd. 3.  [REGISTRANT DUTIES.] In order to receive work 
readiness assistance, a registrant shall:  (1) cooperate with 
the county agency in all aspects of the work readiness program; 
(2) accept any suitable employment, including employment offered 
through the job training partnership act, Minnesota employment 
and economic development act, and other employment and training 
options; and (3) participate in work readiness activities 
assigned by the county agency.  The county agency may terminate 
assistance to a registrant who fails to cooperate in the work 
readiness program, as provided in subdivision 3c 1a. 
    Sec. 40.  Minnesota Statutes 1990, section 256D.051, 
subdivision 3a, is amended to read: 
    Subd. 3a.  [PERSONS REQUIRED TO REGISTER FOR AND 
PARTICIPATE IN THE WORK READINESS PROGRAM.] Each person in a 
work readiness assistance unit who is 18 years old or older must 
register for and participate in the work readiness program.  A 
child person in the assistance unit who is at least 16 years old 
but less than 19 years old and who is not a full-time secondary 
school student is required to register and participate.  A 
student who was enrolled as a full-time student during the last 
school term must be considered a full-time student during 
summers and school holidays.  If an assistance unit includes 
children under age six and suitable child care is not available 
at no cost to the family, one adult member of the assistance 
unit is exempt from registration for and participation in the 
work readiness program.  The county agency shall designate the 
adult who must register.  The registrant must be the adult who 
is the principal wage earner, having earned the greater of the 
incomes, except for income received in-kind, during the 24 
months immediately preceding the month of application for 
assistance.  When there are no earnings or when earnings are 
identical for each parent, the applicant must designate the 
principal wage earner, and that designation must not be 
transferred after program eligibility is determined as long as 
assistance continues without interruption. 
    Sec. 41.  Minnesota Statutes 1990, section 256D.051, 
subdivision 6, is amended to read: 
    Subd. 6.  [SERVICE COSTS.] The commissioner shall reimburse 
92 percent of county agency expenditures for providing work 
readiness services including direct participation expenses and 
administrative costs, except as provided in section 256.017; and 
reimbursement from the state appropriation must not exceed an 
average of $260 each year for each registrant who has completed 
an employment development plan for direct expenses incurred by 
the registrant for transportation, clothes, and tools necessary 
for employment.  Beginning July 1, 1991, the state will 
reimburse counties, up to the limit of state appropriations, 
according to the payment schedule in section 256.025 for the 
county share of costs incurred under this subdivision from 
January 1, 1991, on.  State work readiness funds shall be used 
only to pay the county agency's and work readiness service 
provider's actual costs of providing participant support 
services, direct program services, and program administrative 
costs for persons who participate in work readiness services.  
Beginning January 1, 1991, the average reimbursable cost per 
recipient must not exceed $283 annually.  Beginning July 1, 
1991, the average annual reimbursable cost for providing work 
readiness services to a recipient for whom an individualized 
employability development plan is not completed must not exceed 
$60 for the work readiness services, and $223 for necessary 
recipient support services such as transportation or child care 
needed to participate in work readiness services.  If an 
individualized employability development plan has been 
completed, the annual reimbursable cost for providing work 
readiness services must not exceed $283 for all services and 
costs necessary to implement the plan, including the costs of 
training, employment search assistance, placement, work 
experience, on-the-job training, other appropriate activities, 
the administrative and program costs incurred in providing these 
services, and necessary recipient support services such as 
tools, clothing, and transportation needed to participate in 
work readiness services.  Beginning July 1, 1991, the state will 
reimburse counties, up to the limit of state appropriations, 
according to the payment schedule in section 256.025 for the 
county share of costs incurred under this subdivision on or 
after January 1, 1991.  Payment to counties under this 
subdivision is subject to the provisions of section 
256.017.  After paying direct expenses as needed by individual 
registrants, the county agency may use any remaining money to 
provide additional services as needed by any registrant 
including employability assessments and employability 
development plans, education, orientation, employment search 
assistance, placement, other work experience, on-the-job 
training, and other appropriate activities and the 
administrative costs incurred providing these services. 
    Sec. 42.  Minnesota Statutes 1990, section 256D.051, 
subdivision 8, is amended to read: 
    Subd. 8.  [VOLUNTARY QUIT.] A person who is required to 
participate in work readiness services is not eligible for 
general assistance or work readiness payments or services if, 
without good cause, the person refuses a legitimate offer of, or 
quits, suitable employment within 60 days before the date of 
application.  A person who is required to participate in work 
readiness services and, without good cause, voluntarily quits 
suitable employment or refuses a legitimate offer of suitable 
employment while receiving general assistance or work readiness 
payments or services shall be terminated from the general 
assistance or work readiness program and disqualified for two 
months according to rules adopted by the commissioner as 
specified in subdivision 1a. 
    Sec. 43.  Minnesota Statutes 1990, section 256D.052, 
subdivision 3, is amended to read: 
    Subd. 3.  [SERVICES PROVIDED.] Within the limits of the 
state appropriation the county agency must provide child care 
and transportation to enable people to participate in literacy 
training under this section.  The state shall reimburse county 
agencies for the costs of providing transportation under this 
section up to the amount of the state appropriation.  Counties 
must make every effort to ensure that child care is available as 
needed by recipients who are pursuing literacy training. 
    Sec. 44.  Minnesota Statutes 1990, section 256D.052, 
subdivision 4, is amended to read: 
    Subd. 4.  [PAYMENT OF WORK READINESS.] The county agency 
must provide assistance under section 256D.051 to persons who: 
    (1) participate in a literacy program assigned under 
subdivision 2.  To "participate" means to attend regular 
classes, complete assignments, and make progress toward literacy 
goals; or 
    (2) are not assigned to literacy training because there is 
no program available or accessible to them.  
    Notwithstanding contrary provisions of section 256D.051, 
subdivision 1, a person eligible for assistance under this 
section is eligible for assistance for a maximum period of seven 
consecutive calendar months during any 12 consecutive calendar 
month period, subject to section 256D.051, subdivision 1, 
paragraph (d).  Work readiness payments may be terminated for 
persons who fail to attend the orientation and participate in 
the assessment and development of the employment development 
plan. 
    Sec. 45.  [256D.065] [GENERAL ASSISTANCE AND WORK READINESS 
PAYMENTS FOR NEW RESIDENTS.] 
    Notwithstanding any other provisions of sections 256D.01 to 
256D.21, otherwise eligible applicants without minor children, 
who have been residing in the state less than six months, shall 
be granted general assistance and work readiness payments in an 
amount that, when added to the nonexempt income actually 
available to the applicant, shall equal 60 percent of the amount 
that the applicant would be eligible to receive under section 
256D.06, subdivision 1.  A person may receive benefits in excess 
of this amount, equal to the lesser of the benefits actually 
received in the last state of residence or the maximum benefits 
allowable under section 256D.06, subdivision 1.  To receive the 
higher benefit amount, the person must provide verification of 
the amount of assistance received in the last state of 
residence.  Nonexempt income is the income considered available 
under Minnesota Rules, parts 9500.1200 to 9500.1270. 
    Sec. 46.  Minnesota Statutes 1990, section 256D.07, is 
amended to read: 
    256D.07 [TIME OF PAYMENT OF ASSISTANCE.] 
    An applicant for general assistance or general assistance 
medical care authorized by section 256D.03, subdivision 3, shall 
be deemed eligible if the application and the verification of 
the statement on that application demonstrate that the applicant 
is within the eligibility criteria established by sections 
256D.01 to 256D.21 and any applicable rules of the 
commissioner.  Any person requesting general assistance or 
general assistance medical care shall be permitted by the county 
agency to make an application for assistance as soon as 
administratively possible and in no event later than the fourth 
day following the date on which assistance is first requested, 
and no county agency shall require that a person requesting 
assistance appear at the offices of the county agency more than 
once prior to the date on which the person is permitted to make 
the application.  The application shall be in writing in the 
manner and upon the form prescribed by the commissioner and 
attested to by the oath of the applicant or in lieu thereof 
shall contain the following declaration which shall be signed by 
the applicant:  "I declare that this application has been 
examined by me and to the best of my knowledge and belief is a 
true and correct statement of every material point."  On the 
date that general assistance is first requested, the county 
agency shall inquire and determine whether the person requesting 
assistance is in immediate need of food, shelter, clothing, 
assistance for necessary transportation, or other emergency 
assistance pursuant to section 256D.06, subdivision 2.  A person 
in need of emergency assistance shall be granted emergency 
assistance immediately, and necessary emergency assistance shall 
continue until either the person is determined to be ineligible 
for general assistance or the first grant of general assistance 
is paid to the person for up to 30 days following the date of 
application.  A determination of an applicant's eligibility for 
general assistance shall be made by the county agency as soon as 
the required verifications are received by the county agency and 
in no event later than 30 days following the date that the 
application is made.  Any verifications required of the 
applicant shall be reasonable, and the commissioner shall by 
rule establish reasonable verifications.  General assistance 
shall be granted to an eligible applicant without the necessity 
of first securing action by the board of the county agency.  The 
first month's grant must be computed to cover the time period 
starting with the date a signed application form is received by 
the county agency or from the date that the applicant meets all 
eligibility factors, whichever occurs later.  The first grant 
may be reduced by the amount of emergency general assistance 
provided to the applicant.  
    If upon verification and due investigation it appears that 
the applicant provided false information and the false 
information materially affected the applicant's eligibility for 
general assistance or general assistance medical care provided 
pursuant to section 256D.03, subdivision 3, or the amount of the 
applicant's general assistance grant, the county agency may 
refer the matter to the county attorney.  The county attorney 
may commence a criminal prosecution or a civil action for the 
recovery of any general assistance wrongfully received, or both. 
    Sec. 47.  Minnesota Statutes 1990, section 256D.10, is 
amended to read: 
    256D.10 [HEARINGS PRIOR TO REDUCTION; TERMINATION; 
SUSPENSION OF GENERAL ASSISTANCE GRANTS.] 
    No grant of general assistance except one made pursuant to 
sections section 256D.06, subdivision 2; 256D.051, subdivisions 
1, paragraph (d), and 1a, paragraph (b); or 256D.08, subdivision 
2, shall be reduced, terminated or suspended unless the 
recipient receives notice and is afforded an opportunity to be 
heard prior to any action by the county agency. 
    Nothing herein shall deprive a recipient of the right to 
full administrative and judicial review of an order or 
determination of a county agency as provided for in section 
256.045 subsequent to any action taken by a county agency after 
a prior hearing. 
    Sec. 48.  Minnesota Statutes 1990, section 256D.101, 
subdivision 1, is amended to read: 
    Subdivision 1.  [NOTICE REQUIREMENTS.] (a) At the time a 
registrant is registered for the work readiness program, and at 
least every 30 days on the first day of each month of services 
after that, the county agency shall provide, in advance, a 
clear, written description of the specific tasks and assigned 
duties the registrant which the mandatory registrant must 
complete to receive general assistance or work readiness pay.  
The notice must explain that the registrant will be terminated 
from the work readiness program unless the registrant has 
completed the specific tasks and assigned duties.  The notice 
must inform the registrant that at the end of the month if the 
registrant fails without good cause to comply with work 
readiness requirements more than once every six months, the 
registrant will be terminated from the work readiness program 
and disqualified from receiving assistance for one month if it 
is the registrant's first disqualification within the preceding 
six months, or for two months if the registrant has been 
previously disqualified within the preceding six months, and 
must include the name, location, and telephone number of a 
person or persons the registrant may contact to discuss the 
registrant's work readiness compliance obligations. 
    (b) If after the initial certification period the county 
agency determines that a registrant has failed to comply with 
work readiness requirements, the county agency shall notify the 
registrant of the determination.  Notice must be hand delivered 
or mailed to the registrant within three days after the agency 
makes the determination but no later than the date work 
readiness pay was scheduled to be paid.  For a recipient who has 
failed to provide the county agency with a mailing address, the 
recipient must be assigned a schedule by which a recipient is to 
visit the agency to pick up any notices.  For a recipient 
without a mailing address, notices must be deemed delivered on 
the date of the registrant's next scheduled visit with the 
county agency.  The notification shall be in writing and shall 
state the facts that support the county agency's determination.  
For the first time in a six-month period that the registrant has 
failed without good cause to comply with program requirements, 
the notification shall inform the registrant that the registrant 
may lose eligibility for work readiness pay and must specify the 
particular actions that must be taken by the registrant to 
achieve compliance and reinstate work readiness payments.  The 
notice must state that the recipient must take the specified 
actions by a date certain, which must be at least five working 
days following the date the notification is mailed or delivered 
to the registrant; must explain the ramifications of the 
registrant's failure to take the required actions by the 
specified date; and must advise the registrant that the 
registrant may request and have a conference with the county 
agency to discuss the notification.  A registrant who fails 
without good cause to comply with requirements of the program 
more than once in a six-month period must be notified of 
termination.  
    Sec. 49.  Minnesota Statutes 1990, section 256D.101, 
subdivision 3, is amended to read: 
    Subd. 3.  [BENEFITS AFTER NOTIFICATION.] Assistance 
payments otherwise due to the registrant under section 256D.051 
may not be paid after the notification required in subdivision 1 
has been provided to the registrant unless, before the date 
stated in the notification, the registrant takes the specified 
action necessary to achieve compliance or, within five days 
after the effective date stated in the notice, files an appeal 
of the grant reduction, suspension, or termination.  If, by the 
required date, the registrant does take the specified action 
necessary to achieve compliance, both the notification required 
by subdivision 1 and the notice required by subdivision 2 shall 
be canceled and all benefits due to the registrant shall be paid 
promptly.  If, by the required date, the registrant files an 
appeal of the grant termination, benefits otherwise due to the 
registrant shall be continued pending the outcome of the 
appeal.  An appeal of a proposed termination shall be brought 
under section 256.045, except that the timelines specified in 
this section shall apply, notwithstanding the requirements of 
section 256.045, subdivision 3.  Appeals of proposed 
terminations from the work readiness program shall be heard 
within 30 days of the date that the appeal was filed. 
    Sec. 50.  Minnesota Statutes 1990, section 256D.111, is 
amended to read: 
    256D.111 [REGISTRATION FOR WORK; DISQUALIFICATION 
TERMINATION.] 
    Subd. 5.  [RULEMAKING.] The commissioner shall adopt rules 
and is authorized to adopt emergency rules:  
    (a) providing for the disqualification termination from the 
receipt of general assistance or work readiness assistance for a 
recipient who has been determined to have failed to comply with 
work requirements or the requirements of the work readiness 
program; 
    (b) providing for the use of vouchers or vendor payments 
with respect to the family of a disqualified recipient 
terminated for failure to comply with requirements of the work 
readiness program; and 
    (c) providing that at the time of the approval of an 
application for assistance, the county agency gives to the 
recipient a written notice in plain and easily understood 
language describing the recipient's job registration, search, 
and acceptance obligations, and the disqualification that will 
be imposed for a failure to comply with those obligations.  
    Sec. 51.  Minnesota Statutes 1990, section 256D.36, 
subdivision 1, is amended to read: 
    Subdivision 1.  [STATE PARTICIPATION.] (a) [ELIGIBILITY.] 
Commencing January 1, 1974, the commissioner shall certify to 
each county agency the names of all county residents who were 
eligible for and did receive aid during December, 1973, pursuant 
to a categorical aid program of old age assistance, aid to the 
blind, or aid to the disabled.  The amount of supplemental aid 
for each individual eligible under this section shall be 
calculated according to the formula in title II, section 212(a) 
(3) of Public Law Number 93-66, as amended. 
    (b)  [DIVISION COSTS.] From and after January 1, 1980, 
until January 1, 1981, the state shall pay 70 percent and the 
county shall pay 30 percent of the supplemental aid calculated 
for each county resident certified under this section who is an 
applicant for or recipient of supplemental security income.  
After December 31, 1980, the state share of aid paid shall be 85 
percent and the county share shall be 15 percent.  The amount of 
supplemental aid for each individual eligible under this section 
shall be calculated according to the formula in title II, 
section 212 (a) (3) of Public Law Number 93-66, as amended. 
Benefits shall be issued to recipients by the state or county 
and funded according to section 256.025, subdivision 3, subject 
to provisions of section 256.017. 
    Beginning July 1, 1991, the state will reimburse counties 
according to the payment schedule in section 256.025 for the 
county share of county agency expenditures for financial 
benefits to individuals under this subdivision from January 1, 
1991, on.  Payment to counties under this subdivision is subject 
to the provisions of section 256.017. 
    Sec. 52.  Minnesota Statutes 1990, section 256H.02, is 
amended to read: 
     256H.02 [DUTIES OF COMMISSIONER.] 
     The commissioner shall develop standards for county and 
human services boards to provide child care services to enable 
eligible families to participate in employment, training, or 
education programs.  Within the limits of available 
appropriations, the commissioner shall distribute money to 
counties to reduce the costs of child care for eligible 
families.  The commissioner shall adopt rules to govern the 
program in accordance with this section.  The rules must 
establish a sliding schedule of fees for parents receiving child 
care services.  In the rules adopted under this section, county 
and human services boards shall be authorized to establish 
policies for payment of child care spaces for absent children, 
when the payment is required by the child's regular provider.  
The rules shall not set a maximum number of days for which 
absence payments can be made, but instead shall direct the 
county agency to set limits and pay for absences according to 
the prevailing market practice in the county.  County policies 
for payment of absences shall be subject to the approval of the 
commissioner.  The commissioner shall maximize the use of 
federal money under the AFDC employment special needs program in 
section 256.736, subdivision 8, and other programs that provide 
federal reimbursement for child care services for recipients of 
aid to families with dependent children who are in education, 
training, job search, or other activities allowed under those 
programs.  Money appropriated under this section must be 
coordinated with the AFDC employment special needs program and 
other programs that provide federal reimbursement for child care 
services to accomplish this purpose.  Federal reimbursement 
obtained must be allocated to the county that spent money for 
child care that is federally reimbursable under the AFDC 
employment special needs program or other programs that provide 
federal reimbursement for child care services.  The counties 
shall use the federal money to expand child care services to 
AFDC recipients.  The commissioner may adopt rules under chapter 
14 to implement and coordinate federal program requirements.  
    Sec. 53.  Minnesota Statutes 1990, section 256H.03, is 
amended to read: 
    256H.03 [BASIC SLIDING FEE PROGRAM.] 
    Subdivision 1.  [COUNTIES ALLOCATION PERIOD; NOTICE OF 
ALLOCATION.] When the commissioner notifies county and human 
service boards of the forms and instructions they are to follow 
in the development of their biennial community social services 
plans required under section 256E.08, the commissioner shall 
also notify county and human services boards of their estimated 
child care fund program allocation for the two years covered by 
the plan.  By June 1 of each year, the commissioner shall notify 
all counties of their final child care fund program allocation. 
    Subd. 1a.  [WAITING LIST.] Each county that receives funds 
under this section and section 256H.05 must keep a written 
record and report to the commissioner the number of eligible 
families who have applied for a child care subsidy or have 
requested child care assistance.  Counties shall perform a 
cursory determination of eligibility when a family requests 
information about child care assistance.  A family that appears 
to be eligible must be put on a waiting list if funds are not 
immediately available.  The waiting list must identify students 
in need of child care.  When money is available counties shall 
expedite the processing of student applications during key 
enrollment periods. 
    Subd. 2.  [ALLOCATION; LIMITATIONS.] From July 1, 1991, 
through June 30, 1992, the commissioner shall allocate the money 
appropriated under the child care fund for the basic sliding fee 
program and shall allocate those funds between the metropolitan 
area, comprising the counties of Anoka, Carver, Dakota, 
Hennepin, Ramsey, Scott, and Washington, and the area outside 
the metropolitan area as follows: 
    (1) 50 percent of the money shall be allocated among the 
counties on the basis of the number of families below the 
poverty level, as determined from the most recent census or 
special census; and 
    (2) 50 percent of the money shall be allocated among the 
counties on the basis of the counties' portion of the AFDC 
caseload for the preceding state fiscal year. 
    If, under the preceding formula, either the seven-county 
metropolitan area consisting of Anoka, Carver, Dakota, Hennepin, 
Ramsey, Scott, and Washington counties or the area consisting of 
counties outside the seven-county metropolitan area is allocated 
more than 55 percent of the basic sliding fee funds, each 
county's allocation in that area shall be proportionally reduced 
until the total for the area is no more than 55 percent of the 
basic sliding fee funds.  The amount of the allocations 
proportionally reduced shall be used to proportionally increase 
each county's allocation in the other area. 
    Subd. 2a.  [ELIGIBLE RECIPIENTS.] Families that meet the 
eligibility requirements under sections 256H.10, except AFDC 
recipients and transition year families, and 256H.11 are 
eligible for child care assistance under the basic sliding fee 
program.  From July 1, 1990, to June 30, 1991, a county may not 
accept new applications for the basic sliding fee program unless 
the county can demonstrate that its state money expenditures for 
the basic sliding fee program for this period will not exceed 95 
percent of the county's allocation of state money for the fiscal 
year ending June 30, 1990.  As basic sliding fee program money 
becomes available to serve new families, eligible families whose 
benefits were terminated during the fiscal year ending June 30, 
1990, for reasons other than loss of eligibility shall be 
reinstated.  Families enrolled in the basic sliding fee program 
as of July 1, 1990, shall be continued until they are no longer 
eligible.  Counties shall make vendor payments to the child care 
provider or pay the parent directly for eligible child care 
expenses on a reimbursement basis. 
    Subd. 2b.  [FUNDING PRIORITY.] (a) First priority for child 
care assistance under the basic sliding fee program must be 
given to eligible non-AFDC families who do not have a high 
school or general equivalency diploma or who need remedial and 
basic skill courses in order to pursue employment or to pursue 
education leading to employment.  Within this priority, the 
following subpriorities must be used: 
    (1) child care needs of minor parents; 
    (2) child care needs of parents under 21 years of age; and 
    (3) child care needs of other parents within the priority 
group described in this paragraph. 
    (b) Second priority must be given to all other parents who 
are eligible for the basic sliding fee program have completed 
their AFDC transition year. 
    Subd. 3.  [REVIEW OF USE OF FUNDS; REALLOCATION.] After 
each quarter, the commissioner shall review the use of basic 
sliding fee program and AFDC child care program allocations by 
county.  The commissioner may reallocate unexpended or 
unencumbered money among those counties who have expended their 
full allocation.  Any unexpended money from the first year of 
the biennium may be carried forward to the second year of the 
biennium.  
    Subd. 4.  [ALLOCATION FORMULA.] Beginning July 1, 1992, the 
basic sliding fee funds shall be allocated according to the 
following formula:  
    (a) One-half of the funds shall be allocated in proportion 
to each county's total expenditures for the basic sliding fee 
child care program reported during the 12-month period ending on 
December 31 of the preceding state fiscal year.  
    (b) One-fourth of the funds shall be allocated based on the 
number of children under age 13 in each county who are enrolled 
in general assistance medical care, medical assistance, and the 
children's health plan on July 1, of each year. 
    (c) One-fourth of the funds shall be allocated based on the 
number of children under age 13 who reside in each county, from 
the most recent estimates of the state demographer. 
    Subd. 5.  [FORMULA LIMITATION.] The amounts computed under 
subdivision 4 shall be subject to the following limitation.  No 
county shall be allocated an amount less than its guaranteed 
floor as provided in subdivision 6.  If the amount allocated to 
a county under subdivision 4 would be less that its guaranteed 
floor, the shortage shall be recovered proportionally from all 
counties which would be allocated more than their guaranteed 
floor.  
    Subd. 6.  [GUARANTEED FLOOR.] (a) Each county's guaranteed 
floor shall equal the lesser of:  
    (1) the county's original allocation in the preceding state 
fiscal year; or 
    (2) 110 percent of the county's basic sliding fee child 
care program state earnings for the 12-month period ending on 
December 31 of the preceding state fiscal year.  For purposes of 
this clause, "state earnings" means the reported nonfederal 
share of direct child care expenditures adjusted for the 15 
percent required county match and seven percent administration 
limit.  
    (b) When the amount of funds available for allocation is 
less than the amount available in the previous year, each 
county's previous year allocation shall be reduced in proportion 
to the reduction in the statewide funding, for the purpose of 
establishing the guaranteed floor.  
    Sec. 54.  [256H.035] [FEDERAL AT-RISK CHILD CARE PROGRAM.] 
    Subdivision 1.  [COMMISSIONER TO ADMINISTER PROGRAM.] The 
commissioner of human services is authorized and directed to 
receive, administer, and expend funds available under the 
at-risk child care program under Public Law Number 101-508 (1).  
    Subd. 2.  [RULEMAKING AUTHORITY.] The commissioner may 
adopt rules under chapter 14 to administer the at-risk child 
care program.  
    Sec. 55.  Minnesota Statutes 1990, section 256H.05, is 
amended to read: 
    256H.05 [AFDC CHILD CARE PROGRAM.] 
    Subd. 1b.  [ELIGIBLE RECIPIENTS.] Families eligible for 
guaranteed child care assistance under the AFDC child care 
program are: 
    (1) persons receiving services under section 256.736; 
    (2) AFDC recipients who are employed; and 
    (3) persons who are members of transition year families 
under section 256H.01, subdivision 16; and 
    (4) members of the control group for the STRIDE evaluation 
conducted by the Manpower Demonstration Research Corporation. 
    Subd. 1c.  [FUNDING WAITING LIST PRIORITY.] AFDC recipients 
must be put on a waiting list for the basic sliding fee program 
when they leave AFDC due to their earned income. 
    Subd. 2.  [COOPERATION WITH OTHER PROGRAMS.] The county 
shall develop cooperative agreements with the employment and 
training service provider for coordination of child care funding 
with employment, training, and education programs for all AFDC 
recipients who receive services under section 256.736.  The 
cooperative agreement shall specify that individuals receiving 
employment, training, and education services under an 
employability plan from the employment and training service 
provider shall be guaranteed child care assistance from the 
county responsible for the current employability development 
plan.  
    Subd. 3.  [CONTRACTS; OTHER USES ALLOWED.] Counties may 
contract for administration of the program or may arrange for or 
contract for child care funds to be used by other appropriate 
programs, in accordance with this section and as permitted by 
federal law and regulations.  
    Subd. 5.  [FEDERAL REIMBURSEMENT.] Counties shall maximize 
their federal reimbursement under Public Law Number 100-485 or 
other federal reimbursement programs for money spent for persons 
listed in this section eligible under this chapter.  The 
commissioner shall allocate any federal earnings to the county 
to be used to expand child care services under these sections 
this chapter. 
    Sec. 56.  [256H.055] [FEDERAL CHILD CARE AND DEVELOPMENT 
BLOCK GRANT.] 
    Subdivision 1.  [COMMISSIONER TO ADMINISTER BLOCK 
GRANT.] The commissioner of human services is authorized and 
directed to receive, administer, and expend child care funds 
available under the child care and development block grant 
authorized under Public Number 101-508 (2).  
    Subd. 2.  [RULEMAKING AUTHORITY.] The commissioner may 
adopt rules under chapter 14 to administer the child care 
development block grant program.  
    Sec. 57.  Minnesota Statutes 1990, section 256H.08, is 
amended to read: 
    256H.08 [USE OF MONEY.] 
    Money for persons listed in sections 256H.03, subdivision 
2a, and 256H.05, subdivision 1b, shall be used to reduce the 
costs of child care for students, including the costs of child 
care for students while employed if enrolled in an eligible 
education program at the same time and making satisfactory 
progress towards completion of the program.  Counties may not 
limit the duration of child care subsidies for a person in an 
employment or educational program, except when the person is 
found to be ineligible under the child care fund eligibility 
standards.  Any limitation must be based on a person's 
employability plan in the case of an AFDC recipient, and county 
policies included in the child care allocation plan.  Time 
limitations for child care assistance, as specified in Minnesota 
Rules, parts 9565.5000 to 9565.5200, do not apply to basic or 
remedial educational programs needed to prepare for 
post-secondary education or employment.  These programs 
include:  high school, general equivalency diploma, and English 
as a second language.  Programs exempt from this time limit must 
not run concurrently with a post-secondary program.  Financially 
eligible students who have received child care assistance for 
one academic year shall be provided child care assistance in the 
following academic year if funds allocated under sections 
256H.03 and 256H.05 are available.  If an AFDC recipient who is 
receiving AFDC child care assistance under this chapter moves to 
another county as authorized in their employability plan, 
continues to participate in educational or training programs 
authorized in their employability development plans, and 
continues to be eligible for AFDC child care assistance under 
this chapter, the AFDC caretaker must receive continued child 
care assistance from the county responsible for their current 
employability development plan, without interruption. 
    Sec. 58.  Minnesota Statutes 1990, section 256H.15, 
subdivision 1, is amended to read: 
    Subdivision 1.  [SUBSIDY RESTRICTIONS.] (a) Until June 30, 
1991, the maximum child care rate is determined under this 
paragraph.  The county board may limit the subsidy allowed by 
setting a maximum on the provider child care rate that the 
county shall subsidize.  The maximum rate set by any county 
shall not be lower than 110 percent or higher than 125 percent 
of the median rate in that county for like care arrangements for 
all types of care, including special needs and handicapped care, 
as determined by the commissioner.  If the county sets a maximum 
rate, it must pay the provider's rate for each child receiving a 
subsidy, up to the maximum rate set by the county.  If a county 
does not set a maximum provider rate, it shall pay the 
provider's rate for every child in care.  The maximum state 
payment is 125 percent of the median provider rate.  If the 
county has not set a maximum provider rate and the provider rate 
is greater than 125 percent of the median provider rate in the 
county, the county shall pay the amount in excess of 125 percent 
of the median provider rate from county funding sources.  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, including 
special needs and handicapped care.  
    (b) Effective July 1, 1991, the maximum rate paid for child 
care assistance under the child care fund is the maximum rate 
eligible for federal reimbursement except as that a provider 
receiving reimbursement under paragraph (a) as of January 1, 
1991, shall be paid at a rate no less than the rate of 
reimbursement received under that paragraph.  A rate which 
includes a provider bonus paid under subdivision 2 or a special 
needs rate paid under subdivision 3 may be in excess of the 
maximum rate allowed under this subdivision 2.  The department 
of human services 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, including special needs and handicapped care.  
    (c) When the provider charge is greater than the maximum 
provider rate allowed, the parent is responsible for payment of 
the difference in the rates in addition to any family copayment 
fee. 
    Sec. 59.  Minnesota Statutes 1990, section 256H.15, 
subdivision 2, is amended to read: 
    Subd. 2.  [PROVIDER RATE BONUS FOR ACCREDITATION.] 
Currently accredited child care centers shall be paid a ten 
percent bonus above the maximum rate established in subdivision 
1, up to the actual provider rate.  A family day care provider 
shall be paid a ten percent bonus above the maximum rate 
established in subdivision 1, if the provider holds a current 
early childhood development credential approved by the 
commissioner, up to the actual provider rate.  For purposes of 
this subdivision, "accredited" means accredited by the National 
Association for the Education of Young Children. 
    Sec. 60.  Minnesota Statutes 1990, section 256H.15, is 
amended by adding a subdivision to read: 
    Subd. 4.  [RATES CHARGED TO PUBLICLY SUBSIDIZED 
FAMILIES.] Child care providers receiving reimbursement under 
chapter 256H may not charge a rate to clients receiving 
assistance under chapter 256H that is higher than the private, 
full-paying client rate. 
    Sec. 61.  Minnesota Statutes 1990, section 256H.18, is 
amended to read: 
    256H.18 [ADMINISTRATIVE EXPENSES.] 
    A county may not use more than The commissioner shall use 
up to seven percent of its allocation the state funds 
appropriated for the Basic Sliding Fee program for payments to 
counties for administrative expenses under the basic sliding fee 
program.  The commissioner shall use up to ten percent of 
federal funds for payments to counties for administrative 
expenses. 
    Sec. 62.  [256H.195] [MINNESOTA EARLY CHILDHOOD CARE AND 
EDUCATION COUNCIL.] 
    Subdivision 1.  [ESTABLISHMENT; MEMBERS.] The Minnesota 
early childhood care and education council shall consist of 19 
members appointed by the governor.  Members must represent the 
following groups and organizations:  parents, family child care 
providers, child care center providers, private foundations, 
corporate executives, small business owners, and public school 
districts.  The council membership also includes the 
commissioners of human services, jobs and training, education, 
and health; a representative of the higher education 
coordinating board; a representative of the Minnesota headstart 
association; representatives of two Minnesota counties; three 
members from child care resource and referral programs, one of 
whom shall be from a county-operated resource and referral, one 
of whom shall be from a rural location, and one of whom shall be 
from the metropolitan area; and a community group 
representative.  The governor shall consult with the councils 
established under sections 3.922, 3.9223, 3.9225, and 3.9226, 
representing the communities of color, to ensure that membership 
of the council is representative of all racial minority groups.  
In addition to the 19 members appointed by the governor, two 
members of the senate shall be appointed by the president of the 
senate and two members of the house of representatives shall be 
appointed by the speaker of the house to serve as ex officio 
members of the council.  Membership terms, compensation, and 
removal of members are governed by section 15.059, except that 
the council shall not expire as required by that section.  
    Subd. 2.  [EXECUTIVE DIRECTOR; STAFF.] The council shall 
select an executive director of the council by a vote of a 
majority of all council members.  The executive director is in 
the unclassified service and shall provide administrative 
support for the council and provide administrative leadership to 
implement council mandates, policies, and objectives.  The 
executive director shall employ and direct other staff. 
    Subd. 3.  [DUTIES AND POWERS.] The council has the 
following duties and powers: 
    (1) develop a biennial plan for early childhood care and 
education in the state; 
    (2) take a leadership role in developing its 
recommendations in conjunction with the recommendations of other 
state agencies on the state budget for early childhood care and 
education; 
    (3) apply for and receive state money and public and 
private grant money; 
    (4) participate in and facilitate the development of 
interagency agreements on early childhood care and education 
issues; 
    (5) review state agency policies on early childhood care 
and education issues so that they do not conflict; 
    (6) advocate for an effective and coordinated early 
childhood care and education system with state agencies and 
programs; 
    (7) study the need for child care funding for special 
populations whose needs are not being met by current programs; 
    (8) ensure that the early childhood care and education 
system reflects community diversity; 
    (9) be responsible for advocating policies and funding for 
early childhood care and education; and 
    (10) provide a report to the legislature on January 1 of 
every odd-numbered year, containing a description of the 
activities and the work plan of the council and any legislative 
recommendations developed by the council. 
    Sec. 63.  [256H.196] [REGIONAL CHILD CARE RESOURCE AND 
REFERRAL PROGRAMS.] 
    Subdivision 1.  [ESTABLISHMENT.] Existing child care 
resource and referral programs shall become the regional child 
care resource and referral programs provided they are in 
compliance with other provisions of this chapter. 
    Subd. 2.  [DUTIES.] The regional resource and referral 
program shall have the duties specified in section 256H.20.  In 
addition, the regional program shall be responsible for 
establishing new or collaborating with existing community-based 
committees such as interagency early intervention committees or 
neighborhood groups to advocate for child care needs in the 
community as well as serve as important local resources for 
children and their families. 
    Sec. 64.  Minnesota Statutes 1990, section 256H.20, 
subdivision 3a, is amended to read: 
    Subd. 3a.  [GRANT REQUIREMENTS AND PRIORITY.] Priority for 
awarding resource and referral grants shall be given in the 
following order: 
    (1) start up resource and referral programs in areas of the 
state where they do not exist; and 
    (2) improve resource and referral programs. 
    Resource and referral programs shall meet the following 
requirements:  
    (a) Each program shall identify all existing child care 
services through information provided by all relevant public and 
private agencies in the areas of service, and shall develop a 
resource file of the services which shall be maintained and 
updated at least quarterly.  These services must include family 
day care homes; public and private day care programs; full-time 
and part-time programs; infant, preschool, and extended care 
programs; and programs for school age children. 
    The resource file must include:  the type of program, hours 
of program service, ages of children served, fees, location of 
the program, eligibility requirements for enrollment, special 
needs services, and transportation available to the program.  
The file may also include program information and special 
program features. 
    (b) Each resource and referral program shall establish a 
referral process which responds to parental need for information 
and which fully recognizes confidentiality rights of parents.  
The referral process must afford parents maximum access to all 
referral information.  This access must include telephone 
referral available for no less than 20 hours per week. 
     Each child care resource and referral agency shall 
publicize its services through popular media sources, agencies, 
employers, and other appropriate methods. 
    (c) Each resource and referral program shall maintain 
ongoing documentation of requests for service.  All child care 
resource and referral agencies must maintain documentation of 
the number of calls and contacts to the child care information 
and referral agency or component.  A resource and referral 
program shall collect and maintain the following information: 
    (1) ages of children served; 
    (2) time category of child care request for each child; 
    (3) special time category, such as nights, weekends, and 
swing shift; and 
    (4) reason that the child care is needed. 
    (d) Each resource and referral program shall make available 
the following information as an educational aid to parents: 
     (1) information on aspects of evaluating the quality and 
suitability of child care services, including licensing 
regulation, financial assistance available, child abuse 
reporting procedures, appropriate child development information; 
     (2) information on available parent, early childhood, and 
family education programs in the community. 
    (e) On or after one year of operation a resource and 
referral program shall provide technical assistance to employers 
and existing and potential providers of all types of child care 
services.  This assistance shall include: 
     (1) information on all aspects of initiating new child care 
services including licensing, zoning, program and budget 
development, and assistance in finding information from other 
sources; 
     (2) information and resources which help existing child 
care providers to maximize their ability to serve the children 
and parents of their community; 
     (3) dissemination of information on current public issues 
affecting the local and state delivery of child care services; 
     (4) facilitation of communication between existing child 
care providers and child-related services in the community 
served; 
     (5) recruitment of licensed providers; and 
     (6) options, and the benefits available to employers 
utilizing the various options, to expand child care services to 
employees. 
     Services prescribed by this section must be designed to 
maximize parental choice in the selection of child care and to 
facilitate the maintenance and development of child care 
services and resources. 
    (f) Child care resource and referral information must be 
provided to all persons requesting services and to all types of 
child care providers and employers. 
    (g) Public or private entities may apply to the 
commissioner for funding.  The maximum amount of money which may 
be awarded to any entity for the provision of service under this 
subdivision is $60,000 per year.  A local match of up to 25 
percent is required. 
    Subd. 4.  [APPLICATION; RULES.] Applicants for grants under 
subdivision 1 shall apply on a form provided by the commissioner.
Applications for grants using funds received by the state 
pursuant to subdivision 2 shall include assurances that federal 
requirements have been met.  The commissioner may 
adopt emergency rules and shall adopt permanent rules as 
necessary to implement this section. 
    Sec. 65.  Minnesota Statutes 1990, section 256H.21, 
subdivision 10, is amended to read: 
    Subd. 10.  [RESOURCE AND REFERRAL PROGRAM.] "Resource and 
referral program" means a program that provides information to 
parents, including referrals and coordination of community child 
care resources for parents and public or private providers of 
care.  It also means the agency with the duties specified in 
sections 256H.196 and 256H.20.  Services may include parent 
education, technical assistance for providers, staff development 
programs, and referrals to social services. 
    Sec. 66.  Minnesota Statutes 1990, section 256H.22, 
subdivision 2, is amended to read: 
    Subd. 2.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
shall allocate grant money appropriated for child care service 
development among the development regions designated by the 
governor under section 462.385, as follows: 
    (1) 50 percent of the child care service development grant 
appropriation shall be allocated to the metropolitan economic 
development region; and 
    (2) 50 percent of the child care service development grant 
appropriation shall be allocated to economic development regions 
other than the metropolitan economic development region. 
    (b) The following formulas shall be used to allocate grant 
appropriations among the economic development regions:  
    (1) 50 percent of the funds shall be allocated in 
proportion to the ratio of children under 12 years of age in 
each economic development region to the total number of children 
under 12 years of age in all economic development regions; and 
    (2) 50 percent of the funds shall be allocated in 
proportion to the ratio of children under 12 years of age in 
each economic development region to the number of licensed child 
care spaces currently available in each economic development 
region. 
    (c) Out of the amount allocated for each economic 
development region, the commissioner shall award grants based on 
the recommendation of the grant review advisory task force.  In 
addition, the commissioner shall award no more than 75 percent 
of the money either to child care facilities for the purpose of 
facility improvement or interim financing or to child care 
workers for staff training expenses.  
    (d) Any funds unobligated may be used by the commissioner 
to award grants to proposals that received funding 
recommendations by the advisory task force but were not awarded 
due to insufficient funds.  
    (e) The commissioner may allocate grants under this section 
for a two-year period and may carry forward funds from the first 
year as necessary. 
    Sec. 67.  Minnesota Statutes 1990, section 256H.22, is 
amended by adding a subdivision to read: 
    Subd. 3a.  [DISTRIBUTION OF FUNDS FOR CHILD CARE RESOURCE 
AND REFERRAL PROGRAMS.] The commissioner shall allocate funds 
appropriated for child care resource and referral services 
considering the following factors for each economic development 
region served by the child care resource and referral agency:  
    (1) the number of children under 13 years of age needing 
child care in the service area; 
    (2) the geographic area served by the agency; 
    (3) the ratio of children under 13 years of age needing 
care to the number of licensed spaces in the service area; 
    (4) the number of licensed child care providers and 
extended day school age child care programs in the service area; 
and 
    (5) other related factors determined by the commissioner.  
    Sec. 68.  [256H.225] [ASSISTANCE TO CHILD CARE CENTERS AND 
PROVIDERS.] 
    The commissioner shall work with the early childhood care 
and education council and with the resource and referral 
programs to develop tools to assist child care centers and 
family child care providers to obtain accreditation and 
certification and to achieve improved pay for child care workers.
    Sec. 69.  Minnesota Statutes 1990, section 257.57, 
subdivision 2, is amended to read: 
    Subd. 2.  The child, the mother, or personal representative 
of the child, the public authority chargeable by law with the 
support of the child, the personal representative or a parent of 
the mother if the mother has died or is a minor, a man alleged 
or alleging himself to be the father, or the personal 
representative or a parent of the alleged father if the alleged 
father has died or is a minor may bring an action: 
    (1) at any time for the purpose of declaring the existence 
of the father and child relationship presumed under section 
257.55, subdivision 1, clause (d) or, (e), or (f), or the 
nonexistence of the father and child relationship presumed under 
clause (d) of that subdivision; or 
    (2) for the purpose of declaring the nonexistence of the 
father and child relationship presumed under section 257.55, 
subdivision 1, clause (e) only if the action is brought within 
three years after the date of the execution of the declaration; 
or 
    (3) for the purpose of declaring the nonexistence of the 
father and child relationship presumed under section 257.55, 
subdivision 1, paragraph (f), only if the action is brought 
within three years after the party bringing the action, or the 
party's attorney of record, has been provided the blood test 
results. 
    Sec. 70.  Minnesota Statutes 1990, section 260.165, is 
amended by adding a subdivision to read: 
    Subd. 3.  [NOTICE TO PARENT OR CUSTODIAN.] Whenever a peace 
officer takes a child into custody for shelter care placement 
pursuant to subdivision 1; section 260.135, subdivision 5; or 
section 260.145, the officer shall give the parent or custodian 
of the child a list of names, addresses, and telephone numbers 
of social service agencies that offer child welfare services.  
If the parent or custodian was not present when the child was 
removed from the residence, the list shall be left with an adult 
on the premises or left in a conspicuous place on the premises 
if no adult is present.  If the officer has reason to believe 
the parent or custodian is not able to read and understand 
English, the officer must provide a list that is written in the 
language of the parent or custodian.  The list shall be prepared 
by the commissioner of human services.  The commissioner shall 
prepare lists for each county and provide each county with 
copies of the list without charge.  The list shall be reviewed 
annually by the commissioner and updated if it is no longer 
accurate.  Neither the commissioner nor any peace officer or the 
officer's employer shall be liable to any person for mistakes or 
omissions in the list.  The list does not constitute a promise 
that any agency listed will in fact assist the parent or 
custodian. 
    Sec. 71.  Minnesota Statutes 1990, section 270A.04, 
subdivision 2, is amended to read: 
    Subd. 2.  Any debt owed to a claimant agency shall be 
submitted by the agency for collection under the procedure 
established by sections 270A.01 to 270A.12 unless (a) an 
alternative means of collection is pending and the debtor is 
complying with the terms of alternative means of 
collection, except that this limitation does not apply to debts 
owed resulting from a default in payment of child support or 
maintenance, (b) the collection attempt would result in a loss 
of federal funds, or (c) the agency is unable to supply the 
department with the necessary identifying information required 
by subdivision 3 or rules promulgated by the commissioner, or 
(d) the debt is barred by section 541.05. 
    Sec. 72.  Minnesota Statutes 1990, section 270A.08, 
subdivision 2, is amended to read: 
    Subd. 2.  (a) This written notice shall clearly and with 
specificity set forth the basis for the claim to the refund 
including the name of the benefit program involved if the debt 
arises from a public assistance grant and the dates on which the 
debt was incurred and, further, shall advise the debtor of the 
claimant agency's intention to request setoff of the refund 
against the debt.  
    (b) The notice will also advise the debtor that any debt 
incurred more than six years from the date of the notice to the 
commissioner under section 270A.07, except for debts owed 
resulting from a default in payment of child support or 
maintenance, must not be setoff against a refund and will advise 
the debtor of the right to contest the validity of the claim at 
a hearing.  The debtor must assert this right by written request 
to the claimant agency, which request the agency must receive 
within 45 days of the mailing date of the original notice or of 
the corrected notice, as required by subdivision 1.  If the 
debtor has not received the notice, the 45 days shall not 
commence until the debtor has received actual notice.  The 
debtor shall have the burden of showing no notice and shall be 
entitled to a hearing on the issue of notice as well as on the 
merits. 
    Sec. 73.  Minnesota Statutes 1990, section 393.07, 
subdivision 10, is amended to read: 
    Subd. 10.  [FEDERAL FOOD STAMP PROGRAM.] (a) The county 
welfare board shall establish and administer the food stamp 
program pursuant to rules of the commissioner of human services, 
the supervision of the commissioner as specified in section 
256.01, and all federal laws and regulations.  The commissioner 
of human services shall monitor food stamp program delivery on 
an ongoing basis to ensure that each county complies with 
federal laws and regulations.  Program requirements to be 
monitored include, but are not limited to, number of 
applications, number of approvals, number of cases pending, 
length of time required to process each application and deliver 
benefits, number of applicants eligible for expedited issuance, 
length of time required to process and deliver expedited 
issuance, number of terminations and reasons for terminations, 
client profiles by age, household composition and income level 
and sources, and the use of phone certification and home 
visits.  The commissioner shall determine the county-by-county 
and statewide participation rate.  The commissioner shall report 
on the monitoring activities on a county-by-county basis in a 
report presented to the legislature by July 1 each year.  This 
monitoring activity shall be separate from the management 
evaluation survey sample required under federal regulations.  
    (b) On July 1 of each year, the commissioner of human 
services shall determine a statewide and county-by-county food 
stamp program participation rate.  The commissioner may 
designate a different agency to administer the food stamp 
program in a county if the agency administering the program 
fails to increase the food stamp program participation rate 
among families or eligible individuals, or comply with all 
federal laws and regulations governing the food stamp program.  
The commissioner shall review agency performance annually to 
determine compliance with this paragraph. 
     (c) A person who commits any of the following acts has 
violated section 256.98 and is subject to both the criminal and 
civil penalties provided under that section: 
     (1) Obtains or attempts to obtain, or aids or abets any 
person to obtain by means of a willfully false statement or 
representation, or intentional concealment of a material fact, 
food stamps to which the person is not entitled or in an amount 
greater than that to which that person is entitled; or 
     (2) Presents or causes to be presented, coupons for payment 
or redemption knowing them to have been received, transferred or 
used in a manner contrary to existing state or federal law; or 
     (3) Willfully uses or transfers food stamp coupons or 
authorization to purchase cards in any manner contrary to 
existing state or federal law. 
    Sec. 74.  Minnesota Statutes 1990, section 393.07, 
subdivision 10a, is amended to read: 
    Subd. 10a.  [EXPEDITED ISSUANCE OF FOOD STAMPS.] The 
commissioner of human services shall continually monitor the 
expedited issuance of food stamp benefits to ensure that each 
county complies with federal regulations and that households 
eligible for expedited issuance of food stamps are identified, 
processed, and certified within the time frames prescribed in 
federal regulations.  By July 1 each year the commissioner of 
human services shall present a report to the governor and the 
legislature regarding its monitoring of expedited issuance and 
the degree of compliance with federal regulations on a 
county-by-county basis. 
    County food stamp offices shall screen and issue food 
stamps to applicants on the day of application.  Applicants who 
meet the federal criteria for expedited issuance and have an 
immediate need for food assistance shall receive either: 
    (1) a manual Authorization to Participate (ATP) card; or 
    (2) the immediate issuance of food stamp coupons.  
    The local food stamp agency shall conspicuously post in 
each food stamp office a notice of the availability of and the 
procedure for applying for expedited issuance and verbally 
advise each applicant of the availability of the expedited 
process. 
    Sec. 75.  Minnesota Statutes 1990, section 518.551, 
subdivision 5, is amended to read: 
    Subd. 5.  [NOTICE TO PUBLIC AUTHORITY; GUIDELINES.] (a) The 
petitioner shall notify the public authority of all proceedings 
for dissolution, legal separation, determination of parentage or 
for the custody of a child, if either party is receiving aid to 
families with dependent children or applies for it subsequent to 
the commencement of the proceeding.  After receipt of the 
notice, the court shall set child support as provided in this 
subdivision.  The court may order either or both parents owing a 
duty of support to a child of the marriage to pay an amount 
reasonable or necessary for the child's support, without regard 
to marital misconduct.  The court shall approve a child support 
agreement stipulation of the parties if each party is 
represented by independent counsel, unless the agreement is not 
in the interest of justice stipulation does not meet the 
conditions of paragraph (h).  In other cases the court shall 
determine and order child support in a specific dollar amount in 
accordance with the guidelines and the other factors set forth 
in paragraph (b) and any departure therefrom. 
    The court shall derive a specific dollar amount by 
multiplying the obligor's net income by the percentage indicated 
by the following guidelines:  
Net Income Per            Number of Children 
Month of Obligor 
                   1      2      3      4      5      6    7 or 
                                                           more 
$400 and Below          Order based on the ability of the 
                        obligor to provide support  
                        at these income levels, or at higher  
                        levels, if the obligor has 
                        the earning ability. 
$401 - 500        14%    17%    20%    22%    24%    26%    28% 
$501 - 550        15%    18%    21%    24%    26%    28%    30% 
$551 - 600        16%    19%    22%    25%    28%    30%    32% 
$601 - 650        17%    21%    24%    27%    29%    32%    34% 
$651 - 700        18%    22%    25%    28%    31%    34%    36% 
$701 - 750        19%    23%    27%    30%    33%    36%    38% 
$751 - 800        20%    24%    28%    31%    35%    38%    40% 
$801 - 850        21%    25%    29%    33%    36%    40%    42% 
$851 - 900        22%    27%    31%    34%    38%    41%    44% 
$901 - 950        23%    28%    32%    36%    40%    43%    46% 
$951 - 1000       24%    29%    34%    38%    41%    45%    48% 
$1001- 4000       25%    30%    35%    39%    43%    47%    50% 
      Guidelines for support for an obligor with a monthly income 
of $4,001 or more shall be the same dollar amounts as provided 
for in the guidelines for an obligor with a monthly income of 
$4,000.  
         Net Income defined as: 
         Total monthly 
         income less           *(i) Federal Income Tax 
                              *(ii) State Income Tax 
                              (iii) Social Security
                                     Deductions 
                               (iv) Reasonable
                                     Pension Deductions 
         *Standard 
         Deductions apply-      (v) Union Dues 
         use of tax tables     (vi) Cost of Dependent Health
               recommended           Insurance Coverage  
                              (vii) Cost of Individual or Group
                                     Health/Hospitalization
                                     Coverage or an        
                                     Amount for Actual 
                                     Medical Expenses   
                             (viii) A Child Support or  
                                     Maintenance Order that is
                                     Currently Being Paid. 
     "Net income" does not include: 
     (1) the income of the obligor's spouse, but does include 
in-kind payments received by the obligor in the course of 
employment, self-employment, or operation of a business if the 
payments reduce the obligor's living expenses; or 
     (2) compensation received by a party for employment in 
excess of a 40-hour work week, provided that: 
    (a) (i) support is nonetheless ordered in an amount at 
least equal to the guidelines amount based on income not 
excluded under this clause; and 
    (b) (ii) the party demonstrates, and the court finds, that: 
    (i) (A) the excess employment began after the filing of the 
petition for dissolution; 
    (ii) (B) the excess employment reflects an increase in the 
work schedule or hours worked over that of the two years 
immediately preceding the filing of the petition; 
    (iii) (C) the excess employment is voluntary and not a 
condition of employment; 
    (iv) (D) the excess employment is in the nature of 
additional, part-time or overtime employment compensable by the 
hour or fraction of an hour; and 
    (v) (E) the party's compensation structure has not been 
changed for the purpose of affecting a support or maintenance 
obligation. 
    (b) In addition to the child support guidelines, the court 
shall take into consideration the following factors in setting 
or modifying child support: 
    (1) all earnings, income, and resources of the parents, 
including real and personal property, but excluding income from 
excess employment of the obligor or obligee that meets the 
criteria of paragraph (a), clause (2)(b) (ii); 
    (2) the financial needs and resources, physical and 
emotional condition, and educational needs of the child or 
children to be supported; 
    (3) the standards of living the child would have enjoyed 
had the marriage not been dissolved, but recognizing that the 
parents now have separate households; 
    (4) the amount of the aid to families with dependent 
children grant for the child or children; 
    (5) which parent receives the income taxation dependency 
exemption and what financial benefit the parent receives from 
it; and 
    (6) the parents' debts as provided in paragraph (c).  
    (c) In establishing or modifying a support obligation, the 
court may consider debts owed to private creditors, but only if: 
    (1) the right to support has not been assigned under 
section 256.74; 
    (2) the court determines that the debt was reasonably 
incurred for necessary support of the child or parent or for the 
necessary generation of income.  If the debt was incurred for 
the necessary generation of income, the court shall consider 
only the amount of debt that is essential to the continuing 
generation of income; and 
      (3) the party requesting a departure produces a sworn 
schedule of the debts, with supporting documentation, showing 
goods or services purchased, the recipient of them, the amount 
of the original debt, the outstanding balance, the monthly 
payment, and the number of months until the debt will be fully 
paid. 
    (d) Any schedule prepared under paragraph (c), clause (3), 
shall contain a statement that the debt will be fully paid after 
the number of months shown in the schedule, barring emergencies 
beyond the party's control.  
    (e) Any further departure below the guidelines that is 
based on a consideration of debts owed to private creditors 
shall not exceed 18 months in duration, after which the support 
shall increase automatically to the level ordered by the court.  
Nothing in this section shall be construed to prohibit one or 
more step increases in support to reflect debt retirement during 
the 18-month period.  
    (f) Where payment of debt is ordered pursuant to this 
section, the payment shall be ordered to be in the nature of 
child support.  
    (d) (g) Nothing shall preclude the court from receiving 
evidence on the above factors to determine if the guidelines 
should be exceeded or modified in a particular case.  
    (e) The above guidelines are binding in each case unless 
the court makes express findings of fact as to the reason for 
departure below or above the guidelines. (h) The guidelines in 
this subdivision are a rebuttable presumption and shall be used 
in all cases when establishing or modifying child support.  If 
the court does not deviate from the guidelines, the court shall 
make written findings concerning the amount of the obligor's 
income used as the basis for the guidelines calculation and any 
other significant evidentiary factors affecting the 
determination of child support.  If the court deviates from the 
guidelines, the court shall make written findings giving the 
reasons for the deviation and shall specifically address the 
criteria in paragraph (b) and how the deviation serves the best 
interest of the child.  The provisions of this paragraph apply 
whether or not the parties are each represented by independent 
counsel and have entered into a written agreement.  The court 
shall review stipulations presented to it for conformity to the 
guidelines and the court is not required to conduct a hearing, 
but the parties shall provide the documentation of earnings 
required under subdivision 5b. 
    Sec. 76.  Minnesota Statutes 1990, section 518.551, is 
amended by adding a subdivision to read: 
    Subd. 5b.  [DETERMINATION OF INCOME.] (a) The parties shall 
timely serve and file documentation of earnings and income.  
When there is a prehearing conference, the court must receive 
the documentation of income at least ten days prior to the 
prehearing conference.  Documentation of earnings and income 
also includes, but is not limited to, pay stubs for the most 
recent three months, employer statements, or statement of 
receipts and expenses if self-employed.  Documentation of 
earnings and income also includes copies of each parent's most 
recent federal tax returns, including W-2 forms, 1099 forms, 
unemployment compensation statements, workers' compensation 
statements, and all other documents evidencing income as 
received that provide verification of income over a longer 
period. 
    (b) If a parent under the jurisdiction of the court does 
not appear at a court hearing after proper notice of the time 
and place of the hearing, the court shall set income for that 
parent based on credible evidence before the court or in 
accordance with paragraph (c).  Credible evidence may include 
documentation of current or recent income, testimony of the 
other parent concerning recent earnings and income levels, and 
the parent's wage reports filed with the Minnesota department of 
jobs and training under section 268.121.  
    (c) If the court finds that a parent is voluntarily 
unemployed or underemployed, child support shall be calculated 
based on a determination of imputed income.  A parent is not 
considered voluntarily unemployed or underemployed upon a 
showing by the parent that the unemployment or underemployment:  
(1) is temporary and will ultimately lead to an increase in 
income; or (2) represents a bona fide career change that 
outweighs the adverse effect of that parent's diminished income 
on the child.  Imputed income means the estimated earning 
ability of a parent based on the parent's prior earnings 
history, education, and job skills, and on availability of jobs 
within the community for an individual with the parent's 
qualifications.  If the court is unable to determine or estimate 
the earning ability of a parent, the court may calculate child 
support based on full-time employment of 40 hours per week at 
the federal minimum wage or the Minnesota minimum wage, 
whichever is higher.  If a parent is physically or mentally 
incapacitated, it shall be presumed that the parent is not 
voluntarily unemployed or underemployed. 
    Sec. 77.  Minnesota Statutes 1990, section 518.551, is 
amended by adding a subdivision to read: 
    Subd. 5c.  [CHILD SUPPORT GUIDELINES TO BE REVIEWED EVERY 
FOUR YEARS.] No later than 1994 and every four years after that, 
the department of human services shall conduct a review of the 
child support guidelines.  
    Sec. 78.  Minnesota Statutes 1990, section 518.551, is 
amended by adding a subdivision to read: 
    Subd. 12.  [OCCUPATIONAL LICENSE SUSPENSION.] Upon petition 
of an obligee or public agency responsible for child support 
enforcement, if the court finds that the obligor is or may be 
licensed by a licensing board listed in section 214.01 and the 
obligor is in arrears in court-ordered child support payments, 
the court may direct the licensing board to conduct a hearing 
under section 214.101 concerning suspension of the obligor's 
license.  If the obligor is a licensed attorney, the court may 
report the matter to the lawyers professional responsibility 
board for appropriate action in accordance with the rules of 
professional conduct.  The remedy under this subdivision is in 
addition to any other enforcement remedy available to the court. 
    Sec. 79.  Minnesota Statutes 1990, section 518.64, is 
amended to read: 
    518.64 [MODIFICATION OF ORDERS OR DECREES.] 
    Subdivision 1.  After an order for maintenance or support 
money, temporary or permanent, or for the appointment of 
trustees to receive property awarded as maintenance or support 
money, the court may from time to time, on petition motion of 
either of the parties, a copy of which is served on the public 
authority responsible for child support enforcement if payments 
are made through it, or on petition motion of the public 
authority responsible for support enforcement, modify the order 
respecting the amount of maintenance or support money, and the 
payment of it, and also respecting the appropriation and payment 
of the principal and income of property held in trust, and may 
make an order respecting these matters which it might have made 
in the original proceeding, except as herein otherwise provided. 
    Subd. 2.  [MODIFICATION.] (a) The terms of a decree an 
order respecting maintenance or support may be modified upon a 
showing of one or more of the following:  (1) substantially 
increased or decreased earnings of a party; (2) substantially 
increased or decreased need of a party or the child or children 
that are the subject of these proceedings; (3) receipt of 
assistance under sections 256.72 to 256.87; or (4) a change in 
the cost of living for either party as measured by the federal 
bureau of statistics, any of which makes the terms unreasonable 
and unfair.  
    The terms of a current support order shall be rebuttably 
presumed to be unreasonable and unfair if the application of the 
child support guidelines in section 518.551, subdivision 5, to 
the current circumstances of the parties results in a calculated 
court order that is at least 20 percent and at least $50 per 
month higher or lower than the current support order.  
    (b) On a motion for modification of maintenance, the court 
shall apply, in addition to all other relevant factors, the 
factors for an award of maintenance under section 518.552 that 
exist at the time of the motion.  On a motion for modification 
of support, the court:  
    (1) shall take into consideration the needs of the children 
apply section 518.551, subdivision 5, and shall not consider the 
financial circumstances of each party's spouse, if any; and 
    (2) shall not consider compensation received by a party for 
employment in excess of a 40-hour work week, provided that the 
party demonstrates, and the court finds, that: 
    (i) the excess employment began after entry of the existing 
support order; 
    (ii) the excess employment is voluntary and not a condition 
of employment; 
    (iii) the excess employment is in the nature of additional, 
part-time employment, or overtime employment compensable by the 
hour or fractions of an hour; 
    (iv) the party's compensation structure has not been 
changed for the purpose of affecting a support or maintenance 
obligation; 
    (v) in the case of an obligor, current child support 
payments are at least equal to the guidelines amount based on 
income not excluded under this clause; and 
    (vi) in the case of an obligor who is in arrears in child 
support payments to the obligee, any net income from excess 
employment must be used to pay the arrearages until the 
arrearages are paid in full. 
    (c) A modification of support or maintenance may be made 
retroactive only with respect to any period during which the 
petitioning party has pending a motion for modification but only 
from the date of service of notice of the motion on the 
responding party and on the public authority if public 
assistance is being furnished or the county attorney is the 
attorney of record.  However, modification may be applied to an 
earlier period if the court makes express findings that the 
party seeking modification was precluded from serving a motion 
by reason of a significant physical or mental disability or, a 
material misrepresentation of another party, or fraud upon the 
court and that the party seeking modification, when no longer 
precluded, promptly served a motion.  
    (d) Except for an award of the right of occupancy of the 
homestead, provided in section 518.63, all divisions of real and 
personal property provided by section 518.58 shall be final, and 
may be revoked or modified only where the court finds the 
existence of conditions that justify reopening a judgment under 
the laws of this state, including motions under section 518.145, 
subdivision 2.  The court may impose a lien or charge on the 
divided property at any time while the property, or subsequently 
acquired property, is owned by the parties or either of them, 
for the payment of maintenance or support money, or may 
sequester the property as is provided by section 518.24. 
    Subd. 3.  Unless otherwise agreed in writing or expressly 
provided in the decree, the obligation to pay future maintenance 
is terminated upon the death of either party or the remarriage 
of the party receiving maintenance. 
    Subd. 4.  Unless otherwise agreed in writing or expressly 
provided in the decree order, provisions for the support of a 
child are terminated by emancipation of the child but not by the 
death of a parent obligated to support the child. When a parent 
obligated to pay support dies, the amount of support may be 
modified, revoked, or commuted to a lump sum payment, to the 
extent just and appropriate in the circumstances. 
    Subd. 5.  [FORM.] The department of human services shall 
prepare and make available to courts, obligors and persons to 
whom child support is owed a form to be submitted by the obligor 
or the person to whom child support is owed in support of a 
motion for a modification of an order pursuant to this section 
or section 256.87 for support or maintenance.  The rulemaking 
provisions of chapter 14 shall not apply to the preparation of 
the form. 
    Subd. 6.  [EXPEDITED PROCEDURE.] (a) The public authority 
may seek a modification of the child support order in accordance 
with the rules of civil procedure or under the expedited 
procedures in this subdivision.  
    (b) The public authority may serve the following documents 
upon the obligor either by certified mail or in the manner 
provided for service of a summons under the rules of civil 
procedure: 
    (i) a notice of its application for modification of the 
obligor's support order stating the amount and effective date of 
the proposed modification which date shall be no sooner than 30 
days from the date of service; 
    (ii) an affidavit setting out the basis for the 
modification under subdivision 2, including evidence of the 
current income of the parties; 
    (iii) any other documents the public authority intends to 
file with the court in support of the modification; 
    (iv) the proposed order; 
    (v) notice to the obligor that if the obligor fails to move 
the court and request a hearing on the issue of modification of 
the support order within 30 days of service of the notice of 
application for modification, the public authority will likely 
obtain an order, ex parte, modifying the support order; and 
    (vi) an explanation to the obligor of how a hearing can be 
requested, together with a motion for review form that the 
obligor can complete and file with the court to request a 
hearing. 
    (c) If the obligor moves the court for a hearing, any 
modification must be stayed until the court has had the 
opportunity to determine the issue.  Any modification ordered by 
the court is effective on the date set out in the notice of 
application for modification, but no earlier than 30 days 
following the date the obligor was served. 
    (d) If the obligor fails to move the court for hearing 
within 30 days of service of the notice, the public authority 
shall file with the court a copy of the notice served on the 
obligor as well as all documents served on the obligor, proof of 
service, and a proposed order modifying support. 
    (e) If, following judicial review, the court determines 
that the procedures provided for in this subdivision have been 
followed and the requested modification is appropriate, the 
order shall be signed ex parte and entered. 
    (f) Failure of the court to enter an order under this 
subdivision does not prejudice the right of the public authority 
or either party to seek modification in accordance with the 
rules of civil procedure. 
    (g) The supreme court shall develop standard forms for the 
notice of application of modification of the support order, the 
supporting affidavit, the obligor's responsive motion, and 
proposed order granting the modification. 
    Sec. 80.  Minnesota Statutes 1990, section 609.52, is 
amended by adding a subdivision to read: 
    Subd. 4.  [WRONGFULLY OBTAINED PUBLIC ASSISTANCE; 
CONSIDERATION OF DISQUALIFICATION.] When determining the 
sentence for a person convicted of theft by wrongfully obtaining 
public assistance, as defined in section 256.98, subdivision 1, 
the court shall consider the fact that, under section 256.98, 
subdivision 8, the person will be disqualified from receiving 
public assistance as a result of the person's conviction. 
    Sec. 81.  [STUDY.] 
    The commissioner of human services shall monitor the 
families who are unable to get child care subsidies through the 
basic sliding fee program after completing their year of 
transition child care and shall report findings to the 
legislature by January 1, 1993.  The report shall include, but 
not be limited to, the following data on these families:  the 
total number losing child care and the counties in which they 
live, the length of time for each family to reach the top of the 
waiting list, the number of families returning to AFDC while 
they are waiting for child care, and, if available, the type of 
child care arrangements made by families who lost child care 
subsidies.  
    Sec. 82.  [REPEALERS; PLAN.] 
    Subdivision 1.  [FAMILY INVESTMENT PLAN.] Minnesota 
Statutes 1990, sections 256.032, subdivisions 5 and 9; 256.035, 
subdivisions 6 and 7; and 256.036, subdivision 10, are repealed. 
    Subd. 2.  [GENERAL ASSISTANCE WORK READINESS.] Minnesota 
Statutes 1990, sections 256D.051, subdivisions 1b, 3c, and 16; 
256D.09, subdivision 4; and 256D.101, subdivision 2, are 
repealed. 
    Subd. 3.  [CHILD CARE.] Minnesota Statutes 1990, sections 
256H.25 and 256H.26; and Laws 1989, chapter 282, article 5, 
section 130, are repealed. 
    Sec. 83.  [INSTRUCTION TO THE REVISOR.] 
    In the next edition of Minnesota Statutes, the revisor of 
statutes shall renumber Minnesota Statutes, section 256.035, 
subdivision 4, as Minnesota Statutes, section 256.033, 
subdivision 1a. 
    Sec. 84.  [FUNDS ALLOCATION; FEDERAL CHILD CARE FUNDS.] 
    The commissioner shall consult with and consider the 
recommendations of the early childhood care and education 
council for the use of federal funds received for child care 
purposes.  After public hearing on the matter, the commissioner 
shall develop a state plan for expenditure of the federal funds, 
to include allocation of federal funds for the Minnesota early 
childhood care and education council for the biennium ending 
June 30, 1993.  Legislative hearings on the provisions of this 
section and sections 17; 32, subdivision 2b; 47 to 49; 52 to 55; 
58; 59; 70; and 71 constitute a public hearing as required by 
this section and by federal law. 
    Sec. 85.  [EFFECTIVE DATES.] 
    Subdivision 1.  [MINNESOTA FAMILY INVESTMENT 
PLAN.] Sections 12 to 21; 82, subdivision 1; and 83 are 
effective July 1, 1991, only for purposes of planning and 
securing federal waivers.  Actual implementation of the program 
is delayed until specifically authorized during the biennium 
beginning July 1, 1993. 
    Subd. 2.  [PUBLIC ASSISTANCE FRAUD.] Sections 26 and 80 are 
effective July 1, 1991, and apply to assistance wrongfully 
obtained after that date.  Sections 27, subdivision 2; and 29 
are effective the day following final enactment.  
    Subd. 3.  [OTHER ASSISTANCE PROVISIONS.] Sections 6 to 10, 
22 to 25, 30, 31, and 51 are effective the day after final 
enactment, except as indicated in section 9. 
    Subd. 4.  [CHILD SUPPORT.] Sections 4 and 78 are effective 
May 1, 1992.  Sections 75 and 77 are effective June 1, 1991.  
Sections 1 to 3 are effective January 1, 1992. 

                                ARTICLE 6

              MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
    Section 1.  Minnesota Statutes 1990, section 245.461, 
subdivision 3, is amended to read: 
    Subd. 3.  [REPORT.] By February 15, 1988, and annually 
after that until February 15, 1990 1994, the commissioner shall 
report to the legislature on all steps taken and recommendations 
for full implementation of sections 245.461 to 245.486 and on 
additional resources needed to further implement those sections. 
    Sec. 2.  Minnesota Statutes 1990, section 245.461, is 
amended by adding a subdivision to read: 
    Subd. 5.  [FUNDING FROM THE FEDERAL GOVERNMENT AND OTHER 
SOURCES.] The commissioner shall seek and apply for federal and 
other nonstate, nonlocal government funding for the mental 
health services specified in sections 245.461 to 245.486, in 
order to maximize nonstate, nonlocal dollars for these services. 
    Sec. 3.  Minnesota Statutes 1990, section 245.462, 
subdivision 6, is amended to read: 
    Subd. 6.  [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community 
support services program" means services, other than inpatient 
or residential treatment services, provided or coordinated by an 
identified program and staff under the clinical supervision of a 
mental health professional designed to help adults with serious 
and persistent mental illness to function and remain in the 
community.  A community support services program includes: 
    (1) client outreach, 
    (2) medication monitoring, 
    (3) assistance in independent living skills, 
    (4) development of employability and work-related 
opportunities, 
    (5) crisis assistance, 
    (6) psychosocial rehabilitation, 
    (7) help in applying for government benefits, and 
    (8) the development, identification, and monitoring of 
living arrangements housing support services.  
    The community support services program must be coordinated 
with the case management services specified in section 245.4711. 
    Sec. 4.  Minnesota Statutes 1990, section 245.462, 
subdivision 18, is amended to read: 
    Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
professional" means a person providing clinical services in the 
treatment of mental illness who is qualified in at least one of 
the following ways:  
    (1) in psychiatric nursing:  a registered nurse who is 
licensed under sections 148.171 to 148.285, and who is certified 
as a clinical specialist in adult psychiatric and mental health 
nursing by the American nurses association or who has a master's 
degree in nursing or one of the behavioral sciences or related 
fields from an accredited college or university or its 
equivalent, with at least 4,000 hours of post-master's 
supervised experience in the delivery of clinical services in 
the treatment of mental illness; 
    (2) in clinical social work:  a person licensed as an 
independent clinical social worker under section 148B.21, 
subdivision 6, or a person with a master's degree in social work 
from an accredited college or university, with at least 4,000 
hours of post-master's supervised experience in the delivery of 
clinical services in the treatment of mental illness; 
    (3) in psychology:  a psychologist licensed under sections 
148.88 to 148.98 who has stated to the board of psychology 
competencies in the diagnosis and treatment of mental illness; 
    (4) in psychiatry:  a physician licensed under chapter 147 
and certified by the American board of psychiatry and neurology 
or eligible for board certification in psychiatry; or 
    (5) in allied fields:  a person with a master's degree from 
an accredited college or university in one of the behavioral 
sciences or related fields, with at least 4,000 hours of 
post-master's supervised experience in the delivery of clinical 
services in the treatment of mental illness.  
    Sec. 5.  Minnesota Statutes 1990, section 245.4711, is 
amended by adding a subdivision to read: 
    Subd. 9.  [REVISION OF RULES.] (a) The commissioner, by 
July 1, 1992, shall revise existing rules governing case 
management services, in order to: 
    (1) make improvements in rule flexibility; 
    (2) establish a comprehensive coordination of services; 
    (3) require case managers to arrange for standardized 
assessments of side effects related to the administration of 
psychotropic medication; 
    (4) establish a reasonable caseload limit for case 
managers; 
    (5) provide reimbursement for transportation costs for case 
managers; and 
    (6) review the eligibility criteria for case management 
services covered by medical assistance. 
    (b) Until rule amendments are adopted under paragraph (a), 
in-county travel by case managers is reimbursable under the 
medical assistance program subject to the six-hour limit on case 
management services.  
    Sec. 6.  Minnesota Statutes 1990, section 245.472, 
subdivision 2, is amended to read: 
    Subd. 2.  [SPECIFIC REQUIREMENTS.] Providers of residential 
services must be licensed under applicable rules adopted by the 
commissioner and must be clinically supervised by a mental 
health professional.  Persons employed in facilities licensed 
under Minnesota Rules, parts 9520.0500 to 9520.0690, in the 
capacity of program director as of July 1, 1987, in accordance 
with Minnesota Rules, parts 9520.0500 to 9520.0690, may be 
allowed to continue providing clinical supervision within a 
facility until July 1, 1991, provided they continue to be 
employed as a program director in a facility licensed under 
Minnesota Rules, parts 9520.0500 to 9520.0690.  
    Sec. 7.  Minnesota Statutes 1990, section 245.472, is 
amended by adding a subdivision to read: 
    Subd. 4.  [ADMISSION, CONTINUED STAY, AND DISCHARGE 
CRITERIA.] No later than January 1, 1992, the county board shall 
ensure that placement decisions for residential services are 
based on the clinical needs of the adult.  The county board 
shall ensure that each entity under contract with the county to 
provide residential treatment services has admission, continued 
stay, discharge criteria and discharge planning criteria as part 
of the contract.  Contracts shall specify specific 
responsibilities between the county and service providers to 
ensure comprehensive planning and continuity of care between 
needed services according to data privacy requirements.  All 
contracts for the provision of residential services must include 
provisions guaranteeing clients the right to appeal under 
section 245.477 and to be advised of their appeal rights. 
    Sec. 8.  Minnesota Statutes 1990, section 245.473, is 
amended by adding a subdivision to read: 
    Subd. 3.  [ADMISSION, CONTINUED STAY, AND DISCHARGE 
CRITERIA.] No later than January 1, 1992, the county board shall 
ensure that placement decisions for acute care inpatient 
services are based on the clinical needs of the adult.  The 
county board shall ensure that each entity under contract with 
the county to provide acute care hospital treatment services has 
admission, continued stay, discharge criteria and discharge 
planning criteria as part of the contract.  Contracts shall 
specify specific responsibilities between the county and service 
providers to ensure comprehensive planning and continuity of 
care between needed services according to data privacy 
requirements.  All contracts for the provision of acute care 
hospital inpatient treatment services must include provisions 
guaranteeing clients the right to appeal under section 245.477 
and to be advised of their appeal rights.  
    Sec. 9.  Minnesota Statutes 1990, section 245.473, is 
amended by adding a subdivision to read: 
    Subd. 4.  [INDIVIDUAL PLACEMENT AGREEMENT.] Except for 
services reimbursed under chapters 256B and 256D, the county 
board shall enter into an individual placement agreement with a 
provider of acute care hospital inpatient treatment services to 
an adult eligible for services under this section.  The 
agreement must specify the payment rate and the terms and 
conditions of county payment for the placement.  
    Sec. 10.  Minnesota Statutes 1990, section 245.484, is 
amended to read: 
    245.484 [RULES.] 
    The commissioner shall adopt emergency rules to govern 
implementation of case management services for eligible children 
in section 245.4881 and professional home-based family treatment 
services for medical assistance eligible children, in section 
245.4884, subdivision 3, by January 1, 1992, and must adopt 
permanent rules by January 1, 1993. 
    The commissioner shall adopt permanent rules as necessary 
to carry out sections 245.461 to 245.486 and Laws 1989, chapter 
282, article 4, sections 1 to 53 245.487 to 245.4887.  The 
commissioner shall reassign agency staff as necessary to meet 
this deadline. 
    Sec. 11.  Minnesota Statutes 1990, section 245.487, 
subdivision 4, is amended to read: 
    Subd. 4.  [IMPLEMENTATION.] (a) The commissioner shall 
begin implementing sections 245.487 to 245.4887 by February 15, 
1990, and shall fully implement sections 245.487 to 245.4887 by 
January July 1, 1992 1993. 
    (b) Annually until February 15, 1992 1994, the commissioner 
shall report to the legislature on all steps taken and 
recommendations for full implementation of sections 245.487 to 
245.4887 and on additional resources needed to further implement 
those sections.  The report shall include information on county 
and state progress in identifying the needs of cultural and 
racial minorities and in using special mental health consultants 
to meet these needs. 
    Sec. 12.  Minnesota Statutes 1990, section 245.487, is 
amended by adding a subdivision to read: 
    Subd. 6.  [FUNDING FROM THE FEDERAL GOVERNMENT AND OTHER 
SOURCES.] The commissioner shall seek and apply for federal and 
other nonstate, nonlocal government funding for mental health 
services specified in sections 245.487 to 245.4887, in order to 
maximize nonstate, nonlocal dollars for these services. 
    Sec. 13.  Minnesota Statutes 1990, section 245.4871, 
subdivision 27, is amended to read: 
    Subd. 27.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
professional" means a person providing clinical services in the 
diagnosis and treatment of children's emotional disorders.  A 
mental health professional must have training and experience in 
working with children consistent with the age group to which the 
mental health professional is assigned.  A mental health 
professional must be qualified in at least one of the following 
ways:  
    (1) in psychiatric nursing, the mental health professional 
must be a registered nurse who is licensed under sections 
148.171 to 148.285 and who is certified as a clinical specialist 
in child and adolescent psychiatric or mental health nursing by 
the American nurses association or who has a master's degree in 
nursing or one of the behavioral sciences or related fields from 
an accredited college or university or its equivalent, with at 
least 4,000 hours of post-master's supervised experience in the 
delivery of clinical services in the treatment of mental 
illness; 
    (2) in clinical social work, the mental health professional 
must be a person licensed as an independent clinical social 
worker under section 148B.21, subdivision 6, or a person with a 
master's degree in social work from an accredited college or 
university, with at least 4,000 hours of post-master's 
supervised experience in the delivery of clinical services in 
the treatment of mental disorders; 
    (3) in psychology, the mental health professional must be a 
psychologist licensed under sections 148.88 to 148.98 who has 
stated to the board of psychology competencies in the diagnosis 
and treatment of mental disorders; 
    (4) in psychiatry, the mental health professional must be a 
physician licensed under chapter 147 and certified by the 
American board of psychiatry and neurology or eligible for board 
certification in psychiatry; or 
    (5) in allied fields, the mental health professional must 
be a person with a master's degree from an accredited college or 
university in one of the behavioral sciences or related fields, 
with at least 4,000 hours of post-master's supervised experience 
in the delivery of clinical services in the treatment of 
emotional disturbances. 
    Sec. 14.  Minnesota Statutes 1990, section 245.4871, 
subdivision 31, is amended to read: 
    Subd. 31.  [PROFESSIONAL HOME-BASED FAMILY TREATMENT.] 
"Professional home-based family treatment" means intensive 
mental health services provided to children because of an 
emotional disturbance (1) who are at risk of out-of-home 
placement; (2) who are in out-of-home placement; or (3) who are 
returning from out-of-home placement because of an emotional 
disturbance.  Services are provided to the child and the child's 
family primarily in the child's home environment or other 
location.  Services may also be provided in the child's school, 
child care setting, or other community setting appropriate to 
the child.  Examples of appropriate locations include, but are 
not limited to, the child's school, day care center, home, and 
any other living arrangement of the child.  Services must be 
provided on an individual family basis, must be child-oriented 
and family-oriented, and must be designed using information from 
diagnostic and functional assessments to meet the specific 
mental health needs of the child and the child's 
family.  Examples of services include family and are:  (1) 
individual therapy and; (2) family therapy; (3) client outreach; 
(4) assistance in developing individual living skills training 
and; (5) assistance in developing parenting skills necessary to 
address the needs of the child; (6) assistance with leisure and 
recreational services; (7) crisis assistance, including crisis 
respite care and arranging for crisis placement; and (8) 
assistance in locating respite and child care.  Services must be 
coordinated with other service providers services provided to 
the child and family.  
    Sec. 15.  Minnesota Statutes 1990, section 245.4871, is 
amended by adding a subdivision to read: 
     Subd. 33a.  [SPECIAL MENTAL HEALTH CONSULTANT.] "Special 
mental health consultant" is a mental health practitioner or 
professional with special expertise in treating children from a 
particular cultural or racial minority group. 
    Sec. 16.  Minnesota Statutes 1990, section 245.4873, 
subdivision 6, is amended to read: 
    Subd. 6.  [PRIORITIES.] By January 1, 1992, the 
commissioner shall require that each of the treatment services 
and management activities described in sections 245.487 to 
245.4887 be developed for children with emotional disturbances 
within available resources based on the following ranked 
priorities.  The commissioner shall reassign agency staff and 
use consultants as necessary to meet this deadline:  
    (1) the provision of locally available mental health 
emergency services; 
    (2) the provision of locally available mental health 
services to all children with severe emotional disturbance; 
    (3) the provision of early identification and intervention 
services to children who are at risk of needing or who need 
mental health services; 
    (4) the provision of specialized mental health services 
regionally available to meet the special needs of all children 
with severe emotional disturbance, and all children with 
emotional disturbances; 
    (5) the provision of locally available services to children 
with emotional disturbances; and 
    (6) the provision of education and preventive mental health 
services. 
    Sec. 17.  Minnesota Statutes 1990, section 245.4874, is 
amended to read: 
    245.4874 [DUTIES OF COUNTY BOARD.] 
    The county board in each county shall use its share of 
mental health and community social service act funds allocated 
by the commissioner according to a biennial local children's 
mental health service proposal required under section 245.4887, 
and approved by the commissioner.  The county board must: 
    (1) develop a system of affordable and locally available 
children's mental health services according to sections 245.487 
to 245.4887; 
    (2) 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; 
    (3) 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; 
    (4) 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; 
    (5) 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; 
    (6) 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; 
    (7) 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; 
    (8) 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; 
    (9) 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; and 
    (10) assure that children's mental health services are 
coordinated with adult mental health services specified in 
sections 245.461 to 245.486 so that a continuum of mental health 
services is available to serve persons with mental illness, 
regardless of the person's age; and 
    (11) assure that special 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. 
    Sec. 18.  Minnesota Statutes 1990, section 245.4881, 
subdivision 1, is amended to read: 
    Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
    (a) By July April 1, 1991 1992, the county board shall 
provide case management services for each child with severe 
emotional disturbance who is a resident of the county and the 
child's family who request or consent to the services.  Staffing 
ratios must be sufficient to serve the needs of the clients.  
The case manager must meet the requirements in section 245.4871, 
subdivision 4.  
    (b) Except as permitted by law and the commissioner under 
demonstration projects, case management services provided to 
children with severe emotional disturbance eligible for medical 
assistance must be billed to the medical assistance program 
under sections 256B.02, subdivision 8, and 256B.0625.  
    Sec. 19.  Minnesota Statutes 1990, section 245.4882, is 
amended by adding a subdivision to read: 
    Subd. 4.  [ADMISSION, CONTINUED STAY, AND DISCHARGE 
CRITERIA.] No later than January 1, 1992, the county board shall 
ensure that placement decisions for residential treatment 
services are based on the clinical needs of the child.  The 
county board shall ensure that each entity under contract to 
provide residential treatment services has admission, continued 
stay, discharge criteria and discharge planning criteria as part 
of the contract.  Contracts shall specify specific 
responsibilities between the county and service providers to 
ensure comprehensive planning and continuity of care between 
needed services according to data privacy requirements.  The 
county board shall ensure that, at least ten days prior to 
discharge, the operator of the residential treatment facility 
shall provide written notification of the discharge to the 
child's parent or caretaker, the local education agency in which 
the child is enrolled, and the receiving education agency to 
which the child will be transferred upon discharge.  When the 
child has an individual education plan, the notice shall include 
a copy of the individual education plan.  All contracts for the 
provision of residential services must include provisions 
guaranteeing clients the right to appeal under section 245.4886 
and to be advised of their appeal rights. 
    Sec. 20.  Minnesota Statutes 1990, section 245.4882, is 
amended by adding a subdivision to read: 
    Subd. 5.  [SPECIALIZED RESIDENTIAL TREATMENT SERVICES.] The 
commissioner of human services shall establish or contract for 
specialized residential treatment services for children.  The 
services shall be designed for children with emotional 
disturbance who exhibit violent or destructive behavior and for 
whom local treatment services are not feasible due to the small 
number of children statewide who need the services and the 
specialized nature of the services required.  The services shall 
be located in community settings.  If no appropriate services 
are available in Minnesota or within the geographical area in 
which the residents of the county normally do business, the 
commissioner is responsible for 50 percent of the nonfederal 
costs of out-of-state treatment of children for whom no 
appropriate resources are available in Minnesota.  Counties are 
eligible to receive enhanced state funding under this section 
only if they have established juvenile screening teams under 
section 260.151, subdivision 3.  
    Sec. 21.  Minnesota Statutes 1990, section 245.4883, is 
amended by adding a subdivision to read: 
    Subd. 3.  [ADMISSION, CONTINUED STAY, AND DISCHARGE 
CRITERIA.] No later than January 1, 1992, the county board shall 
ensure that placement decisions for acute care hospital 
inpatient treatment services are based on the clinical needs of 
the child and, if appropriate, the child's family.  The county 
board shall ensure that each entity under contract with the 
county to provide acute care hospital treatment services has 
admission, continued stay, discharge criteria and discharge 
planning criteria as part of the contract.  Contracts should 
specify the specific responsibilities between the county and 
service providers to ensure comprehensive planning and 
continuity of care between needed services according to data 
privacy requirements.  All contracts for the provision of acute 
care hospital inpatient treatment services must include 
provisions guaranteeing clients the right to appeal under 
section 245.4886 and to be advised of their appeal rights. 
    Sec. 22.  Minnesota Statutes 1990, section 245.4884, 
subdivision 1, is amended to read: 
    Subdivision 1.  [AVAILABILITY OF FAMILY COMMUNITY SUPPORT 
SERVICES.] By July 1, 1991, county boards must provide or 
contract for sufficient family community support services within 
the county to meet the needs of each child with severe emotional 
disturbance who resides in the county and the child's family.  
Children or their parents may be required to pay a fee in 
accordance with section 245.481.  
    Family community support services must be designed to 
improve the ability of children with severe emotional 
disturbance to:  
    (1) handle manage basic activities of daily living; 
    (2) improve functioning function appropriately in home, 
school, and community settings; 
    (3) participate in leisure time or community youth 
activities; 
    (4) set goals and plans; 
    (5) reside with the family in the community; 
    (6) participate in after-school and summer activities; 
    (7) make a smooth transition among mental health and 
education services provided to children; and 
    (8) make a smooth transition into the adult mental health 
system as appropriate.  
    In addition, family community support services must be 
designed to improve overall family functioning if clinically 
appropriate to the child's needs, and to reduce the need for and 
use of placements more intensive, costly, or restrictive both in 
the number of admissions and lengths of stay than indicated by 
the child's diagnostic assessment.  
    Sec. 23.  Minnesota Statutes 1990, section 245.4885, 
subdivision 1, is amended to read: 
    Subdivision 1.  [SCREENING REQUIRED.] The county board 
shall, upon prior to admission, except in the case of emergency 
admission, screen all children admitted referred for treatment 
of severe emotional disturbance to a residential treatment 
facility, an acute care hospital, or informally admitted to a 
regional treatment center if public funds are used to pay for 
the services.  The county board shall also screen 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 of emotional 
disturbance or held for emergency care by a regional treatment 
center under section 253B.05, subdivision 1, screening must 
occur within five three working days of admission.  Screening 
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. 
    Screening shall include both a diagnostic assessment and a 
functional assessment which evaluates family, school, and 
community living situations.  If a diagnostic assessment or 
functional assessment has been completed by a mental health 
professional within 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 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 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 shall be in compliance with section 256F.07 or 
257.071, whichever applies.  Wherever possible, the parent shall 
be consulted in the screening process, unless clinically 
inappropriate.  
    The screening process, 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 (5) (4).  
    Sec. 24.  Minnesota Statutes 1990, section 245.4885, 
subdivision 2, is amended to read: 
    Subd. 2.  [QUALIFICATIONS.] No later than July 1, 1991, 
screening of children for residential and inpatient services 
must be conducted by a mental health professional.  Where 
appropriate and available, special mental health consultants 
must participate in the screening.  Mental health professionals 
providing screening for inpatient and residential services must 
not be financially affiliated with any acute care inpatient 
hospital, residential treatment facility, or regional treatment 
center.  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. 
    Sec. 25.  Minnesota Statutes 1990, section 245.4885, is 
amended by adding a subdivision to read: 
    Subd. 5.  [SUMMARY DATA COLLECTION.] The county board shall 
annually collect summary information on the number of children 
screened, the age and racial or ethnic background of the 
children, the presenting problem, and the screening 
recommendations.  The county shall include information on the 
degree to which these recommendations are followed and the 
reasons for not following recommendations.  Summary data shall 
be available to the public and shall be used by the county board 
and local children's advisory council to identify needed service 
development.  
    Sec. 26.  [245.4888] [CHILDREN'S COMMUNITY-BASED MENTAL 
HEALTH FUND.] 
    Subdivision 1.  [STATEWIDE PROGRAM; ESTABLISHMENT.] The 
commissioner shall establish a statewide program to assist 
counties in providing services to children with severe emotional 
disturbance as defined in section 245.4871, subdivision 15, and 
their families.  Services must be designed to help each child to 
function and remain with the child's family in the community.  
The commissioner shall make grants to counties to establish, 
operate, or contract with private providers to provide the 
following services in the following order of priority when these 
cannot be reimbursed under section 256B.0625: 
    (1) family community support services including crisis 
placement and crisis respite care as specified in section 
245.4871, subdivision 17; 
    (2) case management services as specified in section 
245.4871, subdivision 3; 
    (3) day treatment services as specified in section 
245.4871, subdivision 10; 
    (4) professional home-based family treatment as specified 
in section 245.4871, subdivision 31; and 
    (5) therapeutic support of foster care as specified in 
section 245.4871, subdivision 34. 
    Funding appropriated beginning July 1, 1991, must be used 
by county boards to provide family community support services 
and case management services.  Additional services shall be 
provided in the order of priority as identified in this 
subdivision. 
    Subd. 2.  [GRANT APPLICATION AND REPORTING 
REQUIREMENTS.] To apply for a grant a county board shall submit 
an application and budget for the use of the money in the form 
specified by the commissioner.  The commissioner shall make 
grants only to counties whose applications and budgets are 
approved by the commissioner.  In awarding grants, the 
commissioner shall give priority to those counties whose 
applications indicate plans to collaborate in the development, 
funding, and delivery of services with other agencies in the 
local system of care.  The commissioner may adopt emergency and 
permanent rules to govern grant applications, approval of 
applications, allocation of grants, and maintenance of financial 
statements by grant recipients and may establish grant 
requirements for the fiscal year ending June 30, 1992, without 
adopting rules.  The commissioner shall specify requirements for 
reports, including quarterly fiscal reports, according to 
section 256.01, subdivision 2, paragraph (17).  The commissioner 
shall require collection of data and periodic reports which the 
commissioner deems necessary to demonstrate the effectiveness of 
each service in realizing the stated purpose as specified for 
family community support in section 245.4884, subdivision 1; 
therapeutic support of foster care in section 245.4884, 
subdivision 4; professional home-based family treatment in 
section 245.4884, subdivision 3; day treatment in section 
245.4884, subdivision 2; and case management in section 245.4881.
    Sec. 27.  Minnesota Statutes 1990, section 245.697, 
subdivision 1, is amended to read: 
    Subdivision 1.  [CREATION.] A state advisory council on 
mental health is created.  The council must have 30 members 
appointed by the governor in accordance with federal 
requirements.  The council must be composed of:  
    (1) the assistant commissioner of mental health for the 
department of human services; 
    (2) a representative of the department of human services 
responsible for the medical assistance program; 
    (3) one member of each of the four core mental health 
professional disciplines (psychiatry, psychology, social work, 
nursing); 
    (4) one representative from each of the following advocacy 
groups:  mental health association of Minnesota, Minnesota 
alliance for the mentally ill, and Minnesota mental health law 
project; 
    (5) providers of mental health services; 
    (6) consumers of mental health services; 
    (7) family members of persons with mental illnesses; 
    (8) legislators; 
    (9) social service agency directors; 
    (10) county commissioners; and 
    (11) other members reflecting a broad range of community 
interests, as the United States Secretary of Health and Human 
Services may prescribe by regulation or as may be selected by 
the governor. 
    The council shall select a chair.  Terms, compensation, and 
removal of members and filling of vacancies are governed by 
section 15.059.  The council does not expire as provided in 
section 15.059.  The commissioner of human services shall 
provide staff support and supplies to the council. 
    Sec. 28.  Minnesota Statutes 1990, section 246.18, 
subdivision 4, is amended to read: 
    Subd. 4.  [COLLECTIONS DEPOSITED IN MEDICAL ASSISTANCE 
ACCOUNT.] Except as provided in subdivision subdivisions 2 and 
5, all receipts from collection efforts for the regional 
treatment centers, state nursing homes, and other state 
facilities as defined in section 246.50, subdivision 3, must be 
deposited in the medical assistance account and are appropriated 
for that purpose.  The commissioner shall ensure that the 
departmental financial reporting systems and internal accounting 
procedures comply with federal standards for reimbursement for 
program and administrative expenditures and fulfill the purpose 
of this paragraph. 
    Sec. 29.  Minnesota Statutes 1990, section 246.18, is 
amended by adding a subdivision to read: 
    Subd. 5.  [FUNDED DEPRECIATION ACCOUNTS FOR STATE-OPERATED, 
COMMUNITY-BASED PROGRAMS.] Separate interest-bearing funded 
depreciation accounts shall be established in the state treasury 
for state-operated, community-based programs meeting the 
definition of a facility in Minnesota Rules, part 9553.0020, 
subpart 19, or a vendor in section 252.41, subdivision 9.  As 
payments for state-operated community-based services are 
received by the commissioner, the portion of the payment rate 
representing allowable depreciation expense and the capital debt 
reduction allowance shall be deposited in the state treasury and 
credited to the separate interest-bearing accounts as dedicated 
receipts with unused funds carried over to the next fiscal 
year.  Funds within these funded depreciation accounts are 
appropriated to the commissioner of human services for the 
purchase or replacement of capital assets or payment of 
capitalized repairs for each respective program.  These accounts 
will satisfy the requirements of Minnesota Rules, part 
9553.0060, subparts 1, item E, and 5.  
    Sec. 30.  Minnesota Statutes 1990, section 251.011, 
subdivision 3, is amended to read: 
    Subd. 3.  [AH-GWAH-CHING NURSING HOME CENTER.] When 
tuberculosis treatment is discontinued at Ah-Gwah-Ching that 
facility may be used by the commissioner of human services for 
the care of geriatric patients, and shall be known as the 
Ah-Gwah-Ching Nursing Home Center. 
    Sec. 31.  Minnesota Statutes 1990, section 251.011, 
subdivision 4a, is amended to read: 
    Subd. 4a.  [NURSING HOME BEDS AT REGIONAL TREATMENT 
CENTERS.] The commissioner shall operate the following number of 
nursing home beds at regional treatment centers in addition to 
current capacity:  at Brainerd, 105 beds; at Cambridge, 70 beds; 
and at Fergus Falls, 85 beds.  The commissioner may operate 
nursing home beds at other regional treatment centers as 
necessary to provide an appropriate level of care for persons 
served at those centers.  The commissioner shall develop the 
regional treatment center nursing home beds authorized in the 
worksheets of the house appropriations and senate finance 
committees.  The commissioner shall finance the purchase or 
construction of the nursing home beds with the Minnesota housing 
finance agency.  The commissioner shall make payments through 
the department of administration to the Minnesota housing 
finance agency in repayment of mortgage loans granted for the 
purposes of this section. 
    Sec. 32.  Minnesota Statutes 1990, section 252.27, 
subdivision 1a, is amended to read: 
    Subd. 1a.  [DEFINITIONS.] A person has a "related 
condition" if that person has a severe, chronic disability that 
is meets all of the following conditions:  (a) is attributable 
to cerebral palsy, epilepsy, autism, Prader-Willi syndrome, or 
any other condition, other than mental illness, found to be 
closely related to mental retardation because the condition 
results in impairment of general intellectual functioning or 
adaptive behavior similar to that of persons with mental 
retardation or and requires treatment or services similar to 
those required for persons with mental retardation; (b) is 
manifested before the person reaches 22 years of age; (c) is 
likely to continue indefinitely; and (c) (d) results in 
substantial functional limitations in three or more of the 
following areas of major life activity:  (1) self-care, (2) 
understanding and use of language, (3) learning, (4) mobility, 
(5) self-direction, or (6) capacity for independent living.  For 
the purposes of this section, a child has an "emotional 
handicap" if the child has a psychiatric or other emotional 
disorder which substantially impairs the child's mental health 
and requires 24-hour treatment or supervision. 
    Sec. 33.  Minnesota Statutes 1990, section 252.27, 
subdivision 2a, is amended to read: 
    Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
adoptive parents of a minor child, including a child determined 
eligible for medical assistance without consideration of 
parental income, must contribute monthly to the cost of 
services, unless the child is married or has been married, 
parental rights have been terminated, or the child's adoption is 
subsidized according to section 259.40 or through title IV-E of 
the Social Security Act. 
    (b) The parental contribution equals the following 
percentage of that portion of shall be computed by applying to 
the adjusted gross income of the natural or adoptive parents 
that exceeds 200 percent of the federal poverty guidelines for 
the applicable household size, the following schedule of rates: 
        Adjusted Gross         Percentage contribution
            Income         exceeding 200 percent of poverty
        Under $49,999                     10 
     $50,000 to $59,999                   12 
     $60,000 to $74,999                   14 
       $75,000 or more                    15
    (1) on the amount of adjusted gross income over 200 percent 
of poverty, but not over $50,000, ten percent; 
    (2) on the amount of adjusted gross income over 200 percent 
of poverty and over $50,000 but not over $60,000, 12 percent; 
    (3) on the amount of adjusted gross income over 200 percent 
of poverty, and over $60,000 but not over $75,000, 14 percent; 
and 
    (4) on all adjusted gross income amounts over 200 percent 
of poverty, and over $75,000, 15 percent. 
    If the child lives with the parent, the parental 
contribution is reduced by $200.  If the child resides in an 
institution specified in section 256B.35, the parent is 
responsible for the personal needs allowance specified under 
that section in addition to the parental contribution determined 
under this section.  The parental contribution is reduced by any 
amount required to be paid directly to the child pursuant to a 
court order, but only if actually paid. 
    (c) The household size to be used in determining the amount 
of contribution under paragraph (b) includes natural and 
adoptive parents and their dependents under age 21, including 
the child receiving services.  Adjustments in the contribution 
amount due to annual changes in the federal poverty guidelines 
shall be implemented on the first day of July following 
publication of the changes. 
    (d) For purposes of paragraph (b), "income" means the 
adjusted gross income of the natural or adoptive parents 
determined according to the previous year's federal tax form. 
    (e) The contribution shall be explained in writing to the 
parents at the time eligibility for services is being 
determined.  The contribution shall be made on a monthly basis 
effective with the first month in which the child receives 
services.  Annually upon redetermination or at termination of 
eligibility, if the contribution exceeded the cost of services 
provided, the local agency or the state shall reimburse that 
excess amount to the parents, either by direct reimbursement if 
the parent is no longer required to pay a contribution, or by a 
reduction in or waiver of parental fees until the excess amount 
is exhausted. 
     (f) The monthly contribution amount must be reviewed at 
least every 12 months; when there is a change in household size; 
and when there is a loss of or gain in income from one month to 
another in excess of ten percent.  The local agency shall mail a 
written notice 30 days in advance of the effective date of a 
change in the contribution amount.  A decrease in the 
contribution amount is effective in the month that the parent 
verifies a reduction in income or change in household size. 
     (g) Parents of a minor child who do not live with each 
other shall each pay the contribution required under paragraph 
(a), except that a court-ordered child support payment actually 
paid on behalf of the child receiving services shall be deducted 
from the contribution of the parent making the payment. 
    (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. 
    Sec. 34.  Minnesota Statutes 1990, section 252.275, is 
amended to read: 
    252.275 [SEMI-INDEPENDENT LIVING SERVICES FOR PERSONS WITH 
MENTAL RETARDATION OR RELATED CONDITIONS.] 
    Subdivision 1.  [PROGRAM.] The commissioner of human 
services shall establish a statewide program to assist counties 
in reducing the utilization of intermediate care services in 
state hospitals and in community residential facilities, 
including nursing homes, provide support for persons with mental 
retardation or related conditions to live as independently as 
possible in the community.  An objective of the program is to 
reduce unnecessary use of intermediate care facilities for 
persons with mental retardation or related conditions and home 
and community-based services.  The commissioner shall make 
grants to reimburse county boards to establish, operate, or 
contract for the provision of semi-independent living services 
licensed by the commissioner pursuant to sections 245A.01 to 
245A.16 and 252.28, and for the provision of one-time living 
allowances to secure and furnish a home for a person who will 
receive semi-independent living services under this section, if 
other public funds are not available for the allowance.  
    For the purposes of this section, "semi-independent living 
services" means training and assistance in managing money, 
preparing meals, shopping, maintaining personal appearance and 
hygiene, and other activities which are needed to maintain and 
improve an adult with mental retardation or a related 
condition's capability to live in the community.  Eligible 
persons must be age 18 or older, must need less than a 24-hour 
plan of care, and must be unable to function independently 
without semi-independent living services. 
    Semi-independent living services costs and one-time living 
allowance costs may be paid directly by the county, or may be 
paid by the recipient with a voucher or cash issued by the 
county. 
    Subd. 1a.  [SERVICE REQUIREMENTS.] The methods, materials, 
and settings used to provide semi-independent living services to 
a person must be designed to: 
    (1) increase the person's independence in performing tasks 
and activities by teaching skills that reduce dependence on 
caregivers; 
    (2) provide training in an environment where the skill 
being taught is typically used; 
    (3) increase the person's opportunities to interact with 
nondisabled individuals who are not paid caregivers; 
    (4) increase the person's opportunities to use community 
resources and participate in community activities, including 
recreational, cultural, and educational resources, stores, 
restaurants, religious services, and public transportation; 
    (5) increase the person's opportunities to develop 
decision-making skills and to make informed choices in all 
aspects of daily living, including: 
    (i) selection of service providers; 
    (ii) goals and methods; 
    (iii) location and decor of residence; 
    (iv) roommates; 
    (v) daily routines; 
    (vi) leisure activities; and 
    (vii) personal possessions; 
    (6) provide daily schedules, routines, environments and 
interactions similar to those of nondisabled individuals of the 
same chronological age; and 
    (7) comply with section 245.825, subdivision 1. 
    Subd. 2.  [APPLICATION; CRITERIA.] To apply for a grant, a 
county board shall submit an application and budget for use of 
grant money in the form specified by the commissioner.  The 
commissioner shall make grants only to counties whose 
applications and budgets or portions thereof are approved by the 
commissioner.  
    Subd. 3.  [REIMBURSEMENT.] On or before September 1 of each 
year, the commissioner shall allocate available funds to the 
counties which have approved plans and budgets.  The 
commissioner shall disburse the funds on a quarterly basis 
during the fiscal year to reimburse counties for costs incurred 
in providing services to individual clients in accordance with 
the approved plans and budgets.  Counties shall be reimbursed 
for all expenditures made pursuant to subdivision 1 at a rate of 
70 percent, up to the allocation determined pursuant to 
subdivisions 4, 4a, and 4b.  However, the commissioner shall not 
reimburse costs of services for any person if the costs exceed 
the state share of the average medical assistance costs for 
services provided by intermediate care facilities for a person 
with mental retardation or a related condition for the same 
fiscal year, and shall not reimburse costs of a one-time living 
allowance for any person if the costs exceed $1,500 in a state 
fiscal year.  For the biennium ending June 30, 1993, the 
commissioner shall not reimburse costs in excess of the 85th 
percentile of hourly service costs based upon the cost 
information supplied to the legislature in the proposed budget 
for the biennium.  The commissioner may make payments to each 
county in quarterly installments.  The commissioner may certify 
an advance of up to 25 percent of the allocation.  Subsequent 
payments shall be made on a reimbursement basis for reported 
expenditures and may be adjusted for anticipated spending 
patterns.  
    Subd. 4.  [FORMULA.] From the appropriations made available 
for this program, the commissioner shall allocate grants under 
this section to finance up to 95 percent of each county's 
approved budget for semi-independent living services for persons 
with mental retardation or related conditions.  The commissioner 
shall not approve budgeted costs for services for any person 
which exceed the state share of the average medical assistance 
costs for services provided by intermediate care facilities for 
a person with mental retardation or a related condition for the 
same fiscal year.  Effective January 1, 1992, the commissioner 
shall allocate funds on a calendar year basis.  For calendar 
year 1992, funds shall be allocated based on each county's 
portion of the statewide reimbursement received under this 
section for state fiscal year 1991.  For subsequent calendar 
years, funds shall be allocated based on each county's portion 
of the statewide expenditures eligible for reimbursement under 
this section during the 12 months ending on June 30 of the 
preceding calendar year. 
    If the legislature appropriates funds for special purposes, 
the commissioner may allocate the funds based on proposals 
submitted by the counties to the commissioner in a format 
prescribed by the commissioner.  Nothing in this subdivision 
section prevents a county from using other funds to pay for 
additional costs of semi-independent living services. 
    As of July 1, 1987, the commissioner shall allocate funds 
and reimburse county costs for persons approved for funding.  
The commissioner shall proportionally allocate funds to counties 
based on the approved budgeted costs for persons approved for 
funding.  The commissioner shall adjust county grants based on 
actual approved expenditures and shall reallocate funds to the 
extent necessary.  The commissioner may set aside up to two 
percent of the appropriations to fund county demonstration 
projects that improve the efficiency and effectiveness of 
semi-independent living services. 
    Subd. 4a.  [FORMULA LIMITATION.] For calendar year 1993 and 
all subsequent years, the amounts computed pursuant to 
subdivision 4 shall be subject to the following limitation:  no 
county shall be allocated an amount less than its guaranteed 
floor as provided in subdivision 4b.  If the amount allocated to 
any county pursuant to subdivision 4 would be less than its 
guaranteed floor, the shortage shall be recovered proportionally 
from all counties which would be allocated more than their 
guaranteed floor. 
    Subd. 4b.  [GUARANTEED FLOOR.] Each county with an original 
allocation for the preceding year that is equal to or less than 
the guaranteed floor minimum index shall have a guaranteed floor 
equal to its original allocation for the preceding year.  Each 
county with an original allocation for the preceding year that 
is greater than the guaranteed floor minimum index shall have a 
guaranteed floor equal to the lesser of clause (1) or (2): 
    (1) the county's original allocation for the preceding 
year; or 
    (2) 70 percent of the county's reported expenditures 
eligible for reimbursement during the 12 months ending on June 
30 of the preceding calendar year. 
    For calendar year 1993, the guaranteed floor minimum index 
shall be $20,000.  For each subsequent year, the index shall be 
adjusted by the projected change in the average value in the 
United States Department of Labor Bureau of Labor Statistics 
consumer price index (all urban) for that year. 
    When the amount of funds available for allocation is less 
than the amount available in the previous year, each county's 
previous year allocation shall be reduced in proportion to the 
reduction in the statewide funding, to establish each county's 
guaranteed floor. 
    Subd. 4c.  [REVIEW OF FUNDS; REALLOCATION.] After each 
quarter, the commissioner shall review county program 
expenditures.  The commissioner may reallocate unexpended money 
at any time among those counties which have earned their full 
allocation. 
    Subd. 5.  [DISPLACED HOSPITAL WORKERS.] Providers of 
semi-independent living services shall make reasonable efforts 
to hire qualified employees of state hospital regional treatment 
center mental retardation units who have been displaced by 
reorganization, closure, or consolidation of state hospital 
regional treatment center mental retardation units.  
    Subd. 6.  [RULES.] The commissioner shall may adopt 
emergency and permanent rules in accordance with chapter 14 to 
govern grant applications, criteria for approval of 
applications, allocation of grants, and maintenance of program 
and financial statements by grant recipients, reimbursement, and 
compliance.  
    Subd. 7.  [REPORTS.] The commissioner shall specify 
requirements for reports, including quarterly fiscal and annual 
program reports, according to section 256.01, subdivision 2, 
paragraph (17).  
    Subd. 8.  [USE OF FEDERAL FUNDS.] The commissioner shall 
make every reasonable effort to maximize the use of federal 
funds for semi-independent living services. 
    Subd. 9.  [COMPLIANCE.] If a county board or provider under 
contract with a county board to provide semi-independent living 
services does not comply with this section and the rules adopted 
by the commissioner of human services under this section, 
including the reporting requirements, the commissioner may 
recover, suspend, or withhold payments. 
    Sec. 35.  Minnesota Statutes 1990, section 252.28, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DETERMINATIONS; BIENNIAL 
REDETERMINATIONS.] In conjunction with the appropriate county 
boards, the commissioner of human services shall determine, and 
shall redetermine biennially, the need, location, size, and 
program of public and private residential services and day care 
facilities and training and habilitation services for children 
and adults persons with mental retardation or related 
conditions.  This subdivision does not apply to semi-independent 
living services and residential-based habilitation services 
provided to four or fewer persons at a single site funded as 
home and community-based services. 
    Sec. 36.  Minnesota Statutes 1990, section 252.28, 
subdivision 3, is amended to read: 
    Subd. 3.  [LICENSING DETERMINATIONS.] (1) No new license 
shall be granted pursuant to this section when the issuance of 
the license would substantially contribute to an excessive 
concentration of community residential facilities within any 
town, municipality or county of the state. 
    (2) In determining whether a license shall be issued 
pursuant to this subdivision, the commissioner of human services 
shall specifically consider the population, size, land use plan, 
availability of community services and the number and size of 
existing public and private community residential facilities in 
the town, municipality or county in which a licensee seeks to 
operate a residence.  Under no circumstances may the 
commissioner newly license any facility pursuant to this section 
except as provided in section 245A.11.  The commissioner of 
human services shall establish uniform rules to implement the 
provisions of this subdivision. 
    (3) Licenses for community facilities and services shall be 
issued pursuant to section 245.821. 
    (4) No new license shall be granted for a residential 
program that provides home and community-based waivered services 
to more than four individuals at a site, except as authorized by 
the commissioner for emergency situations that would result in 
the placement of individuals into regional treatment centers.  
Such licenses shall not exceed 24 months.  
    (5) The commissioner shall not approve a determination of 
need application that requests that an existing residential 
program license under Minnesota Rules, parts 9525.0215 to 
9525.0355 be modified in a manner that would result in the 
issuance of two or more licenses for the same residential 
program at the same location.  
    Sec. 37.  Minnesota Statutes 1990, section 252.28, is 
amended by adding a subdivision to read: 
    Subd. 5.  [APPEALS.] A county may appeal a determination of 
need, size, location, or program according to chapter 14.  
Notice of appeals must be provided to the commissioner within 30 
days after the receipt of the commissioner's determination.  
    Sec. 38.  [252.293] [EMERGENCY RELOCATIONS.] 
    Subdivision 1.  [EMERGENCY TRANSFERS.] In emergency 
situations, the commissioner of human services may order the 
relocation of existing intermediate care facility for persons 
with mental retardation or related conditions beds, transfer 
residents, and establish an interim payment rate under the 
procedures contained in Minnesota Rules, part 9553.0075, for up 
to two years, as necessary to ensure the replacement of the 
original services for the residents.  The payment rate must be 
based on projected costs and is subject to settle up.  An 
emergency situation exists when it appears to the commissioner 
of human services that the health, safety, or welfare of 
residents may be in jeopardy due to imminent or actual loss of 
use of the physical plant or damage to the physical plant making 
it temporarily or permanently uninhabitable.  The subsequent 
rate for a facility providing services for the same resident 
following the temporary emergency situation must be based upon 
the costs incurred during the interim period if the residents 
are permanently placed in the same facility.  If the residents 
need to be relocated for permanent placements, the temporary 
emergency location must close and the procedures for 
establishing rates for newly constructed or newly established 
facilities must be followed.  This provision regarding emergency 
situations does not apply to facilities placed in receivership 
by the commissioner of human services under section 245A.12 or 
245A.13, or facilities that have rates set under section 
252.292, subdivision 4, or to relocations of residents to 
existing facilities. 
    Subd. 2.  [APPROVAL OF TEMPORARY LOCATIONS.] The 
commissioner of human services shall notify the commissioner of 
health of the existence of the emergency and the decision to 
order the relocation of residents.  This notice shall also 
identify the temporary location or locations selected by the 
commissioner of human services for the relocation of the 
residents.  Notwithstanding the provisions of section 252.291, 
the commissioner of health may license and certify the temporary 
location or locations as an intermediate care facility for 
persons with mental retardation or related conditions if the 
location complies with the applicable state rules and federal 
regulations.  The facility from which the residents were 
relocated shall not be used to house residents until the 
commissioner of human services authorizes the return of 
residents to the facility and the commissioner of health 
verifies that the facility complies with the applicable state 
and federal regulations.  If the temporary location closes under 
the provisions of subdivision 1, the license and certification 
of the temporary location is voided.  The voiding of the license 
and certification shall not be considered as a suspension, 
revocation, or nonrenewal of the license or as an involuntary 
decertification of the facility. 
    Sec. 39.  Minnesota Statutes 1990, section 252.32, is 
amended to read: 
    252.32 [FAMILY SUBSIDY SUPPORT PROGRAM.] 
    Subdivision 1.  [PROGRAM ESTABLISHED; APPLICATION.] In 
accordance with state policy established in section 256F.01 that 
all children are entitled to live in families that offer safe, 
nurturing, permanent relationships, and that public services be 
directed toward preventing the unnecessary separation of 
children from their families, and because many families who have 
children with mental retardation or related conditions have 
special needs and expenses that other families do not have, the 
commissioner of human services shall establish a program 
to provide subsidies to families to enable them to care for 
their dependents with handicaps in their own home assist 
families who have dependents with mental retardation or related 
conditions living in their home.  The program shall make support 
grants available to the families. 
    Subd. 1a.  [SUPPORT GRANTS.] This program (a) Provision of 
support grants must be limited to families who require support 
and whose dependents are under the age of 22 and who are 
mentally retarded or who have mental retardation or who have a 
related condition and otherwise would require or be eligible for 
placement in a licensed residential facility as set forth in 
section 245A.02, subdivision 6 who have been determined by a 
screening team established under section 256B.092 to require the 
level of care provided by an intermediate care facility for 
persons with mental retardation or related conditions.  Families 
who are receiving home and community-based waivered services are 
not eligible for support grants.  Families whose annual adjusted 
gross income is $60,000 or more are not eligible for support 
grants except in cases where extreme hardship is demonstrated.  
Beginning in state fiscal year 1994, the commissioner shall 
adjust the income ceiling annually to reflect the projected 
change in the average value in the United States Department of 
Labor Bureau of Labor Statistics consumer price index (all 
urban) for that year. 
    (b) Support grants may be made available as monthly subsidy 
grants and lump sum grants. 
    (c) Support grants may be issued in the form of cash, 
voucher, and direct county payment to a vendor.  
    (d) Applications for the subsidy support grant shall be 
made by the county social service agency to the department of 
human services.  The application shall specify the needs of the 
family, the form of the grant requested by the family, and how 
the subsidy will be used family intends to use the support grant 
and recommendations of the county.  
    (e) Families who were receiving subsidies on the date of 
implementation of the $60,000 income limit in paragraph (a) 
continue to be eligible for a family support grant until 
December 31, 1991, if all other eligibility criteria are met.  
After December 31, 1991, these families are eligible for a grant 
in the amount of one-half the grant they would otherwise 
receive, for as long as they remain eligible under other 
eligibility criteria. 
    Subd. 2.  [INDIVIDUAL SERVICE PLAN.] Before a support grant 
is issued, an individual service plan for the dependent as 
required by section 256E.08 and the rules adopted thereunder, or 
an individual service plan as requested by the family and 
defined in 256B.092, shall be developed by the county social 
service agency and agreed upon by the parents.  A transitional 
plan shall be developed for the dependent when the dependent 
turns age 17 in order to assure an orderly transition to other 
services when the family terminates services from this program 
and to assure that an application is made for supplemental 
security income and other benefits.  
    Subd. 3.  [SUBSIDY AMOUNT OF SUPPORT GRANT; USE.] Subsidy 
Support grant amounts shall be determined by the commissioner of 
human services.  The subsidy may be used to cover the costs of 
special equipment, special clothing or diets, related 
transportation, therapy, medications, respite care, medical 
care, diagnostic assessments, modifications to the home and 
vehicle, and other services or items that assist the family and 
dependent.  Each service and item purchased with a support grant 
must: 
    (1) be over and above the normal costs of caring for the 
dependent if the dependent did not have a disability; 
    (2) be directly attributable to the dependent's disabling 
condition; and 
    (3) enable the family to delay or prevent the out-of-home 
placement of the dependent. 
    The design and delivery of services and items purchased 
under this section must suit the dependent's chronological age 
and be provided in the least restrictive environment possible, 
consistent with the needs identified in the individual service 
plan. 
    Items and services purchased with support grants must be 
those for which there are no other public or private funds 
available to the family.  Fees assessed to parents for health or 
human services that are funded by federal, state, or county 
dollars are not reimbursable through this program. 
    The maximum monthly amount shall be $250 per eligible 
dependent, or $3,000 per eligible dependent per state fiscal 
year, within the limits of available funds.  During fiscal year 
1992 and 1993, the maximum monthly grant awarded to families who 
are eligible for medical assistance shall be $200, except in 
cases where extreme hardship is demonstrated.  The commissioner 
may consider the child's dependent's supplemental security 
income in determining the amount of the subsidy support grant.  
A variance may be granted by the commissioner to exceed 
$250 $3,000 per state fiscal year per eligible dependent for 
emergency circumstances in cases where exceptional resources of 
the family are required to meet the health, welfare-safety needs 
of the child, for a period not to exceed 90 days per fiscal 
year.  The commissioner may set aside one up to five percent of 
the appropriation to fund emergency situations.  
    Subd. 3a.  [REPORTS AND REIMBURSEMENT.] The commissioner 
shall specify requirements for quarterly fiscal and annual 
program reports according to section 256.01, subdivision 2, 
paragraph (17).  Program reports shall include data which will 
enable the commissioner to evaluate program effectiveness and to 
audit compliance.  The commissioner shall reimburse county costs 
on a quarterly basis. 
    Subd. 3b.  [FEDERAL FUNDS.] The commissioner and the 
counties shall make every reasonable effort to maximize the use 
of federal funds for family supports. 
    Subd. 3c.  [COUNTY BOARD RESPONSIBILITIES.] County boards 
receiving funds under this section shall:  
    (1) determine the needs of families for services in 
accordance with section 256B.092 or 256E.08 and any rules 
adopted under those sections; 
    (2) determine the eligibility of all persons proposed for 
program participation; 
    (3) recommend for approval all items and services to be 
reimbursed and inform families of the commissioner's approval 
decision; 
    (4) issue support grants directly to, or on behalf of, 
eligible families; 
    (5) inform recipients of their right to appeal under 
subdivision 3e; 
    (6) submit quarterly financial reports under subdivision 
3b; and 
    (7) coordinate services with other programs offered by the 
county. 
    Subd. 3d.  [APPEALS.] The denial, suspension, or 
termination of services under this program may be appealed by a 
recipient or application under section 256.045, subdivision 3. 
    Subd. 4.  [RULEMAKING.] The commissioner shall amend 
permanent rules to govern subsidy grant applications under this 
section, criteria for approval, and other areas necessary to 
implement this program.  
    Subd. 5.  [COMPLIANCE.] If a county board or grantee does 
not comply with this section and the rules adopted by the 
commissioner of human services, the commissioner may recover, 
suspend, or withhold payments. 
    Sec. 40.  Minnesota Statutes 1990, section 252.46, is 
amended by adding a subdivision to read: 
    Subd. 15.  [FOR-PROFIT ORGANIZATIONS.] Notwithstanding the 
requirement in section 252.41, subdivision 9, that vendors be 
nonprofit entities, the commissioner may approve up to 15 
for-profit individuals, corporations, partnerships, voluntary 
associations, or other organizations to provide day training and 
habilitation services for the purposes of studying the impacts 
that for-profit vendors have on the delivery, quality, and costs 
of day training and habilitation services.  
    Sec. 41.  Minnesota Statutes 1990, section 252.50, 
subdivision 2, is amended to read: 
    Subd. 2.  [AUTHORIZATION TO BUILD OR PURCHASE.] Within the 
limits of available appropriations, the commissioner may build, 
purchase, or lease suitable buildings for state-operated, 
community-based programs.  The commissioner must develop the 
state-operated community residential facilities authorized in 
the worksheets of the house appropriations and senate finance 
committees.  The commissioner shall finance the purchase or 
construction of state-operated, community-based facilities with 
the Minnesota housing finance agency.  The commissioner shall 
make payments through the department of administration to the 
Minnesota housing finance agency in repayment of mortgage loans 
granted for the purposes of this section.  Programs must be 
adaptable to the needs of persons with mental retardation or 
related conditions and residential programs must be homelike. 
    Sec. 42.  Minnesota Statutes 1990, section 253.015, 
subdivision 2, is amended to read: 
    Subd. 2.  [PLAN FOR NEEDED REGIONAL TREATMENT CENTER 
SERVICES.] (a) By January 30, 1990, the commissioner shall 
develop and submit to the legislature a plan to implement a 
program for persons in southeastern Minnesota who are mentally 
ill. 
    (b) By January 1, 1990, the commissioner shall develop a 
plan to establish a comprehensive brain injury treatment program 
at the Faribault regional center site to meet the needs of 
people with brain injuries in Minnesota.  The program shall 
provide postacute, community integration and family support 
services for people with brain injuries which have resulted in 
behavior, cognitive, emotional, communicative and mobility 
impairments or deficits.  The plan shall include development of 
a brain injury residential unit, a functional evaluation 
outpatient clinic and an adaptive equipment center within the 
outpatient clinic.  Health care services already available at 
the regional center or from the Faribault community must be 
utilized, and the plan shall include provisions and cost 
estimates for capital improvements, staff retraining, and 
program start-up costs. 
    (c) By January 1, 1990, the commissioner shall develop a 
plan to establish 35 auxiliary beds at Brainerd regional 
treatment center for the Minnesota security hospital.  The 
commissioner shall develop secure beds for mentally ill persons 
as authorized in the worksheets of the house appropriations and 
senate finance committees.  The commissioner shall finance the 
purchase or construction of these beds with the Minnesota 
housing finance agency.  The commissioner shall make payments 
through the department of administration to the Minnesota 
housing finance agency in repayment of mortgage loans granted 
for the purposes of this section. 
    Sec. 43.  Minnesota Statutes 1990, section 253C.01, 
subdivision 1, is amended to read: 
    Subdivision 1.  [DEFINITION.] As used in this section, 
"residential program" means (1) a freestanding primary treatment 
program or hospital-based primary treatment program that 
provides residential treatment to chemically dependent or 
mentally ill minors with emotional disturbance as defined by the 
comprehensive children's mental health act in sections 245.487 
to 245.4888, or (2) a facility licensed by the state under 
Minnesota Rules, parts 9545.0900 to 9545.1090, to provide 
services for emotionally disturbed to minors on a 24-hour basis. 
    Sec. 44.  Minnesota Statutes 1990, section 253C.01, 
subdivision 2, is amended to read: 
    Subd. 2.  [ANNUAL REPORT INFORMATION REQUIRED.] Beginning 
June 1, 1986, each residential program shall collect the 
information listed in this subdivision.  Each residential 
program shall file a report no later than December 31, 1986, 
containing the information collected as of that date.  
Thereafter, each residential program shall prepare an annual 
report for the year ending June 30 of each year and file the 
report no later than December 31 of each year.  Hospital-based 
primary treatment programs shall file the report with the 
commissioner of health provide the required information annually 
on a date to be determined by the commissioner of human 
services.  All other residential programs shall file the report 
with to the commissioner of human services.  The summary reports 
on each program are public data and must contain at least the 
following information for the period covered by the report: 
    (1) number of minors admitted to the program; 
    (2) number of minors discharged from the program; 
    (3) primary diagnoses of each admitted minor number of 
minors served during the reporting period; 
    (4) number of minors who remained in residence for less 
than 30 days; 
    (5) number of minors who remained in residence for between 
30 and 60 days; 
    (6) number of minors who remained in residence for more 
than 60 days; 
    (7) average length of stay of minors in the program; 
    (8) number of minors who have received psychotropic 
medications as part of treatment in the program; 
    (9) age, race, and sex of each minor admitted to the 
program; 
    (10) copy of written notices, forms, and other procedures 
being used to advise minors and their parents of their rights; 
    (11) number of minors admitted or presently in residence 
who have previously had residential treatment; 
    (12) (11) number of minors discharged who are on private 
pay or third-party reimbursement payment and number who are 
receiving government funds for treatment; 
    (13) criteria for admission and continued stay (12) the 
county of residence of discharged minors; 
    (14) (13) number of admitted minors whose admission is 
court-ordered; and 
    (15) (14) number of beds on a locked unit and number of 
beds on an unlocked unit. 
    The information required by this subdivision must be 
separately stated for chemically dependent, mentally ill, and 
emotionally disturbed minors as defined by the residential 
programs.  
    Sec. 45.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 20, is amended to read: 
    Subd. 20.  [MENTAL ILLNESS CASE MANAGEMENT.] To the extent 
authorized by rule of the state agency, medical assistance 
covers case management services to persons with serious and 
persistent mental illness or subject to federal approval, 
children with severe emotional disturbance. 
    Sec. 46.  Minnesota Statutes 1990, section 256B.0641, is 
amended by adding a subdivision to read: 
    Subd. 3.  [FACILITY IN RECEIVERSHIP.] Subdivision 2 does 
not apply to the change of ownership of a facility to a 
nonrelated organization while the facility to be sold, 
transferred or reorganized is in receivership under section 
245A.12 or 245A.13, and the commissioner during the receivership 
has not determined the need to place residents of the facility 
into a newly constructed or newly established facility.  Nothing 
in this subdivision limits the liability of a former owner.  
    Sec. 47.  Minnesota Statutes 1990, section 256B.092, is 
amended to read: 
    256B.092 [CASE MANAGEMENT OF PERSONS WITH MENTAL 
RETARDATION OR RELATED CONDITIONS.] 
    Subdivision 1.  [COUNTY OF FINANCIAL RESPONSIBILITY; 
DUTIES.] Before any services shall be rendered to persons with 
mental retardation or related conditions who are in need of 
social service and medical assistance, the county of financial 
responsibility shall conduct or arrange for a diagnostic 
evaluation in order to determine whether the person is has or 
may be mentally retarded have mental retardation or has or may 
have a related condition.  If the county of financial 
responsibility determines that the person has mental retardation 
or a related condition, the county shall inform the person of 
case management services available under this section.  Except 
as provided in subdivision 1g or 4b, if a client person is 
diagnosed as mentally retarded having mental retardation or as 
having a related condition, that the county must of financial 
responsibility shall conduct or arrange for a needs assessment, 
develop or arrange for an individual service plan, provide or 
arrange for ongoing case management services at the level 
identified in the individual service plan, provide or arrange 
for case management administration, and authorize placement for 
services identified in the person's individual service plan 
developed according to subdivision 1b.  Diagnostic information, 
obtained by other providers or agencies, may be used to meet the 
diagnosis requirements of this section.  Nothing in this section 
shall be construed as requiring:  (1) assessment in areas agreed 
to as unnecessary by the case manager and the person, or the 
person's legal guardian or conservator, or the parent if the 
person is a minor, or (2) assessments in areas where there has 
been a functional assessment completed in the previous 12 months 
for which the case manager and the person or person's guardian 
or conservator, or the parent if the person is a minor, agree 
that further assessment is not necessary.  For persons under 
state guardianship, the case manager shall seek authorization 
from the public guardianship office for waiving any assessment 
requirements.  Assessments related to health, safety, and 
protection of the person for the purpose of identifying service 
type, amount, and frequency or assessments required to authorize 
services may not be waived.  To the extent possible, for wards 
of the commissioner the county shall consider the opinions of 
the parent of the person with mental retardation or a related 
condition when developing the person's individual service plan.  
If the county of financial responsibility places a client person 
in another county for services, the placement shall be made in 
cooperation with the host county of service where services are 
provided, according to subdivision 8a, and arrangements shall be 
made between the two counties for ongoing social service, 
including annual reviews of the client's person's individual 
service plan.  The host county where services are provided may 
not make changes in the person's service plan without approval 
by the county of financial responsibility. 
    Subd. 1a.  [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 
Case management services are limited to diagnosis, assessment of 
the individual's service needs, development of an individual 
service plan, specification of methods for providing services, 
and the evaluation and monitoring of the services identified in 
the plan. 
    (a) The administrative functions of case management 
provided to or arranged for a person include: 
    (1) intake; 
    (2) diagnosis; 
    (3) screening; 
    (4) service authorization; 
    (5) review of eligibility for services; and 
    (6) responding to requests for conciliation conferences and 
appeals according to section 256.045 made by the person, the 
person's legal guardian or conservator, or the parent if the 
person is a minor. 
    (b) Case management service activities provided to or 
arranged for a person include: 
    (1) development of the individual service plan; 
    (2) informing the individual or the individual's legal 
guardian or conservator, or parent if the person is a minor, of 
service options; 
    (3) assisting the person in the identification of potential 
providers; 
    (4) assisting the person to access services; 
    (5) coordination of services; 
    (6) evaluation and monitoring of the services identified in 
the plan; and 
    (7) annual reviews of service plans. 
    (c) Case management administration and service activities 
that are provided to the person with mental retardation or a 
related condition shall be provided directly by county agencies 
or under contract.  
    Subd. 1b.  [INDIVIDUAL SERVICE PLAN.] The individual 
service plan must: 
    (1) include the results of the diagnosis and the assessment 
information on the person's need for service, including 
identification of service needs that will be or that are met by 
the person's relatives, friends, and others, as well as 
community services used by the general public; 
    (2) identify the person's preferences for services as 
stated by the person, the person's legal guardian or 
conservator, or the parent if the person is a minor; 
    (3) identify long- and short-range goals and objectives for 
the client, 
    (3) person; 
    (4) identify specific services and the amount and frequency 
of the services to be provided to the client, 
    (4) person based on assessed needs, preferences, and 
available resources.  The individual service plan shall also 
specify other services the person needs that are not available; 
    (5) identify the need for an habilitation component of the 
individual program plan, and 
    (5) identify and coordinate methodologies to carry out the 
goals and objectives. to be developed by the provider according 
to the respective state and federal licensing and certification 
standards, and additional assessments to be completed or 
arranged by the provider after service initiation; 
    (6) identify provider responsibilities to implement and 
make recommendations for modification to the individual service 
plan; 
    (7) include notice of the right to request a conciliation 
conference or a hearing under section 256.045; 
    (8) be agreed upon and signed by the person, the person's 
legal guardian or conservator, or the parent if the person is a 
minor, and the authorized county representative; 
    (9) be reviewed by a health professional if the person has 
overriding medical needs that impact the delivery of services; 
and 
    (10) be completed on forms approved by the commissioner, 
including forms developed for interagency planning such as 
transition and individual family service plans.  
    Subd. 1c.  [FISCAL LIMITATIONS.] Subdivision 1 shall not be 
construed as requiring expenditure of money not available to 
county agencies for services to persons with, or who might have, 
mental retardation or related conditions, except for:  
    (1) services specifically required by federal law or state 
statute such as case management and day training and 
habilitation services; and 
    (2) services identified in the person's individual service 
plan as services that the county will provide until the person's 
individual service plan is amended.  
    Subd. 1d.  [COUNTY REQUIREMENTS.] Before a county denies, 
reduces, or terminates a service to an individual due to fiscal 
limitations, the county agency must show that money is not 
available for services to persons with mental retardation or 
related conditions and that good faith efforts have been made to 
identify needs and obtain available funds.  The county agency 
must show this by documenting that the following actions have 
been taken: 
    (1) the county case manager has identified the person's 
service needs and the actions that will be taken to develop or 
obtain those services in the person's individual service plan 
and action that will be taken to prevent abuse or neglect as 
defined in sections 626.556, subdivision 2, paragraphs (a), (c), 
and (d), and 626.557, subdivision 2, paragraphs (d) and (e); 
    (2) prior to the admission of a person to a regional 
treatment center program for persons with developmental 
disabilities, the county agency made efforts to secure 
community-based alternatives.  If these alternatives were 
rejected in favor of a regional treatment center placement, the 
county agency must also document the reasons why they were 
rejected; and 
    (3) the county agency has made a request for state funds or 
new capacity for services to meet the individual's unmet needs, 
since those needs have been identified in the person's 
individual service plan. 
    Subd. 1e.  [COORDINATION, EVALUATION, AND MONITORING OF 
SERVICES IDENTIFIED IN THE INDIVIDUAL SERVICE PLAN.] (a) If the 
individual service plan identifies the need for individual 
program plans for authorized services, the case manager shall 
assure that individual program plans are developed by the 
providers according to clauses (2) to (5).  The providers shall 
assure that the individual program plans:  
    (1) are developed according to the respective state and 
federal licensing and certification requirements; 
    (2) are designed to achieve the goals of the individual 
service plan; 
    (3) are consistent with other aspects of the individual 
service plan; 
    (4) assure the health and safety of the person; and 
    (5) are developed with consistent and coordinated 
approaches to services among the various service providers.  
    (b) The case manager shall monitor the provision of 
services:  
    (1) to assure that the individual service plan is being 
followed according to paragraph (a); 
    (2) to identify any changes or modifications that might be 
needed in the individual service plan, including changes 
resulting from recommendations of current service providers; 
    (3) to determine if the person's legal rights are 
protected, and if not, notify the person's legal guardian or 
conservator, or the parent if the person is a minor, protection 
services, or licensing agencies as appropriate; and 
    (4) to determine if the person, the person's legal guardian 
or conservator, or the parent if the person is a minor, is 
satisfied with the services provided.  
    (c) If the provider fails to develop or carry out the 
individual program plan according to paragraph (a), the case 
manager shall notify the person's legal guardian or conservator, 
or the parent if the person is a minor, the provider, the 
respective licensing and certification agencies, and the county 
board where the services are being provided.  In addition, the 
case manager shall identify other steps needed to assure the 
person receives the services identified in the individual 
service plan. 
    Subd. 1e. 1f.  [COUNTY WAITING LIST.] The county agency 
shall maintain a waiting list of persons with developmental 
disabilities specifying the services needed but not 
provided.  This waiting list shall be used by county agencies to 
assist them in developing needed services or amending their 
community social services plan as required in section 256E.09, 
subdivision 1.  
    Subd. 1g.  [CONDITIONS NOT REQUIRING DEVELOPMENT OF 
INDIVIDUAL SERVICE PLAN.] Unless otherwise required by federal 
law, the county agency is not required to complete an individual 
service plan as defined in subdivision 1b for:  
    (1) persons whose families are requesting respite care as a 
single service for their family member who resides with them, or 
whose families are requesting only a family subsidy grant and 
are not requesting purchase or arrangement of other habilitative 
or social services; and 
    (2) persons with mental retardation or related conditions, 
living independently without authorized services or receiving 
funding for services at a rehabilitation facility as defined in 
section 268A.01, subdivision 6, and not in need of or requesting 
additional services.  
    Subd. 2.  [MEDICAL ASSISTANCE.] To assure quality case 
management to those county clients persons who are eligible for 
medical assistance, the commissioner shall, upon request by the 
county board: 
    (a) provide consultation on the case management process; 
    (b) assist county agencies in the screening and annual 
reviews of clients review process to assure that appropriate 
levels of service are provided to persons; 
    (c) provide consultation on service planning and 
development of services with appropriate options; 
    (d) provide training and technical assistance to county 
case managers; and 
    (e) authorize payment for medical assistance services 
according to chapter 256B and rules implementing it.  
    Subd. 3.  [AUTHORIZATION AND TERMINATION OF SERVICES.] 
County agency case managers, under rules of the commissioner, 
shall authorize and terminate services of community and state 
hospital regional treatment center providers in accordance with 
according to individual service plans.  Services provided to 
persons with mental retardation or related conditions may only 
be authorized and terminated by case managers according to (1) 
rules of the commissioner and (2) the individual service plan as 
defined in subdivision 1b.  Medical assistance services not 
needed shall not be authorized by county agencies nor or funded 
by the commissioner.  When purchasing or arranging for 
unlicensed respite care services for persons with overriding 
health needs, the county agency shall seek the advice of a 
health care professional in assessing provider staff training 
needs and skills necessary to meet the medical needs of the 
person.  
    Subd. 4.  [ALTERNATIVE HOME AND COMMUNITY-BASED SERVICES 
FOR PERSONS WITH MENTAL RETARDATION OR RELATED CONDITIONS.] The 
commissioner shall make payments to county boards approved 
vendors participating in the medical assistance program to pay 
costs of providing alternative home and community-based 
services, including case management service activities provided 
as an approved home and community-based service, to medical 
assistance eligible persons with mental retardation or related 
conditions who have been screened under subdivision 7 and 
according to federal requirements.  Payments for home and 
community-based services shall not exceed amounts authorized by 
the county of financial responsibility.  For specifically 
identified former residents of regional treatment centers and 
nursing facilities, the commissioner shall be responsible for 
authorizing payments and payment limits under the appropriate 
home and community-based service program.  Payment is available 
under this subdivision only for persons who, if not provided 
these services, would require the level of care provided in an 
intermediate care facility for persons with mental retardation 
or related conditions.  
    Subd. 4a.  [DEMONSTRATION PROJECTS.] The commissioner may 
waive state rules governing home and community-based services in 
order to demonstrate other methods of administering these 
services and to improve efficiency and responsiveness to 
individual needs of persons with mental retardation or related 
conditions, notwithstanding section 14.05, subdivision 4.  All 
demonstration projects approved by the commissioner must comply 
with state laws and federal regulations, must remain within the 
fiscal limitations of the home and community-based services 
program for persons with mental retardation or related 
conditions, and must assure the health and safety of the persons 
receiving services according to section 256E.08, subdivision 1.  
     Subd. 4b.  [CASE MANAGEMENT FOR PERSONS RECEIVING HOME AND 
COMMUNITY-BASED SERVICES.] Persons authorized for and receiving 
home and community-based services may select from vendors of 
case management which have provider agreements with the state to 
provide home and community-based case management service 
activities.  This subdivision becomes effective July 1, 1992, 
only if the state agency is unable to secure federal approval 
for limiting choice of case management vendors to the county of 
financial responsibility.  
    Subd. 5.  [FEDERAL WAIVERS.] The commissioner shall apply 
for any federal waivers necessary to secure, to the extent 
allowed by law, federal financial participation under United 
States Code, title 42, sections 1396 to 1396p et seq., as 
amended through December 31, 1987, for the provision of services 
to persons who, in the absence of the services, would need the 
level of care provided in a state hospital regional treatment 
center or a community intermediate care facility for persons 
with mental retardation or related conditions.  The commissioner 
may seek amendments to the waivers or apply for additional 
waivers under United States Code, title 42, sections 1396 to 
1396p et seq., as amended through December 31, 1987, to contain 
costs.  The commissioner shall ensure that payment for the cost 
of providing home and community-based alternative services under 
the federal waiver plan shall not exceed the cost of 
intermediate care services including day training and 
habilitation services that would have been provided without the 
waivered services.  
    Subd. 6.  [RULES.] The commissioner shall adopt emergency 
and permanent rules to establish required controls, 
documentation, and reporting of services provided in order to 
assure proper administration of the approved waiver plan, and to 
establish policy and procedures to reduce duplicative efforts 
and unnecessary paperwork on the part of case managers.  
    Subd. 7.  [SCREENING TEAMS ESTABLISHED.] (a) Each county 
agency shall establish a screening team which, under the 
direction of the county case manager, shall make an evaluation 
of need for home and community-based services of persons who are 
entitled to the level of care provided by an intermediate care 
facility for persons with mental retardation or related 
conditions or for whom there is a reasonable indication that 
they might require the level of care provided by an intermediate 
care facility.  For persons with mental retardation or a related 
condition, screening teams shall be established which shall 
evaluate the need for the level of care provided by 
residential-based habilitation services, residential services, 
training and habilitation services, and nursing facility 
services.  The evaluation shall address whether home and 
community-based services are appropriate for persons who are at 
risk of placement in an intermediate care facility for persons 
with mental retardation or related conditions, or for whom there 
is reasonable indication that they might require this level of 
care.  The screening team shall make an evaluation of need 
within 15 working days of the date that the assessment is 
completed or within 60 working days of a request for service by 
a person with mental retardation or related conditions, 
whichever is the earlier, and within five working days of an 
emergency admission of an individual a person to an intermediate 
care facility for persons with mental retardation or related 
conditions.  The screening team shall consist of the case 
manager for persons with mental retardation or related 
conditions, the client person, a parent or the person's legal 
guardian or conservator, or the parent if the person is a minor, 
and a qualified mental retardation professional, as defined in 
the Code of Federal Regulations, title 42, section 483.430, as 
amended through June 3, 1988.  The case manager may also act as 
the qualified mental retardation professional if the case 
manager meets the federal definition.  County social service 
agencies may contract with a public or private agency or 
individual who is not a service provider for the person for the 
public guardianship representation required by the screening or 
individual service and habilitation planning process.  The 
contract shall be limited to public guardianship representation 
for the screening and individual service and habilitation 
planning activities.  The contract shall require compliance with 
the commissioner's instructions and may be for paid or voluntary 
services.  For individuals persons determined to have overriding 
health care needs, a registered nurse must be designated as 
either the case manager or the qualified mental retardation 
professional.  The case manager shall consult with the client's 
person's physician, other health professionals or other persons 
individuals as necessary to make this evaluation.  The case 
manager, with the concurrence of the client or the 
client's person, the person's legal representative guardian or 
conservator, or the parent if the person is a minor, may invite 
other persons individuals to attend meetings of the screening 
team.  No member of the screening team shall have any direct or 
indirect service provider interest in the case.  Nothing in this 
section shall be construed as requiring the screening team 
meeting to be separate from the service planning meeting.  
    (b) In addition to the requirements of paragraph (a), the 
following conditions apply to the discharge of persons with 
mental retardation or a related condition from a regional 
treatment center: 
    (1) For a person under public guardianship, at least two 
weeks prior to each screening team meeting the case manager must 
notify in writing parents, near relatives, and the ombudsman 
established under section 245.92 or a designee, and invite them 
to attend.  The notice to parents and near relatives must 
include:  (i) notice of the provisions of section 252A.03, 
subdivision 4, regarding assistance to persons interested in 
assuming private guardianship; (ii) notice of the rights of 
parents and near relatives to object to a proposed discharge by 
requesting a review as provided in clause (7); and (iii) 
information about advocacy services available to assist parents 
and near relatives of persons with mental retardation or related 
conditions.  In the case of an emergency screening meeting, the 
notice must be provided as far in advance as practicable. 
    (2) Prior to the discharge, a screening must be conducted 
under subdivision 8 and a plan developed under subdivision 1a.  
For a person under public guardianship, the county shall 
encourage parents and near relatives to participate in the 
screening team meeting.  The screening team shall consider the 
opinions of parents and near relatives in making its 
recommendations.  The screening team shall determine that the 
services outlined in the plan are available in the community 
before recommending a discharge.  The case manager shall provide 
a copy of the plan to the person, legal representative, parents, 
near relatives, the ombudsman established under section 245.92, 
and the protection and advocacy system established under United 
States Code, title 42, section 6042, at least 30 days prior to 
the date the proposed discharge is to occur.  The information 
provided to parents and near relatives must include notice of 
the rights of parents and near relatives to object to a proposed 
discharge by requesting a review as provided in clause (7).  If 
a discharge occurs, the case manager and a staff person from the 
regional treatment center from which the person was discharged 
must conduct a monitoring visit as required in Minnesota Rules, 
part 9525.0115, within 90 days of discharge and provide an 
evaluation within 15 days of the visit to the person, legal 
representative, parents, near relatives, ombudsman, and the 
protection and advocacy system established under United States 
Code, title 42, section 6042. 
    (3) In order for a discharge or transfer from a regional 
treatment center to be approved, the concurrence of a majority 
of the screening team members is required.  The screening team 
shall determine that the services outlined in the discharge plan 
are available and accessible in the community before the person 
is discharged.  The recommendation of the screening team cannot 
be changed except by subsequent action of the team and is 
binding on the county and on the commissioner.  If the 
commissioner or the county determines that the decision of the 
screening team is not in the best interests of the person, the 
commissioner or the county may seek judicial review of the 
screening team recommendation.  A person or legal representative 
may appeal under section 256.045, subdivision 3 or 4a. 
    (4) For persons who have overriding health care needs or 
behaviors that cause injury to self or others, or cause damage 
to property that is an immediate threat to the physical safety 
of the person or others, the following additional conditions 
must be met: 
    (i) For a person with overriding health care needs, either 
a registered nurse or a licensed physician shall review the 
proposed community services to assure that the medical needs of 
the person have been planned for adequately.  For purposes of 
this paragraph, "overriding health care needs" means a medical 
condition that requires daily clinical monitoring by a licensed 
registered nurse. 
    (ii) For a person with behaviors that cause injury to self 
or others, or cause damage to property that is an immediate 
threat to the physical safety of the person or others, a 
qualified mental retardation professional, as defined in 
paragraph (a), shall review the proposed community services to 
assure that the behavioral needs of the person have been planned 
for adequately.  The qualified mental retardation professional 
must have at least one year of experience in the areas of 
assessment, planning, implementation, and monitoring of 
individual habilitation plans that have used behavior 
intervention techniques. 
    (5) No person with mental retardation or a related 
condition may be discharged from a regional treatment center 
before an appropriate community placement is available to 
receive the person. 
    (6) Effective July 1, 1991, a resident of a regional 
treatment center may not be discharged to a community 
intermediate care facility with a licensed capacity of more than 
15 beds.  Effective July 1, 1993, a resident of a regional 
treatment center may not be discharged to a community 
intermediate care facility with a licensed capacity of more than 
ten beds. 
    (7) If the person, legal representative, parent, or near 
relative of the person proposed to be discharged from a regional 
treatment center objects to the proposed discharge, the 
individual who objects to the discharge may request a review 
under section 256.045, subdivision 4a, and may request 
reimbursement as allowed under section 256.045.  The person must 
not be transferred from a regional treatment center while a 
review or appeal is pending.  Within 30 days of the request for 
a review, the local agency shall conduct a conciliation 
conference and inform the individual who requested the review in 
writing of the action the local agency plans to take.  The 
conciliation conference must be conducted in a manner consistent 
with section 256.045, subdivision 4a.  A person, legal 
representative, parent, or near relative of the person proposed 
to be discharged who is not satisfied with the results of the 
conciliation conference may submit to the commissioner a written 
request for a hearing before a state human services referee 
under section 256.045, subdivision 4a.  The person, legal 
representative, parent, or near relative of the person proposed 
to be discharged may appeal the order to the district court of 
the county responsible for furnishing assistance by serving a 
written copy of a notice of appeal on the commissioner and any 
adverse party of record within 30 days after the day the 
commissioner issued the order and by filing the original notice 
and proof of service with the court administrator of the 
district court.  Judicial review must proceed under section 
256.045, subdivisions 7 to 10.  For a person under public 
guardianship, the ombudsman established under section 245.92 may 
object to a proposed discharge by requesting a review or hearing 
or by appealing to district court as provided in this clause.  
The person must not be transferred from a regional treatment 
center while a conciliation conference or appeal of the 
discharge is pending. 
    Subd. 8.  [SCREENING TEAM DUTIES.] The screening team shall:
    (a) review diagnostic data; 
    (b) review health, social, and developmental assessment 
data using a uniform screening tool specified by the 
commissioner; 
    (c) identify the level of services appropriate to maintain 
the person in the most normal and least restrictive setting that 
is consistent with the person's treatment needs; 
    (d) identify other noninstitutional public assistance or 
social service that may prevent or delay long-term residential 
placement; 
    (e) assess whether a client person is in need of long-term 
residential care; 
    (f) make recommendations regarding placement and payment 
for:  (1) social service or public assistance support, or both, 
to maintain a client person in the client's person's own home or 
other place of residence; (2) training and habilitation service, 
vocational rehabilitation, and employment training activities; 
(3) community residential placement; (4) regional treatment 
center placement; or (5) a home and community-based service 
alternative to community residential placement or state hospital 
regional treatment center placement; 
    (g) evaluate the availability, location, and quality of the 
services listed in paragraph (f), including the impact of 
placement alternatives on the client's person's ability to 
maintain or improve existing patterns of contact and involvement 
with parents and other family members; 
    (h) identify the cost implications of recommendations in 
paragraph (f); 
    (i) make recommendations to a court as may be needed to 
assist the court in making commitments decisions regarding 
commitment of mentally retarded persons with mental retardation; 
and 
    (j) inform clients the person and the person's legal 
guardian or conservator, or the parent if the person is a minor, 
that appeal may be made to the commissioner pursuant to section 
256.045. 
    Subd. 8a.  [COUNTY CONCURRENCE.] (a) When a person has been 
screened and authorized for services in an intermediate care 
facility for persons with mental retardation or related 
conditions or for home and community-based services for persons 
with mental retardation or related conditions, the case manager 
shall assist that person in identifying a service provider who 
is able to meet the needs of the person according to the 
person's individual service plan.  If the identified service is 
to be provided in a county other than the county of financial 
responsibility, the county of financial responsibility shall 
request concurrence of the county where the person is requesting 
to receive the identified services.  The county of service may 
refuse to concur if:  
    (1) it can demonstrate that the provider is unable to 
provide the services identified in the person's individual 
service plan as services that are needed and are to be provided; 
    (2) in the case of an intermediate care facility for 
persons with mental retardation or related conditions, there has 
been no authorization for admission by the admission review team 
as required in section 256B.0926; or 
    (3) in the case of home and community-based services for 
persons with mental retardation or related conditions, the 
county of service can demonstrate that the prospective provider 
has failed to substantially comply with the terms of a past 
contract or has had a prior contract terminated within the last 
12 months for failure to provide adequate services, or has 
received a notice of intent to terminate the contract.  
    (b) The county of service shall notify the county of 
financial responsibility of concurrence or refusal to concur no 
later than 20 working days following receipt of the written 
request.  Unless other mutually acceptable arrangements are made 
by the involved county agencies, the county of financial 
responsibility is responsible for costs of social services and 
the costs associated with the development and maintenance of the 
placement.  The county of service may request that the county of 
financial responsibility purchase case management services from 
the county of service or from a contracted provider of case 
management when the county of financial responsibility is not 
providing case management as defined in section 256B.092 and 
rules adopted under that section, unless other mutually 
acceptable arrangements are made by the involved county 
agencies.  Standards for payment limits under this section may 
be established by the commissioner.  Financial disputes between 
counties shall be resolved as provided in section 256G.09.  
    Subd. 9.  [REIMBURSEMENT.] Payment for services shall not 
be provided to a service provider for any recipient person 
placed in an intermediate care facility for persons with mental 
retardation or related conditions prior to the recipient person 
being screened by the screening team.  The commissioner shall 
not deny reimbursement for:  (a) an individual a person admitted 
to an intermediate care facility for persons with mental 
retardation or related conditions who is assessed to need 
long-term supportive services, if long-term supportive services 
other than intermediate care are not available in that 
community; (b) any individual person admitted to an intermediate 
care facility for persons with mental retardation or related 
conditions under emergency circumstances; (c) any 
eligible individual person placed in the intermediate care 
facility for persons with mental retardation or related 
conditions pending an appeal of the screening team's decision; 
or (d) any medical assistance recipient when, after full 
discussion of all appropriate alternatives including those that 
are expected to be less costly than intermediate care for 
persons with mental retardation or related conditions, 
the individual person or the individual's person's legal 
representative guardian or conservator, or the parent if the 
person is a minor, insists on intermediate care placement.  The 
screening team shall provide documentation that the most cost 
effective alternatives available were offered to this individual 
or the individual's legal representative guardian or conservator.
    Subd. 10.  [ADMISSION OF PERSONS TO AND DISCHARGE OF 
PERSONS FROM REGIONAL TREATMENT CENTERS.] (a) Prior to the 
admission of a person to a regional treatment center program for 
persons with mental retardation, the case manager shall make 
efforts to secure community-based alternatives.  If these 
alternatives are rejected by the person, the person's legal 
guardian or conservator, or the county agency in favor of a 
regional treatment center placement, the case manager shall 
document the reasons why the alternatives were rejected.  
    (b) When discharge of a person from a regional treatment 
center to a community-based service is proposed, the case 
manager shall convene the screening team and in addition to 
members of the team identified in subdivision 7, the case 
manager shall invite to the meeting the person's parents and 
near relatives, and the ombudsman established under section 
245.92 if the person is under public guardianship.  The meeting 
shall be convened at a time and place that allows for 
participation of all team members and invited individuals who 
choose to attend.  The notice of the meeting shall inform the 
person's parents and near relatives about the screening team 
process, and their right to request a review if they object to 
the discharge, and shall provide the names and functions of 
advocacy organizations, and information relating to assistance 
available to individuals interested in establishing private 
guardianships under the provisions of section 252A.03.  The 
screening team meeting shall be conducted according to 
subdivisions 7 and 8.  Discharge of the person shall not go 
forward without consensus of the screening team.  
    (c) The results of the screening team meeting and 
individual service plan developed according to subdivision 1b 
shall be used by the interdisciplinary team assembled in 
accordance with Code of Federal Regulations, title 42, section 
483.440, to evaluate and make recommended modifications to the 
individual service plan as proposed.  The individual service 
plan shall specify postplacement monitoring to be done by the 
case manager according to section 253B.15, subdivision 1a.  
    (d) Notice of the meeting of the interdisciplinary team 
assembled in accordance with Code of Federal Regulations, title 
42, section 483.440, shall be sent to all team members 15 days 
prior to the meeting, along with a copy of the proposed 
individual service plan.  The case manager shall request that 
proposed providers visit the person and observe the person's 
program at the regional treatment center prior to the 
discharge.  Whenever possible, preplacement visits by the person 
to proposed service sites should also be scheduled in advance of 
the meeting.  Members of the interdisciplinary team assembled 
for the purpose of discharge planning shall include but not be 
limited to the case manager, the person, the person's legal 
guardian or conservator, parents and near relatives, the 
person's advocate, representatives of proposed community service 
providers, representatives of the regional treatment center 
residential and training and habilitation services, a registered 
nurse if the person has overriding medical needs that impact the 
delivery of services, and a qualified mental retardation 
professional specializing in behavior management if the person 
to be discharged has behaviors that may result in injury to self 
or others.  The case manager may also invite other service 
providers who have expertise in an area related to specific 
service needs of the person to be discharged.  
    (e) The interdisciplinary team shall review the proposed 
plan to assure that it identifies service needs, availability of 
services, including support services, and the proposed 
providers' abilities to meet the service needs identified in the 
person's individual service plan.  The interdisciplinary team 
shall review the most recent licensing reports of the proposed 
providers and corrective action taken by the proposed provider, 
if required.  The interdisciplinary team shall review the 
current individual program plans for the person and agree to an 
interim individual program plan to be followed for the first 30 
days in the person's new living arrangement.  The 
interdisciplinary team may suggest revisions to the service 
plan, and all team suggestions shall be documented.  If the 
person is to be discharged to a community intermediate care 
facility for persons with mental retardation or related 
conditions, the team shall give preference to facilities with a 
licensed capacity of 15 or fewer beds.  Thirty days prior to the 
date of discharge, the case manager shall send a final copy of 
the service plan to all invited members of the team, the 
ombudsman, if the person is under public guardianship, and the 
advocacy system established under United States Code, title 42, 
section 6042.  
    (f) No discharge shall take place until disputes are 
resolved under section 256.045, subdivision 4a, or until a 
review by the commissioner is completed upon request of the 
chief executive officer or program director of the regional 
treatment center, or the county agency.  For persons under 
public guardianship, the ombudsman may request a review or 
hearing under section 256.045.  Notification schedules required 
under this subdivision may be waived by members of the team when 
judged urgent and with agreement of the parents or near 
relatives participating as members of the interdisciplinary team.
    Sec. 48.  [256B.0926] [ADMISSION REVIEW TEAM FOR ADMISSIONS 
TO INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL 
RETARDATION OR RELATED CONDITIONS.] 
    Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
section, the following terms have the meanings given them in 
this subdivision. 
    (b) "Provider" means a provider of community-based 
intermediate care facility services for persons with mental 
retardation or related conditions. 
    (c) "Facility" means a community-based intermediate care 
facility for persons with mental retardation or related 
conditions. 
    (d) "Person" means a person with mental retardation or 
related conditions who is applying for admission to an 
intermediate care facility for persons with mental retardation 
or related conditions.  
    Subd. 2.  [ADMISSION REVIEW TEAM; RESPONSIBILITIES; 
COMPOSITION.] (a) Before a person is admitted to a facility, an 
admission review team must assure that the provider can meet the 
needs of the person as identified in the person's individual 
service plan required under section 256B.092, subdivision 1. 
    (b) The admission review team must be assembled pursuant to 
Code of Federal Regulations, title 42, section 483.440(b)(2).  
The composition of the admission review team must meet the 
definition of an interdisciplinary team in Code of Federal 
Regulations, title 42, section 483.440.  In addition, the 
admission review team must meet any conditions agreed to by the 
provider and the county where services are to be provided.  
    (c)  The county in which the facility is located may 
establish an admission review team which includes at least the 
following:  
    (1) a qualified mental retardation professional, as defined 
in Code of Federal Regulations, title 42, section 483.440; 
    (2) a representative of the county in which the provider is 
located; 
    (3) at least one professional representing one of the 
following professions:  nursing, psychology, physical therapy, 
or occupational therapy; and 
    (4) a representative of the provider.  
    If the county in which the facility is located does not 
establish an admission review team, the provider shall establish 
a team whose composition meets the definition of an 
interdisciplinary team in Code of Federal Regulations, title 42, 
section 483.440.  The provider shall invite a representative of 
the county agency where the facility is located to be a member 
of the admission review team.  
    Subd. 3.  [FACTORS TO BE CONSIDERED FOR ADMISSION.] (a) The 
determination of the team to admit a person to the facility must 
include, but is not limited to, consideration of the following:  
    (1) the preferences of the person and the person's guardian 
or family for services of an intermediate care facility for 
persons with mental retardation or related conditions; 
    (2) the ability of the provider to meet the needs of the 
person according to the person's individual service plan and the 
admission criteria established by the provider; 
    (3) the availability of a bed in the facility and of 
nonresidential services required by the person as specified in 
the person's individual service plan; and 
    (4) the need of the person for the services in the facility 
to prevent placement of the person in a more restrictive setting.
    (b) When there is more than one qualified person applying 
for admission to the facility, the admission review team shall 
determine which applicant shall be offered services first, using 
the criteria established in this subdivision.  The admission 
review team shall document the factors that resulted in the 
decision to offer services to one qualified person over 
another.  In cases of emergency, a review of the admission by 
the admission review team must occur within the first 14 days of 
placement.  
    Subd. 4.  [INFORMATION FROM PROVIDER.] The provider must 
establish admission criteria based on the level of service that 
can be provided to persons seeking admission to that facility 
and must provide the admission review team with the following 
information:  
    (1) a copy of the admission and level of care criteria 
adopted by the provider; and 
    (2) a written description of the services that are 
available to the person seeking admission, including day 
services, professional support services, emergency services, 
available direct care staffing, supervisory and administrative 
supports, quality assurance systems, and criteria established by 
the provider for discharging persons from the facility. 
    Subd. 5.  [ESTABLISHMENT OF ADMISSION REVIEW TEAM; NOTICE 
TO PROVIDER.] When a county agency decides to establish 
admission review teams for the intermediate care facilities for 
persons with mental retardation or related conditions located in 
the county, the county agency shall notify the providers of the 
county agency's intent at least 60 days prior to establishing 
the teams.  
    Sec. 49.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2p.  [DOWNSIZING OF NURSING FACILITIES THAT ARE 
INSTITUTIONS FOR MENTAL DISEASE.] (a) The provisions of this 
subdivision apply to a nursing facility that is an institution 
for mental disease and that has less than 23 licensed beds.  A 
nursing facility that meets these conditions may reduce its 
total number of licensed beds to 16 licensed beds by July 1, 
1992, by notifying the commissioner of health of the reduction 
by April 1, 1992.  If the nursing facility elects to reduce its 
licensed beds to 16, the commissioner of health shall approve 
that request effective on the date of request.  
    (b) The commissioner of human services must be notified by 
the nursing facility of the reduction in licensed beds by April 
4, 1992, and that notice must include a copy of the request for 
reduction submitted to the commissioner of health. 
    (c) For the rate year beginning July 1, 1992, the 
commissioner shall establish the operating cost payment rates 
for a nursing facility that has reduced its licensed bed 
capacity under this subdivision by taking into account 
paragraphs (1) and (2).  
    (1) The commissioner must reduce the nursing facility's 
nurse's aide, orderly, and attendant salaries account and the 
food expense account for the reporting year ending September 30, 
1991, by 50 percent of the percentage change in licensed beds.  
    (2) The commissioner shall adjust the nursing facility's 
resident days and standardized resident days for the reporting 
year ending September 30, 1991, as in clauses (i) and (ii).  
    (i) Resident days shall be the lesser of the nursing 
facility's actual resident days for that reporting year or 5,840.
    (ii) Standardized resident days shall be the lesser of the 
nursing facility's actual standardized resident days or the 
nursing facility's case mix score for that reporting year times 
5,840.  
    (d) For the rate year beginning July 1, 1993, the 
commissioner shall establish the operating cost payment rates 
for a nursing facility that has reduced its licensed bed 
capacity under this subdivision by taking into account 
paragraphs (1) and (2). 
    (1) The commissioner must reduce the nursing facility's 
account for the nurse's aide, orderly, and attendant salaries, 
and its account for food expense for the reporting year ending 
September 30, 1992, by 37.5 percent of the percentage change in 
licensed beds.  
    (2) The commissioner shall adjust the nursing facility's 
resident days and standardized resident days for the reporting 
year ending September 30, 1992, as in clauses (i) and (ii).  
    (i) Resident days shall be the lesser of the nursing 
facility's actual resident days for that reporting year or 5,840.
    (ii) Standardized resident days shall be the lesser of the 
nursing facility's actual standardized resident days or the 
nursing facility's case mix score for that reporting year times 
5,840.  
    (e) If a nursing facility reduces its total number of 
licensed beds before June 28, 1991, by notifying the 
commissioner of health by that date, the dates and computations 
in this subdivision shall be accelerated by one year. 
    (f) A nursing facility eligible under this subdivision may 
use the notification date and the date on which the licensed 
beds are reduced for purposes of applying the provisions in 
section 256B.431, subdivision 3a, paragraph (d), clause (2).  
    Sec. 50.  Minnesota Statutes 1990, section 256B.431, is 
amended by adding a subdivision to read: 
    Subd. 2q.  [NEGOTIATED RATE CAP EXEMPTION.] A nursing 
facility which requests, after January 1991, that its boarding 
care beds be decertified from participation in the medical 
assistance program, is not eligible for the exception to the 
negotiated rate cap in section 256I.05, subdivision 2, paragraph 
(c), clause (1). 
    Sec. 51.  Minnesota Statutes 1990, section 256I.05, is 
amended by adding a subdivision to read: 
    Subd. 10.  [FOSTER CARE.] Beginning July 1, 1992, the 
negotiated rate of a residence licensed as a foster home is 
limited to the rate set for room and board costs provided the 
foster home is not the license holder's primary residence, or 
the license holder is not the primary caregiver to persons 
receiving services in the negotiated rate residence, and federal 
funding is available to pay for the cost of other necessary 
services.  For the purpose of this section, room and board costs 
mean costs of providing food and shelter for eligible persons, 
and includes the directly identifiable costs of: 
    (1) normal and special diet, food preparation and food 
services; 
    (2) providing linen, bedding, laundering, and laundry 
supplies; 
    (3) housekeeping, including cleaning and lavatory supplies; 
    (4) maintenance and operation of the residence and grounds, 
including fuel, utilities, supplies, and equipment; 
    (5) the allocation of salaries related to these areas; and 
    (6) the lease or mortgage payment, property tax and 
insurance, furnishings and appliances. 
    Sec. 52.  Minnesota Statutes 1990, section 462A.02, 
subdivision 13, is amended to read: 
    Subd. 13.  "Eligible mortgagor" means a nonprofit or 
cooperative housing corporation,; the department of 
administration for the purpose of developing nursing home beds 
under section 251.011, community-based programs as defined in 
sections 252.50 and 253.28, or secure beds for mentally ill 
persons under section 253.015, subdivision 2, paragraph (c); a 
limited profit entity or a builder as defined by the agency in 
its rules, which sponsors or constructs residential housing as 
defined in subdivision 7,; or a natural person of low or 
moderate income, except that the return to a limited dividend 
entity shall not exceed ten percent of the capital contribution 
of the investors or such lesser percentage as the agency shall 
establish in its rules;, provided that residual receipts funds 
of a limited dividend entity may be used for agency-approved, 
housing-related investments owned by the limited dividend entity 
without regard to the limitation on returns.  Owners of existing 
residential housing occupied by renters shall be eligible for 
rehabilitation loans, only if, as a condition to the issuance of 
the loan, the owner agrees to conditions established by the 
agency in its rules relating to rental or other matters that 
will insure that the housing will be occupied by persons and 
families of low or moderate income.  The agency shall require by 
rules that the owner give preference to those persons of low or 
moderate income who occupied the residential housing at the time 
of application for the loan. 
    Sec. 53.  [DEMONSTRATION PROJECTS.] 
    The commissioner shall demonstrate the development of 
family foster care services for persons with developmental 
disabilities in order to achieve regional treatment center 
census reduction or to develop alternative placements for 
persons inappropriately placed in nursing homes.  For all 
persons participating in this demonstration that receive 
services funded by the enhanced waivered services fund, the 
costs of waivered services shall not exceed an average of $120 
per person per day in fiscal year 1993.  The commissioner shall 
demonstrate a family choice option for 100 persons with 
developmental disabilities and their families in fiscal year 
1992 and for 200 persons and their families in fiscal year 
1993.  For all persons authorized by the commissioner to receive 
services under the family choice option, the cost of services 
funded by the Title XIX home- and community-based waiver are 
limited to an average of $35 per person per day in fiscal year 
1992 with annual cost adjustments as authorized by the 
legislature. 
    Sec. 54.  [RULE REVISION.] 
    The commissioner must revise Minnesota Rules, parts 
9545.0900 to 9545.1090, which govern facilities that provide 
residential services for children with emotional handicaps.  The 
rule revisions must be adopted within 12 months of the effective 
date of this section.  
    Sec. 55.  [JOINT LEGISLATIVE STUDY OF RESIDENTIAL PLACEMENT 
FOR CHILDREN WITH SPECIAL MENTAL HEALTH NEEDS.] 
    A joint legislative committee composed of members of the 
house and senate shall hold interim hearings to study the need 
for specialized residential treatment programs for all children 
with emotional disturbance, particularly those who exhibit 
violent or destructive behavior and for whom local treatment 
programs are not feasible due to the small number of children 
who need the services and the specialized nature of the services 
required.  The joint committee shall be appointed under the 
rules of the house and senate and shall be drawn from membership 
of the health and human services and judiciary committees in 
both houses, and the house human resources division of 
appropriations and the health and human services division of the 
senate finance committee.  The committee shall solicit 
information from representatives of the commissioners of the 
departments of human services, corrections, education, and 
health; from the children's mental health advisory committee; 
from representatives of mental health advocacy organizations, 
counties, service providers, the juvenile court system, and 
other interest groups.  The committee shall solicit information 
on the estimated number of children who need specialized 
services and the extent to which these children are now being 
served in other states, and shall make recommendations for 
action that is needed to develop resources within Minnesota and 
any cost-containment initiatives necessary for efficient use of 
these resources.  The joint committee shall report back to the 
full legislature by December 1, 1991, with its findings and 
recommendations, including recommendations on additional 
mechanisms by which the commissioner shall approve out-of-state 
placements of children for whom the commissioner is responsible 
for payment of a portion of specialized treatment costs. 
    Sec. 56.  [PILOT PROJECT FOR MENTAL HEALTH SERVICES 
DELIVERY SYSTEM.] 
    (a) Upon adoption of a resolution by the Dakota county 
board of commissioners, a pilot project shall be established to 
design and plan a mental health services delivery system that 
would reduce the number of commitments to regional treatment 
centers and improve service delivery to mentally ill persons.  
Dakota county will provide in-kind staff resources to study the 
monetary feasibility of implementing the plan, to match the 
appropriation of grant funds from the legislature. 
    (b) The pilot project will seek to maximize local 
community-based living and treatment alternatives for Dakota 
county residents who have serious and persistent mental illness, 
and to create a system by which residents committed for 
treatment pursuant to Minnesota Statutes, chapter 253B, would be 
committed to community facilities and programs.  
    (c) The pilot project will offer services that are more 
accessible and community-based and provide better coordination 
and linkage to other services and resources in the community or 
county than those that are currently provided.  
    (d) The pilot project will be implemented July 1, 1991.  
The planning process for implementation will continue during the 
1992 fiscal year.  The planning process will require that new 
services be developed, existing services be modified, and 
numerous legislative proposals be developed for presentation to 
the legislature in 1992. * (Section 56 was vetoed by the 
governor.) 
    Sec. 57.  [CHILDREN'S MENTAL HEALTH FUNDING.] 
    Subdivision 1.  [STATEWIDE TASK FORCE.] The commissioner of 
human services shall convene a task force to study the 
feasibility of establishing an integrated children's mental 
health fund.  The task force shall consist of mental health 
professionals, county social services personnel, service 
providers, advocates, and parents of children who have 
experienced episodes of emotional disturbance.  The task force 
shall also include representatives of the children's mental 
health subcommittee of the state advisory council and local 
coordinating councils established under Minnesota Statutes, 
sections 245.487 to 245.4887.  The task force shall include the 
commissioners of education, health, and human services; two 
members of the senate; and two members of the house of 
representatives.  The task force shall examine all possible 
county, state, and federal sources of funds for children's 
mental health with a view to designing an integrated children's 
mental health fund, improving methods of coordinating and 
maximizing all funding sources, and increasing federal funding.  
Programs to be examined shall include, but not be limited to, 
the following:  medical assistance, title IV-E of the social 
security act, title XX social service programs, chemical 
dependency programs, education and special education programs, 
and, for children with a dual diagnosis, programs for the 
developmentally disabled.  The task force may consult with 
experts in the field, as necessary.  The task force shall make a 
preliminary report and recommendations on local coordination of 
funding sources by January 1, 1992, to facilitate the 
development of local protocols and procedures under subdivision 
2.  The task force shall submit a final report to the 
legislature by January 1, 1993, with its findings and 
recommendations. 
    Subd. 2.  [DEVELOPMENT OF LOCAL PROTOCOLS AND 
PROCEDURES.] (a) By January 1, 1992, each local children's 
mental health coordinating council established under Minnesota 
Statutes, section 245.4875, subdivision 6, shall establish a 
task force to develop recommended protocols and procedures that 
will ensure that the planning, case management, and delivery of 
services for children with severe emotional disturbance are 
coordinated and make the most efficient and cost-effective use 
of available funding.  The task force must include, at a 
minimum, representatives of local school districts and county 
medical assistance and mental health staff.  The protocols and 
procedures must be designed to:  
    (1) ensure that services to children are driven by the 
children's needs, rather than by the availability or source of 
funding for services; 
    (2) ensure that planning for services, case management, 
service delivery, and payment for services involves coordination 
of all affected agencies, providers, and funding sources; and 
    (2) maximize available funding by making full use of all 
available funding, including medical assistance. 
    (b) By October 1, 1992, each council shall make 
recommendations to the statewide task force established under 
subdivision 1 regarding the feasibility and desirability of 
methods of consolidating or pooling funding sources to ensure 
that services are tailored to the specific needs of each child 
and to allow greater flexibility in paying for services. 
    (c) By October 1, 1992, each local coordinating council 
shall report to the commissioner of human services the council's 
findings and the recommended protocols and procedures.  The 
council shall also recommend legislative changes or rule changes 
that will improve local coordination and further maximize 
available funding. 
    Subd. 3.  [FINAL REPORT.] By February 15, 1993, the 
commissioner of human services shall provide a report to the 
legislature that describes the reports and recommendations of 
the statewide task force under subdivision 1 and of the local 
coordinating councils under subdivision 2, and provides the 
commissioner's recommendations for legislation or other needed 
changes. 
    Sec. 58.  [INSTRUCTION TO REVISOR.] 
    Subdivision 1.  [RENUMBERING.] The revisor of statutes 
shall renumber Minnesota Statutes, section 245.4886 as section 
245.4887 and Minnesota Statutes, section 245.4887 as section 
245.4888, and shall correct all relevant cross-references in 
Minnesota Statutes and Minnesota Rules. 
    Subd. 2.  [INDIVIDUAL HABILITATION PLAN.] The revisor of 
statutes shall delete references to "individual habilitation 
plan" wherever appearing in Minnesota Statutes, chapters 252 and 
252A, and sections 120.17 and 256.045. 
    Subd. 3.  [INSTRUCTION TO REVISOR.] In the next edition of 
Minnesota Statutes, the revisor of statutes is directed to 
change the words "Ah-Gwah-Ching Nursing Home" wherever they 
appear to "Ah-Gwah-Ching Center". 
    Sec. 59.  [REPEALER.] 
    Subdivision 1.  Minnesota Statutes 1990, section 245.476, 
subdivisions 1, 2, and 3, are repealed. 
    Subd. 2.  Minnesota Statutes 1990, section 252.275, 
subdivision 2, is repealed effective January 1, 1992. 
    Sec. 61.  [EFFECTIVE DATE.] 
    Subdivision 1.  Sections 5 and 10 are effective the day 
following final enactment. 
    Subd. 2.  Section 20 is effective July 1, 1993. 
    Subd. 3.  Section 32 is effective January 1, 1992. 
    Subd. 4.  Section 48 is effective September 30, 1991. 

                                ARTICLE 7

                         ALTERNATIVE CARE/SAIL 
    Section 1.  Minnesota Statutes 1990, section 144A.31, is 
amended to read: 
    144A.31 [INTERAGENCY BOARD FOR QUALITY ASSURANCE LONG-TERM 
CARE PLANNING COMMITTEE.] 
    Subdivision 1.  [INTERAGENCY BOARD LONG-TERM CARE PLANNING 
COMMITTEE.] The commissioners of health and human services shall 
establish, by July 1, 1983, an interagency board committee of 
managerial employees of their respective departments who are 
knowledgeable and employed in the areas of long-term care, 
geriatric care, community services for the elderly, long-term 
care facility inspection, or quality of care assurance.  The 
number of interagency board committee members shall not exceed 
eight twelve; three four members each to represent the 
commissioners of health and human services and one member each 
to represent the commissioners of state planning and, housing 
finance, finance, and the chair of the Minnesota board on 
aging.  The board shall identify long-term care issues requiring 
coordinated interagency policies and shall conduct analyses, 
coordinate policy development, and make recommendations to the 
commissioners for effective implementation of these policies.  
The commissioner of human services and the commissioner of 
health or their designees shall annually alternate chairing and 
convening the board committee.  The board committee may utilize 
the expertise and time of other individuals employed by either 
each department as needed.  The board committee may recommend 
that the commissioners contract for services as needed.  
The board committee shall meet as often as necessary to 
accomplish its duties, but at least quarterly.  The board 
committee shall establish procedures, including public hearings, 
for allowing regular opportunities for input from residents, 
nursing homes consumers of long-term care services, advocates, 
trade associations, facility administrators, county agency 
administrators, and other interested persons.  
    Subd. 2.  [INSPECTIONS.] No later than January 1, 1988, the 
board shall develop and recommend implementation and enforcement 
of an effective system to ensure quality of care in each nursing 
home in the state.  Quality of care includes evaluating, using 
the resident's care plan, whether the resident's ability to 
function is optimized and should not be measured solely by the 
number or amount of services provided.  
    The board shall assist the commissioner of health in 
developing methods to ensure that inspections and reinspections 
of nursing homes are conducted with a frequency and in a manner 
calculated to most effectively and appropriately fulfill its 
quality assurance responsibilities and achieve the greatest 
benefit to nursing home residents.  The board shall identify and 
recommend criteria and methods for identifying those nursing 
homes that present the most serious concerns with respect to 
resident health, treatment, comfort, safety, and well-being.  
The commissioner of health shall require a higher frequency and 
extent of inspections with respect to those nursing homes that 
present the most serious concerns with respect to resident 
health, treatment, comfort, safety, and well-being.  These 
concerns include but are not limited to:  complaints about care, 
safety, or rights; situations where previous inspections or 
reinspections have resulted in correction orders related to 
care, safety, or rights; instances of frequent change in 
administration in excess of normal turnover rates; and 
situations where persons involved in ownership or administration 
of the nursing home have been convicted of engaging in criminal 
activity.  A nursing home that presents none of these concerns 
or any other concern or condition recommended by the board and 
established by the commissioner that poses a risk to resident 
care, safety, or rights shall be inspected once every two years 
for compliance with key requirements as determined by the board. 
    The board shall develop and recommend to the commissioners 
mechanisms beyond the inspection process to protect resident 
care, safety, and rights, including but not limited to 
coordination with the office of health facility complaints and 
the nursing home ombudsman program.  
    Subd. 3.  [METHODS FOR DETERMINING RESIDENT CARE NEEDS.] 
The board shall develop and recommend to the commissioners 
definitions for levels of care and methods for determining 
resident care needs for implementation on July 1, 1985, in order 
to adjust payments for resident care based on the mix of 
resident needs in a nursing home.  The methods for determining 
resident care needs shall include assessments of ability to 
perform activities of daily living and assessments of medical 
and therapeutic needs.  
    Subd. 2a.  [DUTIES.] The interagency committee shall 
identify long-term care issues requiring coordinated interagency 
policies and shall conduct analyses, coordinate policy 
development, and make recommendations to the commissioners for 
effective implementation of these policies.  The committee shall 
refine state long-term goals, establish performance indicators, 
and develop other methods or measures to evaluate program 
performance, including client outcomes.  The committee shall 
review the effectiveness of programs in meeting their objectives.
    The committee shall also:  
    (1) facilitate the development of regional and local bodies 
to plan and coordinate regional and local services; 
    (2) recommend a single regional or local point of access 
for persons seeking information on long-term care services; 
    (3) recommend changes in state funding and administrative 
policies that are necessary to maximize the use of home and 
community-based care and that promote the use of the least 
costly alternative without sacrificing quality of care; and 
    (4) develop methods of identifying and serving seniors who 
need minimal services to remain independent but who are likely 
to develop a need for more extensive services in the absence of 
these minimal services. 
    Subd. 2b.  [GOALS OF THE COMMITTEE.] The long-term goals of 
the committee are: 
    (1) to achieve a broad awareness and use of low-cost home 
care and other residential alternatives to nursing homes; 
    (2) to develop a statewide system of information and 
assistance to enable easy access to long-term care services; 
    (3) to develop sufficient alternatives to nursing homes to 
serve the increased number of people needing long-term care; and 
    (4) to maintain the moratorium on new construction of 
nursing home beds and to lower the percentage of elderly served 
in institutional settings. 
     These goals are designed to create a new community-based 
care paradigm for long-term care in Minnesota in order to 
maximize independence of the older adult population, and to 
ensure cost-effective use of financial and human resources. 
    Subd. 4.  [ENFORCEMENT.] The board committee shall develop 
and recommend for implementation effective methods of enforcing 
quality of care standards.  The board committee shall develop 
and monitor, and the commissioner of human services shall 
implement, a resident relocation plan that instructs a county in 
which a nursing home or certified boarding care home is located 
of procedures to ensure that the needs of residents in nursing 
homes or certified boarding care homes about to be closed are 
met.  The duties of a county under the relocation plan also 
apply when residents are to be discharged from a nursing home or 
certified boarding care home as a result of a change in 
certification, closure, or loss or termination of the facility's 
medical assistance provider agreement.  The resident relocation 
plans and county duties required in this subdivision apply to 
the voluntary or involuntary closure, or reduction in services 
or size of, an intermediate care facility for the mentally 
retarded.  The relocation plan for intermediate care facilities 
for the mentally retarded must conform to Minnesota Rules, parts 
4655.6810 to 4655.6830, 9525.0015 to 9525.0165, and 9546.0010 to 
9546.0060, or their successors.  The commissioners of health and 
human services may waive a portion of existing rules that the 
commissioners determine does not apply to persons with mental 
retardation or related conditions.  The county shall ensure 
appropriate placement of residents in licensed and certified 
facilities or other alternative care such as home health care 
and foster care placement.  In preparing for relocation, the 
board committee shall ensure that residents and their families 
or guardians are involved in planning the relocation.  
    Subd. 5.  [REPORTS.] The board committee shall prepare a 
biennial report and the commissioners of health and human 
services shall deliver this report to the legislature no later 
than January 15, 1984, on the board's proposals and progress on 
implementation of the methods required under subdivision 
2 beginning January 31, 1993, listing progress, achievements, 
and current goals and objectives.  The commissioners shall 
recommend changes in or additions to legislation necessary or 
desirable to fulfill their responsibilities.  The board shall 
prepare an annual report and the commissioners shall deliver 
this report annually to the legislature, beginning in January 
1985, on the implementation of the provisions of this section. 
    Subd. 6.  [DATA.] The interagency board may committee shall 
have access to data from the commissioners of health, human 
services, and public safety housing finance, and state planning 
for carrying out its duties under this section.  The 
commissioner of health and the commissioner of human services 
may each have access to data on persons, including data on 
vendors of services, from the other to carry out the purposes of 
this section.  If the interagency board committee, the 
commissioner of health, or the commissioner of human services 
receives data on persons, including data on vendors of services, 
that is collected, maintained, used or disseminated in an 
investigation, authorized by statute and relating to enforcement 
of rules or law, the board committee or the commissioner shall 
not disclose that information except:  
      (a) pursuant to section 13.05; 
      (b) pursuant to statute or valid court order; or 
      (c) to a party named in a civil or criminal proceeding, 
administrative or judicial, for preparation of defense.  
      Data described in this subdivision is classified as public 
data upon its submission to an administrative law judge or court 
in an administrative or judicial proceeding.  
    Subd. 7.  [LONG-TERM CARE RESEARCH AND DATABASE.] The 
interagency long-term care planning committee shall collect and 
analyze state and national long-term care data and research, 
including relevant health data and information and research 
relating to long-term care and social needs, service 
utilization, costs, and client outcomes.  The committee shall 
make recommendations to state agencies and other public and 
private agencies for methods of improving coordination of 
existing data, develop data needed for long-term care research, 
and promote new research activities.  Research and data 
activities must be designed to: 
     (1) improve the validity and reliability of existing data 
and research information; 
    (2) identify sources of funding and potential uses of 
funding sources; 
    (3) evaluate the effectiveness and client outcomes of 
existing programs; and 
    (4) identify and plan for future changes in the number, 
level, and type of services needed by seniors. 
    Sec. 2.  Minnesota Statutes 1990, section 144A.46, 
subdivision 4, is amended to read: 
    Subd. 4.  [RELATION TO OTHER REGULATORY PROGRAMS.] In the 
exercise of the authority granted under sections 144A.43 to 
144A.49, the commissioner shall not duplicate or replace 
standards and requirements imposed under another state 
regulatory program.  The commissioner shall not impose 
additional training or education requirements upon members of a 
licensed or registered occupation or profession, except as 
necessary to address or prevent problems that are unique to the 
delivery of services in the home or to enforce and protect the 
rights of consumers listed in section 144A.44.  For home care 
providers certified under the Medicare program, the state 
standards must not be inconsistent with the Medicare standards 
for Medicare services.  The commissioner of health shall not 
require a home care provider certified under the Medicare 
program to comply with a rule adopted under section 144A.45 if 
the home care provider is required to comply with any equivalent 
federal law or regulation relating to the same subject matter.  
The commissioner of health shall specify in the rules those 
provisions that are not applicable to certified home care 
providers.  To the extent possible, the commissioner shall 
coordinate the inspections required under sections 144A.45 to 
144A.48 with the health facility licensure inspections required 
under sections 144.50 to 144.58 or 144A.10 when the health care 
facility is also licensed under the provisions of Laws 1987, 
chapter 378. 
    Sec. 3.  Minnesota Statutes 1990, section 198.007, is 
amended to read: 
    198.007 [QUALITY ASSURANCE.] 
    The board shall create a utilization review committee for 
each home comprised of the appropriate professionals employed by 
or under contract to the home.  The committee shall use the 
case-mix system established under section 144.072 to assess the 
appropriateness and quality of care and services provided 
residents of the homes. 
    The board shall create an admissions committee for each 
home comprised of the appropriate professionals employed by or 
under contract to each home and adopt a preadmission screening 
program, such as the one established under section 256B.091, for 
all applicants for admission to the homes who may require 
nursing or boarding care, taking into account the eligibility 
requirements in section 198.022, the admissions criteria 
established by board rules, and the availability of space in the 
homes.  
    Sec. 4.  Minnesota Statutes 1990, section 256.025, 
subdivision 2, is amended to read: 
    Subd. 2.  [COVERED PROGRAMS AND SERVICES.] The procedures 
in this section govern payment of county agency expenditures for 
benefits and services distributed under the following programs: 
    (1) aid to families with dependent children under sections 
256.82, subdivision 1, and 256.935, subdivision 1; 
    (2) medical assistance under sections 256B.041, subdivision 
5, and 256B.19, subdivision 1; 
    (3) general assistance medical care under section 256D.03, 
subdivision 6; 
    (4) general assistance under section 256D.03, subdivision 
2; 
    (5) work readiness under section 256D.03, subdivision 2; 
    (6) emergency assistance under section 256.871, subdivision 
6; 
    (7) Minnesota supplemental aid under section 256D.36, 
subdivision 1; 
    (8) preadmission screening and alternative care grants 
under section 256B.091; 
    (9) work readiness services under section 256D.051; 
    (10) case management services under section 256.736, 
subdivision 13; 
    (11) general assistance claims processing, medical 
transportation and related costs; and 
    (12) medical assistance, medical transportation and related 
costs. 
    Sec. 5.  Minnesota Statutes 1990, 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 health care financing 
administration approves the necessary state plan amendments; (c) 
the patient was screened as provided in section 256B.091 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 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.  
    Sec. 6.  Minnesota Statutes 1990, section 256B.48, 
subdivision 1, is amended to read: 
    Subdivision 1.  [PROHIBITED PRACTICES.] A nursing home is 
not eligible to receive medical assistance payments unless it 
refrains from all of the following: 
    (a) Charging private paying residents rates for similar 
services which exceed those which are approved by the state 
agency for medical assistance recipients as determined by the 
prospective desk audit rate, except under the following 
circumstances:  the nursing home may (1) charge private paying 
residents a higher rate for a private room, and (2) charge for 
special services which are not included in the daily rate if 
medical assistance residents are charged separately at the same 
rate for the same services in addition to the daily rate paid by 
the commissioner.  Services covered by the payment rate must be 
the same regardless of payment source.  Special services, if 
offered, must be available to all residents in all areas of the 
nursing home and charged separately at the same rate.  Residents 
are free to select or decline special services.  Special 
services must not include services which must be provided by the 
nursing home in order to comply with licensure or certification 
standards and that if not provided would result in a deficiency 
or violation by the nursing home.  Services beyond those 
required to comply with licensure or certification standards 
must not be charged separately as a special service if they were 
included in the payment rate for the previous reporting year.  A 
nursing home that charges a private paying resident a rate in 
violation of this clause is subject to an action by the state of 
Minnesota or any of its subdivisions or agencies for civil 
damages.  A private paying resident or the resident's legal 
representative has a cause of action for civil damages against a 
nursing home that charges the resident rates in violation of 
this clause.  The damages awarded shall include three times the 
payments that result from the violation, together with costs and 
disbursements, including reasonable attorneys' fees or their 
equivalent.  A private paying resident or the resident's legal 
representative, the state, subdivision or agency, or a nursing 
home may request a hearing to determine the allowed rate or 
rates at issue in the cause of action.  Within 15 calendar days 
after receiving a request for such a hearing, the commissioner 
shall request assignment of an administrative law judge under 
sections 14.48 to 14.56 to conduct the hearing as soon as 
possible or according to agreement by the parties.  The 
administrative law judge shall issue a report within 15 calendar 
days following the close of the hearing.  The prohibition set 
forth in this clause shall not apply to facilities licensed as 
boarding care facilities which are not certified as skilled or 
intermediate care facilities level I or II for reimbursement 
through medical assistance. 
     (b) Requiring an applicant for admission to the home, or 
the guardian or conservator of the applicant, as a condition of 
admission, to pay any fee or deposit in excess of $100, loan any 
money to the nursing home, or promise to leave all or part of 
the applicant's estate to the home.  
    (c) Requiring any resident of the nursing home to utilize a 
vendor of health care services who is a licensed physician or 
pharmacist chosen by the nursing home.  
    (d) Providing differential treatment on the basis of status 
with regard to public assistance.  
    (e) Discriminating in admissions, services offered, or room 
assignment on the basis of status with regard to public 
assistance or refusal to purchase special services.  Admissions 
discrimination shall include, but is not limited to:  
    (1) basing admissions decisions upon assurance by the 
applicant to the nursing home, or the applicant's guardian or 
conservator, that the applicant is neither eligible for nor will 
seek public assistance for payment of nursing home care costs; 
and 
    (2) engaging in preferential selection from waiting lists 
based on an applicant's ability to pay privately or an 
applicant's refusal to pay for a special service. 
    The collection and use by a nursing home of financial 
information of any applicant pursuant to the a preadmission 
screening program established by section 256B.091 law shall not 
raise an inference that the nursing home is utilizing that 
information for any purpose prohibited by this paragraph.  
    (f) Requiring any vendor of medical care as defined by 
section 256B.02, subdivision 7, who is reimbursed by medical 
assistance under a separate fee schedule, to pay any amount 
based on utilization or service levels or any portion of the 
vendor's fee to the nursing home except as payment for renting 
or leasing space or equipment or purchasing support services 
from the nursing home as limited by section 256B.433.  All 
agreements must be disclosed to the commissioner upon request of 
the commissioner.  Nursing homes and vendors of ancillary 
services that are found to be in violation of this provision 
shall each be subject to an action by the state of Minnesota or 
any of its subdivisions or agencies for treble civil damages on 
the portion of the fee in excess of that allowed by this 
provision and section 256B.433.  Damages awarded must include 
three times the excess payments together with costs and 
disbursements including reasonable attorney's fees or their 
equivalent.  
     (g) Refusing, for more than 24 hours, to accept a resident 
returning to the same bed or a bed certified for the same level 
of care, in accordance with a physician's order authorizing 
transfer, after receiving inpatient hospital services. 
     The prohibitions set forth in clause (b) shall not apply to 
a retirement home with more than 325 beds including at least 150 
licensed nursing home beds and which: 
     (1) is owned and operated by an organization tax-exempt 
under section 290.05, subdivision 1, clause (i); and 
     (2) accounts for all of the applicant's assets which are 
required to be assigned to the home so that only expenses for 
the cost of care of the applicant may be charged against the 
account; and 
     (3) agrees in writing at the time of admission to the home 
to permit the applicant, or the applicant's guardian, or 
conservator, to examine the records relating to the applicant's 
account upon request, and to receive an audited statement of the 
expenditures charged against the applicant's individual account 
upon request; and 
     (4) agrees in writing at the time of admission to the home 
to permit the applicant to withdraw from the home at any time 
and to receive, upon withdrawal, the balance of the applicant's 
individual account. 
     For a period not to exceed 180 days, the commissioner may 
continue to make medical assistance payments to a nursing home 
or boarding care home which is in violation of this section if 
extreme hardship to the residents would result.  In these cases 
the commissioner shall issue an order requiring the nursing home 
to correct the violation.  The nursing home shall have 20 days 
from its receipt of the order to correct the violation.  If the 
violation is not corrected within the 20-day period the 
commissioner may reduce the payment rate to the nursing home by 
up to 20 percent.  The amount of the payment rate reduction 
shall be related to the severity of the violation and shall 
remain in effect until the violation is corrected.  The nursing 
home or boarding care home may appeal the commissioner's action 
pursuant to the provisions of chapter 14 pertaining to contested 
cases.  An appeal shall be considered timely if written notice 
of appeal is received by the commissioner within 20 days of 
notice of the commissioner's proposed action.  
    In the event that the commissioner determines that a 
nursing home is not eligible for reimbursement for a resident 
who is eligible for medical assistance, the commissioner may 
authorize the nursing home to receive reimbursement on a 
temporary basis until the resident can be relocated to a 
participating nursing home. 
    Certified beds in facilities which do not allow medical 
assistance intake on July 1, 1984, or after shall be deemed to 
be decertified for purposes of section 144A.071 only.  
    Sec. 7.  [256.9751] [CONGREGATE HOUSING SERVICES PROJECTS.] 
    Subdivision 1.  [DEFINITIONS.] For the purposes of this 
section, the following terms have the meanings given them.  
    (a) [CONGREGATE HOUSING.] "Congregate housing" means 
federally or locally subsidized housing, designed for the 
elderly, consisting of private apartments and common areas which 
can be used for activities and for serving meals. 
    (b) [CONGREGATE HOUSING SERVICES PROJECTS.] "Congregate 
housing services project" means a project in which services are 
or could be made available to older persons who live in 
subsidized housing and which helps delay or prevent nursing home 
placement.  To be considered a congregate housing services 
project, a project must have:  (1) an on-site coordinator, and 
(2) a plan for providing a minimum of one meal per day, for each 
elderly participant, seven days a week.  
    (c) [ON-SITE COORDINATOR.] "On-site coordinator" means a 
person who works on-site in a building or buildings and who 
serves as a contact for older persons who need services, 
support, and assistance in order to delay or prevent nursing 
home placement.  
    (d) [CONGREGATE HOUSING SERVICES PROJECT PARTICIPANTS OR 
PROJECT PARTICIPANTS.] "Congregate housing services project 
participants" or "project participants" means elderly persons 60 
years old or older, who are currently residents of, or who are 
applying for residence in housing sites, and who need support 
services to remain independent. 
    Subd. 2.  [ADVISORY COMMITTEE.] An advisory committee shall 
be appointed to advise the Minnesota board on aging on the 
development and implementation of the congregate housing 
services projects.  The advisory committee shall review 
procedures and provide advice and technical assistance to the 
Minnesota board on aging regarding the grant program established 
under this section.  The advisory committee shall consist of not 
more than 15 people appointed by the Minnesota board on aging, 
and shall be comprised of representatives from public and 
nonprofit service and housing providers and consumers from all 
areas of the state.  Members of the advisory committee shall not 
be compensated for service. 
    Subd. 3.  [GRANT PROGRAM.] The Minnesota board on aging 
shall establish a congregate housing services grant program 
which will enable communities to provide on-site coordinators to 
serve as a contact for older persons who need services and 
support, and assistance to access services in order to delay or 
prevent nursing home placement. 
    Subd. 4.  [USE OF GRANT FUNDS.] Grant funds shall be used 
to develop and fund on-site coordinator positions.  Grant funds 
shall not be used to duplicate existing funds, to modify 
buildings, or to purchase equipment.  
    Subd. 5.  [GRANT ELIGIBILITY.] A public or nonprofit agency 
or housing unit may apply for funds to provide a coordinator for 
congregate housing services to an identified population of frail 
elderly persons in a subsidized multiunit apartment building or 
buildings in a community.  The board shall give preference to 
applicants that meet the requirements of this section, and that 
have a common dining site.  Local match may be required.  State 
money received may also be used to match federal money allocated 
for congregate housing services.  Grants shall be awarded to 
urban and rural sites. 
     Subd. 6.  [CRITERIA FOR SELECTION.] The Minnesota board on 
aging shall select projects under this section according to the 
following criteria: 
    (1) the extent to which the proposed project assists older 
persons to age-in-place to prevent or delay nursing home 
placement; 
    (2) the extent to which the proposed project identifies the 
needs of project participants; 
    (3) the extent to which the proposed project identifies how 
the on-site coordinator will help meet the needs of project 
participants; 
    (4) the extent to which the proposed project assures the 
availability of one meal a day, seven days a week, for 
participants in need; 
    (5) the extent to which the proposed project demonstrates 
involvement of participants and family members in the project; 
and 
    (6) the extent to which the proposed project demonstrates 
involvement of housing providers and public and private service 
agencies, including area agencies on aging. 
    Subd. 7.  [GRANT APPLICATIONS.] The Minnesota board on 
aging shall request proposals for grants and award grants using 
the criteria in subdivision 6.  Grant applications shall include:
    (1) documentation of the need for congregate services so 
the residents can remain independent; 
    (2) a description of the resources, such as social services 
and health services, that will be available in the community to 
provide the necessary support services; 
    (3) a description of the target population, as defined in 
subdivision 1, paragraph (d); 
    (4) a performance plan that includes written performance 
objectives, outcomes, timelines, and the procedure the grantee 
will use to document and measure success in meeting the 
objectives; and 
    (5) letters of support from appropriate public and private 
agencies and organizations, such as area agencies on aging and 
county human service departments that demonstrate an intent to 
work with and coordinate with the agency requesting a grant.  
    Subd. 8.  [REPORT.] By January 1, 1993, the Minnesota board 
on aging shall submit a report to the legislature evaluating the 
programs.  The report must document the project costs and 
outcomes that helped delay or prevent nursing home placement.  
The report must describe steps taken for quality assurance and 
must also include recommendations based on the project findings. 
    Sec. 8.  Minnesota Statutes 1990, section 256B.04, 
subdivision 16, is amended to read: 
    Subd. 16.  [PERSONAL CARE SERVICES.] (a) The commissioner 
shall adopt permanent rules to implement, administer, and 
operate personal care services.  The rules must incorporate the 
standards and requirements adopted by the commissioner of health 
under section 144A.45 which are applicable to the provision of 
personal care.  Notwithstanding any contrary language in this 
paragraph, the commissioner of human services and the 
commissioner of health shall jointly promulgate rules to be 
applied to the licensure of personal care services provided 
under the medical assistance program.  The rules shall consider 
standards for personal care services that are based on the World 
Institute on Disability's recommendations regarding personal 
care services.  These rules shall at a minimum consider the 
standards and requirements adopted by the commissioner of health 
under section 144A.45, which the commissioner of human services 
determines are applicable to the provision of personal care 
services, in addition to other standards or modifications which 
the commissioner of human services determines are appropriate. 
    The commissioner of human services shall establish an 
advisory group including personal care consumers and providers 
to provide advice regarding which standards or modifications 
should be adopted.  The advisory group membership must include 
not less than 15 members, of which at least 60 percent must be 
consumers of personal care services and representatives of 
recipients with various disabilities and diagnoses and ages.  At 
least 51 percent of the members of the advisory group must be 
recipients of personal care. 
    The commissioner of human services may contract with the 
commissioner of health to enforce the jointly promulgated 
licensure rules for personal care service providers. 
    Prior to final promulgation of the joint rule the 
commissioner of human services shall report preliminary findings 
along with any comments of the advisory group and a plan for 
monitoring and enforcement by the department of health to the 
legislature by February 15, 1992. 
    Limits on the extent of personal care services that may be 
provided to an individual must be based on the 
cost-effectiveness of the services in relation to the costs of 
inpatient hospital care, nursing home care, and other available 
types of care.  The rules must provide, at a minimum:  
    (1) that agencies be selected to contract with or employ 
and train staff to provide and supervise the provision of 
personal care services; 
    (2) that agencies employ or contract with a qualified 
applicant that a qualified recipient proposes to the agency as 
the recipient's choice of assistant; 
    (3) that agencies bill the medical assistance program for a 
personal care service by a personal care assistant and 
supervision by the registered nurse supervising the personal 
care assistant; 
    (4) that agencies establish a grievance mechanism; and 
    (5) that agencies have a quality assurance program.  
    (b) For personal care assistants under contract with an 
agency under paragraph (a), the provision of training and 
supervision by the agency does not create an employment 
relationship.  The commissioner may waive the requirement for 
the provision of personal care services through an agency in a 
particular county, when there are less than two agencies 
providing services in that county.  
    Sec. 9.  Minnesota Statutes 1990, section 256B.0625, is 
amended by adding a subdivision to read: 
    Subd. 6a.  [HOME HEALTH SERVICES.] Home health services are 
those services specified in Minnesota Rules, part 9505.0290.  
Medical assistance covers home health services at a recipient's 
home residence.  Medical assistance does not cover home health 
services at a hospital, nursing facility, intermediate care 
facility, or a health care facility licensed by the commissioner 
of health, unless the commissioner of human services has prior 
authorized skilled nurse visits for less than 90 days for a 
resident at an intermediate care facility for persons with 
mental retardation, to prevent an admission to a hospital or 
nursing facility.  Home health services must be provided by a 
Medicare certified home health agency.  All nursing and home 
health aide services must be provided according to section 
256B.0627. 
    Sec. 10.  Minnesota Statutes 1990, section 256B.0625, 
subdivision 7, is amended to read: 
    Subd. 7.  [PRIVATE DUTY NURSING.] Medical assistance covers 
private duty nursing services in a recipient's home.  Recipients 
who are authorized to receive private duty nursing services in 
their home may use approved hours outside of the home during 
hours when normal life activities take them outside of their 
home and when, without the provision of private duty nursing, 
their health and safety would be jeopardized.  Medical 
assistance does not cover private duty nursing services at a 
hospital, nursing facility, intermediate care facility, or a 
health care facility licensed by the commissioner of health, 
except as authorized in section 256B.64 for ventilator dependent 
recipients in hospitals.  Total hours of service and payment 
allowed for services outside the home cannot exceed that which 
is otherwise allowed in an in-home setting according to section 
256B.0627.  All private duty nursing services must be provided 
according to the limits established under section 256B.0627.  
Private duty nursing services may not be reimbursed if the nurse 
is the spouse of the recipient or the parent or foster care 
provider of a recipient who is under age 18, or the recipient's 
legal guardian. 
    Sec. 11.  Minnesota Statutes 1990, section 256B.0625, is 
amended by adding a subdivision to read: 
    Subd. 19a.  [PERSONAL CARE SERVICES.] Medical assistance 
covers personal care services in a recipient's home.  Recipients 
who can direct their own care, or persons who cannot direct 
their own care when accompanied by the responsible party, may 
use approved hours outside the home when normal life activities 
take them outside the home and when, without the provision of 
personal care, their health and safety would be jeopardized.  
Medical assistance does not cover personal care services at a 
hospital, nursing facility, intermediate care facility or a 
health care facility licensed by the commissioner of health, 
except as authorized in section 256B.64 for ventilator dependent 
recipients in hospitals.  Total hours of service and payment 
allowed for services outside the home cannot exceed that which 
is otherwise allowed for personal care services in an in-home 
setting according to section 256B.0627.  All personal care 
services must be provided according to section 256B.0627.  
Personal care services may not be reimbursed if the personal 
care assistant is the spouse of the recipient or the parent of a 
recipient under age 18, the responsible party, the foster care 
provider of a recipient who cannot direct their own care or the 
recipient's legal guardian.  Parents of adult recipients, adult 
children of the recipient or adult siblings of the recipient may 
be reimbursed for personal care services if they are granted a 
waiver under section 256B.0627.  An exception for foster care 
providers may be made according to section 256B.0627, 
subdivision 5, paragraph (j). 
    Sec. 12.  Minnesota Statutes 1990, section 256B.0627, is 
amended to read: 
    256B.0627 [COVERED SERVICE; HOME CARE SERVICES.] 
    Subdivision 1.  [DEFINITION.] "Home care services" means 
a medically necessary health service, determined by the 
commissioner as medically necessary, that is ordered by a 
physician and documented in a care plan of care that is reviewed 
and revised as medically necessary by the physician at least 
once every 60 days.  Home care services include personal care 
and nursing supervision of personal care services which is 
reviewed and revised as medically necessary by the physician 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.  "Medically 
necessary" has the meaning given in Minnesota Rules, parts 
9505.0170 to 9505.0475.  "Care plan" means a written description 
of the services needed which shall include a detailed 
description of the covered home care services, who is providing 
the services, frequency of those services, and duration of those 
services.  The care plan shall also include expected outcomes 
and goals including expected date of goal accomplishment.  
    Subd. 2.  [SERVICES COVERED.] Home care services covered 
under this section include:  
    (1) nursing services under section 256B.0625, subdivision 
6a; 
    (2) private duty nursing services under section 256B.0625, 
subdivision 7; 
    (3) home health aide services under section 256B.0625, 
subdivision 6a; 
    (4) personal care services under section 256B.0625, 
subdivision 19a; and 
    (5) nursing supervision of personal care services under 
section 256B.0625, subdivision 19a.  
    Subd. 3.  [PRIVATE DUTY NURSING SERVICES; WHO MAY PROVIDE.] 
Private duty nursing services may be provided by a registered 
nurse or licensed practical nurse who is not the recipient's 
spouse, legal guardian, or parent of a minor child.  
    Subd. 4.  [PERSONAL CARE SERVICES.] (a) Personal care 
services may be provided by a qualified individual who is not 
the recipient's spouse, legal guardian, or parent of a minor 
child.  
    (b) The personal care services that are eligible for 
payment are the following:  
    (1) bowel and bladder care; 
    (2) skin care to maintain the health of the skin; 
    (3) range of motion exercises; 
    (4) respiratory assistance; 
    (5) transfers; 
    (6) bathing, grooming, and hairwashing necessary for 
personal hygiene; 
    (7) turning and positioning; 
    (8) assistance with furnishing medication that is normally 
self-administered; 
    (9) application and maintenance of prosthetics and 
orthotics; 
    (10) cleaning medical equipment; 
    (11) dressing or undressing; 
    (12) assistance with food, nutrition, and diet activities; 
    (13) accompanying a recipient to obtain medical diagnosis 
or treatment; 
    (14) services provided for the recipient's personal health 
and safety; 
    (15) helping the recipient to complete daily living skills 
such as personal and oral hygiene and medication schedules; 
    (15) supervision and observation that are medically 
necessary because of the recipient's diagnosis or disability; 
and 
    (16) incidental household services that are an integral 
part of a personal care service described in clauses (1) to (15).
    (c) (b) The personal care services that are not eligible 
for payment are the following:  
    (1) personal care services that are not in the care plan of 
care developed by the supervising registered nurse in 
consultation with the personal care assistants and the recipient 
or family the responsible party directing the care of the 
recipient; 
    (2) services that are not supervised by the registered 
nurse; 
    (3) services provided bv the recipient's spouse, legal 
guardian, or parent of a minor child; 
    (4) foster care provider of a recipient who cannot direct 
their own care, unless prior authorized by the commissioner 
under paragraph (j); 
    (4) (5) sterile procedures; and 
    (5) (6) injections of fluids into veins, muscles, or skin.; 
    (7) services provided by parents of adult recipients, adult 
children, or adult siblings, unless these relatives meet one of 
the following hardship criteria and the commissioner waives this 
requirement: 
    (i) the relative resigns from a part-time or full-time job 
to provide personal care for the recipient; 
    (ii) the relative goes from a full-time to a part-time job 
with less compensation to provide personal care for the 
recipient; 
    (iii) the relative takes a leave of absence without pay to 
provide personal care for the recipient; 
    (iv) the relative incurs substantial expenses by providing 
personal care for the recipient; or 
    (v) because of labor conditions, the relative is needed in 
order to provide an adequate number of qualified personal care 
assistants to meet the medical needs of the recipient; 
    (7) homemaker services that are not an integral part of a 
personal care services; and 
    (8) home maintenance, or chore services. 
    Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
payments for home care services shall be limited according to 
paragraphs (a) to (e) this subdivision.  
    (a) [EXEMPTION FROM PAYMENT LIMITATIONS.] The level, or the 
number of hours or visits of a specific service, of home health 
care services to a recipient that began before and is continued 
without increase on or after December 1987, shall be exempt from 
the payment limitations of this section, as long as the services 
are medically necessary.  
    (b) [LEVEL I HOME CARE LIMITS ON SERVICES WITHOUT PRIOR 
AUTHORIZATION.] For all new cases after December 1987, medically 
necessary home care services up to $800 may be provided in a 
calendar month.  
    If the services in the recipient's home care plan will 
exceed the $800 threshold for 30 days or less, the medically 
necessary services may be provided.  A recipient may receive the 
following amounts of home care services during a calendar year: 
    (1) a total of 40 home health aide visits, skilled nurse 
visits, health promotions, or health assessments under section 
256B.0625, subdivision 6a; and 
    (2) a total of ten hours of nursing supervision under 
section 256B.0625, subdivision 7 or 19a.  
    (c) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
services above the limits in paragraph (b) 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; or 
    (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. 
    (d) [RETROACTIVE AUTHORIZATION.] A request for retroactive 
authorization under paragraph (c) will be evaluated according to 
the same criteria applied to prior authorization requests.  
Implementation of this provision shall begin no later than 
October 1, 1991, except that recipients who are currently 
receiving medically necessary services above the limits 
established under this subdivision may have a reasonable amount 
of time to arrange for waivered services under section 256B.49 
or to establish an alternative living arrangement.  All current 
recipients shall be phased down to the limits established under 
paragraph (b) on or before April 1, 1992. 
    (c) (e) [LEVEL II HOME CARE ASSESSMENT AND CARE PLAN.] If 
the services in the recipient's home care plan exceed $800 for 
more than 30 days, a public health nurse from the local 
preadmission screening team shall determine the recipient's 
maximum level of home care according to this paragraph.  The 
home care provider shall conduct an assessment and complete a 
care plan using forms specified by the commissioner.  For the 
recipient to receive, or continue to receive, home care 
services, the provider must submit evidence necessary for the 
commissioner to determine the medical necessity of the home care 
services.  The provider shall submit to the commissioner the 
assessment, the care 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. 
    (1) (f) [PRIOR AUTHORIZATION.] The public health nurse from 
the local preadmission screening team shall base the 
determination of the recipient's maximum level of care on the 
need and eligibility of the recipient for one of the following 
placements commissioner, or the commissioner's designee, shall 
review the assessment, the care plan, and any additional 
information that is submitted.  The commissioner shall, within 
30 days after receiving a request for prior authorization, 
authorize home care services as follows:  
    (i) residential facility for persons with mental 
retardation or related conditions operated under section 
256B.501; 
    (ii) inpatient hospital care for a ventilator-dependent 
recipient.  "Ventilator dependent" means an individual who 
receives mechanical ventilation for life support at least six 
hours per day and is expected to or has been dependent for at 
least 30 consecutive days; or 
    (iii) all other recipients not appropriate for one of the 
above placements.  
    (2) If the recipient is eligible under clause (1)(i), the 
monthly medical assistance reimbursement for home care services 
shall not exceed the total monthly statewide average payment 
rate for residential facilities for children or adults with 
mental retardation or related conditions as appropriate for the 
recipient's age and level of self-preservation as determined 
according to Minnesota Rules, parts 9553.0010 to 9553.0080.  
    (l) [HOME HEALTH SERVICES.] All home health services 
provided by a nurse or a home health aide that exceed the limits 
established in paragraph (b) 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. 
    (2) [PERSONAL CARE SERVICES.] (i) All personal care 
services must be prior authorized by the commissioner or the 
commissioner's designee except for the limits on supervision 
established in paragraph (b).  The amount of personal care 
services authorized must be based on the recipient's case mix 
classification according to section 256B.0911, except that 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 case mix 
level; 
    (B) up to three times the average number of direct care 
hours provided in nursing facilities for recipients who have 
complex medical needs; 
    (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 complex behaviors; 
    (D) up to the amount the commissioner would pay, as of July 
1, 1991, 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.091 
or 256B.092. 
    (ii) The number of direct care hours shall be determined 
according to annual cost reports which are submitted to the 
department by nursing facilities each year.  The average number 
of direct care hours, as established by May 1, shall be 
incorporated into the home care limits on July 1 each year. 
    (iii) The case mix level shall be determined by the 
commissioner or the commissioner's designee based on information 
submitted to the commissioner by the personal care provider on 
forms specified by the commissioner.  The forms 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 children and 
nonelderly adults who need home care.  The commissioner shall 
establish these forms and protocols under this section and shall 
use the advisory group established in section 256B.04, 
subdivision 16, for consultation in establishing the forms and 
protocols by October 1, 1991. 
    (iv) A recipient shall qualify as having complex medical 
needs if they require: 
    (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; or 
    (G) other comparable medical conditions or treatments the 
commissioner determines would otherwise require institutional 
care. 
    (v) A recipient shall qualify as having complex behavior if 
the recipient exhibits on a daily basis the following: 
    (A) self-injurious behavior; 
    (B) unusual or repetitive habits; 
    (C) withdrawal behavior; 
    (D) hurtful behavior to others; 
    (E) socially or offensive behavior; 
    (F) destruction of property; or 
    (G) a need for constant one-to-one supervision for 
self-preservation. 
    (vi) The complex behaviors in clauses (A) to (G) have the 
meanings developed under section 256B.501. 
    (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 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 up to 16 hours per day of 
private duty nursing services or up to 24 hours per day of 
private duty nursing services until such time as the 
commissioner is able to make a determination of eligibility for 
recipients who are applying for home care services under the 
community alternative care program developed under section 
256B.49, or until it is determined that a health benefit plan is 
required to pay for medically necessary nursing services.  
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. 
    (3) (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient 
is eligible under clause (1)(ii) ventilator-dependent, the 
monthly medical assistance reimbursement authorization for home 
care services shall not exceed the monthly cost of 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.  
    (4) If the recipient is not eligible under either clause 
(1)(i) or (1)(ii), the monthly medical assistance reimbursement 
for home care services shall not exceed the total monthly 
statewide average payment for the case mix classification most 
appropriate to the recipient.  The case mix classification is 
established under section 256B.431.  
    (5) The determination of the recipient's maximum level of 
home care by the public health nurse is called a home care cost 
assessment.  The home care cost assessment must be requested by 
the home care provider before the end of the first 30 days of 
provided service and must be conducted by the public health 
nurse within ten working days following request.  
    (6) A home care provider shall request a new home care cost 
assessment when the needs of the individual have changed enough 
to require that a revised care plan be implemented that will 
increase costs beyond what was approved by the previous home 
care cost assessment and the change is anticipated to last for 
more than 30 days.  The home care provider must request the home 
care cost assessment before the end of the first 30 days of 
provided service.  Whenever a home care cost assessment is 
completed, the public health nurse that completes the home care 
cost assessment, in consultation with the home care provider, 
     (g) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner or 
the commissioner's designee shall determine the time period for 
which a home care cost assessment prior authorization shall 
remain valid.  If the recipient continues to require home care 
services beyond the limited duration of the home care cost 
assessment prior authorization, the home care provider must 
request a reassessment through the home care cost assessment new 
prior authorization through the process described above.  Under 
no circumstances shall a home care cost assessment prior 
authorization be valid for more than 12 months.  
    (7) Reimbursement for the home care cost assessment shall 
be made through the Medicaid administrative authority.  The 
state shall pay the nonfederal share.  
    (h) [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, and the amount, scope, and 
duration of home care services reimbursable by medical 
assistance, based on the assessment, the care plan, the 
recipient's age, the recipient's medical condition, and 
diagnosis or disability.  The commissioner may publish 
additional criteria for determining medical necessity according 
to section 256B.04. 
    (d)  [LEVEL III HOME CARE.] If the home care provider 
determines that the recipient's needs exceed the amount approved 
for the appropriate level of care as determined in paragraph 
(c), the home care provider may refer the case to the department 
for a level III determination.  Based on the client needs, 
physician orders, diagnosis, condition, and plan of care, the 
department may give prior approval for care that exceeds level 
II described in paragraph (c).  The amount approved shall not 
exceed the maximum cost for the appropriate level of care as 
determined in paragraph (c), clause (1), which will be the 
maximum ICF/MR rate for intermediate care facilities for persons 
with mental retardation or related conditions, or the maximum 
nursing home case mix payment, or the highest hospital cost for 
the state.  
    (i) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] The 
department has 30 days from receipt of the request to complete 
the level III determination prior authorization, during which 
time it may approve the higher level while reviewing the case a 
temporary level of home care service.  Authorization under this 
authority for a temporary level of home care services is limited 
to the time specified by the commissioner.  
    Case reviews or approval of home care services in levels II 
and III may result in assignment of a case manager.  
    (e) (j) [PRIOR APPROVAL AUTHORIZATION REQUIRED IN FOSTER 
CARE SETTING.] Any Home care service services provided in an 
adult or child foster care setting must receive prior approval 
authorization by the department according to the limits 
established in paragraph (b).  
    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 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 the recipient is referred to the commissioner by a 
regional treatment center preadmission evaluation team; 
    (3) personal care services when the responsible party is an 
employee of, or under contract with, or has any direct or 
indirect financial relationship with the personal care provider 
or personal care assistant, unless the recipient is referred to 
the commissioner by a regional treatment center preadmission 
evaluation team; 
    (4) home care services when the number of foster care 
residents is greater than four; or 
     (5) home care services when combined with foster care 
payments, less the base rate, that exceed the total amount that 
public funds would pay for the recipient's care in a medical 
institution. 
    Subd. 6.  [RECOVERY OF EXCESSIVE PAYMENTS.] The 
commissioner shall seek monetary recovery from providers of 
payments made for services which exceed the limits established 
in this section.  
    Sec. 13.  [256B.0628] [PRIOR AUTHORIZATION AND REVIEW OF 
HOME CARE SERVICES.] 
    Subdivision 1.  [STATE COORDINATION.] The commissioner 
shall supervise the coordination of the prior authorization and 
review of home care services that are reimbursed by medical 
assistance. 
    Subd. 2.  [CONTRACTOR DUTIES.] (a) The commissioner may 
contract with qualified registered nurses, or qualified 
agencies, to provide home care prior authorization and review 
services for medical assistance recipients who are receiving 
home care services. 
    (b) Reimbursement for the prior authorization function 
shall be made through the medical assistance administrative 
authority.  The state shall pay the nonfederal share.  The 
contractor must: 
    (1) assess the recipient's individual need for services 
required to be cared for safely in the community; 
    (2) ensure that a care plan that meets the recipient's 
needs is developed by the appropriate agency or individual; 
    (3) ensure cost-effectiveness of medical assistance home 
care services; 
    (4) recommend to the commissioner the approval or denial of 
the use of medical assistance funds to pay for home care 
services when home care services exceed thresholds established 
by the commissioner under Minnesota Rules, parts 9505.0170 to 
9505.0475; 
    (5) reassess the recipient's need for and level of home 
care services at a frequency determined by the commissioner; and 
    (6) conduct on-site assessments when determined necessary 
by the commissioner. 
    (c) In addition, the contractor may be requested by the 
commissioner to: 
    (1) review care plans and reimbursement data for 
utilization of services that exceed community-based standards 
for home care, inappropriate home care services, home care 
services that do not meet quality of care standards, or 
unauthorized services and make appropriate referrals to the 
commissioner or other appropriate entities based on the 
findings; 
    (2) assist the recipient in obtaining services necessary to 
allow the recipient to remain safely in or return to the 
community; 
    (3) coordinate home care services with other medical 
assistance services under section 256B.0625; 
    (4) assist the recipient with problems related to the 
provision of home care services; and 
    (5) assure the quality of home care services. 
    (d) For the purposes of this section, "home care services"  
means medical assistance services defined under section 
256B.0625, subdivisions 6a, 7, and 19a. 
    Sec. 14.  [256B.0911] [NURSING HOME PREADMISSION 
SCREENING.] 
    Subdivision 1.  [PURPOSE AND GOAL.] The purpose of the 
preadmission screening program is to prevent or delay certified 
nursing facility placements by assessing applicants and 
residents and offering cost-effective alternatives appropriate 
for the person's needs.  Further, the goal of the program is to 
contain costs associated with unnecessary certified nursing 
facility admissions.  The commissioners of human services and 
health shall seek to maximize use of available federal and state 
funds and establish the broadest program possible within the 
funding available. 
    Subd. 2.  [PERSONS REQUIRED TO BE SCREENED; 
EXEMPTIONS.] All applicants to Medicaid certified nursing 
facilities must be screened prior to admission, regardless of 
income, assets, or funding sources, except the following: 
    (1) patients who, having entered acute care facilities from 
certified nursing facilities, are returning to a certified 
nursing facility; 
    (2) residents transferred from other certified nursing 
facilities; 
    (3) individuals whose length of stay is expected to be 30 
days or less based on a physician's certification, if the 
facility notifies the screening team prior to admission and 
provides an update to the screening team on the 30th day after 
admission; 
    (4) individuals who have a contractual right to have their 
nursing facility care paid for indefinitely by the veteran's 
administration; or 
    (5) individuals who are enrolled in the Ebenezer/Group 
Health social health maintenance organization project at the 
time of application to a nursing home; or 
    (6) individuals who are screened by another state within 
three months before admission to a certified nursing facility. 
    Regardless of the exemptions in clauses (2) to (6), persons 
who have a diagnosis or possible diagnosis of mental illness, 
mental retardation, or a related condition must be screened 
before admission unless the admission prior to screening is 
authorized by the local mental health authority or the local 
developmental disabilities case manager, or unless authorized by 
the county agency according to Public Law Number 101-508. 
    Persons transferred from an acute care facility to a 
certified nursing facility may be admitted to the nursing 
facility before screening, if authorized by the county agency; 
however, the person must be screened within ten working days 
after the admission. 
    Other persons who are not applicants to nursing facilities 
must be screened if a request is made for a screening. 
    Subd. 3.  [PERSONS RESPONSIBLE FOR CONDUCTING THE 
PREADMISSION SCREENING.] (a) A local screening team shall be 
established by the county agency and the county public health 
nursing service of the local board of health.  Each local 
screening team shall be composed of a social worker and a public 
health nurse from their respective county agencies.  Two or more 
counties may collaborate to establish a joint local screening 
team or teams. 
    (b) Both members of the team must conduct the screening.  
However, individuals who are being transferred from an acute 
care facility to a certified nursing facility may be screened by 
only one member of the screening team in consultation with the 
other member. 
    (c) In assessing a person's needs, each screening team 
shall have a physician available for consultation and shall 
consider the assessment of the individual's attending physician, 
if any.  The individual's physician shall be included on the 
screening team if the physician chooses to participate.  Other 
personnel may be included on the team as deemed appropriate by 
the county agencies.  
    (d) If a person who has been screened must be reassessed to 
assign a case mix classification because admission to a nursing 
facility occurs later than the time allowed by rule following 
the initial screening and assessment, the reassessment may be 
completed by the public health nurse member of the screening 
team. 
    Subd. 4.  [RESPONSIBILITIES OF THE COUNTY AGENCY AND THE 
SCREENING TEAM.] (a) The county agency shall: 
    (1) provide information and education to the general public 
regarding availability of the preadmission screening program; 
    (2) accept referrals from individuals, families, human 
service and health professionals, and hospital and nursing 
facility personnel; 
    (3) assess the health, psychological, and social needs of 
referred individuals and identify services needed to maintain 
these persons in the least restrictive environments; 
     (4) determine if the individual screened needs nursing 
facility level of care; 
    (5) assess active treatment needs in cooperation with: 
    (i) a qualified mental health professional for persons with 
a primary or secondary diagnosis of mental illness; and 
    (ii) a qualified mental retardation professional for 
persons with a primary or secondary diagnosis of mental 
retardation or related conditions.  For purposes of this clause, 
a qualified mental retardation professional must meet the 
standards for a qualified mental retardation professional in 
Code of Federal Regulations, title 42, section 483.430; 
    (6) make recommendations for individuals screened regarding 
cost-effective community services which are available to the 
individual; 
     (7) make recommendations for individuals screened regarding 
nursing home placement when there are no cost-effective 
community services available; 
    (8) develop an individual's community care plan and provide 
follow-up services as needed; and 
    (9) prepare and submit reports that may be required by the 
commissioner of human services. 
    The county agency may determine in cooperation with the 
local board of health that the public health nursing agency of 
the local board of health is the lead agency which is 
responsible for all of the activities above except clause (5). 
    (b) The screening team shall document that the most 
cost-effective alternatives available were offered to the 
individual or the individual's legal representative.  For 
purposes of this section, "cost-effective alternatives" means 
community services and living arrangements that cost the same or 
less than nursing facility care. 
    The screening shall be conducted within ten working days 
after the date of referral or, for those approved for transfer 
from an acute care facility to a certified nursing facility, 
within ten working days after admission to the nursing 
facility.  For persons who are eligible for medical assistance 
or who would be eligible within 180 days of admission to a 
nursing facility and who are admitted to a nursing facility, the 
nursing facility must include the screening team or the case 
manager in the discharge planning process for those individuals 
who the team has determined have discharge potential.  The 
screening team or the case manager must ensure a smooth 
transition and follow-up for the individual's return to the 
community. 
    Local screening teams shall cooperate with other public and 
private agencies in the community, in order to offer a variety 
of cost-effective services to the disabled and elderly.  The 
screening team shall encourage the use of volunteers from 
families, religious organizations, social clubs, and similar 
civic and service organizations to provide services. 
     Subd. 5.  [SIMPLIFICATION OF FORMS.] The commissioner shall 
minimize the number of forms required in the preadmission 
screening process and shall limit the screening document to 
items necessary for care plan approval, reimbursement, program 
planning, evaluation, and policy development. 
    Subd. 6.  [REIMBURSEMENT FOR PREADMISSION SCREENING.] (a) 
The total screening cost for each county must be paid monthly by 
certified nursing facilities in the county.  The monthly amount 
to be paid by each nursing facility for each fiscal year must be 
determined by dividing the county's estimate of the total annual 
cost of screenings allowed in the county for the following rate 
year by 12 to determine the monthly cost estimate and allocating 
the monthly cost estimate to each nursing facility based on the 
number of licensed beds in the nursing facility. 
    (b) The rate allowed for a screening where two team members 
are present shall be the actual costs up to $195.  The rate 
allowed for a screening where only one team member is present 
shall be the actual costs up to $117.  Annually on July 1, the 
commissioner shall adjust the rate up to the percentage change 
forecast in the fourth quarter of the prior calendar year by the 
Home Health Agency Market Basket of Operating Costs, unless 
otherwise adjusted by statute.  The Home Health Agency Market 
Basket of Operating Costs is published by Data Resources, Inc. 
    (c) The monthly cost estimate for each certified nursing 
facility must be submitted to the state by the county no later 
than February 15 of each year for inclusion in the nursing 
facility's payment rate on the following rate year.  The 
commissioner shall include the reported annual estimated cost of 
screenings for each nursing facility as an operating cost of 
that nursing facility in accordance with section 256B.431, 
subdivision 2b, paragraph (g).  The monthly cost estimates 
approved by the commissioner must be sent to the nursing 
facility by the county no later than April 15 of each year.  
    (d) If in more than ten percent of the total number of 
screenings performed by a county in a fiscal year for all 
individuals regardless of payment source, the screening 
timelines were not met because a county was late in screening 
the individual, the county is solely responsible for paying the 
cost of those delayed screenings that exceed ten percent. 
    (e) Notwithstanding section 256B.0641, overpayments 
attributable to payment of the screening costs under the medical 
assistance program may not be recovered from a facility.  
    (f) The commissioner of human services shall amend the 
Minnesota medical assistance plan to include reimbursement for 
the local screening teams. 
    Subd. 7.  [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 
Medical assistance reimbursement for nursing facilities shall be 
authorized for a medical assistance recipient only if a 
preadmission screening has been conducted or the local county 
agency has authorized an exemption.  Medical assistance 
reimbursement for nursing facilities shall not be provided for 
any recipient who the local screening team has determined does 
not meet the level of care criteria for nursing facility 
placement. 
    An individual has a choice and makes the final decision 
between nursing facility placement and community placement after 
the screening team's recommendation.  However, the local county 
mental health authority or the local mental retardation 
authority under Public Law Numbers 100-203 and 101-508 may 
prohibit admission to a nursing facility, if the individual does 
not meet the nursing facility level of care criteria or does 
need active treatment as defined in Public Law Numbers 100-203 
and 101-508. 
    Appeals from the screening team's recommendation or the 
county agency's final decision shall be made according to 
section 256.045, subdivision 3. 
     Subd. 8.  [ADVISORY COMMITTEE.] The commissioner shall 
appoint an advisory committee to advise the commissioner on the 
preadmission screening program, the alternative care program 
under section 256B.0913, and the home- and community-based 
services waiver programs for the elderly and the disabled.  The 
advisory committee shall review policies and procedures and 
provide advice and technical assistance to the commissioner 
regarding the effectiveness and the efficient administration of 
the programs.  The advisory committee must consist of not more 
than 20 people appointed by the commissioner and must be 
comprised of representatives from public agencies, public and 
private service providers, and consumers from all areas of the 
state.  Members of the advisory committee must not be 
compensated for service. 
    Sec. 15.  [256B.0913] [ALTERNATIVE CARE PROGRAM.] 
    Subdivision 1.  [PURPOSE AND GOALS.] The purpose of the 
alternative care program is to provide funding for or access to 
home and community-based services for frail elderly persons, in 
order to limit nursing facility placements.  The program is 
designed to support frail elderly persons in their desire to 
remain in the community as independently and as long as possible 
and to support informal caregivers in their efforts to provide 
care for frail elderly people.  Further, the goals of the 
program are: 
    (1) to contain medical assistance expenditures by providing 
care in the community at a cost the same or less than nursing 
facility costs; and 
    (2) to maintain the moratorium on new construction of 
nursing home beds. 
    Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
services are available to all frail older Minnesotans.  This 
includes: 
    (1) persons who are receiving medical assistance and served 
under the medical assistance program or the Medicaid waiver 
program; 
    (2) persons who would be eligible for medical assistance 
within 180 days of admission to a nursing facility and served 
under subdivisions 4 to 13; and 
    (3) persons who are paying for their services out-of-pocket.
    Subd. 3.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR MEDICAL 
ASSISTANCE RECIPIENTS.] Funding for services for persons who are 
eligible for medical assistance is available under section 
256B.0627, governing home care services, or 256B.0915, governing 
the Medicaid waiver for home and community-based services. 
    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 screened by the county screening 
team or, if previously screened and served under the alternative 
care program, assessed by the local county social worker or 
public health nurse; 
    (2) the person is age 65 or older; 
    (3) the person would be eligible for medical assistance 
within 180 days of admission to a nursing facility; 
    (4) the screening team would recommend nursing facility 
admission or continued stay for the person if alternative care 
services were not available; 
    (5) the person needs services that are not available at 
that time in the county through other county, state, or federal 
funding sources; and 
    (6) the monthly cost of the alternative care services 
funded by the program for this person does not exceed 75 percent 
of the statewide average monthly medical assistance payment for 
nursing facility care at the individual's case mix 
classification to which the individual would be assigned under 
Minnesota Rules, parts 9549.0050 to 9549.0059. 
    (b) Individuals who meet the criteria in paragraph (a) and 
who have been approved for alternative care funding are called 
180-day eligible clients. 
    (c) The statewide average payment for nursing facility care 
is the statewide average monthly nursing facility rate in effect 
on July 1 of the fiscal year in which the cost is incurred, less 
the statewide average monthly income of nursing facility 
residents who are age 65 or older and who are medical assistance 
recipients in the month of March of the previous fiscal year.  
This monthly limit does not prohibit the 180-day eligible client 
from paying for additional services needed or desired.  
    (d) In determining the total costs of alternative care 
services for one month, the costs of all services funded by the 
alternative care program, including supplies and equipment, must 
be included. 
    (e) 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 
spend-down if the person applied, unless authorized by the 
commissioner. 
    (f) Alternative care funding is not available for a person 
who resides in a licensed nursing home or boarding care home, 
except for case management services which are being provided in 
support of the discharge planning process.  
    Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
Alternative care funding may be used for payment of costs of: 
    (1) adult foster care; 
    (2) adult day care; 
    (3) home health aide; 
    (4) homemaker services; 
    (5) personal care; 
    (6) case management; 
    (7) respite care; 
    (8) assisted living; and 
    (9) care-related supplies and equipment. 
    (b) The county agency may use up to ten percent of the 
annual allocation of alternative care funding for payment of 
costs of meals delivered to the home, transportation, skilled 
nursing, chore services, companion services, nutrition services, 
and training for direct informal caregivers. The commissioner 
shall determine the impact on alternative care costs of allowing 
these additional services to be provided and shall report the 
findings to the legislature by February 15, 1993, including any 
recommendations regarding provision of the additional services. 
    (c) The county agency must ensure that the funds are used 
only to supplement and not supplant services available through 
other public assistance or services programs. 
    (d) These services must be provided by a licensed provider, 
a home health agency certified for reimbursement under Titles 
XVIII and XIX of the Social Security Act, or by persons or 
agencies employed by or contracted with the county agency or the 
public health nursing agency of the local board of health. 
    (e) The adult foster care rate shall be considered a 
difficulty of care payment and shall not include room and board. 
    (f) Personal care services may be provided by a personal 
care provider organization.  A county agency may contract with a 
relative of the client to provide personal care services, but 
must ensure nursing supervision.  Covered personal care services 
defined in section 256B.0627, subdivision 4, must meet 
applicable standards in Minnesota Rules, part 9505.0335. 
    (g) Costs for supplies and equipment that exceed $150 per 
item per month must have prior approval from the commissioner. 
    (h) For the purposes of this section, "assisted living" 
refers to supportive services provided by a single vendor to two 
or more alternative care grant clients who reside in the same 
apartment building of ten or more units.  These services may 
include care coordination, the costs of preparing one or more 
nutritionally balanced meals per day, general oversight, and 
other supportive services which the vendor is licensed to 
provide according to sections 144A.43 to 144A.49, and which 
would otherwise be available to individual alternative care 
grant clients.  Reimbursement from the lead agency shall be made 
to the vendor as a monthly capitated rate negotiated with the 
county agency.  The capitated rate shall not exceed the state 
share of the average monthly medical assistance nursing facility 
payment rate of the case mix resident class to which the 180-day 
eligible client would be assigned under Minnesota Rules, parts 
9549.0050 to 9549.0059.  The capitated rate may not cover rent 
and direct food costs.  A person's eligibility to reside in the 
building must not be contingent on the person's acceptance or 
use of the assisted living services.  Assisted living services 
as defined in this section shall not be authorized in boarding 
and lodging establishments licensed according to sections 157.01 
to 157.031. 
    (i) For purposes of this section, companion services are 
defined as nonmedical care, supervision and oversight, provided 
to a functionally impaired adult.  Companions may assist the 
individual with such tasks as meal preparation, laundry and 
shopping, but do not perform these activities as discrete 
services.  The provision of companion services does not entail 
hands-on medical care.  Providers may also perform light 
housekeeping tasks which are incidental to the care and 
supervision of the recipient.  This service must be approved by 
the case manager as part of the care plan.  Companion services 
must be provided by individuals or nonprofit organizations who 
are under contract with the local agency to provide the 
service.  Any person related to the waiver recipient by blood, 
marriage or adoption cannot be reimbursed under this service.  
Persons providing companion services will be monitored by the 
case manager. 
    (j) For purposes of this section, training for direct 
informal caregivers is defined as a classroom or home course of 
instruction which may include:  transfer and lifting skills, 
nutrition, personal and physical cares, home safety in a home 
environment, stress reduction and management, behavioral 
management, long-term care decision making, care coordination 
and family dynamics.  The training is provided to an informal 
unpaid caregiver of a 180-day eligible client which enables the 
caregiver to deliver care in a home setting with high levels of 
quality.  The training must be approved by the case manager as 
part of the individual care plan.  Individuals, agencies, and 
educational facilities which provide caregiver training and 
education will be monitored by the case manager. 
    Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 
alternative care program is administered by the county agency.  
This agency is the lead agency responsible for the local 
administration of the alternative care program as described in 
this section.  However, it may contract with the public health 
nursing service to be the lead agency. 
    Subd. 7.  [CASE MANAGEMENT.] The lead agency shall appoint 
a social worker from the county agency or a registered nurse 
from the county public health nursing service of the local board 
of health to be the case manager for any person receiving 
services funded by the alternative care program.  The case 
manager must ensure the health and safety of the individual 
client and is responsible for the cost effectiveness of the 
alternative care individual care plan. 
    Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] The case 
manager shall implement the plan of care for each 180-day 
eligible client and ensure that a client's service needs and 
eligibility are reassessed at least every six months.  The plan 
shall include any services prescribed by the individual's 
attending physician as necessary to allow the individual to 
remain in a community setting.  In developing the individual's 
care plan, the case manager should include the use of volunteers 
from families and neighbors, religious organizations, social 
clubs, and civic and service organizations to support the formal 
home care services.  The county shall be held harmless for 
damages or injuries sustained through the use of volunteers 
under this subdivision including workers' compensation 
liability.  The lead agency shall provide documentation to the 
commissioner verifying that the individual's alternative care is 
not available at that time through any other public assistance 
or service program.  The lead agency shall provide documentation 
in each individual's plan of care and to the commissioner that 
the most cost-effective alternatives available have been offered 
to the individual and that the individual was free to choose 
among available qualified providers, both public and private. 
    Subd. 9.  [CONTRACTING PROVISIONS FOR PROVIDERS.] The lead 
agency shall document to the commissioner that the agency made 
reasonable efforts to inform potential providers of the 
anticipated need for services under the alternative care 
program, including a minimum of 14 days' written advance notice 
of the opportunity to be selected as a service provider and an 
annual public meeting with providers to explain and review the 
criteria for selection.  The lead agency shall also document to 
the commissioner that the agency allowed potential providers an 
opportunity to be selected to contract with the county agency.  
Funds reimbursed to counties under this subdivision are subject 
to audit by the commissioner for fiscal and utilization control. 
    The lead agency must select providers for contracts or 
agreements using the following criteria and other criteria 
established by the county: 
    (1) the need for the particular services offered by the 
provider; 
    (2) the population to be served, including the number of 
clients, the length of time services will be provided, and the 
medical condition of clients; 
    (3) the geographic area to be served; 
    (4) quality assurance methods, including appropriate 
licensure, certification, or standards, and supervision of 
employees when needed; 
    (5) rates for each service and unit of service exclusive of 
county administrative costs; 
    (6) evaluation of services previously delivered by the 
provider; and 
    (7) contract or agreement conditions, including billing 
requirements, cancellation, and indemnification. 
    The county must evaluate its own agency services under the 
criteria established for other providers.  The county shall 
provide a written statement of the reasons for not selecting 
providers. 
    Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
appropriation for fiscal years 1992 and beyond shall cover only 
180-day eligible clients. 
    (b) Prior to July 1 of each year, the commissioner shall 
allocate to county agencies the state funds available for 
alternative care for persons eligible under subdivision 2.  The 
allocation for fiscal year 1992 shall be calculated using a base 
that is adjusted to exclude the medical assistance share of 
alternative care expenditures.  The adjusted base is calculated 
by multiplying each county's allocation for fiscal year 1991 by 
the percentage of county alternative care expenditures for 
180-day eligible clients.  The percentage is determined based on 
expenditures for services rendered in fiscal year 1989 or 
calendar year 1989, whichever is greater. 
    (c) If the county expenditures for 180-day eligible clients 
are 95 percent or more of its adjusted base allocation, the 
allocation for the next fiscal year is 100 percent of the 
adjusted base, plus inflation to the extent that inflation is 
included in the state budget. 
    (d) If the county expenditures for 180-day eligible clients 
are less than 95 percent of its adjusted base allocation, the 
allocation for the next fiscal year is the adjusted base 
allocation less the amount of unspent funds below the 95 percent 
level. 
    (e) For fiscal year 1992 only, a county may receive an 
increased allocation if annualized service costs for the month 
of May 1991 for 180-day eligible clients are greater than the 
allocation otherwise determined.  A county may apply for this 
increase by reporting projected expenditures for May to the 
commissioner by June 1, 1991.  The amount of the allocation may 
exceed the amount calculated in paragraph (b).  The projected 
expenditures for May must be based on actual 180-day eligible 
client caseload and the individual cost of clients' care plans.  
If a county does not report its expenditures for May, the amount 
in paragraph (c) or (d) shall be used. 
    (f) Calculations for paragraphs (c) and (d) are to be made 
as follows:  for each county, the determination of expenditures 
shall be based on payments for services rendered from April 1 
through March 31 in the base year, to the extent that claims 
have been submitted by June 1 of that year. 
    Subd. 11.  [TARGETED FUNDING.] (a) The purpose of targeted 
funding is to make additional money available to counties with 
the greatest need.  Targeted funds are not intended to be 
distributed equitably among all counties, but rather, allocated 
to those with long-term care strategies that meet state goals. 
    (b) The funds available for targeted funding shall be the 
total appropriation for each fiscal year minus county 
allocations determined under subdivision 10 as adjusted for any 
inflation increases provided in appropriations for the biennium. 
    (c) The commissioner shall allocate targeted funds to 
counties that demonstrate to the satisfaction of the 
commissioner that they have developed feasible plans to increase 
alternative care grant spending.  In making targeted funding 
allocations, the commissioner shall use the following priorities:
    (1) counties that received a lower allocation in fiscal 
year 1991 than in fiscal year 1990.  Counties remain in this 
priority until they have been restored to their fiscal year 1990 
level plus inflation; 
    (2) counties that sustain a base allocation reduction for 
failure to spend 95 percent of the allocation if they 
demonstrate that the base reduction should be restored; 
    (3) counties that propose projects to divert community 
residents from nursing home placement or convert nursing home 
residents to community living; and 
    (4) counties that can otherwise justify program growth by 
demonstrating the existence of waiting lists, demographically 
justified needs, or other unmet needs. 
    (d) Counties that would receive targeted funds according to 
paragraph (c) must demonstrate to the commissioner's 
satisfaction that the funds would be appropriately spent by 
showing how the funds would be used to further the state's 
alternative care goals as described in subdivision 1, and that 
the county has the administrative and service delivery 
capability to use them.  
    (e) The commissioner shall request applications by June 1 
each year, for county agencies to apply for targeted funds.  The 
counties selected for targeted funds shall be notified of the 
amount of their additional funding by August 1 of each year.  
Targeted funds allocated to a county agency in one year shall be 
treated as part of the county's base allocation for that year in 
determining allocations for subsequent years.  No reallocations 
between counties shall be made. 
    (f) The allocation for each year after fiscal year 1992 
shall be determined using the previous fiscal year's allocation, 
including any targeted funds, as the base and then applying the 
criteria under subdivision 10, paragraphs (c), (d), and (f), to 
the current year's expenditures. 
    Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
all 180-day eligible clients to help pay for the cost of 
participating in the program.  
    (b) The county agency must collect the premium from the 
client and forward the amounts collected to the commissioner in 
the manner and at the times prescribed by the commissioner.  
Money collected must be deposited in the general fund and is 
appropriated to the commissioner for the alternative care 
program.  The client must supply the county with the client's 
social security number at the time of application.  If a client 
fails or refuses to pay the premium due, the county shall supply 
the commissioner with the client's social security number and 
other information the commissioner requires to collect the 
premium from the client.  The commissioner shall collect unpaid 
premiums using the revenue recapture act in chapter 270A and 
other methods available to the commissioner.  The commissioner 
may require counties to inform clients of the collection 
procedures that may be used by the state if a premium is not 
paid.  
    (c) The commissioner shall establish a premium schedule 
ranging from $25 to $75 per month based on the client's income 
and assets.  The schedule is not subject to chapter 14, but the 
commissioner shall publish the schedule and any later changes in 
the State Register and allow a period of 20 working days from 
the publication date for interested persons to comment before 
adopting the schedule in final form.  The commissioner shall 
begin to adopt emergency or permanent rules governing client 
premiums within 30 days after the effective date of this 
section, including criteria for determining when services to a 
client must be terminated due to failure to pay a premium.  
Emergency or permanent rules governing client premiums supersede 
any schedule adopted under the exemption from chapter 14 in this 
section. 
    Subd. 13.  [COUNTY ALTERNATIVE CARE BIENNIAL PLAN.] The 
commissioner shall establish by rule, in accordance with chapter 
14, procedures for the submittal and approval of a biennial 
county plan for the administration of the alternative care 
program and the coordination with other planning processes for 
the older adult.  In addition to the procedures in rule, this 
county biennial plan shall also include: 
    (1) information on the administration of the preadmission 
screening program; 
    (2) information on the administration of the home and 
community-based services waivers for the elderly under section 
256B.0915, and for the disabled under section 256.49; 
    (3) an application for targeted funds under subdivision 11; 
and 
    (4) an optional notice of intent to apply to participate in 
the long-term care projects under section 256B.0917. 
    Subd. 14.  [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 
Reimbursement for expenditures for the alternative care services 
shall be through the invoice processing procedures of the 
department's Medicaid management information system (MMIS), only 
with the approval of the client's case manager.  To receive 
reimbursement, the county or vendor must submit invoices within 
120 days following the month of service.  The county agency and 
its vendors under contract shall not be reimbursed for services 
which exceed the county allocation. 
    (b) If a county collects less than 50 percent of the client 
premiums due under subdivision 12, the commissioner may withhold 
up to three percent of the county's final alternative care 
program allocation determined under subdivisions 10 and 11. 
    (c) Beginning July 1, 1991, the state will reimburse 
counties, up to the limits of state appropriations, according to 
the payment schedule in section 256.025 for the county share of 
costs incurred under this subdivision on or after January 1, 
1991, for individuals who would be eligible for medical 
assistance within 180 days of admission to a nursing home. 
    (d) Annually on July 1, the commissioner must adjust the 
rates allowed for alternative care services by the forecasted 
percentage change in the Home Health Agency Market Basket of 
Operating Costs, for the fiscal year beginning July 1, compared 
to the previous fiscal year, unless otherwise adjusted by 
statute.  The Home Health Agency Market Basket of Operating 
Costs is published by Data Resources, Inc.  The forecast to be 
used is the one published for the calendar quarter beginning 
January 1, six months prior to the beginning of the fiscal year 
for which rates are set. 
    Sec. 16.  [256B.0915] [MEDICAID WAIVER FOR HOME AND 
COMMUNITY-BASED SERVICES.] 
    Subdivision 1.  [AUTHORITY.] The commissioner is authorized 
to apply for a home and community-based services waiver for the 
elderly, authorized under section 1915(c) of the Social Security 
Act, in order to obtain federal financial participation to 
expand the availability of services for persons who are eligible 
for medical assistance.  The commissioner may apply for 
additional waivers or pursue other federal financial 
participation which is advantageous to the state for funding 
home care services for the frail elderly who are eligible for 
medical assistance.  The provision of waivered services to 
medical assistance recipients must comply with the criteria 
approved in the waiver. 
    Subd. 2.  [SPOUSAL IMPOVERISHMENT POLICIES.] The 
commissioner shall seek to amend the federal waiver and the 
medical assistance state plan to allow spousal impoverishment 
criteria as authorized in Code of Federal Regulations, title 42, 
section 435.726(1924), and as implemented in sections 256B.0575, 
256B.058, and 256B.059 to be applied to persons who are screened 
and determined to need a nursing facility level of care. 
    Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 
FORECASTING.] (a) The number of medical assistance waiver 
recipients that a county may serve must be allocated according 
to the number of medical assistance waiver cases open on July 1 
of each fiscal year.  Additional recipients may be served with 
the approval of the commissioner. 
    (b) The monthly limit for the cost of waivered services to 
an individual waiver client shall be the statewide average 
payment rate of the case mix resident class to which the waiver 
client would be assigned under medical assistance case mix 
reimbursement system.  The statewide average payment rate is 
calculated by determining the statewide average monthly nursing 
home rate effective July 1 of the fiscal year in which the cost 
is incurred, less the statewide average monthly income of 
nursing home residents who are age 65 or older, and who are 
medical assistance recipients in the month of March of the 
previous state fiscal year.  The following costs must be 
included in determining the total monthly costs for the waiver 
client: 
    (1) cost of all waivered services, including extended 
medical supplies and equipment; and 
    (2) cost of skilled nursing, home health aide, and personal 
care services reimbursable by medical assistance.  
    (c) Medical assistance funding for skilled nursing 
services, home health aide, and personal care services for 
waiver recipients must be approved by the case manager and 
included in the individual care plan. 
    (d) Expenditures for extended medical supplies and 
equipment that cost over $150 per month must have the 
commissioner's prior approval. 
    (e) Annually on July 1, the commissioner must adjust the 
rates allowed for services by the forecasted percentage change 
in the Home Health Agency Market Basket of Operating Costs, for 
the fiscal year beginning July 1, compared to the previous 
fiscal year, unless otherwise adjusted by statute.  The Home 
Health Agency Market Basket of Operating Costs is published by 
Data Resources, Inc.  The forecast to be used is the one 
published for the calendar quarter beginning January 1, six 
months prior to the beginning of the fiscal year for which rates 
are set. 
    (f) Reimbursement for the medical assistance recipients 
under the approved waiver shall be made from the medical 
assistance account through the invoice processing procedures of 
the department's Medicaid management information system (MMIS), 
only with the approval of the client's case manager.  The budget 
for the state share of the Medicaid expenditures shall be 
forecasted with the medical assistance budget, and shall be 
consistent with the approved waiver.  
    (g) Beginning July 1, 1991, the state shall reimburse 
counties according to the payment schedule