1.1                          A bill for an act 
  1.2             relating to human services; making changes to certain 
  1.3             licensing provisions and continuing care programs; 
  1.4             planning for a pilot program to provide deaf-blind 
  1.5             services and requiring a feasibility assessment of 
  1.6             medical assistance programs covering expansion of 
  1.7             deaf-blind services; amending Minnesota Statutes 2000, 
  1.8             sections 13.41, subdivision 1; 13.46, subdivision 3; 
  1.9             245A.02, by adding subdivisions; 245A.035, subdivision 
  1.10            3; 245A.04, by adding a subdivision; 256.9657, 
  1.11            subdivision 1; 256B.0625, by adding a subdivision; 
  1.12            256B.0915, subdivisions 4, 6, by adding a subdivision; 
  1.13            256B.431, subdivisions 14, 30; 256B.5012, subdivision 
  1.14            2; 261.063; 626.557, subdivision 3a; Minnesota 
  1.15            Statutes 2001 Supplement, sections 13.46, subdivisions 
  1.16            1, 4; 144A.071, subdivision 1a; 144A.36, subdivision 
  1.17            1; 245A.03, subdivision 2; 245A.04, subdivisions 3, 
  1.18            3a, 3b; 245A.07, subdivisions 2a, 3; 245A.144; 
  1.19            245A.16, subdivision 1; 256.045, subdivisions 3b, 4; 
  1.20            256B.0913, subdivisions 4, 5, 8, 10, 12, 14; 
  1.21            256B.0915, subdivision 5; 256B.431, subdivisions 2e, 
  1.22            33; 256B.437, subdivisions 3, 6; 256B.438, subdivision 
  1.23            1; 256B.76; 626.556, subdivision 10i; 626.557, 
  1.24            subdivision 9d; proposing coding for new law in 
  1.25            Minnesota Statutes, chapters 245A; 604A; repealing 
  1.26            Minnesota Statutes 2001 Supplement, section 256B.0621, 
  1.27            subdivision 1. 
  1.28  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.29                             ARTICLE 1 
  1.30                             LICENSING 
  1.31     Section 1.  Minnesota Statutes 2000, section 13.41, 
  1.32  subdivision 1, is amended to read: 
  1.33     Subdivision 1.  [DEFINITION.] As used in this section 
  1.34  "licensing agency" means any board, department or agency of this 
  1.35  state which is given the statutory authority to issue 
  1.36  professional or other types of licenses, except the various 
  2.1   agencies primarily administered by the commissioner of human 
  2.2   services.  Data pertaining to persons or agencies licensed or 
  2.3   registered under authority of the commissioner of human services 
  2.4   shall be administered pursuant to section 13.46~~, subdivision 4~~. 
  2.5      Sec. 2.  Minnesota Statutes 2001 Supplement, section 13.46, 
  2.6   subdivision 1, is amended to read: 
  2.7      Subdivision 1.  [DEFINITIONS.] As used in this section: 
  2.8      (a) "Individual" means an individual according to section 
  2.9   13.02, subdivision 8, but does not include a vendor of services. 
  2.10     (b) "Program" includes all programs for which authority is 
  2.11  vested in a component of the welfare system according to statute 
  2.12  or federal law, including, but not limited to, the aid to 
  2.13  families with dependent children program formerly codified in 
  2.14  sections 256.72 to 256.87, Minnesota Family Investment Program, 
  2.15  medical assistance, general assistance, general assistance 
  2.16  medical care, and child support collections.  
  2.17     (c) "Welfare system" includes the department of human 
  2.18  services, local social services agencies, county welfare 
  2.19  agencies, private licensing agencies, the public authority 
  2.20  responsible for child support enforcement, human services 
  2.21  boards, community mental health center boards, state hospitals, 
  2.22  state nursing homes, the ombudsman for mental health and mental 
  2.23  retardation, and persons, agencies, institutions, organizations, 
  2.24  and other entities under contract to any of the above agencies 
  2.25  to the extent specified in the contract. 
  2.26     (d) "Mental health data" means data on individual clients 
  2.27  and patients of community mental health centers, established 
  2.28  under section 245.62, mental health divisions of counties and 
  2.29  other providers under contract to deliver mental health 
  2.30  services, or the ombudsman for mental health and mental 
  2.31  retardation. 
  2.32     (e) "Fugitive felon" means a person who has been convicted 
  2.33  of a felony and who has escaped from confinement or violated the 
  2.34  terms of probation or parole for that offense. 
  2.35     (f) "Private licensing agency" means an agency licensed by 
  2.36  the commissioner of human services under chapter 245A to perform 
  3.1   the duties under section 245A.16. 
  3.2      Sec. 3.  Minnesota Statutes 2000, section 13.46, 
  3.3   subdivision 3, is amended to read: 
  3.4      Subd. 3.  [INVESTIGATIVE DATA.] (a) Data on persons, 
  3.5   including data on vendors of services and data on licensees, 
  3.6   that is collected, maintained, used, or disseminated by the 
  3.7   welfare system in an investigation, authorized by statute and 
  3.8   relating to the enforcement of rules or law, is confidential 
  3.9   data on individuals pursuant to section 13.02, subdivision 3, or 
  3.10  protected nonpublic data not on individuals pursuant to section 
  3.11  13.02, subdivision 13, and shall not be disclosed except: 
  3.12     ~~(a)~~ (1) pursuant to section 13.05; 
  3.13     ~~(b)~~ (2) pursuant to statute or valid court order; 
  3.14     ~~(c)~~ (3) to a party named in a civil or criminal proceeding, 
  3.15  administrative or judicial, for preparation of defense; or 
  3.16     ~~(d)~~ (4) to provide notices required or permitted by statute.
  3.17     The data referred to in this subdivision shall be 
  3.18  classified as public data upon its submission to an 
  3.19  administrative law judge or court in an administrative or 
  3.20  judicial proceeding.  Inactive welfare investigative data shall 
  3.21  be treated as provided in section 13.39, subdivision 3.  
  3.22     (b) Notwithstanding any other provision in law, the 
  3.23  commissioner of human services shall provide all active and 
  3.24  inactive investigative data, including the name of the reporter 
  3.25  of alleged maltreatment under section 626.556 or 626.557, to the 
  3.26  ombudsman for mental health and retardation upon the request of 
  3.27  the ombudsman. 
  3.28     Sec. 4.  Minnesota Statutes 2001 Supplement, section 13.46, 
  3.29  subdivision 4, is amended to read: 
  3.30     Subd. 4.  [LICENSING DATA.] (a) As used in this subdivision:
  3.31     (1) "licensing data" means all data collected, maintained, 
  3.32  used, or disseminated by the welfare system pertaining to 
  3.33  persons licensed or registered or who apply for licensure or 
  3.34  registration or who formerly were licensed or registered under 
  3.35  the authority of the commissioner of human services; 
  3.36     (2) "client" means a person who is receiving services from 
  4.1   a licensee or from an applicant for licensure; and 
  4.2      (3) "personal and personal financial data" means social 
  4.3   security numbers, identity of and letters of reference, 
  4.4   insurance information, reports from the bureau of criminal 
  4.5   apprehension, health examination reports, and social/home 
  4.6   studies. 
  4.7      (b)(1) Except as provided in paragraph (c), the following 
  4.8   data on current and former licensees are public:  name, address, 
  4.9   telephone number of licensees, date of receipt of a completed 
  4.10  application, dates of licensure, licensed capacity, type of 
  4.11  client preferred, variances granted, type of dwelling, name and 
  4.12  relationship of other family members, previous license history, 
  4.13  class of license, and the existence and status of complaints.  
  4.14  When a correction order or fine has been issued, a license is 
  4.15  suspended, immediately suspended, revoked, denied, or made 
  4.16  conditional, or a complaint is resolved, the following data on 
  4.17  current and former licensees are public:  the substance and 
  4.18  investigative findings of the complaint, licensing violation, or 
  4.19  substantiated maltreatment; the record of informal resolution of 
  4.20  a licensing violation; orders of hearing; findings of fact; 
  4.21  conclusions of law; specifications of the final correction 
  4.22  order, fine, suspension, immediate suspension, revocation, 
  4.23  denial, or conditional license contained in the record of 
  4.24  licensing action; and the status of any appeal of these 
  4.25  actions.  When an individual licensee is a substantiated 
  4.26  perpetrator of maltreatment, and the substantiated maltreatment 
  4.27  is a reason for the licensing action, the identity of the 
  4.28  licensee as a perpetrator is public data.  For purposes of this 
  4.29  clause, a person is a substantiated perpetrator if the 
  4.30  maltreatment determination has been upheld under section 
  4.31  626.556, subdivision 10i, 626.557, subdivision 9d, or 256.045, 
  4.32  or an individual or facility has not timely exercised appeal 
  4.33  rights under these sections. 
  4.34     (2) For applicants who withdraw their application prior to 
  4.35  licensure or denial of a license, the following data are 
  4.36  public:  the name of the applicant, the city and county in which 
  5.1   the applicant was seeking licensure, the dates of the 
  5.2   commissioner's receipt of the initial application and completed 
  5.3   application, the type of license sought, and the date of 
  5.4   withdrawal of the application. 
  5.5      (3) For applicants who are denied a license, the following 
  5.6   data are public:  the name of the applicant, the city and county 
  5.7   in which the applicant was seeking licensure, the dates of the 
  5.8   commissioner's receipt of the initial application and completed 
  5.9   application, the type of license sought, the date of denial of 
  5.10  the application, the nature of the basis for the denial, and the 
  5.11  status of any appeal of the denial. 
  5.12     (4) The following data on persons subject to 
  5.13  disqualification under section 245A.04 in connection with a 
  5.14  license to provide family day care for children, child care 
  5.15  center services, foster care for children in the provider's 
  5.16  home, or foster care or day care services for adults in the 
  5.17  provider's home, are public:  the nature of any disqualification 
  5.18  set aside under section 245A.04, subdivision 3b, and the reasons 
  5.19  for setting aside the disqualification; and the reasons for 
  5.20  granting any variance under section 245A.04, subdivision 9. 
  5.21     (5) When maltreatment is substantiated under section 
  5.22  626.556 or 626.557 and the victim and the substantiated 
  5.23  perpetrator are affiliated with a program licensed under chapter 
  5.24  245A, the commissioner of human services, local social services 
  5.25  agency, or county welfare agency may inform the license holder 
  5.26  where the maltreatment occurred of the identity of the 
  5.27  substantiated perpetrator and the victim. 
  5.28     (c) The following are private data on individuals under 
  5.29  section 13.02, subdivision 12, or nonpublic data under section 
  5.30  13.02, subdivision 9:  personal and personal financial data on 
  5.31  family day care program and family foster care program 
  5.32  applicants and licensees and their family members who provide 
  5.33  services under the license. 
  5.34     (d) The following are private data on individuals:  the 
  5.35  identity of persons who have made reports concerning licensees 
  5.36  or applicants that appear in inactive investigative data, and 
  6.1   the records of clients or employees of the licensee or applicant 
  6.2   for licensure whose records are received by the licensing agency 
  6.3   for purposes of review or in anticipation of a contested 
  6.4   matter.  The names of reporters under sections 626.556 and 
  6.5   626.557 may be disclosed only as provided in section 626.556, 
  6.6   subdivision 11, or 626.557, subdivision 12b. 
  6.7      (e) Data classified as private, confidential, nonpublic, or 
  6.8   protected nonpublic under this subdivision become public data if 
  6.9   submitted to a court or administrative law judge as part of a 
  6.10  disciplinary proceeding in which there is a public hearing 
  6.11  concerning a license which has been suspended, immediately 
  6.12  suspended, revoked, or denied. 
  6.13     (f) Data generated in the course of licensing 
  6.14  investigations that relate to an alleged violation of law are 
  6.15  investigative data under subdivision 3. 
  6.16     (g) Data that are not public data collected, maintained, 
  6.17  used, or disseminated under this subdivision that relate to or 
  6.18  are derived from a report as defined in section 626.556, 
  6.19  subdivision 2, or 626.5572, subdivision 18, are subject to the 
  6.20  destruction provisions of sections 626.556, subdivision 11c, and 
  6.21  626.557, subdivision 12b.  
  6.22     (h) Upon request, not public data collected, maintained, 
  6.23  used, or disseminated under this subdivision that relate to or 
  6.24  are derived from a report of substantiated maltreatment as 
  6.25  defined in section 626.556 or 626.557 may be exchanged with the 
  6.26  department of health for purposes of completing background 
  6.27  studies pursuant to section 144.057 and with the department of 
  6.28  corrections for purposes of completing background studies 
  6.29  pursuant to section 241.021. 
  6.30     (i) Data on individuals collected according to licensing 
  6.31  activities under chapter 245A, and data on individuals collected 
  6.32  by the commissioner of human services according to maltreatment 
  6.33  investigations under sections 626.556 and 626.557, may be shared 
  6.34  with the department of human rights, the department of health, 
  6.35  the department of corrections, the ombudsman for mental health 
  6.36  and retardation, and the individual's professional regulatory 
  7.1   board when there is reason to believe that laws or standards 
  7.2   under the jurisdiction of those agencies may have been violated. 
  7.3      (j) In addition to the notice of determinations required 
  7.4   under section 626.556, subdivision 10f, if the commissioner or 
  7.5   the local social services agency has determined that an 
  7.6   individual is a substantiated perpetrator of maltreatment of a 
  7.7   child based on sexual abuse, as defined in section 626.556, 
  7.8   subdivision 2, and the commissioner or local social services 
  7.9   agency knows that the individual is a person responsible for a 
  7.10  child's care in another facility, the commissioner or local 
  7.11  social services agency shall notify the head of that facility of 
  7.12  this determination.  The notification must include an 
  7.13  explanation of the individual's available appeal rights and the 
  7.14  status of any appeal.  If a notice is given under this 
  7.15  paragraph, the government entity making the notification shall 
  7.16  provide a copy of the notice to the individual who is the 
  7.17  subject of the notice. 
  7.18     Sec. 5.  Minnesota Statutes 2000, section 245A.02, is 
  7.19  amended by adding a subdivision to read: 
  7.20     Subd. 2a.  [ADULT DAY CARE.] "Adult day care" means a 
  7.21  program operating less than 24 hours per day that provides 
  7.22  functionally impaired adults with an individualized and 
  7.23  coordinated set of services including health services, social 
  7.24  services, and nutritional services that are directed at 
  7.25  maintaining or improving the participants' capabilities for 
  7.26  self-care.  Adult day care does not include programs where 
  7.27  adults gather or congregate primarily for purposes of 
  7.28  socialization, education, supervision, caregiver respite, 
  7.29  religious expression, exercise, or nutritious meals. 
  7.30     Sec. 6.  Minnesota Statutes 2000, section 245A.02, is 
  7.31  amended by adding a subdivision to read: 
  7.32     Subd. 2b.  [ANNUAL OR ANNUALLY.] "Annual" or "annually" 
  7.33  means prior to or within the same month of the subsequent 
  7.34  calendar year. 
  7.35     Sec. 7.  Minnesota Statutes 2001 Supplement, section 
  7.36  245A.03, subdivision 2, is amended to read: 
  8.1      Subd. 2.  [EXCLUSION FROM LICENSURE.] (a) This chapter does 
  8.2   not apply to: 
  8.3      (1) residential or nonresidential programs that are 
  8.4   provided to a person by an individual who is related unless the 
  8.5   residential program is a child foster care placement made by a 
  8.6   local social services agency or a licensed child-placing agency, 
  8.7   except as provided in subdivision 2a; 
  8.8      (2) nonresidential programs that are provided by an 
  8.9   unrelated individual to persons from a single related family; 
  8.10     (3) residential or nonresidential programs that are 
  8.11  provided to adults who do not abuse chemicals or who do not have 
  8.12  a chemical dependency, a mental illness, mental retardation or a 
  8.13  related condition, a functional impairment, or a physical 
  8.14  handicap; 
  8.15     (4) sheltered workshops or work activity programs that are 
  8.16  certified by the commissioner of economic security; 
  8.17     (5) programs for children enrolled in kindergarten to the 
  8.18  12th grade and prekindergarten special education in a school as 
  8.19  defined in section 120A.22, subdivision 4, and programs serving 
  8.20  children in combined special education and regular 
  8.21  prekindergarten programs that are operated or assisted by the 
  8.22  commissioner of children, families, and learning; 
  8.23     (6) nonresidential programs primarily for children that 
  8.24  provide care or supervision, without charge for ten or fewer 
  8.25  days a year, and for periods of less than three hours a day 
  8.26  while the child's parent or legal guardian is in the same 
  8.27  building as the nonresidential program or present within another 
  8.28  building that is directly contiguous to the building in which 
  8.29  the nonresidential program is located; 
  8.30     (7) nursing homes or hospitals licensed by the commissioner 
  8.31  of health except as specified under section 245A.02; 
  8.32     (8) board and lodge facilities licensed by the commissioner 
  8.33  of health that provide services for five or more persons whose 
  8.34  primary diagnosis is mental illness who have refused an 
  8.35  appropriate residential program offered by a county agency~~.~~  
  8.36  ~~This exclusion expires on July 1, 1990~~; 
  9.1      (9) homes providing programs for persons placed there by a 
  9.2   licensed agency for legal adoption, unless the adoption is not 
  9.3   completed within two years; 
  9.4      (10) programs licensed by the commissioner of corrections; 
  9.5      (11) recreation programs for children or adults that 
  9.6   operate for fewer than 40 calendar days in a calendar year or 
  9.7   programs operated by a park and recreation board of a city of 
  9.8   the first class whose primary purpose is to provide social and 
  9.9   recreational activities to school age children, provided the 
  9.10  program is approved by the park and recreation board; 
  9.11     (12) programs operated by a school as defined in section 
  9.12  120A.22, subdivision 4, whose primary purpose is to provide 
  9.13  child care to school-age children, provided the program is 
  9.14  approved by the district's school board; 
  9.15     (13) Head Start nonresidential programs which operate for 
  9.16  less than 31 days in each calendar year; 
  9.17     (14) noncertified boarding care homes unless they provide 
  9.18  services for five or more persons whose primary diagnosis is 
  9.19  mental illness or mental retardation; 
  9.20     (15) nonresidential programs for nonhandicapped children 
  9.21  provided for a cumulative total of less than 30 days in any 
  9.22  12-month period; 
  9.23     (16) residential programs for persons with mental illness, 
  9.24  that are located in hospitals, until the commissioner adopts 
  9.25  appropriate rules; 
  9.26     (17) the religious instruction of school-age children; 
  9.27  Sabbath or Sunday schools; or the congregate care of children by 
  9.28  a church, congregation, or religious society during the period 
  9.29  used by the church, congregation, or religious society for its 
  9.30  regular worship; 
  9.31     (18) camps licensed by the commissioner of health under 
  9.32  Minnesota Rules, chapter 4630; 
  9.33     (19) mental health outpatient services for adults with 
  9.34  mental illness or children with emotional disturbance; 
  9.35     (20) residential programs serving school-age children whose 
  9.36  sole purpose is cultural or educational exchange, until the 
 10.1   commissioner adopts appropriate rules; 
 10.2      (21) unrelated individuals who provide out-of-home respite 
 10.3   care services to persons with mental retardation or related 
 10.4   conditions from a single related family for no more than 90 days 
 10.5   in a 12-month period and the respite care services are for the 
 10.6   temporary relief of the person's family or legal representative; 
 10.7      (22) respite care services provided as a home and 
 10.8   community-based service to a person with mental retardation or a 
 10.9   related condition, in the person's primary residence; 
 10.10     (23) community support services programs as defined in 
 10.11  section 245.462, subdivision 6, and family community support 
 10.12  services as defined in section 245.4871, subdivision 17; 
 10.13     (24) the placement of a child by a birth parent or legal 
 10.14  guardian in a preadoptive home for purposes of adoption as 
 10.15  authorized by section 259.47; 
 10.16     (25) settings registered under chapter 144D which provide 
 10.17  home care services licensed by the commissioner of health to 
 10.18  fewer than seven adults; or 
 10.19     (26) consumer-directed community support service funded 
 10.20  under the Medicaid waiver for persons with mental retardation 
 10.21  and related conditions when the individual who provided the 
 10.22  service is:  
 10.23     (i) the same individual who is the direct payee of these 
 10.24  specific waiver funds or paid by a fiscal agent, fiscal 
 10.25  intermediary, or employer of record; and 
 10.26     (ii) not otherwise under the control of a residential or 
 10.27  nonresidential program that is required to be licensed under 
 10.28  this chapter when providing the service. 
 10.29     For purposes of clause (6), a building is directly 
 10.30  contiguous to a building in which a nonresidential program is 
 10.31  located if it shares a common wall with the building in which 
 10.32  the nonresidential program is located or is attached to that 
 10.33  building by skyway, tunnel, atrium, or common roof. 
 10.34     (b) Nothing in this chapter shall be construed to require 
 10.35  licensure for any services provided and funded according to an 
 10.36  approved federal waiver plan where licensure is specifically 
 11.1   identified as not being a condition for the services and funding.
 11.2      Sec. 8.  Minnesota Statutes 2000, section 245A.035, 
 11.3   subdivision 3, is amended to read: 
 11.4      Subd. 3.  [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 
 11.5   emergency license may be issued, the following requirements must 
 11.6   be met: 
 11.7      (1) the county agency must conduct an initial inspection of 
 11.8   the premises where the foster care is to be provided to ensure 
 11.9   the health and safety of any child placed in the home.  The 
 11.10  county agency shall conduct the inspection using a form 
 11.11  developed by the commissioner; 
 11.12     (2) at the time of the inspection or placement, whichever 
 11.13  is earlier, the relative being considered for an emergency 
 11.14  license shall receive an application form for a child foster 
 11.15  care license; ~~and~~ 
 11.16     (3) whenever possible, prior to placing the child in the 
 11.17  relative's home, the relative being considered for an emergency 
 11.18  license shall provide the information required by section 
 11.19  245A.04, subdivision 3, paragraph (b); and 
 11.20     (4) if the county determines, prior to the issuance of an 
 11.21  emergency license, that anyone requiring a background study is 
 11.22  disqualified under section 245A.04, and the disqualification is 
 11.23  one which the commissioner cannot set aside, an emergency 
 11.24  license shall not be issued. 
 11.25     Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 11.26  245A.04, subdivision 3, is amended to read: 
 11.27     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
 11.28  (a) Individuals and organizations that are required in statute 
 11.29  to initiate background studies under this section shall comply 
 11.30  with the following requirements: 
 11.31     (1) Applicants for licensure, license holders, and other 
 11.32  entities as provided in this section must submit completed 
 11.33  background study forms to the commissioner before individuals 
 11.34  specified in paragraph (c), clauses (1) to (4), (6), and (7), 
 11.35  begin positions allowing direct contact in any licensed program. 
 11.36     (2) Applicants and license holders under the jurisdiction 
 12.1   of other state agencies who are required in other statutory 
 12.2   sections to initiate background studies under this section must 
 12.3   submit completed background study forms to the commissioner 
 12.4   prior to the background study subject beginning in a position 
 12.5   allowing direct contact in the licensed program, or where 
 12.6   applicable, prior to being employed. 
 12.7      (3) Organizations required to initiate background studies 
 12.8   under section 256B.0627 for individuals described in paragraph 
 12.9   (c), clause (5), must submit a completed background study form 
 12.10  to the commissioner before those individuals begin a position 
 12.11  allowing direct contact with persons served by the 
 12.12  organization.  The commissioner shall recover the cost of these 
 12.13  background studies through a fee of no more than $12 per study 
 12.14  charged to the organization responsible for submitting the 
 12.15  background study form.  The fees collected under this paragraph 
 12.16  are appropriated to the commissioner for the purpose of 
 12.17  conducting background studies.  
 12.18     Upon receipt of the background study forms from the 
 12.19  entities in clauses (1) to (3), the commissioner shall complete 
 12.20  the background study as specified under this section and provide 
 12.21  notices required in subdivision 3a.  Unless otherwise specified, 
 12.22  the subject of a background study may have direct contact with 
 12.23  persons served by a program after the background study form is 
 12.24  mailed or submitted to the commissioner pending notification of 
 12.25  the study results under subdivision 3a.  A county agency may 
 12.26  accept a background study completed by the commissioner under 
 12.27  this section in place of the background study required under 
 12.28  section 245A.16, subdivision 3, in programs with joint licensure 
 12.29  as home and community-based services and adult foster care for 
 12.30  people with developmental disabilities when the license holder 
 12.31  does not reside in the foster care residence and the subject of 
 12.32  the study has been continuously affiliated with the license 
 12.33  holder since the date of the commissioner's study. 
 12.34     (b) The definitions in this paragraph apply only to 
 12.35  subdivisions 3 to 3e. 
 12.36     (1) "Background study" means the review of records 
 13.1   conducted by the commissioner to determine whether a subject is 
 13.2   disqualified from direct contact with persons served by a 
 13.3   program, and where specifically provided in statutes, whether a 
 13.4   subject is disqualified from having access to persons served by 
 13.5   a program. 
 13.6      (2) "Continuous, direct supervision" means an individual is 
 13.7   within sight or hearing of the supervising person to the extent 
 13.8   that supervising person is capable at all times of intervening 
 13.9   to protect the health and safety of the persons served by the 
 13.10  program. 
 13.11     (3) "Contractor" means any person, regardless of employer, 
 13.12  who is providing program services for hire under the control of 
 13.13  the provider. 
 13.14     (4) "Direct contact" means providing face-to-face care, 
 13.15  training, supervision, counseling, consultation, or medication 
 13.16  assistance to persons served by the program. 
 13.17     (5) "Reasonable cause" means information or circumstances 
 13.18  exist which provide the commissioner with articulable suspicion 
 13.19  that further pertinent information may exist concerning a 
 13.20  subject.  The commissioner has reasonable cause when, but not 
 13.21  limited to, the commissioner has received a report from the 
 13.22  subject, the license holder, or a third party indicating that 
 13.23  the subject has a history that would disqualify the person or 
 13.24  that may pose a risk to the health or safety of persons 
 13.25  receiving services. 
 13.26     (6) "Subject of a background study" means an individual on 
 13.27  whom a background study is required or completed. 
 13.28     (c) The applicant, license holder, registrant under section 
 13.29  144A.71, subdivision 1, bureau of criminal apprehension, 
 13.30  commissioner of health, and county agencies, after written 
 13.31  notice to the individual who is the subject of the study, shall 
 13.32  help with the study by giving the commissioner criminal 
 13.33  conviction data and reports about the maltreatment of adults 
 13.34  substantiated under section 626.557 and the maltreatment of 
 13.35  minors in licensed programs substantiated under section 
 13.36  626.556.  If a background study is initiated by an applicant or 
 14.1   license holder and the applicant or license holder receives 
 14.2   information about a possible criminal or maltreatment history of 
 14.3   an individual who is the subject of a background study, the 
 14.4   applicant or license holder must immediately provide the 
 14.5   information to the commissioner.  The individuals to be studied 
 14.6   shall include: 
 14.7      (1) the applicant; 
 14.8      (2) persons age 13 and over living in the household where 
 14.9   the licensed program will be provided; 
 14.10     (3) current employees or contractors of the applicant who 
 14.11  will have direct contact with persons served by the facility, 
 14.12  agency, or program; 
 14.13     (4) volunteers or student volunteers who have direct 
 14.14  contact with persons served by the program to provide program 
 14.15  services, if the contact is not ~~directly supervised by the~~ 
 14.16  ~~individuals~~ under the continuous, direct supervision by an 
 14.17  individual listed in clause (1) or (3); 
 14.18     (5) any person required under section 256B.0627 to have a 
 14.19  background study completed under this section; 
 14.20     (6) persons ages 10 to 12 living in the household where the 
 14.21  licensed services will be provided when the commissioner has 
 14.22  reasonable cause; and 
 14.23     (7) persons who, without providing direct contact services 
 14.24  at a licensed program, may have unsupervised access to children 
 14.25  or vulnerable adults receiving services from the program 
 14.26  licensed to provide family child care for children, foster care 
 14.27  for children in the provider's own home, or foster care or day 
 14.28  care services for adults in the provider's own home when the 
 14.29  commissioner has reasonable cause. 
 14.30     (d) According to paragraph (c), clauses (2) and (6), the 
 14.31  commissioner shall review records from the juvenile courts.  For 
 14.32  persons under paragraph (c), clauses (1), (3), (4), (5), and 
 14.33  (7), who are ages 13 to 17, the commissioner shall review 
 14.34  records from the juvenile courts when the commissioner has 
 14.35  reasonable cause.  The juvenile courts shall help with the study 
 14.36  by giving the commissioner existing juvenile court records on 
 15.1   individuals described in paragraph (c), clauses (2), (6), and 
 15.2   (7), relating to delinquency proceedings held within either the 
 15.3   five years immediately preceding the background study or the 
 15.4   five years immediately preceding the individual's 18th birthday, 
 15.5   whichever time period is longer.  The commissioner shall destroy 
 15.6   juvenile records obtained pursuant to this subdivision when the 
 15.7   subject of the records reaches age 23. 
 15.8      (e) Beginning August 1, 2001, the commissioner shall 
 15.9   conduct all background studies required under this chapter and 
 15.10  initiated by supplemental nursing services agencies registered 
 15.11  under section 144A.71, subdivision 1.  Studies for the agencies 
 15.12  must be initiated annually by each agency.  The commissioner 
 15.13  shall conduct the background studies according to this chapter.  
 15.14  The commissioner shall recover the cost of the background 
 15.15  studies through a fee of no more than $8 per study, charged to 
 15.16  the supplemental nursing services agency.  The fees collected 
 15.17  under this paragraph are appropriated to the commissioner for 
 15.18  the purpose of conducting background studies. 
 15.19     (f) For purposes of this section, a finding that a 
 15.20  delinquency petition is proven in juvenile court shall be 
 15.21  considered a conviction in state district court. 
 15.22     (g) A study of an individual in paragraph (c), clauses (1) 
 15.23  to (7), shall be conducted at least upon application for initial 
 15.24  license for all license types or registration under section 
 15.25  144A.71, subdivision 1, and at reapplication for a license ~~or~~ 
 15.26  ~~registration~~ for family child care, child foster care, and adult 
 15.27  foster care.  The commissioner is not required to conduct a 
 15.28  study of an individual at the time of reapplication for a 
 15.29  license or if the individual has been continuously affiliated 
 15.30  with a foster care provider licensed by the commissioner of 
 15.31  human services and registered under chapter 144D, other than a 
 15.32  family day care or foster care license, if:  (i) a study of the 
 15.33  individual was conducted either at the time of initial licensure 
 15.34  or when the individual became affiliated with the license 
 15.35  holder; (ii) the individual has been continuously affiliated 
 15.36  with the license holder since the last study was conducted; and 
 16.1   (iii) the procedure described in paragraph (j) has been 
 16.2   implemented and was in effect continuously since the last study 
 16.3   was conducted.  For the purposes of this section, a physician 
 16.4   licensed under chapter 147 is considered to be continuously 
 16.5   affiliated upon the license holder's receipt from the 
 16.6   commissioner of health or human services of the physician's 
 16.7   background study results.  For individuals who are required to 
 16.8   have background studies under paragraph (c) and who have been 
 16.9   continuously affiliated with a foster care provider that is 
 16.10  licensed in more than one county, criminal conviction data may 
 16.11  be shared among those counties in which the foster care programs 
 16.12  are licensed.  A county agency's receipt of criminal conviction 
 16.13  data from another county agency shall meet the criminal data 
 16.14  background study requirements of this section. 
 16.15     (h) The commissioner may also conduct studies on 
 16.16  individuals specified in paragraph (c), clauses (3) and (4), 
 16.17  when the studies are initiated by: 
 16.18     (i) personnel pool agencies; 
 16.19     (ii) temporary personnel agencies; 
 16.20     (iii) educational programs that train persons by providing 
 16.21  direct contact services in licensed programs; and 
 16.22     (iv) professional services agencies that are not licensed 
 16.23  and which contract with licensed programs to provide direct 
 16.24  contact services or individuals who provide direct contact 
 16.25  services. 
 16.26     (i) Studies on individuals in paragraph (h), items (i) to 
 16.27  (iv), must be initiated annually by these agencies, programs, 
 16.28  and individuals.  Except as provided in paragraph (a), clause 
 16.29  (3), no applicant, license holder, or individual who is the 
 16.30  subject of the study shall pay any fees required to conduct the 
 16.31  study. 
 16.32     (1) At the option of the licensed facility, rather than 
 16.33  initiating another background study on an individual required to 
 16.34  be studied who has indicated to the licensed facility that a 
 16.35  background study by the commissioner was previously completed, 
 16.36  the facility may make a request to the commissioner for 
 17.1   documentation of the individual's background study status, 
 17.2   provided that: 
 17.3      (i) the facility makes this request using a form provided 
 17.4   by the commissioner; 
 17.5      (ii) in making the request the facility informs the 
 17.6   commissioner that either: 
 17.7      (A) the individual has been continuously affiliated with a 
 17.8   licensed facility since the individual's previous background 
 17.9   study was completed, or since October 1, 1995, whichever is 
 17.10  shorter; or 
 17.11     (B) the individual is affiliated only with a personnel pool 
 17.12  agency, a temporary personnel agency, an educational program 
 17.13  that trains persons by providing direct contact services in 
 17.14  licensed programs, or a professional services agency that is not 
 17.15  licensed and which contracts with licensed programs to provide 
 17.16  direct contact services or individuals who provide direct 
 17.17  contact services; and 
 17.18     (iii) the facility provides notices to the individual as 
 17.19  required in paragraphs (a) to (j), and that the facility is 
 17.20  requesting written notification of the individual's background 
 17.21  study status from the commissioner.  
 17.22     (2) The commissioner shall respond to each request under 
 17.23  paragraph (1) with a written or electronic notice to the 
 17.24  facility and the study subject.  If the commissioner determines 
 17.25  that a background study is necessary, the study shall be 
 17.26  completed without further request from a licensed agency or 
 17.27  notifications to the study subject.  
 17.28     (3) When a background study is being initiated by a 
 17.29  licensed facility or a foster care provider that is also 
 17.30  registered under chapter 144D, a study subject affiliated with 
 17.31  multiple licensed facilities may attach to the background study 
 17.32  form a cover letter indicating the additional facilities' names, 
 17.33  addresses, and background study identification numbers.  When 
 17.34  the commissioner receives such notices, each facility identified 
 17.35  by the background study subject shall be notified of the study 
 17.36  results.  The background study notice sent to the subsequent 
 18.1   agencies shall satisfy those facilities' responsibilities for 
 18.2   initiating a background study on that individual. 
 18.3      (j) If an individual who is affiliated with a program or 
 18.4   facility regulated by the department of human services or 
 18.5   department of health or who is affiliated with any type of home 
 18.6   care agency or provider of personal care assistance services, is 
 18.7   convicted of a crime constituting a disqualification under 
 18.8   subdivision 3d, the probation officer or corrections agent shall 
 18.9   notify the commissioner of the conviction.  For the purpose of 
 18.10  this paragraph, "conviction" has the meaning given it in section 
 18.11  609.02, subdivision 5.  The commissioner, in consultation with 
 18.12  the commissioner of corrections, shall develop forms and 
 18.13  information necessary to implement this paragraph and shall 
 18.14  provide the forms and information to the commissioner of 
 18.15  corrections for distribution to local probation officers and 
 18.16  corrections agents.  The commissioner shall inform individuals 
 18.17  subject to a background study that criminal convictions for 
 18.18  disqualifying crimes will be reported to the commissioner by the 
 18.19  corrections system.  A probation officer, corrections agent, or 
 18.20  corrections agency is not civilly or criminally liable for 
 18.21  disclosing or failing to disclose the information required by 
 18.22  this paragraph.  Upon receipt of disqualifying information, the 
 18.23  commissioner shall provide the notifications required in 
 18.24  subdivision 3a, as appropriate to agencies on record as having 
 18.25  initiated a background study or making a request for 
 18.26  documentation of the background study status of the individual.  
 18.27  This paragraph does not apply to family day care and child 
 18.28  foster care programs. 
 18.29     (k) The individual who is the subject of the study must 
 18.30  provide the applicant or license holder with sufficient 
 18.31  information to ensure an accurate study including the 
 18.32  individual's first, middle, and last name and all other names by 
 18.33  which the individual has been known; home address, city, county, 
 18.34  and state of residence for the past five years; zip code; sex; 
 18.35  date of birth; and driver's license number or state 
 18.36  identification number.  The applicant or license holder shall 
 19.1   provide this information about an individual in paragraph (c), 
 19.2   clauses (1) to (7), on forms prescribed by the commissioner.  By 
 19.3   January 1, 2000, for background studies conducted by the 
 19.4   department of human services, the commissioner shall implement a 
 19.5   system for the electronic transmission of:  (1) background study 
 19.6   information to the commissioner; and (2) background study 
 19.7   results to the license holder.  The commissioner may request 
 19.8   additional information of the individual, which shall be 
 19.9   optional for the individual to provide, such as the individual's 
 19.10  social security number or race. 
 19.11     (l) For programs directly licensed by the commissioner, a 
 19.12  study must include information related to names of substantiated 
 19.13  perpetrators of maltreatment of vulnerable adults that has been 
 19.14  received by the commissioner as required under section 626.557, 
 19.15  subdivision 9c, paragraph (i), and the commissioner's records 
 19.16  relating to the maltreatment of minors in licensed programs, 
 19.17  information from juvenile courts as required in paragraph (c) 
 19.18  for persons listed in paragraph (c), clauses (2), (6), and (7), 
 19.19  and information from the bureau of criminal apprehension.  For 
 19.20  child foster care, adult foster care, and family day care homes, 
 19.21  the study must include information from the county agency's 
 19.22  record of substantiated maltreatment of adults, and the 
 19.23  maltreatment of minors, information from juvenile courts as 
 19.24  required in paragraph (c) for persons listed in paragraph (c), 
 19.25  clauses (2), (6), and (7), and information from the bureau of 
 19.26  criminal apprehension.  The commissioner may also review arrest 
 19.27  and investigative information from the bureau of criminal 
 19.28  apprehension, the commissioner of health, a county attorney, 
 19.29  county sheriff, county agency, local chief of police, other 
 19.30  states, the courts, or the Federal Bureau of Investigation if 
 19.31  the commissioner has reasonable cause to believe the information 
 19.32  is pertinent to the disqualification of an individual listed in 
 19.33  paragraph (c), clauses (1) to (7).  The commissioner is not 
 19.34  required to conduct more than one review of a subject's records 
 19.35  from the Federal Bureau of Investigation if a review of the 
 19.36  subject's criminal history with the Federal Bureau of 
 20.1   Investigation has already been completed by the commissioner and 
 20.2   there has been no break in the subject's affiliation with the 
 20.3   license holder who initiated the background study. 
 20.4      (m) When the commissioner has reasonable cause to believe 
 20.5   that further pertinent information may exist on the subject, the 
 20.6   subject shall provide a set of classifiable fingerprints 
 20.7   obtained from an authorized law enforcement agency.  For 
 20.8   purposes of requiring fingerprints, the commissioner shall be 
 20.9   considered to have reasonable cause under, but not limited to, 
 20.10  the following circumstances: 
 20.11     (1) information from the bureau of criminal apprehension 
 20.12  indicates that the subject is a multistate offender; 
 20.13     (2) information from the bureau of criminal apprehension 
 20.14  indicates that multistate offender status is undetermined; or 
 20.15     (3) the commissioner has received a report from the subject 
 20.16  or a third party indicating that the subject has a criminal 
 20.17  history in a jurisdiction other than Minnesota. 
 20.18     (n) The failure or refusal of an applicant, license holder, 
 20.19  or registrant under section 144A.71, subdivision 1, to cooperate 
 20.20  with the commissioner is reasonable cause to disqualify a 
 20.21  subject, deny a license application or immediately suspend, 
 20.22  suspend, or revoke a license or registration.  Failure or 
 20.23  refusal of an individual to cooperate with the study is just 
 20.24  cause for denying or terminating employment of the individual if 
 20.25  the individual's failure or refusal to cooperate could cause the 
 20.26  applicant's application to be denied or the license holder's 
 20.27  license to be immediately suspended, suspended, or revoked. 
 20.28     (o) The commissioner shall not consider an application to 
 20.29  be complete until all of the information required to be provided 
 20.30  under this subdivision has been received.  
 20.31     (p) No person in paragraph (c), clauses (1) to (7), who is 
 20.32  disqualified as a result of this section may be retained by the 
 20.33  agency in a position involving direct contact with persons 
 20.34  served by the program ~~or in a position allowing~~ and no person in 
 20.35  paragraph (c), clauses (2), (6), and (7), or as provided 
 20.36  elsewhere in statute who is disqualified as a result of this 
 21.1   section may be allowed access to persons served by the 
 21.2   program ~~as provided for in statutes~~, unless the commissioner has 
 21.3   provided written notice to the agency stating that: 
 21.4      (1) the individual may remain in direct contact during the 
 21.5   period in which the individual may request reconsideration as 
 21.6   provided in subdivision 3a, paragraph (b), clause (2) or (3); 
 21.7      (2) the individual's disqualification has been set aside 
 21.8   for that agency as provided in subdivision 3b, paragraph (b); or 
 21.9      (3) the license holder has been granted a variance for the 
 21.10  disqualified individual under subdivision 3e. 
 21.11     (q) Termination of affiliation with persons in paragraph 
 21.12  (c), clauses (1) to (7), made in good faith reliance on a notice 
 21.13  of disqualification provided by the commissioner shall not 
 21.14  subject the applicant or license holder to civil liability. 
 21.15     (r) The commissioner may establish records to fulfill the 
 21.16  requirements of this section. 
 21.17     (s) The commissioner may not disqualify an individual 
 21.18  subject to a study under this section because that person has, 
 21.19  or has had, a mental illness as defined in section 245.462, 
 21.20  subdivision 20. 
 21.21     (t) An individual subject to disqualification under this 
 21.22  subdivision has the applicable rights in subdivision 3a, 3b, or 
 21.23  3c. 
 21.24     (u) For the purposes of background studies completed by 
 21.25  tribal organizations performing licensing activities otherwise 
 21.26  required of the commissioner under this chapter, after obtaining 
 21.27  consent from the background study subject, tribal licensing 
 21.28  agencies shall have access to criminal history data in the same 
 21.29  manner as county licensing agencies and private licensing 
 21.30  agencies under this chapter. 
 21.31     Sec. 10.  Minnesota Statutes 2001 Supplement, section 
 21.32  245A.04, subdivision 3a, is amended to read: 
 21.33     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
 21.34  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 
 21.35  working days, the commissioner shall notify the applicant, 
 21.36  license holder, or registrant under section 144A.71, subdivision 
 22.1   1, and the individual who is the subject of the study, in 
 22.2   writing or by electronic transmission, of the results of the 
 22.3   study or that more time is needed to complete the study.  When 
 22.4   the study is completed, a notice that the study was undertaken 
 22.5   and completed shall be maintained in the personnel files of the 
 22.6   program.  For studies on individuals pertaining to a license to 
 22.7   provide family day care or group family day care, foster care 
 22.8   for children in the provider's own home, or foster care or day 
 22.9   care services for adults in the provider's own home, the 
 22.10  commissioner is not required to provide a separate notice of the 
 22.11  background study results to the individual who is the subject of 
 22.12  the study unless the study results in a disqualification of the 
 22.13  individual. 
 22.14     The commissioner shall notify the individual studied if the 
 22.15  information in the study indicates the individual is 
 22.16  disqualified from direct contact with persons served by the 
 22.17  program.  The commissioner shall disclose the information 
 22.18  causing disqualification and instructions on how to request a 
 22.19  reconsideration of the disqualification to the individual 
 22.20  studied.  An applicant or license holder who is not the subject 
 22.21  of the study shall be informed that the commissioner has found 
 22.22  information that disqualifies the subject from direct contact 
 22.23  with persons served by the program.  However, only the 
 22.24  individual studied must be informed of the information contained 
 22.25  in the subject's background study unless the basis for the 
 22.26  disqualification is failure to cooperate, substantiated 
 22.27  maltreatment under section 626.556 or 626.557, the Data 
 22.28  Practices Act provides for release of the information, or the 
 22.29  individual studied authorizes the release of the information.  
 22.30  When a disqualification is based on the subject's failure to 
 22.31  cooperate with the background study or substantiated 
 22.32  maltreatment under section 626.556 or 626.557, the agency that 
 22.33  initiated the study shall be informed by the commissioner of the 
 22.34  reason for the disqualification. 
 22.35     (b) Except as provided in subdivision 3d, paragraph (b), if 
 22.36  the commissioner determines that the individual studied has a 
 23.1   disqualifying characteristic, the commissioner shall review the 
 23.2   information immediately available and make a determination as to 
 23.3   the subject's immediate risk of harm to persons served by the 
 23.4   program where the individual studied will have direct contact.  
 23.5   The commissioner shall consider all relevant information 
 23.6   available, including the following factors in determining the 
 23.7   immediate risk of harm:  the recency of the disqualifying 
 23.8   characteristic; the recency of discharge from probation for the 
 23.9   crimes; the number of disqualifying characteristics; the 
 23.10  intrusiveness or violence of the disqualifying characteristic; 
 23.11  the vulnerability of the victim involved in the disqualifying 
 23.12  characteristic; and the similarity of the victim to the persons 
 23.13  served by the program where the individual studied will have 
 23.14  direct contact.  The commissioner may determine that the 
 23.15  evaluation of the information immediately available gives the 
 23.16  commissioner reason to believe one of the following: 
 23.17     (1) The individual poses an imminent risk of harm to 
 23.18  persons served by the program where the individual studied will 
 23.19  have direct contact.  If the commissioner determines that an 
 23.20  individual studied poses an imminent risk of harm to persons 
 23.21  served by the program where the individual studied will have 
 23.22  direct contact, the individual and the license holder must be 
 23.23  sent a notice of disqualification.  The commissioner shall order 
 23.24  the license holder to immediately remove the individual studied 
 23.25  from direct contact.  The notice to the individual studied must 
 23.26  include an explanation of the basis of this determination. 
 23.27     (2) The individual poses a risk of harm requiring 
 23.28  continuous, direct supervision while providing direct contact 
 23.29  services during the period in which the subject may request a 
 23.30  reconsideration.  If the commissioner determines that an 
 23.31  individual studied poses a risk of harm that requires 
 23.32  continuous, direct supervision, the individual and the license 
 23.33  holder must be sent a notice of disqualification.  The 
 23.34  commissioner shall order the license holder to immediately 
 23.35  remove the individual studied from direct contact services or 
 23.36  assure that the individual studied is ~~within sight or hearing~~ 
 24.1   under the continuous, direct supervision of another staff person 
 24.2   when providing direct contact services during the period in 
 24.3   which the individual may request a reconsideration of the 
 24.4   disqualification.  If the individual studied does not submit a 
 24.5   timely request for reconsideration, or the individual submits a 
 24.6   timely request for reconsideration, but the disqualification is 
 24.7   not set aside for that license holder, the license holder will 
 24.8   be notified of the disqualification and ordered to immediately 
 24.9   remove the individual from any position allowing direct contact 
 24.10  with persons receiving services from the license holder. 
 24.11     (3) The individual does not pose an imminent risk of harm 
 24.12  or a risk of harm requiring continuous, direct supervision while 
 24.13  providing direct contact services during the period in which the 
 24.14  subject may request a reconsideration.  If the commissioner 
 24.15  determines that an individual studied does not pose a risk of 
 24.16  harm that requires continuous, direct supervision, only the 
 24.17  individual must be sent a notice of disqualification.  The 
 24.18  license holder must be sent a notice that more time is needed to 
 24.19  complete the individual's background study.  If the individual 
 24.20  studied submits a timely request for reconsideration, and if the 
 24.21  disqualification is set aside for that license holder, the 
 24.22  license holder will receive the same notification received by 
 24.23  license holders in cases where the individual studied has no 
 24.24  disqualifying characteristic.  If the individual studied does 
 24.25  not submit a timely request for reconsideration, or the 
 24.26  individual submits a timely request for reconsideration, but the 
 24.27  disqualification is not set aside for that license holder, the 
 24.28  license holder will be notified of the disqualification and 
 24.29  ordered to immediately remove the individual from any position 
 24.30  allowing direct contact with persons receiving services from the 
 24.31  license holder.  
 24.32     (c) County licensing agencies performing duties under this 
 24.33  subdivision may develop an alternative system for determining 
 24.34  the subject's immediate risk of harm to persons served by the 
 24.35  program, providing the notices under paragraph (b), and 
 24.36  documenting the action taken by the county licensing agency.  
 25.1   Each county licensing agency's implementation of the alternative 
 25.2   system is subject to approval by the commissioner.  
 25.3   Notwithstanding this alternative system, county licensing 
 25.4   agencies shall complete the requirements of paragraph (a). 
 25.5      Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 25.6   245A.04, subdivision 3b, is amended to read: 
 25.7      Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 25.8   individual who is the subject of the disqualification may 
 25.9   request a reconsideration of the disqualification.  
 25.10     The individual must submit the request for reconsideration 
 25.11  to the commissioner in writing.  A request for reconsideration 
 25.12  for an individual who has been sent a notice of disqualification 
 25.13  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 25.14  submitted within 30 calendar days of the disqualified 
 25.15  individual's receipt of the notice of disqualification.  Upon 
 25.16  showing that the information in clause (1) or (2) cannot be 
 25.17  obtained within 30 days, the disqualified individual may request 
 25.18  additional time, not to exceed 30 days, to obtain that 
 25.19  information.  A request for reconsideration for an individual 
 25.20  who has been sent a notice of disqualification under subdivision 
 25.21  3a, paragraph (b), clause (3), must be submitted within 15 
 25.22  calendar days of the disqualified individual's receipt of the 
 25.23  notice of disqualification.  An individual who was determined to 
 25.24  have maltreated a child under section 626.556 or a vulnerable 
 25.25  adult under section 626.557, and who was disqualified under this 
 25.26  section on the basis of serious or recurring maltreatment, may 
 25.27  request reconsideration of both the maltreatment and the 
 25.28  disqualification determinations.  The request for 
 25.29  reconsideration of the maltreatment determination and the 
 25.30  disqualification must be submitted within 30 calendar days of 
 25.31  the individual's receipt of the notice of disqualification.  
 25.32  Removal of a disqualified individual from direct contact shall 
 25.33  be ordered if the individual does not request reconsideration 
 25.34  within the prescribed time, and for an individual who submits a 
 25.35  timely request for reconsideration, if the disqualification is 
 25.36  not set aside.  The individual must present information showing 
 26.1   that: 
 26.2      (1) the information the commissioner relied upon in 
 26.3   determining that the underlying conduct giving rise to the 
 26.4   disqualification occurred, and for maltreatment, that the 
 26.5   maltreatment was serious or recurring, is incorrect ~~or~~ 
 26.6   ~~inaccurate.  If the basis of a reconsideration request is that a~~ 
 26.7   ~~maltreatment determination or disposition under section 626.556~~ 
 26.8   ~~or 626.557 is incorrect, and the commissioner has issued a final~~ 
 26.9   ~~order in an appeal of that determination or disposition under~~ 
 26.10  ~~section 256.045 or 245A.08, subdivision 5, the commissioner's~~ 
 26.11  ~~order is conclusive on the issue of maltreatment.  If the~~ 
 26.12  ~~individual did not request reconsideration of the maltreatment~~ 
 26.13  ~~determination, the maltreatment determination is deemed~~ 
 26.14  ~~conclusive~~; or 
 26.15     (2) the subject of the study does not pose a risk of harm 
 26.16  to any person served by the applicant, license holder, or 
 26.17  registrant under section 144A.71, subdivision 1. 
 26.18     (b) The commissioner shall rescind the disqualification if 
 26.19  the commissioner finds that the information relied on to 
 26.20  disqualify the subject is incorrect.  The commissioner may set 
 26.21  aside the disqualification under this section if the 
 26.22  commissioner finds that the individual does not pose a risk of 
 26.23  harm to any person served by the applicant, license holder, or 
 26.24  registrant under section 144A.71, subdivision 1.  In determining 
 26.25  that an individual does not pose a risk of harm, the 
 26.26  commissioner shall consider the nature, severity, and 
 26.27  consequences of the event or events that lead to 
 26.28  disqualification, whether there is more than one disqualifying 
 26.29  event, the age and vulnerability of the victim at the time of 
 26.30  the event, the harm suffered by the victim, the similarity 
 26.31  between the victim and persons served by the program, the time 
 26.32  elapsed without a repeat of the same or similar event, 
 26.33  documentation of successful completion by the individual studied 
 26.34  of training or rehabilitation pertinent to the event, and any 
 26.35  other information relevant to reconsideration.  In reviewing a 
 26.36  disqualification under this section, the commissioner shall give 
 27.1   preeminent weight to the safety of each person to be served by 
 27.2   the license holder, applicant, or registrant under section 
 27.3   144A.71, subdivision 1, over the interests of the license 
 27.4   holder, applicant, or registrant under section 144A.71, 
 27.5   subdivision 1. 
 27.6      (c) Unless the information the commissioner relied on in 
 27.7   disqualifying an individual is incorrect, the commissioner may 
 27.8   not set aside the disqualification of an individual in 
 27.9   connection with a license to provide family day care for 
 27.10  children, foster care for children in the provider's own home, 
 27.11  or foster care or day care services for adults in the provider's 
 27.12  own home if: 
 27.13     (1) less than ten years have passed since the discharge of 
 27.14  the sentence imposed for the offense; and the individual has 
 27.15  been convicted of a violation of any offense listed in sections 
 27.16  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 27.17  in the second degree), criminal vehicular homicide under 609.21 
 27.18  (criminal vehicular homicide and injury), 609.215 (aiding 
 27.19  suicide or aiding attempted suicide), felony violations under 
 27.20  609.221 to 609.2231 (assault in the first, second, third, or 
 27.21  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 27.22  drugs to injure or to facilitate crime), 609.24 (simple 
 27.23  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 27.24  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 27.25  first or second degree), 609.71 (riot), burglary in the first or 
 27.26  second degree under 609.582 (burglary), 609.66 (dangerous 
 27.27  weapon), 609.665 (spring guns), 609.67 (machine guns and 
 27.28  short-barreled shotguns), 609.749 (harassment; stalking), 
 27.29  152.021 or 152.022 (controlled substance crime in the first or 
 27.30  second degree), 152.023, subdivision 1, clause (3) or (4), or 
 27.31  subdivision 2, clause (4) (controlled substance crime in the 
 27.32  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 27.33  (controlled substance crime in the fourth degree), 609.224, 
 27.34  subdivision 2, paragraph (c) (fifth-degree assault by a 
 27.35  caregiver against a vulnerable adult), 609.228 (great bodily 
 27.36  harm caused by distribution of drugs), 609.23 (mistreatment of 
 28.1   persons confined), 609.231 (mistreatment of residents or 
 28.2   patients), 609.2325 (criminal abuse of a vulnerable adult), 
 28.3   609.233 (criminal neglect of a vulnerable adult), 609.2335 
 28.4   (financial exploitation of a vulnerable adult), 609.234 (failure 
 28.5   to report), 609.265 (abduction), 609.2664 to 609.2665 
 28.6   (manslaughter of an unborn child in the first or second degree), 
 28.7   609.267 to 609.2672 (assault of an unborn child in the first, 
 28.8   second, or third degree), 609.268 (injury or death of an unborn 
 28.9   child in the commission of a crime), 617.293 (disseminating or 
 28.10  displaying harmful material to minors), a felony level 
 28.11  conviction involving alcohol or drug use, a gross misdemeanor 
 28.12  offense under 609.324, subdivision 1 (other prohibited acts), a 
 28.13  gross misdemeanor offense under 609.378 (neglect or endangerment 
 28.14  of a child), a gross misdemeanor offense under 609.377 
 28.15  (malicious punishment of a child), 609.72, subdivision 3 
 28.16  (disorderly conduct against a vulnerable adult); or an attempt 
 28.17  or conspiracy to commit any of these offenses, as each of these 
 28.18  offenses is defined in Minnesota Statutes; or an offense in any 
 28.19  other state, the elements of which are substantially similar to 
 28.20  the elements of any of the foregoing offenses; 
 28.21     (2) regardless of how much time has passed since the 
 28.22  involuntary termination of parental rights under section 
 28.23  260C.301 or the discharge of the sentence imposed for the 
 28.24  offense, the individual was convicted of a violation of any 
 28.25  offense listed in sections 609.185 to 609.195 (murder in the 
 28.26  first, second, or third degree), 609.2661 to 609.2663 (murder of 
 28.27  an unborn child in the first, second, or third degree), a felony 
 28.28  offense under 609.377 (malicious punishment of a child), a 
 28.29  felony offense under 609.324, subdivision 1 (other prohibited 
 28.30  acts), a felony offense under 609.378 (neglect or endangerment 
 28.31  of a child), 609.322 (solicitation, inducement, and promotion of 
 28.32  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
 28.33  the first, second, third, or fourth degree), 609.352 
 28.34  (solicitation of children to engage in sexual conduct), 617.246 
 28.35  (use of minors in a sexual performance), 617.247 (possession of 
 28.36  pictorial representations of a minor), 609.365 (incest), a 
 29.1   felony offense under sections 609.2242 and 609.2243 (domestic 
 29.2   assault), a felony offense of spousal abuse, a felony offense of 
 29.3   child abuse or neglect, a felony offense of a crime against 
 29.4   children, or an attempt or conspiracy to commit any of these 
 29.5   offenses as defined in Minnesota Statutes, or an offense in any 
 29.6   other state, the elements of which are substantially similar to 
 29.7   any of the foregoing offenses; 
 29.8      (3) within the seven years preceding the study, the 
 29.9   individual committed an act that constitutes maltreatment of a 
 29.10  child under section 626.556, subdivision 10e, and that resulted 
 29.11  in substantial bodily harm as defined in section 609.02, 
 29.12  subdivision 7a, or substantial mental or emotional harm as 
 29.13  supported by competent psychological or psychiatric evidence; or 
 29.14     (4) within the seven years preceding the study, the 
 29.15  individual was determined under section 626.557 to be the 
 29.16  perpetrator of a substantiated incident of maltreatment of a 
 29.17  vulnerable adult that resulted in substantial bodily harm as 
 29.18  defined in section 609.02, subdivision 7a, or substantial mental 
 29.19  or emotional harm as supported by competent psychological or 
 29.20  psychiatric evidence. 
 29.21     In the case of any ground for disqualification under 
 29.22  clauses (1) to (4), if the act was committed by an individual 
 29.23  other than the applicant, license holder, or registrant under 
 29.24  section 144A.71, subdivision 1, residing in the applicant's or 
 29.25  license holder's home, or the home of a registrant under section 
 29.26  144A.71, subdivision 1, the applicant, license holder, or 
 29.27  registrant under section 144A.71, subdivision 1, may seek 
 29.28  reconsideration when the individual who committed the act no 
 29.29  longer resides in the home.  
 29.30     The disqualification periods provided under clauses (1), 
 29.31  (3), and (4) are the minimum applicable disqualification 
 29.32  periods.  The commissioner may determine that an individual 
 29.33  should continue to be disqualified from licensure or 
 29.34  registration under section 144A.71, subdivision 1, because the 
 29.35  license holder, applicant, or registrant under section 144A.71, 
 29.36  subdivision 1, poses a risk of harm to a person served by that 
 30.1   individual after the minimum disqualification period has passed. 
 30.2      (d) The commissioner shall respond in writing or by 
 30.3   electronic transmission to all reconsideration requests for 
 30.4   which the basis for the request is that the information relied 
 30.5   upon by the commissioner to disqualify is incorrect or 
 30.6   inaccurate within 30 working days of receipt of a request and 
 30.7   all relevant information.  If the basis for the request is that 
 30.8   the individual does not pose a risk of harm, the commissioner 
 30.9   shall respond to the request within 15 working days after 
 30.10  receiving the request for reconsideration and all relevant 
 30.11  information.  If the request is based on both the correctness or 
 30.12  accuracy of the information relied on to disqualify the 
 30.13  individual and the risk of harm, the commissioner shall respond 
 30.14  to the request within 45 working days after receiving the 
 30.15  request for reconsideration and all relevant information.  If 
 30.16  the disqualification is set aside, the commissioner shall notify 
 30.17  the applicant or license holder in writing or by electronic 
 30.18  transmission of the decision. 
 30.19     (e) Except as provided in subdivision 3c, if a 
 30.20  disqualification for which reconsideration was requested is not 
 30.21  set aside or is not rescinded, an individual who was 
 30.22  disqualified on the basis of a preponderance of evidence that 
 30.23  the individual committed an act or acts that meet the definition 
 30.24  of any of the crimes ~~lists~~ listed in subdivision 3d, paragraph 
 30.25  (a), clauses (1) to (4); or for failure to make required reports 
 30.26  under section 626.556, subdivision 3, or 626.557, subdivision 3, 
 30.27  pursuant to subdivision 3d, paragraph (a), clause (4), may 
 30.28  request a fair hearing under section 256.045.  Except as 
 30.29  provided under subdivision 3c, the ~~commissioner's final order~~ 
 30.30  ~~for an individual under this paragraph is conclusive on the~~ 
 30.31  ~~issue of maltreatment and disqualification, including for~~ 
 30.32  ~~purposes of subsequent studies conducted under subdivision 3,~~ 
 30.33  ~~and~~ fair hearing is the only administrative appeal of the final 
 30.34  agency determination, specifically, including a challenge to the 
 30.35  accuracy and completeness of data under section 13.04.  
 30.36     (f) Except as provided under subdivision 3c, if an 
 31.1   individual was disqualified on the basis of a determination of 
 31.2   maltreatment under section 626.556 or 626.557, which was serious 
 31.3   or recurring, and the individual has requested reconsideration 
 31.4   of the maltreatment determination under section 626.556, 
 31.5   subdivision 10i, or 626.557, subdivision 9d, and also requested 
 31.6   reconsideration of the disqualification under this subdivision, 
 31.7   reconsideration of the maltreatment determination and 
 31.8   reconsideration of the disqualification shall be consolidated 
 31.9   into a single reconsideration.  For maltreatment and 
 31.10  disqualification determinations made by county agencies, the 
 31.11  consolidated reconsideration shall be conducted by the county 
 31.12  agency.  If the county agency has disqualified an individual on 
 31.13  multiple bases, one of which is a county maltreatment 
 31.14  determination for which the individual has a right to request 
 31.15  reconsideration, the county shall conduct the reconsideration of 
 31.16  all disqualifications.  Except as provided under subdivision 3c, 
 31.17  if an individual who was disqualified on the basis of serious or 
 31.18  recurring maltreatment requests a fair hearing on the 
 31.19  maltreatment determination under section 626.556, subdivision 
 31.20  10i, or 626.557, subdivision 9d, and requests a fair hearing on 
 31.21  the disqualification, which has not been set aside or rescinded 
 31.22  under this subdivision, the scope of the fair hearing under 
 31.23  section 256.045 shall include the maltreatment determination and 
 31.24  the disqualification.  Except as provided under subdivision 3c, 
 31.25  ~~the commissioner's final order for an individual under this~~ 
 31.26  ~~paragraph is conclusive on the issue of maltreatment and~~ 
 31.27  ~~disqualification, including for purposes of subsequent studies~~ 
 31.28  ~~conducted under subdivision 3, and~~ a fair hearing is the only 
 31.29  administrative appeal of the final agency determination, 
 31.30  specifically, including a challenge to the accuracy and 
 31.31  completeness of data under section 13.04. 
 31.32     Sec. 12.  Minnesota Statutes 2000, section 245A.04, is 
 31.33  amended by adding a subdivision to read: 
 31.34     Subd. 3f.  [CONCLUSIVE DETERMINATIONS OR DISPOSITIONS.] 
 31.35  Unless otherwise specified in statute, the following 
 31.36  determinations or dispositions are deemed conclusive: 
 32.1      (1) a maltreatment determination or disposition under 
 32.2   section 626.556 or 626.557, if: 
 32.3      (i) the commissioner has issued a final order in an appeal 
 32.4   of that determination or disposition under section 245A.08, 
 32.5   subdivision 5, or 256.045; 
 32.6      (ii) the individual did not request reconsideration of the 
 32.7   maltreatment determination or disposition under section 626.556 
 32.8   or 626.557; or 
 32.9      (iii) the individual did not request a hearing of the 
 32.10  maltreatment determination or disposition under section 256.045; 
 32.11  and 
 32.12     (2) a determination that the information relied upon to 
 32.13  disqualify an individual under subdivision 3d, was correct based 
 32.14  on serious or recurring maltreatment; or 
 32.15     (3) a preponderance of evidence shows that the individual 
 32.16  committed an act or acts that meet the definition of any of the 
 32.17  crimes listed in subdivision 3d, paragraph (a), clauses (1) to 
 32.18  (4); or the individual's failure to make required reports under 
 32.19  section 626.556, subdivision 3, or 626.557, subdivision 3, if: 
 32.20     (i) the commissioner has issued a final order in an appeal 
 32.21  of that determination under section 245A.08, subdivision 5, or 
 32.22  256.045, or a court has issued a final decision; 
 32.23     (ii) the individual did not request reconsideration of the 
 32.24  disqualification under this subdivision; or 
 32.25     (iii) the individual did not request a hearing on the 
 32.26  disqualification under section 256.045. 
 32.27     Sec. 13.  Minnesota Statutes 2001 Supplement, section 
 32.28  245A.07, subdivision 2a, is amended to read: 
 32.29     Subd. 2a.  [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 
 32.30  Within five working days of receipt of the license holder's 
 32.31  timely appeal, the commissioner shall request assignment of an 
 32.32  administrative law judge.  The request must include a proposed 
 32.33  date, time, and place of a hearing.  A hearing must be conducted 
 32.34  by an administrative law judge within 30 calendar days of the 
 32.35  request for assignment, unless an extension is requested by 
 32.36  either party and granted by the administrative law judge for 
 33.1   good cause.  The commissioner shall issue a notice of hearing by 
 33.2   certified mail at least ten working days before the hearing.  
 33.3   The scope of the hearing shall be limited solely to the issue of 
 33.4   whether the temporary immediate suspension should remain in 
 33.5   effect pending the commissioner's final order under section 
 33.6   245A.08, regarding a licensing sanction issued under subdivision 
 33.7   3 following the immediate suspension.  The burden of proof in 
 33.8   expedited hearings under this subdivision shall be limited to 
 33.9   the commissioner's demonstration that reasonable cause exists to 
 33.10  believe that the license holder's actions or failure to comply 
 33.11  with applicable law or rule poses an imminent risk of harm to 
 33.12  the health, safety, or rights of persons served by the program.  
 33.13     (b) The administrative law judge shall issue findings of 
 33.14  fact, conclusions, and a recommendation within ten working days 
 33.15  from the date of hearing.  The commissioner's final order shall 
 33.16  be issued within ten working days from receipt of the 
 33.17  recommendation of the administrative law judge.  Within 90 
 33.18  calendar days after a final order affirming an immediate 
 33.19  suspension, the commissioner shall make a determination 
 33.20  regarding whether a final licensing sanction shall be issued 
 33.21  under subdivision 3.  The license holder shall continue to be 
 33.22  prohibited from operation of the program during this 90-day 
 33.23  period.  
 33.24     (c) When the final order under paragraph (b) affirms an 
 33.25  immediate suspension, and a final licensing sanction is issued 
 33.26  under subdivision 3, and the license holder appeals that 
 33.27  sanction, the license holder continues to be prohibited from 
 33.28  operation of the program pending a final commissioner's order 
 33.29  under section 245A.08, subdivision 5, regarding the final 
 33.30  licensing sanction. 
 33.31     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 33.32  245A.07, subdivision 3, is amended to read: 
 33.33     Subd. 3.  [LICENSE SUSPENSION, REVOCATION, OR FINE.] The 
 33.34  commissioner may suspend or revoke a license, or impose a fine 
 33.35  if a license holder fails to comply fully with applicable laws 
 33.36  or rules, or knowingly withholds relevant information from or 
 34.1   gives false or misleading information to the commissioner in 
 34.2   connection with an application for a license, in connection with 
 34.3   the background study status of an individual, or during an 
 34.4   investigation.  A license holder who has had a license 
 34.5   suspended, revoked, or has been ordered to pay a fine must be 
 34.6   given notice of the action by certified mail.  The notice must 
 34.7   be mailed to the address shown on the application or the last 
 34.8   known address of the license holder.  The notice must state the 
 34.9   reasons the license was suspended, revoked, or a fine was 
 34.10  ordered. 
 34.11     (a) If the license was suspended or revoked, the notice 
 34.12  must inform the license holder of the right to a contested case 
 34.13  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
 34.14  1400.8612 and successor rules.  The license holder may appeal an 
 34.15  order suspending or revoking a license.  The appeal of an order 
 34.16  suspending or revoking a license must be made in writing by 
 34.17  certified mail and must be received by the commissioner within 
 34.18  ten calendar days after the license holder receives notice that 
 34.19  the license has been suspended or revoked.  Except as provided 
 34.20  in subdivision 2a, paragraph (c), a timely appeal of an order 
 34.21  suspending or revoking a license shall stay the suspension or 
 34.22  revocation until the commissioner issues a final order.  
 34.23     (b)(1) If the license holder was ordered to pay a fine, the 
 34.24  notice must inform the license holder of the responsibility for 
 34.25  payment of fines and the right to a contested case hearing under 
 34.26  chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 
 34.27  successor rules.  The appeal of an order to pay a fine must be 
 34.28  made in writing by certified mail and must be received by the 
 34.29  commissioner within ten calendar days after the license holder 
 34.30  receives notice that the fine has been ordered.  
 34.31     (2) The license holder shall pay the fines assessed on or 
 34.32  before the payment date specified.  If the license holder fails 
 34.33  to fully comply with the order, the commissioner may issue a 
 34.34  second fine or suspend the license until the license holder 
 34.35  complies.  If the license holder receives state funds, the 
 34.36  state, county, or municipal agencies or departments responsible 
 35.1   for administering the funds shall withhold payments and recover 
 35.2   any payments made while the license is suspended for failure to 
 35.3   pay a fine.  A timely appeal shall stay payment of the fine 
 35.4   until the commissioner issues a final order.  
 35.5      (3) A license holder shall promptly notify the commissioner 
 35.6   of human services, in writing, when a violation specified in the 
 35.7   order to forfeit a fine is corrected.  If upon reinspection the 
 35.8   commissioner determines that a violation has not been corrected 
 35.9   as indicated by the order to forfeit a fine, the commissioner 
 35.10  may issue a second fine.  The commissioner shall notify the 
 35.11  license holder by certified mail that a second fine has been 
 35.12  assessed.  The license holder may appeal the second fine as 
 35.13  provided under this subdivision. 
 35.14     (4) Fines shall be assessed as follows:  the license holder 
 35.15  shall forfeit $1,000 for each determination of maltreatment of a 
 35.16  child under section 626.556 or the maltreatment of a vulnerable 
 35.17  adult under section 626.557; the license holder shall forfeit 
 35.18  $200 for each occurrence of a violation of law or rule governing 
 35.19  matters of health, safety, or supervision, including but not 
 35.20  limited to the provision of adequate staff-to-child or adult 
 35.21  ratios, and failure to submit a background study; and the 
 35.22  license holder shall forfeit $100 for each occurrence of a 
 35.23  violation of law or rule other than those subject to a $1,000 or 
 35.24  $200 fine above.  For purposes of this section, "occurrence" 
 35.25  means each violation identified in the commissioner's fine order.
 35.26     (5) When a fine has been assessed, the license holder may 
 35.27  not avoid payment by closing, selling, or otherwise transferring 
 35.28  the licensed program to a third party.  In such an event, the 
 35.29  license holder will be personally liable for payment.  In the 
 35.30  case of a corporation, each controlling individual is personally 
 35.31  and jointly liable for payment.  
 35.32     Sec. 15.  [245A.085] [CONSOLIDATION OF HEARINGS; 
 35.33  RECONSIDERATION.] 
 35.34     Hearings authorized under this chapter and sections 
 35.35  256.045, 626.556, and 626.557, shall be consolidated if feasible 
 35.36  and in accordance with other applicable statutes and rules.  
 36.1   Reconsideration under sections 245A.04, subdivision 3c; 626.556, 
 36.2   subdivision 10i; and 626.557, subdivision 9d, shall also be 
 36.3   consolidated if feasible. 
 36.4      Sec. 16.  Minnesota Statutes 2001 Supplement, section 
 36.5   245A.144, is amended to read: 
 36.6      245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME 
 36.7   IN CHILD CARE PROGRAMS.] 
 36.8      License holders must ensure that before staff persons, 
 36.9   caregivers, and helpers assist in the care of infants, they 
 36.10  receive training on reducing the risk of sudden infant death 
 36.11  syndrome.  The training on reducing the risk of sudden infant 
 36.12  death syndrome may be provided as orientation training under 
 36.13  Minnesota Rules, part 9503.0035, subpart 1, as initial training 
 36.14  under Minnesota Rules, part 9502.0385, subpart 2, as in-service 
 36.15  training under Minnesota Rules, part 9503.0035, subpart 4, or as 
 36.16  ongoing training under Minnesota Rules, part 9502.0385, subpart 
 36.17  3.  Training required under this section must be at least one 
 36.18  hour in length and must be completed at least once every five 
 36.19  years.  At a minimum, the training must address the risk factors 
 36.20  related to sudden infant death syndrome, means of reducing the 
 36.21  risk of sudden infant death syndrome in child care, and license 
 36.22  holder communication with parents regarding reducing the risk of 
 36.23  sudden infant death syndrome.  Training for family and group 
 36.24  family child care providers must be approved by the county 
 36.25  licensing agency according to Minnesota Rules, part 9502.0385. 
 36.26     Sec. 17.  Minnesota Statutes 2001 Supplement, section 
 36.27  245A.16, subdivision 1, is amended to read: 
 36.28     Subdivision 1.  [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 
 36.29  County agencies and private agencies that have been designated 
 36.30  or licensed by the commissioner to perform licensing functions 
 36.31  and activities under section 245A.04, to recommend denial of 
 36.32  applicants under section 245A.05, to issue correction orders, to 
 36.33  issue variances, and recommend a conditional license under 
 36.34  section 245A.06, or to recommend suspending or revoking a 
 36.35  license or issuing a fine under section 245A.07, shall comply 
 36.36  with rules and directives of the commissioner governing those 
 37.1   functions and with this section.  The following variances are 
 37.2   excluded from the delegation of variance authority and may be 
 37.3   issued only by the commissioner: 
 37.4      (1) dual licensure of family child care and child foster 
 37.5   care, dual licensure of child and adult foster care, and adult 
 37.6   foster care and family child care; 
 37.7      (2) adult foster care maximum capacity; 
 37.8      (3) adult foster care minimum age requirement; 
 37.9      (4) child foster care maximum age requirement; 
 37.10     (5) variances regarding disqualified individuals except 
 37.11  that county agencies may issue variances under section 245A.04, 
 37.12  subdivision 3e, regarding disqualified individuals when the 
 37.13  county is responsible for conducting a consolidated 
 37.14  reconsideration according to section 245A.04, subdivision 3b, 
 37.15  paragraph (f), of a county maltreatment determination and a 
 37.16  disqualification based on serious or recurring maltreatment; and 
 37.17     (6) the required presence of a caregiver in the adult 
 37.18  foster care residence during normal sleeping hours. 
 37.19     (b) County agencies must report information about 
 37.20  disqualification reconsiderations under section 245A.04, 
 37.21  subdivision 3b, paragraph (f), and variances granted under 
 37.22  paragraph (a), clause (5), to the commissioner at least monthly 
 37.23  in a format prescribed by the commissioner. 
 37.24     (c) For family day care programs, the commissioner may 
 37.25  authorize licensing reviews every two years after a licensee has 
 37.26  had at least one annual review. 
 37.27     Sec. 18.  Minnesota Statutes 2001 Supplement, section 
 37.28  256.045, subdivision 3b, is amended to read: 
 37.29     Subd. 3b.  [STANDARD OF EVIDENCE FOR MALTREATMENT AND 
 37.30  DISQUALIFICATION HEARINGS.] (a) The state human services referee 
 37.31  shall determine that maltreatment has occurred if a 
 37.32  preponderance of evidence exists to support the final 
 37.33  disposition under sections 626.556 and 626.557.  For purposes of 
 37.34  hearings regarding disqualification, the state human services 
 37.35  referee shall affirm the proposed disqualification in an appeal 
 37.36  under subdivision 3, paragraph (a), clause (9), if a 
 38.1   preponderance of the evidence shows the individual has:  
 38.2      (1) committed maltreatment under section 626.556 or 
 38.3   626.557, which is serious or recurring; 
 38.4      (2) committed an act or acts meeting the definition of any 
 38.5   of the crimes listed in section 245A.04, subdivision 3d, 
 38.6   paragraph (a), clauses (1) to (4); or 
 38.7      (3) failed to make required reports under section 626.556 
 38.8   or 626.557, for incidents in which~~:~~  
 38.9      ~~(i)~~ the final disposition under section 626.556 or 626.557 
 38.10  was substantiated maltreatment~~; and~~ 
 38.11     ~~(ii) the maltreatment was recurring or serious; or~~ 
 38.12  ~~substantiated serious or recurring maltreatment of a minor under~~ 
 38.13  ~~section 626.556 or of a vulnerable adult under section 626.557~~ 
 38.14  ~~for which there is a preponderance of evidence that the~~ 
 38.15  ~~maltreatment occurred, and that the subject was responsible for~~ 
 38.16  ~~the maltreatment~~ that was serious or recurring.  
 38.17     (b) If the disqualification is affirmed, the state human 
 38.18  services referee shall determine whether the individual poses a 
 38.19  risk of harm in accordance with the requirements of section 
 38.20  245A.04, subdivision 3b. 
 38.21     (c) The state human services referee shall recommend an 
 38.22  order to the commissioner of health, children, families, and 
 38.23  learning, or human services, as applicable, who shall issue a 
 38.24  final order.  The commissioner shall affirm, reverse, or modify 
 38.25  the final disposition.  Any order of the commissioner issued in 
 38.26  accordance with this subdivision is conclusive upon the parties 
 38.27  unless appeal is taken in the manner provided in subdivision 7.  
 38.28  ~~Except as provided under section 245A.04, subdivisions 3b,~~ 
 38.29  ~~paragraphs (e) and (f), and 3c,~~ In any licensing appeal under 
 38.30  chapter 245A and sections 144.50 to 144.58 and 144A.02 to 
 38.31  144A.46, the commissioner's determination as to maltreatment is 
 38.32  conclusive as provided under section 245A.04, subdivision 3f. 
 38.33     Sec. 19.  Minnesota Statutes 2001 Supplement, section 
 38.34  256.045, subdivision 4, is amended to read: 
 38.35     Subd. 4.  [CONDUCT OF HEARINGS.] (a) All hearings held 
 38.36  pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 
 39.1   according to the provisions of the federal Social Security Act 
 39.2   and the regulations implemented in accordance with that act to 
 39.3   enable this state to qualify for federal grants-in-aid, and 
 39.4   according to the rules and written policies of the commissioner 
 39.5   of human services.  County agencies shall install equipment 
 39.6   necessary to conduct telephone hearings.  A state human services 
 39.7   referee may schedule a telephone conference hearing when the 
 39.8   distance or time required to travel to the county agency offices 
 39.9   will cause a delay in the issuance of an order, or to promote 
 39.10  efficiency, or at the mutual request of the parties.  Hearings 
 39.11  may be conducted by telephone conferences unless the applicant, 
 39.12  recipient, former recipient, person, or facility contesting 
 39.13  maltreatment objects.  The hearing shall not be held earlier 
 39.14  than five days after filing of the required notice with the 
 39.15  county or state agency.  The state human services referee shall 
 39.16  notify all interested persons of the time, date, and location of 
 39.17  the hearing at least five days before the date of the hearing.  
 39.18  Interested persons may be represented by legal counsel or other 
 39.19  representative of their choice, including a provider of therapy 
 39.20  services, at the hearing and may appear personally, testify and 
 39.21  offer evidence, and examine and cross-examine witnesses.  The 
 39.22  applicant, recipient, former recipient, person, or facility 
 39.23  contesting maltreatment shall have the opportunity to examine 
 39.24  the contents of the case file and all documents and records to 
 39.25  be used by the county or state agency at the hearing at a 
 39.26  reasonable time before the date of the hearing and during the 
 39.27  hearing.  In hearings under subdivision 3, paragraph (a), 
 39.28  clauses (4), (8), and (9), either party may subpoena the private 
 39.29  data relating to the investigation prepared by the agency under 
 39.30  section 626.556 or 626.557 that is not otherwise accessible 
 39.31  under section 13.04, provided the identity of the reporter may 
 39.32  not be disclosed. 
 39.33     (b) The private data obtained by subpoena in a hearing 
 39.34  under subdivision 3, paragraph (a), clause (4), (8), or (9), 
 39.35  must be subject to a protective order which prohibits its 
 39.36  disclosure for any other purpose outside the hearing provided 
 40.1   for in this section without prior order of the district court.  
 40.2   Disclosure without court order is punishable by a sentence of 
 40.3   not more than 90 days imprisonment or a fine of not more than 
 40.4   $700, or both.  These restrictions on the use of private data do 
 40.5   not prohibit access to the data under section 13.03, subdivision 
 40.6   6.  Except for appeals under subdivision 3, paragraph (a), 
 40.7   clauses (4), (5), (8), and (9), upon request, the county agency 
 40.8   shall provide reimbursement for transportation, child care, 
 40.9   photocopying, medical assessment, witness fee, and other 
 40.10  necessary and reasonable costs incurred by the applicant, 
 40.11  recipient, or former recipient in connection with the appeal.  
 40.12  All evidence, except that privileged by law, commonly accepted 
 40.13  by reasonable people in the conduct of their affairs as having 
 40.14  probative value with respect to the issues shall be submitted at 
 40.15  the hearing and such hearing shall not be "a contested case" 
 40.16  within the meaning of section 14.02, subdivision 3.  The agency 
 40.17  must present its evidence prior to or at the hearing, and may 
 40.18  not submit evidence after the hearing except by agreement of the 
 40.19  parties at the hearing, provided the petitioner has the 
 40.20  opportunity to respond. 
 40.21     (c) In hearings under subdivision 3, paragraph (a), clauses 
 40.22  (4), (8), and (9), involving determinations of maltreatment or 
 40.23  disqualification made by more than one county agency, by a 
 40.24  county agency and a state agency, or by more than one state 
 40.25  agency, the hearings may be consolidated into a single fair 
 40.26  hearing upon the consent of all parties and the state human 
 40.27  services referee. 
 40.28     Sec. 20.  Minnesota Statutes 2000, section 256.9657, 
 40.29  subdivision 1, is amended to read: 
 40.30     Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
 40.31  Effective July 1, 1993, each non-state-operated nursing home 
 40.32  licensed under chapter 144A shall pay to the commissioner an 
 40.33  annual surcharge according to the schedule in subdivision 4.  
 40.34  The surcharge shall be calculated as $620 per licensed bed.  If 
 40.35  the number of licensed beds is reduced, the surcharge shall be 
 40.36  based on the number of remaining licensed beds the second month 
 41.1   following the receipt of timely notice by the commissioner of 
 41.2   human services that beds have been delicensed.  The nursing home 
 41.3   must notify the commissioner of health in writing when beds are 
 41.4   delicensed.  The commissioner of health must notify the 
 41.5   commissioner of human services within ten working days after 
 41.6   receiving written notification.  If the notification is received 
 41.7   by the commissioner of human services by the 15th of the month, 
 41.8   the invoice for the second following month must be reduced to 
 41.9   recognize the delicensing of beds.  Beds on layaway status 
 41.10  continue to be subject to the surcharge.  The commissioner of 
 41.11  human services must acknowledge a medical care surcharge appeal 
 41.12  within 30 days of receipt of the written appeal from the 
 41.13  provider. 
 41.14     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
 41.15  shall be increased to $625. 
 41.16     (c) Between March 1, 2002, and August 15, 2003, a facility 
 41.17  governed by this subdivision may elect to assume full 
 41.18  participation in the medical assistance program by agreeing to 
 41.19  comply with all of the requirements of the medical assistance 
 41.20  program, including the rate equalization law in section 256B.48, 
 41.21  subdivision 1, paragraph (a), and all other requirements 
 41.22  established in law or rule, and to resume intake of new medical 
 41.23  assistance recipients.  Rates will be determined under Minnesota 
 41.24  Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
 41.25  256B.431, subdivision 27, paragraph (i), rate calculations will 
 41.26  be subject to limits as prescribed in rule and law.  Other than 
 41.27  the adjustments in Minnesota Rules, part 9549.0057; sections 
 41.28  256B.431, subdivisions 30 and 32; 256B.437, subdivision 3, item 
 41.29  (b), and any other applicable legislation enacted prior to the 
 41.30  finalization of rates, facilities returning to medical 
 41.31  assistance under this paragraph are not eligible for any rate 
 41.32  adjustments until the July 1 following their settle-up period. 
 41.33     Sec. 21.  [604A.33] [REFERENCE CHECKS BY CERTAIN HEALTH 
 41.34  CARE PROVIDERS AND FACILITIES.] 
 41.35     Subdivision 1.  [APPLICATION.] This section applies to 
 41.36  residential treatment programs for children or group homes for 
 42.1   children licensed under chapter 245A, residential services and 
 42.2   programs for juveniles licensed under section 241.021, providers 
 42.3   licensed pursuant to sections 144A.01 to 144A.33 or sections 
 42.4   144A.43 to 144A.48, providers of day training and habilitation 
 42.5   services under sections 252.40 to 252.46, board and lodging 
 42.6   facilities licensed under chapter 157, intermediate care 
 42.7   facilities for persons with mental retardation or related 
 42.8   conditions, and other facilities licensed to provide residential 
 42.9   services to persons with developmental disabilities. 
 42.10     Subd. 2.  [CAUSES OF ACTION.] No action may be brought 
 42.11  against a provider or facility listed in subdivision 1 or a 
 42.12  designated employee or agent of such a provider or facility who 
 42.13  discloses information regarding a former or current employee to 
 42.14  a prospective employer as provided under this section.  This 
 42.15  subdivision does not preclude a charge or action under chapter 
 42.16  363, or an action arising from a disclosure that the plaintiff 
 42.17  proves, by a preponderance of the evidence, was made 
 42.18  fraudulently or with deliberate disregard as to its truth or 
 42.19  falsity.  This subdivision does not preclude an action against a 
 42.20  prospective employer for disclosing information received under 
 42.21  this section.  
 42.22     Subd. 3.  [REFERENCE CHECKS.] (a) Upon written request, a 
 42.23  provider or facility listed in subdivision 1 or a designated 
 42.24  employee or agent of such a provider or facility may disclose 
 42.25  the following information about a current or former employee to 
 42.26  a prospective employer: 
 42.27     (1) dates of employment; 
 42.28     (2) compensation and wage history; 
 42.29     (3) job description and duties; 
 42.30     (4) training and education provided by the employer; and 
 42.31     (5) all acts of violence, theft, harassment, or illegal 
 42.32  conduct documented in the personnel record which resulted in 
 42.33  disciplinary action or resignation, and the employee's written 
 42.34  response, if necessary, contained in the personnel record. 
 42.35     (b) With the written authorization of the current or former 
 42.36  employee, a provider or facility listed in subdivision 1 or a 
 43.1   designated employee or agent of such a provider or facility may 
 43.2   also disclose the following information in writing to a 
 43.3   prospective employer: 
 43.4      (1) written employee evaluations conducted prior to the 
 43.5   employee's separation from the employer and the employee's 
 43.6   written response, if any, contained in the employee's personnel 
 43.7   record; 
 43.8      (2) disciplinary warnings and actions in the five years 
 43.9   before the date of the authorization and the employee's written 
 43.10  response, if any, contained in the employee's personnel record; 
 43.11  and 
 43.12     (3) reasons for separation from employment. 
 43.13     (c) The provider, facility, designated employee, or agent 
 43.14  must provide a written copy of a disclosure made under this 
 43.15  subdivision and information on to whom the disclosure was made 
 43.16  to the current or former employee upon request. 
 43.17     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002, 
 43.18  and applies to causes of action arising on or after that date. 
 43.19     Sec. 22.  Minnesota Statutes 2001 Supplement, section 
 43.20  626.556, subdivision 10i, is amended to read: 
 43.21     Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
 43.22  DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
 43.23  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
 43.24  provided under paragraph (e), an individual or facility that the 
 43.25  commissioner of human services, a local social service agency, 
 43.26  or the commissioner of children, families, and learning 
 43.27  determines has maltreated a child, an interested person acting 
 43.28  on behalf of the child, regardless of the determination, who 
 43.29  contests the investigating agency's final determination 
 43.30  regarding maltreatment, may request the investigating agency to 
 43.31  reconsider its final determination regarding maltreatment.  The 
 43.32  request for reconsideration must be submitted in writing to the 
 43.33  investigating agency within 15 calendar days after receipt of 
 43.34  notice of the final determination regarding maltreatment or, if 
 43.35  the request is made by an interested person who is not entitled 
 43.36  to notice, within 15 days after receipt of the notice by the 
 44.1   parent or guardian of the child.  Effective January 1, 2002, an 
 44.2   individual who was determined to have maltreated a child under 
 44.3   this section and who was disqualified on the basis of serious or 
 44.4   recurring maltreatment under section 245A.04, subdivision 3d, 
 44.5   may request reconsideration of the maltreatment determination 
 44.6   and the disqualification.  The request for reconsideration of 
 44.7   the maltreatment determination and the disqualification must be 
 44.8   submitted within 30 calendar days of the individual's receipt of 
 44.9   the notice of disqualification under section 245A.04, 
 44.10  subdivision 3a. 
 44.11     (b) Except as provided under paragraphs (e) and (f), if the 
 44.12  investigating agency denies the request or fails to act upon the 
 44.13  request within 15 calendar days after receiving the request for 
 44.14  reconsideration, the person or facility entitled to a fair 
 44.15  hearing under section 256.045 may submit to the commissioner of 
 44.16  human services or the commissioner of children, families, and 
 44.17  learning a written request for a hearing under that section.  
 44.18  Section 256.045 also governs hearings requested to contest a 
 44.19  final determination of the commissioner of children, families, 
 44.20  and learning.  For reports involving maltreatment of a child in 
 44.21  a facility, an interested person acting on behalf of the child 
 44.22  may request a review by the child maltreatment review panel 
 44.23  under section 256.022 if the investigating agency denies the 
 44.24  request or fails to act upon the request or if the interested 
 44.25  person contests a reconsidered determination.  The investigating 
 44.26  agency shall notify persons who request reconsideration of their 
 44.27  rights under this paragraph.  The request must be submitted in 
 44.28  writing to the review panel and a copy sent to the investigating 
 44.29  agency within 30 calendar days of receipt of notice of a denial 
 44.30  of a request for reconsideration or of a reconsidered 
 44.31  determination.  The request must specifically identify the 
 44.32  aspects of the agency determination with which the person is 
 44.33  dissatisfied. 
 44.34     (c) If, as a result of a reconsideration or review, the 
 44.35  investigating agency changes the final determination of 
 44.36  maltreatment, that agency shall notify the parties specified in 
 45.1   subdivisions 10b, 10d, and 10f. 
 45.2      (d) Except as provided under paragraph (f), if an 
 45.3   individual or facility contests the investigating agency's final 
 45.4   determination regarding maltreatment by requesting a fair 
 45.5   hearing under section 256.045, the commissioner of human 
 45.6   services shall assure that the hearing is conducted and a 
 45.7   decision is reached within 90 days of receipt of the request for 
 45.8   a hearing.  The time for action on the decision may be extended 
 45.9   for as many days as the hearing is postponed or the record is 
 45.10  held open for the benefit of either party. 
 45.11     (e) Effective January 1, 2002, if an individual was 
 45.12  disqualified under section 245A.04, subdivision 3d, on the basis 
 45.13  of a determination of maltreatment, which was serious or 
 45.14  recurring, and the individual has requested reconsideration of 
 45.15  the maltreatment determination under paragraph (a) and requested 
 45.16  reconsideration of the disqualification under section 245A.04, 
 45.17  subdivision 3b, reconsideration of the maltreatment 
 45.18  determination and reconsideration of the disqualification shall 
 45.19  be consolidated into a single reconsideration.  If 
 45.20  reconsideration of the maltreatment determination is denied or 
 45.21  the disqualification is not set aside or rescinded under section 
 45.22  245A.04, subdivision 3b, the individual may request a fair 
 45.23  hearing under section 256.045.  If an individual ~~disqualified on~~ 
 45.24  ~~the basis of a determination of maltreatment, which was serious~~ 
 45.25  ~~or recurring~~ requests a fair hearing ~~under paragraph (b)~~ on the 
 45.26  maltreatment determination and the disqualification, the scope 
 45.27  of the fair hearing shall include both the maltreatment 
 45.28  determination and the disqualification. 
 45.29     (f) Effective January 1, 2002, if a maltreatment 
 45.30  determination or a disqualification based on serious or 
 45.31  recurring maltreatment is the basis for a denial of a license 
 45.32  under section 245A.05 or a licensing sanction under section 
 45.33  245A.07, the license holder has the right to a contested case 
 45.34  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
 45.35  1400.8612 and successor rules.  As provided for under section 
 45.36  245A.08, subdivision 2a, the scope of the contested case hearing 
 46.1   shall include the maltreatment determination, disqualification, 
 46.2   and licensing sanction or denial of a license.  In such cases, a 
 46.3   fair hearing regarding the maltreatment determination shall not 
 46.4   be conducted under paragraph (b).  If the disqualified subject 
 46.5   is an individual other than the license holder and upon whom a 
 46.6   background study must be conducted under section 245A.04, 
 46.7   subdivision 3, the hearings of all parties may be consolidated 
 46.8   into a single contested case hearing upon consent of all parties 
 46.9   and the administrative law judge. 
 46.10     (g) For purposes of this subdivision, "interested person 
 46.11  acting on behalf of the child" means a parent or legal guardian; 
 46.12  stepparent; grandparent; guardian ad litem; adult stepbrother, 
 46.13  stepsister, or sibling; or adult aunt or uncle; unless the 
 46.14  person has been determined to be the perpetrator of the 
 46.15  maltreatment. 
 46.16     Sec. 23.  Minnesota Statutes 2000, section 626.557, 
 46.17  subdivision 3a, is amended to read: 
 46.18     Subd. 3a.  [REPORT NOT REQUIRED.] The following events are 
 46.19  not required to be reported under this section:  
 46.20     (a) A circumstance where federal law specifically prohibits 
 46.21  a person from disclosing patient identifying information in 
 46.22  connection with a report of suspected maltreatment, unless the 
 46.23  vulnerable adult, or the vulnerable adult's guardian, 
 46.24  conservator, or legal representative, has consented to 
 46.25  disclosure in a manner which conforms to federal requirements.  
 46.26  Facilities whose patients or residents are covered by such a 
 46.27  federal law shall seek consent to the disclosure of suspected 
 46.28  maltreatment from each patient or resident, or a guardian, 
 46.29  conservator, or legal representative, upon the patient's or 
 46.30  resident's admission to the facility.  Persons who are 
 46.31  prohibited by federal law from reporting an incident of 
 46.32  suspected maltreatment shall immediately seek consent to make a 
 46.33  report.  
 46.34     (b) Verbal or physical aggression occurring between 
 46.35  patients, residents, or clients of a facility, or self-abusive 
 46.36  behavior by these persons does not constitute abuse unless the 
 47.1   behavior causes serious harm.  The operator of the facility or a 
 47.2   designee shall record incidents of aggression and self-abusive 
 47.3   behavior to facilitate review by licensing agencies and county 
 47.4   and local welfare agencies. 
 47.5      (c) Accidents as defined in section 626.5572, subdivision 3.
 47.6      (d) Events occurring in a facility that result from an 
 47.7   individual's ~~single mistake~~ error in the provision of 
 47.8   therapeutic conduct to a vulnerable adult, as ~~defined~~ provided 
 47.9   in section 626.5572, subdivision 17, paragraph (c), clause (4). 
 47.10     (e) Nothing in this section shall be construed to require a 
 47.11  report of financial exploitation, as defined in section 
 47.12  626.5572, subdivision 9, solely on the basis of the transfer of 
 47.13  money or property by gift or as compensation for services 
 47.14  rendered. 
 47.15     Sec. 24.  Minnesota Statutes 2001 Supplement, section 
 47.16  626.557, subdivision 9d, is amended to read: 
 47.17     Subd. 9d.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
 47.18  DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
 47.19  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
 47.20  provided under paragraph (e), any individual or facility which a 
 47.21  lead agency determines has maltreated a vulnerable adult, or the 
 47.22  vulnerable adult or an interested person acting on behalf of the 
 47.23  vulnerable adult, regardless of the lead agency's determination, 
 47.24  who contests the lead agency's final disposition of an 
 47.25  allegation of maltreatment, may request the lead agency to 
 47.26  reconsider its final disposition.  The request for 
 47.27  reconsideration must be submitted in writing to the lead agency 
 47.28  within 15 calendar days after receipt of notice of final 
 47.29  disposition or, if the request is made by an interested person 
 47.30  who is not entitled to notice, within 15 days after receipt of 
 47.31  the notice by the vulnerable adult or the vulnerable adult's 
 47.32  legal guardian.  An individual who was determined to have 
 47.33  maltreated a vulnerable adult under this section and who was 
 47.34  disqualified on the basis of serious or recurring maltreatment 
 47.35  under section 245A.04, subdivision 3d, may request 
 47.36  reconsideration of the maltreatment determination and the 
 48.1   disqualification.  The request for reconsideration of the 
 48.2   maltreatment determination and the disqualification must be 
 48.3   submitted within 30 calendar days of the individual's receipt of 
 48.4   the notice of disqualification under section 245A.04, 
 48.5   subdivision 3a. 
 48.6      (b) Except as provided under paragraphs (e) and (f), if the 
 48.7   lead agency denies the request or fails to act upon the request 
 48.8   within 15 calendar days after receiving the request for 
 48.9   reconsideration, the person or facility entitled to a fair 
 48.10  hearing under section 256.045, may submit to the commissioner of 
 48.11  human services a written request for a hearing under that 
 48.12  statute.  The vulnerable adult, or an interested person acting 
 48.13  on behalf of the vulnerable adult, may request a review by the 
 48.14  vulnerable adult maltreatment review panel under section 256.021 
 48.15  if the lead agency denies the request or fails to act upon the 
 48.16  request, or if the vulnerable adult or interested person 
 48.17  contests a reconsidered disposition.  The lead agency shall 
 48.18  notify persons who request reconsideration of their rights under 
 48.19  this paragraph.  The request must be submitted in writing to the 
 48.20  review panel and a copy sent to the lead agency within 30 
 48.21  calendar days of receipt of notice of a denial of a request for 
 48.22  reconsideration or of a reconsidered disposition.  The request 
 48.23  must specifically identify the aspects of the agency 
 48.24  determination with which the person is dissatisfied.  
 48.25     (c) If, as a result of a reconsideration or review, the 
 48.26  lead agency changes the final disposition, it shall notify the 
 48.27  parties specified in subdivision 9c, paragraph (d). 
 48.28     (d) For purposes of this subdivision, "interested person 
 48.29  acting on behalf of the vulnerable adult" means a person 
 48.30  designated in writing by the vulnerable adult to act on behalf 
 48.31  of the vulnerable adult, or a legal guardian or conservator or 
 48.32  other legal representative, a proxy or health care agent 
 48.33  appointed under chapter 145B or 145C, or an individual who is 
 48.34  related to the vulnerable adult, as defined in section 245A.02, 
 48.35  subdivision 13. 
 48.36     (e) If an individual was disqualified under section 
 49.1   245A.04, subdivision 3d, on the basis of a determination of 
 49.2   maltreatment, which was serious or recurring, and the individual 
 49.3   has requested reconsideration of the maltreatment determination 
 49.4   under paragraph (a) and reconsideration of the disqualification 
 49.5   under section 245A.04, subdivision 3b, reconsideration of the 
 49.6   maltreatment determination and requested reconsideration of the 
 49.7   disqualification shall be consolidated into a single 
 49.8   reconsideration.  If reconsideration of the maltreatment 
 49.9   determination is denied or if the disqualification is not set 
 49.10  aside or rescinded under section 245A.04, subdivision 3b, the 
 49.11  individual may request a fair hearing under section 256.045.  If 
 49.12  an individual ~~who was disqualified on the basis of serious or~~ 
 49.13  ~~recurring maltreatment~~ requests a fair hearing ~~under paragraph~~ 
 49.14  ~~(b)~~ on the maltreatment determination and the disqualification, 
 49.15  the scope of the fair hearing shall include both the 
 49.16  maltreatment determination and the disqualification. 
 49.17     (f) If a maltreatment determination or a disqualification 
 49.18  based on serious or recurring maltreatment is the basis for a 
 49.19  denial of a license under section 245A.05 or a licensing 
 49.20  sanction under section 245A.07, the license holder has the right 
 49.21  to a contested case hearing under chapter 14 and Minnesota 
 49.22  Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
 49.23  provided for under section 245A.08, the scope of the contested 
 49.24  case hearing shall include the maltreatment determination, 
 49.25  disqualification, and licensing sanction or denial of a 
 49.26  license.  In such cases, a fair hearing shall not be conducted 
 49.27  under paragraph (b).  If the disqualified subject is an 
 49.28  individual other than the license holder and upon whom a 
 49.29  background study must be conducted under section 245A.04, 
 49.30  subdivision 3, the hearings of all parties may be consolidated 
 49.31  into a single contested case hearing upon consent of all parties 
 49.32  and the administrative law judge. 
 49.33     (g) Until August 1, 2002, an individual or facility that 
 49.34  was determined by the commissioner of human services or the 
 49.35  commissioner of health to be responsible for neglect under 
 49.36  section 626.5572, subdivision 17, after October 1, 1995, and 
 50.1   before August 1, 2001, that believes that the finding of neglect 
 50.2   does not meet an amended definition of neglect may request a 
 50.3   reconsideration of the determination of neglect.  The 
 50.4   commissioner of human services or the commissioner of health 
 50.5   shall mail a notice to the last known address of individuals who 
 50.6   are eligible to seek this reconsideration.  The request for 
 50.7   reconsideration must state how the established findings no 
 50.8   longer meet the elements of the definition of neglect.  The 
 50.9   commissioner shall review the request for reconsideration and 
 50.10  make a determination within 15 calendar days.  The 
 50.11  commissioner's decision on this reconsideration is the final 
 50.12  agency action. 
 50.13     (1) For purposes of compliance with the data destruction 
 50.14  schedule under subdivision 12b, paragraph (d), when a finding of 
 50.15  substantiated maltreatment has been changed as a result of a 
 50.16  reconsideration under this paragraph, the date of the original 
 50.17  finding of a substantiated maltreatment must be used to 
 50.18  calculate the destruction date. 
 50.19     (2) For purposes of any background studies under section 
 50.20  245A.04, when a determination of substantiated maltreatment has 
 50.21  been changed as a result of a reconsideration under this 
 50.22  paragraph, any prior disqualification of the individual under 
 50.23  section 245A.04 that was based on this determination of 
 50.24  maltreatment shall be rescinded, and for future background 
 50.25  studies under section 245A.04 the commissioner must not use the 
 50.26  previous determination of substantiated maltreatment as a basis 
 50.27  for disqualification or as a basis for referring the 
 50.28  individual's maltreatment history to a health-related licensing 
 50.29  board under section 245A.04, subdivision 3d, paragraph (b). 
 50.30                             ARTICLE 2 
 50.31                      CONTINUING CARE PROGRAMS 
 50.32     Section 1.  Minnesota Statutes 2001 Supplement, section 
 50.33  144A.071, subdivision 1a, is amended to read: 
 50.34     Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
 50.35  to 144A.073, the following terms have the meanings given them: 
 50.36     (a) "Attached fixtures" has the meaning given in Minnesota 
 51.1   Rules, part 9549.0020, subpart 6. 
 51.2      (b) "Buildings" has the meaning given in Minnesota Rules, 
 51.3   part 9549.0020, subpart 7. 
 51.4      (c) "Capital assets" has the meaning given in section 
 51.5   256B.421, subdivision 16. 
 51.6      (d) "Commenced construction" means that all of the 
 51.7   following conditions were met:  the final working drawings and 
 51.8   specifications were approved by the commissioner of health; the 
 51.9   construction contracts were let; a timely construction schedule 
 51.10  was developed, stipulating dates for beginning, achieving 
 51.11  various stages, and completing construction; and all zoning and 
 51.12  building permits were applied for. 
 51.13     (e) "Completion date" means the date on which a certificate 
 51.14  of occupancy is issued for a construction project, or if a 
 51.15  certificate of occupancy is not required, the date on which the 
 51.16  construction project is available for facility use. 
 51.17     (f) "Construction" means any erection, building, 
 51.18  alteration, reconstruction, modernization, or improvement 
 51.19  necessary to comply with the nursing home licensure rules. 
 51.20     (g) "Construction project" means: 
 51.21     (1) a capital asset addition to, or replacement of a 
 51.22  nursing home or certified boarding care home that results in new 
 51.23  space or the remodeling of or renovations to existing facility 
 51.24  space; 
 51.25     (2) the remodeling or renovation of existing facility space 
 51.26  the use of which is modified as a result of the project 
 51.27  described in clause (1).  This existing space and the project 
 51.28  described in clause (1) must be used for the functions as 
 51.29  designated on the construction plans on completion of the 
 51.30  project described in clause (1) for a period of not less than 24 
 51.31  months; or 
 51.32     (3) capital asset additions or replacements that are 
 51.33  completed within 12 months before or after the completion date 
 51.34  of the project described in clause (1). 
 51.35     (h) "New licensed" or "new certified beds" means: 
 51.36     (1) newly constructed beds in a facility or the 
 52.1   construction of a new facility that would increase the total 
 52.2   number of licensed nursing home beds or certified boarding care 
 52.3   or nursing home beds in the state; or 
 52.4      (2) newly licensed nursing home beds or newly certified 
 52.5   boarding care or nursing home beds that result from remodeling 
 52.6   of the facility that involves relocation of beds but does not 
 52.7   result in an increase in the total number of beds, except when 
 52.8   the project involves the upgrade of boarding care beds to 
 52.9   nursing home beds, as defined in section 144A.073, subdivision 
 52.10  1.  "Remodeling" includes any of the type of conversion, 
 52.11  renovation, replacement, or upgrading projects as defined in 
 52.12  section 144A.073, subdivision 1. 
 52.13     (i) "Project construction costs" means the cost of the 
 52.14  facility capital asset additions, replacements, renovations, or 
 52.15  remodeling projects, construction site preparation costs, and 
 52.16  related soft costs.  Project construction costs include the cost 
 52.17  of any remodeling or renovation of existing facility space which 
 52.18  is modified as a result of the construction project.  Project 
 52.19  construction costs also includes the cost of new technology 
 52.20  implemented as part of the construction project.  Project 
 52.21  construction costs also include the cost of new technology 
 52.22  implemented as part of the construction project and depreciable 
 52.23  equipment directly identified to the project.  Any new 
 52.24  technology and depreciable equipment included in the project 
 52.25  construction costs shall, at the written election of the 
 52.26  facility, be included in the facility's appraised value for 
 52.27  purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt 
 52.28  incurred for its purchase shall be included as allowable debt 
 52.29  for purposes of Minnesota Rules, part 9549.0060, subpart 5, 
 52.30  items A and C.  Any new technology and depreciable equipment 
 52.31  included in the project construction costs that the facility 
 52.32  elects not to include in its appraised value and allowable debts 
 52.33  shall be treated as provided in section 256B.431, subdivision 
 52.34  17, paragraph (b).  Written election under this paragraph must 
 52.35  be included in the facility's request for the rate change 
 52.36  related to the project, and this election may not be changed. 
 53.1      (j) "Technology" means information systems or devices that 
 53.2   make documentation, charting, and staff time more efficient or 
 53.3   encourage and allow for care through alternative settings 
 53.4   including, but not limited to, touch screens, monitors, 
 53.5   hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
 53.6   medication dispensers, and equipment to monitor vital signs and 
 53.7   self-injections, and to observe skin and other conditions. 
 53.8      Sec. 2.  Minnesota Statutes 2001 Supplement, section 
 53.9   144A.36, subdivision 1, is amended to read: 
 53.10     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
 53.11  means any nursing home licensed under sections 144A.01 to 
 53.12  144A.155 ~~and~~ or a boarding care facility, certified by the 
 53.13  appropriate authority under United States Code, title 42, 
 53.14  sections 1396-1396p, to participate as a vendor in the medical 
 53.15  assistance program established under chapter 256B. 
 53.16     Sec. 3.  Minnesota Statutes 2000, section 256B.0625, is 
 53.17  amended by adding a subdivision to read: 
 53.18     Subd. 44.  [TARGETED CASE MANAGEMENT SERVICES.] Medical 
 53.19  assistance covers case management services for vulnerable adults 
 53.20  and adults with developmental disabilities, as provided under 
 53.21  section 256B.0924. 
 53.22     Sec. 4.  Minnesota Statutes 2001 Supplement, section 
 53.23  256B.0913, subdivision 4, is amended to read: 
 53.24     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
 53.25  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
 53.26  under the alternative care program is available to persons who 
 53.27  meet the following criteria: 
 53.28     (1) the person has been determined by a community 
 53.29  assessment under section 256B.0911 to be a person who would 
 53.30  require the level of care provided in a nursing facility, but 
 53.31  for the provision of services under the alternative care 
 53.32  program; 
 53.33     (2) the person is age 65 or older; 
 53.34     (3) the person would be eligible for medical assistance 
 53.35  within 180 days of admission to a nursing facility; 
 53.36     (4) the person is not ineligible for the medical assistance 
 54.1   program due to an asset transfer penalty; 
 54.2      (5) the person needs services that are not funded through 
 54.3   other state or federal funding; and 
 54.4      (6) the monthly cost of the alternative care services 
 54.5   funded by the program for this person does not exceed 75 percent 
 54.6   of the statewide weighted average monthly nursing facility rate 
 54.7   of the case mix resident class to which the individual 
 54.8   alternative care client would be assigned under Minnesota Rules, 
 54.9   parts 9549.0050 to 9549.0059, less the recipient's maintenance 
 54.10  needs allowance as described in section 256B.0915, subdivision 
 54.11  1d, paragraph (a), until the first day of the state fiscal year 
 54.12  in which the resident assessment system, under section 256B.437, 
 54.13  for nursing home rate determination is implemented.  Effective 
 54.14  on the first day of the state fiscal year in which a resident 
 54.15  assessment system, under section 256B.437, for nursing home rate 
 54.16  determination is implemented and the first day of each 
 54.17  subsequent state fiscal year, the monthly cost of alternative 
 54.18  care services for this person shall not exceed the alternative 
 54.19  care monthly cap for the case mix resident class to which the 
 54.20  alternative care client would be assigned under Minnesota Rules, 
 54.21  parts 9549.0050 to 9549.0059, which was in effect on the last 
 54.22  day of the previous state fiscal year, and adjusted by the 
 54.23  greater of any legislatively adopted home and community-based 
 54.24  services cost-of-living percentage increase or any legislatively 
 54.25  adopted statewide percent rate increase for nursing facilities.  
 54.26  This monthly limit does not prohibit the alternative care client 
 54.27  from payment for additional services, but in no case may the 
 54.28  cost of additional services purchased under this section exceed 
 54.29  the difference between the client's monthly service limit 
 54.30  defined under section 256B.0915, subdivision 3, and the 
 54.31  alternative care program monthly service limit defined in this 
 54.32  paragraph.  If medical supplies and equipment or environmental 
 54.33  modifications are or will be purchased for an alternative care 
 54.34  services recipient, the costs may be prorated on a monthly basis 
 54.35  for up to 12 consecutive months beginning with the month of 
 54.36  purchase.  If the monthly cost of a recipient's other 
 55.1   alternative care services exceeds the monthly limit established 
 55.2   in this paragraph, the annual cost of the alternative care 
 55.3   services shall be determined.  In this event, the annual cost of 
 55.4   alternative care services shall not exceed 12 times the monthly 
 55.5   limit described in this paragraph. 
 55.6      (b) Alternative care funding under this subdivision is not 
 55.7   available for a person who is a medical assistance recipient or 
 55.8   who would be eligible for medical assistance without a spenddown 
 55.9   or waiver obligation.  A person whose initial application for 
 55.10  medical assistance is being processed may be served under the 
 55.11  alternative care program for a period up to 60 days.  If the 
 55.12  individual is found to be eligible for medical assistance, 
 55.13  medical assistance must be billed for services payable under the 
 55.14  federally approved elderly waiver plan and delivered from the 
 55.15  date the individual was found eligible for the federally 
 55.16  approved elderly waiver plan.  Notwithstanding this provision, 
 55.17  upon federal approval, alternative care funds may not be used to 
 55.18  pay for any service the cost of which is payable by medical 
 55.19  assistance or which is used by a recipient to meet a medical 
 55.20  assistance income spenddown or waiver obligation.  
 55.21     (c) Alternative care funding is not available for a person 
 55.22  who resides in a licensed nursing home, certified boarding care 
 55.23  home, hospital, or intermediate care facility, except for case 
 55.24  management services which are provided in support of the 
 55.25  discharge planning process to a nursing home resident or 
 55.26  certified boarding care home resident ~~who is ineligible for case~~ 
 55.27  ~~management funded by medical assistance~~. 
 55.28     Sec. 5.  Minnesota Statutes 2001 Supplement, section 
 55.29  256B.0913, subdivision 5, is amended to read: 
 55.30     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 55.31  Alternative care funding may be used for payment of costs of: 
 55.32     (1) adult foster care; 
 55.33     (2) adult day care; 
 55.34     (3) home health aide; 
 55.35     (4) homemaker services; 
 55.36     (5) personal care; 
 56.1      (6) case management; 
 56.2      (7) respite care; 
 56.3      (8) assisted living; 
 56.4      (9) residential care services; 
 56.5      (10) care-related supplies and equipment; 
 56.6      (11) meals delivered to the home; 
 56.7      (12) transportation; 
 56.8      (13) ~~skilled~~ nursing services; 
 56.9      (14) chore services; 
 56.10     (15) companion services; 
 56.11     (16) nutrition services; 
 56.12     (17) training for direct informal caregivers; 
 56.13     (18) ~~telemedicine~~ telehome care devices to monitor 
 56.14  recipients in their own homes as an alternative to hospital 
 56.15  care, nursing home care, or home visits; 
 56.16     (19) other services which includes discretionary funds and 
 56.17  direct cash payments to clients, following approval by the 
 56.18  commissioner, subject to the provisions of paragraph (j).  Total 
 56.19  annual payments for "other services" for all clients within a 
 56.20  county may not exceed either ten percent of that county's annual 
 56.21  alternative care program base allocation or $5,000, whichever is 
 56.22  greater.  In no case shall this amount exceed the county's total 
 56.23  annual alternative care program base allocation; and 
 56.24     (20) environmental modifications. 
 56.25     (b) The county agency must ensure that the funds are not 
 56.26  used to supplant services available through other public 
 56.27  assistance or services programs. 
 56.28     (c) Unless specified in statute, the ~~service~~ services, 
 56.29  service definitions, and standards for alternative care services 
 56.30  shall be the same as the ~~service~~ services, service definitions, 
 56.31  and standards specified in the federally approved elderly waiver 
 56.32  plan.  Except for the county agencies' approval of direct cash 
 56.33  payments to clients as described in paragraph (j) or for a 
 56.34  provider of supplies and equipment when the monthly cost of the 
 56.35  supplies and equipment is less than $250, persons or agencies 
 56.36  must be employed by or under a contract with the county agency 
 57.1   or the public health nursing agency of the local board of health 
 57.2   in order to receive funding under the alternative care program.  
 57.3   Supplies and equipment may be purchased from a vendor not 
 57.4   certified to participate in the Medicaid program if the cost for 
 57.5   the item is less than that of a Medicaid vendor.  
 57.6      (d) The adult foster care rate shall be considered a 
 57.7   difficulty of care payment and shall not include room and 
 57.8   board.  The adult foster care rate shall be negotiated between 
 57.9   the county agency and the foster care provider.  The alternative 
 57.10  care payment for the foster care service in combination with the 
 57.11  payment for other alternative care services, including case 
 57.12  management, must not exceed the limit specified in subdivision 
 57.13  4, paragraph (a), clause (6). 
 57.14     (e) Personal care services must meet the service standards 
 57.15  defined in the federally approved elderly waiver plan, except 
 57.16  that a county agency may contract with a client's relative who 
 57.17  meets the relative hardship waiver requirement as defined in 
 57.18  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
 57.19  provide personal care services if the county agency ensures 
 57.20  supervision of this service by a ~~registered nurse or mental~~ 
 57.21  ~~health practitioner~~ qualified professional as defined in section 
 57.22  256B.0625, subdivision 19c.  
 57.23     (f) For purposes of this section, residential care services 
 57.24  are services which are provided to individuals living in 
 57.25  residential care homes.  Residential care homes are currently 
 57.26  licensed as board and lodging establishments and are registered 
 57.27  with the department of health as providing special services 
 57.28  under section 157.17 and are not subject to registration under 
 57.29  chapter 144D.  Residential care services are defined as 
 57.30  "supportive services" and "health-related services."  
 57.31  "Supportive services" means the provision of up to 24-hour 
 57.32  supervision and oversight.  Supportive services includes:  (1) 
 57.33  transportation, when provided by the residential care home only; 
 57.34  (2) socialization, when socialization is part of the plan of 
 57.35  care, has specific goals and outcomes established, and is not 
 57.36  diversional or recreational in nature; (3) assisting clients in 
 58.1   setting up meetings and appointments; (4) assisting clients in 
 58.2   setting up medical and social services; (5) providing assistance 
 58.3   with personal laundry, such as carrying the client's laundry to 
 58.4   the laundry room.  Assistance with personal laundry does not 
 58.5   include any laundry, such as bed linen, that is included in the 
 58.6   room and board rate.  "Health-related services" are limited to 
 58.7   minimal assistance with dressing, grooming, and bathing and 
 58.8   providing reminders to residents to take medications that are 
 58.9   self-administered or providing storage for medications, if 
 58.10  requested.  Individuals receiving residential care services 
 58.11  cannot receive homemaking services funded under this section.  
 58.12     (g) For the purposes of this section, "assisted living" 
 58.13  refers to supportive services provided by a single vendor to 
 58.14  clients who reside in the same apartment building of three or 
 58.15  more units which are not subject to registration under chapter 
 58.16  144D and are licensed by the department of health as a class A 
 58.17  home care provider or a class E home care provider.  Assisted 
 58.18  living services are defined as up to 24-hour supervision, and 
 58.19  oversight, supportive services as defined in clause (1), 
 58.20  individualized home care aide tasks as defined in clause (2), 
 58.21  and individualized home management tasks as defined in clause 
 58.22  (3) provided to residents of a residential center living in 
 58.23  their units or apartments with a full kitchen and bathroom.  A 
 58.24  full kitchen includes a stove, oven, refrigerator, food 
 58.25  preparation counter space, and a kitchen utensil storage 
 58.26  compartment.  Assisted living services must be provided by the 
 58.27  management of the residential center or by providers under 
 58.28  contract with the management or with the county. 
 58.29     (1) Supportive services include:  
 58.30     (i) socialization, when socialization is part of the plan 
 58.31  of care, has specific goals and outcomes established, and is not 
 58.32  diversional or recreational in nature; 
 58.33     (ii) assisting clients in setting up meetings and 
 58.34  appointments; and 
 58.35     (iii) providing transportation, when provided by the 
 58.36  residential center only.  
 59.1      (2) Home care aide tasks means:  
 59.2      (i) preparing modified diets, such as diabetic or low 
 59.3   sodium diets; 
 59.4      (ii) reminding residents to take regularly scheduled 
 59.5   medications or to perform exercises; 
 59.6      (iii) household chores in the presence of technically 
 59.7   sophisticated medical equipment or episodes of acute illness or 
 59.8   infectious disease; 
 59.9      (iv) household chores when the resident's care requires the 
 59.10  prevention of exposure to infectious disease or containment of 
 59.11  infectious disease; and 
 59.12     (v) assisting with dressing, oral hygiene, hair care, 
 59.13  grooming, and bathing, if the resident is ambulatory, and if the 
 59.14  resident has no serious acute illness or infectious disease.  
 59.15  Oral hygiene means care of teeth, gums, and oral prosthetic 
 59.16  devices.  
 59.17     (3) Home management tasks means:  
 59.18     (i) housekeeping; 
 59.19     (ii) laundry; 
 59.20     (iii) preparation of regular snacks and meals; and 
 59.21     (iv) shopping.  
 59.22     Individuals receiving assisted living services shall not 
 59.23  receive both assisted living services and homemaking services.  
 59.24  Individualized means services are chosen and designed 
 59.25  specifically for each resident's needs, rather than provided or 
 59.26  offered to all residents regardless of their illnesses, 
 59.27  disabilities, or physical conditions.  Assisted living services 
 59.28  as defined in this section shall not be authorized in boarding 
 59.29  and lodging establishments licensed according to sections 
 59.30  157.011 and 157.15 to 157.22. 
 59.31     (h) For establishments registered under chapter 144D, 
 59.32  assisted living services under this section means either the 
 59.33  services described in paragraph (g) and delivered by a class E 
 59.34  home care provider licensed by the department of health or the 
 59.35  services described under section 144A.4605 and delivered by an 
 59.36  assisted living home care provider or a class A home care 
 60.1   provider licensed by the commissioner of health. 
 60.2      (i) Payment for assisted living services and residential 
 60.3   care services shall be a monthly rate negotiated and authorized 
 60.4   by the county agency based on an individualized service plan for 
 60.5   each resident and may not cover direct rent or food costs.  
 60.6      (1) The individualized monthly negotiated payment for 
 60.7   assisted living services as described in paragraph (g) or (h), 
 60.8   and residential care services as described in paragraph (f), 
 60.9   shall not exceed the nonfederal share in effect on July 1 of the 
 60.10  state fiscal year for which the rate limit is being calculated 
 60.11  of the greater of either the statewide or any of the geographic 
 60.12  groups' weighted average monthly nursing facility payment rate 
 60.13  of the case mix resident class to which the alternative care 
 60.14  eligible client would be assigned under Minnesota Rules, parts 
 60.15  9549.0050 to 9549.0059, less the maintenance needs allowance as 
 60.16  described in section 256B.0915, subdivision 1d, paragraph (a), 
 60.17  until the first day of the state fiscal year in which a resident 
 60.18  assessment system, under section 256B.437, of nursing home rate 
 60.19  determination is implemented.  Effective on the first day of the 
 60.20  state fiscal year in which a resident assessment system, under 
 60.21  section 256B.437, of nursing home rate determination is 
 60.22  implemented and the first day of each subsequent state fiscal 
 60.23  year, the individualized monthly negotiated payment for the 
 60.24  services described in this clause shall not exceed the limit 
 60.25  described in this clause which was in effect on the last day of 
 60.26  the previous state fiscal year and which has been adjusted by 
 60.27  the greater of any legislatively adopted home and 
 60.28  community-based services cost-of-living percentage increase or 
 60.29  any legislatively adopted statewide percent rate increase for 
 60.30  nursing facilities. 
 60.31     (2) The individualized monthly negotiated payment for 
 60.32  assisted living services described under section 144A.4605 and 
 60.33  delivered by a provider licensed by the department of health as 
 60.34  a class A home care provider or an assisted living home care 
 60.35  provider and provided in a building that is registered as a 
 60.36  housing with services establishment under chapter 144D and that 
 61.1   provides 24-hour supervision in combination with the payment for 
 61.2   other alternative care services, including case management, must 
 61.3   not exceed the limit specified in subdivision 4, paragraph (a), 
 61.4   clause (6). 
 61.5      (j) A county agency may make payment from their alternative 
 61.6   care program allocation for "other services" which include use 
 61.7   of "discretionary funds" for services that are not otherwise 
 61.8   defined in this section and direct cash payments to the client 
 61.9   for the purpose of purchasing the services.  The following 
 61.10  provisions apply to payments under this paragraph: 
 61.11     (1) a cash payment to a client under this provision cannot 
 61.12  exceed 80 percent of the monthly payment limit for that client 
 61.13  as specified in subdivision 4, paragraph (a), clause (6); 
 61.14     (2) a county may not approve any cash payment for a client 
 61.15  who meets either of the following: 
 61.16     (i) has been assessed as having a dependency in 
 61.17  orientation, unless the client has an authorized 
 61.18  representative.  An "authorized representative" means an 
 61.19  individual who is at least 18 years of age and is designated by 
 61.20  the person or the person's legal representative to act on the 
 61.21  person's behalf.  This individual may be a family member, 
 61.22  guardian, representative payee, or other individual designated 
 61.23  by the person or the person's legal representative, if any, to 
 61.24  assist in purchasing and arranging for supports; or 
 61.25     (ii) is concurrently receiving adult foster care, 
 61.26  residential care, or assisted living services; 
 61.27     (3) cash payments to a person or a person's family will be 
 61.28  provided through a monthly payment and be in the form of cash, 
 61.29  voucher, or direct county payment to a vendor.  Fees or premiums 
 61.30  assessed to the person for eligibility for health and human 
 61.31  services are not reimbursable through this service option.  
 61.32  Services and goods purchased through cash payments must be 
 61.33  identified in the person's individualized care plan and must 
 61.34  meet all of the following criteria: 
 61.35     (i) they must be over and above the normal cost of caring 
 61.36  for the person if the person did not have functional 
 62.1   limitations; 
 62.2      (ii) they must be directly attributable to the person's 
 62.3   functional limitations; 
 62.4      (iii) they must have the potential to be effective at 
 62.5   meeting the goals of the program; 
 62.6      (iv) they must be consistent with the needs identified in 
 62.7   the individualized service plan.  The service plan shall specify 
 62.8   the needs of the person and family, the form and amount of 
 62.9   payment, the items and services to be reimbursed, and the 
 62.10  arrangements for management of the individual grant; and 
 62.11     (v) the person, the person's family, or the legal 
 62.12  representative shall be provided sufficient information to 
 62.13  ensure an informed choice of alternatives.  The local agency 
 62.14  shall document this information in the person's care plan, 
 62.15  including the type and level of expenditures to be reimbursed; 
 62.16     (4) the state of Minnesota, county, lead agency under 
 62.17  contract, or tribal government under contract to administer the 
 62.18  alternative care program shall not be liable for damages, 
 62.19  injuries, or liabilities sustained through the purchase of 
 62.20  direct supports or goods by the person, the person's family, or 
 62.21  the authorized representative with funds received through the 
 62.22  cash payments under this section.  Liabilities include, but are 
 62.23  not limited to, workers' compensation, the Federal Insurance 
 62.24  Contributions Act (FICA), or the Federal Unemployment Tax Act 
 62.25  (FUTA); 
 62.26     (5) persons receiving grants under this section shall have 
 62.27  the following responsibilities: 
 62.28     (i) spend the grant money in a manner consistent with their 
 62.29  individualized service plan with the local agency; 
 62.30     (ii) notify the local agency of any necessary changes in 
 62.31  the grant expenditures; 
 62.32     (iii) arrange and pay for supports; and 
 62.33     (iv) inform the local agency of areas where they have 
 62.34  experienced difficulty securing or maintaining supports; and 
 62.35     (6) the county shall report client outcomes, services, and 
 62.36  costs under this paragraph in a manner prescribed by the 
 63.1   commissioner. 
 63.2      ~~(k) Upon implementation of direct cash payments to clients~~ 
 63.3   ~~under this section, any person determined eligible for the~~ 
 63.4   ~~alternative care program who chooses a cash payment approved by~~ 
 63.5   ~~the county agency shall receive the cash payment under this~~ 
 63.6   ~~section and not under section 256.476 unless the person was~~ 
 63.7   ~~receiving a consumer support grant under section 256.476 before~~ 
 63.8   ~~implementation of direct cash payments under this section.~~ 
 63.9      Sec. 6.  Minnesota Statutes 2001 Supplement, section 
 63.10  256B.0913, subdivision 8, is amended to read: 
 63.11     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
 63.12  case manager shall implement the plan of care for each 
 63.13  alternative care client and ensure that a client's service needs 
 63.14  and eligibility are reassessed at least every 12 months.  The 
 63.15  plan shall include any services prescribed by the individual's 
 63.16  attending physician as necessary to allow the individual to 
 63.17  remain in a community setting.  In developing the individual's 
 63.18  care plan, the case manager should include the use of volunteers 
 63.19  from families and neighbors, religious organizations, social 
 63.20  clubs, and civic and service organizations to support the formal 
 63.21  home care services.  The county shall be held harmless for 
 63.22  damages or injuries sustained through the use of volunteers 
 63.23  under this subdivision including workers' compensation 
 63.24  liability.  The lead agency shall provide documentation in each 
 63.25  individual's plan of care and, if requested, to the commissioner 
 63.26  that the most cost-effective alternatives available have been 
 63.27  offered to the individual and that the individual was free to 
 63.28  choose among available qualified providers, both public and 
 63.29  private.  The case manager must give the individual a ten-day 
 63.30  written notice of any ~~decrease in or~~ denial, termination, or 
 63.31  reduction of alternative care services. 
 63.32     (b) If the county administering alternative care services 
 63.33  is different than the county of financial responsibility, the 
 63.34  care plan may be implemented without the approval of the county 
 63.35  of financial responsibility. 
 63.36     Sec. 7.  Minnesota Statutes 2001 Supplement, section 
 64.1   256B.0913, subdivision 10, is amended to read: 
 64.2      Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
 64.3   appropriation for fiscal years 1992 and beyond shall cover only 
 64.4   alternative care eligible clients.  ~~Prior to~~ By July 1 of each 
 64.5   year, the commissioner shall allocate to county agencies the 
 64.6   state funds available for alternative care for persons eligible 
 64.7   under subdivision 2. 
 64.8      (b) The adjusted base for each county is the county's 
 64.9   current fiscal year base allocation plus any targeted funds 
 64.10  approved during the current fiscal year.  Calculations for 
 64.11  paragraphs (c) and (d) are to be made as follows:  for each 
 64.12  county, the determination of alternative care program 
 64.13  expenditures shall be based on payments for services rendered 
 64.14  from April 1 through March 31 in the base year, to the extent 
 64.15  that claims have been submitted and paid by June 1 of that year. 
 64.16     (c) If the alternative care program expenditures as defined 
 64.17  in paragraph (b) are 95 percent or more of the county's adjusted 
 64.18  base allocation, the allocation for the next fiscal year is 100 
 64.19  percent of the adjusted base, plus inflation to the extent that 
 64.20  inflation is included in the state budget. 
 64.21     (d) If the alternative care program expenditures as defined 
 64.22  in paragraph (b) are less than 95 percent of the county's 
 64.23  adjusted base allocation, the allocation for the next fiscal 
 64.24  year is the adjusted base allocation less the amount of unspent 
 64.25  funds below the 95 percent level. 
 64.26     (e) If the annual legislative appropriation for the 
 64.27  alternative care program is inadequate to fund the combined 
 64.28  county allocations for a biennium, the commissioner shall 
 64.29  distribute to each county the entire annual appropriation as 
 64.30  that county's percentage of the computed base as calculated in 
 64.31  paragraphs (c) and (d). 
 64.32     Sec. 8.  Minnesota Statutes 2001 Supplement, section 
 64.33  256B.0913, subdivision 12, is amended to read: 
 64.34     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
 64.35  all alternative care eligible clients to help pay for the cost 
 64.36  of participating in the program.  The amount of the premium for 
 65.1   the alternative care client shall be determined as follows: 
 65.2      (1) when the alternative care client's income less 
 65.3   recurring and predictable medical expenses is greater than the 
 65.4   recipient's maintenance needs allowance as defined in section 
 65.5   256B.0915, subdivision 1d, paragraph (a), but less than 150 
 65.6   percent of the federal poverty guideline effective on July 1 of 
 65.7   the state fiscal year in which the premium is being computed, 
 65.8   and total assets are less than $10,000, the fee is zero; 
 65.9      (2) when the alternative care client's income less 
 65.10  recurring and predictable medical expenses is greater than 150 
 65.11  percent of the federal poverty guideline effective on July 1 of 
 65.12  the state fiscal year in which the premium is being computed, 
 65.13  and total assets are less than $10,000, the fee is 25 percent of 
 65.14  the cost of alternative care services or the difference between 
 65.15  150 percent of the federal poverty guideline effective on July 1 
 65.16  of the state fiscal year in which the premium is being computed 
 65.17  and the client's income less recurring and predictable medical 
 65.18  expenses, whichever is less; and 
 65.19     (3) when the alternative care client's total assets are 
 65.20  greater than $10,000, the fee is 25 percent of the cost of 
 65.21  alternative care services.  
 65.22     For married persons, total assets are defined as the total 
 65.23  marital assets less the estimated community spouse asset 
 65.24  allowance, under section 256B.059, if applicable.  For married 
 65.25  persons, total income is defined as the client's income less the 
 65.26  monthly spousal allotment, under section 256B.058. 
 65.27     All alternative care services except case management shall 
 65.28  be included in the estimated costs for the purpose of 
 65.29  determining 25 percent of the costs. 
 65.30     ~~The monthly premium shall be calculated based on the cost~~ 
 65.31  ~~of the first full month of alternative care services and shall~~ 
 65.32  ~~continue unaltered until the next reassessment is completed or~~ 
 65.33  ~~at the end of 12 months, whichever comes first.~~  Premiums are 
 65.34  due and payable each month alternative care services are 
 65.35  received unless the actual cost of the services is less than the 
 65.36  premium. 
 66.1      (b) The fee shall be waived by the commissioner when: 
 66.2      (1) a person who is residing in a nursing facility is 
 66.3   receiving case management only; 
 66.4      (2) a person is applying for medical assistance; 
 66.5      (3) a married couple is requesting an asset assessment 
 66.6   under the spousal impoverishment provisions; 
 66.7      (4) a person is found eligible for alternative care, but is 
 66.8   not yet receiving alternative care services; or 
 66.9      (5) a person's fee under paragraph (a) is less than $25. 
 66.10     (c) The county agency must record in the state's receivable 
 66.11  system the client's assessed premium amount or the reason the 
 66.12  premium has been waived.  The commissioner will bill and collect 
 66.13  the premium from the client.  Money collected must be deposited 
 66.14  in the general fund and is appropriated to the commissioner for 
 66.15  the alternative care program.  The client must supply the county 
 66.16  with the client's social security number at the time of 
 66.17  application.  The county shall supply the commissioner with the 
 66.18  client's social security number and other information the 
 66.19  commissioner requires to collect the premium from the client.  
 66.20  The commissioner shall collect unpaid premiums using the Revenue 
 66.21  Recapture Act in chapter 270A and other methods available to the 
 66.22  commissioner.  The commissioner may require counties to inform 
 66.23  clients of the collection procedures that may be used by the 
 66.24  state if a premium is not paid.  This paragraph does not apply 
 66.25  to alternative care pilot projects authorized in Laws 1993, 
 66.26  First Special Session chapter 1, article 5, section 133, if a 
 66.27  county operating under the pilot project reports the following 
 66.28  dollar amounts to the commissioner quarterly: 
 66.29     (1) total premiums billed to clients; 
 66.30     (2) total collections of premiums billed; and 
 66.31     (3) balance of premiums owed by clients. 
 66.32  If a county does not adhere to these reporting requirements, the 
 66.33  commissioner may terminate the billing, collecting, and 
 66.34  remitting portions of the pilot project and require the county 
 66.35  involved to operate under the procedures set forth in this 
 66.36  paragraph. 
 67.1      ~~(d) The commissioner shall begin to adopt emergency or~~ 
 67.2   ~~permanent rules governing client premiums within 30 days after~~ 
 67.3   ~~July 1, 1991, including criteria for determining when services~~ 
 67.4   ~~to a client must be terminated due to failure to pay a premium.~~  
 67.5      Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 67.6   256B.0913, subdivision 14, is amended to read: 
 67.7      Subd. 14.  [PROVIDER REQUIREMENTS, PAYMENT, AND RATE 
 67.8   ADJUSTMENTS.] (a) Unless otherwise specified in statute, 
 67.9   providers must be enrolled in the state's Minnesota health care 
 67.10  program and abide by the requirements for provider participation 
 67.11  according to Minnesota Rules, part 9505.0195. 
 67.12     (b) Payment for provided alternative care services as 
 67.13  approved by the client's case manager shall ~~be~~ occur through the 
 67.14  invoice processing procedures of the department's Medicaid 
 67.15  Management Information System (MMIS).  To receive payment, the 
 67.16  county or vendor must submit invoices within 12 months following 
 67.17  the date of service.  The county agency and its vendors under 
 67.18  contract shall not be reimbursed for services which exceed the 
 67.19  county allocation. 
 67.20     ~~(b)~~ (c) The county shall negotiate individual rates with 
 67.21  vendors and may authorize service payment for actual costs up to 
 67.22  the county's current approved rate.  Notwithstanding any other 
 67.23  rule or statutory provision to the contrary, the commissioner 
 67.24  shall not be authorized to increase rates by an annual inflation 
 67.25  factor, unless so authorized by the legislature.  To improve 
 67.26  access to community services and eliminate payment disparities 
 67.27  between the alternative care program and the elderly waiver 
 67.28  program, the commissioner shall establish statewide maximum 
 67.29  service rate limits and eliminate county-specific service rate 
 67.30  limits. 
 67.31     (1) Effective July 1, 2001, for service rate limits, except 
 67.32  those in subdivision 5, paragraphs (d) and (i), the rate limit 
 67.33  for each service shall be the greater of the alternative care 
 67.34  statewide maximum rate or the elderly waiver statewide maximum 
 67.35  rate. 
 67.36     (2) Counties may negotiate individual service rates with 
 68.1   vendors for actual costs up to the statewide maximum service 
 68.2   rate limit. 
 68.3      Sec. 10.  Minnesota Statutes 2000, section 256B.0915, 
 68.4   subdivision 4, is amended to read: 
 68.5      Subd. 4.  [TERMINATION NOTICE.] The case manager must give 
 68.6   the individual a ten-day written notice of any ~~decrease in~~ 
 68.7   denial, reduction, or termination of waivered services. 
 68.8      Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 68.9   256B.0915, subdivision 5, is amended to read: 
 68.10     Subd. 5.  [ASSESSMENTS AND REASSESSMENTS FOR WAIVER 
 68.11  CLIENTS.] Each client shall receive an initial assessment of 
 68.12  strengths, informal supports, and need for services in 
 68.13  accordance with section 256B.0911, subdivisions 3, 3a, and 3b.  
 68.14  A reassessment of a client served under the elderly waiver must 
 68.15  be conducted at least every 12 months and at other times when 
 68.16  the case manager determines that there has been significant 
 68.17  change in the client's functioning.  This may include instances 
 68.18  where the client is discharged from the hospital.  
 68.19     Sec. 12.  Minnesota Statutes 2000, section 256B.0915, 
 68.20  subdivision 6, is amended to read: 
 68.21     Subd. 6.  [IMPLEMENTATION OF CARE PLAN.] Each elderly 
 68.22  waiver client shall be provided a copy of a written care plan 
 68.23  that meets the requirements outlined in section 256B.0913, 
 68.24  subdivision 8.  If the county administering waivered services is 
 68.25  different than the county of financial responsibility, the care 
 68.26  plan may be implemented without the approval of the county of 
 68.27  financial responsibility. 
 68.28     Sec. 13.  Minnesota Statutes 2000, section 256B.0915, is 
 68.29  amended by adding a subdivision to read: 
 68.30     Subd. 8.  [SERVICES AND SUPPORTS.] (a) Services and 
 68.31  supports shall meet the requirements set out in United States 
 68.32  Code, title 42, section 1396n. 
 68.33     (b) Services and supports shall promote consumer choice and 
 68.34  be arranged and provided consistent with individualized, written 
 68.35  care plans. 
 68.36     (c) The state of Minnesota, county, or tribal government 
 69.1   under contract to administer the elderly waiver shall not be 
 69.2   liable for damages, injuries, or liabilities sustained through 
 69.3   the purchase of direct supports or goods by the person, the 
 69.4   person's family, or the authorized representatives with funds 
 69.5   received through consumer directed community support services 
 69.6   under the federally approved waiver plan.  Liabilities include, 
 69.7   but are not limited to, workers' compensation liability, the 
 69.8   Federal Insurance Contributions Act (FICA), or the Federal 
 69.9   Unemployment Tax Act (FUTA). 
 69.10     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 69.11  256B.431, subdivision 2e, is amended to read: 
 69.12     Subd. 2e.  [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 
 69.13  PERSONS.] The commissioner may ~~contract~~ negotiate with a nursing 
 69.14  facility eligible to receive medical assistance payments to 
 69.15  provide services to a ventilator-dependent person identified by 
 69.16  the commissioner according to criteria developed by the 
 69.17  commissioner, including:  
 69.18     (1) nursing facility care has been recommended for the 
 69.19  person by a preadmission screening team; 
 69.20     (2) the person has been hospitalized and no longer requires 
 69.21  inpatient acute care hospital services; and 
 69.22     (3) the commissioner has determined that necessary services 
 69.23  for the person cannot be provided under existing nursing 
 69.24  facility rates.  
 69.25     ~~The commissioner may issue a request for proposals to~~ 
 69.26  ~~provide services to a ventilator-dependent person to nursing~~ 
 69.27  ~~facilities eligible to receive medical assistance payments and~~ 
 69.28  ~~shall select nursing facilities from among respondents according~~ 
 69.29  ~~to criteria developed by the commissioner, including:~~  
 69.30     ~~(1) the cost-effectiveness and appropriateness of services;~~ 
 69.31     ~~(2) the nursing facility's compliance with federal and~~ 
 69.32  ~~state licensing and certification standards; and~~ 
 69.33     ~~(3) the proximity of the nursing facility to a~~ 
 69.34  ~~ventilator-dependent person identified by the commissioner who~~ 
 69.35  ~~requires nursing facility placement.~~  
 69.36     The commissioner may negotiate an adjustment to the 
 70.1   operating cost payment rate for a nursing facility ~~selected by~~ 
 70.2   ~~the commissioner from among respondents to the request for~~ 
 70.3   ~~proposals~~ with a resident who is ventilator-dependent, for that 
 70.4   resident.  The negotiated adjustment must reflect only the 
 70.5   actual additional cost of meeting the specialized care needs of 
 70.6   a ventilator-dependent person identified by the commissioner for 
 70.7   whom necessary services cannot be provided under existing 
 70.8   nursing facility rates and which are not otherwise covered under 
 70.9   Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 
 70.10  9505.0475.  For persons who are initially admitted to a nursing 
 70.11  facility before July 1, 2001, and have their payment rate under 
 70.12  this subdivision negotiated after July 1, 2001, the negotiated 
 70.13  payment rate must not exceed 200 percent of the highest multiple 
 70.14  bedroom payment rate for the facility, as initially established 
 70.15  by the commissioner for the rate year for case mix 
 70.16  classification K; or, upon implementation of the RUGs-based case 
 70.17  mix system, 200 percent of the highest RUGs rate.  For persons 
 70.18  initially admitted to a nursing facility on or after July 1, 
 70.19  2001, the negotiated payment rate must not exceed 300 percent of 
 70.20  the facility's multiple bedroom payment rate for case mix 
 70.21  classification K; or, upon implementation of the RUGs-based case 
 70.22  mix system, 300 percent of the highest RUGs rate.  The 
 70.23  negotiated adjustment shall not affect the payment rate charged 
 70.24  to private paying residents under the provisions of section 
 70.25  256B.48, subdivision 1.  
 70.26     Sec. 15.  Minnesota Statutes 2000, section 256B.431, 
 70.27  subdivision 14, is amended to read: 
 70.28     Subd. 14.  [LIMITATIONS ON SALES OF NURSING FACILITIES.] 
 70.29  (a) For rate periods beginning on October 1, 1992, and for rate 
 70.30  years beginning after June 30, 1993, a nursing facility's 
 70.31  property-related payment rate as established under subdivision 
 70.32  13 shall be adjusted by either paragraph (b) or (c) for the sale 
 70.33  of the nursing facility, including sales occurring after June 
 70.34  30, 1992, as provided in this subdivision. 
 70.35     (b) If the nursing facility's property-related payment rate 
 70.36  under subdivision 13 prior to sale is greater than the nursing 
 71.1   facility's rental rate under Minnesota Rules, parts 9549.0010 to 
 71.2   9549.0080, and this section prior to sale, the nursing 
 71.3   facility's property-related payment rate after sale shall be the 
 71.4   greater of its property-related payment rate under subdivision 
 71.5   13 prior to sale or its rental rate under Minnesota Rules, parts 
 71.6   9549.0010 to 9549.0080, and this section calculated after sale. 
 71.7      (c) If the nursing facility's property-related payment rate 
 71.8   under subdivision 13 prior to sale is equal to or less than the 
 71.9   nursing facility's rental rate under Minnesota Rules, parts 
 71.10  9549.0010 to 9549.0080, and this section prior to sale, the 
 71.11  nursing facility's property-related payment rate after sale 
 71.12  shall be the nursing facility's property-related payment rate 
 71.13  under subdivision 13 plus the difference between its rental rate 
 71.14  calculated under Minnesota Rules, parts 9549.0010 to 9549.0080, 
 71.15  and this section prior to sale and its rental rate calculated 
 71.16  under Minnesota Rules, parts 9549.0010 to 9549.0080, and this 
 71.17  section calculated after sale. 
 71.18     (d) For purposes of this subdivision, "sale" means the 
 71.19  purchase of a nursing facility's capital assets with cash or 
 71.20  debt.  The term sale does not include a stock purchase of a 
 71.21  nursing facility or any of the following transactions:  
 71.22     (1) a sale and leaseback to the same licensee that does not 
 71.23  constitute a change in facility license; 
 71.24     (2) a transfer of an interest to a trust; 
 71.25     (3) gifts or other transfers for no consideration; 
 71.26     (4) a merger of two or more related organizations; 
 71.27     (5) a change in the legal form of doing business, other 
 71.28  than a publicly held organization that becomes privately held or 
 71.29  vice versa; 
 71.30     (6) the addition of a new partner, owner, or shareholder 
 71.31  who owns less than 20 percent of the nursing facility or the 
 71.32  issuance of stock; and 
 71.33     (7) a sale, merger, reorganization, or any other transfer 
 71.34  of interest between related organizations other than those 
 71.35  permitted in this section.  
 71.36     (e) For purposes of this subdivision, "sale" includes the 
 72.1   sale or transfer of a nursing facility to a close relative as 
 72.2   defined in Minnesota Rules, part 9549.0020, subpart 38, item C, 
 72.3   upon the death of an owner, due to serious illness or 
 72.4   disability, as defined under the Social Security Act, under 
 72.5   United States Code, title 42, section 423(d)(1)(A), or upon 
 72.6   retirement of an owner from the business of owning or operating 
 72.7   a nursing home at 62 years of age or older.  For sales to a 
 72.8   close relative allowed under this paragraph, otherwise 
 72.9   nonallowable debt resulting from seller financing of all or a 
 72.10  portion of the debt resulting from the sale shall be allowed and 
 72.11  shall not be subject to Minnesota Rules, part 9549.0060, subpart 
 72.12  5, item E, provided that in addition to existing requirements 
 72.13  for allowance of debt and interest, the debt is subject to 
 72.14  repayment through annual principal payments and the interest 
 72.15  rate on the related organization debt does not exceed three 
 72.16  percentage points above the posted yield for standard 
 72.17  conventional fixed rate mortgages of the Federal Home Loan 
 72.18  Mortgage Corporation for delivery in 60 days in effect on the 
 72.19  day of sale.  If at any time, the seller forgives the related 
 72.20  organization debt allowed under this paragraph for other than 
 72.21  equal amount of payment on that debt, then the buyer shall pay 
 72.22  to the state the total revenue received by the nursing facility 
 72.23  after the sale attributable to the amount of allowable debt 
 72.24  which has been forgiven.  Any assignment, sale, or transfer of 
 72.25  the debt instrument entered into by the close relatives, either 
 72.26  directly or indirectly, which grants to the close relative buyer 
 72.27  the right to receive all or a portion of the payments under the 
 72.28  debt instrument shall, effective on the date of the transfer, 
 72.29  result in the prospective reduction in the corresponding portion 
 72.30  of the allowable debt and interest expense.  Upon the death of 
 72.31  the close relative seller, any remaining balance of the close 
 72.32  relative debt must be refinanced and such refinancing shall be 
 72.33  subject to the provisions of Minnesota Rules, part 9549.0060, 
 72.34  subpart 7, item G.  This paragraph shall not apply to sales 
 72.35  occurring on or after June 30, 1997.  
 72.36     (f) For purposes of this subdivision, "effective date of 
 73.1   sale" means the later of either the date on which legal title to 
 73.2   the capital assets is transferred or the date on which closing 
 73.3   for the sale occurred.  
 73.4      (g) The effective day for the property-related payment rate 
 73.5   determined under this subdivision shall be the first day of the 
 73.6   month following the month in which the effective date of sale 
 73.7   occurs or October 1, 1992, whichever is later, provided that the 
 73.8   notice requirements under section 256B.47, subdivision 2, have 
 73.9   been met. 
 73.10     (h) Notwithstanding Minnesota Rules, part 9549.0060, 
 73.11  subparts 5, item A, subitems (3) and (4), and 7, items E and F, 
 73.12  the commissioner shall limit the total allowable debt and 
 73.13  related interest for sales occurring after June 30, 1992, to the 
 73.14  sum of clauses (1) to (3):  
 73.15     (1) the historical cost of capital assets, as of the 
 73.16  nursing facility's most recent previous effective date of sale 
 73.17  or, if there has been no previous sale, the nursing facility's 
 73.18  initial historical cost of constructing capital assets; 
 73.19     (2) the average annual capital asset additions after 
 73.20  deduction for capital asset deletions, not including 
 73.21  depreciations; and 
 73.22     (3) one-half of the allowed inflation on the nursing 
 73.23  facility's capital assets.  The commissioner shall compute the 
 73.24  allowed inflation as described in paragraph ~~(h)~~ (i). 
 73.25     (i) For purposes of computing the amount of allowed 
 73.26  inflation, the commissioner must apply the following principles: 
 73.27     (1) the lesser of the Consumer Price Index for all urban 
 73.28  consumers or the Dodge Construction Systems Costs for Nursing 
 73.29  Homes for any time periods during which both are available must 
 73.30  be used.  If the Dodge Construction Systems Costs for Nursing 
 73.31  Homes becomes unavailable, the commissioner shall substitute the 
 73.32  index in subdivision 3f, or such other index as the secretary of 
 73.33  the health care financing administration may designate; 
 73.34     (2) the amount of allowed inflation to be applied to the 
 73.35  capital assets in paragraph (g), clauses (1) and (2), must be 
 73.36  computed separately; 
 74.1      (3) the amount of allowed inflation must be determined on 
 74.2   an annual basis, prorated on a monthly basis for partial years 
 74.3   and if the initial month of use is not determinable for a 
 74.4   capital asset, then one-half of that calendar year shall be used 
 74.5   for purposes of prorating; 
 74.6      (4) the amount of allowed inflation to be applied to the 
 74.7   capital assets in paragraph (g), clauses (1) and (2), must not 
 74.8   exceed 300 percent of the total capital assets in any one of 
 74.9   those clauses; and 
 74.10     (5) the allowed inflation must be computed starting with 
 74.11  the month following the nursing facility's most recent previous 
 74.12  effective date of sale or, if there has been no previous sale, 
 74.13  the month following the date of the nursing facility's initial 
 74.14  occupancy, and ending with the month preceding the effective 
 74.15  date of sale. 
 74.16     (j) If the historical cost of a capital asset is not 
 74.17  readily available for the date of the nursing facility's most 
 74.18  recent previous sale or if there has been no previous sale for 
 74.19  the date of the nursing facility's initial occupancy, then the 
 74.20  commissioner shall limit the total allowable debt and related 
 74.21  interest after sale to the extent recognized by the Medicare 
 74.22  intermediary after the sale.  For a nursing facility that has no 
 74.23  historical capital asset cost data available and does not have 
 74.24  allowable debt and interest calculated by the Medicare 
 74.25  intermediary, the commissioner shall use the historical cost of 
 74.26  capital asset data from the point in time for which capital 
 74.27  asset data is recorded in the nursing facility's audited 
 74.28  financial statements. 
 74.29     (k) The limitations in this subdivision apply only to debt 
 74.30  resulting from a sale of a nursing facility occurring after June 
 74.31  30, 1992, including debt assumed by the purchaser of the nursing 
 74.32  facility. 
 74.33     Sec. 16.  Minnesota Statutes 2000, section 256B.431, 
 74.34  subdivision 30, is amended to read: 
 74.35     Subd. 30.  [BED LAYAWAY AND DELICENSURE.] (a) For rate 
 74.36  years beginning on or after July 1, 2000, a nursing facility 
 75.1   reimbursed under this section which has placed beds on layaway 
 75.2   shall, for purposes of application of the downsizing incentive 
 75.3   in subdivision 3a, paragraph ~~(d)~~ (c), and calculation of the 
 75.4   rental per diem, have those beds given the same effect as if the 
 75.5   beds had been delicensed so long as the beds remain on layaway.  
 75.6   At the time of a layaway, a facility may change its single bed 
 75.7   election for use in calculating capacity days under Minnesota 
 75.8   Rules, part 9549.0060, subpart 11.  The property payment rate 
 75.9   increase shall be effective the first day of the month following 
 75.10  the month in which the layaway of the beds becomes effective 
 75.11  under section 144A.071, subdivision 4b. 
 75.12     (b) For rate years beginning on or after July 1, 2000, 
 75.13  notwithstanding any provision to the contrary under section 
 75.14  256B.434, a nursing facility reimbursed under that section which 
 75.15  has placed beds on layaway shall, for so long as the beds remain 
 75.16  on layaway, be allowed to: 
 75.17     (1) aggregate the applicable investment per bed limits 
 75.18  based on the number of beds licensed immediately prior to 
 75.19  entering the alternative payment system; 
 75.20     (2) retain or change the facility's single bed election for 
 75.21  use in calculating capacity days under Minnesota Rules, part 
 75.22  9549.0060, subpart 11; and 
 75.23     (3) establish capacity days based on the number of beds 
 75.24  immediately prior to the layaway and the number of beds after 
 75.25  the layaway. 
 75.26  The commissioner shall increase the facility's property payment 
 75.27  rate by the incremental increase in the rental per diem 
 75.28  resulting from the recalculation of the facility's rental per 
 75.29  diem applying only the changes resulting from the layaway of 
 75.30  beds and clauses (1), (2), and (3).  If a facility reimbursed 
 75.31  under section 256B.434 completes a moratorium exception project 
 75.32  after its base year, the base year property rate shall be the 
 75.33  moratorium project property rate.  The base year rate shall be 
 75.34  inflated by the factors in section 256B.434, subdivision 4, 
 75.35  paragraph (c).  The property payment rate increase shall be 
 75.36  effective the first day of the month following the month in 
 76.1   which the layaway of the beds becomes effective. 
 76.2      (c) If a nursing facility removes a bed from layaway status 
 76.3   in accordance with section 144A.071, subdivision 4b, the 
 76.4   commissioner shall establish capacity days based on the number 
 76.5   of licensed and certified beds in the facility not on layaway 
 76.6   and shall reduce the nursing facility's property payment rate in 
 76.7   accordance with paragraph (b). 
 76.8      (d) For the rate years beginning on or after July 1, 2000, 
 76.9   notwithstanding any provision to the contrary under section 
 76.10  256B.434, a nursing facility reimbursed under that section, 
 76.11  which has delicensed beds after July 1, 2000, by giving notice 
 76.12  of the delicensure to the commissioner of health according to 
 76.13  the notice requirements in section 144A.071, subdivision 4b, 
 76.14  shall be allowed to: 
 76.15     (1) aggregate the applicable investment per bed limits 
 76.16  based on the number of beds licensed immediately prior to 
 76.17  entering the alternative payment system; 
 76.18     (2) retain or change the facility's single bed election for 
 76.19  use in calculating capacity days under Minnesota Rules, part 
 76.20  9549.0060, subpart 11; and 
 76.21     (3) establish capacity days based on the number of beds 
 76.22  immediately prior to the delicensure and the number of beds 
 76.23  after the delicensure. 
 76.24  The commissioner shall increase the facility's property payment 
 76.25  rate by the incremental increase in the rental per diem 
 76.26  resulting from the recalculation of the facility's rental per 
 76.27  diem applying only the changes resulting from the delicensure of 
 76.28  beds and clauses (1), (2), and (3).  If a facility reimbursed 
 76.29  under section 256B.434 completes a moratorium exception project 
 76.30  after its base year, the base year property rate shall be the 
 76.31  moratorium project property rate.  The base year rate shall be 
 76.32  inflated by the factors in section 256B.434, subdivision 4, 
 76.33  paragraph (c).  The property payment rate increase shall be 
 76.34  effective the first day of the month following the month in 
 76.35  which the delicensure of the beds becomes effective. 
 76.36     (e) For nursing facilities reimbursed under this section or 
 77.1   section 256B.434, any beds placed on layaway shall not be 
 77.2   included in calculating facility occupancy as it pertains to 
 77.3   leave days defined in Minnesota Rules, part 9505.0415. 
 77.4      (f) For nursing facilities reimbursed under this section or 
 77.5   section 256B.434, the rental rate calculated after placing beds 
 77.6   on layaway may not be less than the rental rate prior to placing 
 77.7   beds on layaway. 
 77.8      (g) A nursing facility receiving a rate adjustment as a 
 77.9   result of this section shall comply with section 256B.47, 
 77.10  subdivision 2. 
 77.11     (h) A facility that does not utilize the space made 
 77.12  available as a result of bed layaway or delicensure under this 
 77.13  subdivision to reduce the number of beds per room or provide 
 77.14  more common space for nursing facility uses or perform other 
 77.15  activities related to the operation of the nursing facility 
 77.16  shall have its property rate increase calculated under this 
 77.17  subdivision reduced by the ratio of the square footage made 
 77.18  available that is not used for these purposes to the total 
 77.19  square footage made available as a result of bed layaway or 
 77.20  delicensure. 
 77.21     Sec. 17.  Minnesota Statutes 2001 Supplement, section 
 77.22  256B.431, subdivision 33, is amended to read: 
 77.23     Subd. 33.  [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 
 77.24  the rate years beginning July 1, 2001, and July 1, 2002, the 
 77.25  commissioner shall adjust the operating payment rates for 
 77.26  low-rate nursing facilities reimbursed under this section or 
 77.27  section 256B.434.  
 77.28     (b) For the rate year beginning July 1, 2001, for each case 
 77.29  mix level, if the amount computed under subdivision ~~32~~ 31 is 
 77.30  less than the amount in clause (1), the commissioner shall make 
 77.31  available the lesser of the amount in clause (1) or an increase 
 77.32  of ten percent over the rate in effect on June 30, 2001, as an 
 77.33  adjustment to the operating payment rate.  For the rate year 
 77.34  beginning July 1, 2002, for each case mix level, if the amount 
 77.35  computed under subdivision ~~32~~ 31 is less than the amount in 
 77.36  clause (2), the commissioner shall make available the lesser of 
 78.1   the amount in clause (2) or an increase of ten percent over the 
 78.2   rate in effect on June 30, 2002, as an adjustment to the 
 78.3   operating payment rate.  For purposes of this subdivision, 
 78.4   nursing facilities shall be considered to be metro if they are 
 78.5   located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, 
 78.6   Scott, or Washington counties; or in the cities of Moorhead or 
 78.7   Breckenridge; or in St. Louis county, north of Toivola and south 
 78.8   of Cook; or in Itasca county, east of a north south line two 
 78.9   miles west of Grand Rapids:  
 78.10     (1) Operating Payment Rate Target Level for July 1, 2001: 
 78.11      Case Mix Classification        Metro       Nonmetro
 78.12                A                    $ 76.00     $ 68.13
 78.13                B                    $ 83.40     $ 74.46
 78.14                C                    $ 91.67     $ 81.63
 78.15                D                    $ 99.51     $ 88.04
 78.16                E                    $107.46     $ 94.87
 78.17                F                    $107.96     $ 95.29
 78.18                G                    $114.67     $100.98
 78.19                H                    $126.99     $111.31
 78.20                I                    $131.42     $115.06
 78.21                J                    $138.34     $120.85
 78.22                K                    $152.26     $133.10
 78.23     (2) Operating Payment Rate Target Level for July 1, 2002: 
 78.24      Case Mix Classification        Metro       Nonmetro
 78.25                A                    $ 78.28     $ 70.51
 78.26                B                    $ 85.91     $ 77.16
 78.27                C                    $ 94.42     $ 84.62
 78.28                D                    $102.50     $ 91.42
 78.29                E                    $110.68     $ 98.40
 78.30                F                    $111.20     $ 98.84
 78.31                G                    $118.11     $104.77
 78.32                H                    $130.80     $115.64
 78.33                I                    $135.38     $119.50
 78.34                J                    $142.49     $125.38
 78.35                K                    $156.85     $137.77
 78.36     Sec. 18.  Minnesota Statutes 2001 Supplement, section 
 79.1   256B.437, subdivision 3, is amended to read: 
 79.2      Subd. 3.  [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 
 79.3   FACILITIES.] (a) By August 15, 2001, the commissioner of human 
 79.4   services shall implement and announce a program for closure or 
 79.5   partial closure of nursing facilities.  Names and identifying 
 79.6   information provided in response to the announcement shall 
 79.7   remain private unless approved, according to the timelines 
 79.8   established in the plan.  The announcement must specify: 
 79.9      (1) the criteria in subdivision 4 that will be used by the 
 79.10  commissioner to approve or reject applications; 
 79.11     (2) ~~a requirement for the submission of a letter of intent~~ 
 79.12  ~~before the submission of an application;~~ 
 79.13     ~~(3)~~ the information that must accompany an application; and 
 79.14     ~~(4)~~ (3) that applications may combine planned closure rate 
 79.15  adjustments with moratorium exception funding, in which case a 
 79.16  single application may serve both purposes. 
 79.17  Between August 1, 2001, and June 30, 2003, the commissioner may 
 79.18  approve planned closures of up to 5,140 nursing facility beds, 
 79.19  less the number of ~~licensed~~ beds delicensed in facilities ~~that~~ 
 79.20  ~~close~~ during the same time period without approved closure plans 
 79.21  or that have notified the commissioner of health of their intent 
 79.22  to close without an approved closure plan. 
 79.23     (b) A facility or facilities reimbursed under section 
 79.24  256B.431 or 256B.434 with a closure plan approved by the 
 79.25  commissioner under subdivision 5 may assign a planned closure 
 79.26  rate adjustment to another facility or facilities that are not 
 79.27  closing or in the case of a partial closure, to the facility 
 79.28  undertaking the partial closure.  A facility may also elect to 
 79.29  have a planned closure rate adjustment shared equally by the 
 79.30  five nursing facilities with the lowest total operating payment 
 79.31  rates in the state development region designated under section 
 79.32  462.385, in which the facility that is closing is located.  The 
 79.33  planned closure rate adjustment must be calculated under 
 79.34  subdivision 6.  Facilities that ~~close~~ delicense beds without a 
 79.35  closure plan, or whose closure plan is not approved by the 
 79.36  commissioner, are not eligible to assign a planned closure rate 
 80.1   adjustment under subdivision 6~~.~~, unless they are delicensing 
 80.2   five or fewer beds, or less than six percent of their total 
 80.3   licensed bed capacity, whichever is greater.  Facilities 
 80.4   delicensing, in any three-month period, five or fewer beds or 
 80.5   less than six percent of their total licensed bed capacity, 
 80.6   whichever is greater, without an approved closure plan are 
 80.7   eligible to assign the amount calculated under subdivision 6 to 
 80.8   themselves, if the facilities are located in a county that is in 
 80.9   the top three quartiles when ranked on nursing facility beds per 
 80.10  thousand individuals age 65 and older.  When facilities are 
 80.11  delicensing more than five beds, or six percent or more of their 
 80.12  total licensed bed capacity, whichever is greater, and if they 
 80.13  do not have an approved closure plan or are not eligible for the 
 80.14  adjustment under subdivision 6, the commissioner shall calculate 
 80.15  the amount the facility or facilities would have been eligible 
 80.16  to assign under subdivision 6, and shall use this amount to 
 80.17  provide equal rate adjustments to the five nursing facilities 
 80.18  with the lowest total operating payment rates in the state 
 80.19  development region designated under section 462.385, in which 
 80.20  the facility or facilities that ~~closed is~~ delicense beds are 
 80.21  located. 
 80.22     (c) To be considered for approval, an application must 
 80.23  include: 
 80.24     (1) a description of the proposed closure plan, which must 
 80.25  include identification of the facility or facilities to receive 
 80.26  a planned closure rate adjustment ~~and the amount and timing of a~~ 
 80.27  ~~planned closure rate adjustment proposed for each facility~~; 
 80.28     (2) the proposed timetable for any proposed closure, 
 80.29  including the proposed dates for announcement to residents, 
 80.30  commencement of closure, and completion of closure; 
 80.31     (3) if available, the proposed relocation plan for current 
 80.32  residents of any facility designated for closure.  ~~The proposed~~ 
 80.33  If a relocation plan is not available, the application must 
 80.34  include a statement agreeing to develop a relocation plan ~~must~~ 
 80.35  ~~be~~ designed to comply with ~~all applicable state and federal~~ 
 80.36  ~~statutes and regulations, including, but not limited to,~~ section 
 81.1   144A.161; 
 81.2      (4) a description of the relationship between the nursing 
 81.3   facility that is proposed for closure and the nursing facility 
 81.4   or facilities proposed to receive the planned closure rate 
 81.5   adjustment.  If these facilities are not under common ownership, 
 81.6   copies of any contracts, purchase agreements, or other documents 
 81.7   establishing a relationship or proposed relationship must be 
 81.8   provided; 
 81.9      (5) documentation, in a format approved by the 
 81.10  commissioner, that all the nursing facilities receiving a 
 81.11  planned closure rate adjustment under the plan have accepted 
 81.12  joint and several liability for recovery of overpayments under 
 81.13  section 256B.0641, subdivision 2, for the facilities designated 
 81.14  for closure under the plan; and 
 81.15     (6) an explanation of how the application coordinates with 
 81.16  planning efforts under subdivision 2.  If the planning group 
 81.17  does not support a level of nursing facility closures that the 
 81.18  commissioner considers to be reasonable, the commissioner may 
 81.19  approve a planned closure proposal without its support. 
 81.20     (d) The application must address the criteria listed in 
 81.21  subdivision 4. 
 81.22     Sec. 19.  Minnesota Statutes 2001 Supplement, section 
 81.23  256B.437, subdivision 6, is amended to read: 
 81.24     Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 
 81.25  commissioner of human services shall calculate the amount of the 
 81.26  planned closure rate adjustment available under subdivision 3, 
 81.27  paragraph (b), for up to 5,140 beds according to clauses (1) to 
 81.28  (4): 
 81.29     (1) the amount available is the net reduction of nursing 
 81.30  facility beds multiplied by $2,080; 
 81.31     (2) the total number of beds in the nursing facility or 
 81.32  facilities receiving the planned closure rate adjustment must be 
 81.33  identified; 
 81.34     (3) capacity days are determined by multiplying the number 
 81.35  determined under clause (2) by 365; and 
 81.36     (4) the planned closure rate adjustment is the amount 
 82.1   available in clause (1), divided by capacity days determined 
 82.2   under clause (3). 
 82.3      (b) A planned closure rate adjustment under this section is 
 82.4   effective on the first day of the month following completion of 
 82.5   closure of the facility designated for closure in the 
 82.6   application and becomes part of the nursing facility's total 
 82.7   operating payment rate. 
 82.8      (c) Applicants may use the planned closure rate adjustment 
 82.9   to allow for a property payment for a new nursing facility or an 
 82.10  addition to an existing nursing facility or as an operating 
 82.11  payment rate adjustment.  Applications approved under this 
 82.12  subdivision are exempt from other requirements for moratorium 
 82.13  exceptions under section 144A.073, subdivisions 2 and 3. 
 82.14     (d) Upon the request of a closing facility, the 
 82.15  commissioner must allow the facility a closure rate adjustment 
 82.16  as provided under section 144A.161, subdivision 10. 
 82.17     (e) If the per bed dollar amount specified in paragraph 
 82.18  (a), clause (1) is increased, the commissioner shall recalculate 
 82.19  planned closure rate adjustments for facilities that delicense 
 82.20  beds under this section on or after July 1, 2001, to reflect the 
 82.21  increase in the per bed dollar amount.  The recalculated planned 
 82.22  closure rate adjustment shall be effective from the date the per 
 82.23  bed dollar amount is increased. 
 82.24     Sec. 20.  Minnesota Statutes 2001 Supplement, section 
 82.25  256B.438, subdivision 1, is amended to read: 
 82.26     Subdivision 1.  [SCOPE.] This section establishes the 
 82.27  method and criteria used to determine resident reimbursement 
 82.28  classifications based upon the assessments of residents of 
 82.29  nursing homes and boarding care homes whose payment rates are 
 82.30  established under section 256B.431, 256B.434, or 256B.435.  
 82.31  Resident reimbursement classifications shall be established 
 82.32  according to the 34 group, resource utilization groups, version 
 82.33  III or RUG-III model as described in section 144.0724.  
 82.34  Reimbursement classifications established under this section 
 82.35  shall be implemented after June 30, 2002, but no later than 
 82.36  January 1, 2003.  Reimbursement classifications established 
 83.1   under this section shall be implemented no earlier than six 
 83.2   weeks after the commissioner mails notices of payment rates to 
 83.3   the facilities. 
 83.4      Sec. 21.  Minnesota Statutes 2000, section 256B.5012, 
 83.5   subdivision 2, is amended to read: 
 83.6      Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
 83.7   payment rate equals the facility's total payment rate in effect 
 83.8   on September 30, 2000, minus the property rate.  The operating 
 83.9   payment rate includes the special operating rate and the 
 83.10  efficiency incentive in effect as of September 30, 2000.  Within 
 83.11  the limits of appropriations specifically for this purpose, the 
 83.12  operating payment shall be increased for each rate year by the 
 83.13  annual percentage change in the Employment Cost Index for 
 83.14  Private Industry Workers - Total Compensation, as forecasted by 
 83.15  the commissioner of finance's economic consultant, in the second 
 83.16  quarter of the calendar year preceding the start of each rate 
 83.17  year.  In the case of the initial rate year beginning October 1, 
 83.18  2000, and continuing through December 31, 2001, the percentage 
 83.19  change shall be based on the percentage change in the Employment 
 83.20  Cost Index for Private Industry Workers - Total Compensation for 
 83.21  the 15-month period beginning October 1, 2000, as forecast by 
 83.22  Data Resources, Inc., in the first quarter of 2000. 
 83.23     (b) Effective October 1, 2000, the operating payment rate 
 83.24  shall be adjusted to reflect an occupancy rate equal to 100 
 83.25  percent of the facility's capacity days as of September 30, 2000.
 83.26     (c) Effective July 1, 2001, the operating payment rate 
 83.27  shall be adjusted for the increases in the department of health 
 83.28  licensing fees that were authorized in Laws 2001, First Special 
 83.29  Session chapter 9, article 1, section 30. 
 83.30     Sec. 22.  Minnesota Statutes 2001 Supplement, section 
 83.31  256B.76, is amended to read: 
 83.32     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
 83.33     (a) Effective for services rendered on or after October 1, 
 83.34  1992, the commissioner shall make payments for physician 
 83.35  services as follows: 
 83.36     (1) payment for level one Health Care Finance 
 84.1   Administration's common procedural coding system (HCPCS) codes 
 84.2   titled "office and other outpatient services," "preventive 
 84.3   medicine new and established patient," "delivery, antepartum, 
 84.4   and postpartum care," "critical care," cesarean delivery and 
 84.5   pharmacologic management provided to psychiatric patients, and 
 84.6   HCPCS level three codes for enhanced services for prenatal high 
 84.7   risk, shall be paid at the lower of (i) submitted charges, or 
 84.8   (ii) 25 percent above the rate in effect on June 30, 1992.  If 
 84.9   the rate on any procedure code within these categories is 
 84.10  different than the rate that would have been paid under the 
 84.11  methodology in section 256B.74, subdivision 2, then the larger 
 84.12  rate shall be paid; 
 84.13     (2) payments for all other services shall be paid at the 
 84.14  lower of (i) submitted charges, or (ii) 15.4 percent above the 
 84.15  rate in effect on June 30, 1992; 
 84.16     (3) all physician rates shall be converted from the 50th 
 84.17  percentile of 1982 to the 50th percentile of 1989, less the 
 84.18  percent in aggregate necessary to equal the above increases 
 84.19  except that payment rates for home health agency services shall 
 84.20  be the rates in effect on September 30, 1992; 
 84.21     (4) effective for services rendered on or after January 1, 
 84.22  2000, payment rates for physician and professional services 
 84.23  shall be increased by three percent over the rates in effect on 
 84.24  December 31, 1999, except for home health agency and family 
 84.25  planning agency services; and 
 84.26     (5) the increases in clause (4) shall be implemented 
 84.27  January 1, 2000, for managed care. 
 84.28     (b) Effective for services rendered on or after October 1, 
 84.29  1992, the commissioner shall make payments for dental services 
 84.30  as follows: 
 84.31     (1) dental services shall be paid at the lower of (i) 
 84.32  submitted charges, or (ii) 25 percent above the rate in effect 
 84.33  on June 30, 1992; 
 84.34     (2) dental rates shall be converted from the 50th 
 84.35  percentile of 1982 to the 50th percentile of 1989, less the 
 84.36  percent in aggregate necessary to equal the above increases; 
 85.1      (3) effective for services rendered on or after January 1, 
 85.2   2000, payment rates for dental services shall be increased by 
 85.3   three percent over the rates in effect on December 31, 1999; 
 85.4      (4) the commissioner shall award grants to community 
 85.5   clinics or other nonprofit community organizations, political 
 85.6   subdivisions, professional associations, or other organizations 
 85.7   that demonstrate the ability to provide dental services 
 85.8   effectively to public program recipients.  Grants may be used to 
 85.9   fund the costs related to coordinating access for recipients, 
 85.10  developing and implementing patient care criteria, upgrading or 
 85.11  establishing new facilities, acquiring furnishings or equipment, 
 85.12  recruiting new providers, or other development costs that will 
 85.13  improve access to dental care in a region.  In awarding grants, 
 85.14  the commissioner shall give priority to applicants that plan to 
 85.15  serve areas of the state in which the number of dental providers 
 85.16  is not currently sufficient to meet the needs of recipients of 
 85.17  public programs or uninsured individuals.  The commissioner 
 85.18  shall consider the following in awarding the grants: 
 85.19     (i) potential to successfully increase access to an 
 85.20  underserved population; 
 85.21     (ii) the ability to raise matching funds; 
 85.22     (iii) the long-term viability of the project to improve 
 85.23  access beyond the period of initial funding; 
 85.24     (iv) the efficiency in the use of the funding; and 
 85.25     (v) the experience of the proposers in providing services 
 85.26  to the target population. 
 85.27     The commissioner shall monitor the grants and may terminate 
 85.28  a grant if the grantee does not increase dental access for 
 85.29  public program recipients.  The commissioner shall consider 
 85.30  grants for the following: 
 85.31     (i) implementation of new programs or continued expansion 
 85.32  of current access programs that have demonstrated success in 
 85.33  providing dental services in underserved areas; 
 85.34     (ii) a pilot program for utilizing hygienists outside of a 
 85.35  traditional dental office to provide dental hygiene services; 
 85.36  and 
 86.1      (iii) a program that organizes a network of volunteer 
 86.2   dentists, establishes a system to refer eligible individuals to 
 86.3   volunteer dentists, and through that network provides donated 
 86.4   dental care services to public program recipients or uninsured 
 86.5   individuals; 
 86.6      (5) beginning October 1, 1999, the payment for tooth 
 86.7   sealants and fluoride treatments shall be the lower of (i) 
 86.8   submitted charge, or (ii) 80 percent of median 1997 charges; 
 86.9      (6) the increases listed in clauses (3) and (5) shall be 
 86.10  implemented January 1, 2000, for managed care; and 
 86.11     (7) effective for services provided on or after January 1, 
 86.12  2002, payment for diagnostic examinations and dental x-rays 
 86.13  provided to children under age 21 shall be the lower of (i) the 
 86.14  submitted charge, or (ii) 85 percent of median 1999 charges.  
 86.15     (c) Effective for dental services rendered on or after 
 86.16  January 1, 2002, the commissioner may, within the limits of 
 86.17  available appropriation, increase reimbursements to dentists and 
 86.18  dental clinics deemed by the commissioner to be critical access 
 86.19  dental providers.  Reimbursement to a critical access dental 
 86.20  provider may be increased by not more than 50 percent above the 
 86.21  reimbursement rate that would otherwise be paid to the 
 86.22  provider.  Payments to health plan companies shall be adjusted 
 86.23  to reflect increased reimbursements to critical access dental 
 86.24  providers as approved by the commissioner.  In determining which 
 86.25  dentists and dental clinics shall be deemed critical access 
 86.26  dental providers, the commissioner shall review: 
 86.27     (1) the utilization rate in the service area in which the 
 86.28  dentist or dental clinic operates for dental services to 
 86.29  patients covered by medical assistance, general assistance 
 86.30  medical care, or MinnesotaCare as their primary source of 
 86.31  coverage; 
 86.32     (2) the level of services provided by the dentist or dental 
 86.33  clinic to patients covered by medical assistance, general 
 86.34  assistance medical care, or MinnesotaCare as their primary 
 86.35  source of coverage; and 
 86.36     (3) whether the level of services provided by the dentist 
 87.1   or dental clinic is critical to maintaining adequate levels of 
 87.2   patient access within the service area. 
 87.3   In the absence of a critical access dental provider in a service 
 87.4   area, the commissioner may designate a dentist or dental clinic 
 87.5   as a critical access dental provider if the dentist or dental 
 87.6   clinic is willing to provide care to patients covered by medical 
 87.7   assistance, general assistance medical care, or MinnesotaCare at 
 87.8   a level which significantly increases access to dental care in 
 87.9   the service area. 
 87.10     (d) Effective July 1, 2001, the medical assistance rates 
 87.11  for outpatient mental health services provided by an entity that 
 87.12  operates: 
 87.13     (1) a Medicare-certified comprehensive outpatient 
 87.14  rehabilitation facility; and 
 87.15     (2) a facility that was certified prior to January 1, 1993, 
 87.16  with at least 33 percent of the clients receiving rehabilitation 
 87.17  services in the most recent calendar year are medical assistance 
 87.18  recipients, will be increased by 38 percent, when those services 
 87.19  are provided within the comprehensive outpatient rehabilitation 
 87.20  facility and provided to residents of nursing facilities owned 
 87.21  by the entity. 
 87.22     (e) An entity that operates both a Medicare certified 
 87.23  comprehensive outpatient rehabilitation facility and a facility 
 87.24  which was certified prior to January 1, 1993, that is licensed 
 87.25  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
 87.26  whom at least 33 percent of the clients receiving rehabilitation 
 87.27  services in the most recent calendar year are medical assistance 
 87.28  recipients, shall be reimbursed by the commissioner for 
 87.29  rehabilitation services at rates that are 38 percent greater 
 87.30  than the maximum reimbursement rate allowed under paragraph (a), 
 87.31  clause (2), when those services are (1) provided within the 
 87.32  comprehensive outpatient rehabilitation facility and (2) 
 87.33  provided to residents of nursing facilities owned by the entity. 
 87.34     Sec. 23.  Minnesota Statutes 2000, section 261.063, is 
 87.35  amended to read: 
 87.36     261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 
 88.1   PENALTY.] 
 88.2      (a) The board of county commissioners of each county shall 
 88.3   annually levy taxes and fix a rate sufficient to produce the 
 88.4   full amount required for poor relief, general assistance, 
 88.5   Minnesota family investment program, county share of county and 
 88.6   state supplemental aid to supplemental security income 
 88.7   applicants or recipients, and any other social security measures 
 88.8   wherein there is now or may hereafter be county participation, 
 88.9   sufficient to produce the full amount necessary for each such 
 88.10  item, including administrative expenses, for the ensuing year, 
 88.11  within the time fixed by law in addition to all other tax levies 
 88.12  and tax rates, however fixed or determined, and any commissioner 
 88.13  who shall fail to comply herewith shall be guilty of a gross 
 88.14  misdemeanor and shall be immediately removed from office by the 
 88.15  governor.  For the purposes of this paragraph, "poor relief" 
 88.16  means county services provided under sections 261.035, 261.04, 
 88.17  and 261.21 to 261.231. 
 88.18     (b) Nothing within the provisions of this section shall be 
 88.19  construed as requiring a county agency to provide income support 
 88.20  or cash assistance to needy persons when they are no longer 
 88.21  eligible for assistance under general assistance, the Minnesota 
 88.22  family investment program, or Minnesota supplemental aid. 
 88.23     Sec. 24.  [PILOT PROGRAM FOR DEAF-BLIND SERVICES.] 
 88.24     (a) The commissioners of human services; children, 
 88.25  families, and learning; and state services for the blind shall 
 88.26  meet with deaf-blind citizens, parents of deaf-blind children, 
 88.27  and the Minnesota commission serving deaf and hard-of-hearing 
 88.28  individuals to determine which agency can most efficiently and 
 88.29  effectively develop and administer a pilot program for 
 88.30  consumer-directed services to provide needed services to 
 88.31  deaf-blind adults, children, and their families. 
 88.32     (b) The planning for this pilot program must proceed using 
 88.33  current appropriations.  The agency that develops the pilot 
 88.34  program described in paragraph (a) shall provide a report to the 
 88.35  senate and house of representatives policy and fiscal committees 
 88.36  having jurisdiction over human services issues by January 1, 
 89.1   2003, that addresses future funding for the program.  The report 
 89.2   shall include the program proposal, recommendations, and a 
 89.3   fiscal note. 
 89.4      Sec. 25.  [SERVICES FOR DEAF-BLIND PERSONS.] 
 89.5      (a) Effective for fiscal years beginning on or after July 
 89.6   1, 2003, the commissioner of human services shall combine the 
 89.7   existing $1,000,000 biennial base level funding for deaf-blind 
 89.8   services into a single grant program.  Within the limits of the 
 89.9   appropriation for this purpose, each biennium at least $350,000 
 89.10  shall be awarded for services to deaf-blind children and their 
 89.11  families and at least $250,000 shall be awarded for services to 
 89.12  deaf-blind adults. 
 89.13     (b) The commissioner may make grants to organizations for: 
 89.14     (1) services provided by the organizations; or 
 89.15     (2) consumer-directed services. 
 89.16     (c) Any entity that is able to satisfy the grant criteria 
 89.17  is eligible to receive a grant under paragraph (a). 
 89.18     (d) Deaf-blind service providers are not required to, but 
 89.19  may, provide intervenor services as part of the service package 
 89.20  provided with grant funds under this section. 
 89.21     Sec. 26.  [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE 
 89.22  EXPANSION TO COVER DEAF-BLIND SERVICES.] 
 89.23     The commissioner of human services shall study and report 
 89.24  to the legislature by January 15, 2003, with a feasibility 
 89.25  assessment of the costs and policy implications, including the 
 89.26  necessity of federal waivers, to expand benefits covered under 
 89.27  medical assistance and under medical assistance waiver programs 
 89.28  to include the following services for deaf-blind persons: 
 89.29     (1) sign language interpreters; 
 89.30     (2) intervenors; 
 89.31     (3) support service persons; 
 89.32     (4) orientation and mobility services; and 
 89.33     (5) rehabilitation teaching services. 
 89.34     Sec. 27.  [REPEALER; TARGETED CASE MANAGEMENT.] 
 89.35     Minnesota Statutes 2001 Supplement, section 256B.0621, 
 89.36  subdivision 1, is repealed.